Equity, Access, Inclusion in Medicine
Stanford Medicine’s new center, Presence - The Art and Science of Human Connection in Medicine is partnering with campus wide centers to explore a thoughtful, equitable and inclusive development and deployment of Artificial Intelligence solutions for human health and wellbeing. Presence’s core commitments are basic research and implementation science focused on the human experience in medicine. The available evidence suggests very clearly that “being present” is integral to the art and science of medicine and predicates the quality of medical care. The experience of suffering and the care of those who are suffering is the most poignant of human experiences; both of these can be better addressed in society and in our healthcare systems. Theinadvertent, adverse effects created by the unintended intrusion of technologyinclude: missing obvious disease revealed by the body, patient and physician dissatisfaction, and unplanned loss of social rituals, all of which negatively impact health outcomes.
Artificial intelligence (AI) in the form of data-driven machine learning (ML) algorithms are already transforming our society and lives from automated credit card fraud detection and employment screening to self-driving cars and personalized internet news feeds. Clinical diagnostic excellence and the broader practice of medicine exhibits both the broad societal need and opportunity to ascend on this wave of these technologies, enabled by the progressive coverage of a national electronic health record data infrastructure.
While medicine has always embraced new technologies, it is fundamentally an endeavor involving humans caring for other humans. With purposeful foresight, we can recognize the opportunities for future outcomes while mitigating the risk of unintended consequences. We can learn from other domains where over confidence and reliance on purely data-driven AI/ML algorithms can exacerbate social inequity if not overt racial and gender bias in issues such as bail sentencing. We will learn from history where previous decades of clinical decision support efforts failed to have their desired impact, and where indiscriminate deployment of electronic medical record systems inadvertently contributed to physician burnout as it compromised the effective human application of medicine. Where does technology provide us opportunities for care that was previously unavailable? Where might technology impose barriers between providers and patients? How can we ensure equitable and inclusive solutions in healthcare?
Our year+ long arc on AI/ML/Medicine/Equity is aimed at addressing issues in medicine such as biased data sets, access (patients/framilies (aka friends and family)), physician burnout, and preventing the chaos that resulted from EHR (electronic health record) rollouts which did not take into account the unintended consequences on the humans in the healthcare ecosystem (patients, framilies, clinical teams, etc.).
Built and deployed the Stanford-Meharry Initiative, with the sponsorship and support of Chair Harrington and the Department of Medicine. We expect to grow and continue this work.
Our lead research area today, funded by the Gordon and Betty Moore Foundation is building the Stanford Presence 5. To ensure we build a solution that addresses the needs of diverse populations and clinical settings - our clinical sites include an Oakland Clinic, Ravenswood Clinic (East Palo Alto), the VA in Palo Alto, in addition to Stanford Primary Care.
Our work in the role of Human and Artificial Intelligence in Medicine includes a deliberate partnerships across campus to host various symposia. These include the Stanford Center for Poverty and Inequality.
Our partners include:
- Participating in the National Academy of Medicine's AI/ML in Medicine working committee's monthly meetings.
- Stanford's Center for Poverty and Inequality
- IDEO collaboration includes design thinking in creating, testing and deploying solutions.
- and more.