Introduction by Croakey: On the day she introduced the Digital Duty of Care Bill into Parliament this week, Federal Communications Minister Annika Wells gave an impassioned address to the National Press club.
In it, she reminded her audience that the digital world comes with concrete harms from untested and unchecked technologies that, as per the harrowing stories she told, are harming Australians.
And she also said that Australia, of all countries, has a great record of implementing innovative legislation to protect public health. “We are a common sense nation,” she said. “We see a problem, and we fix it.”
The article below is drawn from Marie McInerney’s Croakey Conference News Service coverage of the Royal Australasian College of Medical Administrators’ conference, where RACMA President Professor Erwin Loh announced the establishment of a Faculty of Digital Health and AI within the College.
Experts contacted by Croakey are supportive, and have urged the College to place consumers at the heart of their planning, training and policymaking.
AI has crept into every facet of our lives and has many current and potential uses in medicine. But, in a week in which we also learned a Lancet Commission named AI as a major threat to global health with “extinction potential”, the new Faculty will have its hands full providing leadership and training leaders in this field.
It’s a task RACMA says they are keen to embrace.
Marie McInerney writes:
The Royal Australasian College of Medical Administrators (RACMA) has begun work to establish a Faculty of Digital Health and AI, heeding advice from multiple quarters that, when it comes to artificial intelligence, the health sector must “run, not walk”.
RACMA President Professor Erwin Loh announced plans for the Faculty at the opening of the College’s annual conference in Naarm/Melbourne this week.
“If medical leaders don’t set the standard for how AI is governed in health, others will,” Loh warned.
“AI is changing clinical care at a pace few of us have seen in our careers, and every decision about how it’s used safely is a leadership decision,” he said.
“Many of our members are already doing this work. Today is our first step towards a professional home where they can connect, build their expertise and help set the standard for the field.”
RACMA’s announcement came as a Lancet Commission named the emergence of powerful AI systems as one of the major threats to global health for this century.
The Commission observed that much health advocacy understandably is driven by single-issue activism, but says the “unpleasant reality is that the threats we face are multiple, complex and difficult”.
Among 17 priority identified threats to human health, the Commission says two – nuclear conflict and the malicious use of AI – “have extinction potential”. It urges authorities to build readiness, including to “create and fund threat-ready health systems and capabilities for preparedness and protection”.
Like RACMA, other health and medical colleges and organisations are also accelerating their consideration of AI, and how it can be safely adopted. The Royal Australian and New Zealand College of Radiologists (RANZCR), for example, recently dedicated a conference to the risks and opportunities. See Croakey’s coverage of that meeting.
But many decisions about AI are, of course, being made elsewhere.
Contested field
Prime Minister Anthony Albanese has promised “a world-leading artificial intelligence framework” to balance some critical tensions – “to ensure Australia can capture the opportunity, share the benefits and keep Australians safe”.
But he’s also up against big global forces: the United States issued an extraordinary public statement on Australia’s proposed digital duty of care, introduced to Parliament this week, warning it would be “extraterritorial censorship of protected speech”.
US President Trump has also unequivocally warned trading partners like Australia against imposing digital services taxes, fines, “and other forms of extortion on America’s leading technology sector”.
In New York last month to speak on children’s rights and protections in the age of AI, Albanese revealed that an OpenAI agent had hacked the Medicare website, bringing risks for health very close to home.
This all underscores the concerns of AI experts who have welcomed RACMA’s announcement, but urged the College to contribute its expertise as broadly as possible, to prioritise the views of consumers and First Nations communities, and to beware that AI leadership does “not become become synonymous with accelerating adoption”.
“Health expertise needs a seat at the table not only when AI enters hospitals and clinics, but also when the rules governing AI across society are being written,” said Dr Raffaele Fabio Ciriello, a senior lecturer in Business Information Systems at the University of Sydney, who wants AI to be understood not just as a tool in healthcare but as a determinant of health.
