Background and Concept

AI tools have the potential to transform healthcare and mitigate health disparities through improving diagnosis and treatment, enabling personalized precision medicine, providing predictive analytics that support early intervention, powering telemedicine to rural and remote areas, disseminating health information and combating health misinformation. Each of these opportunities is of high relevance to Hawai'i, where indigenous, migrant, and low-income communities are adversely affected by health inequity. Native Hawaiians and Pacific Islanders have strikingly high rates of obesity and cardiometabolic disease; smoke, contract TB and experience houselessness and incarceration at some of the highest rates in the nation; died of COVID-19 at the highest rate of any ethnic or racial group during the pandemic; and have excess mortality in certain cancers, neurodegenerative disease and suicide. Social determinants of health that compound inequity in Hawai'i include poverty, geographical isolation, historical trauma, erosion of traditional culture and neocolonialism.

Against this backdrop, Hawai'i healthcare operates through a complex assemblage of HMOs, academic medical centers, rural clinics, state agencies, the VA, Federally Qualified Health Centers, insurers, non-profits, grassroots community organizations and cultural practitioners. Without a coordinated effort, Hawai'i is at risk of an AI-divide where our population is disenfranchised from the benefits of AI in healthcare because of technical barriers to adoption, lack of local and regional expertise in AI methods and an underprepared workforce. In the era of freely available open AI, piecemeal and under-informed adoption of AI tools also carries significant risks to patients and serious ethical pitfalls.

Vision

Academic and healthcare stakeholders in Hawaii collaborate to build ARCH. ARCH mitigates AI divides and risks, and fosters AI use to improve health and decrease health inequities for Hawaii’s diverse communities. ARCH proposes a holistic three-armed approach - strengthening the AI-capable healthcare workforce, empowering social sector and non-profit healthcare organizations with AI/ML capability, and increasing academic and community AI/ML healthcare research capacity.

Mission

The overall mission of ARCH is to facilitate informed healthcare stakeholder access to AI/ML tools to improve Hawaii’s health and reduce health inequity while navigating the technical challenges, ethical burdens and risks associated with these technologies.

Goals

A