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Time Magazine
2 days ago
- Health
- Time Magazine
AI Helps Prevent Medical Errors in Real-World Clinics
There has been a lot of talk about the potential for AI in health, but most of the studies so far have been stand-ins for the actual practice of medicine: simulated scenarios that predict what the impact of AI could be in medical settings. But in one of the first real-world tests of an AI tool, working side-by-side with clinicians in Kenya, researchers showed that AI can reduce medical errors by as much as 16%. In a study available on that is being submitted to a scientific journal, researchers at OpenAI and Penda Health, a network of primary care clinics operating in Nairobi, found that an AI tool can provide a powerful assist to busy clinicians who can't be expected to know everything about every medical condition. Penda Health employs clinicians who are trained for four years in basic health care: the equivalent of physician assistants in the U.S. The health group, which operates 16 primary care clinics in Nairobi Kenya, has its own guidelines for helping clinicians navigate symptoms, diagnoses, and treatments, and also relies on national guidelines as well. But the span of knowledge required is challenging for any practitioner. That's where AI comes in. 'We feel it acutely because we take care of such a broad range of people and conditions,' says Dr. Robert Korom, chief medical officer at Penda. 'So one of the biggest things is the breadth of the tool.' Read More: A Psychiatrist Posed As a Teen With Therapy Chatbots. The Conversations Were Alarming Previously, Korom says he and his colleague, Dr. Sarah Kiptinness, head of medical services, had to create separate guidelines for each scenario that clinicians might commonly encounter—for example, guides for uncomplicated malaria cases, or for malaria cases in adults, or for situations in which patients have low platelet counts. AI is ideal for amassing all of this knowledge and dispensing it under the appropriately matched conditions. Korom and his team built the first versions of the AI tool as a basic shadow for the clinician. If the clinician had a question about what diagnosis to provide or what treatment protocol to follow, he or she could hit a button that would pull a block of related text collated by the AI system to help the decision-making. But the clinicians were only using the feature in about half of visits, says Korom, because they didn't always have time to read the text, or because they often felt they didn't need the added guidance. So Penda improved on the tool, calling it AI Consult, that runs silently in the background of visits, essentially shadowing the clinicians' decisions, and prompting them only if they took questionable or inappropriate actions, such as over prescribing antibiotics. 'It's like having an expert there,' says Korom—similar to how a senior attending physician reviews the care plan of a medical resident. 'In some ways, that's how [this AI tool] is functioning. It's a safety net—it's not dictating what the care is, but only giving corrective nudges and feedback when it's needed.' Read More: The World's Richest Woman Has Opened a Medical School Penda teamed up with OpenAI to conduct a study of AI Consult to document what impact it was having on helping about 20,000 doctors to reduce errors, both in making diagnoses and in prescribing treatments. The group of clinicians using the AI Consult tool reduced errors in diagnosis by 16% and treatment errors by 13% compared to the 20,000 Penda providers who weren't using it. The fact that the study involved thousands of patients in a real-world setting sets a powerful precedent for how AI could be effectively used in providing and improving health care, says Dr. Isaac Kohane, professor of biomedical informatics at Harvard Medical School, who looked at the study. 'We need much more of these kinds of prospective studies as opposed to the retrospective studies, where [researchers] look at big observational data sets and predict [health outcomes] using AI. This is what I was waiting for.' Not only did the study show that AI can help reduce medical errors, and therefore improve the quality of care that patients receive, but the clinicians involved viewed the tool as a useful partner in their medical education. That came as a surprise to OpenAI's Karan Singhal, Health AI lead, who led the study. 'It was a learning tool for [those who used it] and helped them educate themselves and understand a wider breadth of care practices that they needed to know about,' says Singhal. 'That was a bit of a surprise, because it wasn't what we set out to study.' Kiptinness says AI Consult served as an important confidence builder, helping clinicians gain experience in an efficient way. 'Many of our clinicians now feel that AI Consult has to stay in order to help them have more confidence in patient care and improve the quality of care.' Clinicians get immediate feedback in the form of a green, yellow, and red-light system that evaluates their clinical actions, and the company gets automatic evaluations on their strengths and weaknesses. 'Going forward, we do want to give more individualized feedback, such as, 'You are great at managing obstetric cases, but in pediatrics, these are the areas you should look into,'" says Kiptinness. "We have many ideas for customized training guides based on the AI feedback.' Read More: The Surprising Reason Rural Hospitals Are Closing Such co-piloting could be a practical and powerful way to start incorporating AI into the delivery of health care, especially in areas of high need and few health care professionals. The findings have 'shifted what we expect as standard of care within Penda,' says Korom. 'We probably wouldn't want our clinicians to be completely without this.' The results also set the stage for more meaningful studies of AI in health care that move the practice from theory to reality. Dr. Ethan Goh, executive director of the Stanford AI Research and Science Evaluation network and associate editor of the journal BMJ Digital Health & AI, anticipates that the study will inspire similar ones in other settings, including in the U.S. 'I think that the more places that replicate such findings, the more the signal becomes real in terms of how much value [from AI-based systems] we can capture," he says. "Maybe today we are just catching mistakes, but what if tomorrow we are able to go beyond, and AI suggests accurate plans before a doctor makes mistakes to being with?' Tools like AI Consult may extend access of health care even further by putting it in the hands of non-medical people such as social workers, or by providing more specialized care in areas where such expertise is unavailable. 'How far can we push this?' says Korom. The key, he says, would be to develop, as Penda did, a highly customized model that accurately incorporates the work flow of the providers and patients in a given setting. Penda's AI Consult, for example, focused on the types of diseases most likely to occur in Kenya, and the symptoms clinicians are most likely to see. If such factors are taken into account, he says, 'I think there is a lot of potential there.'
