Abstract
Background: Advances in healthcare artifcial intelligence (AI) are occurring rapidly and there is a growing discussion about managing its development. Many AI technologies end up owned and controlled by private entities. The nature of the implementation of AI could mean such corporations, clinics and public bodies will have a greater than typical role in obtaining, utilizing and protecting patient health information. This raises privacy issues relating to implementation and data security.
Main body: The frst set of concerns includes access, use and control of patient data in private hands. Some recent public–private partnerships for implementing AI have resulted in poor protection of privacy. As such, there have been calls for greater systemic oversight of big data health research. Appropriate safeguards must be in place to maintain privacy and patient agency. Private custodians of data can be impacted by competing goals and should be structurally encouraged to ensure data protection and to deter alternative use thereof. Another set of concerns relates to the external risk of privacy breaches through AI-driven methods. The ability to deidentify or anonymize patient health data may be compromised or even nullifed in light of new algorithms that have successfully reidentifed such data. This could increase the risk to patient data under private custodianship.
Conclusions: We are currently in a familiar situation in which regulation and oversight risk falling behind the technologies they govern. Regulation should emphasize patient agency and consent, and should encourage increasingly sophisticated methods of data anonymization and protection.
Conclusions
It is an exciting period in the development and implementation of healthcare AI, and patients whose data are used by these AI should beneft signifcantly, if not greatly, from the health improvements these technologies generate. Nonetheless, the implementation of commercial healthcare AI faces serious privacy challenges. Given personal medical information is among the most private and legally protected forms of data, there are signifcant concerns about how access, control and use by for-proft parties might change over time with a self-improving AI. An emphasis on patient agency and consent in the development of regulation in this space would refect the key legal and ethical values of liberal democracies. For example, requirements for technologically-facilitated recurrent informed consent for new uses of data, where possible, would help to respect the privacy and agency of patients.
