CES: FDA Commissioner Robert Califf on Bias in Healthcare

Introduced by Consumer Technology Association VP of Regulatory Affairs David Grossman, FDA Commissioner Robert Califf took the CES stage with interviewer Lisa Dwyer, a partner at international law firm King & Spalding. Califf noted the monumental differences in technology that have taken place between his first stint at the Food & Drug Administration in 2015 and today. “The changes are so dramatic, it’s hard to characterize them,” he said. “We’re moving into a different world.” He’s excited about “the hundreds of products with AI” that can bring so much good to the market but also noted the potential harms.

We’re still in an early stage in the digitization of healthcare, he reports. “You can compare it to when you had to pull off the side of the road to read your map,” he said. “You can see it’s going to be guided by more algorithms but the digitization of everything is something we haven’t fully grasped.”

Connected products for the home is one of the three areas he’s most excited about. Second is the operating room. “With robotics plus digital imaging around the world, there’s no reason why you can’t have the experts scrub in, wherever you are,” he explained.

The harm that bias causes is of particular concern to him regarding his third area of interest: the clinic, or what he calls “bread & butter” healthcare. “Everyone knows it’s suffering,” he pointed out. “You wait forever for an appointment and then have five minutes with the doctor. It’s so obvious that clinicians are distracted from their task by tedious work.”

Digital technologies can relieve much of that, he says, but the problem is that it is “structurally designed to favor people with money and power. “AI will only be good in the system in which it is deployed,” he suggested. “The gatekeepers are suppressing information that will show the problems we have.”

“In terms of life span, the U.S. is in dead last place of high-income countries,” he added. “An unfettered analysis would show why that’s the case, but it’s not getting the priority. If that were unfettered, it would show that we are putting our best clinics not where the need is but where the money is. If we can get bias out of the way, it’ll be a big advantage for where we rate in the list of high-income countries.”

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