A recent study published in JMIR Aging reveals that while artificial intelligence (AI) has vast potential to revolutionize healthcare for older individuals, there are significant tensions between the stakeholders who use AI health technologies and those involved in their development and funding. Researchers from Johns Hopkins University, the University of Iowa, and Washington University in St. Louis conducted this study, which underscores the diverse interpretations of value, usability, and costs among crucial stakeholders. This discord presents systemic obstacles to the adoption of such technologies.
Zhang Zhang, PhD, from the Johns Hopkins Bloomberg School of Public Health and Washington University in St. Louis, led the study alongside senior author Nancy L. Schoenborn, MD, from the Johns Hopkins University School of Medicine, along with a diverse team. They conducted semistructured interviews with 49 representatives from six different groups to identify varying perspectives on the key drivers of decision-making: cost, usability, and perceived value.
Older adults and their care partners emphasized the importance of low out-of-pocket expenses and ease of physical and sensory access. In contrast, clinicians expressed a concern for patient affordability and the need to alleviate workflow burnout. Meanwhile, payers and health system leaders concentrated on overall return on investment (ROI), system integration, and the effects on high-cost health events, while developers and investors aimed at market size, scalability, and profit margins to mitigate substantial regulatory and development risks.
These differing viewpoints contribute to notable points of friction. End users reported feelings of frustration with AI tools that seemed like "solutions in search of a problem." They indicated that the focus of developers on existing technologies often overlooks the specific needs of older adults. Developers and investors, for their part, pointed out that the lengthy 4-to-7-year regulatory timelines and the high financial stakes compel them to pursue significant profit margins, ultimately increasing costs for consumers.
To address these challenges, the authors propose several actionable strategies, including early engagement involving multiple stakeholders, targeted public education initiatives aimed at demystifying AI for older populations, and public-private partnerships like the Johns Hopkins Artificial Intelligence and Technology Collaboratory (JHU-AITC) for Aging Research. They conclude that, similar to previous health technology advancements, aligning the priorities of all stakeholders involved is essential for the successful development of impactful AI health technologies for older adults.
