LEGAL REGIME ON ARTIFICIAL INTELLIGENCE IN

HEALTHCARE SYSTEM

DISSERTATION SUBMITTED FOR THE AWARD OF THE DEGREE OF

MASTER OF LAW (2 YEAR DEGREE COURSE)
IN
CORPORATE LAW

Submitted by:

K.S.S Sowmya
Reg No: 19LULBL003
4th Semester (2020-2021), Corporate and Commercial Law
University Law College & Dept. Of Studies in Law,
Bangalore University, Bangalore

Research Supervisor:

Prof. Dr. Suresh V Nadagoudar

M.A, LL.M, Ph.D.

Principal, Chairman and Research Supervisor

University Law College & Dept. Of
Studies in Law,
Bangalore University, Bangalore.

JULY 2021
 CERTIFICATE

This is to certify that this dissertation, entitled with “LEGAL REGIME ON ARTIFICIAL
INTELLIGENCE IN HEALTHCARE SYSTEM”, submitted by K.S.S SOWMYA for the
award of the Degree of Master of Law, by University Law College & Department of Studies
in Law, Bangalore University is carried out under my guidance and supervision during the
year 2020-2021 and submitted to Bangalore University in partial fulfillment for the award of
the Degree of “Master of Law”. This dissertation topic has not been submitted either in part
or whole to any University or any Educational Institutions for the purpose of an award of any
Degree or any Qualification at any time before this.

Date: Prof. Dr. Suresh V. Nadagoudar

Principal, Chairman &
Place: Research Supervisor
University Law College & Dept of
Studies in Law, Bangalore University,
Bangalore.

I
 DECLARATION

I, K.S.S SOWMYA do hereby declare that this dissertation titled “LEGAL REGIME ON
ARTIFICIAL INTELLIGENCE IN HEALTHCARE SYSTEM”. has been individually
carried out by me under the guidance of my respectable Research Supervisor, Prof. Dr.
Suresh V. Nadagoudar, Principal, Chairman & Research Supervisor, University Law
College & Department of Studies in Law, Bangalore University, Bangalore. The extent of
information collected from the existing literature has been indicated and fully acknowledged
in appropriate places. I, further declare that this dissertation, wholly or in part, has not been
submitted to any other University for the award of any Degree or Diploma.

Date: K.S. S SOWMYA

IV Semester - LLM
Place: Corporate/Commercial Law
Registration No.19LULBL003
University Law College & Dept of
studies in law, Bangalore University,
Bangalore.

II
 ACKNOWLEDGEMENT

In my honest endeavour and persistent effort to do the maximum possible to this LL.M.
dissertation work, I owe my sincere thanks to many who are directly and indirectly
associated. For me, this is more than a customary mention of names and this gratitude comes
straight from my heart.

I express my deep sense of gratitude, indebtedness, and reverence with sincerity to Prof. Dr.
Suresh V. Nadagoudar, Principal, Chairman & Research Supervisor, University Law
College & Department of Studies in Law, Bangalore University, Bangalore, for his academic
guidance and continuous support during the conduct of this dissertation. I am proud and
delighted of having got groomed by a dynamic and versatile scholar. He sowed a seed to my
research problem. The completion of this research is impossible without his support,
guidance and continuous encouragement.

I must acknowledge my thanks with gratitude to Prof. Dr. V. Sudesh, Former Principal,
Chairman & Dean – Faculty of Law, Prof. Dr. N. Dasharath, Dean – Faculty of Law, Dr.
Sathish Gowda N., Dr. Jyothi Vishwanath & Dr. Chandrakanthi L, Associate Professors
of University Law College & Department of Studies in Law, Bangalore University,
Bangalore for their encouragement and support.

I also extend my thanks to Smt. B G Shivakumari, Librarian, University Law College &
Department of Studies in Law, Bangalore University, Bangalore, for their help in my research
work.

I would like to express the heartfelt gratitude to my parents Shri K.V Subrahmanyam and
Smt. Gowri for their divine blessings and constant support in completing this dissertation
work without any hardship.

Date: K.S.S SOWMYA

Place: Bangalore

III
LIST OF ABBREVIATIONS

AI : Artificial Intelligence

ANN : Artificial Neural Network

CNN : Convolutional Neural Network

ML : Machine Learning

DARPA : Defence Advanced Research Projects Agency 

NN : Neural Network

PC : Personal Computer

CPU : Central Processing Unit

GPU : Graphics Processing Unit

R&D : Research and Development

BVLC : Berkeley Vision Learning Centre

DNN : Deep Neural Network

CNTK : Microsoft Cognitive Toolkit

UCLH : University College London Hospital

NLP : Natural Language Processing

EHR : Electronic Health Record

ANI : Artificial Narrow Intelligence

AGI : Artificial General Intelligence

IV
ASI : Artificial Super Intelligence

HIMSS : Healthcare Information and Management Systems Society Inc.

MRI : Magnetic Resonance Scanning

CT : Computed Tomography Scanning

CDSS : Clinical Decision-Making Support Systems

IDC : International Data Corporation

EMR : Electronic Medical Record

IoT : Internet of Things

EP data : Electro Physiological data

FDA : Food and Drug Administration

UV : Ultra violet Rays

NYU : New York University

DISHA Act : Digital Information Security in Healthcare Act, 2018

NDHA : National Digital Health Authority

IT : Information Technology

ECG : Electro Cardio Gram

CORE : Centres of Research Excellence

ICTAI : International Centre for Transformational AI

CSTS : Centre for Studies on Technological Sustainability

RCH : Reproductive Child Healthcare

IDSP : Integrated Disease Surveillance Program

IHIS : Integrated Health Information System

V
EVIN : Electronic Vaccine Intelligence Network

IHIN : Integrated Health Information Platform

CGHS : Central Government Health Scheme

NHP : National Health Portal

NIN : National Identification Number

ORS : Online Registration System

NMCN : National Medical College Network

HMIS : Health Management Information System

CDSCO : The Central Drug Standard Control Organisation

MeitY : Ministry of Electronics and Information Technology

NeGD : the National E-Governance Division

NASSCOM : the National Association of Software and Service Companies

DIAT : The Defence Institute of Advanced Technology

NIPI : The Norway India Partnership Initiative

UAV : Unmanned Aerial Vehicle

NIC : Designed by National Informatics Centre

SOI : Survey of India

NMA : India’s National Mapping Agency

IIIT : The Indraprastha Institute of Information Technology

VI
TABLE OF CONTENTS

i. Certificate i
ii. Declaration ii
iii. Acknowledgement iii
iv. List of Abbreviations iv

CHAPTER – 1

INTRODUCTION 1

1.1 Statement of the problem 2

1.2 Objectives 3
1.3 Hypothesis 3
1.4 Scope and significance of the study 3
1.5 Research methodology 5
1.6 Literature review 5
1.7 Chapterisation and Scheme of Study 6

CHAPTER II

ARTIFICIAL INTELLIGENCE: CONCEPT AND MEANING

2.1 Introduction 10
2.2 Evolution of Artificial Intelligence 11
2.2.1 The 1950’s to 1970’s 11
2.2.2 The 1970’s to 2000’s 12
2.2.3 From 2000 to 2020: Advancements in AI 12
2.3 Meaning of Artificial Intelligence 14
2.4 Tools of Artificial Intelligence 14
2.5 Aspects of Artificial Intelligence 18
2.5.1 Deep Learning 18
2.5.2 Facial Recognition 18
2.5.3 Automate Simple and Repetitive tasks 18
2.5.4 Data Ingestion 19
2.5.5 Chatbots 19
2.5.6 Quantum Computing 19
2.5.7 Cloud Computing 20
2.6 Conclusion 20

CHAPTER III

ARTIFICIAL INTELLIGENCE IN HEALTHCARE SYSTEM

3.1 Introduction 21
3.2 Artificial intelligence in healthcare across different domains 21
3.3 Categories of AI in Healthcare System 28
3.3.1 Machine learning – Neural networks and deep learning 28
3.3.2 Natural Language Processing 29
3.3.3 Rule-based Expert Systems 30
3.3.4 Reactive Machines 30
3.3.5 Limited Memory 31
3.3.6 Theory of Mind 31
3.3.7 Self-aware 31
3.3.8 Artificial Narrow Intelligence 31
3.4 Pros and cons of Artificial Intelligence in healthcare 32
3.4.1 Pros of AI in Healthcare 32
3.4.2 Cons of AI in Healthcare 34
3.5 Conclusion 36
CHAPTER IV

ARTIFICIAL INTELLIGENCE IN HEALTHCARE SYSTEM: AN ANALYSIS

4.1 Introduction 37
4.2 Decision making and Artificial Intelligence in healthcare system 38
4.2.1 Clinical Decision-Making Support Systems 39
4.2.2 Shared decision making 40
4.3 Future of Artificial Intelligence in Healthcare 41
4.4 Use of Artificial Intelligence in the storage of patient data 44
4.5 Storage of information of various diseases with the help of Artificial 46
Intelligence
4.6 Conclusion 47

CHAPTER V

APPLICATION OF ARTIFICIAL INTELLIGENCE IN MEDICAL DIAGNOSIS

5.1 Introduction 49
5.2 Diagnosis of diseases with the help of Artificial Intelligence 49
5.2.1 How machines learn to diagnose 50
5.2.2 Medical Diagnosis Process using Machine Learning 50
5.2.3 Medical Diagnosis using Deep Learning 51
5.2.4 Help with training or diagnosis in under resourced areas 53
5.3 Treatment of diseases using Artificial Intelligence 53
5.3.1 Virtual Nursing Assistants 54
5.3.2 Image Analysis 54
5.4 Impact of Artificial Intelligence on patient safety 54
5.4.1 Diagnostics 55
5.4.2 Medical AI in consumer devices 55
5.4.3 Assessing the impact of AI on Physicians 55
5.5 Role of robotics in surgery 56
5.5.1 Types of medical robots used in healthcare 58
5.5.2 How Artificial Intelligence is used in Robotics 60
5.5.3 Benefits of Robotics in healthcare 61
5.6 Conclusion 61
CHAPTER VI

LEGAL REGIME OF ARTIFICIAL INTELLIGENCE IN HEALTHCARE SYSTEM

AND EXAMPLES OF SOME TOP COMPANIES

6.1 Introduction 63
6.2 Threats and risks faced by Artificial Intelligence in Healthcare 64
6.2.1 Data digitization and consolidation 64
6.2.2 Updating Regulation 64
6.2.3 Human Interventions 64
6.2.4 Errors and Injuries 65
6.2.5 Privacy Issues 65
6.2.6 Inequality and Discrimination 65
6.2.7 Professional Reshuffling 66
6.3 Liability issues 66
6.3.1 Unanswered Questions 66
6.3.2 Torts and Private Causes of Action 67
6.3.3 Information Technology Act, 2000 (“IT Act”)  68
and Information Technology (Reasonable Security Practices and Procedures
and Sensitive Personal Data or Information) Rules, 2011
6.3.4 Digital Information Security in Healthcare Act, 2018 (DISHA) 68
6.3.5 Artificial Intelligence and Medical Negligence Interface 69
6.4 Government initiatives with respect to Artificial Intelligence 69
6.4.1 Ministry of Health and Commerce 70
6.4.2 Ministry of Health and Family Welfare 71
6.4.3 IPR Regime 71
6.4.4 Data Protection Laws 71
6.4.5 IT Act, 2000 71
6.4.6 NITI Aayog-National Strategy for Artificial Intelligence 72
6.4.7 India AI-The national AI Portal of India 73
6.4.8 National Program for Government Schools: Responsible 74
AI for Youth
6.5 Artificial intelligence in healthcare market and top companies 75
6.6 Artificial Intelligence and COVID-19 80

I
 6.6.1 AI-Powered tools for screening of COVID-19 81
6.6.2 Mobile applications for preliminary screening of COVID-19 81
6.6.3 AI for containment of Corona Virus 82
6.6.4 Mobile applications for COVID-19 contact tracing and 82
further investigation
6.6.5 AI for treatment and remote monitoring of patients 82
6.7 Conclusion 83

CHAPTER VII
CONCLUSIONS AND SUGGESTIONS 84
BIBLIOGRAPHY 95
 CHAPTER - 1
INTRODUCTION
Artificial intelligence (AI) is a sub-field of Computer Science and Engineering. In the word
Artificial Intelligence, the first word “Artificial” indicates the objects that are made or
constructed by human beings and the second word “Intelligence” denotes the ability to form
tactics to accomplish the goals by communicating with information-rich surroundings hence
Artificial Intelligence on a whole is mostly concerned about the intelligent behaviour of
machines. Artificial intelligence in healthcare refers to the use of complex algorithms
designed to perform certain tasks in an automated fashion. When researchers, doctors and
scientists inject data into computers, the newly built algorithms can review, interpret, and
even suggest solutions to complex medical problems. The term “Artificial Intelligence” was
first introduced at a conference at Dartmouth College in 1956.
Artificial intelligence is becoming increasingly advanced day by day at accomplishing tasks
that humans do with more efficiency. From finding new connections between genetic codes
to performing robotic-assisted surgery the lives of patients, doctors, and hospital
administrators had become easy with the introduction of AI in healthcare. In today’s world
technologies have become part and parcel of the healthcare system. In addition to this many
healthcare institutions are encouraging AI-driven computers to make decisions with little
human interference. But on the contrary, it is always believed that these programmed systems
might make wrong decisions with their own understanding and without any human
interventions.

The mechanism of healthcare is a data-driven one. With the increased digitization in

healthcare, most of the amount of data is obtained not only from hospitals but also from other
segments of healthcare industry such as medical insurance, life sciences, medical research
etc. The evolution of machine learning and artificial intelligence equips us with more
opportunities for providing high quality patient care, respond to emergency situations and
save more lives on the clinical front along with an optimisation of the use of resources. It also
improves the processes and services with a reduction in the costs. With the use of artificial
intelligence in healthcare helps in predicting future outcomes (predictive analytics) for
current situation.

1
To improve the quality of healthcare, artificial intelligence has gained attention in healthcare
research and practice.

Taking all the above advantages of Artificial Intelligence in healthcare the researcher had
aimed to study the importance of Artificial Intelligence in healthcare sector. This dissertation
discusses about the progress and adoption of AI across all sectors, the challenges, and
problems of AI in healthcare. The study about Artificial Intelligence provides a review of
existing and near-future applications of AI in this sector from the point of view of their
potential benefits and pitfalls, ethical and social impact. This research can be extended for the
healthcare professionals to understand how, when, and where AI can be most effective and
achieve the greatest impact.

1.1 STATEMENT OF PROBLEM:

Technology plays a major role in achieving the perception of a connected healthcare

ecosystem. Many of the medical instruments that are used in hospitals/ clinics, mobile care
applications, wearables and sensors are all part of various types of technology and the play an
important role in transforming this ecosystem. Despite all these efforts, there are several
challenges in the present healthcare system in India. Few of these include insufficiency in
basic healthcare services, inadequate availability of medical personnel, quality assurance,
inadequate outlay for health and most importantly insufficient equipment to research. Since
the extent of these challenges is important, the government alone might not be sufficient to
solve these problems. Hence the solution we can seek here is to make the private sector take
part in solving the problems, while the government continues to invest. A midst of all these
Artificial Intelligence also plays a significant role in expanding the level of Indian healthcare
system. Though Artificial Intelligence does not eradicate all the problems in the healthcare
sector it might be a great help in meeting the demands of the patients and doctors with regard
to various situations. The main reasons behind the introducing Artificial Intelligence in the
field of healthcare are as follows –
a. Delay in the diagnosis process
b. Non availability of efficient medical personnel
c. Inadequate availability of data with regarding to various diseases.
d. Lack of transparency in dealing with medico legal cases.
e. Threat to patient safety

2
 To verify the usefulness of AI to address the above said issues from which the present
healthcare system is suffering from and to make it more effective and efficient.
1.2 OBJECTIVES:
1. To study the evolution and development of Artificial Intelligence with special
reference to healthcare system.
2. To verify the programs of AI in diagnosis processes, treatment protocol development,
drug development, personalized medicine, and patient monitoring and care.
3. To Analyse large amounts of data related to diseases, medicines etc.
4. To understand patient safety and to enhance faster diagnosis of diseases through
Artificial Intelligence.
5. To understand the drawbacks and deficiencies in handling of medico legal cases and
healthcare system.
6. To make appropriate suggestions to address the problem.
1.3 HYPOTHESIS:

 The application of Artificial Intelligence in the field of healthcare ensures safety and
transparency.
 The present system of AI in healthcare system is suffering from drawbacks and
deficiencies and they need to be addressed to make the system more efficient.

1.4 SCOPE AND SIGNIFICANCE OF STUDY:

Artificial Intelligence started serving medical sector in various ways. The scope of the study
in short is to study the application and impact of Artificial Intelligence in various sectors of
the healthcare system. There is a need to understand the use of technology in the field of
healthcare system to rectify the flaws in the healthcare system. It helps the medical
researchers and professionals in taking data from the medical history of cancer patients to
help the doctors in making a better diagnosis. Some organizations are using AI to help
patients get telemedicine.
Today! The medical world lives with a huge amount of knowledge, which has arisen from
laboratory tests and clinical and physiological observations. As clinicians began to shift in
clinical practice from accidental analysis and belief on the accuracy of their observation to
the analysis of various data and structured algorithms, supported continuously updated sets of
knowledge to enhance the power to diagnose a disease or predict patient outcomes 1. Several
1
The scientific world, “Importance of Artificial Intelligence in Modern Healthcare System”, published on Mar
7, 2021, Accessed on Jun 8, 2021

3
sorts of AI are already in use by the world's health care providers and drug and food
development companies. With algorithms already surpassing radiologists in detecting
malignant tumors and guiding researchers in the way to build clinical scientific trials with the
assistance of AI, it'll take several years before official bodies and international health
organizations adopt the utilization of AI as a reliable medical partner.AI technology is often
tried in matters like analyzing data, and this needs the machine to find out something called
tongue Processing. There are many medical procedures in which the application of AI is
found to be important. they are:
 Collecting information data from patient discussions and checks.
 Applying several causes of data to derive a particular identification.
 Defining an applicable cure technique.
 Arranging and controlling the chosen cure technique
 Treating and examining outcomes of the result.
 Rehabilitation, continuation arrangements.
 Observing patient involvement in deciding.
Although there are many cases during which AI can perform the specified work better or
almost like humans, the moral issue in enabling the machine or giving it the responsibility for
health care is to maintain accuracy in the decision making and thus the machine remains the
assistant and not the medical decision-maker. Therefore, machine learning cannot replace the
doctor, but doctors who learn and use AI will replace the normal doctors.
AI can in turn analyse the database of patients with similar symptoms and suggest the
treatment that was the most successful in those cases thereby avoiding errors. As a part of this
many major organizations, including IBM and MICROSOFT, are collaborating with medical
institutions to solve the various problems present in the healthcare sector. AI enhances the
capacity of healthcare professionals to better understand the daily patterns and requirements
of the people they care for, which would in turn help them in providing better feedback,
guidance and support for staying healthy. In many countries AI is already being used to
identify the diseases, such as cancer in their early stages. The growth of consumer wearables
and other medical devices linked with AI is applied to detect the early stages of various
diseases such as heart diseases etc. which would enable the doctors and other caregivers to
better monitor and detect the diseases.

1.5 RESEARCH METHODOLOGY:

4
Doctrinal Method of Research would be depended upon for conducting the research. For the
doctrinal methods various books on Artificial intelligence and Healthcare, role of machine
learning in medicine etc. will be investigated. The dissertation paper has reached the findings
based on the data collected through various sources. Further books, case laws and other
references would be used for guidance to give the research paper a firm structure. Along with
the above primary sources secondary and electronic resources have been mostly used to
collect the information and data about the topic. Websites, articles and reports have also been
referred here. Footnotes are also given in the places wherever they are necessary.
1.6 LITERATURE REVIEW:
Panesar, Arjun in his book machine learning and AI for healthcare concentrates mainly on
machine learning and AI for healthcare. He explains about the practical applications of
artificial intelligence (AI) and machine learning in healthcare. This book offers a great
knowledge about machine learning algorithms, design, and applications of learning in
healthcare. The book provides a guided tour about the future of AI in population and patient
health optimization. Machine learning and AI for healthcare provides techniques on how to
apply machine learning within your organization and evaluate the efficacy, suitability, and
efficiency of AI applications.
Parag Suresh Mahajan’s artificial intelligence in healthcare deals with the relationship
between artificial intelligence (AI) & healthcare and improvement healthcare with the use of
AI. As artificial intelligence (AI) is revolutionizing all aspects of healthcare this book would
guide about the current and future applications of AI in healthcare. It discusses the use of AI
in healthcare and its vital role in all major medical specialties.
Articles written on the need of technology in healthcare sector by various doctors such as Dr.
Raviganesh Venkataraman CEO of Cloudnine Hospitals and Dr. Ashutosh Raghuvanshi MD
and CEO of Fortis Hospitals were also referred as a part of research. Through the above
review of literature, the researcher has made an attempt to study the various concepts and
various applications of AI in the healthcare system so that the research on the present study
goes in a right path.
1.7 CHAPTERISATION AND SCHEME OF STUDY:
The researcher has categorised the research work into following chapters.
CHAPTER I: Introduction
This chapter deals with a general introduction of the study. It also discusses about the
significance of the study; the statement of the research problem; hypothesis; the research
method; and literature information and finally the chapter concludes with the overview of

5
each chapter of the research. Finally, the chapter concludes with the scheme of the study of
the research.

1.1 Statement of the problem

1.2 Objectives
1.3 Hypothesis
1.4 Scope and significance of the study
1.5 Research methodology
1.6 Literature review
1.7 Plan of study

CHAPTER II: Artificial Intelligence: Concept and Meaning

This chapter explains the meaning of the concept of Artificial Intelligence and the evolution
of Artificial Intelligence. It also provides us the information about the tools of Artificial
Intelligence that are helpful in the healthcare system along with a discussion about the aspects
of Artificial Intelligence. Finally, the chapter concludes with the overview of the chapter.

2.1 Introduction
2.2 Meaning of Artificial Intelligence
2.3 Evolution of Artificial Intelligence
2.4 Tools of Artificial Intelligence
2.5 Aspects of Artificial Intelligence
2.6 Conclusion

CHAPTER III: Artificial Intelligence in Healthcare System

In this chapter the focus is laid on the role of Artificial Intelligence in various areas of
medical research along with an explanation about the categories of AI in healthcare system. It
also describes the advantages and disadvantages of Artificial Intelligence in healthcare
system and Artificial Intelligence across different domains. Finally, the chapter concludes
with the overview of the chapter.

3.1 Introduction
3.2 Artificial intelligence in healthcare across different domains
3.3 Categories of AI in Healthcare System
3.4 Pros and cons of Artificial Intelligence in healthcare
3.5 Conclusion

6
CHAPTER IV: AI in Healthcare System: An Analysis
This chapter explains about the importance of Artificial Intelligence on decision making
process with an emphasis on the future of Artificial Intelligence in healthcare system. The
chapter also describes about the role of Artificial Intelligence in the storage of information of
various diseases and use of Artificial Intelligence in the storage of patient data. Finally, the
chapter concludes with the overview of the chapter of the research.

4.1 Introduction
4.2 Decision making and Artificial Intelligence in healthcare system.
4.3 Future of Artificial Intelligence in Healthcare
4.4 Use of Artificial Intelligence in the storage of patient data.
4.5 Storage of information of various diseases with the help of Artificial Intelligence
4.6 Conclusion

CHAPTER V: Application of Artificial Intelligence for Medical Diagnosis

In this chapter an attempt is made to explain the diagnosis of disease using Artificial
Intelligence along with a discussion about the treatment of such diseases using Artificial
Intelligence. The chapter also emphasises on the study of impact of Artificial Intelligence on
patent safety and the role of robotics in surgery. Finally, the chapter concludes with the
overview of the chapter.

