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Let's Be Frank

Will Advances in Smart Technology Help Our Patients or Dumb Us Down?

“Creating a true AI could be our greatest achievement and, perhaps, our last.”  
—Professor Stephen Hawking

Just like in every facet of life, smart technology has been a welcome tool in health care among patients and providers alike. Simply put, smart devices allow us to improve the care and the communications that we provide to our patients—at least in theory.

The growth and sophistication of technology continues to expand exponentially, and its application in health care continues to fascinate. New wound care–related technology helps to validate assessments, leading to more prompt referrals and ultimately improved outcomes. Where we once heard “I don’t need technology” or, more accurately, “I don’t want technology to take my job” predominantly throughout the industry, technology is now becoming standard for us and our patients.

It’s an exciting, positive development for the most part. But the presence of technology overall should also worry us, especially when it comes artificial intelligence (AI), which is proving to be a double-edged sword if not utilized properly and objectively.

Years ago, we were introduced to smart technology for the assessment and documentation of wounds to capture objective information as it drives our plan of care. Based on the data, smart technology will provide clinicians with intervention suggestions. After trialing it, we adopted smart technology, noticing that it streamlined our process, improved efficiency, consistency between clinicians, and provided data to improve outcomes. It doesn’t happen often but when access to the internet is disrupted, software glitches occur, or during power outages (on backup generator), we have to resort to the “old days” and the “suggestions” disappear.

So the question becomes: are we becoming dependent on technology to help us or is technology replacing our ability make decisions?

Learning To Trust Technology

John McCarthy coined the concept of AI at Dartmouth.1 It’s easy to realize why some older generations have had difficulty adapting to and trusting technology. I’m no slouch on technology—and yes, Siri and Alexa have become dear friends—but even I can admit that the utilization of computers is not something I excel at. And I’d rather spend my time learning about wound care from a human being as opposed to searching for guidance online. But AI is here to stay. A paper published in January 2020 compared the use of AI versus human experts in breast cancer prediction.2 The results indicated that AI not only performed well compared to a radiologist, but showed a reduction in false positives and false negative while reducing workloads and preserving standard of care.

But we as humans rely on AI for so much more. It’s as if we can’t even get in the car anymore without using our phone to tell us how to get to where we’re going—even in our own neighborhoods.

Is this truly advanced technology or is it more a crutch for the human brain? We can at the very least give technology credit for increased obesity in this country as well as anxiety and other mental health conditions. Dr. Michael Mosley explains that the increasing sophistication of our devices actually leads to less work being done.3

Professor Stephen Hawking wrote in his final book that creating a true AI could be our greatest achievement and, perhaps, our last.4

Using Technology ‘At Work’

In the clinic, these advances have been integrated into our daily routines to allow us, if used properly, to make faster decisions in a fast-paced environment. Electronic health records (EHRs) access information instantly, give us recommendations on how to care for patients based on algorithms, share patients’ records to gather needed data, and share information efficiently between providers. EHRs continue to guide care, but we must still consider that AI should not completely dwarf our own willingness and ability to think for ourselves as clinicians based on our education and real experiences.

I am honored to assist as a reviewer for a peer-reviewed journal. It is exciting to see the advancement, utilization, and application of technology to help clinicians and patients as we continue to encounter chronic and complex wounds.   

These advances demonstrate a positive forward progression in helping patients, but my question becomes will work opportunities decrease and are we becoming too dependent on these systems? Nicolas Carr stated, “Worrisome evidence suggests that our own intelligence is withering as we become more dependent on the artificial variety … Rather than lifting us up, smart software seems to be dumbing us down.”5 Consider the Flynn Effect, named after psychologist James Flynn. He reviewed studies on IQ and noted that the scores have been rising in most industrialized countries every decade. He attributes this to improved nutrition, increased time in school, and a demanding intellectual environment.

But now, IQ levels have stopped rising and are falling. Could this have anything to do with the increase of technology? As we allowing AI to do our thinking, are we therefore regressing our brainpower? If we don’t use it, will we lose it? The answer then becomes advancements in technology should not replace but compliment and enhance our clinical skills.

Frank Aviles Jr. is wound care service line director at Natchitoches (LA) Regional Medical Center; wound care and lymphedema instructor at the Academy of Lymphatic Studies, Sebastian, FL; physical therapy (PT)/wound care consultant at Louisiana Extended Care Hospital, Natchitoches; and PT/wound care consultant at Cane River Therapy Services LLC, Natchitoches.

Let's Be Frank

1. Dartmouth University. Artificial Intelligence (AI) coined at Dartmouth.
2. McKinney SM, Sieniek M, Godbole V, et al. International evaluation of an AI system for cancer screening. Nature. 2020 Jan; 577(7788):89–94.
3. Mosley M. I’m worried artificial intelligence could make us stupid. Daily Mail. Published Oct. 20, 2018.
4. Cellan-Jones R. Stephen Hawking warns artificial intelligence could end mankind. BBC News. Published Dec. 2, 2014.
5. Carr N. Automation makes us dumb. Wall Street Journal. Published Nov. 21, 2014.


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