The third Healthcare Week Luxembourg (HWL) kicked off on Tuesday 7 October at Luxexpo The Box. The theme chosen this year for this major exhibition dedicated to healthcare, organised on the initiative of the Federation of Luxembourg Hospitals (FHL), with the support of the events agency Quinze Mai, is: "AI in healthcare: a transformation of medical professions and practices." FHL President Philippe Turk takes stock of what is at stake in this forward-looking topic for medicine.
After "the health of tomorrow" last year, the theme of this third edition of the HWL is AI. Has this subject taken centre stage in all the discussions?
Philippe Turk. – “Yes, this subject has come to the fore because we are facing a profound cultural revolution in all areas of healthcare. There is an incredible sense of urgency linked to the speed of development and the range of products on offer in terms of artificial intelligence, while at the same time there is a need for reflection and discussion to consolidate the ethical and regulatory framework within which we want to evolve. AI or AI tools must not be applied in healthcare, at the risk of jeopardising the notion of trust that we all really need, patients and professionals alike.
We mustn't confuse speed with haste?
"Exactly. There's also the whole issue of data, the RGPD and data protection. It's obvious that AI works thanks to health data, so this data needs to be secure and of high quality, because it's often fragmented. On these points, we have ongoing work to do on data, the notion of metadata, what data is used for and how it is defined. One of the challenges, for me, is to be able to put in place sufficiently agile governance to manage all these technological innovations, which will be extremely useful.
Hence the interest in working together, in particular with the European Health Data Space (EEDS)?
"I believe that the time for rivalries is over and that the issues go beyond competition between hospitals, for example, since we are touching on the research sector, start-ups, teaching, universities and so on. I really believe that we need to invent a new form of governance if we are to maintain the cohesion of the system, with a very ambitious outlook. The EEDS is a great adventure for European democracy: our social systems represent 450 million insured people, whose data can be used to support the development of artificial intelligence.
We don't want a black box.
But is the system ready today?
"It is obviously out of the question to let AI decide anything. Healthcare professionals will keep their place, but they will have to adapt, because they will be supported by AI, which must be transparent. We don't want a black box. We want to know why this or that reason was given, and we want to know why it was given. We want to know why this or that line of reasoning is the basis of this or that composition, and so on. So the skills of healthcare professionals need to go up a level and they need to be able to keep that critical mind, so that we don't all become dependent on AI, which has - and will continue to have for a long time to come - biases.
So healthcare staff need to be trained?
"A huge amount of training is needed for all staff and in all areas, whether clinical, research or teaching. Patients, too, will have to take charge of their own healthcare pathway and retain their critical faculties.
Is the government supporting you enough?
"At a time when our sickness funds are announcing progressive deficits, we are being told that we need a lot of money to invest in developments and, on the other hand, we are still being promised quite spectacular efficiency gains. So there's a balance to be struck. I think we need to have the courage to invest, but to invest well, so that we can reap the rewards in terms of system efficiency.
What do you mean by "invest well"?
"I think we need governance structures that go beyond one or two ministries. We need to support cultural change from the top down and provide an effective framework for decisions relating to the implementation of AI. It won't happen overnight: it's a long road ahead."