5.1 Introduction
5.2 Diagnosis of diseases with the help of Artificial Intelligence
5.3 Treatment of diseases using Artificial Intelligence.
5.4 Impact of Artificial Intelligence on patient safety
5.5 Role of robotics in surgery
5.6 Conclusion

CHAPTER VI: Legal Regime of Artificial Intelligence in the Healthcare System and
Examples of Some Top Companies
In this chapter the risks faced by Artificial Intelligence are discussed. Further the chapter also
concentrates on liability issues in case of medico legal cases. When Artificial Intelligence is
used in the healthcare system, the initiatives undertook by government for the application of
AI in healthcare system and some of the examples of companies which discusses about the

7
application of AI in medicine. Finally, the chapter concludes with the overview of the
chapter.

6.1 Introduction
6.2 Threats and risks faced by Artificial Intelligence in Healthcare
6.3 Liability issues
6.4 Government initiatives with respect to Artificial Intelligence
6.5 Artificial intelligence in healthcare market and top companies
6.6 Conclusion

CHAPTER VII: Conclusions and Suggestions

At the end of the research work, the researcher has stated suggestions which will be useful for
better implementation of Artificial Intelligence in healthcare system.
Conclusion
Suggestions
BIBLIOGRAPHY

8
 CHAPTER – II
ARTIFICIAL INTELLIGENCE: CONCEPT AND MEANING
2.1 INTRODUCTION
Artificial Intelligence (AI) is a new domain of science and technology. It had already created
its mark in many human activities at all societal levels starting from individuals to social
groups, corporations and nations. The spread of AI is rapidly found in almost all the sectors
of society such as industrial, economical and societal sectors. Along with the rise in
Information technologies to commerce, manufacturing, space, remote sensing, security and
defence, transport and vehicles and from XXI century, it is found to be more effective in the
sector of Medicine and Health Care.
In the present contemporary world AI techniques have gained more importance across
healthcare. Though human physicians cannot be replaced by machines AI can certainly give
assistance to the physicians in arriving at better clinical decisions or in restoring the human
decision in some areas of healthcare (eg. radiology). The rise in accessibility of healthcare
data and the expeditious development of data analytic methods has made the applications of
AI successful in healthcare. This study provides a review of existing and near-future
applications of AI in this sector from the point of view of their potential benefits and pitfalls,
ethical and social impact.

This dissertation examines the progress and adoption of AI across all sectors, the challenges
and promise of AI in healthcare, and takes the position that integrating this technology into
existing workflows at the point of care is essential to widespread adoption. It’s also a guide
for healthcare professionals to understand how, when, and where AI can be most effective
and achieve the greatest impact. While AI is becoming ubiquitous, we have yet to realize the
game-changing clinical, operational, and financial opportunities that await us in healthcare.
However, AI has already begun making progress to solve process inefficiencies, tedious and
expensive procedures, guard against human error, and promises to usher in a new era of
patient care. Unlocking this potential will require a closer collaboration between the creators
of AI and the providers who use it since the contours of healthcare are complex, dynamic,
and highly regulated.

2.2 EVOLUTION OF ARTIFICIAL INTELLIGENCE:

9
The use of computers in replicating the intelligent behaviour and critical thinking of a human
was first explained by Alan Turing in 19502. Turing has introduced a test known as the
“Turing test,” to find out the capability of computers in determining human intelligence.
Later, John McCarthy had stated that artificial intelligence (AI) is “the science and
engineering of making intelligent machines.AI has developed drastically over the past 5
decades.
Moving on to the area of healthcare India faces many issues with regard to the distribution of
healthcare wherein these issues are mostly related to the dearth of clinicians, insufficient
infrastructure and inadequate government investment, costs of the treatment, late diagnosis
etc. However along with the urbanization the government started to show more enthusiasm
for new innovations and sustainable projects. As a result of this the Indian government
increased the application technology in the area of medical research, hospital operations and
robotic surgeries3.

2.2.1 The 1950s to 1970s

Before the focus of AI was merely on the capability of machines to make inferences or
decisions. It is the industrial robot arm (Unimate; Unimation, Danbury, Conn, USA) which
has first joined the assembly line at General Motors in 1961 and its focus was mainly on
automated die casting4.
Later in1964 Joseph Weizenbaum has brought Eliza into the market which was able to
communicate using pattern matching and substitution methodology to mimic human
conversation. This was in turn considered as future chatter bot.
Then in 1966, “the first electronic person,” was discovered by Shakey and this was also
considered as the first mobile robot with the potential to interpret instructions. This has got
the capacity to process more complex instructions. This was one of the important
developments in the field of robotics and AI. Later when the Medical Literature Analysis and
Retrieval System and the web-based search engine Pub Med by the National Library of
Medicine had come into existence in 1960s they became an important digital resource in the
field of bio-medicine.

2.2.2 The 1970s to 2000s

2
Vivek Kaul MD, Sarah Enslin and Seth on “A Gross MD on History of Artificial Intelligence” in Volume 92,
Issue 4, October 2020, Pages 807-812, Accessed on Jun 5, 2021
3
“Evolution of AI”, posted by Leapfrog company, posted on Aug 16,2019, Accessed on Jun 1,2021
4
Shani is founder and CEO of Adgorithms, “From Science Fiction to Reality: The Evolution of Artificial
Intelligence”, Accessed on Jun 10,2020

10
Many of them refer to 2 major winters: the first in the late 1970s, the period in which various
limitations in AI are observed, and the second in the late 1980s till early 1990s, where an
excessive cost in enhancing and maintaining digital information databases are observed. This
mainly helped in developing The Research Resource on Computers in Bio-medicine at
Rutgers University.
Later in 1973 the Stanford University Medical Experimental–Artificial Intelligence in
Medicine, a time-shared computer system, has invented updated networking abilities among
clinical and biomedical researchers.
The first prototype to exhibit the practicality of AI to medicine was the development of a
consultation program for glaucoma using the CASNET model which is considered as a
causal–association network comprising of 3 separate programs. This is basically used to
apply information about a particular disease to patients and as well as to the physicians
thereby helping them by providing advice on patient management. As a part of this a system
called “backward chaining” was introduced in the early 1970s and its concentration
was based on input of patient information.
Moving on to 1980s, the University of Massachusetts has introduced DXplain, a decision
support system whose emphasis was on the use of inputted symptoms to generate a
differential diagnosis. 
Then finally by late 1990s, ML was brought specifically in the medical world along with the
above technological developments. This in turn has set a new stage for the modern era of AI.

2.2.3 From 2000 to 2020: Advancements in AI

The next advancement in the journey of healthcare towards AI is the invention of a new
technology called DeepQA. This particular technology helps in drawing information from a
patient’s electronic medical record and other electronic resources. DeepQA helps in
providing evidence-based medicine responses as it uses natural language processing to
examine data over unstructured content. 
As a result of the improvement in computer hardware and software programs, digitalize
medicine had become more readily available, and a rapid growth was observed in the field of
AI in healthcare. Along with Siri, in 2011 and Alexa, in 2014 pharma Bot was a chat-bot
which was introduced in the year 2015 to aid in medication education for pediatric patients
and their parents. Mandy was another advancement brought in 2017 as an automated patient
intake process for a primary care practice.

11
A network called convolutional neural network (CNN) is a type of deep learning algorithm
which is implemented to image processing that replicates the conduct of interlinked neurons
of the human brain. As CNN comprises of several layers it analyses the input image to
identify patterns and create specific filters. Few of such CNN algorithms are Le-NET, Alex
Net, VGG, Google Net etc.
Finally, the first attempt to introduce Artificial Intelligence in healthcare was made in the late
XX century when Dendral was inaugurated in the Stanford University, USA and this is
considered to be the first tool of Artificial Intelligence in the healthcare system. But
originally it was used to assist chemists in recognizing unknown organic molecules. As
Dendral was considered as the first Artificial Intelligence in healthcare was named as father
for many Artificial Intelligence systems in healthcare. Further it was decided that if AI has to
provide any assistance it has to be guided by expert physicians. This has finally paved a way
for the advancement of Artificial Intelligence in healthcare.
In the first half of the 20th century, science fiction familiarized the world with the concept of
artificially intelligent robots.
These successes coupled with the approval of leading researchers convinced government
agencies such as the Defence Advanced Research Projects Agency (DARPA) to sponsor AI
research at several institutions. In 1997 IBM’s Deep Blue, a chess playing computer program
has defeated world chess champion and grand master Gary Kasparov and this loss has led to
an artificially intelligent decision-making program. Further in the same year another software
was developed by Dragon Systems and it was named as speech recognition software. This
was considered as a great step in the direction of the spoken language interpretation
endeavour. Finally, it was believed that there weren’t any which problem machines couldn’t
handle and hence this belief paved way for the introduction of artificial intelligence in the
area of healthcare.
2.3 MEANING
Artificial Intelligence is the capability of a computer programme to perform tasks or
reasoning processes that we usually associate with intelligence in a human being.

Artificial intelligence (AI) is defined as the intellectual capacity of machines contrary to the
mental capacity of humans or other living beings. AI basically deals with the study of
‘‘intelligent agents”. These intelligent agents are agents or instruments which recognizes and
understands its surrounding to achieve its objectives. AI also refers to the set of
circumstances wherein machines and devices can replicate human minds in studying and

12
understanding the problem-solving techniques. This type of intelligence is known as machine
learning (ML).
AI basically consists within itself a system of both software and hardware. As far as software
is concerned AI specifically deals with algorithms wherein an artificial neural network
(ANN) is used for executing AI algorithms. It is actually an imitation of the human brain
along with an interlinked network of neurons. These neurons are in turn burdened with
communication channels between them. Every single neuron can respond to multiple stimuli
from adjacent neurons, and this would result in the change of whole network.
Next is the neural network (NN) which is used to generate outputs to environmental stimuli.
In the recent times NNs have gained more importance as they contain more layers of neurons
in the network to reciprocate a human brain. Moreover, additional functions can also be
included into the NN. As far as hardware is concerned AI is mainly associated with the
execution of NN algorithms on a physical computation platform.
2.4 TOOLS OF ARTIFICIAL INTELLIGENCE:
Few of the most significant tools of Artificial Intelligence are:

Scikit learn:

Scikit-learn is considered as one of very familiar ML libraries. It strengthens most of the

regulated and unsupervised learning calculations5.

 It basically enlarges on two necessary libraries of Python, NumPy and SciPy.

 It consists in itself a lot of computations for regular AI and data mining assignments,
including bunching, relapse and order. With this AI even operations like modifying
the information, feature governance and ensemble techniques can be implemented in a
pair of lines. 

TensorFlow:

The interesting thing about TensorFlow is that when you formulate a program in Python, you
can set out and keep running either on our CPU or GPU. So, this reduces the use of C++ or
CUDA level to run on GPUs. 
It makes use of an organization of multi-layered hubs that allows us to rapidly construct,
instruct and send counterfeit neural systems with huge datasets. This is the thing that permits
5
Sayantini. ‘Top 10 Artificial Intelligence tools you need to know’, Updated on November 25, 2020, Accessed
on Jun 22,2021

13
Google to identify questions in photographs or understand verbally expressed words in its
voice-acknowledgment application. 

Theano:

Theano is overlapped over Keras, an unusual state of neural systems library that goes on
along with the Theano library. Keras’ basic suitable position is that it is a moderate Python
library that keeps running over Theano or TensorFlow.

 It was introduced to make studying models as quick and simple as feasible for
innovative work.
 It goes on with Python 2.7 or 3.5 and can harmoniously execute on GPUs and CPUs.

The main thing that separates Theano is that it makes use of the PC’s GPU. This allows it to
make information escalated counts to multiple times quicker than when kept running on the
CPU alone. Theano’s speed is found to be more profitable for studying and other estimated
complex undertakings.

Caffe:

 ‘Caffe’ is an extreme learning structure which is made keeping in view the fluency, speed,
and measured quality as a topmost priority. It is introduced by the Berkeley Vision and
Learning Centre (BVLC) and by network donors. The main basis for Google’s Deep Dream
is the Caffe Framework. 

Mx Net:

It permits for trading computation time for memory via ‘forgetful backprop’ which is utilized
for repetitive nets on very long series.

 Constructed with flexible adaptability in mind.

 Many cool features, like writing custom layers in high-level languages.
 Contrary to almost all other important frameworks, it is not directly regulated by a
huge corporation which is a healthy situation for an open source, community-
developed framework.
 TVM support, which will enhance deployment support in future, and permit running
on a whole host of new device types.

14
Keras:

Keras denote python way of doing things. It is a high-end library for the sake of neural
networks, using TensorFlow or Theano as its back-end.  
The majority of practical problems are more like:

 Adopting an architecture necessary for a problem,

 for image acknowledged problems – utilizing weights trained on Image-net,
 Building a network to optimize the results (a long, iterative process).

Compared to all the above Keras is found to be a gem. It also proposes a conceptual layout
which can be easily transformed to other frameworks, if required.

PyTorch:

PyTorch is one of the AI system which is introduced by Facebook. Its code is available
on GitHub . It has taken up a great deal of energy from 2017 and is in a constant reception
development from then.

CNTK:

CNTK empowers users to easily perceive and linkup all the well-known model types such as
feed forward DNNs, convolutional nets (CNNs), and recurrent networks (RNNs/LSTMs). It
executes stochastic gradient descent (SGD, error back propagation) learning with pre-
programmed differentiation and parallelization across wide variety of GPUs and servers.

Auto Machine Learning:

Auto ML is also considered as one of the powerful and a fairly current addition to the arsenal
of tools accessible at the transfer of a machine learning engineer. As discussed earlier in the
introduction, optimizations are of the considered as the essence in machine learning tasks.

Open NN:

OpenNN puts forward an arsenal of updated analytic. It is characterized as a tool, Neural

Designer for updated analytic which furnishes us with graphs and tables to understand data
entries.

15
H20: Open-Source AI Platform:

H20 is said to be an open source deep learning platform. It is found to be business oriented,

and it also helps in arriving at a decision from data and permits the user to draw insights. The
two open-source versions of it are one is standard H2O and other is paid version Sparkling
Water. It is mainly utilized for predictive modelling, risk and inquiry of fraud, insurance
analytic, advertising technology, and healthcare and customer intelligence.

Google ML Kit:

Google ML Kit, Google’s machine learning beta SDK for mobile developers, is structured to
enable developers to build customized aspects on Android and IOS phones.
This kit basically grants the developers to implant machine learning technologies with app-
based APIs coordinating either on the device or in the cloud. These also contains
characteristics such as face and text identification, bar-code scanning, image labeling and
more.
This ends the topic of tools of Artificial Intelligence wherein some of the tools that provide
the data scientists and engineers with an opportunity to solve real-life problems.
2.5 ASPECTS OF ARTIFICIAL INTELLIGENCE:

2.5.1 Deep Learning

Deep learning is nothing but a machine learning method that assists the computers in
performing any work which is naturally done by human beings 6. Many numbers of
developers are in support of the latest deep learning new technologies in order to achieve new
heights.
There are many numbers of branches of Artificial Intelligence technology like autonomous
vehicles, computer vision, automatic text generation etc. One of such examples is the
attribute of Self-Driving in cars like Tesla (Autopilot), which works with the technology of
Deep learning. This feature in the car identifies a stop sign or differentiates a pedestrian from
a lamppost.
2.5.2 Facial Recognition
Artificial Intelligence has made it feasible to identify the individual faces using biometric
mapping which in turn has led to path breaking advancements in surveillance technologies.

6
Jiang F, Jiang Y, Zhi H. ‘Artificial intelligence in healthcare: past, present and future’, Stroke and Vascular
Neurology 2017, Accessed on Jun 22,2021

16
This basically helps in comparing the knowledge with a database of known faces to find out a
match. A Clear view AI, an American technology company provides a technology for
scrutinizing law agencies and to keep a check on entire cities which are running with the
network of CCTV Cameras.

2.5.3 Automate Simple and Repetitive Tasks

AI has the potential to implement the same type of work again and again without any
tiresome. This feature can better be explained by taking the example of Siri, a voice-enabled
assistant who is introduced by the Apple Inc. The main distinguishing characteristic of this is
that it can hold so many instructions in a single day. This particular automation of technology
not only led to the growth of efficiency, but it also reduced the stress in the work and in some
instances a safer work environment.

2.5.4 Data Ingestion

The next most important aspect is Data Ingestion. As there is an increased growth in the
production of data the need for the introduction of AI in this sphere has gained more
importance. This has reduced the manual feeding of data and has also enabled gathering of
data along with the analysis of such data.
Data ingestion means the transit of knowledge from various sources to a data-storage medium
where it is often obtained, utilized and examined by a corporation. The use of neural
networks in AI scrutinizes a large amount of such data and assists in providing a logical
inference out of it.
2.5.5 Chatbots
Chatbots mainly concentrates on resolving the customer problems. It deals with a software
which brings forth a window for solving customer problems with the help of either audio or
textual input. These chatbots were enabled with artificial intelligence to make them respond
to all kinds of commands as earlier they were programmed to respond only for specific
commands. This recent advancement brought in chatbots understands the language and not
just the commands. One such example of chatbot is the Watson Assistant, an AI-powered
assistant originated by IBM. The main feature of this is that it can operate across various
channels like websites, messengers, and apps and along with this it does not require human
intervention once programming is done.

17
The chatbots not only resolve the issues related to customers but they also provide product
suggestions to them. All these advancements are found to be because of AI.

2.5.6 Quantum Computing

AI assists in resolving compound quantum physics issues with the accuracy of

supercomputers with the help of quantum neural networks which may result in path-breaking
developments in future. It is a multidisciplinary area that basically concentrates on building
quantum algorithms for enhancing computational tasks within AI and machine learning.
The best example in this area is Google AI Quantum whose main aim is to develop
superconducting qubit processors and quantum assisted optimization for the AI application in
various fields.

2.5.7 Cloud Computing

Next important and basic feature of Artificial Intelligence is Cloud Computing. The use of AI
within the business cloud computing environment would in turn help in making the
organizations more efficient, tactical, and insight driven.
For example, the Microsoft Azure which is one of the important players in the cloud
computing industry allows us to utilize our own machine learning models to our data stored
in cloud servers without any lock-in system.
2.6 CONCLUSION
In order to provide better healthcare to patients, Artificial Intelligence is found to be a
cornerstone in the healthcare industry. This chapter gives a clear picture of various aspects of
intelligent behaviour, such as resolving problems, building inferences, learning, and
understanding language etc. AI programs can outperform human experts by converting all the
above-mentioned aspects into coded computer programs. This idea of the ability of machines
to think and perform tasks just as humans do is thousands of years old. The main aim of
artificial intelligence is to create new technology in an intelligent manner to perform tasks
faster than human being.

18
 CHAPTER III

ARTIFICIAL INTELLIGENCE IN HEALTHCARE SYSTEM

3.1 INTRODUCTION:
The focus of this chapter is on the various areas of medical research. This particular chapter
outlines the most recent advancements and improvements in the field of healthcare. When
Artificial Intelligence is developed in the healthcare field it provides wide variety of solutions
such as, Heart sound analysis, provision of companion robots for the elder people, mining
medical records, helps in designing treatment plans, assists in repetitive jobs, provide
consultations, observing patient, helps in creation of new drugs etc.
Artificial intelligence is an ‘automated process’ wherein it uses technology in the process of
diagnosis and treatment of patients. Though diagnosis and treatment are considered as basic
processes they require several other background procedures for a patient’s proper recovery.
The main distinguishing feature of artificial intelligence is that it uses computer techniques to
carryout clinical diagnoses and to suggest treatments. AI has the ability of identifying
meaningful relationships in a data set and it is also used in many clinical situations to
diagnose, treat, and anticipate the results. The present chapter focuses on the importance of
AI in different domains along with a mention about various categories of AI. It also deals
with the advantages and disadvantages of AI in healthcare.

3.2 ARTIFICIAL INTELLIGENCE IN HEALTHCARE ACROSS DIFFERENT

DOMAINS:

In medical research, AI is mostly employed to analyse and identify patterns in large, complex
datasets. Importantly, this data can be analyzed in a significantly faster, precise and more
cost-effective way than traditional analytical methods — reducing spend and improving
outcomes.

19
There are various dimensions of AI in healthcare. Most of the times, AI uses a web database
permitting doctors and practitioners to obtain thousands of diagnostic resources so that this in
turn might help in obtaining a faster outcome.
Sometimes, a patient can complain about multiple symptoms that can match up with various
conditions. This correlation of symptoms by both genetic and physical characteristics might
delay the process of diagnosis. So, AI is not only a benefit in terms of efficiency, but it also
helps in improving accuracy in early recognition of diseases. It also helps in diagnosis and
treatment plan of the diseases along with an anticipated outcome of such diseases.
This arrangement of updated information has helped the practitioners to improve their
treatment capabilities with unlimited resources.
The structured data processes are like Natural Language Processing, which focuses on all of
the unstructured data in a clinical setting. This type of data is from clinical notes and
documented speech to text processing when a practitioner sees a patient. This data includes
narratives from physical examinations, laboratory reports, and exam summaries. The Natural
Language Processing uses historical databases that have disease relevant keywords aiding in
the decision-making process for a diagnosis. Using these processes can provide a more
accurate and efficient diagnosis for a patient, which in turn saves time for the practitioner,
and more importantly can speed up the treatment process. The faster, more targeted, and
specific the diagnosis, the sooner a patient can be on the road to recovery.
Similarly, AI can be used to trawl through vast troves of scientific literature to find relevant
studies, as well as combining different datasets. At the Institute of Cancer Research, for
example, researchers have developed a unique canSAR database that is able to combine
patients’ clinical and genetic data with independent chemistry, biology, and patient and
disease information. Once the AI system has collated and “translated” this vast haul of data
into a common language, it can then employ machine-learning algorithms to make useful
cancer drug-discovery predictions.
Big data has the potential to revolutionize research and development (R&D) in the life
sciences sector — and is already making waves. Here are some ongoing applications of AI
and machine learning within specific fields of clinical research:

 Diagnostics

Diagnosis of diseases involves years of medical training. But the demand for specialists
exceeds the available supply. This obviously imposes stress on the doctors and often delays

20
life-saving patient diagnostics. As a result of it machine learning particularly Deep Learning
algorithms were brought to automatically diagnose the diseases.

Medical diagnostics is a part of medical testing which is introduced to identify infections,

conditions, and diseases. The concentration of almost all the healthcare companies is
exclusively on the diagnostics part as it is considered as crucial area for AI application.
Taking this as an inspiration, in the year 2016 IBM Watson Health had inaugurated a
partnership initiative with Quest Diagnostics. As a part of it IBM Watson Genomics had
focused on enabling highly customized cancer treatment by merging cognitive computing
with state-of-the-art genomics tumour sequencing. Along with these AI was also applied in
the field of radiology by the University College London Hospital (UCLH) to develop
machine-learning algorithms that can discover the differences in healthy and cancerous
tissues.
 Personalized/precision medicine

The response of the patient towards drugs and treatment varies depending on their
personalities. So customized treatment has more power to increase patients’ lifespans. Hence
machine learning can easily deal with this complicated work and it also helps in finding out
the response of a patient to that particular treatment i.e., the algorithm can anticipate a
patient’s expected response to a particular treatment.

Precision medicine is observed as an approach to patient safety wherein it aims at targeted

therapies. It is also known as personalized medicine7. This medical model integrates genetics,
behaviour, and environment with a goal of modifying the treatment.
Now a days doctors started using AI to spread precision treatments for complicated diseases.
This would give them an ability to explore huge datasets that were too complex. The new
insights into the healthcare system makes patients healthy at the individual level and they also
help the researchers to encourage the evolution of new drugs. Along with these they also help
in finding out new uses for existing drugs, advice customized combinations, and even
anticipates the future risks regarding the diseases.By this precision treatment the treatments
between similar patients and the outcomes from such treatment can be compared and the

7
Joe Lofts, Senior Content Editor at SRG, “How useful is artificial intelligence (AI) in medical research?”,
Published on Jun, 2021, Accessed on Jun 26, 2021

21
resulting outcome predictions make it much easier for doctors to decide about the right
treatment plan.
In future, we can look forward for an increased utilization of micro biosensors, devices and
mobile apps with advanced remote monitoring capabilities. Apart from giving patients more
freedom regarding the efficacy of their treatment, the application of AI technologies also
helps in motivating the research and development while simultaneously cutting the costs.
 Drug discovery
Developing drugs is considered as a costly process. Many of the systematic procedures in
drug development can be made more efficient with the tools of Artificial Intelligence8.
The establishment of machine learning to drug discovery is timely. The researchers at the
Universities of Cambridge and Manchester have introduced an AI “robot scientist” by name
“Eve” to assist in optimizing the process of time-consuming. In 2018, Eve found out that a
compound which is usually available in soap and toothpaste can be used as a weapon to fight
against drug-resistant malaria. Hence intelligent technologies such as Eve not only help the
researchers to speed up the drug discovery process, but they also help in reducing the price
of new  drug discovery. This reduction in the price is done by cutting down the cost for
certain aspects which were done during the drug discovery.

