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This cutting-edge research center is using AI to enhance quality and equity in America’s healthcare system

Co-directors Ritu Agarwal and Gordon Gao discuss the center’s vision for advancing digital innovation in healthcare, molding the next generation of digital health experts and increasing fairness in the U.S. healthcare system.

The Carey Business School building at JHU. (Courtesy photo)

This article is sponsored by Johns Hopkins University and was reviewed before publication.

Ritu Agarwal spent the first 15 years of her career researching how information technology could be used to improve the way businesses operate, but she wasn’t making the kind of impact she wanted.

So to maximize her influence, Agarwal focused her attention on the medical space to address the longstanding issues within the U.S. healthcare system such as lack of access to providers, high costs and inefficient procedures.

“One day, I woke up and I said, ‘I’m frustrated with using my skills, my knowledge, and not having the kind of impact that I want to have,’” Agarwal said. “I wanted to be spending my time doing things that mattered, not just for academic publication or research purposes, but also from broader societally backed considerations.”

She founded the Center for Health Information and Decision Systems (CHIDS) at the University of Maryland’s Robert H. Smith School of Business in 2005, creating the first research center within a major business school to study the application of information technology in healthcare, focusing on cutting-edge research that could contribute to improving America’s rigid healthcare system.

“Medical practice has a centuries-old tradition of doing things in a particular way,” she said. “Medicine is by nature highly routinized, as it should be because errors can have life and death consequences. But that makes driving change a challenge.”

Agarwal knew it was crucial to work with people who shared her immense devotion to this mission in order to make significant advancements, so she brought on her mentee Dr. Gordon Gao as co-director for CHIDS.

Gao and Agarwal formed a bond through their passion for healthcare research, collaborating on a myriad of research papers that highlight the impact of IT on various aspects of the healthcare industry.

“At that time, everyone believed that healthcare was lagging behind in terms of information technology,” Gao said. “You looked at all the industries and their rate of using IT, and healthcare was only ahead of the mining industry. There was a big push to digitize health records.”

Agarwal’s drive to enact meaningful change never wavered after more than 18 years of leading CHIDS. In fact, the evolution of digital technology since CHIDS’ inception motivated her to expand her outreach.

With AI growing rapidly over the past few years, it was not surprising that CHIDS turned its attention to this disruptive technology that could potentially have enormous implications for medicine.

“I knew from our previous work that digital technology, data [and] analytics can be effective tools if they’re deployed in the correct way, and now we have an incredibly powerful new way to take advantage of all the data that has become available in healthcare,” Agarwal said.

So in August 2022, she teamed up with Gao to launch the Center for Digital Health and Artificial Intelligence (CDHAI) at Johns Hopkins Carey Business School.

The research center collaborates with universities, government agencies, corporations and the entrepreneurial community to conduct research revealing the role, value and challenges of implementing digital health solutions. A particular focus of the center is to understand how to ensure that health equity is front and center in all digital health solutions.

“With any new technology, you want to make sure that the technology doesn’t introduce new biases or intensify health disparities,” Gao said. “This is a challenge with many digital technologies, but with AI this can be especially difficult. We must ensure that AI is not biased against any subpopulations. We want to ensure its safe and responsible use.”

Photo of Gordon Gao and Ritu Agarwal.

Gordon Gao and Ritu Agarwal. (Courtesy photo)

CDHAI also aims to use evidence-based research to shed light on the intersections between digital technologies, AI and racial disparities in hopes of inspiring lawmakers to legislate solutions for these inequities.

With the digital health market projected to hit over $800 billion by 2030, according to a report by Grand View Research, it’s paramount for CDHAI to expose this discrimination while the AI trend is still in its early stages.

“It is terrifying to see the extent to which disparities have permeated health outcomes for people across the world,” Agarwal added. “I strongly believe that governments and policymakers have a moral obligation to make sure that every section of society has an equal opportunity for accessing the healthcare resources they need.”

Addressing this bias starts with educating researchers about how to identify it in the first place.

This is why CDHAI is leading NIH AIM-AHEAD’s Program for Artificial Intelligence Readiness (PAIR) to set up virtual AI research labs at minority-serving institutions. PAIR helps researchers learn how to reduce bias within algorithms by using AI and allows them to apply that knowledge through research projects.

CDHAI also fosters collaboration internally, with several faculty from the Johns Hopkins School of Medicine, Bloomberg School of Public Health and Whiting School of Engineering serving as affiliated faculty who are leaders and contributors to its research projects.

The group has recently launched an outreach program in AIHE (Artificial Intelligence Health Equity) at Hopkins’ new 555 Penn campus in Washington, D.C. The focus of this program is to develop a consortium of key faculty from sister schools and partner with government agencies — like the Food and Drug Administration and Centers for Medicare & Medicaid Services — to foster scientific discovery and knowledge diffusion in AI for health equity.

And the research center’s partnerships aren’t limited to academia and policymakers.

Making an impact

CDHAI develops research initiatives with industry partners like digital health platform Welldoc, healthcare technology solutions company DrFirst and healthcare system MedStar Health.

Plus, CDHAI recently partnered with leading government services company Accenture Federal Services to explore innovations in advanced health analytics modeling and AI, with a special focus on infectious diseases and breast cancer.

CDHAI’s current projects involve addressing disparities in breast cancer care, examining how AI can be used to mitigate disparities in health, exploring digital health interventions that are personalized and data science training for health equity and researcher diversity. While these efforts are critical for the future of healthcare, Agarwal stresses that shifting the minds of policymakers requires patience and persistence.

“The healthcare system that we’re building is for the next generation of consumers, who will have very different expectations of efficiency, quality, ease of access and ease of use,” she said. “We are working hard to diffuse these digital innovations so that we can make healthcare safer, of higher quality, more accessible and equitable and cheaper for the benefit of society.”

These advancements could result in a wave of new healthcare products as well. CDHAI coordinates with Johns Hopkins Technology Ventures (JHTV), a commercialization hub within JHU, to bring its research projects from the lab to the market.

This partnership not only offers students a path toward profiting from their arduous research, but it also serves as a pipeline that develops entrepreneurs whose products take the needs of patients into consideration.

“I want us to have vibrant engagement with the entrepreneurial community and the technology builders who will be constructing this next generation of tools that will transform health care,” Agarwal said.

Gao stressed the importance of new researchers remaining vigilant to the issue of health disparities and being persistent in their pursuit of health equity.

“This is a complex, multi-faceted issue that is not going to be solved by a single training program or research project. But when we unpack the issue incrementally, I am optimistic we will see progress,” he said.

Agarwal believes the research center can establish itself as a central figure in Maryland’s robust ecosystem moving forward.

“It’s a tremendous opportunity to build an organization that is multidisciplinary in nature,” she said. “This particular nexus of technology, analytics, data, AI and healthcare is a space that’s critical to the future of health systems across the world. CDHAI will be the central convener of this.”

Learn more about the CDHAI

Companies: Johns Hopkins

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