October 2024 - What Should Occupational Therapists Consider if Using Artificial Intelligence (AI) in Practice?

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Artificial Intelligence (AI) refers to various technologies designed to simulate human thinking and learning. AI works by collecting information and using algorithms to learn, predict and make decisions. With its capability to perform certain automated tasks, the use of AI in daily life and in health care is growing.

AI and Occupational Therapy

Many AI technologies have emerged to support occupational therapy practice, but the decision to use AI requires some careful consideration. It is important to remember that occupational therapists are still expected to meet the Standards of Practice and follow appropriate legislation, such as the Health Care Consent Act and the Personal Health Information Protection Act.

AI only imitates human cognition and is not a substitute for an occupational therapist’s experience, competence, or judgement. Occupational therapists are still responsible for the clinical decisions they make and the services they provide, even when it is augmented by AI.

The literature has identified several areas where AI can potentially support occupational therapists:

Assessment: For example, wearable devices or sensors may provide occupational therapists with information when assessing a client’s health.
Monitoring: AI technology may be used to monitor a client’s health status, activities or behaviour which can provide information to support occupational therapy intervention or a client’s self management of their condition.
Intervention: Some virtual reality technologies can mimic real life experiences which may be used as part of occupational therapy intervention. Smart home and voice-controlled personal assistants (for example, Alexa or Google Home devices) may help to support a client’s ability to be independent in their home.
Administrative tasks: AI that uses large language models (for example, Chat GPT) may assist occupational therapists by summarizing large amounts of information into shorter notes. There is digital scribe technology that can record sessions and transcribe verbal information to written notes.
Education: AI technology may provide simulation opportunities or generate learning materials for the education of students, staff and caregivers.
Client motivation: AI can provide personalized and motivational messages for clients and help them track progress towards their goals.

The potential benefits make AI an attractive option, with its capability to supplement assessment and intervention, promote client safety and independence, increase efficiencies with work tasks and empower clinical decision-making. Occupational therapists however must also keep in mind the risks of using AI.

Risks to Consider

Client impact: Will AI impact the therapeutic relationship or compromise the care provided to the client? What is in the best interest of the client and does AI align with their goals? Does the client feel comfortable and trust AI and technology?
Privacy: AI technologies may store or share information (including any personal health information) that is inputted into the AI data system. It is important to understand the terms of use and privacy policies of the AI system being used and the risk of privacy breaches.
Accuracy and Reliability: Information generated by AI may contain falsehoods or errors. These are known as AI “hallucinations”. Some AI systems generate incomplete or partial information which may be misleading. Other AI systems produce information without revealing the reasoning or sources behind its internal workings and decision making (this is known as the black-box effect).
Bias: Information generated by AI may be biased. AI algorithms are based on data they have been trained to analyze and may not take into account other client factors such as gender, ethnicity, socio-economic status, environment, etc.
Equity: AI tools that are available to the public at no charge may use more basic algorithms, in comparison to AI tools that require a paid subscription may have more advanced algorithms and technology. Occupational therapists should be aware of the potential disparities in accessing AI and possible impacts for those who do not have access to the most up to date technology.
Over-reliance: Over-reliance on AI may lead to the erosion of critical thinking skills. AI should not be a substitute for an occupational therapist’s critical thinking and clinical judgement skills.

Professional Responsibilities

It is recommended that occupational therapists exercise caution and consider the following if integrating AI into their practice:

Be accountable: Occupational therapists are held accountable for the service they provide and the documentation that they apply their signature to. Therefore, occupational therapists should ensure they have the competencies in using the technology and ensure they are adhering to the Standards of Practice, legislation and mitigating client risks.
Be critical: Occupational therapists should critically evaluate the accuracy and reliability of AI-generated information. Information may be incorrect, biased, lack transparency or lack professional language and judgement. Occupational therapists must determine if they can rely on the information they gathered and be able to provide supporting rationale (i.e. assessment findings or treatment approaches) for their decision making.
Obtain Consent: Occupational therapists must obtain client consent before incorporating AI into their service plan. If personal information is being entered into an AI tool, there should be clear communication with the client about the risks and benefits and how their information will be used and shared.
Maintain Privacy: Occupational therapists are responsible for following the relevant privacy laws in their setting, such as the Personal Health Information Protection Act, 2004 (PHIPA). Occupational therapists should read and understand the privacy policies and terms of use for the AI tools they want to use and take reasonable steps to ensure security of client information. This may include avoiding the input of confidential information into AI tools.
Consider Ethical implications: Occupational therapists should be mindful of biased AI information or disparities in access to technology that could promote or perpetuate inequities in health care.
Develop policies: Occupational therapists are encouraged to collaborate with employers and seek legal consultation to develop policies surrounding AI use. For example, policies developed around consent and privacy can be shared with clients if questions arise in practice.

Summary

AI may be a useful adjunct in practice, but it does not replace the clinical judgement and decision-making of the occupational therapist. Occupational therapists deciding to use AI should keep privacy and ethical considerations in mind and ensure they are still following the Standards of Practice and applicable legislation.