AI in healthcare: Involving the public in the conversation
As we begin the 21st century, we are in an era of unprecedented innovation, where computers are becoming smarter, being used to deliver products and services powered by Artificial Intelligence (AI). I was fascinated how AI is being used in advertising, when I saw a TV advert this week from Microsoft where a musician was talking about the benefits of AI. Organisations in every sector, including healthcare, are having to think how they can harness the power of AI. I wrote a lot about my own experiences in 2017 using AI products for health in my last blog, You can’t care for patients, you’re not human!
Now when we think of AI in healthcare potentially replacing some of the tasks done by doctors, we think of it as a relatively recent concept. We forget that doctors themselves have been experimenting with technology for a long time. In this video from 1974 (44 years ago!), computers were being tested in the UK with patients to help optimise the time spent by the doctor during the consultation. What I find really interesting is that in the video, it’s mentioned that the computer never gets tired and some patients prefer dealing with the machine than the human doctor.
Fast forward to 2018, where it feels like technology is opening up new possibilities every day, and often from organisations that are not traditionally part of the healthcare system. We think of tech giants like Google and Facebook helping us send emails or share photos with our friends, but researchers at Google are working with AI on being able to improve detection of breast cancer and Facebook has rolled out an AI powered tool to automatically detect if a user’s post shows signs of suicidal ideation.
What about going to the doctor? I remember growing up in the UK that my family doctor would even come and visit me at home when I was not well. Those are simply memories for me, as it feels increasingly difficult to get an appointment to see the doctor in their office, let alone getting a housecall. Given many of us are using modern technology to do our banking and shopping online, without having to travel to a store or a bank and deal with a human being, what if that were possible in healthcare? Can we automate part (or even all) of the tasks done by human doctors? You may think this is a silly question, but we have to step back a second and reflect upon the fact that we have 7.5 billion people on Earth today and that is set to rise to an expected 11 billion by the end of this century. If we have a global shortage of doctors today, and since it’s predicted to get worse, surely the right thing to do is to leverage emerging technology like AI, 4G and smartphones to deliver healthcare anywhere, anytime to anyone?
We have the emergence of a new type of app known as Symptom Checkers, which provides anyone with the ability to enter symptoms on their phone and to be given a list of things that may be wrong with them. Note that at present, these apps cannot provide a medical diagnosis, they merely help you decide whether you should go to the hospital or whether you can self care.. However, the emergence of these apps and related services is proving controversial. It’s not just a question of accuracy, but there are huge questions about trust, accountability and power? In my opinion, the future isn’t about humans vs AI, which is the most frequent narrative being paraded in healthcare. The future is about how human healthcare professionals stay relevant to their patients.
It’s critical that in order to create the type of healthcare we want, we involve everyone in the discussion about AI, not just the privileged few. I’ve seen countless debates this past year about AI in healthcare, both in the UK and around the world, but it’s a tiny group of people at present who are contributing to (and steering) this conversation. I wonder how many of these new services are being designed with patients as partners? Many countries are releasing national AI strategies in a bid to signal to the world that they are at the forefront of innovation. I also wonder if the UK government is rushing into the implementation of AI in the NHS too quickly? Who stands to profit the most from this new world of AI powered healthcare? Is this wave of change really about putting the patient first? There are more questions than answers at this point of time, but those questions do need to be answered. Some may consider anyone asking difficult questions about AI in healthcare as standing in the way of progress, but I believe it’s healthy to have a dialogue where we can discuss our shared concerns in a scientific, rational and objective manner.
That’s why I’m excited that BBC Horizon is airing a documentary this week in the UK, entitled “Diagnosis on Demand? The Computer Will See You Now” – they had behind the scenes access to one of the most well known firms developing AI for healthcare, UK based Babylon Health, whose products are pushing boundaries and triggering controversy. I’m excited because I really do want the general public to understand the benefits and the risks of AI in healthcare so that they can be part of the conversation. The choices we make today could impact how healthcare evolves not just in the UK, but globally. Hence, it’s critical that we have more science based journalism which can help members of the public navigate the jargon and understand the facts so that informed choices can be made. The documentary will be airing in the UK on BBC Two at 9pm on Thursday 1st November 2018. I hope that this program acts as a catalyst for greater public involvement in the conversation about how we can use AI in healthcare in a transparent, ethical and responsible manner.
For my international audience, my understanding is that you can’t watch the program on BBC iPlayer, because at present, BBC shows can only be viewed from the UK.
[Disclosure: I have no commercial ties with any of the organisations mentioned in this post]