Realization by Medical Providers of the Importance of Knowledge of Artificial Intelligence, and its Already Present Integration into Medical Care

By Amgad N. Makaryus MD, Professor, Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Chairman, Department of Cardiology, Nassau University Medical Center

Many of my colleagues and healthcare providers that I interact with feel that artificial intelligence (AI) integration into the field of medicine will be years, if not decades, into the future. This sentiment is backed by many reports and surveys that I have read and encountered ever since Chat GPT came on the scene in November of 2022. The practice of medicine is ever-changing, especially with the development and integration of new AI methods of machine learning. The integral role of AI-based systems is already improving the accuracy and efficiency of diagnosis and treatment across the various specialties of medicine and, especially in the specialties of radiology and my field of expertise, which is cardiology.^1,2 It is key for all providers at all levels in the medical healthcare field to be aware of and well-versed in the advantages, benefits, abilities, and limitations of artificial intelligence.  The realization of the importance of this awareness is key to the appropriate further integration and implementation of artificial intelligence across the field and practice of medicine.  All healthcare providers need to be well-versed in, or, at minimum, “aware” of artificial intelligence and its capabilities.

The beneficial capabilities and useful integration of artificial intelligence into medical practice are undebatable.  The ever-expanding areas and capabilities of artificial intelligence, whether it be in digital transformation, data & analytics, cloud/machine learning, cybersecurity and endless other areas, is evident in our daily lives.  In the field of healthcare, this advancement is clearly ongoing and expanding.  This availability and integration of AI is frequently referred to as a “disruptor,” but I feel this term denotes negative implications, which likely leads to decreased awareness of the benefits and utility of artificial intelligence in medicine.  I prefer to refer to AI as a “transformative” and “integral” technology in the field of medicine, despite the fact that the use of AI in medicine is becoming more and more evident for many tasks such, for example, in the diagnostic analysis of patients, whether it be of their laboratory studies or imaging testing, to creating personalized precision medicine treatment plans based on a patient’s demographics and risk factor profile, to even distilling large amounts of data pertaining to a particular patient into a form that is easily analyzed and which leads to diagnostic and therapeutic recommendations. Other areas for AI include its benefits in teaching trainees, and even in tasks as simple as writing a letter to a patient at their reading level to allow for them to understand the medical meaning of their diagnosis and treatment.  The possibilities are endless when it comes to artificial intelligence and medical care.

It is important that the realization of the above views and trends should serve as a call to action for more awareness and knowledge of AI in medicine.

Despite the great and endless possibilities of benefits that come with artificial intelligence and the tremendous permeation of AI into the field of medicine, the realization that there are also drawbacks and limitations of artificial intelligence must be examined.  However, without knowledge of the capabilities and benefits of artificial intelligence in medicine, the realization of the limitations and possible dangers of artificial intelligence cannot occur. Many surveys and studies have examined the awareness of artificial intelligence by healthcare practitioners in the field of medicine.  It is astounding to me that despite the widespread influence artificial intelligence is having upon the healthcare industry, many, if not most, healthcare providers are either not aware or minimally aware of artificial intelligence and its uses.  There is a tendency among healthcare professionals to resist or ignore the ever-expanding AI technologies. The reasons for the lack of engagement include privacy and autonomy concerns, perceived threats to professional independence, legal issues of responsibility, and ethical or even empathy/humanism concerns.^2-5

A recently published study found that general familiarity with AI in healthcare professionals was low, with 21.3% of the participants who responded to the survey about awareness of AI answering that they had good familiarity with AI, and only 16% of them had good familiarity with the role of AI in medicine. As expected, 47.9% of respondents disagreed that AI would surpass the physician in the important traits of professionalism, and the minority (20.2%) believed AI to be diagnostically superior to medical providers. Most (61%) were worried about placing full trust in AI to make decisions, and 58.1% believed that AI systems would not be able to mirror the humanism and empathy of the physician-patient relationship. On the other side of the coin, the majority of respondents (74.4%) believed that AI would be useful in administrative tasks.⁶  These findings are seen throughout the medical field and it is important to realize these perceptions and work to mitigate fears and concerns while encouraging hopes and desires for the implementation of AI in the medical field.

The other important consideration that we must realize is that not only are our providers not optimally aware of artificial intelligence, but patients as well do not understand the use of AI in healthcare and, furthermore, do not trust nor prefer the use of artificial intelligence and machine learning in medicine. A recent nationwide poll conducted in 2023 by a large healthcare software company found that 75% of the U.S. patients surveyed do not trust artificial intelligence in a healthcare setting, and most are not aware of whether their provider is already using AI in their care. In this survey, more than 40% of respondents acknowledged a limited understanding of AI, and about half were not comfortable with AI’s use in the healthcare setting.⁷  These findings highlight the importance of the interaction between patients and their providers, and it is the duty of the providers to become more knowledgeable about artificial intelligence so as to alleviate many of the concerns and worries of patients, as was seen in this national survey.

In summary, it is important that the realization of the above views and trends should serve as a call to action for more awareness and knowledge of AI in medicine. The reason for this is that the more knowledge is gathered by healthcare professionals, the more they will be likely to appropriately and efficaciously implement and use AI. A recent study revealed that the willingness to use AI technologies increases with increasing knowledge about AI.⁸ It is only through the enlightenment of the benefits and utilities of AI and its concerns and possible dangers that this robust and integral tool of artificial intelligence will continue to transform the field of medicine.

References

1. Patel B, Makaryus AN. Artificial Intelligence Advances in the World of Cardiovascular Imaging. Healthcare (Basel). 2022 Jan 14;10(1):154.
2. Gala D, Behl H, Shah M, Makaryus AN. The Role of Artificial Intelligence in Improving Patient Outcomes and Future of Healthcare Delivery in Cardiology: A Narrative Review of the Literature. Healthcare (Basel). 2024 Feb 16;12(4):481.
3. Walter Z, Lopez MS. Physician acceptance of information technologies: Role of perceived threat to professional autonomy. Decision Support Systems 2008;46:206-215.
4. Gala D, Makaryus AN. The Utility of Language Models in Cardiology: A Narrative Review of the Benefits and Concerns of ChatGPT-4. Int J Environ Res Public Health. 2023 Jul 25;20(15):6438.
5. Lamanna C, Byrne L. Should artificial intelligence augment medical decision-making? The case for an autonomy algorithm. AMA journal of ethics 2018;20:902-910.
6. Umer M, Naveed A, Maryam Q, Malik AR, Bashir N, Kandel K. Investigating awareness of artificial intelligence in healthcare among medical students and professionals in Pakistan: a cross-sectional study. Ann Med Surg (Lond). 2024 Mar 18;86(5):2606-2611.
7. Carta Healthcare survey results indicate that education around AI may improve consumer trust. https://www.businesswire.com/news/home/20231012647360/en/. Accessed 8/12/2024.
8. Weber S, Wyszynski M, Godefroid M, Plattfaut R, Niehaves B. How do medical professionals make sense (or not) of AI? A social-media-based computational grounded theory study and an online survey. Comput Struct Biotechnol J. 2024 Feb 17;24:146-159.