The 4 main stages of drug development in which AI is used are as follows:

Stage 1: Recognizing targets for intervention.
Stage 2: Locating drug candidates.
Stage 3: Hurrying up clinical trials.
Stage 4: Discovering Biomarkers for detecting the disease.

 Clinical trials

There are many numbers of methods through which machine-learning algorithms can boost
up clinical trial research. The costs for recruiting employees for clinical trials can be large,
and solutions brought through AI can significantly reduce them.
Another application of AI is to upgrade the safety of the trials. Real-time data access and
remote monitoring of members permits researchers to keep more precise and specific tabs on

8
Markus Schmitt, Artificial Intelligence in Medicine”, a blog by data revenue published in 2020, Accessed on
June 20, 2021

22
biological modifications along with a supervision of whether a participant is responding to
the medical care and attention or not.

 Epidemiology

In the field of epidemiology, statistical modelling using artificial intelligence is being utilised
to anticipate future disease outbursts. An example for this would be the development of an
instrument by epidemiology/tech company, AIME Inc to provide a real-time predictions on
the timing of dengue outbreaks. In the same way the researchers from the University Of
Southern California Viterbi School Of Engineering have formulated an algorithm which
helps in slowing down the spread of communicable disease.
 Telehealth: Artificial Intelligence on a Smaller Scale
Though Artificial Intelligence is applied for the detection of high-risk diseases this telehealth
tools helps in treating homes of patients thereby preventing high-risk situations and hospital
re admissions. When a high-risk variable is recorded this particular technology helps in
notifying the practitioners immediately. Artificial Intelligence as a whole assists the
practitioners in making more efficient and analytical decisions, improving the care for
patients which is the ultimate goal.
 Artificial Intelligence Integrated in Major Disease Areas
Many of the chronic diseases such as cardiovascular, neurological disorders and cancer
diseases has to be detected in their early stages for a proper recovery. So, it is crucial that as
many resources as possible must be used to assist the doctors and the practitioners in early
detection, diagnosis and treatment of the diseases. One of such examples is that in a study it
was found that AI algorithms were used for detecting a stroke in its earlier stage. This early
detection was made based on their presented symptoms and genetic history. In this stage any
abnormal physical movement of the patient was registered and that would trigger an alert to
make the doctors cautious about the risk. This trigger alert is found to provide 87.6%
accuracy in the diagnosis of a disease. As a result of this the practitioners were able to
execute the treatment faster and predict whether the patient had a higher probability of future
stroke.

 Artificial intelligence and diagnostic dentistry

Proper diagnosis of any disease is the basis for successful treatment. In several studies the
diagnosis given by a dentist is compared with the one obtained by ANN, results inferred are

23
high as in some cases, dentists don't have enough knowledge to form the proper clinical
decision during a limited period. AI applications functions in such a way that they are
believed to make better decisions and perform in a better way compared to humans. Hence,
AI might be ready to satisfy the ever-existing requirement of a way to diagnose oral cancers
at their early stage. Genetic Algorithms and ANN also are useful in predicting the sizes of
uninterrupted canines or premolars and may even be standardized for predicting the tooth
surface loss. These AI models are utilized in detection and diagnosis of cavity, vertical root
fractures, apical lesions, exocrine gland diseases, maxillary sinusitis, maxillofacial cysts,
dental decay etc. AI can detect dental decay through a clinical examination of the teeth and
through the inspection of dental radio graphs. AI uses convolutional neural networks to detect
dental decay. This software utilizes a cloud-based algorithm which highlights the areas of
dental decay through the images on digital radio graphs

Indian healthcare industry consists of a large set of sections. A study of literature proves that
AI is implemented in a variety of ways which are discussed below:

 Hospitals:

Here when we consider the aspect of hospitals it includes both govt. hospitals and private
hospitals. It is found that AI assists many leading hospitals in the diagnosis of various
diseases. For example, Manipal group of hospitals in association with IBM ‘s Watson for
Oncology has started dealing with different types of cancer and it was found out that nearly
two lakh patients received cancer related therapies with the help of AI in their healthcare
operations9.
Similarly, many numbers of products such as Microsoft azure, data analytic, office365 and
CRM online are applied by different leading hospitals such as Apollo, Narayana Health,
Fortis and Max healthcare etc. to strengthen medical facilities to patients.

 Pharmaceuticals:

In pharma industry Artificial Intelligence is used at various stages such as production,

extraction, operation, purification and packing of chemical products for humans or animals.
In order to facilitate the use of AI the Indian pharmaceutical companies are testing and
formulating AI based algorithms for illustrative and predictive AI.

9
Mrinmoy Roy, Dr. Mohit Jamwal. ‘An Overview of Artificial Intelligence (AI) Intervention in Indian
Healthcare System’, International Journal of Science and Research, Accessed on 25,2021

24
One of the examples is the procedure of scanning across all existing literatures on a particular
molecule for developing a drug which is usually termed as targeted molecule discovery.
With the use of AI, the pharma industry experiences many advantages like detection of both
physical and immaterial improved value proposition, enhanced rival distinction, effective
resources allotment for obtaining higher share in the market thereby having a dominance over
others in pharma marketing. This effective allotment of resources might in turn lead to a hike
in revenue and profit along with growth maximization, personalisation of marketing
communication for better customer engagement.
A very good example for this would be the initiatives undertook by Abbott Healthcare
regarding certain apps such as apps for heart & liver ailments, vertigo exercises, pharma rack
a software-as-a service (SaaS) based application wherein it uses AI to technologize the
logistics in pharmaceutical industry.

 Medical Equipment and Supplies:

The companies involved in the manufacture if medical devices and hospital stocks, surgical,
orthopedic and laboratory equipment etc. have started using descriptive and predictive AI. As
a part of above initiatives AI is also employed to monitor the patients ‘vital signs in intensive
care units, and to intimate the doctor in case of any emergency.
For example, Niramai uses a high-resolution thermal sensing machine to scan the chest
through a type of a camera, and it is also used to assess the thermal pictures for early
detection of cancer

 Medical Insurance:

Firms providing medical insurance in India are also using descriptive and predictive AI.
Machine Learning which forms a part of AI helps in automating claims, scrutinizing the data
in less time thereby building consumer satisfaction. Due to the changes in the life styles and
habits of the consumers the insurance agencies also started offering customized plans. This
necessitates the insurance agencies to use more data for offering the insurance at early-stages
of illnesses.
The best example for the use of AI in the field of medical insurance is the use of MyRA, a
chatbot platform, by ICICI Lombard to sell insurance policies. Email bot of HDFC Life is

25
considered as the first to use AI in its operations in India as it can automatically read,
comprehend, arrange, organize and answer to client messages.
3.3 CATEGORIES OF AI IN HEALTHCARE SYSTEM

Artificial intelligence is a collection of various types of technology. Though all these

technologies have immediate connection to the healthcare field, but the particular procedures
and tasks they support differ depending on the situations. Some of which are described
below.

3.3.1 Machine learning – Neural Networks and Deep Learning

Machine learning is observed as an analytical technique and is also found as one of the most
common forms of AI. In 2018 a survey conducted by Deloitte has proved that 63% of
companies has started employing machine learning in their businesses10. This broad technique
being the core of many approaches to AI contains many versions in it.

Neural network being the complex form of machine learning is available from 1960s and is
now well established in healthcare research. It is basically used for categorizing applications
like deciding whether a patient will get a particular disease or not. It views the diseases in the
form of signals which are in turn processed by neuron. This neural network contains
thousands of hidden characteristics which are helpful in predicting future diseases. Deep
learning is applied to radiomics, for oncology-oriented image analysis. Deep learning is also
a type of natural language processing (NLP) which is mostly used in speech recognition.

X Rays
X-rays are specially used for bones and sometimes deep organs like the lungs or the heart.
The machine works by sending radiation (x-ray) through a specific area of the body. If there
exists a hindrance in the flow of radiation due to some dense objects the that will appear
white in the film. The X- Rays are typically used to detect disease / bone degradation,
discoloration, fractures, tumors, Infections etc. but these pictures provided by X-Rays are
usually less detailed than other imaging solutions as they capture single 2D image. They are
usually the cheapest option for medical imaging and it is the first and foremost option even if
a clinician thinks you may need a CT or MRI afterward.
CT scans

10
Thomas Davenport, Ravi Kalakota. ‘The potential of Artificial Intelligence in Healthcare’, Future Healthcare
Journal by Royal College of Physicians, vol 6(2): 94–98, Jun 2019, Accessed on Jun 25, 2021

26
A CT scan is same as an x-ray whereas in that radiation is to capture an image and this
captures multiple slices of the body, which gives the medical practitioner a 3D view of the
section being captured11. But these CTs are found to be more powerful and more expensive
than X-Rays because they permit clinicians to obtain detailed images of bone, blood vessels
soft tissues, and other organs. They’re used to detect, Appendicitis, Cancer, Trauma, Heart
Disease, Infections etc.
MRI Scans
Magnetic Resonance Imaging (or MRI) is commonly utilized for soft tissue damages like
muscles or connective tissues. MRI’s usually make use of an electromagnet to capture an
image so they don’t deal with the concept of radiation. MRI’s produce both 2D and 3D

images and they are also found to be more expensive imaging tool a physician may have.

3.3.2 Natural Language Processing

Since the 1950s human language was considered as the main goal of AI researchers. This
goal is further achieved by inserting this particular technology called Natural Language
Processing wherein it includes applications such as speech recognition, text analysis,
translation and other aspects related to language.
However, there are mainly two basic approaches to it:
1. Statistical NLP - Based on deep learning neural networks
2. Semantic NLP
In the field of healthcare NLP is mainly applied in the creation, recognition and
categorization of clinical documentation and published research. The systems related to NLP
can examine unorganized clinical notes of patients. It also helps in preparing reports and in
copying patient interactions.

3.3.3 Rule-based Expert Systems

Expert systems are nothing but the collections of ‘if-then’ rules. These Expert Systems were
observed to be the most dominant technology in AI and it was widely used commercially
11
Bruce Ironhardt, “AI for Healthcare-An introduction for everything that you might not think of”, Sep 11,2020,
Accessed on Jun 25,2021

27
during 1980’s. In healthcare sector, these expert systems were applied for ‘clinical decision
support’. Due to this advancement most of the electronic health record (EHR) providers were
able to furnish the patients a set of rules with their systems today.
But unlike the other applications in AI these Expert systems needs human experts and
intellectual engineers to frame a chain of rules in a particular knowledge domain. These rules
are however found to work well up to a point. Only one particular drawback in this is that if
the knowledge domain is modified, changing of rules may become difficult and time-
consuming. The researcher started working on it to replace them by more approaches based
on data and machine learning algorithms.
3.3.4 Reactive machines
Reactive machines are the most fundamental types of AI systems. These particular machines
understand the world directly and reacts on what it perceives. Here in this case the computer
is purely reactive, and it does not take past experience into consideration.
The best example for that would be the IBM’s chess-playing supercomputer which paved a
way for an innovation by beating grand master Garry Kasparov in 1997 was a reactive
machine. Here all that the machine knows was only about the conditions and procedure of the
game.
3.3.5 Limited Memory
Limited memory machines are same as reactive machines. The main distinguishing feature of
Limited Memory machine is that it contains historical data of a disease or a patient which
might help the doctors to take decisions. Most of the machines that we use now in the present
healthcare sector are limited memory machines and these machines are constructed with large
volumes of data to use it as a reference model for resolving future problems.
For example, an image recognition AI is structured to identify and name certain things like a
cat or a dog from a picture. This identification of how does a cat or a dog look like is taken
from the previously trained datasets.
3.3.6 Theory of mind

This technology of Theory of Mind is an advanced class of technology. This kind of AI

studies and understands the feelings and behaviour of people within a particular environment.
Theory of minds is understood to be a complicated technological improvement as it requires a
perception of people’s emotions, sentiments, and thoughts.
For example, Kismet, invented in the late 1990s can mimic human emotions by recognizing
them.

28
3.3.7 Self-aware
Self-aware technology is a type of AI that we usually observe in movies. The robots that act
on their own way to perform a work better than humans is the ideology taken from self-aware
AI. Though the technology of self-aware is considered as little risky there are also chances
that the futuristic AI might go along with humans. Hence this self-aware AI is on the wish list
for many scientists.
3.3.8 Artificial Narrow Intelligence (ANI)
Artificial Narrow Intelligence is also known as ‘week AI’. It is basically formulated and
brought by the tech world. Artificial Narrow Intelligence works under a limited set of
constraints.
One of such examples is the voice recognition AI which is used to recognize people’s voice
based on the data set it is structured with.
Artificial General Intelligence (AGI)
Artificial General Intelligence is also known as ‘strong AI’. It assists a machine to apply
knowledge and abilities in different situations. In a way this is closely related to human
intelligence as it can successfully perform any intellectual task that a human being can
perform to solve a problem.
Artificial Super Intelligence (ASI)
Artificial Super Intelligence is an updated version of ‘strong AI’. They will not only
reproduce the intelligence of human beings, but they are also found to be extremely better at
everything. ASI is mainly equipped with features like greater memory power, faster data
processing, analysis of data and decision-making capabilities.
3.4 PROS AND CONS OF ARTIFICIAL INTELLIGENCE IN HEALTHCARE
Artificial intelligence (AI) has already transformed many numbers of industries,
including healthcare. It is increasing rapidly day by day and we can observe many
innovations which were found to be impossible before. Every techie and science company
involved in medical research is working very hard to make authentic and prescriptive
devices for both diagnosing and treatment.

3.4.1 Pros of AI in Healthcare 

1. Clinical decision making

The Healthcare Information and Management Systems Society Inc. (HIMSS) has stated that
AI in healthcare has aided in supplying the decision makers with necessary, real-time data

29
which in turn can be used to diagnose patients, schedule treatments, and manage population
health . According to HIMSS AI also has the ability to modify clinical decision making. AI
tools specialized in radiology, pathology identification and ophthalmology can give solutions
for various chronic diseases.

1. Information sharing

AI can track a particular patient’s data more accurately and this is found to be an essential
tool in many of the leading healthcare institutions such as the National Health Service.
Recently in 2019, NHS has set up a national AI lab to expand the role of AI within the
healthcare sector. 
In case of personalized medicine, the US National Institute of Health held that AI can be
utilised to recognize the patterns within patient data and also to find out their chances of
getting a specific disease or illness. This level of intuition added a great value to the medical
profession as it can fully streamline patient care and decrease potential risks by finding out
the root causes of a particular disease.
2. AI fosters healthcare accessibility
Unfortunately for many of the developing countries the technological advancement in the
field of healthcare remained as the most painful one. As a result of it most of the people
living in the rural areas of the country are experiencing the fear of death as it is practically
impossible for them to get good medical help on time.
Digital infrastructure can always assist the patients in understanding the symptoms and
further it also helps in receiving necessary treatment. In order to provide medical assistance
to almost all the areas in a country many new applications were developed recently through
collaborations between national and international healthcare organizations.
One of such examples is the Ada App, based on intelligent technology and it is made
available in 140 countries to increase accessibility of medical guidance for the poor
population.
3. AI-driven tools help reveal early disease risks 12
AI facilitates accumulation of people’s data in a single place, and it can further be used to
check the previous and current health problems. This comparison of diseases allows the
physicians to make accurate diagnosis. In addition to this the database of health apps has

Valeriy, CEO of ByteAnt. ‘AI Adoption in Healthcare: 10 Pros and Cons’ published on 7th September, 2020,
12

Accessed on Jun 25, 2021

30
collected millions of symptoms which may help the health experts to predict the potential
threats and prevent them in the future by undertaking necessary measures today.
This application called “Verily” structured by Google is specialized in predicting both
noncontagious and hereditary genetic diseases.
4. AI algorithms can save time and costs.
The benefit of applying AI in the healthcare system is that it can examine the patients and it
can diagnose the diseases of the patients within swift time frame. Another advantage with
the implementation of AI tools in the healthcare sector is that the AI algorithms are more
cost-efficient than the normal traditional methods 13. Hence this relieves the people from
undergoing various expensive lab tests.
As an example, for this one can consider the biomarkers which has the capability to detect
certain illnesses in the human body.

5. AI as unique and unrivalled assistance in surgery

AI surgical system helps in conducting tiniest and complex operations with minimal pain,
less blood loss, and low risks of side effects. Furthermore, it was found that after such
surgeries the patients were observed to recover much quicker. In addition to it AI also
equips the surgeons with accurate information regarding the patient’s current condition.
This type of tools increases the trust among patients when they still have some doubts about
surgery.
The best example for this is the application of Antibacterial Nanorobots for clearing the
patient’s blood from infections either before or after the operation.

6. AI helps augment human abilities and support mental health.

Patients can be given medical assistance not only by medical staff, but they can also be
assisted by robots. With the advent of exoskeleton robots, the need to depend on the care
takers had reduced. These robots are also capable of performing daily tasks and this in turn
helps the elderly or sick patients to escape from the thought of loneliness. Some of the
robots also help in controlling temperature, blood pressure, sugar levels, as well as taking
pills.

13
Sumi menon, “How Artificial Intelligence is Changing the Healthcare Industry”, Published on September 24
2018, Accessed on Jun 25,2021

31
3.4.2 Cons of AI in Healthcare

As it was discussed above there exists both pros and cons for a technology in any sector and
AI is not an exception to it .AI also faces numerous challenges ahead.

1. Human assistance

AI is an expert in applying specific instructions which it has been programmed to do but the
main drawback is that AI cannot work on its own and it should work in association with
physicians. Though AI works as second pair of eyes to the doctors and practitioners it still
requires the human expertise to provide accurate results.

2. A lack of personal involvement

Though surgery robots are found to be most accurate and logical they are not programmed
to express any kind of sympathy towards the patients. This particular aspect is considered
as a disadvantage by some of the experts because the abilities of human beings in terms of
personal interaction with the sick patients go beyond those of computers. Relationship
between a doctor and a patient plays a major role in building trust and treatment.

3. A rise in unemployment rates among healthcare workers

With the advent of AI, the need for many of the traditional activities which were performed
by humans have come to an end. As a result of this most of the people lost their
employment. This has put the healthcare professionals at risk of losing their livelihood.
Although Chatbots and robots can examine the patient’s health and condition it is
impossible for them to replace doctors in the nearest future.

4. Possibility of a Defective Diagnosis

The correct diagnosis of a particular disease is based on the data gathered from various
people who have undergone same symptoms and conditions. But in order to get the proper
comparison, the AI database should contain necessary data about the patients. Hence, if
there is insufficient information about a person then AI can provide an inaccurate diagnosis
as a result of which the doctors may provide wrong treatment. By this we can understand
that poorly trained AI devices can add to the losses.

5. Social Prejudices

32
As AI doesn’t take human emotions and nature into consideration while offering treatment,
the solutions provided by the tools may or may not be feasible for certain patients. Moreover,
the expensive prices that are imposed on the services may depress the patient to continue
the treatment. So it is only the doctor, who can come to a conclusion on the appropriate
treatment plan taking into account the patient’s social and financial position.
Although there are many concerns with regarding to AI’s involvement in healthcare, it will
be impossible to decrease the utilization of AI in medicine now. The only solution available
to curb the disadvantages is by means of effective monitoring and proper regulations.

3.5 CONCLUSION:

The introduction of artificial intelligence in healthcare system is being seen as a rebellion

towards decreasing cost, and upgrading the efficiency, quality and availability of healthcare
services to millions of users. The main underlying idea behind most of the AI based devices
in India is to spread AI based medical services to remote rural areas in India. This expansion
of medical services to remote areas helps to address the problems of economic inequality by
improving the availability of efficient medical facilities. However, as we have discussed
above there exists both advantages and disadvantages of artificial intelligence in healthcare.
No one technology is the final solution to all the complaints in an industry and so AI must be
applied in an organized way to obtain the desired outcomes. Though AI is considered as an
efficient tool in the field of healthcare physicians are still required for traditional physical
exams, mainly in the spheres of neurology, which needs advanced-level of patient-physician
interaction. Finally, even if AI reach the point of performing real-time CT scans or other
physical scans, physicians are still required for interpretation in ambiguous and challenging
situations.

33
 CHAPTER – IV

ARTIFICIAL INTELLIGENCE IN HEALTHCARE SYSTEM: AN ANALYSIS

4.1 INTRODUCTION

Artificial Intelligence (AI) is observed to be on hike from past few years and the
technologies, based on AI such as machine learning has become interlocutors of human
operators. They also help in performing complex tasks involving reasoning and decision
making. Considering this as the main concept the present chapter deals with the importance
of Artificial Intelligence in decision making along with a discussion about the role of clinical
decision-making systems in the field of healthcare. Basically “machine learning” means a
branch of computer science which develops algorithms to detect associations, similarities,
patterns in data and uncertain outcomes.

Now these AI based devices are present in many numbers of technologies, such as email,
social media, mobile software, and digital advertising. However, it cannot be said that the
near future of AI will continue as it is but on the other side it is believed that AI would be in
association with human operators to perform many numbers of tasks and activities by
analyzing enormous quantities of data. But one main issue with regarding to the application
of AI in healthcare is that it is supposed to be used by non-professionals. As the doctors,
marketers, or military personnel cannot be experts in the field of technology and informatics
they have to seek the help of artificial entities to take important decisions in their fields.

As per patient-centred perspective, whatever care or choices should be made they should be
made by the patient and the doctor with a mutual understanding. This concept of taking
decisions with mutual understanding is termed as “Shared Decision Making”. So, when
implementing AIs in diagnosis and therapy identification the concept of “shared decision”
should be taken into consideration. In addition to the above aspects this chapter gives a clear
picture about the future applications of AI in the field of healthcare with a mention about of
the role of AI in the storage of patient data.

34
4.2 DECISION MAKING AND ARTIFICIAL INTELLIGENCE IN HEALTHCARE
SYSTEM
As far as the healthcare industry is considered, Artificial Intelligence is modifying the way
clinical providers make decisions. AI plays an important role in clinical decision support by
providing data to the doctors and practitioners regarding the diagnosis and treatment
planning14.
By enhancing clinical decision software Artificial Intelligence reduces the administrative
responsibility on clinicians. Natural language processing helps in converting clinical notes
into Electronic Health Records. AI-based programs can provide access to data from various
sources such as medical images, EHR data and even user devices such as activity trackers,
smartphones, and other associated medical devices. AI based algorithms also helps in
expanding the diagnostic and treatment options for clinicians. Along with expansion of
options it can also modify the health outcomes by concentrating more on personalized care
delivery. It also helps the clinicians to locate different patterns of treatment which might
result in better decision-making.
For example, it can assist the nurses in finding out proper number of days a patient should
stay in the hospital and that can obviously save a patient from further complications along
with a reduction in costly re admissions.
An examination of the present hospital protocols is very much important for a computer
programmer to expand the algorithms and to apply the automation of acute care in
diagnostics and treatment. The main purpose behind this is that the current hospital protocols
are based on twentieth century decision making. The main intention behind applying AI in
decision making is to get ahead of chronic diseases, expensive acute events, and unexpected
deterioration. Taking the above aims into considerations every provider would develop the
procedures that will enable proactive and predictive interventions. AI enabled algorithms can
also provide warning for conditions like seizures or sepsis.
Machine learning which forms a part of AI helps in taking decisions as to whether or not to
continue treatment for seriously ill patients, such as for those who are in coma after cardiac
arrest. AI algorithm helps in identifying subtle improvements which might show an impact on
the decisions making. The use of Artificial intelligence makes the lives of patients, doctors
and hospital administrators easy as they perform the tasks in less time and at a fraction of the
cost. This helps the doctors and the practitioners to take the decision faster without any

Health Catalyst, “AI Assisted Decision Making in healthcare – The next frontier”, Published on Jun 10 2020,
14

Visited on Jun 25 2021

35
delay.  Moreover, the ability of AI to “know” from the data helps in improving the accuracy
in the decision-making process as the Assembled data is a cluster of various medical notes,
electronic recordings from medical instruments, laboratory images and physical
examinations. Hence in this way the technology is already being utilized to support decisions
made in data concentrated departments like radiology, pathology and ophthalmology.
4.2.1 Clinical decision-making support systems (CDSS)

Clinical Decision Support Systems (CDSS) are formulated with rule-based systems, artificial
neural networks, as well as general machine-learning techniques. This CDSS with learning
algorithms are presently under development to help and assist the clinician in their decision-
making regarding the diagnoses and treatment. When these clinicians use AI-based CDSS to
identify the problems of the patients and to predict treatment outcome all the relevant data,
such as medical and social history of the patient, diagnostic tests etc. are stored into patient’s
EHR and then they are again fed back into the CDSS for advanced machine Learning.
Role of clinical decision-making support systems in healthcare sector:
 Assists the clinicians in diagnostic decisions.
 Anticipates the treatment outcomes.
 Monitors the patient’s data that is stored in Electronic Health Record
 Makes recommendations based on algorithms.
 The deep learning algorithms present in this help in analyzing medical images
regarding various diseases.
 Promotes accountability and transparency.
 Helps in delivering efficient healthcare services.

