AI for health can’t leave older people behind, says WHO

By Kat Jercich for Healthcare IT News

The World Health Organization released a policy brief this past week aimed at combating age-related bias in health-related artificial intelligence tools.

The brief, “Ageism in artificial intelligence for health,” proposes a wide range of measures to ensure older people are effectively engaged in the processes, technologies and services affecting them.

“The implicit and explicit biases of society, including around age, are often replicated in AI technologies,” said Alana Officer, unit head of demographic change and healthy aging at the WHO.

“To ensure that AI technologies play a beneficial role, ageism must be identified and eliminated from their design, development, use and evaluation,” Officer continued.

WHY IT MATTERS 

As the WHO brief notes, AI carries great potential for transforming healthcare, including on a population-wide level.

When it comes to older people specifically, tools to enable community and long-term care via remote patient monitoring and ones to develop aging-related drugs can be particularly useful. At the same time, AI technologies can replicate societal biases, potentially exacerbating existing disparities in care.

For this brief, WHO focused on biases affecting older people, although it acknowledged that other ethical challenges – such as those relating to race, gender or socioeconomic status – must also be addressed.

“Encoding of stereotypes, prejudice, or discrimination in AI technology or their manifestation in its use could undermine, for example, the quality of healthcare for older people, reduce intergenerational engagement or limit the beneficial use of AI technologies for older people because of preconceived, often flawed assumptions of how older people wish to live or interact with technology in their daily lives,” wrote researchers in the WHO brief.

For instance, older people may be excluded from data sets used to train AI tools, or left out of market research, design and testing.

The brief outlines several strategies for maximizing the benefits of health AI for older people, including:

  • Participatory design of AI technologies by and with older people.
  • Age-diverse data science teams.
  • Age-inclusive data collection.
  • Investments in digital infrastructure and digital literacy for older people, their healthcare providers and their caregivers.
  • The establishment of older people’s right to consent to and contest AI recommendations for health.
  • Governance frameworks and regulations to empower and work with older people.
  • Increased research to understand new uses of AI and how to avoid bias.
  • Robust ethics processes in the development and application of AI.

“AI technologies for health can strengthen health and social care for older people by helping to identify risks and enabling older people to meet their own needs individually or in collaboration with their healthcare providers,” read the policy brief.

“To ensure that AI technologies play a beneficial role, ageism must be identified and eliminated from their design, development, use and evaluations,” it continued.

THE LARGER TREND  

Renewed focus has been placed on addressing bias in AI, especially in the context of the COVID-19 pandemic.

Chris Hemphill, VP of applied AI and growth at SymphonyRM, told Healthcare IT News this past year that tackling the issue requires a comprehensive approach.

“There’s the machine learning part, but there’s also the people part,” they said. “Modeling means nothing if you don’t have the user experience; the user discussions; the training about how and why people should use it.”

ON THE RECORD 

“AI holds great promise for the practice of public health and medicine,” wrote researchers in the WHO brief.

“Yet, to fully reap the benefits of AI, ethical challenges for healthcare systems, practitioners and beneficiaries of medical and public health services must be addressed,” they continued.

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