June 24, 2024

A First Principles Approach to Responsible AI Use in Healthcare

First-principles thinking is a process of breaking down complicated problems into basic elements and then reassembling them from the ground up. It has driven significant innovations throughout history, from Aristotle’s philosophies to Jeff Bezos’s strategies at Amazon. At Playback Health, with fifteen years of experience in leveraging digital technology at the point of care, we have gained valuable insights into what works and what does not. We are ardent supporters of the AI revolution, believing that its successful deployment in healthcare can transform clinical efficiency and revolutionize a care system in dire need of innovation.

As healthcare grapples with the inevitability of AI amid a landscape of endless algorithms, security challenges, and assembly-line care, we believe it’s crucial to ground our approach in first principles. Here, we outline our guiding principles for responsible and meaningful AI use in healthcare.

1. Adherence to Medical Ethics

Playback’s AI solutions adhere to core medical ethics: non-maleficence (doing no harm), beneficence (promoting well-being), autonomy (respecting patient choice), and justice (ensuring equitable care). Our solutions are built with clinical validation and rigorously tested in clinical settings to uphold the highest safety and efficacy standards. We believe that not using AI tools, which enhance healthcare efficiency and address long standing industry challenges, is potentially harmful because its ultimate adoption is likely to be exceptionally beneficial.

2. Respect the Risk

AI is rapidly advancing, and has the potential to impact nearly every aspect of healthcare- from diagnostics to ambient speech and note creation. Therefore, it is essential to consider potential risks related to patient information, provider responsibilities, workflows, and clinical decision-making. The provider-patient bond, built upon trust, must be respected and supported by AI. We ensure transparency in developing and validating our AI models, clearly disclosing their capabilities, limitations, and potential biases. We establish processes for monitoring AI performance and addressing errors or adverse events, maintaining transparency by linking AI model inputs and outputs to clinical evidence, fostering trust, and supporting shared decision-making with patients.

Protecting patient privacy is paramount. We have developed and patented a unique credentialing system, ensuring strict SOC 2 and HIPAA compliance. This scrutiny ensures that every aspect of our AI implementation prioritizes patient privacy, trust, and safety. Robust governance, risk assessment, and accountability are fundamental in our AI integrations.

3. Design for Doctors, Deliver for Patients

Effective AI tools should be designed to alleviate clinicians' administrative burdens, enhance job satisfaction, and enhance the human aspects of care. Technology at the bedside, in the form of EHRs, has wreaked havoc on clinicians' sense of mission and motivation. When designed properly, AI solutions will bring technology to the bedside and enhance the provider experience. Our AI solutions are designed around clinicians' needs, aiming to streamline workflows and reduce administrative tasks to provide more time for clinicians to focus on patients’ understanding and engagement in their care. 

Playback Health’s ambient listening technology, developed with clinicians at the point of care, has been effective across diverse care verticals, including neurosurgery, cardiology, oncology, bariatrics, ER, and many more, in both inpatient and ambulatory settings. These tools integrate seamlessly into existing workflows, enhancing the patient experience through intuitive, user-friendly interfaces that facilitate clear communication and understanding.

By listening to our customers, providers, and patients, we remain grounded in practical, daily needs, ensuring our AI solutions are real and effective, not just theoretical ideas.

4. Leverage Intelligence to Improve Lives

Many of these new AI tools' applications in healthcare are more boring than they sound. They aren’t magical time machines—they’re practical time-saving machines.

By breaking down the administrative processes into their core elements, we identified repetitive tasks that can be automated to save time and reduce stress for clinicians and administrative staff. This allows doctors, nurses, and advanced care providers to focus more on patient care, aligning with our mission to enhance health outcomes through efficient technology.

AI is most easily and foundationally incorporated into a medical system by allowing it to automate repetitive, time-consuming tasks like documentation, pre-charting, and billing. Automating repetitive paperwork for clinicians frees up their time substantially, allowing for more meaningful patient interactions and higher-order, care-impacting work. Patient engagement and health outcomes improve when the patient-provider bond is prioritized with personal, focused communication. Dr. Sanjeev J. Suratwala, Northwell Health Associate Professor of Orthopaedic Surgery, reported, “I've had the opportunity to use the Playback Health service for my office patients over the past few months. It has been a revolutionary and game changing experience for my office workflow! The number of patients seen during the day has increased and the charting burden reduced significantly with the ambient AI service!". With time saved on admin, providers can focus on what's most important: care.

5. Support Clinical Communication at All Levels

Effective communication is critical for ensuring patient safety and high-quality care. Miscommunication can lead to serious medical errors and adverse patient outcomes, and has been attributed to 30 percent of malpractice claims, and 37 percent of all high-severity injury cases.  27% of unplanned hospital readmissions, estimated to be $57.7 billion in 2018, are preventable. Poor communication between providers and patients is highest on the list at an estimated cost of $4.8 billion annually.

With such staggering numbers out in the open, healthcare has a big miscommunication problem that AI can solve. Comprehensive care requires teamwork, cross-functional care teams, and strong patient-provider partnerships. AI offers clinicians a profound layer of support in their stressful roles. 

Because medical error stems from human error, AI should act as a more robust set of “eyes” that can flag mistakes, inconsistencies, and erroneous patterns in charting and documentation. Human oversight should be expected to guarantee that AI-generated documentation is accurately compliant and maintains data integrity for clinical care and billing purposes.

To maintain the highest levels of communication, our AI solutions standardize communication protocols and enhance information sharing through advanced technology. We foster a culture of openness and teamwork among healthcare providers, ensuring clear and efficient communication across all levels of care. This approach improves care coordination, enhances collaboration, reduces errors, and improves patient outcomes.

6. Strengthen Care Coordination and Connectivity

If teamwork makes the dream work, AI makes the team “dream” by offloading administrative burdens while improving the comprehensiveness and accuracy of documentation. AI's organizational power should unite people, strengthening teams through enhanced communication and reliable record-keeping. When a care team is unified, the quality of care it provides patients skyrockets. 

AI tools promote care coordination by streamlining information sharing, prioritizing patient data, and enabling efficient care management. This could involve summarizing patient records, highlighting critical information, and facilitating communication between care team members. 

Playback enables clinicians and specialists across entire care teams to access and share mobilized medical records and receive synced updates simultaneously. Clinical notes are accessible on any device, anytime. They can incorporate input from care team members at each stage of the patient journey to ensure a comprehensive and relevant note. Patient recordings interrupted by phone calls are never lost; they are held until the conversation resumes. 

7. Lean into Learning

Implementing AI in healthcare is a dynamic process. AI models should continuously learn and adapt based on new clinical evidence, creativity, and real-world feedback, ensuring they remain accurate, tailored to population needs, and protected health information remains private. Playback encourages transparency, accountability, and a prudent approach to AI’s evolving applications. We rely on metrics and data to validate AI features, ensuring everything is measured, recorded, and qualified.  

Playback is committed to supporting clinicians in integrating AI into their practice. Our user-friendly AI tools are designed to be intuitive and beneficial, and our team ensures a smooth transition, helping clinicians feel confident and competent with AI. This confidence leads to better patient care and a more efficient healthcare system.

The future of healthcare is undeniably intertwined with AI adoption. Encouraging doctors to embrace AI is not just our business model; it is essential for advancing medical practice, enhancing the provider experience, and improving patient outcomes.

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