After methodically gathering more than 1,300 members, the Coalition for Health AI is under its CEO's ambitious promise to become “a trusted source and curator of best practices for AI in health.” It was officially launched on March 5th.
CHAI CEO Brian Anderson added during the webinar that to gain confidence in the “AI revolution,” “we have to become a big tent” that welcomes all voices.
As I listened to the group's grand plans, I realized that CHAI aims to become the “Goo Goo” of healthcare AI. If this label doesn't ring a bell, let me explain.
The term “goo goo” was coined in the late 19th century.th-Century is an abbreviation for “good government” groups that sprung up in New York, Chicago, and other cities to combat the harm caused by corrupt city governments.This word was revived in the late 1920sth-Century Chicago, columnist Mike Royko mentions habitual do-gooders. CHAI is a partner of the government rather than an adversary, much like the traditional “Goo-Goo”, but it is equally a good We seek to establish governance practices. Sector rush for AI riches.
Chicago Citizens United, a pioneer of Goo Goo, believes that by engaging citizens in campaigns to improve health through better sanitation standards, they are “awakening in the hearts of all citizens…a sense of the duty they have.” ”. In parallel, CHAI seeks to engage all sectors of the medical public to “improve lives” through standards, in this case “reliable, fair and transparent medical AI systems.”
The Citizens League recognized the need for influence and credibility. Early members included famous “consumer advocates” (such as social worker and future Nobel Peace Prize winner Jane Addams) and influential business leaders. CHAI's initial partners include respected consumer groups, the National Health Council, and powerful private sector players such as Google, Microsoft, and the Mayo Clinic.
Additionally, just as Citizens League has developed legislative and regulatory proposals to ensure change in its reforms, CHAI will work with the federal government to develop “guidelines and guardrails.” CHAI lists seven federal agencies as “observers,” and the director of the Food and Drug Administration's Digital Health Center of Excellence and the National Health Information Technology Coordinator serve on its nine-member board of directors.
STAT's Casey Ross wrote that this level of engagement is “an experiment in whether industry and government can work together effectively in regulating rapidly advancing technology.”
But despite the benevolent atmosphere, I kept thinking about two big unanswered questions.
The first is whether CHAI's commitment to the “responsible use of AI in health care” will give it the courage to address questionable uses of medical AI that are already impacting tens of millions of Americans. As I've written in health policy publications and elsewhere, large health plans and medical centers sell personally identifiable information, such as credit reports, shopping habits, and even website login information, to data brokers. It is secretly collected from sources such as This trove of data is fed into AI algorithms in a process of “data fusion” aimed at identifying individuals who may need special assistance due to social determinants of health.
This process is similar to the one recently exposed by Sen. Ron Wyden (D-Ore.) that the National Security Agency covertly uses in areas such as health care, ostensibly for the public's own benefit. It's the same. In the medical field, the predictive accuracy of algorithms has never been subject to transparent third-party oversight of bias and effectiveness.
(When I mentioned this lack of public evidence to an executive at one of the organizations using this data, he smiled and said, “We know it works.”) Presumably the NSA does the same. (I guess he felt that way.)
CHAI's statement of purpose reminds us that “lives depend on health care.” But huge amounts of money are also an issue here. The government pays hundreds of billions of dollars a year for MA plans, but many large health systems have “value-based” payment arrangements. Will CHAI stick to its ideals even if it angers prominent supporters?
My second concern is broader, but under the soaring rhetoric of “creating an ecosystem that fully realizes the potential of AI to transform patient care,” CHAI is truly an industry-ready technology. Is it intended to do more than serve as a practical solution? Currently, the Group's action plan is technically well-organized, setting out principles, criteria, standards, evaluation and monitoring.
All these are extremely necessary and will definitely benefit the people. However, new AI tools are beginning to provide patients with personalized, timely, and reliable health information that was previously reserved for professionals. The use of this type of AI threatens to significantly disrupt the role of physicians, and as I have written, is far more troubling.
Will CHAI be an ally in patient empowerment that disrupts the position of those who control healthcare today? CHAI's current “focus” on the needs of patients, families, and communities is primarily It appears to involve seeking input on how the health system should use AI tools and using that input to persuade the public to trust them. In Anderson's words, it's about “helping the public better understand how these tools are developed and used.”
In fact, it’s only when you dig deeper into CHAI’s list of 13 different workstreams that you find a workstream in number 10 about “AI solutions intended for direct use by patients without the involvement of healthcare providers.” Notably, although each board member spoke briefly during the webinar, not one mentioned this type of independence.
Similarly, patients are the focus of both covert AI-powered analyzes purportedly designed to help them and the public attention of clinicians, researchers, and AI experts seeking to help them as well. Or is the patient also a subject that could be used if AI were to be used? How to make your own decisions independently? Although CHAI's leaders regularly raise the flag of revolution, they have not yet shown any readiness to embrace a radical democratization of health information.
CHAI leaders must choose. Do they see themselves as the same old “goo-goo”-led business executives dedicated to solving a list of important but specific problems? Or are they true Do we also have the spirit of Jane Addams, the passionate activist who worked tirelessly for change?
I know many of CHAI's leaders personally, and I know others by reputation. I have great respect for their abilities and have no doubt that their hearts are in the right place. However, it remains to be seen how CHAI will actually act.
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