In this episode of Commerce Talk, we sit down with Dr.Avneesh a Physician turned Med Tech (AI) consultant and educator to talk about the importance of regulation, education and ethics when it comes to AI in Healthcare. We hear about some of the ways in which AI will help to make predictions to improve and personalize patient care and how important blockchain will be as a combined tool to facilitate the secure transferring of patient records and more.

AI and the Need for Empathy

Dr. Avneesh: My interest in AI was sparked after my exposure to the electronic medical records during my stint in the Middle East and a question came to my mind about how we can put this data to better use for improving the quality of care and patient outcomes and that is when I started exploring online and got in touch with some great thought leaders. At that time I read a few books and joined a few online communities and I also took the online course by Stanford that is AI in healthcare specialization, as well as the american board of AI in medicine and then I realized that AI has a huge potential to transform the art of medicine and to positively impact the entire field of healthcare starting right  from better prevention and right up to better diagnosis and treatment of various diseases. AI has the ability to analyze vast amounts of data quickly and accurately and this can help clinicians in making more informed decisions about patient care. So this is what got me excited about AI in healthcare in today’s world regarding increasing knowledge about AI.  I am trying to bridge the gap between technologists and Clinicians and I am helping medical technology startups in building  better solutions. They can do so by understanding the nuances of healthcare. With my experience in Healthcare of around a decade I helped them with identifying the problems, validating them and then developing proper solutions to solve those real-world problems and at the same time I’m also helping medical professionals to expand their horizons by understanding and embracing artificial intelligence. Which seems to be the future of healthcare.

Aziza: When we start talking about AI and machine learning and mixing that with healthcare oftentimes from a consumer point of view I would say there is a worry or fear around losing the human touch. I had a really great conversation with another guest who launched Thailand’s first ever mental health app. She was talking about AI and machine learning and how these will really help her business of course. But then we spoke about the other side of that which was from a psychology point of view if you are seeking out help with a psychologists or a therapist and there’s AI integrated in that there’s naturally the worry of the lack of empathy and the vulnerability that you’re willing to give when you know that on the other side of the conversation is a machine. Not a human. What do you say about that and what do you think the future holds in terms of building the bridge as you say between both worlds?

Dr. Avneesh: So, you’re correct there’s a lot of fear around this technology because it’s quite disruptive and people can already see what it is capable of doing with the release of ChatGPT so I would say that those fears are not like we should not worry about the bad parts of artificial intelligence, of course we need to be careful about those, but I think the ideal approach to integrating an AI in healthcare would always be to find a balance between technology and human touch. We have had a bad experience with electronic medical records in the past because of those tools instead of improving the health care as they promised. They took away the valuable time from the patients. So we don’t want these new technologies to do the same so those concerns are valid. I would like everyone to go through a book which is deep medicine by Eric Topol and he has written in a very simple language and he has made a case of how AI can make healthcare human again. So the whole point is how to bring back the human touch into healthcare which has been somehow lost in the age of advancement and how AI can enable that. Having said that, I think the main points for us moving forward both for technologists and clinicians is that AI should be used as a tool to enhance and not replace the care provided by clinicians. I see a lot of studies in the research area which compares the performance of artificial intelligence to humans. So it is like a situation of AI versus humans, but my belief is that we should be having more studies where we don’t compare AI or humans alone but move to AI plus humans. So that is the correct way to integrate AI into healthcare. The focus should be to automate the routine tasks which take away a lot of useful time of clinicians away from patient care and also to provide data-driven insights that can help the clinicians to make better and informed decisions so that we can improve patient outcomes.  It will  always be about  the doctor patient / relationship, which is  at the center of Healthcare and we should not allow any technology to undermine that in any way.  That is why I say that it is more important for Clinicians, especially, to take hold of the field of artificial intelligence and understand how it works and how it can be applied ethically so that we do not lose the human touch in healthcare.

What Value Will AI Bring to People?

Aziza: When we talk then about the value given to patients and people, how will all of this improve the lives of others? 