One of the major concerns about AI-assisted CDSS is how the machines reach decisions, and
whose decision should prevail when there is disagreement between the CDSS and the
medical professional. Unlike traditional software, the machine learning algorithms and the
models AI uses to make decisions are highly complex and, in some cases, opaque. While
methods are available to allow users to visualize the factors that the machine has learned in
making a particular prediction (e.g., graphical-based networks and attention mechanisms),
some techniques are indecipherable even to software engineers (Burrell 2016). This lack of
transparency is referred to as the ‘black box’ of AI.
Effective management of health systems, just like the provision of public health or health
care, is similar to data processing tasks. Policy makers modify health system functions of

36
organisation and governance, financing and resource management to realize health system
outputs, health care services and public health and system goals. The supply of health care
itself involves two core information tasks: first, screening and diagnosis, which is that the
classification of cases depending on history, examination and investigations, and second
treatment and monitoring, which involves the design, implementation and monitoring of a
multi step process to deliver a future outcome. The essential classification of these processes
across the domains of health system management and the provision of care includes in itself
hypothesis generation, hypothesis testing and action. Machine learning has the potential to
enhance hypothesis generation and hypothesis testing tasks within a health system by
revealing previously hidden trends in data, and thus has the strength to impact both at the
individual patient and system level. Machine learning works on existing statistical
techniques, utilizing methods and they are not based on previous assumptions about the
distribution of the information. Thus, whilst machine learning models are harder to interpret,
they will incorporate more variables and comes to a conclusion based on a broader array of
knowledge, and as a result of it, it produces solutions to more complex situations. These
methods are employed in screening and diagnosis and prediction of future events. However,
the rapid pace of development of machine learning continues both within health care and
more broadly across all information science tasks in society

4.2.2 Shared Decision Making

Shared decision making is considered as an alternative model to the disease-centred model 15.
In the disease centred model, the physician being authoritative and independent provides
suggestions to the patients without understanding their concerns, needs, and emotions. But if
the doctor wants to act in accordance with the interests of the patient, then such an approach
may be ineffective because the patient may not understand the recommendations suggested
by the physician. Then is when “Shared decision making” has come into picture. It is a
process by which patients and health professionals converse and evaluate with each other to
arrive at a particular decision. In simple words shared decision making is a process of
communication and negotiation between the doctors and the patient in which both
information regarding the medical issues (diagnosis, treatment etc.) and patient's concerns
(e.g., doubts and request for clarification, lifestyle changes, worries for the future, etc.) are
discussed. By this process, the patient becomes acquainted with diagnostic and treatment

15
Stefano Triberti, Ilaria Durosini, Gabriella Pravettoni, “A Third Wheel Effect in Health Decision Making
Involving Artificial Entities: A Psychological Perspective”, Article published on 28 April 2020, visited on 24
Jun 2021

37
pathways along with a knowledge about the related risks and benefits. Therefore, this process
of shared decision making helps the patients to get the best available treatment and it also
helps the doctors to understand the patient's point of view their preferences and personal
concerns.

4.3 FUTURE OF ARTIFICIAL INTELLIGENCE

The future of AI in health care comprises of activities that differ from basic to advance. It is
believed that AI will always play a predominant role in the healthcare offerings in future.
Hereafter it may involve answering calls, examining medical records, analyzing population
health, expanding medicinal drugs and devices, interpreting radio logical images,
constructing medical diagnostic and treatment plans etc. Along with these many other tasks
can be automatically performed by this technology in future. With the advent of AI in
Healthcare the costs of the treatment might fall due to previous and more accurate diagnoses.
AI technologies changes the perception of the doctors towards their patients. It provides
various opportunities to predict and treat diseases thereby providing medical care in the areas
where access to healthcare is limited.

Due to rapid increase of AI systems in the healthcare sector it is can be anticipated that these
devices and instruments can replace some of or if not all, the human elements of clinical care.
Leaving the final decision making to human clinicians, AI systems can be referred for regular
and less risky diagnostic and treatment procedures. ML being a part of AI helps in identifying
abnormal or undesired pattern changes. When an unusual pattern change is identified, the
monitoring system will automatically inform the patient’s provider and advice the patient to
fix an appointment with the doctor. The underlying idea behind this is not to replace human
clinicians but to introduce an efficient high-quality healthcare delivery process16.
Apart from all the AI novelties robotics is given a significant role in the medical automation
process. Robots give a shape to AI and the algorithms/programs in AI provide intellectual
capacity to the robots. These robotic assistants are already being used in many places and
countries to perform surgeries, monitor hospital patients etc. and mobile robotic assistants are

16
Varun H Buch, Clinical Technology Lead, Irfan Ahmed, GP Lead, Mahiben Maruthappu, CEO, “Artificial
intelligence in medicine: current trends and future possibilities”, published on Mar 018, Accessed on June 24,
2021

38
used to help the elderly people in their daily activities. With the rapid growth of AI in the
field of medicine it is anticipated that most radiology and pathology images can be
scrutinized at some point by a machine.
The biggest challenge to AI is not the capability of technologies to perform the functions of
human but rather it’s their adoption in daily clinical practice. For a successful implementation
of AI systems in the field of medicine they must be combined with EHR systems, and the
clinicians must be taught about the mechanism of AI in healthcare. By this we can predict the
use of AI in clinical practice within 5 years and more extensive use within 10 years. For
example, when a patient arrives at the hospital he can check his registration details in the
register through voice-enabled biometric kiosk. As a result of this the patient need not wait at
the front desk to discuss about the account balance.
India is experiencing a new dimension in healthcare sector from past 5 years wherein
advanced techniques are being used to replace the healthcare system. Some of these include
online consults or chat-based basic healthcare service apps. With the adoption of latest
technology in the healthcare sector a few predictions were made by the International Data
Corporation (IDC) for explaining the impact of AI and automation in the field of healthcare:
1. By 2022 most of the hospitals will be equipped with Io T-enabled management systems
so that they would help in enhancing patient safety, staff satisfaction, and operational
efficiency.
2. In future it is believed that every hospital with 200+ beds will be installed with robotics
to handle time-consuming tasks, reduce labour, and prevent errors. This would in turn
help in developing its business operations along with an improvement in patient safety.
3. Further it is also believed that 20% of healthcare institutions will be using block chain
for operations management and patient recognition. Hence with the adoption of AI
technology the healthcare organizations can achieve 15 to 20% of productivity gains
within a period of 1 or 2 years.

Apart from the above aspects AI is implemented in many other areas in healthcare such as17:

1. Radiology – In radiology AI is used to mechanize image analysis and further it is also

used for scanning purposes.  This in turn helps in reducing human error and also in the
diagnosis of diseases. Now a days AI is mainly being used for tumour detection on MRI's

17
Simon Marshall “How AI is transforming the future of Healthcare” – International client magazine
International SOS, visited on Jun 24, 2021

39
 and CT's. Recently a company in the USA started implementing AI-based platform to
examine and interpret Cardiac MRI images. 
2. Drug Discovery - AI solutions are used to develop new therapies from existing medicines,
which can be used to cure critical diseases such as the Ebola virus etc. This helps in the
development of new drugs, accelerating the process to bring new drugs to market in
response to deadly disease threats.
3. Patient Risk Identification18 – As AI analyses vast amounts of patient data multiple
companies and healthcare systems are formulating solutions-based patient’s electronic
health record. In many of the countries AI is believed to be an expert in predicting the risk
of cardiovascular disease by just having a look at patient’s retina.
4. Primary Care - Direct-to-patient solutions through voice or chat-based interaction would
help in providing quick access for basic medical issues. With this voice-enabled assistant
the doctor and the patient can communicate with each other freely as it listens to the
patient and puts down their problems and concerns into EMRs. This will also prevent the
problem of missing medical records.

4.4 USE OF ARTIFICIAL INTELLIGENCE IN THE STORAGE OF PATIENT DATA

We live in the world where our smartphones are used to guess the location where we want to
go or the topic what we want to say next. As health care is transforming towards digital
health, the amount of data has also increased. But providing the clinicians with more raw data
might become burden on them as they are already overloaded with large amount of data. An
advancement of AI has helped in studying the past history of the patients. By this AI can
access those patterns that are not immediately obvious to the human eye.
From past few years, AI-based data analysis and learning tools are used in research with
patient electronic health records (EHRs). Before these records were maintained on a paper in
hospitals but now, they are stored electronically on secure computer servers. The increased
use of AI algorithms has enabled new platforms integrating EHRs with other sources of data,
such as biomedical research databases, genome sequencing data banks, pathology
laboratories, insurance claims, as well as data collected from mobile Internet of Things (IoT)
devices such as heart rate monitors etc.

18
HT TECH, “How Artificial Intelligence is transforming the future of healthcare one step at a time” –
published on 16 Apr 2021, visited on 24 Jun 2021

40
The two major data sources with regarding to medical diagnosis and treatment are physical
examination notes and clinical laboratory results. These data sources are further divided into
image, genetic and electrophysiological (EP) data. They cannot be analyzed directly because
they contain large amounts of unorganized texts, such as clinical notes etc. Hence these AI
applications first translates the unstructured text to machine-understandable electronic
medical record (EMR). This ability of AI to gather and examine large amount of data, AI
could yield considerably helps in obtaining accurate diagnoses for a broader section of the
population.

Predictive analytics plays a major role in clinical decision-making. But for achieving the goal
of predictive analytics patient care must be taken into consideration. Development of patient
care mandates a proper arrangement of health data with accurate and timely decisions. So,
when a user logs into the online platform, a sidebar will appear with different categories such
as case management, patient registration and his last encounter with the doctor. If the doctor,
social worker, or transporter wants to know about the patient, they can select case
management category after logging in to the platform and later on he can search for a client
basing on his name or by any other means. This provides the client profile along with an
information about his/her old and recent encounters with their doctors. Machine Learning in
AI falls under this category. Machine Learning methods utilizes analytical algorithms to
know about specific patient traits such as information about their last visit with a practitioner,
physical exam results, medications, symptoms, information about their disease, lab tests etc.
Machine Learning also helps in converting the dictated note into codified information so that
it would automatically generate the billing information to transfer it to the patient’s insurance
company for reimbursement. In addition, this electronic medical record can also be used in
modifying the patient’s current treatment plan.

Healthcare and data science are interlinked with each other. When healthcare and data
science are interlinked with each other the resultant answer would be electronic health
records (EHR). This EHR was introduced into the healthcare industry in late 90s.The data
science is used by EHR to study the medical treatments and procedures. EHR is nothing but a
digital arrangement of patient information into one database. This database may consist of
medical history, information about treatments, diagnoses, prescriptions, patient records,
allergies to medication etc. The increase in the use of data necessitates the presence of ML
algorithms in the process and analysis of patient information during data mining. Patient-

41
centred data mining is used to assess different types of treatments and results by studying
EHR database as EHR is found to be efficient at making data accessible and available. An
EHR is basically a graph of raw data containing various aspects of a patient's medical
condition. Here ML plays the role of interpreting that data into accessible form.
This role of AI in the storage of patient data is observed to be present in various companies of
healthcare sector. They are as follows:

Prognos

Prognos a New York- based company has started using machine learning to analyse
electronic medical records from various hospitals and healthcare systems. The company
contends that AI algorithms recognizes the patients who requires advanced treatment options,
along with quality of treatment. In this company the algorithms are framed in such a way that
they can also provide pharmaceutical clients with weekly alerts when newly diagnosed
patients are identified.

CareSkore

This company uses AI to gather the patient data including clinical information, insurance
claims and demographics. The above information is collected from electronic medical
records. Hence here in this company after the profile is generated for the patient, if a
healthcare provider logs into that patient’s profile, the CareSkore’s integration can alert the
clinicians about patients who appear to be on a higher risk.

Roam Analytics

In Roam Analytic when a health provider logs into the patient’s profile using the data from
existing EMRs he will be able to access “actionable insights” about each patient along with
treatment suggestions or tests based on the patient’s medical condition.

4.5 STORAGE OF INFORMATION ABOUT VARIOUS DISEASES WITH THE

HELP OF ARTIFICIAL INTELLIGENCE
The concern about the transmission of infectious diseases has urged the authorities to set up
procedures to detect individuals at risk. This has become one of the factors for introducing AI
in the healthcare sector.

42
After the discussions about the above aspect a Seattle-based start-up KenSci started using
machine learning to anticipate patient risks by analyzing clinical data. As this KenSci’s
platform is linked up with clinical systems such as electronic medical records (EMRs) the
recommendations suggested by it can be readily implemented by healthcare teams. The
company also states that the software present in KenSci identifies those patterns which may
indicate potential risks19. This identification of risks is done by examining client data which
in turn provides predictive insights on healthcare outcomes.
The different tools of AI maintain the data related to various diseases such as cardiac arrest,
diabetology, cancer, tuberculosis, tumors etc. AI is found to be more efficient in recognizing
a particular disease because it creates several databases wherein these databases consist of
information regarding various diseases, their symptoms, effects, and causes. As a result of
this the doctors, practitioners and the clinicians can seek this data to obtain confirmation on
the treatment regarding a particular disease. In addition to the information regarding the
diseases these databases would also suggest various types of treatments possible for that
disease. So once when a clinician enters the details of the patient it would automatically
direct the doctor to that database under which the patient medical condition falls. This would
not only ensure accurate diagnosis of a disease, but it would also help in predicting the future
outcomes of a particular disease. This helps the doctor to gain trust among the patients as
they will be able to know about their medical condition and the treatment that the doctor is
going to give them. Using AI in this way would ensure transparency in the field of healthcare
as everyone in the world will gain some knowledge about the process of treatment. There
would be no space for ambiguity as everything is automated and systematized. The deep
learning technologies in AI would scrutinize the images and identifies the patterns of the
diseases. Several types of algorithms were created to assist the doctors diagnosing specific
diseases faster and more accurately. AI-based algorithms can be programmed to accurately
identify symptoms of a certain disease in medical images such as MRI's, x-rays, and CT
scans.
Machine learning helps in identifying those diseases which are difficult to diagnose. This type
of ML system is structured on large datasets containing raw images of the diseases and as a
result of its critical diseases which are not recognized by the human eye can be detected
through this Machine Learning technique. Hence MRI and other enhanced imaging systems
are being equipped with ML algorithms to detect various serious diseases such as cancer etc.

19
Kumba Sennar, “Data Mining Medical Records with Machine Learning – 5 Current Applications”, Published
by EMERJ the AI Research and Advisory Company, published on May 20, 2019, visited on 25 Jun, 2021

43
These tools of AI are proved to be more efficient because early diagnoses of the diseases are
crucial to prevent the deterioration of patients’ health status. Moreover, detection of a disease
in advance can be achieved by developing the analysis procedures on imaging, genetic, EP or
EMR, which is the strength of the AI system.
Two of such examples were the Long et al, who examined the ocular image data to detect and
identify congenital cataract disease, and secondly Gulshan et al, which has helped in
detecting diabetic retinopathy through the retinal fundus photographs.
4.6 CONCLUSION:

The delivery of healthcare services is becoming complex and challenging day by day. This
difficulty in healthcare sector is because of the large amount of data that is generated in the
process of healthcare. In order to avoid this complexity all, the data must be interpreted in an
intelligent fashion. The intelligent architecture of AI and its capability to act automatically
without requiring human attention helps in resolving this problem. Due to the expensive
nature of healthcare services the stakeholders started looking for solutions that can replace
the elements in patient care. Though AI solutions were found to be an answer for this
problem the cold technology cannot totally replace the human elements in patient care and
hence a technique that integrates both technological innovations and human care must be
investigated.
In the coming days, clinicians would bring out the time pattern-based analysis and decisions
made by the AI to ensure patient safety. But then the new healthcare ecosystems should
balance the utility and perception of AI for both doctors as well as patients. AI must be
developed and used in hybrid models. It should always be considered as an instrument or
amplifier of medical knowledge and not as a substitute for doctors. Though AI is used in
diagnosis, treatment planning, and identifying risk factors the clinicians should have a final
say in deciding the treatment. This would automatically help in achieving patient satisfaction
thereby ensuring patient’s safety.
While this technology still looms over certain layers of dangers and perils, AI tools can aid
the medical industry in enabling faster service, more accurate diagnosis, and data analytic for
detecting trends or any genetic information that might expose someone to a specific disease.
We exist in an era where saving few minutes is considered as saving lives and, in these times,
AI and machine learning are often transformative not just for healthcare except for every
single patient.

44
 CHAPTER V

APPLICATION OF ARTIFICIAL INTELLIGENCE FOR MEDICAL DIAGNOSIS

5.1 INTRODUCTION
AI has evolved to become the second pair of eyes that never need to sleep. Artificial
intelligence in medical diagnosis and healthcare provides overworked medical practitioners
and facilities with reliable support, helping to minimize workload pressure while maximizing
practitioner efficiency. Medical diagnosis, a problem solving, is very vital and one of the
important problems from the real world. Diagnosis of diseases is the process of converting
observed evidence into the names of diseases. The evidence consists of data obtained from
examining a patient and substances derived from the patient; the diseases are conceptual
medical entities that identify abnormalities in the observed evidence. The process of causal
diagnosis usually begins with an investigation of patients’ symptoms, tracing them back
down the chain until the source of the problem is confirmed. The most urgent need for AI in
bio medicine is in the diagnostics of diseases. A number of interesting breakthroughs have
been made in this area. AI allows health professionals to give earlier and more accurate
diagnostics for many kinds of diseases. In order to get a detailed view on the above aspects
the present chapter explains about the process of diagnosis using AI followed by procedure of
treatment with the help of AI and role of robotics in the surgical operations.

5.2 DIAGNOSIS OF DISEASES WITH THE HELP OF ARTIFICIAL

INTELLIGENCE

45
Diagnosis and treatment of disease has been the focal point of AI since 1970s, when MYCIN
was structured at Stanford for detecting blood-borne bacterial infections. All the other early
rule-based systems are formulated for the accurate diagnosis and treatment of diseases, but
the attempt was unsuccessful as they were not found better than human diagnosticians, and
they were found to be poor in medical record systems.
Correct identification of diseases requires years of study regarding various diseases and their
medical conditions. Even after that, diagnostics is considered as a difficult and time-
consuming process. This obviously imposes burden on doctors which in turn delays the
process of diagnosis. Machine Learning and specifically Deep Learning algorithms have
brought huge advances in identifying diseases, making diagnostics cheaper and more
available. Though these advancements are being adopted by many of the Tech firms and
start-ups it is mostly confined to the research labs and as far as tech firms is considered, a
week goes without a research lab contending that it started using AI or big data to diagnose
and treat a disease with equal or greater accuracy than human clinicians do.

5.2.1 How machines learn to diagnose

Machine Learning algorithms can understand the patterns similarly to the way doctors
understand them. So, Machine Learning is mainly helpful in the places where the diagnostic
information is digitized. Due to the availability of good data algorithms are becoming good at
diagnostics like the specialists. The main difference is that the algorithm can extract
conclusions in a fraction of second. This helps everyone to access to the same quality of
medical assistance for a low price. But one thing that is to be kept in mind is that AI cannot
replace doctors completely instead, AI systems can be used to highlight serious cardiac
patterns for the expert to review them. After the identification of dangerous patterns, the
doctor would focus on the interpretation of those signals.

5.2.2 Medical Diagnosis Process Using Machine Learning

Machine learning is a field of AI that provides machines the strength to learn itself by
examples. The procedure of ML is as follows:
1. Data Collection: Basically, this step involves the collection of patient details. This
step is considered as a crucial step as quality and quantity affect the overall
performance of the system.

46
 2. Data Preparation: once the collection of data is done, the next step is data pre-
processing. In this process raw data is changed to useful data, on which a decision
could be made. This process is also termed as data cleaning.
3. Choose a Model: After the data is pre-processed in order to represent the pre-
processed data into a model, an appropriate algorithm will be chosen depending on
the task.
4. Train the Model: To increase accuracy of decision making the above model is
trained by ML using supervised learning.
5. Evaluate the Model: The evaluation of a model requires several parameters, and
these parameters are taken from the pre-defined objectives. Along with this the
present model should be compared with the other models to pick the best one.
6. Parameter Tuning: Parameter Tuning includes steps such as numbering of training
steps, performance, result, learning rate, initialization values, and distribution, etc.
7. Make Predictions: For the developed model to be evaluated with the real world,
some outcome should be anticipated on the test data set and if that outcome suits with
expert’s opinions, then that model can be used for further predictions.

Through the Face2Gene app, facial recognition software is being combined with machine

learning to help clinicians diagnose rare diseases (in this case, from facial dysmorphic
features). Patient photos are analyzed using facial analysis and deep learning to detect
phenotypes that correlate with rare genetic diseases.

5.2.3 Medical Diagnosis Using Deep Learning

Absence of important information is a considered as a hindrance for deep learning models.

currently, medical research utilizes electronic health records, but there is no anticipated
technique to assess the EHRs. This implies that accuracy of diagnostic process using
automated system could be limited. If the system fails to gather correct data, the model will
lose the ability to diagnose a disease precisely. Hence to address this problem the authors
started establishing efficient deep learning model for fast & accurate detection of various
diseases. As a part of this in the present days deep CNN model is used to identify diseases.
All the layers in CNN filters the raw data present inside the image to obtain a definite pattern.
The last layer of CNN works as an ordinary neural network, and it brings together highly
advanced features like various symptoms of the disease which in turn helps in predicting the
outcome of the disease.

47
The suggested model for Web-Based medical diagnosis and prediction includes the following
components:
 Databases
 prediction module
 diagnosis module
 User interface
The databases contain patient’s information and information about patients-diseases. This
database is used to save patient’s information such as name, addresses, and other particulars
details. On the other hand, Patients-disease database saves all the data about patients and their
sickness. This information in the database consists of types of diseases, the treatments, and
other particulars. Patients’ information is stored separately in a different database to develop
the patient’s records storage, so that other departments can utilize the records when the
patients are referred to them. Therefore, this method of databases blocks the other
departments or illegal users from acquiring the information about patients and their diseases.
This also helps in providing a centralized information access for the patients records.
Prediction module and diagnosis module are two of the main characteristics of Web-Based
Medical Diagnosis and Prediction.
Prediction module uses neural networks techniques to anticipate patient’s diseases or
conditions. Here data from patients-disease database is used for detecting the diseases. This
data will be used to analyse the new data. Diagnosis module contains of an expert system
and fuzzy logic techniques to carry on diagnosis tasks. After the diagnosis is done a set of
rules will be framed using the patients and patients-disease databases along with an expert
knowledge on the disease domain. This expert system utilizes the framed rules to identify
patient’s illness depending on their present medical conditions and symptoms.
Recently, IBM's Watson has gained recognition in the media for its attention on precision
medicine, mainly for cancer diagnosis and treatment. Watson is also found to employ a
combination of machine learning and NLP capabilities.
Another example would be the collaboration of Google with health delivery networks to
establish prediction models from large data to alert the clinicians about high-risk conditions,
such as sepsis and heart failure. Hence Google, Enlitic are few start-ups which started
developing AI-based image interpretation algorithms. Each of these would assist in decision
making to the clinicians to provide the best diagnosis and treatment for patients.

