PracticalDermatology

Citing its potential to enhance the patient experience, improve population health, reduce costs, and improve the professional fulfillment of care teams, the American Academy of Dermatology (AAD) recently published a position statement supporting the use of Augmented Intelligence (Aul). (Members can view the statement at aad.org/Forms/Policies/Uploads/PS/PS-Augmented%20Intelligence.pdf)

A natural offshoot of Artificial Intelligence (AI), Aul aims to use technology to supplement and support human intelligence, not replace it. In other words, it’s not about man versus machine, instead it’s about man and machine working together for the greater good. The new position paper also highlights the need for education, advocacy, and proper safeguards as Aul becomes more mainstream.

We spoke with one of the authors of the new statement, Justin Ko, MD, MBA, Director and Chief of Medical Dermatology for Stanford Health Care (SHC) in Stanford, CA, and Chair of the AAD’s Task Force on Aul, to learn more about what Aul is and the ways it may change the practice of dermatology for the better.

What is AuI?

Justin Ko, MD, MBA: AuI is an alternative concept that focuses on AI’s assistive role, emphasizing that AuI is designed to enhance human intelligence rather than replace it. It’s an explicit repudiation of the concept of robots taking over human work, and rather sees that the promise of Aul is to enable the synergy of man and machine to do more than either alone can do.

How is Aul being integrated into dermatology practice today?

Dr. Ko: I think that we are at the precipice of seeing AuI tools influence our practice. At the outset, it will likely be systems and tools that are working on practice management processes, insights, and analytics. However, I don’t believe we’re far from seeing the mainstream integration of triage, point of care diagnostic support, or chronic disease management capabilities that rely in some part on AuI models. I think the key is that we recognize that this is on the horizon and actively work to shape the development and deployment of these tools in a way that enhances patient care and ensures that patient safety is held paramount.

What are the benefits?

Dr. Ko: AI is great at synthesizing large amounts of complex data and providing insights. It is also great at performing mundane repetitive tasks efficiently and effectively and doesn’t suffer from cognitive fatigue. Any clinical task that falls into one of these two categories could be taken on by an AuI “virtual assistant,” freeing us to do those things that are uniquely human and provide the elements of care that patients most value and are the things that are most fulfilling to us as physicians. Imagine a practice unburdened by documentation and administrative tasks with clinical insights and decision support at my fingertips. I’d be the first in line.

What are the risks?

Dr. Ko: We see the benefits of technology in our everyday lives. Yet, the same technology and platforms can lead to unintended consequences. In medicine, we have to be especially careful. Ensuring patient safety is of paramount importance. We also need to have the bigger picture in mind and be thoughtful and ensure that the deployment and integration of these technologies bridges gaps in health equity and inclusivity rather than exacerbating them.

What are some of the challenges?

Dr. Ko: There is a long path of defining the appropriate guardrails and “rules” for this technology. We fully recognize that this is a rapidly evolving field and that active and long-term engagement is necessary to tackle head-on the breadth and complexity of issues that have and will continue to emerge.

Are dermatologists at risk of being replaced by algorithms?

Dr. Ko: No. We are far from algorithms being able to do what we as humans can do: understand context and synthesize and tailor discussions around diagnosis, treatment, and management of a patient’s disease. They can’t provide what people want and need when they are facing illness: recognition of their humanity and partnership in addressing how their condition impacts their lives and the healing touch.

What do dermatologists need to know about Aul?

Dr. Ko: As clinicians, we must play a central role in advocating for and collaborating in the development of technology that is human-centered, ethical, accessible, high-quality, and outcome-driven. As a specialty, we need to embrace and shape the change and learn the lessons from electronic health record’s impact on our field and profession. We can enhance our clinical capabilities in patient care and experience. Productivity, efficiency, and workflow can be improved. Our engagement can help us focus on the healing relationship.

What policies are being developed?

Dr. Ko: We expect that this position statement will undergo future revisions and updates as the field matures and develops. Through collaboration and discourse with our members, the Academy strives to influence the design, implementation, and regulation of these technologies. We will also look to engage and collaborate with administrative and legislative colleagues to promote policies that ensure AuI tools and systems are high-quality, inclusive, equitable, and accessible.