Warnings of a Dark Side to A.I. in Health Care - The New York Times
▻https://www.nytimes.com/2019/03/21/science/health-medicine-artificial-intelligence.html
Similar forms of artificial intelligence are likely to move beyond hospitals into the computer systems used by health care regulators, billing companies and insurance providers. Just as A.I. will help doctors check your eyes, lungs and other organs, it will help insurance providers determine reimbursement payments and policy fees.
Ideally, such systems would improve the efficiency of the health care system. But they may carry unintended consequences, a group of researchers at Harvard and M.I.T. warns.
In a paper published on Thursday in the journal Science, the researchers raise the prospect of “adversarial attacks” — manipulations that can change the behavior of A.I. systems using tiny pieces of digital data. By changing a few pixels on a lung scan, for instance, someone could fool an A.I. system into seeing an illness that is not really there, or not seeing one that is.
_ Software developers and regulators must consider such scenarios, as they build and evaluate A.I. technologies in the years to come, the authors argue. The concern is less that hackers might cause patients to be misdiagnosed, although that potential exists. More likely is that doctors, hospitals and other organizations could manipulate the A.I. in billing or insurance software in an effort to maximize the money coming their way. _
In turn, changing such diagnoses one way or another could readily benefit the insurers and health care agencies that ultimately profit from them. Once A.I. is deeply rooted in the health care system, the researchers argue, business will gradually adopt behavior that brings in the most money.
The end result could harm patients, Mr. Finlayson said. Changes that doctors make to medical scans or other patient data in an effort to satisfy the A.I. used by insurance companies could end up on a patient’s permanent record and affect decisions down the road.
Already doctors, hospitals and other organizations sometimes manipulate the software systems that control the billions of dollars moving across the industry. Doctors, for instance, have subtly changed billing codes — for instance, describing a simple X-ray as a more complicated scan — in an effort to boost payouts.
Hamsa Bastani, an assistant professor at the Wharton Business School at the University of Pennsylvania, who has studied the manipulation of health care systems, believes it is a significant problem. “Some of the behavior is unintentional, but not all of it,” she said.
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