Regulations, cultural factors will shape AI in India’s healthcare: Mount Sinai President

Bengaluru: David L. Reich sees AI-enabled systems as potentially driving revolutionary changes in India’s healthcare landscape. The president of The Mount Sinai Hospital, New York, however, emphasises one of the key challenges involved in India’s adoption of these systems – striking a balance between their potential for public good and the regulations on their use.

Dr Reich, professor of anesthesiology, AI and pathology, told DH that Large Language Models (LLM) could make impactful interventions in India’s rural areas that have limited access to top-quality healthcare. The AI adoption here will be different from how it is in the US and smartphone-powered access to the internet will be a game-changer.

“LLM will be more important here, especially in the rural areas with limited access to healthcare. The ability to extend the access is important in providing quality diagnosis. These models are significant considering India’s socio-economic disparities; with a large population that has access to the internet, I expect a complete explosion here,” he said.

A recent study at Mount Sinai found that hospitalised patients are 43 per cent more likely to have their care escalated and “significantly less likely” to die if their care team received AI-generated alerts on their health. India is a different proposition, also because of the cultural expectations and the relatively less stringent regulatory systems, Dr Reich, senior author of the study, said.

“I can sense that the expectations here are different. People want to be with a doctor, they want to be examined by a doctor. A part of the challenge will be in changing these expectations. In return, there could be access to more affordable, and in some cases even free, healthcare. There is a need to convince people that this is a good thing. But before that, we need to be sure ourselves,” he said.

Dr Reich noted that medical practitioners are engaging with ChatGPT at an experimental level, letting the tool write medical notes and make recommendations on diagnosis and available treatments. The pandemic has conditioned large sections of the population to remotely administered healthcare. Mount Sinai has implemented an AI-powered chatbot that asks patients questions to determine if their condition is minor or if they require a visit to the urgent care centre or the ER.

Addressing apprehensions about AI applications in healthcare, against the backdrop of data breaches, Dr Reich said it was important to have in place robust security systems and strong laws that ensure consequences to violations of patient privacy.

“When you build a clinical decision support system based on predictive analytics, you must always build it in a layer that protects patient privacy. I don’t believe that the regulatory environment here is as intense as in the US. There is also a need for balance – you don’t want so much regulation that it stifles the ability of the technology to help people,” he said.

The Ramaiah partnership

Dr Reich was in Bengaluru for the formal launch of a 10-year partnership between Mount Sinai Health System and Ramaiah Memorial Hospital (RMH), aimed at upgrading services across domains at the city-based hospital.

“This is a collaboration that has information flow in both directions. There is interest in how data is stored and transferred here. AI applications in Mount Sinai’s clinical decision support systems – the use of augmented intelligence – is something we can share learnings and expertise on. We’ll be learning from RMH as much as we are able to share,” he said.