Artificial intelligence (AI) has the power to transform healthcare, from making care delivery more efficient to improving patient outcomes and addressing growing workforce needs in an increasingly complex patient care environment.

As health systems and clinicians begin to adopt these new technologies, there are understandable hesitancies among some clinicians. Though AI can play a crucial role in delivering personalized patient care, streamlining operations, and detecting complex patterns within large datasets, some clinicians, including nurses, worry it may exacerbate health disparities by perpetuating biases in existing data, and even potentially alter their job roles and responsibilities. The resistance to AI within healthcare signals the need for safe and responsible implementation strategies with nurses’ essential input.

One effort aiming to enhance the nursing workforce’s AI capabilities is Fostering AI Research for Health Equity and Learning Transformation Hub, a new research and training initiative from the Duke University School of Nursing.

Duke’s AI initiative has a dual mission of improving health equity through advancements in AI education and research. The first-of-its-kind initiative hopes to revolutionize how healthcare professionals are taught about AI and how research is conducted. The objective: building AI systems in healthcare that are rooted in fairness and ensuring that each patient population can reap the benefits of AI without bias or exclusion.

Michael Cary, PhD, RN, FAAN, Associate Professor at the Duke University School of Nursing, has built his career at the intersection of health equity, patient care and data science. By integrating clinical expertise with advanced data analytics, his work focuses on analyzing massive data sets to identify high-risk populations and developed targeted approaches to addressing health disparities, personalizing care, and ultimately improving patient outcomes.

One of his first job experiences after graduating was with a major health insurer’s quality improvement program, where he worked with providers to improve patient satisfaction and health outcomes. When his position and entire office were eliminated, he found inspiration in his supervisor, who encouraged him to return to school to pursue a career in nursing.

Now, as the first African American Tenure Associate Professor in the Duke School of Nursing’s 93-year history, he spends his time designing research proposals and conducting studies focused on developing predictive risk models, with a particular emphasis on mitigating bias and promoting fairness in these models. He also serves on the governance committee of Duke AI Health, which works to develop infrastructures and policies for the equitable and ethical deployment of AI within the health system. Cary works with these teams to ensure the algorithms produce less bias in both results and decision-making.

Cary’s experience in both data science and healthcare delivery uniquely positions him for his role in the initiative, where he focuses on leveraging large data sets and AI tools to improve patient care and preparing health professionals tasked with delivering that care.

“That combination has truly informed the work of [Fostering AI Research for Health Equity and Learning Transformation Hub],” said Cary. “We’re all about enhancing skills for nurses and safely integrating AI into clinical practice, the classroom, and research.”

As a nurse himself, Cary understands the power that nurses hold as healthcare’s most trusted profession. While healthy skepticism of new and disruptive technologies is both normal and encouraged, he urges nurses to see the potential to not only enhance their roles and skills but define them as healthcare’s largest discipline. It’s an opportunity that he doesn’t take lightly, especially as Big Tech takes note of AI’s impact on healthcare.

“I often hear nurses express their concerns,” says Cary. “We’ve been trying to conduct series of surveys to identify the most pressing issues, and we’ve been developing training programs specifically to address those concerns.”

Cary also notices the considerable gap between how nursing schools currently train students and what is expected of them in practice related to the use of AI technology. He notes that nursing schools continue to work with health systems in identifying the competencies that make nurses practice-ready in this new AI driven era and how to best educate them on integrating practical and responsible AI into their clinical work.

Cary is optimistic about what’s on the horizon for Duke’s AI initiative. The growth of AI in healthcare reminds him of his early days at the Duke University School of Nursing when few were focused on utilizing machine-learning and interpreting results in meaningful ways for healthcare. It was a challenge to find resources that advocate for the importance of this work in improving healthcare delivery and patient outcomes. Now, he says, it’s gratifying that others are finally recognizing the value and potential of AI in the field.

Going forward, Cary is focused on building more workshops for the initiative to equip nurses and other health professionals with knowledge about AI and its implications beyond the bedside, but also in governance, evaluation, and more. These workshops prepare health professionals for AI, such as leveraging algorithms in clinical decision-making, while remaining vigilant to the potential of bias.

What excites Cary the most is giving students the opportunity to gain those competencies through research, education and hands-on training, and empowering healthcare’s decision-makers to ensure that AI helps, not harms patients. As nurses become more comfortable with AI as an ally, not an adversary, the potential for improved access and outcomes is significant. Fostering AI Research for Health Equity and Learning Transformation Hub
wants to partner with nurses both locally and around the globe to co-create training programs that improve AI literacy, improve clinical decision making, and ultimately lead to a better patient experience. By actively addressing their concerns and working collaboratively, the initiative helps nurses stay ahead of the curve and confidently embrace AI as tool in service to patients.

Learn more about the role of nurses in technology and informatics as AI is poised to streamline systems and practices. Visit nursing.duke.edu/fairhealth for more information.