Cabinet prescribes healthcare AI but forgets package insert

The Schoof administration has seen the light when it comes to the future of healthcare. But it is artificial light. Artificial intelligence (AI) is, in the eyes of the cabinet, the appropriate medicine for the many ills from which the Dutch healthcare system suffers. However, an insert is missing from the plans for Budget Day. Given the many side effects that AI has, a painful placebo for all those people who have to toil daily in a failing system.

Personnel shortages are high on the cabinet's agenda. "It is impossible to avert these labor market shortages by attracting more and more people from outside the care sector, after all, there are major shortages there too," we read in the first Budget Day documents by Schoof et al."We will have to make do with the people already working in care and the natural recruitment. That requires great efforts, but it can be done."

With a view to addressing the workforce shortage, the cabinet wants to use the "momentum" "to make solutions we have been talking about for so long really possible now." Chief among these solutions is the deployment of "generative artificial intelligence (AI)." [sic]. Particularly in reducing the administrative burden, the cabinet says the possibilities are "revolutionary": "If we manage to halve administrative time to about 20 percent of working time, we are already there for the next few years."

Golden formula
This sounds like a golden formula: more AI = less administrative work = end of staff shortages. Unfortunately, there is quite a bit to be said against this reasoning. A knee-jerk reaction is to fall over the confusion of terminology (see above- the fact that artificial and artificial intelligence are synonymous does not make the abbreviation interchangeable).

But the way the administration is twisting the timeline is telling. For the record: ChatGPT made its appearance less than two years ago. So not a topic "we have been talking about for so long. Correctly representing the time perspective does have significance. Due to the ultra-short adoption time of AI, the phenomenon is surrounded by questions and uncertainties, which are certainly of basic importance for a sector like healthcare.

Huge costs
What is clear by now: the rollout of AI is driving healthcare providers to huge costs. They are looking at price premiums of tens to hundreds of millions of dollars because companies like Microsoft and Google have added "smart" functionalities to their software packages. Hospitals cannot argue much against this, as Big Tech's dominance has only increased with the introduction of AI.

Even more bureaucracy
Not a word about this cost aspect in the cabinet plans. Apart from this, wider introduction of AI in healthcare has more problematic aspects. For example, there is a danger that AI will only further increase the number of administrative transactions. After all, why would we in healthcare look at one more or less form, registration or questionnaire if AI catches it all speech-driven? Just to draw an analogy: the average office worker doesn't have thousands of emails in the mailbox because he likes it so much, but because the functionality allows it.

Patterns of AI
While the latter may be an example of sloppy individual PC management, with AI, data hoarding is an essential feature. Indeed, for AI to work, the machine must be fed nonstop. This irrevocably affects the nature and content of the work of anyone working with AI, including those in healthcare. Where the government presents artificial intelligence as the tool to save traditional working methods in healthcare, these will change beyond recognition with the arrival of AI. As much as we like to keep a human in the loop, as AI penetrates deeper into the work process, employees will have to conform more to the patterns that AI carves out.

Professionals who live off the pen are already experiencing this dystopian representation firsthand. For the sake of digital findability, they must write and structure their pieces in such a way that the computer can make sense of them. So numbered bullet points, bullets and calls to action get a smiley face. Imagery, ingenuity or varied word choice is seo-suicide.

Prodigy
Im Grunde, of course, the advance of AI is nothing but the next phase of the Fourth Industrial Revolution. To present AI as a stand alone panacea -as the cabinet does- is a fundamental misunderstanding of its disruptive nature. Like it or not, in a sector like healthcare in which data will soon be the most important means of production, employees from top to bottom will increasingly resemble data processors, data analysts and data engineers. No hands-on-the-bed, then, but heads-behind-the-computer.

Data Eaters
This disruptive nature also manifests itself in another way. The fact that LLMs are giant data guzzlers imposes a huge environmental burden. Recent research shows that LLMs consume up to nearly 700 percent more energy than companies like Apple, Google, Meta and Microsoft claim. Even before the introduction of LLMs, data centers accounted for 1.5 percent of global energy consumption. When it is considered that an AI query requires 100 times more energy than a regular Google search, it is clear in which direction this percentage is moving. Of course, we can build a few more data centers in the Wieringermeer or in Flevoland to serve healthcare. But then we won't have to think at all about building new houses or roads in the coming decades. Even the sustainability agenda of healthcare as laid down in the Green Deal Sustainable Healthcare can then be thrown in the garbage can.

Promising goal
Rather than pay attention to such issues, the Cabinet is coming up with clever ways to sing the blessings of AI for healthcare. For those who don't understand, the cabinet has captured the "promising goal" in a hashtag: #NeverMoreTikken. Until then, doctors, scientists, researchers and journalists will hopefully persist in dated but proven practices and critically monitor developments around AI. But then again, many of these professions are tapped into the populist mindset.