This article was previously published in Hebrew in The Marker, Haaretz, on the 5.4.2020
The Corona pandemic demonstrates the important role of digital health in the medical world. In most western countries, Corona health policy is based on epidemiological "big data" prediction. Technology is used for monitoring the spread of the disease. Wireless and wearable sensor technologies enable monitoring patients at a distance and in their own home. The telemedicine platform - i.e. digital medical appointments - allows physicians to dispense medical treatment without patients actually having to come to a doctor's office.
Digital health was already on the rise before the outbreak of Corona, but there is little doubt that in the wake of the virus it will become an integral part of routine medical treatment in the near future.
There are legal and ethical challenges that derive from digital health tools that regulation does not fully address. Here are some of the primary issues.
First, wireless and wearable medical devices are potentially subject to cyber-attacks that can affect their efficacy and infringe on the patients' privacy. In addition, medical teams need to be trained to use medical devices that treat patients remotely, and recognize and address the risks arising from this practice. The patient's role in the process needs to be delineated, while establishing that the patient's involvement does not detract from the physician's responsibility for the case management. When a patient's medical device is activated by a remote company, it is essential that the company and the medical authority clearly demarcate and specify their respective responsibilities.
The input of artificial intelligence can lead to actions that seem to be based on prejudice, racism, and sexism. Aside from this, the output might simply be wrong. Hence the data base needs to be examined before adapting recommendations based on artificial intelligence, to ensure that discrimination or faulty presumptions do not lead to bad decisions. Special attention is required in a "black-box" situation. This is a situation when one cannot explain the causality between the input and the output. i.e., we are unable to explain how certain input (medical data on a disease for example) leads to a specific output (such as a recommended treatment). In the medical world, such lack of knowledge can be dangerous, and risk management is required. In addition, a "learning algorithm" can produce new conclusions regarding the same case as time goes by. Hence, supervision and control mechanisms are needed to ensure that reliance on artificial intelligence does not harm the patient or negatively impact on the proper medical treatment.
In the past, it was clear that physicians employ various diagnostic devices to formulate their medical decisions. In the future, it is expected that physicians will increasingly rely on the output of artificial intelligence. As artificial intelligence is embedded in medical treatment, the borderline between it and human judgment blurs. This will become a major challenge in the future of medical treatment.
Dealing with a pandemic necessitates using every tool at our disposal, including digital health mechanisms. However, when the Corona epidemic is over, one needs to consider that digital health encompasses medical and legal challenges that are here to stay. It is not too early to confront these issues.
Originally published by LinkedIn on May 1, 2020.
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