基层医疗做好迎接人工智能的准备了吗？基层医疗利益相关者怎么说？
Is primary health care ready for artificial intelligence? What do primary health care stakeholders say?
机构信息
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada.
Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
出版信息
BMC Med Inform Decis Mak. 2022 Sep 9;22(1):237. doi: 10.1186/s12911-022-01984-6.
BACKGROUND
Effective deployment of AI tools in primary health care requires the engagement of practitioners in the development and testing of these tools, and a match between the resulting AI tools and clinical/system needs in primary health care. To set the stage for these developments, we must gain a more in-depth understanding of the views of practitioners and decision-makers about the use of AI in primary health care. The objective of this study was to identify key issues regarding the use of AI tools in primary health care by exploring the views of primary health care and digital health stakeholders.
METHODS
This study utilized a descriptive qualitative approach, including thematic data analysis. Fourteen in-depth interviews were conducted with primary health care and digital health stakeholders in Ontario. NVivo software was utilized in the coding of the interviews.
RESULTS
Five main interconnected themes emerged: (1) Mismatch Between Envisioned Uses and Current Reality-denoting the importance of potential applications of AI in primary health care practice, with a recognition of the current reality characterized by a lack of available tools; (2) Mechanics of AI Don't Matter: Just Another Tool in the Toolbox- reflecting an interest in what value AI tools could bring to practice, rather than concern with the mechanics of the AI tools themselves; (3) AI in Practice: A Double-Edged Sword-the possible benefits of AI use in primary health care contrasted with fundamental concern about the possible threats posed by AI in terms of clinical skills and capacity, mistakes, and loss of control; (4) The Non-Starters: A Guarded Stance Regarding AI Adoption in Primary Health Care-broader concerns centred on the ethical, legal, and social implications of AI use in primary health care; and (5) Necessary Elements: Facilitators of AI in Primary Health Care-elements required to support the uptake of AI tools, including co-creation, availability and use of high quality data, and the need for evaluation.
CONCLUSION
The use of AI in primary health care may have a positive impact, but many factors need to be considered regarding its implementation. This study may help to inform the development and deployment of AI tools in primary health care.
背景
在初级医疗保健中有效部署人工智能工具需要从业者参与这些工具的开发和测试，并使由此产生的人工智能工具与初级医疗保健中的临床/系统需求相匹配。为了为这些发展奠定基础，我们必须更深入地了解从业者和决策者对人工智能在初级医疗保健中的使用的看法。本研究的目的是通过探索初级医疗保健和数字健康利益相关者的观点，确定在初级医疗保健中使用人工智能工具的关键问题。
方法
本研究采用描述性定性方法，包括主题数据分析。在安大略省与初级医疗保健和数字健康利益相关者进行了 14 次深入访谈。使用 NVivo 软件对访谈进行编码。
结果
出现了五个主要的相互关联的主题：（1）设想用途与当前现实不匹配——强调人工智能在初级医疗保健实践中的潜在应用的重要性，同时认识到目前缺乏可用工具的现实；（2）人工智能的机制不重要：只是工具箱中的另一个工具——反映了对人工智能工具可能为实践带来的价值的兴趣，而不是对人工智能工具本身的机制的关注；（3）实践中的人工智能：一把双刃剑——人工智能在初级医疗保健中的使用可能带来的好处与人工智能在临床技能和能力、错误和失去控制方面可能带来的威胁形成鲜明对比；（4）无法启动：对人工智能在初级医疗保健中的采用持谨慎态度——更广泛的担忧集中在人工智能在初级医疗保健中的使用所涉及的伦理、法律和社会影响；（5）必要因素：初级医疗保健中人工智能的促进因素——支持采用人工智能工具所需的要素，包括共同创造、高质量数据的可用性和使用，以及评估的必要性。
结论
人工智能在初级医疗保健中的使用可能会产生积极影响，但在实施过程中需要考虑许多因素。本研究可能有助于为人工智能工具在初级医疗保健中的开发和部署提供信息。
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