The Centaur in Healthcare: AI and humans (WIRED)

from WIRED magazine article

https://www.wired.com/story/algorithm-doesnt-replace-doctors-makes-them-better/

In the battle between the future of super-intelligent Artificial Intelligence and the paltry skills of increasingly left-behind human brains, some rays of hope. There are a growing number of projects dedicated to combining the skills of AI and humans to perform better than either alone.

The WIRED article above discusses Dermatology AI and how it improves the performance of physicians in detecting skin cancer. However, it mainly improves resident and primary care physician performance, and not expert dermatologists.

Is this good? Bad?

And, what is a Centaur? A horse-human hybrid from greek mythology.

I think this illustrates Arther C Clarke’s (paraphrased) saying:

Any teacher physician who can be replaced by a machine should be.

This is not necessarily a bad thing. Consider: if we can allow AI to be trained to augment physicians or advance practice providers in every case where the providers’ experience is not expert-level, we could raise the standard of healthcare throughout the country, or the world.

AI’s still can’t hold a hand, counsel patients on complex and competing issues, be compassionate, and create human connection.

We already have our computers helping remind us of the mundane yet critical tasks of doing the right thing for out patients: remembering tetanus and pneumonia vaccines, remembering to screen patients for colon and cervical cancer, remembering to repeat diabetes exams at frequent intervals. Why not allow them to give a second opinion on whether a skin mole is likely to be malignant?

CMIO’s take? More like this please. The co-evolution of AI and human is accelerating. We are finding a way forward.

Access to Telemedicine and disparities (WIRED)

from WIRED magazine article

https://www.wired.com/story/access-telemedicine-is-hardest-those-who-need-it-most/

As we work on telehealth options for patients, it is important to keep in mind the population of patients we serve. This article demonstrates the differences in access our most vulnerable patients have in accessing technology.

We cannot rest. We have miles to go, before we sleep.

Explaining Science using a Horse Metaphor

This is a poster I saw last fall at an AI conference sponsored by University of Colorado School of Medicine. The science is interesting and very well conducted.

HOWEVER! Pay close attention to the middle column. The authors have, in my opinion, created a clear metaphor to explain a very complex concept. Do YOU know how to do this? As scientists, we are increasingly subspecialized. How do we translate our important findings so that others can understand? This is getting harder and harder to do, as even OTHER SCIENTISTS (I count myself among them) have a hard time understanding what SCIENTISTS IN OTHER FIELDS are doing.

CMIO’s take? Take a moment to digest this, and decide for yourself: can you tell a story and explain as well as these scientists did? Why not?

Czernik: Counter-intuitive way to connect with the patient (Annals Internal Med)

My awesome colleague Zuzanna Czernick and collaborators have written a brilliant piece about the EHR. She used a CT scan image with a large pulmonary abscess to get the attention of an otherwise hostile, disengaged hospital patient.

Link to article Annals of Internal Medicine : https://annals.org/aim/fullarticle/2738161

My awesome colleague Zuzanna Czernick and collaborators have written a brilliant piece about the EHR. She used a CT scan image with a large pulmonary abscess to get the attention of an otherwise hostile, disengaged hospital patient.

The EHR, although widely disparaged, is also a wonderful tool to bring medical data alive for the patient. She offers a few guidelines on how to most effectively create the trusted “triangle” of provider-patient-computer:

  • Prepare
  • Setup
  • Educate
  • Chart together
  • Review

There are so many opportunities to connect with our patients; why not bring up a screen to show an image, a result, a graph, a note written by a consultant that illustrates and answers a question.

CMIO’s take? Yes, we need counter-intuitive (and soon perhaps simply intuitive) stories about the benefits of a modern information system in caring for patients. Thanks, Dr. Czernik!