Ques­tion of the Fort­night

Will com­put­ers re­place doc­tors?

Computer Active (UK) - - Contents -

By the end of the next decade, we may be di­ag­nos­ing our aches and pains on com­put­ers, rather than vis­it­ing GPS. This was the fu­ture painted by the Health Sec­re­tary in Septem­ber when talking at the NHS Health & Care In­no­va­tion Expo in Manch­ester.

Jeremy Hunt told the con­fer­ence that by 2028 com­put­ers and ro­bots pow­ered by ar­ti­fi­cial in­tel­li­gence (AI) may be able to an­a­lyse a pa­tient’s blood, and com­pare it with re­sults from thou­sands of oth­ers.

Would this leave the typ­i­cal GP twid­dling their stetho­scope, wait­ing for pa­tients who never come? It’s what some health pro­fes­sion­als fear. They say pa­tients value the face-to-face in­ter­ac­tion with a doc­tor and the chance to ask fol­low-up ques­tions.

Tr­isha Green­halgh, Pro­fes­sor of Pri­mary Care at Ox­ford Univer­sity, said on Twit­ter: “What our fo­cus groups of older pa­tients ac­tu­ally want is to be able to phone up and get a hu­man be­ing”. Com­put­ers, doc­tors say, can’t do sen­si­tiv­ity and re­as­sur­ance, nor pick up sub­tle vis­ual cues that would lead to a bet­ter di­ag­no­sis.

Doc­tors ac­cept that while ro­bots can per­form some au­to­mated pro­cesses, such as dis­pens­ing medicine and tak­ing blood, pa­tients might de­mand a hu­man touch.

Pro­fes­sor John Wil­liams, head of Health In­for­mat­ics Unit at the Royal Col­lege of Physi­cians, told the web­site Huff­post: “Mod­ern medicine is a very hu­man part­ner­ship be­tween pa­tients and doc­tors, work­ing to­gether for the best out­come for the pa­tient as a whole”. He claimed it would be “dif­fi­cult” for ro­bots to repli­cate the same level of care.

Such views chal­lenge the Health Sec­re­tary’s op­ti­mistic pre­dic­tion that “the changes in med­i­cal in­no­va­tion are likely to trans­form hu­man­ity by as much in the next 25 years as the in­ter­net has in the last 25 years”.

But doc­tors do ac­knowl­edge that AI can di­ag­nose some con­di­tions faster than they can. NHS Eng­land med­i­cal di­rec­tor Pro­fes­sor Sir Bruce Keogh said: “It’s pos­si­ble that cer­tain types of AI will be able to read X-rays. I’ve been told by peo­ple who are de­vel­op­ing this sort of stuff that’s within a four-year time frame”.

NHS Eng­land chief ex­ec­u­tive Si­mon Stevens told the Expo that the NHS will be in­vest­ing in AI over the next year. That money could be spent on Dna-screen­ing tech­nol­ogy which, Hunt said, will help spot dis­eases be­fore symp­toms ap­pear, “so we have a much bet­ter chance of be­ing able to nip ill­ness in the bud”.

But be­fore AI be­comes main­stream, an­other health rev­o­lu­tion seems to be on the way. Mr Hunt said that by the end of next year pa­tients should be able to per­form seven ba­sic ac­tiv­i­ties on an app “as sim­ply as you can look at your en­tire or­der his­tory on Ama­zon”. These are phon­ing the non-emer­gency num­ber NHS 111; ac­cess­ing per­sonal med­i­cal records; book­ing a GP ap­point­ment; or­der­ing pre­scrip­tions; choos­ing to do­nate or­gans; se­lect­ing how much data to share; and get­ting sup­port for long-term con­di­tions.

He said that the NHS must do “tech­nol­ogy bet­ter” if it’s “go­ing to be the safest, high­est qual­ity healthcare sys­tem in the world”.

How­ever, some doc­tors say that new tech­nol­ogy masks a fund­ing cri­sis in the NHS. Dr Ben White, who cam­paigned against the new con­tract for ju­nior doc­tors, said: “Hunt must stop us­ing ev­ery op­por­tu­nity to dodge real in­vest­ment in the NHS”. His com­ment is a re­minder that for NHS staff to em­brace tech­nol­ogy, the Health Sec­re­tary will need to per­suade them that it won’t com­pro­mise pa­tient care.

What our older pa­tients ac­tu­ally want is to be able to phone up and get a hu­man be­ing

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