CC BY-NC-ND 4.0 · Yearb Med Inform 2019; 28(01): 041-046
DOI: 10.1055/s-0039-1677901
Special Section: Artificial Intelligence in Health: New Opportunities, Challenges, and Practical Implications
Working Group Contributions
Georg Thieme Verlag KG Stuttgart

Artificial Intelligence in Primary Health Care: Perceptions, Issues, and Challenges

Primary Health Care Informatics Working Group Contribution to the Yearbook of Medical Informatics 2019
Harshana Liyanage
1   Department of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, UK
Siaw-Teng Liaw
2   School of Public Health & Community Medicine, UNSW Medicine Australia, Ingham Institute of Applied Medical Research, NSW, Australia
Jitendra Jonnagaddala
2   School of Public Health & Community Medicine, UNSW Medicine Australia, Ingham Institute of Applied Medical Research, NSW, Australia
Richard Schreiber
3   Geisinger Holy Spirit, Camp Hill, PA, USA
Craig Kuziemsky
4   Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
Amanda L Terry
5   Centre for Studies in Family Medicine, Department of Family Medicine, Interfaculty Program in Public Health, Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
Simon de Lusignan
1   Department of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, UK
› Author Affiliations
Further Information

Publication History

Publication Date:
25 April 2019 (online)


Background: Artificial intelligence (AI) is heralded as an approach that might augment or substitute for the limited processing power of the human brain of primary health care (PHC) professionals. However, there are concerns that AI-mediated decisions may be hard to validate and challenge, or may result in rogue decisions.

Objective: To form consensus about perceptions, issues, and challenges of AI in primary care.

Method: A three-round Delphi study was conducted. Round 1 explored experts’ viewpoints on AI in PHC (n=20). Round 2 rated the appropriateness of statements arising from round one (n=12). The third round was an online panel discussion of findings (n=8) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups.

Results: PHC and informatics experts reported AI has potential to improve managerial and clinical decisions and processes, and this would be facilitated by common data standards. The respondents did not agree that AI applications should learn and adapt to clinician preferences or behaviour and they did not agree on the extent of AI potential for harm to patients. It was more difficult to assess the impact of AI-based applications on continuity and coordination of care.

Conclusion: While the use of AI in medicine should enhance healthcare delivery, we need to ensure meticulous design and evaluation of AI applications. The primary care informatics community needs to be proactive and to guide the ethical and rigorous development of AI applications so that they will be safe and effective.

Supplementary Material

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