Radically different
About 10 years after a breast surgeon we interviewed returned to Dubai to practice, a colleague stopped her in a hospital corridor to tell her: “It’s great — since you came back I no longer see those advanced cases of breast cancer.”
She had not stopped to notice. “You get on the wheel,” she told us in an interview for our research. When you return to your home country after training abroad, you run your clinics, train your nurses, drive out to women’s groups in the hinterlands to give talks, design educational videos that explain breast self-examination without showing a breast, because that is what the censors will pass. You argue to have the word “breast” printed on your medical license; the authorities prefer “chest.” You establish a support group, then a drop-in center, likely the only cancer drop-in center in the Middle East. Somewhere in the middle of all that, you alter what late-stage breast cancer looks like in your country.
The AI market is full of big promises of grand transformation. Health care is a prime target for those promises, beset as it is by financial pressures, labor shortages, and the growing burden of caring for an aging population. AI developers are targeting functions that vary widely, from curing cancer and performing surgery to streamlining routine administrative tasks.
The opportunity is genuine, but execution can be difficult. Numerous software vendors have tried to “fix” health care challenges but failed because they misunderstood the environment. “Health care is very complex,” says Steve Bethke, vice president of the solution developer market for Mayo Clinic Platform, which supports the buildout and deployment of digital solutions for health care companies through data-based insights and expert validation. “Solution developers must have a deep focus on clinical and technical capabilities, and then align their solutions to the relevant business impacts. If they miss any dimension, the solution will not be adopted or drive value.”
AI applications for health care are proliferating rapidly. The U.S. Food and Drug Administration has approved more than 1,300 AI-enabled medical devices, mostly for interpreting diagnostic images. More than half of these were approved in the past three years, with the earliest dating as far back as 1995. Non-radiological applications carry out tasks as diverse as tracking sleep apnea, analyzing heart rhythms, and planning orthopedic surgeries.
AI applications that do not count as medical devices— for example, those that handle scheduling and administrative tasks—are more difficult to track but are also rapidly increasing. AI can help coordinate complex tasks and workflows that are often conventionally managed by whiteboards and sticky notes. Such functions may well outstrip clinical uses in their impact on health systems. A recent survey of technology leaders found that 72% said their top priority for AI was reducing caregiver burden and improving caregiver satisfaction, while over half (53%) cited workflow efficiency and productivity.
Any health care-related application can potentially impact patient care, whether directly or indirectly, and AI apps that are poorly designed or inadequately trained and validated can put patients at risk. Providers recognize that risk: In the same survey, 77% said immature AI tools are a significant barrier to adoption. Regulators and lawmakers are also keeping an eye on the risks as development and adoption burgeon, though the U.S. regulatory picture is still in flux, as a 2024 report to Congress on AI in health care observes.
To tackle some of the technical challenges, many health care providers are partnering with application developers to build AI solutions. In a recent study, McKinsey found that 61% of health care organizations intend to pursue partnerships with third-party vendors to develop customized generative AI solutions as a primary strategy as opposed to building them in-house or buying off-the-shelf products.
But health care-specific AI applications must also be tailored to the nuanced clinical needs of medical providers as well as the complex business and regulatory considerations of the wider sector. This is where developers can benefit from working with a partner with a deep understanding of the health care environment to tailor applications to what providers want and need most. Doing so helps to position AI products for maximum impact and value, avoiding the pitfalls unique to the health care environment.
This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.
Background: Sleep quality declines with age and is a known contributor to multiple chronic health conditions, including Alzheimer disease. Emerging evidence suggests that certain electroencephalography (EEG) neural signatures measured during sleep may be predictive of cognitive decline in older adults. Sleep EEG signals are traditionally measured using bulky, rigid, and uncomfortable equipment in an unfamiliar laboratory setting, which can negatively impact sleep signals. Due to these limitations, sleep EEG data acquisition is typically limited to a single night. Objective: This study aimed to validate our recently developed portable, skin-like EEG monitoring patch for 7 nights in the home environment in a pilot sample of young and older adults by evaluating usability and acceptance, and replicating age-related differences in sleep architecture observed in the polysomnography literature. Methods: Eighteen young adults and 18 cognitively unimpaired older adults without sleep disorders were enrolled (data from 11 young adults and 12 older adults were included in the analyses) in a 7-night study during which they wore novel, gel-free, wireless, ultrathin, skin-conforming, sleep monitoring, fabric-based patches. These patches were self-applied to the forehead and face for optimal usability and comfort. The patches incorporate laser-cut mesh electrodes with low-profile electronics (including a rechargeable battery and amplifier) and transmit EEG signals to a participant-controlled, Bluetooth-enabled, tablet-based data acquisition app. An automated algorithm was used to stage sleep and assess microarchitecture features from the EEG commonly impacted for each participant. Averages across nights were computed for these sleep features for each participant. Results: Young and older adults reported that the sleep patch was easy to use and comfortable to wear. There was no loss of signal power over 7 nights of wear across participants (retained-data signal-to-noise ratio over the 7-d period: young adult, mean 20.69, SD 12.78, maximum 52.13, minimum 5.19; older adult, mean 22.10, SD 9.39, maximum 49.96, minimum 13.79). Most datasets not retained were lost due to poor reference electrode adhesion on the nose (75/101, 74% of lost datasets in young adults and 57/88, 65% in older adults). Trained sleep technologists verified that the retained datasets were of sufficient quality to be scored without difficulty. Expected age-group differences in sleep features were observed, including age-related reductions in stage N3 sleep (young adult, mean 18.55, SD 6.70; older adult, mean 10.40, SD 6.43; Mann-Whitney =42.0; =.01) and reduced sleep spindle density (young adult, mean 2.92, SD 2.24; older adult, mean 0.94, SD 1.33; Mann-Whitney =45.0; =.006). Conclusions: This study demonstrates that our novel, comfortable, wearable patch can reliably measure physiological sleep data over multiple nights at home in adults across the lifespan, thereby making multinight sleep assessment in cognitive aging studies and clinical research more accessible than traditional polysomnography. In future studies, the small, lightweight system, which is highly scalable, can be shipped inexpensively to participants’ homes, making this technology and research accessible to individuals who may have difficulty traveling or who are hesitant to travel to a laboratory or clinic.
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