IPPOSI CITIZENS JURY ON AI in HEALTHCARE

Editor's Notes

• #2: Derick Mitchell, CEO at IPPOSI for the past seven years. I come from a research and patient advocacy background, worked previously at EU and Member State levels The emphasis IPPOSI places is on the individual, be it the citizen, the patient or the health service user. This is a really important point – and one which (I think) makes a valuable contribution to how business is done within both the public and private sector.
• #5: Policy makers can determine ‘why the public think the way they do’, as opposed to ‘what they think ‘off the top of their head’? Need to account for any bias potentially introduced. Many are arguing for a re-thinking of the wider social contract in healthcare today
• #9: 10 members were identified from health sector -academic, clinical, HSE, policy, digital, patient groups, public representatives Members included experts in health research, regulation, clinical information, digital health, public participation, and patient representation Members have met six times between Mar 2024 to Sept 2024 to input into the various phases of the Citizens’ Jury project Advise on jury design, jury mission, juror selection, witness identification, and juror surveys Jim Blighe, PPI representative, former Juror Zoe Hughes, PPI representative, former Juror Ann Piercy, PPI representative, HIV Ireland Joe Condon, PPI, Early Onset Parkinson’s Disease Ireland Prof. Alan Smeaton, DCU & National AI Advisory Council Prof. Jane Suiter, DCU Prof. Donal Sexton, Nephrologist, St. James’ Hospital Prof. Richard Greene, Chief Clinical Information Officer, HSE Loretto Grogan, National Clinical Information Officer, Nursing & Midwifery, HSE Gar Mac Chriosta, Digital Advisor, HSE Martin McCormack, CEO, College of Anaesthesiologists of Ireland Dr. Sarah Gibney, Dept of Health / DPER Dr. Laura Brady, RCSI & FutureNeuro Research Center
• #10: A process of assessing the eligibility of applications against the following selection criteria was initiated, with applicants required to demonstrate that they were: Aged 18 and over Without a conflict of interest Retired from HSE and/or healthcare profession (as outlined by HSE here) for 7+ years Current students with an interest in the topic Charity employees GDPR, IT security experts in non-health related fields Available for weekday sessions in October Able to consent to data protection impact assessment (DPIA)  181 applications were removed from the list of applicants following this process, some for being under 18, 130 for declaring a conflict of interest, a number for not being available on weekdays, a few for non-consent to the DPIA. gender, age, residential province, ethnicity, educational attainment
• #12: 4 witness sessions – AI uses in self-management, emergency care, complex care, population health Weaving the themes that we know are going to come up – such as patient-clinician relationships; Explainability and accountability; Regulation, workforce training; Health equalities, machine training, consent 2 witnesses for each of the four online session Opposing or alternative perspectives Share ‘evidence’ in advance, pre-reading Make themselves available for ‘questioning’ on deliberation days (23/24 November) Respond to witness testimony arising from juror reflections (post-session collation of unanswered questions) Use of scenarios in session: Each of the scenarios can be used to explore the future possible uses of AI in healthcare in Ireland. Witnesses can point to the advances in AI technology and the policy recommendations that will be needed to balance AI innovation with care. By doing so, this approach allows the jurors to explore the topic and ground new knowledge in real-world examples of the use of AI in healthcare in Ireland both now, and in the future.
• #13: Deliberative: combination of witness testimony, juror cross examination, juror deliberations, juror voting Impact-oriented: focused on responding to the main question – should we increase the use of AI in healthcare? Juror-led: involves jurors in report drafting process and in verdict sharing process
• #14: Laura / Derick
• #15: Our hope is that jury verdicts can help influence health policy makers (or other stakeholders active in the health sector) exploring the topics discussed by the jurors. We also disseminate the verdicts publicly as we believe the perspectives shared and the recommendations proposed by jurors can be helpful in raising awareness of important issues and sparking wider debate among members of the public. Below are some examples of the types of influence the verdicts can have: Policy, legislation or regulation The jury verdict can often point to a gap in policy, legislation or regulation, or similarly point to a need for certain guidelines or laws to be revised or deleted.   The 2021 IPPOSI Citizens’ Jury on ‘Access to Health Information’ influenced the direction of two key documents – the Government’s Health Information Bill, and the Department of Health Digital Health Strategy Framework for Ireland 2024-30.   The 2022 IPPOSI Citizens’ Jury on ‘The Future use of Genomics’ influenced the timing and the content of the National Strategy for Accelerating Genetic and Genomic Medicine in Ireland.   Pilot projects or best practice adoption The jury verdict can often highlight the need for action, or for action to test a good practice or approach.   The 2022 IPPOSI Citizens’ Jury resulted in patient and public representatives being appointed onto the working groups tasked with developing the National Strategy around genomics.   Research The jury verdict can often identify gaps in our collective understanding about an issue or concerns and underline the need for additional research or evidence.   The 2021 IPPOSI Citizens’ Jury was the focus of a DCU research study to evaluate the jury process.   Both the 2021 and 2022 IPPOSI Citizens’ Juries offered IPPOSI an opportunity to gather attitudes from its own members, and to provide opportunities for dialogue around these topics. The results of the 2021 SURVEY were published with the verdict report.   The 2021 IPPOSI Citizens’ Jury helped the SFI-ADAPT research centre develop and deliver its ADAPT’s ‘Citizens’ Think-Ins’ – a series of public forums that bring people together to discuss some of the ethical issues we face in the digital age. https://thinkins.adaptcentre.ie   The 2022 IPPOSI Citizens’ Jury partnered with the SFI-FUTURENEURO research centre to deliver a Deliberative Dialogue on Genomics in Neurological Healthcare & Research in 2023.   Education and training The jury verdict can often support the importance of education and training, collectively or for a particular stakeholder group.   The 2022 IPPOSI Citizens’ Jury led to the funding of an online public education project by the Health Research Board (HRB) on the topic of genetics and genomics.   More public engagement and awareness The jury verdict can underline the need for continued dialogue in relation to a particularly tricky health topic.   The 2021 IPPOSI Citizens’ Jury participants shared their insights with the Department of Health Slaintecare Office, including the Public Engagement Lead, as well as with the Health Research Board (HRB).   The 2022 IPPOSI Citizens’ Jury participants were invited to share their findings with the HSE National Strategy Steering Group, with the Council of Europe Member Representatives on public dialogues in genomic medicine, as well as with members of parliament in Ireland.