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在加拿大初级保健中实施人工智能:通过全国审议对话确定的障碍和策略。

Implementing artificial intelligence in Canadian primary care: Barriers and strategies identified through a national deliberative dialogue.

机构信息

Upstream Lab, MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada.

Undergraduate Medical Education, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

PLoS One. 2023 Feb 27;18(2):e0281733. doi: 10.1371/journal.pone.0281733. eCollection 2023.

Abstract

BACKGROUND

With large volumes of longitudinal data in electronic medical records from diverse patients, primary care is primed for disruption by artificial intelligence (AI) technology. With AI applications in primary care still at an early stage in Canada and most countries, there is a unique opportunity to engage key stakeholders in exploring how AI would be used and what implementation would look like.

OBJECTIVE

To identify the barriers that patients, providers, and health leaders perceive in relation to implementing AI in primary care and strategies to overcome them.

DESIGN

12 virtual deliberative dialogues. Dialogue data were thematically analyzed using a combination of rapid ethnographic assessment and interpretive description techniques.

SETTING

Virtual sessions.

PARTICIPANTS

Participants from eight provinces in Canada, including 22 primary care service users, 21 interprofessional providers, and 5 health system leaders.

RESULTS

The barriers that emerged from the deliberative dialogue sessions were grouped into four themes: (1) system and data readiness, (2) the potential for bias and inequity, (3) the regulation of AI and big data, and (4) the importance of people as technology enablers. Strategies to overcome the barriers in each of these themes were highlighted, where participatory co-design and iterative implementation were voiced most strongly by participants.

LIMITATIONS

Only five health system leaders were included in the study and no self-identifying Indigenous people. This is a limitation as both groups may have provided unique perspectives to the study objective.

CONCLUSIONS

These findings provide insight into the barriers and facilitators associated with implementing AI in primary care settings from different perspectives. This will be vital as decisions regarding the future of AI in this space is shaped.

摘要

背景

电子病历中积累了大量来自不同患者的纵向数据,初级保健领域正准备好被人工智能(AI)技术所颠覆。在加拿大和大多数国家,初级保健中的 AI 应用仍处于早期阶段,因此有机会让利益相关者参与探讨 AI 将如何使用以及实施方式。

目的

确定患者、提供者和卫生领导人在实施 AI 于初级保健中所感知到的障碍,以及克服这些障碍的策略。

设计

12 次虚拟研讨对话。使用快速民族志评估和解释性描述技术的组合对对话数据进行主题分析。

设置

虚拟会议。

参与者

来自加拿大八个省份的参与者,包括 22 名初级保健服务使用者、21 名跨专业提供者和 5 名卫生系统领导者。

结果

从研讨对话会议中出现的障碍分为四个主题:(1)系统和数据准备就绪;(2)潜在的偏见和不平等;(3)AI 和大数据的监管;(4)作为技术推动者的人的重要性。在每个主题中都强调了克服障碍的策略,其中参与者强烈主张参与式共同设计和迭代实施。

局限性

研究中仅包括 5 名卫生系统领导者,没有自称为土著人的参与者。这是一个限制,因为这两个群体可能为研究目标提供了独特的视角。

结论

这些发现提供了从不同角度看待在初级保健环境中实施 AI 相关的障碍和促进因素的见解。这将是至关重要的,因为未来 AI 在这一领域的决策正在形成。

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