The National Policy Roadmap for AI in Healthcare is out and packed with 16 recommendations. What will DoHAC do with it?
An ambitious, comprehensive and coherent national policy roadmap for AI use in healthcare was launched earlier this month – the question now is whether the federal government will accept its recommendations and act on them.
Launched as part of the AIDH’s AI.Care conference in Melbourne, the Roadmap presents 16 recommendations, chief among them the establishment of a National AI in Healthcare Council, minimum safety and quality standards and a plan for communicating the need for caution around generative AI.
The Roadmap is the child of the Australian Alliance for Artificial Intelligence in Healthcare, collaborating with stakeholders including Macquarie University, the Australian e-Health Research Centre, RMIT, the Digital Health CRC and the AIDH.
Professor Enrico Coiera founder of the AAAIH and director of the Centre for Health Informatics at the Australian Institute of Health Innovation, told Dermatology Republic that so far he had been “delighted with the energy and willingness” of government representatives to engage with the development of the plan.
“We are a community of practice saying to government, this is what we think you should do,” said Professor Coiera.
“These are our priorities. It’s up to government to decide whether it wants to listen or not.
“One of the rules we set ourselves when we designed this current process was that we would engage early and often with government, so that, A, we made sure we were not pushing in directions where they just couldn’t go and, B, to make sure that their voice also come through.
“They will not be surprised to see the roadmap,” he said. “What they think about it, and what they choose to do about it are a separate thing.”
Dermatology Republic has reached out to DoHAC for comment on the Roadmap but it had not responded by publication deadline. It is understood the department’s assistant secretary for digital service and design, Sam Peascod, and his immediate boss, Daniel McCabe, have been regular participants in the stakeholder engagement for the Roadmap.
“We’ve done as much as we can, as a community, to engage with government,” said Professor Coiera. “I’ve been delighted with the energy and willingness that they’ve shown in engaging.”
The Roadmap has five priority areas – safety, quality, ethics and security; workforce; consumers; industry; and research – with the 16 recommendations spread across the five pillars.
Safety, quality, ethics and security
Top recommendation of perhaps the entire Roadmap is the establishment of a National AI in Healthcare Council.
“Two things were clear from our consultations,” Professor Coiera told Dermatology Republic.
“One was, we have plenty enough agencies, we don’t need another one. We have the right agencies, but they all overlap, they interlock, and there are gaps.
“Nobody totally owns that space. So rather than creating a new thing, can you just please come together, agree what your priorities are, agree who’s covering what and if there are gaps, do something about it.
“The council is almost the overarching hope. Because if you get that right, then these conversations and ownership and other things can happen.
“Without that drive and ownership, nothing will happen.”
Other recommendations in this priority area are:
- A robust, risk-based safety framework;
- Minimum AI safety and quality practice standards;
- Urgent communication of the need for caution in the clinical use of generative AI; and
- Ensuring the national AI ethical framework.
Workforce
Two recommendations cover the filling of knowledge gaps and training of current and future healthcare workers in the use and implementation of AI-enabled services:
- Supporting the development of a shared code of conduct for the safe, responsible and effective use of AI; and
- Assisting professional bodies to develop profession-specific codes of practice for the responsible use of AI.
Consumers
“When it comes to generative AI, we know people are using that technology,” Professor Coiera told Dermatology Republic.
“It’s eloquent, persuasive technology. But it’s not always right. If you ask it a straightforward, garden variety question, you probably will get a good answer.
“But that gives you the impression it’s knowledgeable, when all it’s doing is telling you what’s common. So it’s going to get more and more inaccurate, as the questions become more difficult.
“It’s very clear that people confuse eloquence with knowledgeability.
“The other thing is that it’s increasingly obvious that virtual services are more and more how it’s going to be done using digital front doors. And I think part of the education needs to be associated with services.
“So clearly, if you’re going to have your primary care system start with a digital first interaction, you’d better make sure that this is something that people understand how to use well.
“We need to be very pragmatic.”
Recommendations in this priority area are:
- Co-design and collaboratively implement a nationally accessible program for digital health literacy;
- Work together with Aboriginal and Torres Strait Islander communities to develop a mechanism that collates health-related data for use in AI in a culturally safe and trusted manner within their control, in line with principles of Indigenous Data Sovereignty.
- Ensure professional codes of conduct and training emphasises the role of clinicians in educating patients about the responsible use of AI, as part of a commitment to shared decision-making.
Industry
A priority in this pillar of the Roadmap is sovereign capability.
“We would like to have Australia be a world leader and have large companies in the area,” said Professor Coiera.
“That generates taxes and jobs and it’s crazy for us not to do that.
“We’re also at risk of losing control of the process, which is problematic. There’s also the big lesson from covid, which is around just having sovereign capability to do things.
“There will be other crises. And we do need to have these skills as a national resource.”
Often vendors develop products that, when implemented in the real world, fall short of expectations.
“Our vendor community is small, by global standards,” said Professor Coiera.
“There are good examples of companies that are growing and doing a good job, but there aren’t enough of them.
“The challenges are access to talent, and the cost of regulation.
“So there’s this dynamic where you’ll hear people saying, ‘we need to regulate for safety’ versus ‘you’re impeding our capacity to innovate by regulating me, so don’t regulate me’.
“Our perspective was regulation is essential, because we do want high-quality, safe technology. But we equally need to recognise it’s a cost to industry to do that.
“What we’ve suggested is we already have a model where innovation for small companies is supported through tax benefits. But strangely, the cost of getting that innovation regulated is not covered. And the numbers we see is that 50% to 70%, of the cost of new products is actually regulatory compliance.
“The way of avoiding that crazy discussion is to say let’s be safe, and support you being safe.”
Recommendations in this priority are:
- Development of national AI procurement guidelines;
- Provide support and incentives for local industry, including expanding the R&D tax incentives scheme to cover regulatory compliance;
- Develop mechanisms to provide industry with ethical and consent-based access to clinical data to support AI development and leverage existing national biomedical data repositories;
- Support the development of a National AI Capability Centre in Healthcare;
- Identifying emerging markets and opportunities.
Research
One recommendation in this area: Provide significant targeted support for healthcare AI research that builds sovereign capability and can translate to improved priority health services and support for industry.
Professor Coiera said he was excited to see the reaction to the Roadmap.
“This Roadmap is an opportunity for government to open up its engagement now with the community,” he told Dermatology Republic.
“If I was really in fantasyland, I would love to see some real commitment in the next budget to make some things happen in this area.
“We can only keep on meeting and talking. The encouragement I’ve heard is that nobody is saying it’s the wrong idea at the wrong time. Effectively we’re hearing the opposite. So I’m positive from that perspective.”
