“Why a Bot Can’t Replace a Doc” NJMS A.I. Conference April 6, 2019 Vicente Gracias, MD, FACS, FCCP, FCCM Professor of Surgery, RWJMS/NJMS, RU Senior Vice Chancellor for Clinical Affairs, RBHS Vice President for Health Affairs, RU Chief Academic Officer, RWJBH

Disclosure Applied VR Research USAID funding in global surgery NJMS AI Conference April 6, 2019 Disclosure Applied VR Research USAID funding in global surgery I own an iPhone

Pros of A.I. in Healthcare NJMS AI Conference April 6, 2019 Pros of A.I. in Healthcare Capacity to process and store large amounts of data Access to unlimited information, increasing diagnostic accuracy Able to be deployed in areas that face acute shortages of qualified providers Virtual Nurse Assistants – 24/7 Patient Access

NJMS AI Conference April 6, 2019 A.I. vs Doctors In a recent study, an A.I. system was taught how to recognize data patterns. Using these patterns the A.I. system was able to identify how patient symptoms related to specific disease diagnoses. Researchers compared the diagnosis of the A.I. system to the diagnosis generated by doctors. The results? The A.I. system was more than 90% accurate while physicians were between 80% and 94% accurate in diagnosing Asthma. Overall, the study showed that A.I. was more accurate than doctors. What does this mean for doctors? Will A.I. systems and “Bots” take over? Liang, H., Et al. (2019). Evaluation and accurate diagnoses of pediatric diseases using artificial intelligence. Nature Medicine, 25(3),433-438.

No! Doctors are here to stay and a Bot could never replace a Doc. NJMS AI Conference April 6, 2019 No! Doctors are here to stay and a Bot could never replace a Doc. Here’s why….

Medical Practice Is An Art NJMS AI Conference April 6, 2019 Medical Practice Is An Art Data has blind spots. A.I. use relies on extensive testing and precise data. It is only as good as the data that trains it. A flaw in data equals a flaw in A.I. Meticulous documentation still leaves out details that are crucial in the clinical thought process. Clinical decision making is complicated and dependent on the doctor’s experience. Experience is knowing that A.I. has limitations. A common idiom regarding diagnostic prowess states: 80% is evidenced based; 20% is art. This ratio fluctuates depending on the scenario. Ultimately, doctors make decisions on more than just data.

Health Is Not Just A Correct Diagnosis NJMS AI Conference April 6, 2019 Health Is Not Just A Correct Diagnosis A.I. may provide correct diagnosis, but there is more to health than diagnostics. A.I. makes it appear that humans are defined by their disease and this is just not the case. Humans are not the disease! There is no “gallbladder in room 306- it’s a patient” Value is measured not only by being correct, but about understanding the patient. V=Q/C + pt exp Years before A.I will achieve this understanding.

Gold Humanism Honor Society – We must keep healthcare human NJMS AI Conference April 6, 2019 Gold Humanism Honor Society – We must keep healthcare human “The Gold Foundation logo — featuring a golden Mobius loop—symbolizes the continuous bond of trust, respect and communication that connects healthcare professionals with their patients when humanism is at the core of medical practice.”

A.I. Cannot Replicate Empathy NJMS AI Conference April 6, 2019 A.I. Cannot Replicate Empathy Process of building trust. Listening to the patient and attending to their needs. Expressing compassion and responding with assurance A robot can not yet do this. Do we want to imagine healthcare without empathy? Diagnostic accuracy from A.I. is just the beginning of caring for a patient; there is much more.

Complex Technologies Will Always Require Competent Professionals NJMS AI Conference April 6, 2019 Complex Technologies Will Always Require Competent Professionals Sophisticated digital health solutions require competence of qualified medical professionals, no matter robotics or A.I. “IBM Watson” – analyses large amounts of data greater than human capabilities and provides evidence-based treatment options. Doctors still evaluate whether or not algorithm came up with useful suggestions.

No Matter The Tech, There Will Always Be Doctors NJMS AI Conference April 6, 2019 No Matter The Tech, There Will Always Be Doctors A.I. may provide data, interpretation will remain a human territory. “IBM Watson can sift through millions of pages of documents in seconds but as yet can not perform the Heimlich Maneuver.” ** We may never replace every responsibility with technology; there will be tasks where humans are faster, more reliable, or cheaper. However, we must acknowledge the strengths brought by A.I. and advanced technology in the medical field. **5 Reasons Why Artificial Intelligence Won't Replace Physicians. (2018, July 06). Retrieved from https://medicalfuturist.com/5-reasons-artificial-intelligence-wont-replace-physicians

In The End, It Is Not About Technology vs. Humans NJMS AI Conference April 6, 2019 In The End, It Is Not About Technology vs. Humans A.I. serves the purpose to improve our tools. Tools can not replace scholars. Rather than replacing physicians/providers, A.I. will augment their clinical acuity to scales we have yet to imagine!

NJMS AI Conference April 6, 2019 References Doctors, beware: A 'robot doctor' just matched humans' diagnostic performance. (n.d.). Retrieved from https://www.advisory.com/daily-briefing/2019/02/13/ai-diagnosis?WT.mc_id=Email|DailyBriefing Headline|DBECTake|DBA|DB|2019Feb13|ATestDB2019Feb13||||&elq_cid=1731030&x_id=003C000001oBBgEIAW 5 Reasons Why Artificial Intelligence Won't Replace Physicians. (2018, July 06). Retrieved from https://medicalfuturist.com/5-reasons-artificial-intelligence-wont-replace-physicians *An attempt was made to ensure that the pictures used within this presentation were not copyrighted.