The Department of Veterans Affairs needs to take a measured approach to adopting and scaling artificial intelligence (AI) technologies to improve health care of veterans, and inform veterans about how their health information is being used in connection with AI tech, lawmakers said during a Feb. 15 House Committee on Veterans’ Affairs subcommittee oversight hearing.

“The VA is not an island. AI efforts within the Federal government are proceeding in parallel, while private industry is significantly ahead of the public sector. Even within the [VA], this subcommittee has heard that efforts to use AI are fragmented,” said Rep. Mariannette Miller-Meeks, R-Iowa, chair of the House Veterans Affairs Subcommittee on Health.

“A priority of ours is to ensure VA moves forward with a cohesive strategy,” she said.

“Careful implementation will allow VA to establish trust in [AI] and encourage veterans and providers to see AI as a tool to solve problems, rather than a murky technology with potential risks,” said subcommittee ranking member Rep. Julia Brownley, D-Calif.

Charles Worthington, the chief technology officer and chief AI officer of the VA’s Office of Information and Technology, testified that the agency is taking that kind of measured approach to adopting and scaling AI solutions for veterans’ care.

“VA is committed to protecting veterans’ data, while responsibly harnessing the promise of AI to better serve veterans,” said Worthington. He explained that the VA is employing six principles for ensuring a measured approach to AI, including that any new AI tools are purposeful, effective, private, equitable, transparent, and accountable.

Rep. Miller-Meeks also raised concerns that the VA’s ongoing efforts to transition to a new electronic health records system could hinder its AI efforts. The chairwoman challenged Worthington on recent “hiccups” that the VA has had in implementing its new electronic health records management (EHRM) system.

Worthington acknowledged that the ongoing transition of VA’s electronic health records technology has not been a smooth one, but explained to lawmakers that the agency is already leveraging AI effectively in several ways – from enhancing diagnostic accuracy and efficiency in predicting cancer risks to an initiative to identify veterans with the highest level of suicide risk.

In the VA 2023 Agency Inventory of AI use cases, VA tracked over 100 AI use cases. Forty of those cases are in an operational phase — from speech recognition for clinical dictation to computer vision for assisting with endoscopies and customer feedback sentiment analysis modeling.

“I think you’re raising a really critical point, which is that many of these AI solutions, to really be truly effective, need to be carefully integrated into the existing workflows so that they actually reduce burden and reduce the number of clicks and not add yet another thing that the providers need to check,” he said. “By investing in these projects, VA aims to learn how AI technologies could assist VA clinical staff in delivering better healthcare with less clerical work, enabling more meaningful interactions between clinicians and veterans.”

Rep. Matt Rosendale, R-Mont., voiced his concerns over the VA using AI technologies for veteran healthcare without the consent of veterans.

Worthington assured the congressman that the agency is addressing this issue in an ethics group at the Veterans Health Administration that is seeking to understand the best approach to take. He said that the ethics group will likely issue recommendations to the agency but did not provide any further details on when that would take place.

Rep. Rosendale pushed back against Worthington’s assurances.

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Lisbeth Perez
Lisbeth Perez
Lisbeth Perez is a MeriTalk Senior Technology Reporter covering the intersection of government and technology.
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