Geek Wire
7 days ago
- Health
- Geek Wire
PATH launches landmark AI study in Africa exploring LLMs' potential in health diagnoses
Penda Health clinicians Oscar Murebu (left) and Naomi Ndwiga review information in the clinic's electronic medical record, which includes an integrated AI consult tool for clinical decision support. (PATH Photo / Waithera Kamau) PATH has launched the largest study of its kind in Africa, recruiting 9,000 participants to test whether artificial intelligence can help primary care clinicians make better diagnoses and treatment decisions in resource-limited settings. The Seattle-based global health nonprofit is deploying large-language model (LLM) technology at clinics in Nairobi to analyze patient symptoms, health histories, provider notes and lab results, and then assist with diagnosis and treatment planning. Bilal Mateen, PATH's first chief AI officer, is leading the organization's wide-ranging AI initiatives that include using tools to accelerate vaccine development and deploying chatbots to discuss sensitive health topics like HPV vaccination with teenage girls. Mateen is proceeding with both excitement and caution as he navigates what he calls 'potentially very risky technology' in vulnerable populations. The medical AI-assistant study, conducted in partnership with the Kenya Paediatric Research Consortium, the University of Birmingham, and Nairobi clinic operator Penda Health, aims to provide the kind of rigorous evidence that has been missing from digital healthcare initiatives in low- and middle-income countries. Bilal Mateen, chief of AI at PATH. (PATH Photo) 'This trial marks an important milestone for our health sector. AI has the potential to bridge health care gaps, particularly in underserved regions,' said Dr. Deborah Mlongo Barasa, Kenya's cabinet Secretary of Health, in a release announcing the study. 'We look forward to the insights it will generate to guide responsible and effective AI adoption.' While organizations have pursued diagnostic assistance tools for years, most get stuck in pilot phases without proving their real-world value, Mateen said. 'Does this tool reduce the rate of treatment failures, people having to come back with unresolved symptoms, people being admitted to hospital as an emergency, people dying?' Mateen said. 'I don't know the answer yet.' Results from the trial are expected by the end of the year. PATH recently launched a second, smaller trial in Nigeria that features a toll-free hotline the provides responses to health inquiries using generative AI. The tool is called the Community Health Extension Worker Assistant (CHEWA) and is meant to serve healthcare workers who don't have access to the internet. The study will run until providers log 3,000 patient encounters. The work is being done in partnership with Viamo, a Canadian social enterprise. GeekWire recently spoke to Mateen about PATH's broader AI efforts. Here are some highlights. Challenging misconceptions Mateen calls out two misconceptions about AI and healthcare. While AI could boost the efficiency and effectiveness of providers by using diagnostic assistants, that doesn't always equal to lower healthcare costs. Better-performance could identify more healthcare needs for lab tests, treatments, etc. Though LLMs are typically trained on information from higher-income nations, AI tools don't necessarily need to be customized for local communities, depending on the use case. A patient with high blood pressure readings, for example, points to hypertension no matter where they live. Faster, cheaper breakthroughs PATH is testing whether Google's AI co-scientist can identify correlations in immune response and vaccine effectiveness that normally require multimillion-dollar trials to prove, potentially shortcutting research for new vaccines. The nonprofit is also using AI to search scientific literature for 'unicorn biomarkers' — rare biological signals that could help fight deadly diseases including rotavirus, gastroenteritis and Respiratory Syncytial Virus. AI on touchy subjects Mateen is interested in chatbots taking the lead in uncomfortable conversations about sensitive issues such as vaccinating against human papilloma virus, for example, which is sexually transmitted and can cause cervical cancer. It can be awkward discuss these serious issues with teenage girls and in some countries these topics are strictly taboo, said Mateen. 'We've discovered it's much easier to get that 14-year-old to speak to an empathetic chatbot, than it is a teacher or some other authority figure in their lives.' Supporting regulation creation PATH is hoping to land a grant to support the establishment of healthcare related AI-regulations in low- and middle-income countries. AI-based technology poses potentially heightened risks for these populations, Mateen said, given their limited access to healthcare, minimal regulatory oversight in this area, and lack of recourse if the AI goes awry. PATH has spent decades helping these nations strengthen regulations for vaccines, drugs and diagnostic testing, he said. 'As much as we want to be the pioneers delivering the next thing, we also recognize a responsibility for us to make sure that there is a mechanism by which us and others are held to account.'