Dr. Avneesh: AI has a lot of applications and there is still a lot of work that is happening around how it can improve healthcare and how it can improve the situations for all the stakeholders because healthcare is not just about patients. There are providers there. There are players and patients. So basically those are the 3 Ps but if we talk from the perspective of consumers or patients then I think the most important thing that AI will help in providing is personalized care based on individual patient characteristics, because right now most of the medicine that we practice is one size fits all but for the first time in history of medicine we have a technology that has the potential to tailor treatment plans according to a single person. This can also help in personalizing follow up after the treatment so that is where the value will be added to the patient journey.  As well as this, it will be helpful in predicting the health issues before they arise and by bringing the patients to the hospital at the right point of time, so that they can be treated without hassle . Of course, AI will also play  a part in  reducing the waiting times. I am sure that a lot of patients don’t like waiting in the hospital. There are a lot of bottlenecks in the workflow so AI can help in optimizing those and again that will add value to the patient journey.

We hear a lot of talk around virtual care and a lot of care being provided remotely via telemedicine and AI has a huge role in that in enabling those platforms and lastly one of the important and interesting areas is that there’s a lot of patient feedback which is taken at the end of  care and mostly that feedback is just fed into the system and nothing happens because it is a huge task to have someone analyzing that data one by on, but with the help of AI, we can now use  natural language processing to analyze that patient feedback and filter out the key themes and then prioritize the key areas where solutions need to be developed.  So, all of these things will help the patient in navigating the complex world of healthcare in a better way.

Aziza : How quickly is this integration coming? What is happening right now in terms of these changes being made? What are you seeing?

Dr. Avneesh: I have been reviewing the papers published in PubMed for the last three years around healthcare quality improvement and I see a lot of things being applied on ground. One example is the ability to  predict the patient footfalls in the coming days so you can plan your resources accordingly. There have been studies which cite the use of AI for prioritizing the ambulance dispatches depending on the language that the person calling for the ambulance is using, so you can classify it and then respond accordingly. When it comes to  patient feedback analysis, this is an area which is already being applied in big hospitals. There are a lot of chatbots and virtual assistants that are coming up on the hospital websites or or the patient applications in which the patient can ask questions and those chat bots even take your preliminary history and they can try you and direct you to the correct specialist in the hospital. So, these things are already happening on ground and I would not say that everything has been sold and we are all ready to go, but  work is happening and it’s all exponential. We learn from our mistakes and then we build upon those. I think the next few years are quite exciting to look forward to and I think the whole patient journey will be transformed in a positive way. Patients will be a big part in enabling those changes and in bringing about that transformation.

Safeguarding Customer Data

Aziza: When you talk about excitement in this area I’d like to know what emerging technology are you most excited about and all of this?

Dr. Avneesh: By now you know that I’m most excited about artificial intelligence but there are a lot of other emerging technologies which are working in tandem with AI like cloud technology and 5G communication. The one thing that I am most excited about is Blockchain in healthcare because blockchain is something that has the potential to completely transform healthcare when it is  working in conjunction with artificial intelligence. Why? Because when both of these technologies  work in synergy they enhance each other’s capabilities. With blockchain,  we can improve the data security and privacy of patients, which is the most important problem to be solved in healthcare. A lot of data right now is concentrated in health systems,  so we need a decentralized platform which is quite interoperable in order to ensure the  secure sharing of patient data between different healthcare organizations. This will help in streamlining the administrative processes  as well, in areas such as  insurance claims and billing,  all those daily hassles will be solved. One of the biggest problems in the developing world is the issue of counterfeit medicines. So, how do you ensure that the supply chain is intact and the medicine is from a correct source? I see blockchain impacting that field as well.

Development Outpacing Regulation

Aziza: Then if we look at the good and bad sides of all of this I’d like to talk a bit more about the ethics, governance and regulations that need to come in conjunction with this change?

