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1. Leapfrogging Medical AI in Low-Resource Contexts Using Edge Tensor Processing Unit

   https://doi.org/10.1109/HI-POCT54491.2022.9744071  

   Sinha, Priyanshu; Gichoya, Judy W.; Purkayastha, Saptarshi (March 2022, 2022 IEEE Healthcare Innovations and Point of Care Technologies (HI-POCT))

   With each passing year, the state-of-the-art deep learning neural networks grow larger in size, requiring larger computing and power resources. The high compute resources required by these large networks are alienating the majority of the world population that lives in low-resource settings and lacks the infrastructure to benefit from these advancements in medical AI. Current state-of-the-art medical AI, even with cloud resources, is a bit difficult to deploy in remote areas where we don’t have good internet connectivity. We demonstrate a cost-effective approach to deploying medical AI that could be used in limited resource settings using Edge Tensor Processing Unit (TPU). We trained and optimized a classification model on the Chest X-ray 14 dataset and a segmentation model on the Nerve ultrasound dataset using INT8 Quantization Aware Training. Thereafter, we compiled the optimized models for Edge TPU execution. We find that the inference performance on edge TPUs is 10x faster compared to other embedded devices. The optimized model is 3x and 12x smaller for the classification and segmentation respectively, compared to the full precision model. In summary, we show the potential of Edge TPUs for two medical AI tasks with faster inference times, which could potentially be used in low-resource settings for medical AI-based diagnostics. We finally discuss some potential challenges and limitations of our approach for real-world deployments. 

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2. Real-Time Physical Threat Detection on Edge Data Using Online Learning

   https://doi.org/10.1109/MCE.2023.3256641  

   Khakurel, Utsab; Rawat, Danda B. (March 2023, IEEE Consumer Electronics Magazine)

   Sensor-powered devices offer safe global connections; cloud scalability and flexibility, and new business value driven by data. The constraints that have historically obstructed major innovations in technology can be addressed by advancements in Artificial Intelligence (AI) and Machine Learning (ML), cloud, quantum computing, and the ubiquitous availability of data. Edge AI (Edge Artificial Intelligence) refers to the deployment of AI applications on the edge device near the data source rather than in a cloud computing environment. Although edge data has been utilized to make inferences in real-time through predictive models, real-time machine learning has not yet been fully adopted. Real-time machine learning utilizes real-time data to learn on the go, which helps in faster and more accurate real-time predictions and eliminates the need to store data eradicating privacy issues. In this article, we present the practical prospect of developing a physical threat detection system using real-time edge data from security cameras/sensors to improve the accuracy, efficiency, reliability, security, and privacy of the real-time inference model. 

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3. Adopting and expanding ethical principles for generative artificial intelligence from military to healthcare

   https://doi.org/10.1038/s41746-023-00965-x  

   Oniani, David; Hilsman, Jordan; Peng, Yifan; Poropatich, Ronald K.; Pamplin, Jeremy C.; Legault, Gary L.; Wang, Yanshan (December 2023, npj Digital Medicine)

   Abstract In 2020, the U.S. Department of Defense officially disclosed a set of ethical principles to guide the use of Artificial Intelligence (AI) technologies on future battlefields. Despite stark differences, there are core similarities between the military and medical service. Warriors on battlefields often face life-altering circumstances that require quick decision-making. Medical providers experience similar challenges in a rapidly changing healthcare environment, such as in the emergency department or during surgery treating a life-threatening condition. Generative AI, an emerging technology designed to efficiently generate valuable information, holds great promise. As computing power becomes more accessible and the abundance of health data, such as electronic health records, electrocardiograms, and medical images, increases, it is inevitable that healthcare will be revolutionized by this technology. Recently, generative AI has garnered a lot of attention in the medical research community, leading to debates about its application in the healthcare sector, mainly due to concerns about transparency and related issues. Meanwhile, questions around the potential exacerbation of health disparities due to modeling biases have raised notable ethical concerns regarding the use of this technology in healthcare. However, the ethical principles for generative AI in healthcare have been understudied. As a result, there are no clear solutions to address ethical concerns, and decision-makers often neglect to consider the significance of ethical principles before implementing generative AI in clinical practice. In an attempt to address these issues, we explore ethical principles from the military perspective and propose the “GREAT PLEA” ethical principles, namely Governability, Reliability, Equity, Accountability, Traceability, Privacy, Lawfulness, Empathy, and Autonomy for generative AI in healthcare. Furthermore, we introduce a framework for adopting and expanding these ethical principles in a practical way that has been useful in the military and can be applied to healthcare for generative AI, based on contrasting their ethical concerns and risks. Ultimately, we aim to proactively address the ethical dilemmas and challenges posed by the integration of generative AI into healthcare practice. 

