Is primary health care ready for artificial intelligence? What do primary health care stakeholders say?

Amanda L Terry; Jacqueline K Kueper; Ron Beleno; Judith Belle Brown; Sonny Cejic; Janet Dang; Daniel Leger; Scott McKay; Leslie Meredith; Andrew D Pinto; Bridget L Ryan; Moira Stewart; Merrick Zwarenstein; Daniel J Lizotte

doi:10.1186/s12911-022-01984-6

Is primary health care ready for artificial intelligence? What do primary health care stakeholders say?

BMC Med Inform Decis Mak. 2022 Sep 9;22(1):237. doi: 10.1186/s12911-022-01984-6.

Authors

Amanda L Terry^{1

2

3}, Jacqueline K Kueper^{4

5}, Ron Beleno⁶, Judith Belle Brown⁷, Sonny Cejic⁷, Janet Dang^{8

9}, Daniel Leger⁷, Scott McKay⁷, Leslie Meredith⁷, Andrew D Pinto^{10

11

12

13}, Bridget L Ryan^{4

7}, Moira Stewart⁷, Merrick Zwarenstein^{4

7}, Daniel J Lizotte^{4

5}

Affiliations

¹ Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada. aterry4@uwo.ca.
² Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. aterry4@uwo.ca.
³ Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. aterry4@uwo.ca.
⁴ Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada.
⁵ Department of Computer Science, Faculty of Science, Western University, London, ON, Canada.
⁶ Age-Well NCE, Toronto Rehabilitation Institute, Toronto, ON, Canada.
⁷ Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
⁸ London Middlesex Primary Care Alliance, London, ON, Canada.
⁹ Thames Valley Family Health Team, London, ON, Canada.
¹⁰ Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada.
¹¹ Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.
¹² Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
¹³ Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

Abstract

Background: Effective deployment of AI tools in primary health care requires the engagement of practitioners in the development and testing of these tools, and a match between the resulting AI tools and clinical/system needs in primary health care. To set the stage for these developments, we must gain a more in-depth understanding of the views of practitioners and decision-makers about the use of AI in primary health care. The objective of this study was to identify key issues regarding the use of AI tools in primary health care by exploring the views of primary health care and digital health stakeholders.

Methods: This study utilized a descriptive qualitative approach, including thematic data analysis. Fourteen in-depth interviews were conducted with primary health care and digital health stakeholders in Ontario. NVivo software was utilized in the coding of the interviews.

Results: Five main interconnected themes emerged: (1) Mismatch Between Envisioned Uses and Current Reality-denoting the importance of potential applications of AI in primary health care practice, with a recognition of the current reality characterized by a lack of available tools; (2) Mechanics of AI Don't Matter: Just Another Tool in the Toolbox- reflecting an interest in what value AI tools could bring to practice, rather than concern with the mechanics of the AI tools themselves; (3) AI in Practice: A Double-Edged Sword-the possible benefits of AI use in primary health care contrasted with fundamental concern about the possible threats posed by AI in terms of clinical skills and capacity, mistakes, and loss of control; (4) The Non-Starters: A Guarded Stance Regarding AI Adoption in Primary Health Care-broader concerns centred on the ethical, legal, and social implications of AI use in primary health care; and (5) Necessary Elements: Facilitators of AI in Primary Health Care-elements required to support the uptake of AI tools, including co-creation, availability and use of high quality data, and the need for evaluation.

Conclusion: The use of AI in primary health care may have a positive impact, but many factors need to be considered regarding its implementation. This study may help to inform the development and deployment of AI tools in primary health care.

Keywords: Artificial intelligence; Family medicine; Primary health care; Qualitative research.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Artificial Intelligence*
Clinical Competence
Data Accuracy
Humans
Primary Health Care
Software*