Tech Offers Empathy but Digital Divide Looms in Respiratory Health Care

The promise of artificial intelligence (AI) to revolutionize patient care is tempered by complex challenges surrounding ethics and global equity, according to experts who presented at the European Respiratory Society (ERS) Congress 2025. The future of respiratory health care hinges not just on technological advancement but on a concerted effort to close the digital divide and ensure equitable access to these powerful new tools.

While artificial intelligence showed empathy and precision in respiratory health care, its equitable adoption is paramount to prevent the widening digital divide, as highlighted at the European Respiratory Society Congress 2025. | Image Credit: Selvi - stock.adobe.com .jpeg

Evolution and Application of AI in Respiratory Care

Richard Noll, a PhD candidate at the Johann Wolfgang Goethe University in Germany, provided a comprehensive overview of the history and applications of AI in health care, with a specific focus on its potential in diagnosing and treating rare respiratory diseases.1 Noll traced the origins of modern AI back to the Turing test in 1950 and the term artificial intelligence being coined in 1956, later referencing the Chinese Room thought experiment from 1980 that highlighted the distinction between a machine's ability to process syntax and truly understand semantics. While acknowledging AI's superior capabilities in data processing and pattern recognition, Noll contrasted them with human strengths like empathy and judgment.

He presented findings from a study comparing a large language model like ChatGPT-4 with physicians in patient communication for rare diseases. The study showed that AI outperformed physicians in several categories, including correctness, comprehensibility, and even empathy, although the AI model consistently included the important caution to discuss concerns with a consultant.

Noll also addressed critical risks associated with AI, such as data privacy, bias within training data, and hallucinations (generating false information). To mitigate these challenges and make AI usable for training, he emphasized the urgent need to standardize clinical documentation in electronic health records into common terminologies.

Addressing Equitable Access to Respiratory Treatments

The discussion then pivoted to the crucial issue of global equity in health care, particularly for vulnerable populations and in the digital age. David Currow, PhD, professor of palliative and supportive services at Flinders University in Australia, spoke about the challenges of achieving equity of outcomes in health care for patients with chronic conditions, especially when implementing digital health solutions.2 He focused on the fact that access to digital tools varies across the world and even within some countries, such as rural areas within high-income nations, highlighting a level of equity that should be taken into consideration when considering expanding digital health tool utilization.

“The digital health revolution is already widening the gap between those who have great health outcomes and those who have poor health outcomes…. Ultimately, equity is going to be a greater challenge unless we put some really strong foundations in place for digital health and ensure that those who are already most disadvantaged are not further marginalized,” Currow said.

The discussion underscored that the introduction of new technologies, if not planned for equity, risks widening the existing digital divide.

Ambrose Agweyu, PhD, professor of infectious disease and epidemiology at the London School of Hygiene and Tropical Medicine at the University of London and a clinical research scientist at the Kenya Medical Research Institute, centered his discussion on equity and pediatric respiratory infections, highlighting the significant role of social determinants of health and governmental policies in creating disparities in access to essential health care services.3 He stressed the importance of policy- and system-level actions to create the necessary digital foundations—including connectivity, devices, digital literacy, and reimbursement—to ensure equitable digital health implementation for all.

“We are at a crossroads as a global community right now. We’ve seen the gains that we’ve realized over recent decades, particularly for child mortality, but really, we must be alive to the fact that these gains are currently under threat, under real threat, even as we focus on achieving sustainable development goals,” Agweyu emphasized.

Managed Care Implications and Future Action

The presentations collectively pointed to clear actions for policy makers, funders, and institutional leaders in the managed care landscape. These included advocating for policies that promoted the creation of a strong digital infrastructure to prevent the widening of the digital divide in health care and implementing projects to extract and standardize unstructured patient data from electronic health records into registries, which is essential for safely training and deploying AI-assisted clinical decision support systems.

The experts emphasized that human validation for all AI-assisted clinical decision support systems must be prioritized, even as AI models demonstrated high performance. Across the board at the European Respiratory Society Congress 2025, experts underscored that as AI rapidly reshapes respiratory medicine, the ethical and equitable adoption of technology needs to remain central to the conversation.

References

1. Noll R. Artificial intelligence in the diagnosis and treatment of rare respiratory diseases. Presented at: ERS Congress 2025; September 27–October 1, 2025; Amsterdam, Netherlands.

2. Currow D. Access and equity in healthcare in the era of digital heath. Presented at: ERS Congress 2025; September 27–October 1, 2025; Amsterdam, Netherlands.

3. Agweyu A. Equity-based preparedness and response actions to paediatric respiratory infections. Presented at: ERS Congress 2025; September 27–October 1, 2025; Amsterdam, Netherlands.