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AI and the Rheumatologist: An Opportunity for Better Care
My head is spinning as I start to write this editorial on the potential for artificial intelligence to profoundly change the practice of rheumatology and the way we care for our patients.
I have just finished reading Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again, the new book from Eric Topol, MD, founder of the Scripps Research Translational Institute, and it is hard to express how much I learned and how much I enjoyed it.
Calabrese
For those of you who know of him, Dr. Topol indeed has a knack for hitting the critical seams of modern medicine in a creatively disruptive fashion, and in Deep Medicine, he clearly is at it again in a robustly informative way that I found exhilarating and frightening, yet hopeful all at the same time.
If you don’t read the book and want the crash course, I recommend reading his scholarly review in Nature Medicine entitled “High-performance medicine: The convergence of human and artificial intelligence.”
In Deep Medicine, we rheumatologists would be classified as “Clinicians without Patterns,” due to the fact that we don’t spend most of our time reading images (radiology), pathologic specimens (laboratory medicine), skin lesions (dermatology) or fundus imaging (ophthalmology). For these areas, while artificial intelligence (AI) is not entirely ready for prime time, it is moving rapidly and the physicians in these specialties know it.
We rheumatologists will feel the effects of AI more indirectly through its potential to remodel health systems. We will also likely see AI become central in collecting and interpreting data from sensors monitoring physical and mental health domains as well as biomarkers. In this regard, we are not talking about simple algorithms, but actually integrating massive amounts of data that may include multiple omics, including immunomics, at a level we humans are currently incapable of.
Another plus may be the capacity of AI to speed our care delivery while making it more accurate and less prone to errors. How great would it be if AI served to speed data collection, extraction and interpretation and, at last, transformed the electronic medical record to be a positive force for care not just an instrument for documentation and billing? While I will not summarize the scary aspects of AI in terms of hacking, error rates, and threatening our very humanity, I can reassure you that Dr. Topol is even-handed with a capacity to dumbfound the reader with the incredible transformative potential of AI, while simultaneously citing its limitations and rendering opprobrium for the many overzealous claims made upon its behalf.
Finally, I would like to close with the true sleeper in this book and that is the last chapter entitled “Deep Empathy.” While preparing to write this editorial, I Googled the many reviews of the book and while virtually all were highly favorable, none focused on this coda on empathy in health care. In this chapter, in my opinion, he is at his best, simultaneously cautious and inspiring as he reminds us of the profound importance in truly being human.
We are reminded that we must not only preserve humanism in medicine but now, more than ever, is the time that we must cultivate and grow the science of mindfulness, empathy and compassion to keep up with advances in AI. In doing so, we can hopefully optimize its application in patient care in a way that will lead to not only better care of disease but also better caring for the sick and suffering among us. In fact, I am now most excited in seeing more research and hopefully will be engaging in it myself which will explore the Empathy–AI axis and how we can grow these synergies.
Learning how to better use this gift of knowledge and time could help us to truly be present, to empathize, to touch and to heal. I will close by quoting from the last page by Dr. Topol: “Machine Medicine need not be our future. We can choose a technological solution to the profound human disconnection that exists today in health care; a more humane medicine, enabled by machine support, can be the path forward.”
AI is here to stay: Get ready, get smart and hold on.
I would love to hear your views on this exciting and evolving field so please share your thoughts with me by e-mail calabrl@ccf.org or on Twitter @LCalabreseDO.
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- Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.
Disclosure: Calabrese reports serving as an investigator and a consultant to Horizon Pharmaceuticals.