In 2024, as had previously been done in 2016 and 2020, the National Academy of Medicine (NAM) empaneled groups of experts to write recommendations for the incoming Presidential administration. Vital Directions for Health and Health Care: Priorities for 2025, published recently in Health Affairs, offers guidance to the new administration in several areas currently deemed vital by NAM:
• Revitalizing the biomedical research enterprise
• Modernizing public health
• Charting new directions for women’s health
• Safely integrating artificial intelligence (AI) throughout the health care system
• Transforming the U.S. health care system to one that performs at par with the systems of other industrialized nations.
“In health and health care there is a tremendous need for measured guidance that takes into full account both the promise and risks of AI,” said the lead author for the AI recommendations, Michael Matheny, MD, MS, MPH, professor of Biomedical Informatics, Medicine, and Biostatistics, and director of the Center for Improving the Public’s Health through Informatics at Vanderbilt University Medical Center.
The 12 authors of the AI recommendations are mainly academics but also include leaders from tech companies Microsoft, Google and Epic.
“While the use of AI in health care is still relatively new, adoption is proceeding rapidly, as are the advances in AI’s capabilities, raising the potential for positive impacts to the health of individuals and populations,” said co-author, Peter Embí, MD, MS, professor and chair of the Department of Biomedical Informatics, Senior Vice President for Research and Innovation at VUMC, co-director of the ADVANCE Center (AI Discovery & Vigilance to Accelerate Innovation & Clinical Excellence Center), holder of the Endowed Directorship in Biomedical Informatics, and a member of NAM.
The authors set out AI recommendations in four areas:
• The safe, effective and trustworthy use of AI
• Promoting the development of an AI-competent health care workforce
• Promoting research on AI in health and health care
• Clarifying responsibility and liability in the use of AI.
“Besides a focus on ensuring health AI’s safety and effectiveness,” Embí said, “other considerations that informed our recommendations were the importance of ensuring that AI’s benefits reach all patients and populations equally and that those benefits diffuse across the entire health care system.”
Here’s a sampling of the group’s recommended priorities for action:
• Clear and concrete definitions of health care AI technologies, and what does and does not constitute AI, will be critical to ensure appropriate governance.
• Federal agencies should develop policies to incentivize the fair deployment of AI technologies and democratize access to AI across a broad range of health care organizations, all while including patients and end users in AI development and implementation.
• Effective, widespread AI use will entail standardization of the AI implementation life cycle, from development to deployment and monitoring, and will benefit from a combination of translational science methods encompassing applied informatics, process improvement and implementation science.
• Policymakers for higher education funding should consider incentives that support new training requirements and continuous adaptation of curricula to prepare clinicians to leverage AI in patient care.
• Investments are needed to address several open research questions, among them AI’s potential to accelerate drug discovery, to expand capacity of diagnosis and screening and enhance their accuracy, to enable the characterization of disease mechanisms, and to predict disease onset, progression, patient outcomes or treatment responses.
• Policymakers should support and coordinate efforts by professional societies to streamline the adoption of medical AI by clarifying the responsibility and liability landscape for health care professionals.
“It was a tremendous experience working with AI experts to synthesize and summarize some of the key policy challenges facing health AI, and I hope it promotes further discussion of these topics,” Matheny said.
For links to documents not subject to the Health Affairs reader paywall, see NAM’s Vital Directions webpage.
