The algorithm doctor
As the medical and technology worlds converge, the entire healthcare ecosystem is evolving and being given new perspectives and solutions for how best to deliver healthcare, by advances in artificial intelligence (AI) technologies, such as algorithms and machine learning, together with connected smart medical devices and apps.
This couldn’t be more evident at the Consumer Electronics Show (CES), Vegas. During the Disruptive Innovations in Healthcare conference, topics included digital therapeutics, latest remote patient monitoring, expanding telehealth services, new insurance reimbursement models for virtual care and the power of AI, as predictive analytics increase evidence-based discoveries and provide new treatment options. The conference offered insights from a variety of participants, including top physicians, health insurers, medical device companies, legal advisors, health service providers and technology experts.
Such is the impact of technology on health, that in 2018, CES nominated Rene Quashie as its first vice president of policy and regulatory affairs for digital health. Quashie led a panel which looked at technical and regulatory issues relating to consumer digital health and wellness technology products, services, software and apps, and which need to keep pace with developments.
New tech, new concerns
When it comes to health, people need to trust their doctors and take for granted that their personal records remain private. They also need to know that any devices they may have to use are safe and secure. A number of concerns around AI technologies and smart medical devices need to be addressed rapidly.
Can we trust AI with our health?
Accenture research expects the AI health market to reach USD 6,6 billion by 2021, growing 40 percent annually, and potentially generating USD 150 billion in health care savings by 2026.
Whether crunching through masses of big data and improving patient diagnostics, detecting health insurance fraud, providing care to people in their homes or managing patient data, AI could impact most aspects of healthcare in the not too distant future.
But can algorithms based on data-sets inputted by imperfect humans really be bias free? What if the algorithm ends up harming a patient? Will patients want to be managed by algorithms and health bots instead of their human doctors and caregivers?
What about data privacy and security?
According to IBM Watson Health the average person will generate one million gigabytes of health-related data in their lifetime.
This is not so hard to imagine as many already track health and fitness using medical wearables, or treat conditions using smart devices, for example for diabetes. There are a number of important issues around these devices, such as how safe and secure is this data? What if algorithms end up replacing nurses and running all the devices in a critical care unit? What if they miss something only a nurse in the room could have seen, because a particular symptom or situation was not foreseen in the data set that trained it?
The role of standards
International standards developed by IEC for safety and performance of electrical equipment used in medical practice cover a broad spectrum of devices, systems and domains. They are developed by medical and IT experts, industry and regulatory bodies.
“It’s vital that new smart technologies in healthcare are safe and secure for everyone from the get go. We’re already working on standards for new architectures and applications in the field of digital health, artificial intelligence and data analytics, together with ISO,” says Michael Appel, certified anaesthesiologist and Chief Patient Safety Officer for Northeast Georgia Health System, who leads IEC work in this area.
IEC and ISO work together to develop international standards for information technologies through their Joint Technical Committee (ISO/IEC JTC 1). Subcommittee 42 was established to look at the entire AI ecosystem. IT and domains experts from different sectors are taking a broad approach in order to cover the different AI technologies and consider synergies with analytics, big data, cyber security, IoT, and more.
The healthcare sector is using innovative technologies to address a number of key issues, for instance, climbing costs as populations grow and age, and many more people require health-related services.
Around the world, surgeries, hospitals and care homes are becoming overstretched and understaffed. Connected medical devices enable patients to monitor, and in some cases be treated for, different conditions, wherever they are. The result is reduced doctor visits and costs, improved quality of life through tailored medicine, while doctors have more time for more patients.
Growing use of VR
This year at CES, the benefits of telemedicine were showcased. Broadening the point of care, doctors are able to treat patients with limited mobility, living far away, or who don’t have access to healthcare, remotely.
There is nothing worse than needing to see a doctor and not being able to get an appointment. Some US service providers offer doctors on demand without long waits or appointments. Patients get help when required, can have prescriptions delivered rapidly to the door, and by avoiding emergency care or doctor visit charges, it is more affordable.
Virtual and augmented reality programmes are also being used to train healthcare professionals to respond effectively in emergency situations, such as the outbreak of the Ebola or a disaster situation in a city.
Surgeons can livestream and virtually “train” students watching from anywhere, or consult with other surgeons around the world, in real-time, during complicated surgical procedures.
Virtual reality technologies fall within the remit of JTC 1. Subcommittee 24, produces standards which cover the interfaces for information technology-based applications relating to computer graphics and VR, image processing, environmental data representation, support for mixed and augmented reality (MAR), and interaction with, and visual presentation of information.
Innovations in all areas of health tech will continue to be developed, but in order for them to be adopted on a large scale, many safety, security, societal and ethical concerns will need to be resolved as traditional healthcare models and doctor - patient relationships move with the times.