Can artificial intelligence reduce emergency room waiting times?

MONTREAL — Using artificial intelligence to reduce waiting times in hospital emergency rooms, as the CHUM wishes to do, can be a good idea, but we must proceed cautiously, warn experts.

The Center hospitalier de l’Université de Montréal (CHUM) is currently testing an artificial intelligence algorithm designed to help administrators predict emergency room staffing levels and speed up the admission of certain patients.

The university hospital center says the artificial intelligence (AI) system will use data from the past 20 years to predict when its emergency rooms will be particularly busy, allowing the Montreal network to increase staffing on certain days and schedule elective surgeries when fewer patients are expected.

Dr. Élyse Berger-Pelletier, a consultant emergency physician who participates in the project, recalls that a patient waits an average of 18 hours between the time of their admission by a doctor and their transfer to another unit.

Abhishek Gupta, founder of the Montreal Institute for Ethics in Artificial Intelligence, reminds us that algorithms can be useful in reducing wait times. However, he warns hospitals against the temptation to perpetuate prejudice and bias in this way.

“For example, if patient visit histories are to be used as a data source, an analysis to understand if there are any pre-existing biases will help to avoid getting them into the system,” he explained in a Thursday report. e-mail. It is important, he added, that patients know how their data will be used and stored.

Bias is also of concern to Fenwick McKelvey, a professor of communication studies at Concordia University, who studies public policy in the digital sector.

“We know there is systemic racism in Quebec’s health insurance system,” he said in an interview, adding that the 2020 death of Joyce Echaquan brought attention to discrimination in Quebec. the network.

Joyce Echaquan, a 37-year-old Atikamekw from Manawan, filmed herself on “Facebook Live” while a nurse and attendant made disparaging comments about her at a Joliette hospital shortly before her death. A coroner concluded that Ms Echaquan had not received the care she needed because stigma had contributed to a misdiagnosis.

care first

Dr. Élyse Berger-Pelletier, an emergency physician who works on the artificial intelligence project, said that with patients who wait an average of 18 hours from the time they are admitted by a doctor to the time they are found a bed in a room, we absolutely have to work more efficiently in Quebec.

“I’m an emergency doctor, I work in the emergency room full time, I see how badly it’s getting worse,” she said. Obviously, we want to provide quality care and then we are not always able to do it as we would like. So, to be able to work with tools that make our lives easier, for me it is urgent.”

Another element of the AI ​​system, which is being developed by an in-house research team, will consider factors such as a patient’s age and symptoms to determine the likelihood of them being admitted, which would allow physicians to request a bed for a patient before all the tests are completed, explains Dr. Berger-Pelletier.

“That’s really where the value is for the patient, because you don’t want them to wait and you know that when you’re on a stretcher in the emergency room, especially for the elderly, it’s not good for them. We know that there is an increase in mortality and morbidity,” said the emergency physician.

Ms. Berger-Pelletier expects the new system to be officially launched within the next year – some elements could even be deployed in six months.

Moreover, the emergency physician maintains that she takes the risk of bias in the system seriously. But because the AI ​​tool will be used to manage staffing levels and allocate beds, there’s less risk of harm than if it were used to determine the type of care patients should receive, explains she. “It’s not about treating patients: it’s about running a hospital.”

Berger Pelletier says the algorithm will be regularly monitored to make sure it’s working properly — which Gupta says is necessary for AI systems.

But as the potential use of AI in healthcare draws more and more attention, Professor McKelvey fears the technology is just a band-aid to fix deeper problems in the healthcare system. Canadian health care.

“I certainly welcome the innovation in delivery, but it doesn’t seem to address the deeper structural issues plaguing the medicare system across Canada.”

But emergency physician Berger-Pelletier believes technologies like artificial intelligence will become increasingly important as Quebec’s population ages. In particular, she sees the opportunity for technology to help free healthcare workers from office duties so they can focus on patient care.

“If we want to treat everyone in an adequate and quality way, the only way to achieve this is to have technologies to help humans, so that humans remain in care, in contact with the patient.”

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Can artificial intelligence reduce emergency room waiting times?

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