Even the most sophisticated programs, however, will likely need to be monitored by humans to put a diagnosis or treatment option in context. Today, as when AI programs such as INTERNIST and MYCIN were developed, "so-called expert systems have knowledge you might characterize as rather thin," says Patrick Winston, former president of the American Association for Artificial Intelligence. "They might know what to do, but they don't have any common sense. So if by some error the program suggested a barrel of penicillin, the program wouldn't know it was illogical."
And even if it works perfectly, a diagnostic AI system still might not be a major part of technology used by physicians in a clinic or hospital. Even though computers are ubiquitous in modern hospitals, novel technologies can initially slow work flow as people learn to use them. "We have to figure out how to motivate people to say, 'Yes, it's slowing me down, but in the long run it's going to make me more efficient or provide better care,'" M.I.T.'s Szolovits says.
Even if the systems flowed seamlessly into the existing practice of medicine, many experts suspect that physicians will be reluctant to use them. "Doctors don't want to lose control," says Vimla Patel, a cognitive informatics researcher at the University of Texas School of Health Information Sciences at Houston. Instead, for these programs to gain wider use they must supplement human expertise, not replace it. For instance, Patel says, "if a doctor has been working around the clock, or is aging, you want to have information that is easily accessible, retrievable and usable" to act as a backup.
By helping doctors keep track of patients' tests, make diagnoses and determine treatments, intelligent technologies could become invaluable in making health care more efficient. Combining the strengths of doctors and smart software could provide better care than either could alone, Szolovits says. "That's arguably a much better system for health care."