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- Title
Artificial intelligence and social accountability in the Canadian health care landscape: A rapid literature review.
- Authors
Anawati, Alex; Fleming, Holly; Mertz, Megan; Bertrand, Jillian; Dumond, Jennifer; Myles, Sophia; Leblanc, Joseph; Ross, Brian; Lamoureux, Daniel; Patel, Div; Carrier, Renald; Cameron, Erin
- Abstract
Background: Situated within a larger project entitled "Exploring the Need for a Uniquely Different Approach in Northern Ontario: A Study of Socially Accountable Artificial Intelligence," this rapid review provides a broad look into how social accountability as an equity-oriented health policy strategy is guiding artificial intelligence (AI) across the Canadian health care landscape, particularly for marginalized regions and populations. This review synthesizes existing literature to answer the question: How is AI present and impacted by social accountability across the health care landscape in Canada? Methodology: A multidisciplinary expert panel with experience in diverse health care roles and computer sciences was assembled from multiple institutions in Northern Ontario to guide the study design and research team. A search strategy was developed that broadly reflected the concepts of social accountability, AI and health care in Canada. EMBASE and Medline databases were searched for articles, which were reviewed for inclusion by 2 independent reviewers. Search results, a description of the studies, and a thematic analysis of the included studies were reported as the primary outcome. Principal findings: The search strategy yielded 679 articles of which 36 relevant studies were included. There were no studies identified that were guided by a comprehensive, equity-oriented social accountability strategy. Three major themes emerged from the thematic analysis: (1) designing equity into AI; (2) policies and regulations for AI; and (3) the inclusion of community voices in the implementation of AI in health care. Across the 3 main themes, equity, marginalized populations, and the need for community and partner engagement were frequently referenced, which are key concepts of a social accountability strategy. Conclusion: The findings suggest that unless there is a course correction, AI in the Canadian health care landscape will worsen the digital divide and health inequity. Social accountability as an equity-oriented strategy for AI could catalyze many of the changes required to prevent a worsening of the digital divide caused by the AI revolution in health care in Canada and should raise concerns for other global contexts. Author summary: Social accountability has emerged over the past few decades as an equity-oriented health policy strategy in health care leading to a number of positive impacts. Given the rapid onset of an artificial intelligence (AI) revolution in health care our research team at the Dr. Gilles Arcand Centre for Health Equity wanted to broadly explore how a social accountability strategy, and linked health equity concepts, are being used to guide artificial intelligence across the Canadian health care landscape. This study summarizes the key themes of a rapid review of literature that reflect (1) the need to design equity into AI technologies; (2) the urgency for policies and regulations for AI; and (3) the inclusion of community voices in the implementation of AI in health care. The concepts of equity, marginalized populations, and engagement with community and partners were also identified across all 3 themes, which reflect key components of a social accountability strategy. An intentional, equity-oriented social accountability strategy is therefore proposed as a means to guide AI in the Canadian health care landscape, and in other global contexts, before this revolution worsens the digital divide and health inequity.
- Subjects
CANADA; MEDICAL information storage &; retrieval systems; HEALTH services accessibility; DATA security; DIVERSITY &; inclusion policies; ARTIFICIAL intelligence; RESPONSIBILITY; HEALTH policy; DIGITAL divide; SYSTEMATIC reviews; MEDLINE; THEMATIC analysis; COMPUTER literacy; HEALTH facilities; STAKEHOLDER analysis; GOVERNMENT regulation
- Publication
PLoS Digital Health, 2024, Vol 3, Issue 9, p1
- ISSN
2767-3170
- Publication type
Article
- DOI
10.1371/journal.pdig.0000597