“Decisions about advertising, recommendation systems, conversational AI, surveillance, privacy and working conditions can all have downstream health effects,” he told Croakey.
The Consumers Health Forum of Australia (CHF) welcomed RACMA’s recognition that consumer safety must be a focus of the Faculty’s work, but also warned against a “patchwork” of protections and frameworks from individual health or medical colleges.
“RACMA says that if medical leaders don’t set the standard for how AI is governed in health, others will,” CHF CEO Dr Elizabeth Deveny told Croakey.
“But people with the most at stake are those receiving care. Standards for how AI is used in someone’s diagnosis or treatment should be consumer-led from the start,” she said.
Opportunities, challenges, responsibilities
In a statement, RACMA said the announcement of the Faculty follows four months of work by its Faculty Exploration Working Group, led by Board member Dr Monica Trujillo.
The statement said digital health and AI leadership has become a distinct field of medical practice, but “no medical college currently recognises this expertise specifically for doctors”.
Medical leaders across Australia and Aotearoa New Zealand already guide how digital health and AI are governed and implemented, often without a recognised professional identity, common standard or established professional home, the statement said.
The proposed Faculty would focus on clinical governance, patient safety, data governance, workforce leadership and responsible implementation, and aim to partner selectively with organisations that bring technical expertise, without duplicating it.
Loh and Trujillo spoke to Croakey at the conference, saying the Faculty is driven by the adage, “that with great opportunities come great challenges and responsibilities”.
Trujillo said it’s clear that health systems significantly rely on technology and know AI is key to the future of health.
But there is an expertise gap – across all fields of health, including primary care, aged care, hospitals, and community based care — on how to use or deploy it safely in a healthcare environment, she said.
Inclusion and equity
Asked about the role of consumers and the huge political challenges around AI, Trujillo said consumers would “absolutely” be at the centre of the Faculty’s work, which would also be alert to critical issues around how to regulate big technology companies, the environmental costs of AI and implications of disinformation.
Loh said there are various AI policies relating to health in place nationally, including via the Therapeutic Goods Administration, which regulates AI software as a medical device, and in some Australian states and territories.
However, he said medical leaders see “a lot of AI software being used that falls below the threshold of regulation, and so we do need some leadership and guidelines around that”.
Along with others, the Australian Human Rights Commission has warned that AI systems, including in healthcare, “can reinforce systemic racism and produce discriminatory outcomes at scale”, due to biased training data, flawed design or embedded human prejudice.
Loh said RACMA also wanted to work with First Nations people and other communities who may be overlooked or misrepresented in AI data, or lack access to digital systems of care.
“We know AI can close the equity gap. It can also increase it,” he said.
Watch this interview
Community engagement
The Consumers Health Forum has been working to raise questions about the rapid arrival of AI tools for clinicians and patients, asking, for example, at one public forum last year whether they are ‘fit for purpose in healthcare?’.
Responding this week to RACMA’s announcement, Deveny urged the College to involve consumers in its work in a meaningful way, saying AI safety “looks different depending on where you sit”.
“A clinician might judge an AI tool by its accuracy. A consumer also wants to know whether they were told AI was being used, whether they could say no, what happens to their health information, and who is accountable if something goes wrong,” she said.
“Those questions only get asked properly when consumers are in the room where the rules are written.
“Real involvement means consumers co-designing the standards. It also means hearing from the people most likely to be left behind by digital health, including people with disability, older people, people from culturally and linguistically diverse communities, First Nations people and people in rural and remote areas.”
For Dr Yves Saint James Aquino, the RACMA Faculty plan offers “much needed leadership in this space”, as has the work of some other health bodies like RANZCR.
Aquino, a research fellow at the University of Wollongong’s (UoW) Australian Centre for Health Engagement, Evidence and Values (ACHEEV), said Big Tech has “a very simplistic understanding of what medicine and healthcare is”.
“They feel it’s just one action followed by another action, and then it’s done. They forget it’s a very relational profession.”
