Researchers warn of bias as Montreal health network to use AI to reduce wait time in ERs

Artificial researchers say Montreal Hospital’s plan to reduce emergency room waiting time with AI algorithms is to use appropriate technology if it is done with caution.

The Center Hospital de l’Université de Montréal (CHUM), one of the city’s two main hospital chains, is testing an artificial intelligence algorithm aimed at helping managers plan emergency room staff and expedite the process. Accept patients.

The health center says the AI ​​system will use data from the last 20 years to predict when its emergency room will be particularly busy, allowing the network to increase staffing on specific days and schedule selective surgeries. When the patient is less than expected.

Abhishek Gupta, founder of the AI ​​Morality Institute in Montreal, said the algorithm could be useful in reducing waiting time, but warned that hospitals would have to be careful to avoid further bias.

“For example, if historical patient visits would be used as a source of analytical data to find out if there was a pre-existing bias, it would help avoid burning them into the system,” he wrote in an email. . He added that it was important that patients were told how their data would be used and stored.

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Bias is also a concern for Fenwick McKelvey, a professor of communications at the University of Concordia who studies digital policy.

“We know there is systemic discrimination in the Quebec healthcare system,” he said in an interview, adding that the death of Joyce Echaquan in 2020 drew attention to discrimination in the health network of Quebec. Province.

Echaquan, an indigenous woman, posed for pictures on Facebook Live as a nurse and was heard insulting comments at a hospital in Joliette, Que. Northeast of Montreal shortly before her death. The autopsy concluded that Echaquan did not receive the care she needed because the discrimination contributed to the misdiagnosis.

With Quebec patients waiting an average of 18 hours between the time they are allowed by the doctor and when they are given a bed, said Dr. Élyse Berger Pelletier, an emergency room physician working on the AI ​​project. Ward, it needs to work more effectively.

“I am an emergency physician who works in the emergency room full time. I see how worse it is. We want to provide quality care and that we can not always do what we want,” she said. No “. Interview. “So to be able to work with tools that will make our lives easier for me is an urgent solution.”

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Another element of the system that is being developed by the in-house research team will consider factors such as the patient’s age and symptoms to determine if they are allowed to attend, allowing the doctor to request a bed for the patient. Before all normal. The test is complete, Berger Pelletier said.

“This is really worth it for patients because we do not want them to wait and we know that when you stay in a wheelchair in the ER, especially for the elderly it is not good for them, we know them Berger Pelletier There has been an increase in mortality and morbidity.

Berger Pelletier said she expects the system to be officially launched next year and some items could be ready in six months.

Likewise, she said she takes the risk of serious bias. Considering that AI devices will be used to control staff levels and bed settings, it is less likely to be harmful if it is used to identify the type of patient receiving care, she said.

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“It does not treat patients, it is hospital management.”

The algorithm will be regularly monitored to ensure that it works what Gupta says is necessary for AI, Berger Pelletier said.

But while the potential use of AI in healthcare tends to attract attention, McKelvey said he worries the technology is just a band-aid solution to a deeper problem in Canada’s healthcare system.

“I really welcome the innovation in transportation, but it does not seem to address the deeper structural issues that seem to be working in the health care system across Canada.”

But Berger Pelletier says she thinks technologies like artificial intelligence will become more important as Quebec’s population ages. In particular, she sees opportunities for technology to help health care workers free from clerical duties so they can focus on patient care.

“If we want to treat everyone adequately and with quality, the only way is to have technology to help people so that people stay in touch with patients,” she said.

This report by The Canadian Press was first published on December 30, 2022.


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