48
Apart from all these ‘population health’ machine learning models are also used to predict
populations at risk of diseases. These models are found to be efficient in predicting the future
outcomes, although they sometimes lack.

5.2.4 Help with training or diagnosis in under-resourced areas

Some countries or areas face challenges with regarding to qualified clinicians or they are
found to have less access to skilled training. In such cases misdiagnosis or completely
missing a problem are the most common problems. AI systems though are not completely
perfect, they often help in predicting outcomes when used in connection with the human
clinician. As the technology advances day by day, we can expect more advantages of AI in
healthcare diagnostics.
NASA’s Human Research Program is establishing a platform that utilizes machine learning
to recognize a wide variety of critical issues. Many problems like bone density, intracranial
pressure, and cardiovascular pathologies are all considered as important factors to monitor.
Due to this smart guidance systems are introduced to allow the untrained astronauts to use
ultrasound machines properly. If this mechanism is proven accurate, then this would help in
making accurate diagnosis in the remote areas where the medical assistance is not accessible.
As AI has the capacity to surpass humans in the same way AI algorithms are also proved to
be accurate and simple at specialty-level diagnostics. These algorithms are also found to be
cost-effective in terms of diagnosing diabetic retinopathy. 
For example, Path AI is introducing machine learning technology to help the pathologists in
making more accurate diagnoses. The company's aim is to reduce errors in cancer diagnosis
and developing techniques for personalized medical treatment.

5.3 TREATMENT OF DISEASES USING ARTIFICIAL INTELLIGENCE

Even after the disease is identified and classified, the treatment process would cause
additional problems. A treatment plan includes specifying medicines and exercises,
organizing care plans and helping patients to decide on their treatment programs. Modern AI
algorithms advices the doctors to use advanced surgical robots to execute highly complex
operations as this would help in building a comprehensive approach for disease management.

AI has paved way of various advancements in healthcare treatments, such as improving the
treatment tactics, scrutinizing data to provide high level treatment procedure, and monitoring

49
treatments. AI can recognize signs and symptoms of disease in medical images, such as MRI,
CT scans, ultrasound, and x-rays20. This enables faster diagnosis of diseases reducing the time
of patients. Doctors will now have an opportunity to find information regarding modernizing
Medicine, patient information, record of diagnostics, tests and prescriptions to arrange billing
information.

5.3.1 Virtual nursing assistants

Now a days virtual nurses are available 24/7, they can respond to the patients, monitor
patients and give them quick answers. Most of the applications of virtual nursing assistants
today permits for regular interaction between patients and care providers. This is mainly done
to prevent hospital readmission or needless hospital visits. One of such examples is provision
of wellness checks through voice and AI by Care Angel's virtual nurse assistant.

5.3.2 Image analysis

Image analysis is considered as a time consuming for humans, but a machine-learning

algorithm is developed to examine 3D scans. This helps the surgeons in assessing the body
conditions of the patients21. Moreover, AI image analysis could help the remote areas to have
easy access to healthcare providers. This also increases the efficiency of telemedicine as the
patients can use their camera phones to send in pics of rashes, cuts or bruises to determine
what care is necessary.
In this complicated world of healthcare, AI tools assists the human providers in providing
faster service. They would also help in detecting issues and examining the data to identify
trends or genetic information. As saving time can save many lives, AI and machine learning
is found to be transformative for every single patient.

5.4 IMPACT OF ARTIFICIAL INTELLIGENCE ON PATIENT SAFETY

Healthcare is a common sector to implement AI in. It creates large amounts of data, and AI
helps in generating plenty of opportunities to improve the standard of its products and
services by making them more intelligent and intelligible.

20
Markus Schmitt, Artificial Intelligence in Medicine”, a blog by data revenue published in 2020, Accessed on
July 1, 2021
21
Bernard Marr, “How is AI used in healthcare – 5 Powerful real - world examples that show the latest
advances”, published on Jul 27, 2018, Accessed on Jun 29, 2021.

50
5.4.1 Diagnostics

Though Chatbots are not that common in healthcare systems several other kinds of analytics
are being widely used in diagnostics. The tools regarding AI have gained more importance
because machines have proved themselves to be more capable in the process of diagnosis
than human doctors or radiologists22. This has obviously led to supposition that machines
would replace the jobs of human medical staff, especially radiologists. Back in 2016, Geoff
Hinton, often described as the father of deep learning, said within five years, deep learning is
going to do better than radiologists.
Change is not that easy in healthcare sector as there is no powerful market to encourage
innovation. Johnson & Johnson in 2013 has obtained FDA sanction for an automated
anaesthetic system called Sedasys. This is used in un-challenging processes like
colonoscopies. This is also found to be successful in Canada and the USA, but however the
sales were not up to the mark. But a few years later, J&J took over the business with this
advancement.

5.4.2 Medical AI in consumer devices

Now a days Apple Watches are checking heart rate, conducting electrocardiogram test, and
testing atrial fibrillation. Normal sensors attached to watches and smartphones, smart glasses,
have started sampling our sweat and our blood glucose. By this our breath will be checked
and digitized, and this in turn is used in identifying cancer, or potential heart problems. The
phone cameras which we use are used to scan skin cancers, and their microphones are used to
capture data about our voices to our mood, or diagnose serious diseases.

5.4.3 Assessing the Impact of AI on Physicians

Physicians cannot handle hundreds of images in a particular time frame. Hence AI is found to
be more effective in this area through predictive analytics and image recognition. This paved
way for a small hope that AI-based systems will replace physicians, especially radiologists.
Through this image recognition AI helps in interpreting most complex clinical images as
accurately as today’s most experienced radiologists. According to Recht AI would form a
routine part of radiologists’ lives, increasing the accuracy and efficacy in their work. AI-
based tools perform normal reading tasks such as quantification and segmentation etc. This

22
Angela Spatharou, Solveigh Hieronimus, and Jonathan Jenkins, “Transforming Healthcare with AI: The
impact on the workforce and organizations”, published on March 10, 2020, Accessed on Jul 1, 2021

51
assists the radiologists performing more value-added tasks, such as understanding patients
clinical and imaging information, to improve patient care.
Patient-facing AI: Improving experiences, costs, and outcomes
“Patient self-service” is a technique which concentrates on the choice and convenience of
patients. This model basically helps to complete the tasks of organizing appointments, paying
bills and filling out or updating forms everything at their own convenience. With these
patients are able to use the devices such as phones, tablets, and laptops to perform these tasks
at any time and from any place. By applying this model of self-service programs in hospitals
and other healthcare sectors the patients will be able to reap some of the benefits such as
reduced cost, reduced patient waiting times, fewer errors, simple payment options, and
increased patient satisfaction. Recently the organizations started using online portals with
chatbots for patients to perform the above activities. In certain situations, image analysis is
used to study the bar codes, photos, or handwritten notes.

5.5 ROLE OF ROBOTICS IN SURGERY

The first-known automated type machines are Robots. Initially robots were developed for
carrying on specific tasks without any artificial intelligence (AI). But now the situations are
different, AI is included into robots to enhance the level of robotics. The present-day Robots
are not confined to repetitive tasks alone but they are considered as the advanced version of
previous robots. These robots are developed through machine learning training to identify the
various objects and to perform various actions. Due to this the performance of robotics is
getting improved23. The application of robots in the field of healthcare helps the doctors in
performing complex procedures with an accuracy robot with cameras, mechanical arms and
surgical instruments increase the experience, capability and knowledge of doctors to develop
new kinds of surgeries.  This Robotics is being employed in medicine for more than 30 years.
There are different types of robots ranging from simple laboratory robots to highly complex
surgical robots. These robots can assist and help a human surgeon or can perform operations
by themselves. Along with surgery, they’re also utilised in hospitals and labs for various tasks
such as rehabilitation, physical therapy etc. 

23
Blog by Association for advancing Automation, How Artificial Intelligence is Used in Today’s Robots, Nov

09, 2018, Accessed on Jun 27,2021

52
Recently AI robots are also used to provide an automated solution to medicine and other
sectors in the industry. Several companies are now using AI from the healthcare industry to
train robots for different purposes. This makes the AI robots more intelligent to perform
various crucial tasks without human assistance. For the first time the most advanced surgical
robot by name Da Vinci was used to perform an eye surgery, allowing the doctors to perform
complex operations24. With the growth of technologies robots also started functioning more
autonomously, performing certain tasks entirely on their own. As a result of this the doctors,
nurses, and other healthcare workers started concentrating on providing more importance to
patient care.

Surgical robots help surgeons to perform complicated micro procedures without making large
incisions. With the evolution of surgical robotics AI-enabled robots started using computer
vision to locate specific areas of the body while avoiding nerves and other obstacles.
Surgeries performed with robotics assistance fall into two main categories:

Minimally invasive surgeries for the torso:

These include robotic hysterectomy, robotic prostatectomy, bariatric surgery, and other
operations primarily concentrating on soft tissues.
Orthopaedic surgeries:
Instruments and devices like the Mako robot by Stryker can be preprogramed to carry on
common orthopaedic surgeries, such as knee and hip replacements. For example 379
orthopaedic patients contended that AI-based robotic process resulted in five times fewer
complications compared to surgeon’s operation alone.  

5.5.1 Types of Medical Robotics Used in Healthcare

1. Robots for Transporting the Medical Supplies

These robots are used to supply medical supplies and other essential items used in hospitals, or
healthcare centres25. Actually, robots are equipped with self-navigation technology, to roam in
the hospital surroundings to reach a patient’s room or other places in hospitals without human

24
Vikram Singh Bisen, AI in Robotics: Use of Artificial Intelligence in Robotics, Oct 14, 2020, Accessed on Jun
27,2021 
25
Abeer Raza, “How AI Robots are transforming the healthcare industry”, published on May 6, 2021, Accessed
on Jul 5, 2021

53
help. These are also called Mobile Robots. Mobile robots move around hospitals and clinics
confining to predefined tracks. They’re used for several purposes such as disinfecting rooms,
helping transport patients, or moving heavy machinery. In the process of cleaning and
disinfection mobile robots uses ultraviolet (UV) light, hydrogen peroxide vapours, or air
filtration as they help in reducing infection. It simply, sprays the chemicals and purifies the
large areas with high speed. This would in turn save time and effort.

2. Robotics for Prescription Dispensing Systems

AI robots are found to be more accurate than humans in performing certain tasks. This is a
very important aspect for the healthcare industry a providing accurate details or medication is
one of the important requirements for improving patient care. Such robots can help in carryin
on many other items when installed at hospitals or medical centres.

3. Robots Used as Telepresence Physicians

Telepresence physicians are a type of virtual reality physician. They are used to analyse and
treat patients from remote locations or rural areas. They provide the feeling of getting
consulted with a real doctor, making the two-way interaction possible among them. However,
in serious situations, experts can be called, via robot to answer the questions and guide about
the treatment from the remote locations. This type of robots is also equipped with AI
cameras and other features to analyse the patients physical and mental health condition to
provide an accurate diagnosis of patients.

4. Robots to Work as Surgical Assistants

AI-based robots are structured to assist surgeons in performing various surgeries. These are
formulated, with 3DHD technology to deal with highly complex surgeries. All these robots are
developed with different kinds of training data through computer vision to perform the right
action accordingly. The data used to train AI based robots consists of images of the objects
which in turn help the machines to identify and recognize different types of diseases. Robots
scrutinize data from previous medical records to assist a surgeon's during surgery. This can
lead to a 21% reduction in a patient's hospital accommodation.

5. Therapeutic Robots

54
Therapeutic robots are used in rehabilitation after strokes, paralysis, traumatic brain injuries,
or multiple sclerosis. These robots are also equipped with AI and deep cameras to interact
with patients and to provide them coaching and encouragement regarding the treatment.
6. Service Robots
Service robots reduce the burden on healthcare workers by performing routine logistical
tasks. Most of these robots work autonomously they send a report when the task is
accomplished. They also arrange patient rooms, track supplies and transport bed linens to and
from laundry facilities. This relieves health workers from the routine work and allows them
to focus on immediate patient needs.

7. Social Robots

These social robots are known for their interaction patients. They are also called as “friendly
robots” and can be used in long-term to take care of patients. They provide encouragement to
the patients to comply with treatment regimens thereby keeping the patients alert and
positive. Generally social robots are used to reduce the caregivers’ workloads and improve
patient’s emotional well-being.
8. Autonomous Robots
Autonomous robots can self-locate the patients in exam or hospital rooms, permitting the
clinicians to communicate with the patients from afar26. Robots accessed by a remote expert
or other worker can also accompany doctors when they make hospital rounds. They also
allow the specialist to interact through on-screen consultation regarding patient diagnostics
and care. These robots keep track of their own batteries and make their way back to charging
stations when necessary. Some autonomous robots also perform cleaning and disinfection by
identifying infectious disease wards, operating rooms, laboratories, and public hospital
spaces. One of such robots developed by the start-up Akara is being used to sanitize the
hospitals rooms and equipment, aiding in the fight against COVID-19.
A few examples of Robots developed for surgeries are Vicarious Surgical which combines
virtual reality with AI-enabled robots so surgeons can perform minimally invasive operations
as well as Heart lander, a miniature mobile robot developed by the robotics department
at Carnegie Mellon University, which was developed to facilitate therapy on the heart. 
5.5.2 How Artificial Intelligence is Used in Robotics?

26
Intel, “Robotics in Healthcare are to improve patient outcomes”, Accessed on Jul 4 2021

55
The AI in robotics not only helps in performing certain tasks but it also makes machines more
intelligent to carry on different tasks in different scenarios. There are various programs
integrated into robots like computer vision, motion control, detecting the objects, and training
data to interpret physical and logistical data patterns and act accordingly 27. Here, image
annotation plays a key role in handling a large number of datasets assisting the robotics to
detect and grasp different types of objects or carrying on the desired action to make AI
successful in the robotics. A large number of sensors are inserted inside the AI based robots
wherein they help the robots to sense the surroundings or understand the visuals of the
environment. Like the humans have five key sensors, AI based robotics also contains various
sensing technologies to perform for various functions. Starting from motion sensors to
computer vision for object detection, there are several sensors making the AI possible in the
robotics. When the robots detect new objects, the machine learning present in robots makes
the new category to identify such objects if visible again in the near future. This increases the
efficiency and self-recognizing capacity of the machines to detect new objects.
Types of Sensors in Robotics:
 Time-of-flight (ToF) Optical Sensors
 Temperature and Humidity Sensors
 Ultrasonic Sensors
 Vibration Sensors
 Millimetre-wave Sensors
5.5.3 Benefits of Robotics in Healthcare

Health robotics provide a high level of patient care and a safe environment for both patients
and health workers28.
High-Quality Patient Care
Medical robots are mainly used for monitoring patients with chronic diseases, intelligent
therapeutics, and social engagement for elderly patients. In addition, these robots provide
patients more importance and human interaction, which in turn promotes long-term well-
being.
Operational Efficiencies

Vikram Singh Bisen, “AI in Robotics: Use of Artificial Intelligence in Robotics”, Published on Oct 14 2020,
27

Accessed on July 4 2021

28
Emilia Marius, 6 Ways AI and Robotics Are Improving Healthcare, May 29, 2019, Accessed on Jul 8, 2021

56
Service robots helps in making supplies regarding equipment and medication in the places
where they are needed. They keep track of those supplies thereby placing timely orders of
such supplies. Mobile cleaning and disinfection robots sanitise hospital rooms for incoming
patients.
Safe Work Environment
Cleaning and disinfection robots take care of pathogen exposure while helping in reducing
the infections in hospitals. These robots are already used by hundreds of healthcare centres.
Social robots also perform tasks like heavy lifting, such as shifting beds or patients, which
reduces physical strain on healthcare worker.

5.6 CONCLUSION:

Early identification of various chronic diseases by artificial intelligence helps in early

initiation of the treatment for it, which decreases the spread of the disease, enhances patient’s
quality of life and further lowers the economic burden involved in healthcare management.
There is a need to continue the development of these methods which paves way for research
in nearly diagnosis of various chronic diseases.
Artificial intelligence in medical diagnosis helps with medical decision making, management,
automation, admin, and workflows. It can be used to diagnose cancer, triage critical findings
in medical imaging, flag acute abnormalities, provide radiologists with help in prioritizing
life threatening cases, diagnose cardiac arrhythmias, predict stroke outcomes, and help with
the management of chronic diseases. Over the past few years, artificial intelligence in
medical diagnosis has shown immense promise in changing the standards of medical care
while reducing the extreme pressures felt by the medical industry. During the COVID-19
pandemic, hospitals and clinics began deploying robots for a much wider range of tasks. It’s
become clear that the operational efficiencies and risk reduction provided by health robotics
offer value in many areas. When working together, robots are smarter, more accurate and
more profitable. AI has yet to come close to reaching its full potential, but as it advances, so
will robotics. Nowadays a wide range of increasingly more sophisticated and accurate similar
sensors, combined with systems that can fuse all of this sensor data together is empowering
robots to have increasingly good perception and awareness for the right actions in real-life

57
 CHAPTER VI
LEGAL REGIME OF ARTIFICIAL INTELLIGENCE IN THE HEALTHCARE
SYSTEM AND EXAMPLES OF SOME TOP COMPANIES

6.1 INTRODUCTION

Despite the huge progress that comes with AI development, few notable challenges are yet to
be sorted, mainly when it involves data. Artificial Intelligence is rapidly entering health care
and serving major roles, from automating surgeries, performing routine tasks to managing
patients and medical resources. As developers create AI systems to work on the routine tasks,
several risks and challenges also emerge along with the success. These challenges include the
danger of injuries to patients from AI system errors, the danger to patient privacy and more.
The ambit of liability of medical professionals or medical mans in cases of medical
negligence has got to undergo many legal procedures and typically the liability of a medical
practitioner is extremely difficult to prove under law. This is often because the term medical
negligence is narrower in meaning than that of ordinary negligence under the law. the
subsequent article will discuss the concept of medical negligence and therefore the liability of
the healthcare practitioner in cases of medical negligence and malpractices. Further, the
Article will discuss the interface of AI in diagnosis and treatment in times, the article would
discuss government policies and plans associated with regulations of AI within the health
care sector. it'll also discuss various sorts of AI and particularly those specific types which
are currently utilized in the healthcare sector. This chapter mainly focuses on the discussions
and issues concerning the distribution and assigning liability just in case of medical
negligence when AI is involved within the diagnosis or treatment.
Taking all the above aspects into consideration the present chapter provides a basic idea
regarding the threats and challenges faced by Artificial Intelligence in healthcare along with
an explanation about the role of Artificial Intelligence in dealing with the pandemic COVID-
19. The chapter also gives a detailed view on the liability issues in cases of medical
negligence. Further it discusses about the various initiatives undertook by the Government of
India. Finally the chapter concludes with examples of various countries and companies which
have dealt with Artificial Intelligence.
6.2 THREATS AND RISKS FACED BY ARTIFICIAL INTELLIGENCE IN
HEALTHCARE
6.2.1 Data digitization and consolidation

Without the massive portion of data fed into the AI systems, it is difficult to get results.
Hence it is significant to collect high-quality healthcare data which is found to be difficult in
the recent years. The difficulty arises with the unorganized health data spread across various
data systems and organizations. This arises due to the change in the data regarding insurance
providers and healthcare providers too frequently, making data access a challenge. The much
more challenging task than this is to digitize or consolidate the above data with the low-
quality data systems. Training AI systems needs large quantity of data from various sources
such as electronic health records, pharmacy records, insurance claims records, or consumer-
generated data like fitness trackers or purchasing history. But health data is often complex
and complicated29. Patients consult different providers and change insurance companies
which leads to data split in multiple systems and multiple formats. These modifications in
data increases the risk of error, decreases the comprehensiveness of datasets, and expands the
cost of gathering data.

6.2.2 Updating Regulations

There are lots of strict laws regarding confidentiality and privacy of medical records
worldwide. All these laws should be updated for providing an accurate medical assistance to
the patients. Moreover, in the legal cases patients should provide their consent to issue
medical data and use them for such purposes. Medical institutions must also mandate strict
adherence with such rules and be responsible for patient data acquisition and use.

6.2.3 Human interventions.

Almost all the patients and medical professionals are doubtful about the role of AI in
healthcare. In addition to this radiologist do not want robots to take over their jobs and
patients do not want to submit themselves to machines to deal with their health concerns.
Without correcting these mistakes, it is not easy to build an AI-based health care system. AI
should be used to assist healthcare practitioners in implementing their diagnostic roles.

29
Daniel Quest, PhD; David Upjohn; Eric Pool, EdD, PMP, ITIL; Ronald Menaker, EdD FACMPE, MBA;
James S. Hernandez, MD, FCAP; and Kenneth Poole Jr., MD, MBA, CPE, FACP ,“ Demystifying AI in
Healthcare: Historical Perspectives and Current Considerations”, Published on November 9, 2020, Accessed on
Jul 7,2021
6.2.4 Errors and injuries

The most common risk is that AI systems sometimes are proved to be wrong as AI systems
are open to mistakes, which obviously leads to patient injury. For example, a patient may
consume a medicine which is wrongly suggested by the AI system, leading to more
questions. In the same way the AI-driven radiological scan may miss a tumour. The wrong
arrangement of a hospital bed based on AI predictions can lead to deterioration of patient’s
health. Hundreds of patients would suffer from just one error. Of course, many injuries
happen due to medical errors in the health-care field today, even without the role of AI in
healthcare. Patients and providers also react in a different manner to injuries resulting from
software than from human error. Mistakes related to AI systems are more serious because
they effect so many patients at once.
6.2.5 Privacy issues.
Privacy is a serious issue regarding patient data collection. Though measures are taken in
place to secure patient data, there are many hackers out there trying to access the patient data
for various reasons30.  Some patients may also get worried that this collection of data may
violate their privacy, and many lawsuits are also filed based on data-sharing between large
health systems and AI developers. Another way privacy is at risk with AI is the capability of
AI to predict the private information about patients when the algorithm is not saved with that
data. An example of this would be the identification of a person’s disease based on the
trembling of a computer mouse, even if the person had never disclosed that information to
anyone else. Patients consider this a violation of their privacy, mainly if the AI system’s data
was available to third parties, such as banks or life insurance companies.

6.2.6 Inequality and Discrimination.

AI systems treat the patients based on the data on which they are trained, and they can
incorporate biases from those data. For example, if the information available for AI is
collected from academic medical centres, the other AI systems will not be aware about it and
therefore treatment also might be less effective. Even if AI systems take the data from
accurate, representative data, problems are found to exist if that data replicates underlying
biases and inequalities in the health system. If the faintest hint of bias is found to be present
in training AI systems, then according to the report, that bias will be present in the actual AI.

30
Sumi menon, “How Artificial Intelligence is Changing the Healthcare Industry”, Published on September 24
2018, Accessed on Jun 25,2021
6.2.7 Professional reshuffling

We may experience shifts in the medical profession if the AI technology is completely

implemented. Some scholars’ opinion on the widespread use of AI reducing human
knowledge and capacity over time is gaining grounds. According to them, it may get to a
point where providers can practically curb AI errors or advance medical knowledge.
Longer-term risks involve shifts in the medical profession. Some medical specialties, such as
radiology, are likely to shift substantially as much of their work becomes automatable. Some
scholars are concerned that the widespread use of AI will result in decreased human
knowledge and capacity over time, such that providers lose the ability to catch and correct AI
errors and further to develop medical knowledge
One long-term risk of implementing AI technology is that it could lead to “shifts in the
medical profession.”
“Some medical specialties, such as radiology, are likely to shift substantially as much of their
work becomes automatable,” Price II wrote. “Some scholars are concerned that the
widespread use of AI will result in decreased human knowledge and capacity over time, such
that providers lose the ability to catch and correct AI errors and further to develop medical
knowledge.”

