Utopia versus dystopia: Professional perspectives on the impact of healthcare artificial intelligence on clinical roles and skills.

Artificial Intelligence Automation Clinical Skills Ethics Healthcare Medicine

Journal

International journal of medical informatics
ISSN: 1872-8243
Titre abrégé: Int J Med Inform
Pays: Ireland
ID NLM: 9711057

Informations de publication

Date de publication:
01 2023
Historique:
received: 03 05 2022
revised: 23 08 2022
accepted: 19 10 2022
pubmed: 8 11 2022
medline: 15 12 2022
entrez: 7 11 2022
Statut: ppublish

Résumé

Alongside the promise of improving clinical work, advances in healthcare artificial intelligence (AI) raise concerns about the risk of deskilling clinicians. This purpose of this study is to examine the issue of deskilling from the perspective of diverse group of professional stakeholders with knowledge and/or experiences in the development, deployment and regulation of healthcare AI. We conducted qualitative, semi-structured interviews with 72 professionals with AI expertise and/or professional or clinical expertise who were involved in development, deployment and/or regulation of healthcare AI. Data analysis using combined constructivist grounded theory and framework approach was performed concurrently with data collection. Our analysis showed participants had diverse views on three contentious issues regarding AI and deskilling. The first involved competing views about the proper extent of AI-enabled automation in healthcare work, and which clinical tasks should or should not be automated. We identified a cluster of characteristics of tasks that were considered more suitable for automation. The second involved expectations about the impact of AI on clinical skills, and whether AI-enabled automation would lead to worse or better quality of healthcare. The third tension implicitly contrasted two models of healthcare work: a human-centric model and a technology-centric model. These models assumed different values and priorities for healthcare work and its relationship to AI-enabled automation. Our study shows that a diverse group of professional stakeholders involved in healthcare AI development, acquisition, deployment and regulation are attentive to the potential impact of healthcare AI on clinical skills, but have different views about the nature and valence (positive or negative) of this impact. Detailed engagement with different types of professional stakeholders allowed us to identify relevant concepts and values that could guide decisions about AI algorithm development and deployment.

Sections du résumé

BACKGROUND
Alongside the promise of improving clinical work, advances in healthcare artificial intelligence (AI) raise concerns about the risk of deskilling clinicians. This purpose of this study is to examine the issue of deskilling from the perspective of diverse group of professional stakeholders with knowledge and/or experiences in the development, deployment and regulation of healthcare AI.
METHODS
We conducted qualitative, semi-structured interviews with 72 professionals with AI expertise and/or professional or clinical expertise who were involved in development, deployment and/or regulation of healthcare AI. Data analysis using combined constructivist grounded theory and framework approach was performed concurrently with data collection.
FINDINGS
Our analysis showed participants had diverse views on three contentious issues regarding AI and deskilling. The first involved competing views about the proper extent of AI-enabled automation in healthcare work, and which clinical tasks should or should not be automated. We identified a cluster of characteristics of tasks that were considered more suitable for automation. The second involved expectations about the impact of AI on clinical skills, and whether AI-enabled automation would lead to worse or better quality of healthcare. The third tension implicitly contrasted two models of healthcare work: a human-centric model and a technology-centric model. These models assumed different values and priorities for healthcare work and its relationship to AI-enabled automation.
CONCLUSION
Our study shows that a diverse group of professional stakeholders involved in healthcare AI development, acquisition, deployment and regulation are attentive to the potential impact of healthcare AI on clinical skills, but have different views about the nature and valence (positive or negative) of this impact. Detailed engagement with different types of professional stakeholders allowed us to identify relevant concepts and values that could guide decisions about AI algorithm development and deployment.

Identifiants

pubmed: 36343512
pii: S1386-5056(22)00217-9
doi: 10.1016/j.ijmedinf.2022.104903
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104903

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Adjunct Associate Professor Helen Frazer reports a grant from the Australian Government 2019 Medical Research Future Fund (MRFF) Applied Artificial Intelligence Research in Health grant opportunity, and employment with St Vincent’s BreastScreen and BreastScreen Victoria.

Auteurs

Yves Saint James Aquino (YSJ)

Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, University of Wollongong, NSW, Australia. Electronic address: yaquino@uow.edu.au.

Wendy A Rogers (WA)

Department of Philosophy and School of Medicine, Macquarie University, NSW, Australia.

Annette Braunack-Mayer (A)

Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, University of Wollongong, NSW, Australia.

Helen Frazer (H)

St Vincent's Hospital, Melbourne, VIC, Australia.

Khin Than Win (KT)

Centre for Persuasive Technology and Society, School of Computing and Information Technology, University of Wollongong, NSW, Australia.

Nehmat Houssami (N)

School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The Daffodil Centre, The University of Sydney, Joint Venture with Cancer Council NSW, Australia.

Christopher Degeling (C)

Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, University of Wollongong, NSW, Australia.

Christopher Semsarian (C)

Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Australia.

Stacy M Carter (SM)

Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, University of Wollongong, NSW, Australia.

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