Dr. Avneesh: I think this is the most important topic that needs to be discussed right now in the field of artificial intelligence because of the way that technology is moving at a rapid pace.  I think topics like ethics and regulations become really important,  because if we let this technology go unregulated,  it can create disastrous consequences for everyone and lead to bad experiences. You must have heard in the news about Algorithms and their bias in making decisions  for a particular subset of the population. The most important thing to watch out for is the potential for biases in algorithms because after all they are only as good as the data we feed them and our data is full of biases.There are a lot of techniques while training AI algorithms to reduce the bias and ensure that to a large extent the data won’t achieve 100% removal bias, but at least we can ensure that it  is a very low number. Then there’s also a need for proper data management because the pipelines are not developed and a lot of data is not well suited for training AI algorithms and some algorithms like deep learning require a large amount of good quality data. There’s this saying in AI which is called ‘garbage in and garbage out’,  so we need to work on the quality of data. We also need to ensure privacy protection which is quite important in healthcare. There’s a lot of news everyday about data breaches and hacks of patient data. These can only lead to the corruption of AI models and AI models going rogue with disastrous consequences.  I think with AI there’s a lot of pros but there’s a con of making us as a species over-reliant on technology and I think it’s time for human species to think about what makes us human and to enhance those capabilities and to leave the things that make us robots to AI so these are the ethical issues which which I think are most important. There are other topics and questions like  who controls the AI and who benefits from it? Those are the areas to be talked about.  I think with time we will be talking about these issues more and more as more people become aware of AI and its potential. I am quite hopeful that we will be applying AI in an ethical way for the benefit of mankind.

Aziza: It’s really interesting when you’re talking there. I’m almost wondering what comes first because are we developing faster than we’re able to check ourselves and make sure that things are regulated and that things are being looked after carefully and so it’s a really interesting topic and I know that we’ll probably see a lot more about this over the next coming weeks, months years. Do you see it as something that it’s learning and developing? As it goes, are we going to have to learn the hard way? Some of the lessons that come from the ethical side of using these applications.

Dr. Avneesh: Yes,  there is this rapid development of this technology across industries and even in Healthcare it has outpaced regulation. We can clearly see that.The regulatory agencies are trying to keep up and they’re trying to learn about what the technology is as  the technology is being developed. So there’s definitely a gap and that needs to be filled. I’m not sure how that is to be done but an important part of that is going to be education and awareness around the issues and to get the conversation going. I think with time we will develop clear and robust regulations. We have done so with other technologies in the past like nuclear energy and we will of course come up with regulations and once those are those are streamlined then this technology will be developed in a different way than it is being done today. So yeah, things are moving and it will take time.But we need to be aware about the pace of this technology because it is quite disruptive so we need to move fast in the regulation side as well.

Aziza: What’s one thing that you wish you knew sooner in your career?

Dr. Avneesh: The importance of interdisciplinary collaboration and how important it is to learn from people outside of your industry.  I realized this when I started exploring artificial intelligence and I realized that as healthcare becomes more complex it’s really essential to work with experts from other disciplines like engineering, technology and computer science to be able to provide better and comprehensive care for patients to improve their outcomes.

I think some ways in which clinicians can foster this collaboration and which I should have also done is by participating in communities and teams which are interdisciplinary. Don’t be limited to your field of medical education. It has a huge curriculum and there’s hardly any space for other things right now, but still I think it can be involved with other industries in an extracurricular manner and that’s really important with the changing times and this fourth industrial revolution because of these emerging technologies are converging and medical science is a slow field to adopt those things.

I think we should actively seek out ways to collaborate with experts from other fields and of course you can do that by attending conferences, workshops, hackathons and joining some online communities. The most important thing is to be open-minded and willing to learn from others. That is the one thing which I would tell my younger self. If I could go back in time.

CONCLUTION 

This episode was developed as part of a three-part-mini-series for #WorldHealthDay where we embarked on a journey to the future of healthcare,  exploring the fascinating world of machine learning and AI as we moved to further understand how these ever-evolving technologies, tools  and applications will impact the future of health and well-being. From diagnosing illnesses, designing treatment plans and bettering human experiences.

In part one of our #WorldHealthDay mini-series on Commerce Talk, we sat down with Dr. Kanpassorn Eix, the CEO and Founder of Ooca, a groundbreaking app that is revolutionizing access to mental healthcare in Thailand.

In part three, we spoke to  Dr. John Sheehan, a respected and future-focused Radiologist, Clinical Director and Healthcare Technologist about  how collaboration, leadership and continuous learning can help us better serve people in the healthcare industry and beyond.

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