Placement: Stanford University
Co-Mentors: Nirav Shah, MD, MPH, Senior Scholar, Clinical Excellence Research Center, Stanford University School of Medicine
Brian Anderson, MD, Chief Executive Officer, Coalition for Health AI (CHAI)
Project: A Framework to Promote Health Equity in the Regulation of Large Language Models in Health Care
Ed Middleton, MBBS, is a 2024–25 U.K. Harkness Fellow in Health Care Policy and Practice. He is Policy and Portfolio Director at Guy’s and St Thomas’ NHS FT, helping to develop the Trust’s next multiyear strategy and providing strategic input for a range of clinical services. One of his main focuses has been scaling population health management approaches at the Trust, to enable clinical services to identify need and intervene earlier in disease pathways. Middleton secured £1.6 million of philanthropic investment to build a new Population Health Management Hub in the Trust, which will drive greater equity, better outcomes, and a more sustainable health system.
Previously, Middleton was the health policy adviser to the Prime Minister in the 10 Downing St Policy Unit, leading on social care reform and proposals to combat obesity. Earlier in his civil service career, he worked as Senior Private Secretary to the Secretary of State for Health and Social Care, including during the first wave of the COVID-19 pandemic. He started his career as a practicing doctor, training at Imperial College London, and spent his medical elective with McKinsey & Co. working on health care transformation.
Project overview: Large language models (LLMs) offer huge transformational opportunity in health care, including the potential to address systemic problems, including growing demand and costs, impaired access for patients, and health inequities. Regulation will be critical to ensuring that LLMs improve access, outcomes, and experiences, while reducing health inequity.
The aim of this research is to develop a policy framework, for policymakers and regulators, that describes the priorities for ensuring that LLMs are used in health care in a way that reverses health inequities. The project will support efforts from policymakers in the U.S. and U.K. who are developing regulation for this fast-moving field. Health equity is a specific area of need in the current development of regulation and has been relatively under-explored. Without urgent focus, there is a risk that inequity will be baked into the development and deployment of LLMs in a way that is difficult — or impossible — to reverse.