Ethical Artificial Intelligence

Though Artificial Intelligence (AI) is a fascinating and useful application of technology, it is also fraught with ethical questions. Nurses train for years to gain the experience and expertise necessary to give their patients the best possible care – why, then, should they trust their patients’ safety and wellbeing to a computer? This is a legitimate question, and one that Ocuvera has gone to great lengths to address at every level of our project.

First, it is worth noting that AI is not entirely new within the healthcare space. Nurses have long trusted software to monitor other aspects of the patient experience, such as vitals. AI has proved valuable in this role because of its ability to automate otherwise menial tasks and offload them to a computer, freeing up time in nurses’ busy schedules to focus on more complex and demanding duties. This is what the Ocuvera system does. Watching video of patients diligently for hours on end is not only not feasible, but also dangerous: even the most attentive and dedicated person could not watch a motionless patient for hours on end with the level of concentration necessary to ensure fall risk is minimized. Ocuvera takes the most tedious aspects of fall risk reduction out of people’s hands, but leaves nurses at the center of the solution when human attention is most needed. The automation ends when the alert is sent, and the decisions about when and how to intervene to best help the patient are left up to the nurse.

The question still remains why nurses should be confident that the Ocuvera system will alert them when their patient is behaving in a way that increases their risk of falling. Our confidence in our algorithms is based on years of research and hundreds of thousands of hours of video. Computer vision is data hungry, and the more data we use to train our predictive algorithms the more accurate the system’s predictions are.

Our video is of real patients in real care settings. While recorded video is necessary for us to design the Ocuvera system to be effective in true hospital settings, we also understand that our patients are trusting us to treat their recordings with the respect and privacy it deserves. Being recorded is an imposition on the lives of patients and their families. That’s why, as part of our commitment to ethical AI, we take patient privacy and dignity very seriously throughout the data collection process. Most of our data collection has taken place in the context of Institutional Review Board (IRB)-approved studies, several of them grant funded. Part of our IRB agreements consists of detailed informed consent procedures, where patients and their families are briefed on what Ocuvera does, why they are being recorded, and that participation in the study is completely optional and they can stop at any time. A “privacy button” is built into the system to allow patients, family, or nursing staff to temporarily disable the system during sensitive moments. To ensure privacy, all patient video is recorded in depth images only. These are images where featureless shapes represent the activity in a patient room, but where personal identifiers such as skin tone and facial features are not visible. Ocuvera’s use of the depth image to protect patient privacy has been approved by four separate IRBs as containing no personally identifiable images.

Patient privacy remains critically important even after data collection ends. No personally identifiable information is stored at Ocuvera: all information linking patients to their identity is kept exclusively at the hospital. All patient video gathered is encrypted and stored on secure hard drives at Ocuvera. Only Ocuvera employees who have undergone human subjects research training through the Collaborative Institutional Training Initiative (CITI) have access to the data. These employees understand the risks and issues associated with video of patients, and always approach patient video with respect.

All of Ocuvera’s methods to ensure our ethical implementation of our AI stem from the understanding that people are the center of healthcare technology. Nurses and patients are not just the end recipients of our product, but central to our mission of empowering nurses to improve patient lives through technology.