AMA has issued recommendations
for the use and accountability
of AI in healthcare

AMA issues recommendations for accountability of AI in healthcare

June 17, 2019
by John R. Fischer, Senior Reporter
The American Medical Association has come out with a number of recommendations for ensuring proper use, oversight and accountability of augmented intelligence in healthcare.

AMA delegates endorsed the suggestions at their annual meeting this week, viewing them as essential for providing quality patient care with increased value, greater professional satisfaction of physicians, and improved population health for patient care, at reduced costs.

“Our AMA supports the use and payment of augmented intelligence (AI) systems that advance the quadruple aim,” AMA told HCB News. “AI systems should enhance the patient experience of care and outcomes, improve population health, reduce overall costs for the healthcare system while increasing value, and support the professional satisfaction of physicians and the healthcare team.”

Among its recommendations are:

• Oversight and regulation of healthcare AI systems based on risk of harm and benefit. This includes, but is not limited to, intended and reasonably expected use(s); evidence of safety, efficacy, and equity including addressing bias; AI system methods; level of automation; transparency; and, conditions of deployment.

• Payment and coverage for all healthcare AI systems that are conditioned on complying with all appropriate federal and state laws and regulations, including, but not limited to, those governing patient safety, efficacy, equity, truthful claims, privacy, and security, as well as state medical practice and licensure laws.

• Payment and coverage for health care AI systems that (a) are informed by real-world workflow and human-centered design principles; (b) enable physicians to prepare for and transition to new care delivery models; (c) support effective communication and engagement among patients, physicians, and the healthcare team; (d) seamlessly integrate clinical, administrative, and population health management functions into workflow; and (e) seek end-user feedback to support iterative product improvement.

• Payment and coverage policies that advance affordability and access to AI systems designed for small physician practices and patients and not limited to large practices and institutions. Government-conferred exclusivities and intellectual property laws that foster innovation as well as competition, access, and affordability.

• Policies that do not penalize physicians who do not use AI systems while regulatory oversight, standards, clinical validation, clinical usefulness, and standards of care are in flux. Opposing mandates by payers, hospitals, health systems, or governmental entities mandating the use of health care AI systems as a condition of licensure, participation, payment, or coverage.

• Liability and incentives aligned so the individual or entity best positioned to know the AI system risks and best positioned to avert or mitigate harm do so through design, development, validation, and implementation. When a mandate exists to use AI, the individual or entity issuing the mandate must be assigned all applicable liability. Developers of autonomous AI systems with clinical applications (screening, diagnosis, treatment) are in the best position to manage issues of liability arising directly from system failure or misdiagnosis, and must accept this liability.

The association also plans and encourages other national and state medical societies to identify areas of medical practice where AI can advance the quadruple aim; leverage existing expertise to ensure clinical validation and assessment of clinical applications of AI; form new professional roles and capacities for aiding and guiding healthcare AI systems; and develop practice guidelines for clinical applications of AI.

“There should be federal and state interagency collaboration with participation of the physician community and other stakeholders in order to advance the broader infrastructural capabilities and requirements necessary for AI solutions in health care to be sufficiently inclusive to benefit all patients, physicians, and other healthcare stakeholders,” AMA also said among its recommendations. “AI is designed to enhance human intelligence and the patient-physician relationship rather than replace it.”