Digital Determinants of Health: AI and the need for equity-focused innovation in digital health

Abstract

*Nature Reviews Nephrology* welcomes you to this webinar, in which our two speakers — Leo Celi and Kianoush Kashani — will present on the theme of Digital Determinants of Health, with a focus on artificial intelligence (AI) and the need for equity-focused innovation. The webinar will be held on 14th of March 2024 — World Kidney Day — which this year focuses on “Advancing equitable access to care and optimal medication practice”. In their [Comment](https://www.nature.com/articles/s41581-023-00763-4.epdf?sharing_token=ihZn7Tzp1ixBfK7a3X_6x9RgN0jAjWel9jnR3ZoTv0NaWQBzIFRPdPKT7AS3IVVHez49nwrLVjZJyLsCUt5034qu70IjW6yS7U3gUuTEQjm0O_u1j1PiMZLzRs7qKAyY_28RvtE3kXcXmwKeyufyUyKP715Wx73c6p6Bfp6w6Sg%3D) “Digital determinants of health: opportunities and risks amidst health inequities”, Leo Celi and colleagues argue that given the current digital revolution, digital tools and AI applications in health care must be developed with equity at the forefront to avoid perpetuating historical biases and inequities. With their [Consensus Statement](https://www.nature.com/articles/s41581-023-00744-7) on “Digital health and acute kidney injury”, Kianoush Kashani and colleagues highlight some of the potential applications of digital health tools in nephrology, as well as the need for equitable digitization. Artificial Intelligence: The digital determinant of health to rule them all Artificial intelligence (AI) is poised to be the biggest digital determinant of health. From healthcare, to education, to law enforcement, AI can theoretically augment every human task that involves thinking. We will see every decision-making infiltrated by AI. This is why AI is different. Most technologies are much narrower in scope, and therefore, easier to regulate. In addition, the data that we use to build AI reflects everything about the systems we would like to disrupt, both good and bad. Behind the façade of AI lies our legacy systems with all their flaws. The biggest threat to AI delivering its promise stems from the risk of cementing the structural inequities that permeate every aspect of society. AI provides an opportunity to inch us closer to a better care delivery system, but it will require us to design an equity-focused sociotechnical ecosystem. Engineering AI in a vacuum that does not build capacity nor include cultural transformation of how we learn and how we work together will be a waste of time and money, and a huge opportunity cost. To avert the disaster from AI, we need to diversify those sitting at the table. We need to diversify those who are developing and deploying AI. Digital health in acute kidney injury management Acute kidney injury (AKI) is a highly prevalent clinical syndrome that substantially impacts patient outcomes. It is accepted by the clinical communities that the management of AKI is time sensitive. Unfortunately, despite growing proof of its preventability, AKI management remains suboptimal in community, acute care, and post-acute care settings. Digital health solutions comprise various tools and models to improve care processes and patient outcomes in multiple medical fields. AKI development, progression, recovery, or lack thereof, offers tremendous opportunities for developing, validating, and implementing digital health solutions in multiple settings.