Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Clouds and Codes Aren’t Care


The promise of artificial intelligence is that it gives healthcare professionals the opportunity to improve the quality of care by allowing humans to focus on humans.

Patients, doctors, healthcare administrators, and staff are great at exhibiting empathy, practicing compassion, and creating and refining skill sets beyond clinical acumen. Humans also discern and critically evaluate clinical problems in order to judge and weigh best practices and decision-making requirements to provide the best and most appropriate care. Higher order thinking and logic that include differential processing, application, analysis, and evaluation are all still part of the best that humans can share with each other in healthcare.


However, artificial intelligence and information technology can provide technical support to rote and repetitive tasks such as image analysis used for diagnostic predictions where mistakes and inaccuracies can be prevented with deep learning algorithms (machine code). For example, radiologists could spend less time screening and interpreting images, and concentrate more on explaining diagnosis and decision-making with other clinicians. In ophthalmology, AI is capable of diagnosing diabetic retinopathy, a major cause of blindness.


AI can extract and process research information relevant for medical cases. The amount of digital and print information that is accessible in the “cloud” within the medical literature doubles every three years. If physicians wanted to stay up to date, it is estimated they would have to read 29 hours per workday. This is an impossible feat for humans that machine algorithms and code can accomplish infinitely faster and cheaper.


Artificial intelligence can help with skill sets that require precision and error reduction in highly specialized environments such as in surgery. The advantages of surgical robots can benefit humans by reducing technical errors and operation times, enhancing access to hard-to-reach areas of the body, and improving outcomes by removing or reducing human error.


However, we cannot use the efficiencies and technical assistance derived from AI, the cloud, and machine codes to replace human care, empathy, judgement, and connection to each other. We must use AI to our advantage to improve and deepen patient-clinician bonds, by allowing healthcare professionals to spend more time with their patients.


Humans need to be the core unit of analysis, the focus, in healthcare. Clouds and machine codes are simply machine tools that clinicians can use to improve caring for patients. Technology is also not a solution to the broken American healthcare system that is dependent on the quantity of care, the billable encounter, instead of the quality of care.


There are well-documented cases of AI diagnostics and converging technologies that support clinical practice. Beyond image analysis, information extraction, and machine precision, AI can be used to collaborate with humans via patient speech. AI can transcribe conversations with machine learning code that transcend the typical quality of notes in electronic health records. Currently being trialed in the US, it has also been started in select healthcare centers in the UK and China. This collaboration has the promise of reconnecting providers and patients to improve clinician-patient eye contact and connection, improving trust and empathy to healthcare relationships. Thus efficiencies and optimizations derived from technology can be translated into more quality time for care with patients.


If value-based care is going to actualize its promise of delivering better patient outcomes, we must begin with the questions of how to provide better care for humans and how to connect to each other as people, not as billable encounters completed more quickly and efficiently by clouds and codes. People must be at the core of healthcare transformation initiatives, especially those focused on the culture of care.


Reducing the time clinicians spend on repetitive analysis and information extraction can refocus healthcare professionals on the quality of care. The promise of AI in healthcare is that it gives healthcare professionals the opportunity to improve the quality of care by allowing humans to focus more on humans. 


Whether we like it or not, value-based care is here to stay. How we anticipate, identify, and manage the opportunities of caring for people, how we improvise, adapt, and overcome barriers to change can redefine how we fulfill the Hippocratic Oath.