Who pays when AI goes rogue?

From: POLITICO Future Pulse - Wednesday Feb 07,2024 07:03 pm
The ideas and innovators shaping health care
Feb 07, 2024 View in browser
 
Future Pulse

By Daniel Payne, Erin Schumaker and Daniel Payne

POLICY PUZZLE

A programmer writes code and works on computer.

AI's not foolproof, but whether the software or the people using it are responsible for mistakes isn't clear. | Matic Zorman/Getty Images

We don’t know who’s liable when an artificial intelligence system fails, according to a new paper by Stanford researchers in The New England Journal of Medicine.

As a result, doctors and hospitals are playing a risky game when implementing the tech.

“Courts are going to need to evolve some of their existing rules doctrines to create remedies for plaintiffs against software developers,” Michelle Mello, one of the paper's authors and a health law scholar, told Daniel.

Even so: Mello worries that, in the absence of such an evolution in the courts, AI could imperil clinicians who rely too heavily on their software co-pilots — a concern shared by the American Medical Association, the leading doctors’ group — or health systems that implement software without ensuring its safety.

AI’s opaque inner workings, which can change as the systems take in new information, make proving its involvement in a particular injury much more difficult under current judicial standards.

And the sometimes billions of variables an AI system might use to come to an answer could make it difficult for a plaintiff to find a flaw in the product specific enough to win in court.

The authors, in reviewing the limited jurisprudence, say courts seem — at least thus far — “disinclined to create special new rules for AI.”

Advice for providers: The authors say doctors and hospitals should consider archiving an AI system’s work if they need to produce it as evidence.

They “should also insist on favorable terms governing liability, insurance, and risk management in AI licensing contracts.”

 

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This is where we explore the ideas and innovators shaping health care.

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WORLD VIEW

File - Arthur Mensch, cofounder and CEO of Mistral AI, attends the UK Artificial Intelligence (AI) Safety Summit in Bletchley, England on Nov. 2, 2023. France, Germany and Italy have advocated for self-regulation of artificial intelligence companies in a move seen as an effort to help homegrown generative AI players such as French startup Mistral AI and Germany's Aleph Alpha AI. (Toby Melville/Pool Photo via AP, File)

Mistral CEO Arthur Mensch is concerned about overregulation of AI by the EU. | AP

It turns out the agreement European countries reached in December to regulate artificial intelligence might not mean as much for health care as initially thought.

How so? Before EU members formalized their Artificial Intelligence Act in a unanimous vote last week, Germany secured a commitment from the European Commission, the bloc’s executive arm, that coming regulations would not apply to the use of AI in medical devices.

That’s according to a spokesperson for German Digital and Transport Minister Volker Wissing, the foremost AI Act skeptic within Germany’s coalition government, who spoke with POLITICO’s Gian Volpicelli.

Why it matters: Before the concession, Germany and France had threatened to oppose approval of the AI Act, which will ban some AI technology applications, impose strict limits on use cases considered high-risk and rein in the most advanced software models with obligations of transparency and stress-testing.

Paris and Berlin had feared the law — the details of which the commission will work out — would hamstring their budding AI champions, such as France’s Mistral and Germany’s Aleph Alpha.

Both Mistral and Aleph Alpha aim to compete with the major U.S. players, like OpenAI and Google, and team with health care technology firms to create products.

At the time of the December agreement, European device makers said they feared the new law could subject them to two sets of rules, one for AI and another for medical products, and pledged to lobby against it.

 

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FOLLOW THE MONEY

Hospital worker

Hospitals have a long wish list they're presenting to Congress. | Spencer Platt/Getty Images

The American Hospital Association has signaled its priorities for the remainder of this year, most of which have something in common: the bottom line.

With a big government funding package expected at the end of this month, hospitals are lobbying to stop site-neutral proposals from moving forward.

Those proposals aim to equalize payment for treatments regardless of where they take place — whether in hospitals or in often less expensive clinics and doctors’ offices. Hospitals argue they provide better care with more safeguards for sicker patients.

“We are finding a good level of support,” Stacey Hughes, AHA’s executive vice president for government relations and public policy, told Daniel.

The AHA also wants policymakers to:

— Build and support the health care workforce by reauthorizing training programs

— Maintain healthy Medicare and Medicaid funding, including supplemental Medicare payments to hospitals that serve large numbers of low-income patients

— Create a hospital designation that would mean bigger Medicare fees for some facilities in urban environments

— Revise or scuttle a Centers for Medicare and Medicaid Services proposal that would, for the first time, set minimum staffing standards in long-term care facilities

— Enact a national data privacy law to govern how AI shares and uses data

— Make pandemic-era coverage of certain telehealth services permanent.

 

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