6.3 LIABILITY ISSUES

6.3.1 Unanswered Legal Questions
1. How does AI programs ensure patient consent and privacy of confidential medical data?
2. How to deal with the questions regarding liability among the practitioner, hospital, and
the AI system developer, trainer and manager in case of an act of medical negligence?
3. In the case of an AI diagnostic mistake, or inaccurate utilization of data, or a
technological irregularity, who would be held liable: the practitioner, the AI developer,
the specific program engineer who designed it or the AI robot?
4. How to analyse the standard of accountability of the physician when a false diagnosis or
treatment occurs due to a mistake in the data feed or an AI systemic glitch?

The present laws states that, a medical professional will be held responsible in cases where a
deficiency of his/her duty leads to negligence. This is proved through various instances in
which civil as well as criminal penalties were imposed on medical professionals in the past
for negligence. The basic ambiguity in imposing of liability for any kind of negligence is that
the regulations do not distinguish cases where there is an error in diagnosis malfunction of a
technology, or the use of inaccurate or inappropriate data. Hence presently either the software
developer or the specific program engineer is not liable for developing the AI solution. There
is no clear picture regarding determination of the standard of accountability of the medical
professional when he/she provides the wrong treatment or diagnosis due to wrong data entry.
For example, few AI solutions created for treating cancer patients are observed to give unsafe
recommendations. In another instance when a drug was prescribed for a cancer patient for the
reduction in bleeding it was found by the reports that the drug whichever is recommended
instead of reducing it has worsened the bleeding. In this case the current regulations in India
had made the medical professional accountable for prescribing the relevant drug and he/she
was not allowed to take defence that they relied on the recommendation of an AI solution.

6.3.2 Torts and Private Causes of Action

According to the law of torts the doctor is considered as a trusted specialist or the expert. It is
always assumed that the treating doctors are completely responsible for their own decisions,
and eventually, they are also held accountable if the medical care they provide is proved to be
negligent. But whether the physician can be held liable for providing a false treatment at the
recommendation of the AI diagnostic tool? The New York University researchers contend
that medical AI should be provided special legal status equal to person hood to decide on the
matters of decision making by AI. However, one of the concerns is that the aspect of foresee
ability in the traditional tort law may not work when AI systems perform a medical diagnosis
and treatment. Under this law for a person to be held liable for negligence, the injury caused
should be ordinarily foreseeable. The AI or machine learning systems are found to work on
the past data and patterns and hence the act of foresee ability is found to be difficult in this
area.

The recent tort law principles states that when AI exists in the health care services, both the
developer and provider of the services will have the liability.
Strict liability - A developer is held accountable for errors in their AI, design defects,
inadequate planning of AI etc. under this provision a developer can be held liable only if
his/her acts are unreasonably dangerous to users or unreasonably hazardous to consumers.
However, the AI itself will not be liable for its acts or omissions. As a result, whoever are
involved in the process will be exposed to the liability associated with the AI. Along with this
basing on how the AI is utilised, a provider should disclose the use of AI to their patients as a
part of the informed consent process.
6.3.3 Information Technology Act, 2000 (“IT Act”) and Information Technology
(Reasonable Security Practices and Procedures and Sensitive Personal Data or
Information) Rules, 2011

Section 43A of the Information Technology Act, 2000 (“IT Act”) and Information

Technology (Reasonable Security Practices and Procedures and Sensitive Personal Data or
Information) Rules, 2011 requires adequate security measures to be taken by the corporations
for regulating data protection in India because in the absence of proper regulations the
developers of technology would be held responsible for unnecessary reasons. The limitation
of liability as mentioned in the IT Act, 2000 may not work efficiently in the era of artificial
intelligence. Section 79 of the Act states that intermediary service providers in the field of
information technology are considered as the carriers of content. Hence according to this
provision, they will not be held liable for the substance of the content. But this rule should be
re-examined after applying the AI systems in the field of healthcare.

6.3.4 Digital Information Security in Healthcare Act, 2018 (DISHA)

The Digital Information Security in Healthcare Act, 2018 of the Ministry of Health helps
people to secure their confidential and private digital health data. According to the Health
Ministry ‘s proposed Digital Information Security in Healthcare Act (DISHA)

1. A serious breach of healthcare data is punishable up to five years imprisonment

with a fine up to Rs. 5 lakhs. 
2. When a person infringes digital health data intentionally, dishonestly, fraudulently
or negligently, passes on the information and if a person fails to protect the data in
compliance with the standards prescribed by the Act or with any rules then such an
act would amount to serious violation of norms of digital health data.

Here according to the provision of Digital Health services an employer may also be sued
owing to the concept of vicarious liability. The Digital Health Services would impose
criminal charges on the provider if he is found reckless or incompetent in carrying on a
service and if such service results in physical harm or death of the patient/user. If the person
is convicted on a criminal charge, he/she may face both imprisonment and fines.
6.3.5 Artificial intelligence and medical negligence interface
In the present scenario the medical negligence cases which include only human medical
practitioners are itself considered difficult to assign liabilities, due to several reasons. In India
though the doctor’s liability is attributed to many cases, including vicarious liability of hospitals
the development of assigning medical negligence and requesting for compensation etc are still
considered to be in the developing stage. All the previous precedents and case laws or legal
principles relating to the healthcare sector and medical negligence were framed keeping in mind
humans as the main practitioners or healthcare professionals.
The development of AI in the health care sector would not only help in gaining profits but it
would also give rise to serious legal issues and implications which the legislators have to address
beforehand only. Even after the statement by ministry regarding the serious involvement of AI in
the health care sector, agriculture sector and finance and accounts sector, till now, not even a
single bare act provision or case has come where the term AI is mentioned.
For now, as far the liability aspect is considered when an AI work is managed by a medical
practitioner and the medical practitioner makes some errors in handling it, because of which the
patient is dead then such a medical practitioner will be held liable for the negligent act done by
him. But when the mistake on the side of AI, then who will be held accountable for the same,
whether the medical practitioner who has done his or her duty with due care, or whether the AI
developer or the owner of the AI i.e., the hospital is another question to be researched upon.

6.4 GOVERNMENT INITIATIVES

AI in healthcare is facing regulatory challenges which can be solved only by an effective

regulatory framework. The change in technology has increased the standard of AI in
healthcare in India. Hence the Indian laws has to be amended as early as possible to regulate
the role of AI in the healthcare sector. However, there are many suggestions regarding the
establishment of a committee for evaluating the operations of AI-driven solutions.

Presently there are various healthcare organizations governing the digital health in India.

At the national level - Ministry of Health and Family Welfare, Government of India

At the state level – Organisation working under the above department. This organisation is
headed by a Minister and it contains a secretariat headed by a secretary or commissioner
belonging to the cadre of IAS

Apart from these the government undertook many initiatives regarding the digital health such
as Reproductive Child Healthcare(RCH), Integrated Disease Surveillance Program(IDSP),
Integrated Health Information System(IHIS), Electronic Vaccine Intelligence
Network(EVIN), e-hospitals, e-sushrut, Integrated Health Information Platform(IHIN),
Central Government Health Scheme(CGHS), National Health Portal(NHP), National
Identification Number(NIN), Online Registration System(ORS), National Medical College
Network(NMCN), Health Management Information System(HMIS) etc.

The Central Drug Standard Control Organisation (CDSCO) under Directorate General of
Health Services is the governing authority for regulating the medical devices and diagnostics
in India. The Drug Controller General of India is the official responsible for approving
certain medical devices for treatment or diagnosis. The manufacturing, import, sale and
distribution of medical devices and drugs are governed under India’s Drugs & Cosmetic Act
and Rules (DCA).

The planning commission (the NITI Aayog) constituted under the Government of India
issued some guidelines regarding the ethics in AI and its regulation and it also gives a clearer
picture of the regulatory future ahead. These documents include the "National Strategy for
Artificial Intelligence “AI for All” (issued June 2018), "Working Document: Towards
Responsible AIforAll – Part I" (issued August 2020), and the latest one being the "Working
Document: Towards Responsible AI for All – Part I" (issued November 2020)
(collectively Policy Documentation).

6.4.1 Ministry of Health and Commerce

The Ministry of Commerce and Industry in 2017 has formulated a high-powered Task Force
on Artificial Intelligence to give a clear picture on how AI could be applied for India
economic development across different sectors. Though the above task force incudes in itself
outstanding civil servants, entrepreneurs, technocrats and researchers from various fields such
as engineering, IP, robotics, and artificial intelligence, it does not even contain a single
medico-legal expert to address the issues of law. Hence there is an urgent need for the AI
developers, and medical practitioners in India to look into the legal aspects while framing,
applying, and regulating artificial intelligence in the healthcare sector.

6.4.2 Ministry of Health and Family Welfare

The Ministry of Health and Family Welfare passed a draft of the Healthcare Security Act
with an intention to proposes civil and criminal remedies for violation of data and principles.
This Act also paves way for the establishment of the National Digital Health Authority, to
concentrate exclusively on enforcing healthcare data protection norms.

6.4.3 IPR Regime

As it is known from IPR that the intellectual property regime in India does not recognize
patentability of algorithms, the basis on which an AI solution functions. Moreover, the
Patents Act expressly restricts the algorithms from the ambit of “inventions” eligible for
patent protection. Also, Indian laws issue copyrights to inventors of the work with the
monopoly right to reproduce their works. But there is no clear picture regarding the grant of
copyright for the creation of copies of these works and datasets.

6.4.4 Data Protection Laws

According to the Data Protection Act,1998 and National Health Services Act,2006, personal
information of the patient, such as treatment history and clinical conditions are regarded as
Confidential Personal Data or Knowledge. Section 251 of National Health Services Act,2006
states that before seeking the information relating to above aspects the consent of the patient
must be taken wherein it should be in written format.
6.4.5 IT Act
The applicability of the IT Act is little different for digital health services because they only
encourage the interaction between the patient and the service provider and they do not take
part directly in providing the services to the patients. In such cases, the service provider will
be treated as an intermediary so that he would be getting certain relaxations with respect to
liability for third party data under the Intermediary Guidelines and the IT Act.
Below are the various laws in India which deal with Digital Health services:
1. The Information Technology Act (IT Act)
2. The Information Technology (Reasonable security practices and procedures and sensitive
personal data or information) Rules, 2011 (“Data Protection Rules”) 
3. The Information Technology (Intermediaries Guidelines) Rules, 2011 (“Intermediary
Guidelines”)

The Union Ministry of Electronics and Information Technology in February 2018, has
formulated four committees to draft a road map for conducting a national AI programme.
The four committees are as below:
a. Committee on Platforms and Data for AI
 b. Committee on Leveraging AI for identifying National Missions in Key Sectors
c. Committee on Mapping Technological capabilities, key policy enablers required
across sectors, skilling & re-skilling, R&D
d. Committee on Cyber Security, Safety, Legal and Ethical Issues

6.4.6 NITI Aayog – National Strategy for Artificial Intelligence AI FOR ALL
The main focus of AI FOR ALL is to enhance and empower human abilities to face the
challenges of availability, affordability, shortage and inconsistency of skilled medical
practitioners. Proper application of AI initiatives I very much necessary for emerging
economies to tackle some of the global challenges 31. These challenges may arise regarding
application, research, development, technology, or responsible AI. Thus, AI for All refers to
the leadership of technology in AI for achieving the greater success. A three-pronged
approach was proposed by NITI Aayog -
1. Establish AI projects in various spheres such as agriculture, health etc.
2. Formulating a national strategy to bring out a vibrant AI ecosystem in India and
3. Integration with specialists and stakeholders.
Finally in June 2018, NITI Aayog has placed discussion paper on the National strategy for
Artificial Intelligence which is termed as “AI for All” in short. NITI Aayog mentions mainly
about five primary sectors: education, agriculture, healthcare, smart cities and infrastructure,
and smart mobility and transportation. The discussion paper mentioned above on the National
strategy for Artificial Intelligence AI for All states about two institutions:
1) Centres of Research Excellence (CORE), to focus on core research on AI and to collect
existing research and to create new knowledge for encouraging technological advancements;
2) International Centre of Transformational AI (ICTAI), to provide an ecosystem for both
development and deployment of applied research.
The above two authorities would work under an organization the ‘Centre for Studies on
Technological Sustainability (CSTS)’ wherein the main aim of this organisation is to focus
on issues related to finance, social sustainability and global competitiveness of the AI
technologies developed.
6.4.7 INDIA AI -The National AI Portal of India
A joint venture by name INDIA AI is established by the Ministry of Electronics and
Information Technology (MeitY), the National E-Governance Division (NeGD) and the
31
Nirupam Bajpai and Manisha Wadhwa, “Artificial Intelligence and Healthcare in India”, Published on
Jan,2020, Accessed on Jul 8,2021
National Association of Software and Service Companies (NASSCOM). this was begun by
the Indian Government on 1st June 2020. It was framed with a mission to prepare the nation
for an AI future. The main aim of the portal is to establish a unanimous AI ecosystem to
foster economic growth and improve lives through it.
The objective of this platform for AI is to enable
 Allotment of useful AI resources like technical papers and articles and furnishing
information for AI start-ups, companies and educational firms
 Distribution of documents, case studies, research reports
 Grabbing of opportunities

 New job roles and job postings in the domain of AI

6.4.8 National Program for Government Schools: Responsible AI for Youth

A National Program for Government Schools: Responsible AI for Youth was established by
the National e-Governance Division, Ministry of Electronics and Information Technology,
Government of India in cooperation with Intel India (National E-Governance Division
NEGD, Ministry of Electronics and Information Technology, Government of India 2020).
The aims and objectives of the program are as follows:
 To demonstrate AI for youth and train them with the skill sets and the mind-set required
for AI readiness.
 To provide free access to AI tools and prepare the youth to use them skilfully.
 To enable youth to create meaningful social impact solutions as evidence of achievement.

Statutory, Regulatory and Common Law Requirements

Nonetheless of whether we register AI as a health care provider or a developer or both, some

statutory, regulatory and common law requirements should be complied with before
considering AI in the health care space. Basing on the operations of AI, there could be state
and federal laws that mandates a health care provider or an AI developer to seek licensure,
permits and/or other registrations. For instance, if AI is applied in the process of diagnosis
without a health care professional’s review it requires Food and Drug Administration
approval.
Other Countries
However, some of the countries have already enacted laws to govern Artificial Intelligence
which are as follows:
Mississippi - Directs the State Department of Education to execute K-12 computer science
curriculum to include instructions about robotics, artificial intelligence and machine learning.
Alabama – Formulated a state Commission on Artificial Intelligence and Associated
Technologies to monitor and assist on all aspects of the development of artificial intelligence
and associated technology in the state and in various fields.
California – The local agencies should submit a report to the Governor's Office of Business
and Economic Development providing necessary information regarding any net job loss or
replacement due to the use of automation, artificial intelligence, or other technologies, if
known.
The President and the Congress of the United States are urged to establish a comprehensive
Artificial Intelligence Advisory Committee to adopt a comprehensive artificial intelligence
policy.
Illinois – Passed the Artificial Intelligence Video Interview Act. This Act allows the
employer to conduct the video interviews and uses an artificial intelligence analysis to
analyse the applicant's facial expressions, applicant's fitness for the position etc.
Texas – The state agency and local government shall, use the next generation technologies,
including cryptocurrency, block chain technology, and artificial intelligence in their
administration works.
6.5 ARTIFICIAL INTELLIGENCE IN HEALTHCARE COMPANIES

The role of artificial intelligence in healthcare industry is significant that it has become one
stop solution for all patients and doctors. Artificial intelligence is a part of computer science
which can be utilised in the diagnosis, treatment and anticipating outcome in many clinical
scenarios. Artificial intelligence through computers understands the human requirements.
Artificial Intelligence takes care of all types of problems starting from chronic diseases and
cancer to radiology and risk assessment.
Here, are top 10 healthcare AI companies in India32:
Live Health
Live Health consists of a set of young people who are passionate about developing the best
line of products in healthcare diagnostics. The vision of this corporation is to identify data at
the centre of the healthcare ecosystem because all the healthcare providers and customers are
connected in a single environment.

32
“AI in Healthcare Start-ups in India”, June 13, 2021, Accessed on Jul 8, 2021
ChironX
ChironX is known for developing the best software for healthcare industry. ChironX frames
intelligent software to diagnose the diseases that impact large populations from medical
images.
Consure Medical
This particular company is founded by Amit Sharma and Nishith Chasmawala. Consure
Medical establishes new technologies to manage, diagnose, and treat various diseases and
that is what has made it one of the top 10 healthcare AI companies in India.  The company
focuses on addressing latent clinical needs in a compassionate manner with the main aim to
improve clinical outcomes, reducing cost of care, and expanding coverage of use.
Predible Health
Predible Health empowers healthcare providers with data-driven technology to address large,
unmet clinical needs. It gives focuses on the diagnosis of specialized clinical areas through
the implementation of deep learning.  Predible Health’s flagship product, Lung IQ,
concentrates on diagnostics for over 1 billion respiratory patients globally. This company
helps the chest physicians to have access to the right information so that it would avoid
misdiagnosis and detect life-threatening conditions early for their patients.
Lybrate
The base of this company is in New Delhi. AI companies in India. Lybrate provides medical
healthcare communication and it also known as the best delivery platform. Lybrate facilitates
both, doctors as well as patients as it believes in providing world class facilities.
Artel us
Artel us is a Karnataka base company tied up with technology firms Health care
organizations. The basic intention of this company is to obtain medical data and to provide
timely, doctor assisted solutions using technologies such as portable devices, cloud
computing, and deep learning. Artel us is equipped with advanced medical archives that helps
the doctors with disease diagnosis, prognosis, and treatment.
OncoStem
OncoStem examines the aggressiveness of tumors based on tumour biology. It also identifies
the unique features of cancer recurrence risk. Since 2011, the company’s goal is to equip the
doctors with evidence-based treatment plans with sophisticated prognostic tests. These
advanced techniques help the physicians in framing a customized treatment plan by
understanding the tumour biology.
Qure.ai
Qure.ai’s vision is to make healthcare more available and affordable to the people in remote
areas. Qure.ai’s core team integrates deep learning expertise with clinical, scientific and
regulatory knowledge. The company’s advisory panel contains radiologists, other medical
practitioners and public health experts. Qure.ai works with experts to understand clinically
relevant problems and design real-world solutions. This particular company is an AI-based
clinical decision support tool for examining diagnostic images and giving inputs to the
doctor. It can identify the diseases from CT scans, MRI's and X-rays. The company also,
provides digital pathology solution for grading a variety of tumour types.
Tricog
Tricog is known for the predictive healthcare analytics. It was first established by Dr Charit
Bhograjan Interventional Cardiologist who contended that the cardiac arrests got severe due
to a delay in preliminary diagnosis (ECG). Tricog focuses on providing Virtual Cardiology
Services to remote clinics. TriCog deals with ECG devices to doctors and a mobile app for
patients to consult the doctors in case of emergencies. By this the patients can book an
appointment with the doctors having ECG devices and intimate them of their arrival and the
doctors will get a notification about the patient’s appointment33.
Sigtuple
SigTuple goes along with artificial intelligence, robotics and data science to establish
advanced screening solutions, to make healthcare accurate, accessible and affordable.
SigTuple is striving hard to build a healthier India with efficient healthcare and that makes it
capable to get it name in one of the top 10 healthcare AI companies in India. SigTuple
consists of data driven, machine-learned, cloud-based solution for identifying anomalies and
trends in medical testing to enhance the accuracy and efficiency in disease diagnosis. They
maintain a Machine Learning technique called Manthana. Through this Manthana it provides
solutions for automated analysis of blood, urine and semen samples, retinal scans and chest x-
rays They also make use of deep learning technique to detect and guess the chances of the
person having a particular disease. This is done by observing the medical diagnostic images.
Innovaccer
Innovaccer is a company which provides cloud and AI-based patient health data analytics
platform to work on population health management. The company has structured a data

33
Nitisha Dubey, “Top 10 AI Healthcare Companies in India”, May 29, 2021
activation cloud-based platform to consolidate, analyse, and provide insights on patient
health. Some of the company's offerings are In Note, In Connect, In Graph, and In Care. The
characteristics of the product include AI-based patient engagement, decision support, etc. It
also provides several solutions like virtual care networks, remote patient monitoring, SDOH
management, and others34.
Axtria
Axtria works with data analytics and software platforms to assist clients in sales, marketing,
customer, revenue, risk, and supply chain management. The platforms provided by the
company helps its clients with services ranging from planning, forecasting optimization to
lead scoring, reporting, and visualization. The company extends its services to HR analytics,
procurement, spend analytics, and supply chain analytics. The company consists of more than
30 clients and 5 Fortune 50 companies. The company is found to be in 32nd position in inc's
500 fastest-growing companies list.
Evive
The products of Evive uses big data analytics and behavioral science to suggest solutions for
health benefits, voluntary benefits, wealth management, retirement benefits and personalized
incentives. The online platform by name My Evive allows the users to balance the benefits.
Paper Evive is another online platform which provides users with care reminders and savings
opportunities.
Perfint
Perfint Healthcare is a medical device technology company focuses on the development of
diagnostic equipment for oncology department. The products of Perfint are Robio EX (CT &
PET-CT guided robotic positioning system), Robio EZ (robotic, mobile stand-alone system
with 5 DOF for needle placement during CT scan) and Maxio (image-guided, physician
controlled stereo tactic accessory device to a CT system). The image-guided equipment and
robotics are used in medical image processing to assist the clinicians in executing CT-guided
cancer biopsies, drug delivery and ablation of small tumors.
Healthplix

34
John Divine, “Artificial Intelligence Stocks: The 10 Best AI Companies”, Published on Jan. 13, 2021,
Accessed on Jul 8, 2021
Healthplix has framed an electronic medical record solution to deal with chronic care
management35. The various characteristics of this company include e-prescription generation,
lab management, billing, and dashboards providing AI & machine learning-based insights
related to finance, marketing, test clinical hypothesis, and treatment outcomes, tracking
patient records, patients risk management, and more.

Aknamed
Aknamed equips the hospitals with material management software. The product by name
smart buy furnishes a suite of ML-based tools that examines purchase and consumption of
data. All the products of Aknamed are bar-coded and monitored digitally through their life
cycle like the automated entry of product details, batch numbers, expiry date, and others.
Fit Circle
Fit Circle is an AI-powered fitness training and diet coaching app which provides the
information about daily workout challenges and allows users to monitor their activities
through their smartphones. Zi is the AI-based chatbot for providing expert advice and
feedback on fitness training and nutritional strategies.
6.6 AI AND COVID-19
AI and its tools are considered as a boon in dealing with the COVID-19 situation in India.
The AI and its tools are helpful in tracking the pandemic, screening of COVID-19 cases,
containment of corona virus, contact tracing, enforcing quarantine and social distancing,
tracking of suspects, treatment and remote monitoring of COVID-19 patients, vaccine and
drug development etc. Artificial Intelligence-based predictive models are used as powerful
weapons in the fighting against COVID-19 in the country 36. Several hospitals, medical
practitioners and decision makers have used computer simulations to understand the spread of
COVID-19. Companies like TCS (Tata Consultancy Services), KPMG India also started
using machine-learning models to know about the severity of the disease.
My Gov
MyGov is a world’s biggest citizen engagement platform which is launched by the
Government of India, in association with Amplify.ai, a company to make people aware of

35
Rob Toews, “These Are the Start-ups Applying AI To Transform Healthcare”, Published on Aug 26, 2020,
Accessed on Jul 8, 2021
36
Nirupam Bajpai and Manisha Wadhwa, “Artificial Intelligence and Healthcare in India”, Published on
Jan,2020, Accessed on Jul 8,2021
COVID-19 and caution them with real-time updates. The virtual assistant or chatbot also
enables people to ask questions and doubts related to COVID-19.
6.6.1 AI-powered tools for screening of COVID-19

 The Defence Institute of Advanced Technology (DIAT), Pune – Formulated AI based

COVID-19 detection tool to detect the infection in the chest through chest x-rays.
 AI based voice tool, Mumbai – Designed by the professors and students to detect
COVID-19 depending on the voice of COVID-19 patient as their voice might be different
from the healthy person. Here when a person talks to the microphone on the app, his
voice breaks down into multiple parameters like frequency, noise distortion and then the
values of these parameters compared with healthy person’s values.
 The Norway India Partnership Initiative (NIPI) – Designed an AI-based tool to identify
COVID-19 through cough sound analysis. This tool will diagnose COVID-19 based on
the cough of a COVID-19 patient. It will compare the cough of the COVID-19 patient
with the cough of a healthy patient. Depending on this coughing pattern, the AI powered
tool will detect COVID-19 as soon as the person coughs in front of the machine.
6.6.2 Mobile applications for preliminary screening of COVID-19
 Goa – Test Yourself Goa – Self Assessment Test for COVID-19
 Karnataka – Test Yourself Karnataka – Self Assessment Test for COVID-19
 Punjab – COVA Punjab - self-screening for COVID-19, access to COVID-19 statistics,
helpline and customer care numbers, prevention measures, government advisories,
instructions related to journeys and travel and traces nearest COVID-19 hospital.
 Telangana – T-COVID’19 - self-assessment for COVID-19, COVID-19 statistics,
availability of government and WHO advisories, information relating to government
approved labs and test centres, quarantine centres in government and private hospitals and
a telemedicine platform.