Pay attention
Aquino was part of the UoW-led team that in 2023 conducted the first national Australian citizens’ jury on using AI in healthcare, which asked under what circumstances, if any, AI should be used in the Australian health system to detect or diagnose disease.
The jury came up with 15 recommendations across ten categories, including the call for a charter for AI in the Australian health system, which they said must include Aboriginal and Torres Strait Islander peoples and other under-represented people, rural and remote populations, sustainability and the environment, Australian security and sovereignty, and ethics and human rights.
Aquino also hopes initiatives like RACMA’s Faculty do not confine their input to just medical or technical experts, but also engage strongly with consumers and ACHEEV’s research.
“I think AI leadership is not just about pushing for the technology to be implemented safely. There should also be room to accommodate when health consumers, patients, or even administrators or professionals don’t want AI in their care or in their work. So I think they need to engage with the community and not just let the decision making remain within the profession,” he said.
Speaking particularly about RACMA’s remit, Aquino said there can be a misconception in healthcare that there is a clear line between a clinical task and an administrative one, a distinction that is “getting blurred now”, particularly by AI.
“Medical administration is not purely administrative. They’re doing clinical work, or at least doing important tasks that will inform clinical clinical work,” he said.
He also called out the “myth” that AI should be treated as just another tool or device, like Microsoft Word or a calculator, where there was no need to establish evidence of safety.
Unlike Word, where the text output was the same as its input, AI’s large language models might summarise information, rephrase it, or look elsewhere for extra information, he said.
“It becomes unpredictable, and if you have workers, health professions, or patients or health consumers who are not skilled to navigate the tool, it can go awry,” he said.
“Having a faculty that looks into [that risk] and how it impacts on the profession and your professional obligations, and how we should incorporate community attitudes into how we navigate this space is really important.
“It’s not like any other technology we’ve had in the past, and we really need to pay attention.”
Promising step
Dr Raffaele Fabio Ciriello also sees the RACMA Faculty proposal as a “promising step” towards building capability among medical leaders to govern AI well: “to assess evidence, challenge vendors, oversee data use, manage risks, and judge when AI should – and, importantly, should not – be deployed”.
He hopes the Faculty will be able to develop leaders “who can contribute beyond the health sector, bringing perspectives on population health, equity, and prevention into wider AI governance debates”.
“Good leadership means knowing not only how – or not – to deploy AI, but also when it is – or is not – appropriate, whose interests it serves – or does not – [and] who might be harmed or excluded, and what wider consequences may follow,” he said.
Cirello encouraged other health colleges to also strengthen their AI capabilities, although, like Elizabeth Deveny, he is not convinced every profession needs a separate AI Faculty.
“What matters more is whether health professionals are collectively equipped to shape AI governance across society, rather than merely manage AI once it enters the health system.”
Not all are preaching caution.
United States tech champion Tom Lawry is a former hospital director and Microsoft executive, and author of four books on AI specific to health and medicine, including his latest, released at the RACMA. conference, AI in Health: A Guide To Winning in the New Age of Intelligent Health.
An unabashed enthusiast for the power and potential of AI in healthcare, Lawry believes many politicians and others are “having the wrong conversation”, particularly around whether the pace of development of AI models should slow down, as even the CEOs of OpenAI and Anthropic have said.
“Instead of saying ‘let’s slow it down’, shouldn’t we have a conversation saying ‘why don’t we speed up the process of involving people, of getting input and having our leaders, private and public, do a better, faster job of putting guardrails in place….to make sure we’re doing more good than harm?,” Lawry told Croakey at the conference.
To that end, Lawry welcomed RACMA’s work on a new Faculty, saying health and medical leaders “have to start working on a new set of hard and soft skills to be able to lead into the future as [AI] becomes more pervasive in health and medicine.
“AI is unlike any other technology we’ve seen probably in our lifetime,” he said, referring to it as the latest example of a general-purpose technology that comes along once every 100 years or so, like electricity and the internal combustion engine.
“They eventually change not only how we work, but how we live,” he said.
Watch this interview
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