According to Wikipedia, artificial intelligence (AI) in healthcare is an overarching term used to describe the use of machine learning algorithms and software, or artificial intelligence (AI), to mimic human condition in the analysis, presentation and comprehension of complex medical and health care data. This means AI can perform healthcare tasks in our hospitals and clinics better and faster than humans.

The wind of Artificial intelligence is blowing in all sectors of human endeavors and the health sector is not left out. This new technology has the potential to transform every aspect of the Nigerian health sector such as interpreting images (radiology), medical diagnosis, disease detection, clinical diagnosis, drug development, customer facing apps which can provide accessible healthcare services to people as well as providing supervisory activities in hospitals and clinics.

At the center of AI technology in Nigeria is the National Health Care Act 2014 which is a law that provides a frame work for the regulation, development and management of health systems and sets standards for rendering health services in Nigeria. Amidst the glits and beauty of AI in the health sector, it is said to be a double edge sword which poses some ethical and legal challenges.

The National Health Act provides that all information concerning a user, including information relating to his or her health status, treatment or stay in a health establishment is confidential. It goes further to say no person may disclose patients Information excerpt there is a written consent from such a patient.

When talking about patients privacy concerns in data sharing and the use of Artificial Intelligence, the case of Dinerstein vs Google comes to mind. Google was engaged by a US health care system to collect and crunch personal health information of millions of people across 21 states. As part of the research, the university medical center disclosed to Google electronic health records of all adults treated at the hospital without the consent of the patients, from January, 2010 through June 30, 2016.

This case illustrates the challenges and lack of adequate laws protecting data privacy of patients. In the absence of adequate legislation on AI, patients in Nigeria may have their data shared with third parties without consent.

RIGHT TO FULL KNOWLEDGE

The National Health Act provides that every health care provider shall give user relevant information pertaining to his or her state of health, necessary treatment options, procedure as well as the risk involved. However, with AI algorithms it may be difficult to provide an explanation in some cases. For example many AI algorithms particularly deep learning algorithms use for image analysis are virtually impossible to interpret and explain.

BIASES

An AI model is considered biased when it generates an erroneous or biased output based on insufficient or poor model training. The National Health Act creates a legal frame work for rendering health services in Nigeria without biases. However, AI functions base on how it was programmed, by taking in labeled data while being trained and using that to learn and grow. This means the person collecting the data to train the model may inadvertently transfer their bias to the dataset. For example, an AI algorithm trained with data for white people without considering diversity may discriminate against people base on their gender or race. Also, AI data trained to cover limited number of patients in a particular location may classify some population that was not available in the training data as unknown when applied to patients in another location.

A study by Straw and Wu, showed that AI models built to identify people at high risk of liver disease from blood test are twice as likely to miss the disease in women and men.

Furthermore, a biased result generated from an AI enabled computer vision system for radiology can lead to an incorrect diagnosis. This can pose a serious risk for patients.

ACCOUNTABILITY

Under the National Health Act, an action can be brought against a health practitioner for negligence and erroneous decisions made in the line of duty. However, in a case where AI makes an erroneous decision, who is responsible? This lack of accountability in our law raises concerns about possible safety consequence of using AI in the Nigerian health sector.

AI has the potential to transform the Nigerian health sector. However, this technology can create ethical issues. In Europe, all AI health apps that accesses individual information must comply with the EU General Data Protection Regulation 2016/679 (GDPR), while in the UAE the government is taking necessary steps to prepare for the future of AI in healthcare by integrating a secure data system to protect patient data. In this era of AI, Nigeria must take necessary steps to prepare for the future. there is need for the Federal Ministry of health, medical personnel’s, legal experts, the National Assembly, National Information Technology Development Agency and all relevant stakeholders to begin research in this area and come up with adequate data protection laws to protect the privacy of patients.

At an industrial level, Government and all relevant stakeholders must check to ensure that the AI data used is one that can fit properly into the Nigerian healthcare sector to avoid the issue of bias and accountability measures should there be an erroneous decision.

Furthermore, there is need for a legal policy and ethical guidelines for AI technology in healthcare hence our laws are lagging behind. We must begin the process of looking at this new technology as well as the ethical complexities that comes with it. This will help to regenerate the National Health Act to tally with the times and ensure Nigeria is at the forefront of this change.

Artificial Intelligence is taking over the world, Africa and Nigeria must be prepared.

Barr. Christopher Yange Atsen