6.6.3 AI for containment of corona virus

 Milagrow i Map 9 - a robot invented for floor disinfection purposes. It can also locate and
sanitize floors without any human intervention. It was designed by Milagrow Human
Tech.
 Garuda Aerospace, a start-up company having its origin at Chennai, has designed an
automated disinfecting Unmanned Aerial Vehicle (UAV) called “Corona-Killer 100” for
disinfecting areas all over India.
6.6.4 Mobile applications for COVID-19 contact tracing and further investigation

 Arogya Setu App – Designed by National Informatics Centre (NIC), Ministry of

Electronics and Information Technology, Government of India to trace the movement of
COVID-19 patient. An alert will be sent whenever a user is within six feet of a COVID-
19 patient. This app is applicable all over India.
 Sandhane – Tracks COVID-19 patients in rural areas
 Sahyog – Developed by Survey of India (SOI), India’s National Mapping Agency (NMA)
under the Department of Science & Technology, Government of India (Geospatial World
2020: Survey of India 2020). The focus of this app is on contact tracing, public awareness
and self-assessment. It helps in carrying out door to door surveys, public awareness
campaigns, contact tracing and delivery of essential items.
6.6.5 AI for treatment and remote monitoring of patients
 Kerala Government utilizes robots like “Karma Bot” to deliver food and medicines to
COVID-19 patients, to collect waste of COVID-19 patients and to arrange video
consultation between doctors and patient.
 Indore, Uttarakhand, Madhya Pradesh are using certain apps and remote monitoring
systems to monitor the health of COVID-19 patients.

 The Indraprastha Institute of Information Technology (IIIT-Delhi) has designed an AI

model to repurpose and identify those drugs which has success rate in curing COVID-19.
By this it eliminates the unnecessary use of drugs thereby saving both money and time.

6.7 CONCLUSION

The use of AI in healthcare has facilitated conscious health management and an overall
healthy lifestyle. While there are risks and challenges, it's clear that robotics and AI bring
huge benefits to the worldwide healthcare ecosystem. The growth of medical things and AI-
driven tools have recorded significant success, especially in human lives. Particularly in the
present situation of the COVID era. While considering the personal health of the people as
main criteria, COVID has played an important part in putting the developing AI technologies
into practice. The technology had developed new models, established new treatments, along
with the development of the vaccine.
There are regulatory concerns, surrounding AI, for instance, currently there are no standards
to assess the security and efficacy of AI systems. For instance, the basic primary guideline
classifies AI systems as ‘general wellness products’, and will be regulated as devices
intended for low-risk use. The second guideline emphasizes the utilization of real-world
evidence to access the performance of AI systems. Lastly, it states that the establishment of
rules for the adaptive design in clinical trials, which might be widely utilized in assessing the
operating characteristics of AI systems.
It is often concluded that the AI interface is growing day by day and with this involvement of
AI within the healthcare sector, there's an urgent need for legislation to manage the utilization
of AI. It's clear that AI interface is important because the present medical system is inefficient
because it does not satisfy the stress of WHO guidelines, therefore the AI interface will
certainly help in achieving those goals and improving the health standards of the people of
the country. Still, there are many issues associated with the inclusion of AI in healthcare like
the attribution of liability in cases of medical negligence, issues associated with the legal
person hood of AI when functioning as a substitute or replacement of a medical man within
the near future. It is often said that the country is taking baby steps toward including AI in
legal books and definitions, but taking huge steps in including AI within the health care
sector.

CHAPTER VII
CONCLUSIONS AND SUGGESTIONS
CONCLUSION
With a plethora of issues related to well-documented factors like an aging population and
growing rates of chronic disease, the necessity of new innovative solutions in healthcare is
obvious.
AI-powered solutions have started making small steps towards addressing key issues, but it
still has to realize a meaningful overall impact on the worldwide healthcare industry. If the
key challenges are addressed in the coming years, it would play a number one role in the
healthcare systems augmenting clinical resources and ensuring optimal patient outcomes.
The application of AI is important in health services, mainly within the management of health
services. AI is required to form medical decisions and especially for the predictive analysis,
in the diagnosis and treatment of the patients. The challenges faced by AI in the field of
healthcare are facilitating early adoption and sustainable implementation of measures within
the health system. Technology isn't optimally used, but it is important for the adoption of AI
within the public health sector. AI faces number of problems such as safety, efficacy, privacy,
information and consent, accuracy in decision making etc in the area of clinical application.
AI affects the healthcare industry in unprecedented ways. Within the coming decades, we can
ascertain the complete impact. AI technology is providing boundless opportunities. within the
health care industry alone, it's set to save lots of time, reduces the amount of money and
provides more accuracy. Of course, along with the advantages AI also faces some risks in its
application in healthcare sector. These risks have to be clearly outlined for those who use the
technologies in medical sector. Transparency and ethical use of AI systems are the foremost
critical elements for successfully integrating AI into health care.

Artificial Intelligence is certainly improving the healthcare industry. From predictive medical
aid and more accurate diagnosis to motivating the patients to take care of their health. AI will
definitely continue enhancing the patient experience and healthcare expertise in the near
future.AI brings new efficiencies and standard to healthcare outcomes in India. However,
risks and threats in the healthcare sector effect deep-rooted issues. These threats and
challenges may include inadequate funding, weak regulation, insufficient healthcare
infrastructure, and deeply embedded socio-cultural practices. These cannot be solved by AI
systems alone.

Moreover, technological advancement can't be equated to adoption. In India the main

hindrance for adopting AI in healthcare is the poor digital infrastructure, unregulated private
sector, and variable capacity among states and medical professionals. Due to the existence of
these factors the adoption of AI is probably going to be slow and deeply heterogeneous. This
successively would imply that the economic progress alone might not be sufficient to
improve equity and quality. The solutions whatever are prescribed are more likely to address
the populations who have already got access to high-quality care, typically in cities with well-
developed digital infrastructure. In many small hospitals and healthcare centres in India,
administrative systems have rarely moved beyond rudimentary ICT solutions like invoicing
and billing platforms.
The effectiveness of the AI systems will depend upon accurate identification of problems and
their capacity to bring out appropriate solutions. Currently, there's a risk that solutions are
technology-led instead of problem-led, and that they are as a result often blind to specific
contextual needs or constraints. For instance, it is not a simple task or easy task to make real-
time or synchronous solutions through digital products in remote areas where basic internet
infrastructure is lacking. Designing the proper digital interventions is usually challenging
because of the inadequate awareness regarding the digital instruments in the people. Finally,
issues around privacy, misuse and accountability are only slowly being understood, and needs
more understanding before AI can deliver safe and fair healthcare solutions.
Many people use social platforms but aren't conscious of AI applications supporting these
apps like Netflix, Alexa, Siri etc. AI and machine learning strengthen these smart systems
with an intention to make them ready for official use. AI and robotics development within the
healthcare department helps the patients by lowering their pain in real-time. Artificial
intelligence (AI) in healthcare facilitated the spread of healthcare information which resulted
in the examination and review of the foremost important sorts of diseases that AI has
arranged. Machine learning (ML) and tongue processing are two major groups of AI devices.
A typical AI (AI) system must have the machine learning (ML) component which will help in
interpreting the structured data like EP data, images, and genetic data and on another side
tongue processing (NLP) module is used for the deduction of unstructured works. The
doctors should be trained regarding the complicated algorithms as they would support the
physicians in the disease analysis and plans which is required for treatment. This system
focuses on how computer-oriented assessment methods, within an equivalent roof, can help
in improving health and clinical area. Sophisticated information and machine learning form
the basis of AI. This has produced remarkable enthusiasm in several fields of healthcare
science, like drug analysis and public health. Additionally, AI (AI) tools are already emerging
in health-based apps, which may be engaged in handheld, network machines like smart
mobile phones. the main obstructions to be defeated in building health and healthcare data
information are the space between digital data and human cognition. Data information
regarding a patient is usually gained in forms available to healthcare personnel. Typical data
may contain MRI or X-ray or ultrasound pictures of the patient, visual records of lung or
heart function differing with time, or verbal similes of the patient as seen by the medical
personnel. Alternatively, when data are accumulated in data information process and applied,
in health research or to expand treatment procedures, it is usually concentrated in the form of
statistical information which is mainly digital. The transfer of analogy input into digital
output is an oppressive task and mostly it ends in a defeat of important information.

AI is gaining attention in many fields. AI is likely to possess an enormous and positive

impact from doctors and patients in healthcare. The power of AI to analyse a huge amount of
data, would equip the doctors with faster and more accurate diagnosis of diseases for a
broader segment of the population. Individuals without access to highly specialized
healthcare could lose the advantages of that they can gain through AI. Healthcare costs could
potentially drop due to earlier and more accurate diagnoses. But on the other side of the coin
AI also poses risks for the medical community and patients. Though the information
repository is large enough and well fed with data, doctors should still use their training and
knowledge to assure that AI is yielding the right diagnoses and course of medical treatment.
The relationship between AI and healthcare can function and give value only if the
interconnection is smooth and inter-operable.
The multi-tenant cloud architecture and existing traditional healthcare IT infrastructures,
enables healthcare providers to migrate to the new AI enabled digital infrastructure. Cost,
transparency, and compliance with the varied healthcare regulatory bodies are the most
important challenges today for healthcare institutions. The General Data Protection
Regulation which is already in effect, requires data protection for all the collected data. It’s
vital for them to possess a transparent road map for his or her business strategies involving
AI.

The tools specialized in Artificial intelligence has the potential to modify the traditional role
of the physician and nurse. In the future, clinicians will oversee the time pattern-based
analysis and decisions made by the AI to assure that the patients under their care are safe.
However, this requires that AI systems for acute care provide detailed communication of the
factors defining the decisions made by the AI.

Brain-computer interfaces (BCI) backed by AI can help restore the patients’ fundamental
experiences of speech, movement and meaningful interaction with people and their
environments. BCI could drastically improve quality of life for patients with ALS, strokes, or
locked-in syndrome etc. AI could help mitigate the severe deficit of qualified clinical staff by
taking over some of the diagnostic duties typically allocated to humans. Electronic Health
Records (EHR) have played a significant role in the journey of healthcare industry. EHR
developers are now using AI to automate some of the routine processes that consume so
much of a user’s time like clinical documentation, order entry, and sorting through their
inbox mail. Using smartphones which have built-in AI software and hardware to collect
images of eyes, skin lesions, wounds, infections, medications, or other subjects is an
important supplement to AI especially in under-served populations or developing nations
where there's a shortage of specialists.
On the basis of the above conclusions the researcher has tested the hypothesis as under:
RESEARCH HYPOTHESIS 1: The application of Artificial Intelligence in the field of
healthcare ensures safety and transparency.
The health care industry could seem to be the perfect place to deploy AI systems. The
underlying feature of AI is to make the medical processes crystal clear not only to the doctors
and medical practitioners but also to the patients. This storage of patient’s data helps in
achieving transparency as they will be able to monitor the treatment of their problems. All the
medical tests, doctor’s visits, and processes are documented, and patient records are
increasingly saved in electronic formats. AI systems would digest that data and they draw
conclusions from that data to provide better and less expensive care. the intention of
Machine learning is to supply data-driven clinical decision support (CDS) to physicians and
hospital staff paving the way for an increased transparency in treating the patients. Deep
learning, a subset of AI is designed to spot patterns, use algorithms and data to offer
automated insights to healthcare providers. Software that uses AI, like Fit Bits and
smartwatches, can analyse data to alert users and their healthcare professionals on potential
health issues and risks. having the ability to assess one's own health through technology eases
the workload on the medical practitioners and healthcare workers. The technological
innovations like mobile apps, wearables, etc. have made patients in-charge of their health
thereby imparting knowledge about their health condition. this in turn would help in ensuring
patient safety as they would be made aware about their physical and mental conditions. The
deployment of AI in healthcare has been possible with the generation of huge volume of
knowledge which will disclose clinically relevant information hidden within the vast amount
of knowledge. At the present, many AI applications analyses data generated from diagnosis.
procedures like imaging, genetic testing and electro-diagnosis also provide insights and
suggestive measures in a predictive manner with greater granularity. AI is being considered
as a technology with enough potential to satisfy the unmet needs of the ageing population in
terms of monitoring, modifying the intensity and aggressiveness of treatment. Due to the
large shortage of enough medical practitioners, more and more healthcare organizations are
employing AI in their processes. Deploying AI can help remove or reduce human
intervention especially just in case of routine diagnosis. The adoption and integration of AI
tools in the process of decision making will ultimately end in improving patient care and
health in a reasonable manner. Using computer vision models would help doctors process
more patient cases and make fewer diagnostic mistakes and that is what makes the treatment
more transparent. There are models out there that are ready to diagnose simple diagnostic
problems like a fracture on an x-ray or carcinoma better than humans can. The distinguishing
feature of AI tools is to empower the consumers with person-level engagement by enabling
lower-level or home-based care through remote monitoring technology. As health care
providers rely more on AI, the component of trust, becomes a requirement for effective
decisions. The deterministic and comparatively predictable nature of a software is an
important factor contributing to the event of trust. Acceptance of latest technologies requires
trust, and trust requires transparency. This is very true in critical areas like healthcare and
nutrition. In few applications, AI can outperform human decision-making by incorporating
data from multiple sources. Transparency in AI is often achieved through “explainable AI.
The purpose of Explainable AI is that the result of an AI model is often properly explained
and communicated. It allows humans to understand as to why particular decisions are made.
Explainable AI isn’t about publishing algorithms online. the purpose is to explain how a
choice was made by an AI model. Explainable AI enables humans to know what's happening
in AI models.

Artificial Intelligence is not only used to detect complicated diseases but it is also used in
treating and detecting various pandemic diseases such as COVID-19 etc. Many apps and
programs such as Arogya Setu and My Gov were formulated by government of India to
recognize the COVID infected patients.
Finally, from the above discussions it is seen that the observations and the assumptions are
proved to be correct and thus the hypothesis so formulated is also proved to be correct
RESEARCH HYPOTHESIS 2: The present system of AI in healthcare system is
suffering from drawbacks and deficiencies and they need to be addressed to make the
system more efficient.
Since mid-2016, the state has been focusing on the activities of AI. Though there were lots of
debates on the aspect of regulation of AI none of the debate was able bring out a specific law
or enactment on Artificial Intelligence. So, the govt must take steps to create a regulatory
environment so that the organizations get specialized in providing the proper quality of
treatment. Both large and smaller tech companies are fighting for taking lead to develop and
introduce advanced medical AI solutions. More regulatory focus is required from AI policy
makers or managers on the crumbling infrastructure, medical technologies and a strong
framework of regulations for the designing, implementing, and regulating AI in healthcare
space. Furthermore, the extent to which doctors and patients are comfortable in sharing their
health records digitally is always subjected to the supply of infrastructure. For example, just
in case of any diagnostic error or inaccurate treatment or data theft or malfunction, who
would be held responsible? The practitioner, the AI developer, or the robot who performed
the function independently using its intelligence?
Despite advances in AI and ML, there always exists some differences between human and
technological execution. While healthcare providers adapt to AI, the technology can
absolutely complement them in making more accurate clinical decisions or maybe replace
human judgement in some functional areas. But currently, a scarcity of trust within the AI
systems is another significant drawback within the adoption of this technology in healthcare.
Trust in AI are often influenced by several human factors like user education, past
experiences, user biases, and perception towards automation etc. Along with these the
properties of the AI system, including controllability, transparency, and complexity of the
model, associated risks, and lots of others are also under the risk due to the non-availability of
proper legal provisions. The reliability of an AI technology depends on the data that is
inserted in the machines. Humans and AI both have some level of scepticism regarding the
other’s decisions since both are capable of creating mistakes. The quantity of scepticism
necessary for the foremost accurate clinical decisions depends on the potential of the human
user and therefore the AI system. Hence AI must incorporate mechanisms which will
establish and maintain a properly balanced, optimal level of trust from and to the user that
matches the potential of the AI system.
FDA standards, designed for traditional rule-based algorithms, don't apply to advanced AI
systems whose predictive performance might change when exposed to new data. Presently
there are many regulations that govern aspects, like data privacy. However, they don’t fit in
the AI age, and AI brings variety of latest ethical aspects to the table. We require very broad
discussions in all the levels of society, including the industry that's expected to develop these
new solutions.
Hence from the above explanation we can observe that the assumptions regarding the
inadequate regulatory system is proved to be correct and hence the hypothesis formulated
also is proved to be correct.

SUGGESTIONS
The following recommendations are made by the researcher for the effective implementation
of Artificial Intelligence in the Healthcare system:
1. The data in healthcare should be organised and structured: Data in health care are
largely unorganized and unstructured. The first hurdle is with regarding to the matter of
assembling high-quality data and patient privacy. One set of potential solutions is that the
activation of state provision of infrastructural resources for data protection, ranging from
setting standards for electronic health records to directly providing technical support for
high-quality data. A parallel option is direct investment in the creation of high-quality
datasets. Ensuring effective privacy safeguards for these large-scale datasets are going to
be essential to realize the patient trust and satisfaction. The second hurdle is data
exchange. For an effective implementation of AI, the AI systems need to be trained by
data from clinical studies. However, once an AI system is fed with historical data,
continuation of the data supply becomes a difficult task for further development and
improvement of the system. In order to address this issue, the AI systems should be
designed in such a way that they should get accustomed to the changing situations. Since
the performance of AI heavily depends on data, regulatory bodies should invest in data
infrastructure for the collaboration of various health databases. However, digital and
updated record systems provide greater efficiency and accuracy in medicine. Healthcare
stakeholders must find ways to enhance data consolidation and digitization so that
medical data is processed and analyzed by AI in s proper manner. To obtain accurate
outputs, hospitals must collect training data from reliable sources. They can possess the
reliable data from patients’ historical and current medical records as every patient in
healthcare may be a source in themselves. There is a need for the healthcare organizations
to prepare datasets for machine learning algorithms precisely. To organize precise
datasets, hospitals should identify the specified outcome at the earliest and prepare data
accordingly. Healthcare organizations also should confirm that the information gathered
is according to the processes.
2. The existing laws and regulations should be updated: Medical records are protected by
stringent privacy and confidentiality laws, because sharing such data even with an AI
system could also be construed as a violation of those laws. To make sure that medical
data is used for these purposes initially consent from patients must be obtained.
Regulatory bodies must implement rules to protect the identities and thereby permitting
the healthcare providers for maintaining high-quality data. This acquiring of high-quality
data would in turn help in processing of data through AI technologies. Likewise, medical
institutions also must obey these regulations with due diligence to obtain patient consent.
Every patient may be a reliable source of knowledge. But what if these sources deny in
providing their data as nobody wants their data to be exploited for negative means. And to
avoid such situations trust should be built among patients, governments and leading
healthcare organizations. This trust is gained through the creation of regulatory acts to
which each and every hospital should comply. For example, The Healthcare Information
Portability and Accountability Act (HIPAA), 1996 was passed to mandate standards for
the confidential handling of patient data. Another example is that the Health Information
Technology for Economic and Clinical Health Act (HITECH), 2009 which concentrates
on the standardisation electronic health records (EHR). Such regulatory acts enable
patients to be happy to share their data, which may be used for training AI systems. In
today’s world, where we frequently hear news of cybersecurity breaches, securing data
isn’t very straightforward. That’s where healthcare organizations can work with block
chain. The integration of AI and block chain can together revolutionize several industries.
And healthcare is one among these industries. Block chain will enable secure
transmission and storage of patients’ data to reinforce privacy and security. It'll also
provide transparency to patients in order that they will view where their data is stored and
the way it's used.

3. The hospitals and the healthcare centres should involve humans in the medical
processes along with the machines: Medical professionals and patients are also doubtful
about the role of AI in healthcare as it lacks the element of human touch in it. Patients
also become little hesitant about the technology’s ability. As a result, they find it difficult
to address their individual health concerns. Overcoming the anxieties of health
professionals and the scepticism of patients toward AI is the key to build an AI-driven
healthcare system. There must be a full understanding that AI only works on increasing
the diagnostic capabilities of healthcare practitioners. This will encourage everyone to
 embrace AI-assisted medical practices. Along with these the doctors, the medical
practitioner and the healthcare workers also should be made part of the diagnostic and
treatment procedures so that it would help in gaining the trust of patients. When accurate
treatment is combined with human involvement that would automatically help in yielding
patient satisfaction.
4. The hospitals should be trained regarding the use of AI tools: The healthcare
organizations need several tools for diagnosis and treatment. As an example, there are
various sorts of equipment like defibrillators, ventilators, scanners, X-ray machines, and
ECG machines used for diagnosing and treating different medical conditions. It's going to
become complex for healthcare organizations to spot the acceptable machine for that
specific disease or problem. Hence hospitals need to understand the complexity of various
machines to work out the right use case. They also should consult their vendors about
how easily and quickly an AI solution are often integrated with a selected machine.
Health organizations should select the AI vendors wisely. There are various factors to
think about before choosing an AI vendor. Identifying the correct use and selecting the
right vendor depending on the requirements of the patient will help hospitals in creating
AI solutions.
5. The Black Box System should be eliminated: AI systems are developed to reproduce
human brains. Similar to our brains, they also receive inputs and reach outputs. But we
cannot understand the process of how an AI system arrives at a conclusion all we
understand is that the final output. And without understanding how an AI system received
a conclusion, improving them becomes difficult. This challenge of AI systems is known
as the “Black Box Problem”. Solving the black-box is a challenge for nearly every
industry and mainly for healthcare industry. Trusting AI solutions blindly can put
patients’ lives in danger. The answer for this is the use of “Explainable AI.” Explainable
AI helps the researchers to know the outputs of AI systems by bringing transparency in
these systems. Explainable AI is set of tools and frameworks which assists the people in
understanding and interpreting predictions made by our machine learning models. With it,
we can debug and improve model performance. It also helps in understanding our models'
behaviour regarding the diagnosis and treatment of a particular disease. Implementations
of such explainable AI methods will ensure patients’ and doctors’ trust in AI solutions.
6. The staff and the patients should be educated on the aspects of AI: Application of AI
solutions provides numerous benefits, but using them is complicated. The shortage of
awareness about AI and the way to use it can cause skill gaps in organizations. And
 healthcare organizations should work hard to bridge the skill gaps by educating their staff
about AI systems and their capabilities. Hospitals and individual experts can organize
training sessions for various departments on the aspect of how to use AI systems.AI
implementation in healthcare can't be successful until the patients it treats are able to
understand AI-based treatment. Hence, patients also should know about AI’s potential in
the diagnosis of diseases so that they will trust AI-based treatment. For an example,
robotic surgery offers several benefits like shorter hospital stays, reduced pain, minimal
scarring, and lower levels of blood loss. Healthcare organizations should create awareness
about the advantages of robotic surgery among patients. They should educate patients
about AI robotic surgery procedures before operating on them. Educating patients and
staff about AI solutions will ensure to extend their trust in AI systems. Every health
organization wants to employ AI systems in their medical processes. Successful
implementation of AI solutions begins right from building the proper strategy. When
samples of successful AI implementations inherit the limelight, hospitals show more
interest to deploy AI in their processes. The patients should be taught about the
advantages and limitations about AI in healthcare. To train the physicians on AI systems
is the main target of providing medical education on the application of AI should be
achieved. Potential steps to achieve the aim of medical education related to role of AI in
healthcare include;

1. Developing the time pattern phenotypes to tackle with adverse conditions.

2. A constant focus on the study of pathophysiology to generates clinical time patterns,
3. Designing of a time pattern-based ontology with good communication standards
anticipating the clinical outputs of AI based analysis, diagnosis and care.

