Views of Digital Health and Artificial Intelligence from the Oregon Trail

As an “Oregon Trail” physician who’s practiced in both the analog and digitized worlds, here are 10 over-arching thoughts on EHRs and healthcare AI that I covered in my Grand Rounds Presentation that is available here :

1️⃣ Digital technologies are polarizing. They affect how we live our lives and make us question our very nature. They conjure both utopian and dystopian images.

2️⃣ Yet, we must resist polarized views and embrace nuance. As Melvin Kranzberg famously explained, “Technology is neither good nor bad, nor is it neutral.” We humans determine the net effects.

3️⃣ In the early 2000s, experts and policymakers promised that EHRs would make healthcare far safer, more effective, and more affordable. Now, two decades later, we have not yet realized these promises.

4️⃣ Still, EHRs have brought many (under-discussed) benefits and (widely-discussed) side effects.

5️⃣ Healthcare AI will follow a similar path to EHRs. For one, we are almost certainly overestimating AI’s short-term effects and underestimating AI’s long-term impact (Amara’s Law).

6️⃣ Also, like EHRs, healthcare AI will be a mixed bag. AI will make healthcare better in some ways and worse in others.

7️⃣ Healthcare’s deepest challenges are not technical. As Laurie Anderson explained, “If you think technology will solve your problems, you don’t understand technology – and you don’t understand your problems.”

8️⃣ Nonetheless, we (i.e., all healthcare workers) must acknowledge that we are imperfect and embrace AI and other digital tools when appropriate.

9️⃣ This means cutting through the hype, keeping our eyes wide open, and, with each technology, continually asking, “What do we gain? What do we lose?”

🔟Ultimately, we must consider who we are, clarify what we do, and imagine how we can do it better—whether or not that involves new technology.

As above, I discussed these points in the presentation that is available here.