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4. "AI in healthcare: data governance challenges"

   https://doi.org/10.21037/jhmhp-2020-ai-05  

   Winter, J.S. (March 2021, Journal of hospital management and health policy)

   Reddy, S.; Winter, J.S.; Padmanabhan, S. (Ed.)

   AI applications are poised to transform health care, revolutionizing benefits for individuals, communities, and health-care systems. As the articles in this special issue aptly illustrate, AI innovations in healthcare are maturing from early success in medical imaging and robotic process automation, promising a broad range of new applications. This is evidenced by the rapid deployment of AI to address critical challenges related to the COVID-19 pandemic, including disease diagnosis and monitoring, drug discovery, and vaccine development. At the heart of these innovations is the health data required for deep learning applications. Rapid accumulation of data, along with improved data quality, data sharing, and standardization, enable development of deep learning algorithms in many healthcare applications. One of the great challenges for healthcare AI is effective governance of these data—ensuring thoughtful aggregation and appropriate access to fuel innovation and improve patient outcomes and healthcare system efficiency while protecting the privacy and security of data subjects. Yet the literature on data governance has rarely looked beyond important pragmatic issues related to privacy and security. Less consideration has been given to unexpected or undesirable outcomes of healthcare in AI, such as clinician deskilling, algorithmic bias, the “regulatory vacuum”, and lack of public engagement. Amidst growing calls for ethical governance of algorithms, Reddy et al. developed a governance model for AI in healthcare delivery, focusing on principles of fairness, accountability, and transparency (FAT), and trustworthiness, and calling for wider discussion. Winter and Davidson emphasize the need to identify underlying values of healthcare data and use, noting the many competing interests and goals for use of health data—such as healthcare system efficiency and reform, patient and community health, intellectual property development, and monetization. Beyond the important considerations of privacy and security, governance must consider who will benefit from healthcare AI, and who will not. Whose values drive health AI innovation and use? How can we ensure that innovations are not limited to the wealthiest individuals or nations? As large technology companies begin to partner with health care systems, and as personally generated health data (PGHD) (e.g., fitness trackers, continuous glucose monitors, health information searches on the Internet) proliferate, who has oversight of these complex technical systems, which are essentially a black box? To tackle these complex and important issues, it is important to acknowledge that we have entered a new technical, organizational, and policy environment due to linked data, big data analytics, and AI. Data governance is no longer the responsibility of a single organization. Rather, multiple networked entities play a role and responsibilities may be blurred. This also raises many concerns related to data localization and jurisdiction—who is responsible for data governance? In this emerging environment, data may no longer be effectively governed through traditional policy models or instruments. 

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5. Toward Secure, Privacy-Preserving, and Interoperable Medical Data Sharing via Blockchain

   https://doi.org/10.1109/ICPADS47876.2019.00126  

   Jin, Hao; Xu, Chen; Luo, Yan; Li, Peilong; Cao, Yu; Mathew, Jomol (December 2019, 2019 IEEE 25th International Conference on Parallel and Distributed Systems (ICPADS))

   In the era of cloud computing and big data analysis, how to efficiently share and utilize medical information scattered across various care providers has become a critical problem. This paper proposes a new framework for sharing medical data in a secure and privacy-preserving way. This framework holistically integrates multi-authority attribute based encryption, blockchain and smart contract, as well as software defined networking to define and enforce sharing policies. Specifically in our framework, patients' medical records are encrypted and stored in hospital databases, where strict access controls are enforced with attribute based encryption coupled with privacy level classification. Our framework leverages blockchain technology to connect scattered private databases from participating hospitals for efficient and secure data provision, smart contracts to enable the business logic of clinical data usage, and software defined networking to revoke sharing privileges. The performance evaluation of our prototype demonstrates that the associated computation costs are reasonable in practice. 

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