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How artificial intelligence could provide some respite for the NHS

How artificial intelligence could provide some respite for the NHS

How artificial intelligence could provide some respite for the NHS

Emma Rich, University of Bath and Andy Miah, University of Salford

The NHS recently announced plans to trial an artificially intelligent mobile health app to a million people in London. The aim is to help diagnose and treat patients by engaging them in a real time text message conversation which will complement the NHS 111 phone based service (which was criticised by the Care Quality Commission watchdog). The app’s designers, Babylon Healthcare Ltd, use algorithms to make initial diagnoses which are then followed up with human consultations. It has already received a glowing CQC evaluation.

The app is likely to provoke a mixed response, with enthusiastic technophiles up against those concerned that more technology means a less human healthcare service. Yet, with the NHS being described as suffering from a humanitarian crisis, and with a growing healthcare burden and limited resources, some smart solutions are needed. It is hard to deny that problems of limited funding are enduring features of this unique public service. Perhaps AI has the answer.

In fact, providing effective healthcare is always a combination of systematised technological efficiency combined with patient centred human care. Polarised views on technology are often not helpful. It’s also necessary to recognise how this approach to healthcare is part of a wider technical revolution in which connected objects in the Internet of Things will change everything from healthcare to traffic maintenance.

The NHS app is really simple to use and has been likened to using the social messaging service WhatsApp – but with one crucial difference: you are chatting with a computer, not a person. Once the app is downloaded, you log your basic health information, and then start explaining your symptoms. The robotic “responder” will say things like: “I just need a few details from you before we get started,” and “nearly there” to keep the conversation going. After a more detailed exchange, it might come to a conclusion along these lines:

Ok so your symptoms don’t sound urgent, but I think they require further investigation. Make sure you arrange a consultation with a GP within the next two weeks. If left, symptoms like yours can become more serious, so book now while you remember and I’ll remind you closer to the time. If things change in the meantime and you become more unwell, speak to a doctor as soon as you can.

This digital diagnosis service intends to provide an additional communication tool between the NHS and patients. It it part of a broader ecosystem of digital health services which include online health tracking. Also, the app takes advantage of the fact that some people these days are likely to be more comfortable chatting by text than they are with talking on the phone.

This digital phenomenon is driven by the promise of a wider technological fix to social problems. Applications within healthcare could bring about big wins for society, where the functionality of the device is made all the more efficient by the aggregation of “big data” that it generates. Tech firm Babylon is joined by other big players seeking to do similar things, such as Google’s Deep Mind, which wants to mine NHS data to to enable earlier diagnoses for example, or to achieve more effective monitoring of treatments.

At the world’s largest tech expo in Las Vegas at the start of 2017, home AI systems have been one of the biggest hits. So perhaps the NHS has found an intelligent solution at just the right time. People may now be far more willing to have a “relationship” with an attentive machine than a call centre drone.

Digital doctor

Driving these developments is the assumption that, within a digital knowledge economy, these forms of communication can offer more neutral and accurate responses, circumventing human error. Yet, scholars within the emerging field of critical digital health studies suggest that algorithms must be understood as part of a complex network of interconnections between human and non-human actors. A recent study comparing physician and computer diagnostic accuracy revealed that doctors “vastly outperformed” algorithms

So we need to ask some key questions about the assimilation of AI into healthcare. How do people make sense of the list of possible diagnoses they receive from the machine? Will people follow the advice, or trust it? How will AI need to be tailored to accommodate human variation, by geography, capacity, or cultural identity. Another important aspect of this trial will be the consideration given to the backgrounds of the users. Given enduring concerns about inequalities of digital access and digital literacy, trials for future digital health tech need to be conducted amongst those populations with limited resources, experiences, and technological infrastructure.

Perhaps the biggest question we face in a world where ever more of our data is locked up in the mobile app environment, is over the proprietary and privacy of our data. How can we ensure that we have the freedom to move our health data around, over time, and ensure that it is safe and secure? We may need a new Bill of Health Data Rights to underpin and limit their exploitation of our data, and work on this must start now.

The Conversation

Emma Rich, Reader, Department for Health, University of Bath and Andy Miah, Chair in Science Communication & Future Media, University of Salford

This article was originally published on The Conversation. Read the original article.

the $50b Mobile Health Industry

the $50b Mobile Health Industry

My first talk at the Sports Institute of South Africa's 10th meeting on Sport & Fitness focused on the mobile health industry. I wanted to focus on the economics, in part because they are so hard to unravel. The key thing to know is that the mobile health industry is promising efficiencies, but a new era of ingestible sensors is also upon us!


Future Hospitals

Future Hospitals

This week, I took part in a panel discussion about the future of hospitals, following this brief:

The Government is committed to a vision for hospital services structured around the needs of patients, both now and in the future. Delegates will explore the need for changes to how we organise and deliver hospital care and treatment that is safe, effective and meets the needs of patients, 24 hours a day, seven days a week. 

As the constraints on NHS spending continue, coupled with patient’s expectations of safer and higher-quality health care, the need to provide health services differently has never been more crucial.

Under intensifying pressure to change, hospitals are adapting their organisation and services to cope with cuts to financial resources. Simon Stevens, NHS England Chief Executive, has made facing financial challenges a priority. He has also emphasised how frontline staff will be vital to create change and generate innovation to deliver services differently.

A core part of the vision laid out by Simon Stevens in the NHS five year forward view involves hospitals becoming more closely integrated with other forms of care. If the health and social care system is to respond to the changing needs of the population, and also address the financial challenges it faces, all hospitals will need to play a fundamentally different role within local health economies.

Hospitals across the UK and around the world face significant challenges as a result of demographic change, rising demand and a staffing challenges. The changing needs of the population make it increasingly important that hospitals are able to provide high-quality care for people with multiple chronic conditions and complex needs, including but not limited to the growing numbers of frail older people. To respond effectively to these changing needs, health and social care services must be capable of providing ongoing support over time, anticipating and preventing deterioration and exacerbations of existing conditions, and supporting a person’s multiple needs in a well-co-ordinated way.

With all this in mind, hospitals will need to develop new ways of working that span traditional service and organisational boundaries – including working more closely with other hospitals (for example, through alliances and partnerships), and strengthening connections with community-based services such as primary care, social care, community services and mental health. This points towards hospitals playing a more outward-facing role in their local health system, in which they shift

from an organisational focus to a system leadership role, and play a more active part in preventing illness and promoting health in local communities.

What the future hospital will look like and what its central role will be will emerge out of the remnants of a system currently not fit for purpose. The Future of Hospitals Conference will address all the key issues and ask the main question, namely, what will the future hospital look like and how will it operate on a day to day basis

Personal health technologies

Personal health technologies

As part of my involvement with the amazing 2020 Health project, I was asked to take part in a Conservative Party fringe event, exmaining how digital technologies can transform the health care system. It was a pretty far reaching discussion and my central concern was around data ownership, mobility, and expansion. More to come on that.

Chaired by: Dame Helena Shovelton DBE, Chair, 2020health 

With guest speakers: 
Nicola Blackwood MP, Chair, Science & Technology Select Committee (Invited) 
Paul Burstow, Independent Health Consultant
Dr David Lee, Medical Director, Computer Sciences Corporation    
Professor Andy Miah, Chair in Science Communication & Future Media, University of Salford


What's trending at #ECSS2014?

What's trending at #ECSS2014?


In July, I ran a social media and sport workshop at #ECSS2014. Here's a video made from the congress, where I talk a bit about social media...

And here's the prezi from the workshop...