Ever-evolving health care technologies are a classic example of a double-edged sword. On one side, they hold the promise of simultaneously improving patient outcomes and physicians’ professional satisfaction. On the other, they threaten to exacerbate some of the disparities and inequalities found throughout our health care system.
Consider telemedicine. A driving force behind this technology was the desire to extend access to high-quality medical care to those in remote, less-populated areas. A virtual visit could level the playing field by providing the same level of care to patients living 100 miles away from a major medical center as those living down the street from it.
The quality of broadband internet coverage varies widely across the nation, which means the playing field is already tilted toward more-affluent urban communities. According to the Federal Communications Commission, 39 percent of rural Americans have no access to standard broadband service. That figure is just 4 percent for those in urban areas. Lack of access works against a telehealth visit for a sizable chunk of the rural population in this country.
Or consider artificial intelligence (AI). Earlier this year, the AMA adopted its first-ever AI policy recommendations, which stressed that AI in health care should augment a physician’s work and reinforce the physician-patient relationship.
But behind that consideration lurks another potential pitfall. Humans, after all, are writing the algorithms that perform the calculations, data processing, automated reasoning and other functions that comprise AI. And humans, of course, are subject to implicit bias—attitudes or stereotypes held about a group that can subconsciously affect an individual’s actions and decisions about that group.
Implicit bias helps explain why African-Americans are systematically undertreated for pain and underdiagnosed for chronic conditions. The risk posed here is an AI program that reflects and potentially amplifies the health-related biases of the people who wrote it.
Technology will continue to evolve; it will grow and change in ways we can’t predict. It is critical for physicians to constantly ask if new technologies are improving the health care environment for patients, and enhancing the patient-physician relationship. And are the new digital tools truly working to end health disparities, and increase access to care for those too often left out of our health care system?
The true potential for new technologies in medicine is to level the playing field for patients and enhance the ability of physicians to deliver safe and effective care, while reducing disparities in health outcomes.
This is the potential that the AMA and others are working to convert into reality.
