US Primary Care in 2029: A Delphi Survey on the Impact of Machine Learning [article]

Charlotte R Blease, Anna Kharko, Cosima Locher, Catherine M DesRoches, Kenneth D Mandl
2020 medRxiv   pre-print
Objective: To solicit leading health informaticians predictions about the impact of AI/ML on primary care in the US in 2029. Design: A three-round online modified Delphi poll. Participants: Twenty-nine leading health informaticians. Methods: In September 2019, health informatics experts were selected by the research team, and invited to participate the Delphi poll. Participation in each round was anonymous, and panelists were given between 4-8 weeks to respond to each round. In Round 1
more » ... d questions solicited forecasts on the impact of AI/ML on: (1) patient care, (2) access to care, (3) the primary care workforce, (4) technological breakthroughs, and (5) the long-future for primary care physicians. Responses were coded to produce itemized statements. In Round 2, participants were invited to rate their agreement with each item along 7-point Likert scales. Responses were analyzed for consensus which was set at a predetermined interquartile range of ≤ 1. In Round 3 items that did not reach consensus were redistributed. Results: A total of 16 experts participated in Round 1 (16/29, 55%). Of these experts 13/16 (response rate, 81%), and 13/13 (response rate, 100%), responded to Rounds 2 and 3, respectively. As a result of developments in AI/ML by 2029 experts anticipated workplace changes including incursions into the disintermediation of physician expertise, and increased AI/ML training requirements for medical students. Informaticians also forecast that by 2029 AI/ML will increase diagnostic accuracy especially among those with limited access to experts, minorities and those with rare diseases. Expert panelists also predicted that AI/ML-tools would improve access to expert doctor knowledge. Conclusions: This study presents timely information on informaticians consensus views about the impact of AI/ML on US primary care in 2029. Preparation for the near-future of primary care will require improved levels of digital health literacy among patients and physicians.
doi:10.1101/2020.05.08.20095224 fatcat:cifwqwkzxbctlinqkwlt5fvbzi