Artificial intelligence is innovating the way that the world operates, and this is no more evident than in health care delivery—particularly within the Military Health System.

Leaders from across the MHS discussed the uses and implications of AI during a plenary session titled, “Military Medicine in the Age of Artificial Intelligence: Challenges & Opportunities” at the 2024 Military Health System Conference in Portland, Oregon, on April 10.

Dr. Jesus Caban, chief data scientist for the Program Executive Office, Defense Health Care Management Systems, led the panel discussion that included Seileen Mullen, principal deputy assistant secretary of defense for health affairs, Dr. Jonathan Woodson, president of the Uniformed Services University of the Health Sciences, and Dr. Bob Walker, futurist for the Defense Health Agency.

“Artificial intelligence and machine learning have the potential to transform health care,” said Mullen.

AI allows systems to make connections that would be difficult or impossible for a human to make as quickly or accurately. It also learns from examples given, rather than being programmed. There are ethical and reliability concerns related to this ability that MHS leaders addressed during the panel discussion.

Caban noted that each speaker and their respective agencies have been working on an AI mission and vision strategy, finding ways to incorporate AI machine learning into specific areas of military heath, while also keeping in mind that it must be done in a “responsible, ethical, and trustworthy way.”

Mullen emphasized the need for partners across MHS and other government agencies to establish a trustworthy AI framework.

“Health Affairs is working to identify the actions needed to enable advances and adoption of artificial intelligence and machine learning across military medicine, while ensuring robust safeguards are in place,” said Mullen.

“We're also working collaboratively with the Defense Health Agency and other partners to achieve full integration across the MHS,” she added.

She noted that the office of the assistant secretary for health affairs has identified five key priorities for promoting trustworthy AI and machine learning, including:

• Maintain an Al and machine learning inventory
• Enact guidance for responsible AI
• Provide guidance for a trustworthy generative AI
• Promote and enable a digital workforce
• Promote and coordinate with other DOD and federal agencies.

The panel highlighted how AI can transform health care delivery, and how the system can educate future health workers.

AI Paving the Way for Future Medical Providers

“The advancement in AI over the past 20 months has been unparalleled in terms of tech advancement and has produced challenges in higher education,” said Woodson. “We know that this is only the start of what is to come; we cannot even imagine what the field will look like in five or 10 years.”

Many ethical and quality issues surround the use of AI in educating future health care professionals.

Woodson acknowledged that one of these ethical issues is working to improve data quality and network function because of inherent biases in much of the data. He noted that the data needs to be continually refreshed as it informs AI algorithms, and that it must be understood that there are biases in data sources.

“Students will need to understand the social and ethical implications of the influence that social, economic, and political systems have on AI based tools, particularly the underlying data,” said Woodson.

He cited a recent study that encourages the teaching of basic knowledge of AI, machine learning, natural language processing, and neural networks as a fundamental understanding for health professionals.

One of the biggest concerns in today’s classroom is how students learn, according to Woodson.

“There's an existential threat in higher education in competition for students, as the numbers of students entering secondary education are declining, and actually are bled off into other kinds of occupations,” said Woodson.

He said many students are ahead of the curve and are using digital platforms to make education more efficient, advancing beyond the faculty.

He pointed out the trend of students not attending lectures, instead waiting for the video of the lecture and watching it at two-times the speed to get to the content that they want.

“It's too inefficient to sit in a classroom listening to the faculty instructor,” said Woodson.

He also noted that some medical residents and students prepare for operations and procedures by watching videos on YouTube.

“Students clearly need to learn how to use these tools, because it will be part of how they live, work, play, and contribute to the future. And we don't want them to be obsolete when they cross the stage and receive their degrees,” Woodson added.

He said faculty development and retention is important during this digital transformation, with many faculty resigning or not adapting their teaching methodologies to this new environment.

“Development of critical thinking and writing skills is now challenged by AI,” said Woodson. “AI threatens many conventional liberal arts-based curricula. I must say that this challenge is across the higher education spectrum, as many liberal arts colleges are trying to figure out what impact it will have in terms of courses they offer and what the guidelines will be.”

“The effects of AI and online blended and digital education are just unknown. We’re just beginning to sort those issues out,” he added.

How AI May Transform the MHS

“I look at things a little bit differently and look for larger trends,” said Walker. “I’m allowed to be that guy that gets people to think about what is missing.” He studies the future and makes predictions based on current trends, challenging the way that the DHA looks at AI.

He said that organizations often exist in a linear and local environment, without being “exponential and global.”

“Unless you make that switch, you still bring linear and local solutions to large problems, and we want to get out of that binary box that we're stuck in,” said Walker.

He noted that whenever there are new technologies introduced, or the converging of technologies, there are always questions, doubts, and concerns. He stressed that almost every technology that has been introduced has made lives better.

Like any new technology, he noted, “it does have to be reliable, and it has to be responsible.”

“The people who build new technologies and those that tear down old orthodoxies—those folks are in the room today,” said Walker. “That's not something that we can put off.”

“It’s about technology and it really is about health. And it's about people,” he added. “We must remember that.”