7. The future educational system should include the concept of AI as a subject in their
curriculum: The future studies should deal with analytical performance of AI, its effect
on patient safety both in long and short term, its reliability and specific risks related to it.
All these should be furnished by the longer-term studies to offer a transparent picture
about the role of AI in healthcare sector. Additionally, with the above aspects, the studies
should also ensure data standardization. Future work should train AI on the critical
adjustments made by clinicians, in order to prepare AI for different conditions. The future
studies about AI systems are expected to help providers in making faster and more
accurate decisions and to deliver personalized patient care. Thus, the medical education
 system should incorporate necessary AI training for providers in order that they will
better understand the essential functioning of AI systems and extract clinically
meaningful insight from the outcomes of AI.

BIBLIOGRAPHY

1. Lawrence, “Artificial Intelligence Systems for Complex Decision-making in Acute Care

Medicine: A Review”, https://pssjournal.biomedcentral.com/articles/10.1186/s13037-
019-0188-2 , volume 13, published in Feb 2019
2. Health Catalyst Editors, “How Artificial Intelligence Can Overcome Healthcare Data
Security Challenges and Improve Patient Trust”,
https://www.healthcatalyst.com/insights/improving-healthcare-data-security-with-AI ,
published on September 18, 2019
3. Health Catalyst Editors, “AI-Assisted Decision Making: Healthcare’s Next Frontier”,
https://www.healthcatalyst.com/insights/ai-assisted-decision-making-healthcares-next-
frontier, published on January 30, 2020

4. Fei Jiang, Yong Jiang, Hui Zhi, Yi Dong, Hao Li, Sufeng Ma, Yilong Wang, Qiang

Dong, Haipeng Shen, Yongjun Wang, “Artificial Intelligence In Healthcare: Past, Present
and Future”, https://svn.bmj.com/content/2/4/230, BMJ Journal
5. Gawad J, and Bonde C, “Artificial Intelligence: Future of Medicine and Healthcare”,
https://www.tsijournals.com/articles/artificial-intelligence-future-of-medicine-and-
healthcare.html, Volume: 11(2), published on March 15, 2017
6. Sumi Menon, “How Artificial Intelligence is Changing the Healthcare Industry”,
https://www.cabotsolutions.com/how-artificial-intelligence-is-changing-the-healthcare-
industry, published September 24, 2018
7. By Sandeep Reddy,” Use of Artificial Intelligence in Healthcare Delivery”,
https://www.intechopen.com/books/ehealth-making-health-care-smarter/use-of-artificial-
intelligence-in-healthcare-delivery, published on November 5th 2018

8. Markus Schmitt, “Artificial Intelligence in Medicine”, https://www.datarevenue.com/en-

blog/artificial-intelligence-in-medicine
9. Marlee Long, “Artificial intelligence in medical diagnosis”, on
https://www.aidoc.com/blog/artificial-intelligence-medical-diagnosis/, published on
November 17, 2020
10. “Technological Innovations of AI In Medical
Diagnostics”,https://www.healtheuropa.eu/technological-innovations-of-ai-in-medical-
diagnostics/103457/ , published on 26th October 2020
11. By Polly, “How AI Technologies Accelerate Progress in Medical
Diagnosis”, https://roboticsandautomationnews.com/2020/03/09/how-ai-technologies-
accelerate-progress-in-medical-diagnosis/31184/ , published on MARCH 9, 2020 
12. https://www.osplabs.com/ai-medical-diagnosis/

13. By Daniel Fagella, “Machine Learning for Medical Diagnostics – 4 Current

Applications”, https://emerj.com/ai-sector-overviews/machine-learning-medical-
diagnostics-4-current-applications/, published on March 14, 2020,

14. IEEE, “Medical Diagnostic Systems Using Artificial Intelligence (AI) Algorithms:
Principles and Perspectives”, https://ieeexplore.ieee.org/document/9279211 ], volume 8
15. Daniel Greenfield, “Artificial Intelligence in Medicine: Applications, implications, and
Limitations”, https://sitn.hms.harvard.edu/flash/2019/artificial-intelligence-in-medicine-
applications-implications-and-limitations/ , published on June 19, 2019
16. Wan Hussain, FadzilahSiraj, “Artificial Intelligence in Medical Application: An
Exploration”
https://www.researchgate.net/publication/240943548_ARTIFICIAL_INTELLIGENCE_I
N_MEDICAL_APPLICATION_AN_EXPLORATION, published on July 2008
17. Filippo Amato1, Alberto Lopez1, Eladia María Peña-Mendez, Petr Vanhara , Ales
Hampl, Josef Havel1, “Artificial Neural Networks In Medical Diagnosis”,
http://jab.zsf.jcu.cz/pdfs/jab/2013/02/01.pdf, Journal of APPLIED BIOMEDICINE,
published on 7th January 2013

18. Hesham Nabih Elmahdy, “Medical Diagnosis Enhancements Through Artificial

Intelligence”, https://scholar.cu.edu.eg/ehesham/files/medical.pdf
19. Abhishek Kashyap, “Artificial Intelligence & Medical
Diagnosis”,https://www.academia.edu/38097711/Artificial_Intelligence_and_Medical_Di
agnosis, published on Dec 30,018
20. Thomas Davenport and B Ravi Kalakota, “The Potential for Artificial Intelligence in
Healthcare”,https://www.rcpjournals.org/content/futurehosp/6/2/94.full.pdf,Future
Healthcare Journal, published in 2019 Vol 6, No 2: 94–8
21. Bernard Marr,”How Is AI Used In Healthcare - 5 Powerful Real-World Examples That
Show The Latest Advances”, https://www.forbes.com/sites/bernardmarr/2018/07/27/how-
is-ai-used-in-healthcare-5-powerful-real-world-examples-that-show-the-latest-advances/?
sh=7857bc855dfb, published on Jul 27, 2018
22. https://www.foreseemed.com/artificial-intelligence-in-healthcare

23. Amisha, ParasMalik, MonikaPathania,and VyasKumar,Rathaur, “Overview of Artificial

Intelligence in Medicine”, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691444/ ,
published on 2019 Jun

24. Codrin Arsene, “Artificial Intelligence in Healthcare: The Future is Amazing”,

https://healthcareweekly.com/artificial-intelligence-in-healthcare/, published on April 8,
2021
25. Jennifer Bresnick, “Top 12 Ways Artificial Intelligence Will Impact Healthcare”,
https://healthitanalytics.com/news/top-12-ways-artificial-intelligence-will-impact-
healthcare, published on April 30, 2018

26. Angela Spatharou, Solveigh Hieronimus, and Jonathan Jenkins, “Transforming

Healthcare with AI: The Impact on the Workforce and Organizations”,
https://www.mckinsey.com/industries/healthcare-systems-and-services/our-
insights/transforming-healthcare-with-ai, published on March 10, 2020
27. Deloitte, “The Socio-economic Impact of AI in Healthcare”
https://www.medtecheurope.org/wp-content/uploads/2020/10/mte-ai_impact-in-
healthcare_oct2020_report.pdf, published on October 2020
28. Unfold Labs, “The Impact of Artificial Intelligence in Healthcare”,
https://unfoldlabs.medium.com/the-impact-of-artificial-intelligence-in-healthcare-
4bc657f129f5, published on Aug 24, 2017
29. “8 Ways AI Will Impact Healthcare”, https://zif.ai/8-ways-ai-will-impact-healthcare/
30. The Journal of mhealth “The Growing Impact of AI on Healthcare”,
https://thejournalofmhealth.com/the-growing-impact-of-ai-on-healthcare/
31. PeerJ, “The Impact of Artificial Intelligence in Medicine on the Future Role of the
Physician”, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779111/, published on 2019
Oct 4
32. Blog by Association for advancing Automation, “How Artificial Intelligence is Used in
Today’s Robots”, https://www.automate.org/blogs/how-artificial-intelligence-is-used-in-
today-s-robots#:~:text=AI%20helps%20save%20certain%20motions,enough%20for
%20anybody%20to%20do.&text=Robots%20are%20now%20being%20used,and
%20hotels%20around%20the%20world, published on Nov 09, 2018.
33. Vikram Singh Bisen, “AI in Robotics: Use of Artificial Intelligence in Robotics”,
https://medium.com/vsinghbisen/ai-in-robotics-use-of-artificial-intelligence-in-robotics-
726a4e9ade18, published on Oct 14, 2020 
34. Intel, “Robotics in Healthcare to Improve Patient Outcomes”,
https://www.intel.in/content/www/in/en/healthcare-it/robotics-in-healthcare.html
35. Abeer Raza, “How AI Robotics are Transforming the Health Care Industry”,
https://readwrite.com/2021/05/06/how-ai-robotics-are-transforming-the-health-care-
industry/?__cf_chl_jschl_tk__=b0f5377febdf335c726256c1e29188aa6ecc4137-
1625933810-0-
 AWs70cvmtQLAf0U1i0iKHekyUVLrXRWi6zMEnvHMofhs7YZiO0n3zQyEiVBZ79e-
P3E5kH3zpX5jLvn6fX3c764MziaqSPpyOhQjNxl51dHDrVlrF_OR0Qb5Ro9_ucAF3e3s
lCffQK0EnOhDa9RqitGFSGWqMy4jyd1eaABxLDQrVBw2Q0UN1xxyPalVDeJ_cskQi
Bz_AQyAQNMj1TlIOOb2aoINzFtPLe8swZX3f1cZFk93wCpY9xUDVib1JccPfrHbpRX
DRNwilm2p-
KAr2OqCeh3Cdkih1yIacrhobEBtmmTCJaF7H66G3mfdU7zEasFYd2eVrva1Z8d2153rl0
90d61DuQaMJUku5mneWg_3qG-YkbveTsWqBYxxH-
51cLbPyhaMCQKbU8oFJlQTQ9yKXIwrxmOXE_QKpMdQy5Jb2rLLwMDlcdAnO-
NR9QCfIjagihO5T9N2mcIGn62ohcP-5p8DVRPpmbi8I5B6lwUuWc-
EUqLNVILFDLRMB1uzEh21R45EhSp37blQ7EGR4TASerlIQV3hyWry55z27Cev,
published on 06 May 2021
36. Emilia Marius, “6 Ways AI and Robotics Are Improving Healthcare”,
https://www.roboticsbusinessreview.com/health-medical/6-ways-ai-and-robotics-are-
improving-healthcare/,  published on May 29, 2019
37. Upendra Patel, “Artificial Intelligence in Healthcare: Top Benefits, Risks and Challenges,”
https://www.tristatetechnology.com/blog/artificial-intelligence-in-healthcare-top-benefits-
risks-and-challenges/#:~:text=Errors%20and%20injuries.,scan%20may%20miss%20a
%20tumor, published on 22 October , 2020
38. W. Nicholson Price II, “Risks and Remedies for Artificial Intelligence in Health care”,
https://www.brookings.edu/research/risks-and-remedies-for-artificial-intelligence-in-
health-care/, published on November 14, 2019
39. Michael Walter, “6 Serious Risks Associated with AI in Healthcare”,
https://www.aiin.healthcare/topics/diagnostics/6-risks-ai-healthcare-artificial-intelligence,
published on November 18, 2019
40. Alvin Powell Harvard Staff Writer, “AI Revolution in Medicine”,
https://news.harvard.edu/gazette/story/2020/11/risks-and-benefits-of-an-ai-revolution-in-
medicine/, published on November 11, 2020
41. Sohail Merchant, “4 Risks Associated with AI in the Healthcare Industry”,
https://www.aimblog.io/2020/03/30/4-risks-associated-with-ai-in-the-healthcare-
industry/, published on March 30, 2020
42. Mallika Rangaiah, “Artificial Intelligence in Healthcare: Applications and Threats”,
https://www.analyticssteps.com/blogs/artificial-intelligence-healthcare-applications-and-
threats, published on Apr 22, 2020
43. By Jessica Kent, “Could Artificial Intelligence Do More Harm Than Good in
Healthcare?”, https://healthitanalytics.com/news/could-artificial-intelligence-do-more-
harm-than-good-in-healthcare , published on June 25, 2019

44. Laura M. Cascella, “Risk Management tools & Resources”,

https://www.medpro.com/artificial-intelligence-risks-privacysecurityInsightbrief, AI IN
HEALTHCARE – BENEFITS, CHALLENGES &
RISKShttps://www.insightbrief.net/wp-content/uploads/AI-in-Healthcare-Benefits-
Challenges-Risks-InsightBrief.pdf?tagged=true, published on 2018
45. Insight brief, “AI in Healthcare – Benefits, Challenges & Risks”,
https://www.insightbrief.net/wp-content/uploads/AI-in-Healthcare-Benefits-Challenges-
Risks-InsightBrief.pdf?tagged=true, published on 2018
46. SaraGerke, TimoMinssen, and GlennCohen, “ Ethical and Legal Challenges Artificial
Intelligence driven in Healthcare” ,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332220/ , published on Jun 26,2020
47. By Aryan Vij | Views 7087, “AI is Set to Transform India’s Healthcare: Where is the
Legal Framework”, http://www.legalserviceindia.com/legal/article-133-ai-is-set-to-
transform-indias-healthcare-where-is-the-legal-framework.html, legal service India e
journal
48. ET Health world, “Artificial Intelligence in Healthcare: Applications and Legal
Implications”, https://health.economictimes.indiatimes.com/news/industry/artificial-
intelligence-in-healthcare-applications-and-legal-implications/66690368 , published on
November 19, 2018
49. The National Law Review, “Top Ten Legal Considerations for Use and/or Development
of Artificial Intelligence in Health Care”, https://www.natlawreview.com/article/top-ten-
legal-considerations-use-andor-development-artificial-intelligence-health , July 11,
2021,Volume XI, Number 192, Tuesday, published on February 16, 2021
50. Richa Bhatia, “Grave Legal and Ethical Risks Associated with AI in Healthcare”,
https://analyticsindiamag.com/legal-and-ethical-risks-ai-healthcare/ , published on
27/11/2018
51. Diganth Raj Sehgal, “A Legal Study of Digital Healthcare in India”,
https://blog.ipleaders.in/legal-study-digital-healthcare-india/, published on October 10,
2020
52. Krishnan Ganapathy, Director, Apollo Telemedicine Networking Foundation, Chennai,
India, “Artificial Intelligence and Healthcare Regulatory and Legal Concerns”,
https://telehealthandmedicinetoday.com/index.php/journal/article/view/252, volume 6,
issue 2, published in 2021

53. Lawjure, “Attribution of Liability in Medical Negligence with the Introduction of Artificial
Intelligence”, http://www.lawjure.com/attribution-of-liability-in-medical-negligence-with-
the-introduction-of-artificial-intelligence/, published on April 16, 2021
54. By Johan Ordish, “Legal liability for Machine Learning in Healthcare”,
https://www.phgfoundation.org/briefing/legal-liability-machine-learning-in-healthcare

55. https://iclg.com/practice-areas/digital-health-laws-and-regulations/india

56. By Tuhin Batra , “Self-Regulation In Artificial Intelligence: An Indian Perspective”,

https://www.mondaq.com/india/privacy-protection/1015476/self-regulation-in-artificial-
intelligence-an-indian-perspective, published on 11 December 2020

57. Abhinav verma, krisstina rao, vivek eluri, yukti sharma, “Regulating AI in
Public Health: Systems Challenges and Perspectives”,
https://www.orfonline.org/research/regulating-ai-in-public-health-systems-challenges-
and-perspectives/, published on Jul 27 2020
58. Rahul Raj, “What Regulatory Challenges Holding Back the Adoption of AI in Healthcare
In 2020”, https://analyticsindiamag.com/what-regulatory-challenges-holding-back-the-
adoption-of-ai-in-healthcare-in-2020/, published on 30/01/2020
59. Adam Tabriz ,“Legislation Related to Artificial Intelligence”,
https://www.ncsl.org/research/telecommunications-and-information-technology/2020-
legislation-related-to-artificial-intelligence.aspx, published on 4/16

60. University of Illinois Chicago, “AI in Healthcare: 4 Examples in Health Informatics”,

https://healthinformatics.uic.edu/blog/ai-in-healthcare-4-examples-in-health-informatics/,
August 19, 2019 Adam Tabriz MD, Medico-legal Perils of Artificial Intelligence and
Deep Learning, https://www.datadriveninvestor.com/2019/10/24/medico-legal-perils-of-
artificial-intelligence-and-deep-learning/ , published on October 24, 2019
61. The Medical Futurist, “Top Artificial Intelligence Companies in Healthcare to Keep an
Eye On”, https://medicalfuturist.com/top-artificial-intelligence-companies-in-
healthcare/#, published on 21 January 2020
62. John Divine, “Artificial Intelligence Stocks: The 10 Best AI Companies”,
https://money.usnews.com/investing/stock-market-news/slideshows/artificial-
intelligence-stocks-the-10-best-ai-companies, published on Jan. 13, 2021
63. Nitisha Dubey, “Top 10 AI Healthcare Companies in India”,
https://www.bisinfotech.com/leading-ai-healthcare-companies-in-india/, May 29, 2021
64. “AI in Healthcare Start-ups in India”, https://tracxn.com/explore/AI-in-Healthcare-
Startups-in-India, published on June 13, 2021
65. Innohealth Magazine, “India’s top Artificial Intelligence Organizations in Healthcare”,
https://innohealthmagazine.com/2020/innovation/top-artificial-intelligence-organizations-
in-healthcare-in-india/
66. Rob Toews, “These Are The Start-ups Applying AI To Transform Healthcare”,
https://www.forbes.com/sites/robtoews/2020/08/26/ai-will-revolutionize-healthcare-the-
transformation-has-already-begun/?sh=15170dba722f, published on Aug 26, 2020
67. Infographics, “Machine Learning in Healthcare: Examples, Tips & Resources for
Implementing into Your Care Practice”, https://healthinformatics.uic.edu/blog/machine-
learning-in-healthcare/ , published on November 13, 2020
68. Olivia Goldhill, “When AI in Healthcare goes wrong, who is Responsible?”
https://qz.com/1905712/when-ai-in-healthcare-goes-wrong-who-is-responsible-2/,
published on September 20, 2020
69. Helmholtz Zentrum München - German Research Centre for Environmental Health,
“Using Artificial Intelligence for Error Correction in Single Cell Analyses”,
https://www.sciencedaily.com/releases/2019/01/190124105315.htm, published on
January 24, 2019
70. “How AI is Transforming the Future of Healthcare”,
https://www.internationalsos.com/client-magazines/in-this-issue-3/how-ai-is-
transforming-the-future-of-healthcare#:~:text=Patient%20Risk%20Identification
%20%2D%20By%20analysing,help%20identify%20at%20risk%20patients,
71. Cape Start, “How AI Systems Can Improve Healthcare Diagnosis and Treatment”,
https://www.capestart.com/resources/blog/how-ai-systems-can-improve-healthcare-
diagnosis-and-treatment/
72. The university of Scranton’s online resource center, “The Purpose of Risk Management
in Healthcare”, https://elearning.scranton.edu/resource/business-leadership/purpose-of-
risk-management-in-healthcare
73. Alicia Phaneuf, “Use of AI in Healthcare & Medicine is Booming – here's how the
Medical field is Benefiting from AI in 2021 and Beyond”,
https://www.businessinsider.com/artificial-intelligence-healthcare?IR=T, published on
Jan 30, 2021
74. John Banja, PhD, “How Might Artificial Intelligence Applications Impact Risk
Management?”, https://journalofethics.ama-assn.org/article/how-might-artificial-
intelligence-applications-impact-risk-management/2020-11, AMA Journal of Ethic,
published on NOV 2020
75. Jennifer Bresnick, “Arguing the Pros and Cons of Artificial Intelligence in Healthcare”,
https://healthitanalytics.com/news/arguing-the-pros-and-cons-of-artificial-intelligence-in-
healthcare, published on September 17, 2018
76. “Academy of Medical Royal Colleges, Artificial Intelligence in Healthcare”,
http://www.aomrc.org.uk/wp-
content/uploads/2019/01/Artificial_intelligence_in_healthcare_0119.pdf, published on
January / 2019
77. Fei Jiang, Yong Jiang, Hui Zhi, Yi Dong, Hao Li, Sufeng Ma, Yilong Wang,
Qiang Dong,Haipeng Shen, Yongjun Wang, Stroke and Vacular Neurology, “Artificial
Intelligence in Healthcare: Past, Present and Future”,
https://www.semanticscholar.org/paper/Artificial-intelligence-in-healthcare%3A-past
 %2C-and-Jiang-Jiang/10f919b1a5161b560504c225cfb2d1b3a4768f80, published on 14
June 2017
78. N. Murali, N. Sivakumaran,” International Journal of Modern Computation, Information
and Communication Technology Artificial Intelligence in Healthcare – A Review”,
https://www.researchgate.net/publication/329163470_Artificial_Intelligence_in_Healthca
re-A_Review, published in 2018

79. The Scientific World, “Importance of Artificial Intelligence in Modern Healthcare

System”, https://www.scientificworldinfo.com/2021/03/importance-of-artificial-
intelligence-in-healthcare.html, published on March 7,2021

ARTICLES
1. Lawrence, “Artificial Intelligence Systems for Complex Decision-making in Acute Care
Medicine: A Review, Volume 13, published in Feb 2019
2. Sumi Menon, “How Artificial Intelligence is Changing the Healthcare Industry”,
published September 24, 2018
3. By Daniel Fagella, “Machine Learning for Medical Diagnostics – 4 Current
Applications”, published on March 14, 2020
4. Wan Hussain, FadzilahSiraj, “Artificial Intelligence in Medical Application: An
Exploration”, published on July 2008
5. Hesham Nabih Elmahdy, “Medical Diagnosis Enhancements Through Artificial
Intelligence”.
6. Bernard Marr,”How Is AI Used In Healthcare - 5 Powerful Real-World Examples That
Show The Latest Advances”, published on Jul 27, 2018
7. SaraGerke, TimoMinssen, and GlennCohen, “Ethical and Legal Challenges of Artificial
Intelligence-driven Healthcare”, published on Jun 26,2020
8. Diganth Raj Sehgal, “A Legal Study of Digital Healthcare in India”, published on
October 10, 2020
9. Lawjure, “Attribution of Liability in Medical Negligence with the Introduction of Artificial
Intelligence”, published on April 16, 2021
10. By Tuhin Batra , “Self-Regulation In Artificial Intelligence: An Indian Perspective”,
published on 11 December 2020
11. University of Illinois Chicago, “AI in Healthcare: 4 Examples in Health Informatics”,
https://healthinformatics.uic.edu/blog/ai-in-healthcare-4-examples-in-health-informatics/,
 August 19, 2019 Adam Tabriz MD, Medico-legal Perils of Artificial Intelligence and
Deep Learning, published on October 24, 2019
12. Krishnan Ganapathy, Director, Apollo Telemedicine Networking Foundation, Chennai,
India, “Artificial Intelligence and Healthcare Regulatory and Legal Concerns”, volume 6,
issue 2, published in 2021
JOURNALS
1. The British Medical Journal
2. The Journal of applied Bio Medicine
3. The Scholars Journal of Applied Medical Sciences, 2018
4. The Future Healthcare Journal
5. The Journal of National Institutes of Health
6. The Journal of mhealth
7. AMA Journal of Ethic
8. Bio chemistry – An Indian Journal
REPORTS
1. The Socio-economic Impact of AI in Healthcare – Report by Deloitte company (October
2020)
2. Artificial Intelligence in Healthcare: Top Benefits, Risks and Challenges – Report by
tristate technology (October 2020)

NEWS PAPERS AND MAGAZINES

1. Health Europa
2. The healthcare weekly
3. Health IT Analytics – Xtelligent Healthcare Media
4. The Economic Times
5. InnoHealth Magazine
6. International SOS company magazine
7. The National Law Review