Artificial – made or produced by human beings rather than occurring naturally, especially as a copy of something natural.
Intelligence – the ability to acquire and apply knowledge and skills.
There is phenomenally rapid progress of scientific and technological discovery in Health. It is estimated that the doubling time of medical knowledge has shrunk from 50 years in 1950 to just 0.2 of a year – just 10 weeks in the present day. This acceleration has led to a universal decrease in morbidity and mortality and yet there has never been a wholehearted, global commitment to the digitisation of health systems.
Paper based care records are still the most common care record media globally and even in the most developed countries with the best care outcomes, many systems of record are still either paper or stand-alone applications that do not share data across an integrated system. This is especially true of private health care that is subject to less rigorous reporting requirements than public health systems. We now have a hodge podge patchwork of unintegrated digital systems, disparate electronic systems and disconnected paper-based systems dotted around our map of health service delivery.
This is somewhat surprising to someone who has spent most of his working life delivering international health system transformation. We know that getting the right information to the right person at the right time is critical to achieving the best possible care outcomes yet somehow it all seems too hard. In some health services it is against the law to share health records securely and confidentially among treating clinicians (hard to believe right?) In other health services it is just too expensive, there is no Return On Investment on digitising care records and it might even slow down care delivery and deteriorate revenue. For the sceptics, there is no shortage of excuses.
This time – AI is here to stay.
The rapid advances in diagnosis and treatment along with the global re-evaluation of healthcare’s importance following the Covid-19 pandemic will ensure that AI prospers and grows exponentially as never before. What we now think of as, ‘AI in Health’ is a drop in the bucket of where this revolution will take us.
Exciting though this prospect may be, I am even more thrilled by the impact AI is having on the digitisation of those anachronistic systems of record. Even the luddites now realise that, ‘if it ain’t digital, it ain’t AI.’
Health is on the same tier of Maslow’s hierarchy of needs as: employment, property, family and social ability. The challenge is that in our consumerist society of instant gratification we have let it slip down to the bottom tier of physiological needs along with breathing, food, water, shelter, clothing and sleep. We have taken it for granted. We have not bothered replacing legacy systems because they still work. Those assassins of the last millennium, HIV and Cancer, no longer have the same terror and certainty of annihilation. For the hoi polloi, there formed a naïve belief that the experts would figure it out and to a large degree, they did.
Thank you, Coronavirus. You ripped the scales from our eyes. You reminded us of our very real mortality. You helped us understand that we needed to share health records at a population level to fight this thing. You forced us to build real time Application Programming Interfaces. We started adopting interoperability standards like HL7 FHIR that shared pathology test data with QR code data so we could, “test and trace”. Digital health transformation enabled society to isolate households and families at risk and save millions of lives of the unvaccinated.
Corona elevated public health to morning television. It had the public debating the relative merits of messenger RNA vaccines over protein adjuvant vaccines. …and in the melee, more health services realised they needed to lift their digital health game, to invest and participate, to improve patient and workforce experience.
Then along came AI. The playful, poetic and nonsensical ChatGPT that democratised AI. No longer did you require a PhD in neural networks to use AI at home or even at work. Among the health workforce, doctors led the revolution, innovatively adopting GenAI to write up Outpatient medical notes, referral letters and reports so they could improve efficiency. They say necessity is the mother of invention. I say it is easier to beg forgiveness than to seek permission.
We do, of course require updated ethics, good governance, regulation and even a few good policies and guidelines to realise the benefits of AI in Health. To make a poor pun, the needle has moved. Previously, the public was fearful of AI and surveys reported that patients did not want their healthcare professionals using it in their care. The zeitgeist is now ravenous for more AI. Patients now understand that AI may help get a better, faster diagnosis. AI will help select personalised precision medicine therapies. AI will explain the medical record to patients and carers in the comfort of their own home long after the anxiety and emotion of the medical consultation has subsided.
No. AI will not leave us now. AI will drive the relentless adoption of integrated, interoperable systems that enable us to deliver better quality, better value care and achieve greater health outcomes than ever before.
AI is making life easier and improving care quality. According to Forbes and the World Economic Forum AI is already achieving that promise in these areas:
- Interpreting and reporting X-rays, CT scans and MRIs
- Accelerating drug discovery and development
- Improving Clinical Trial efficiency
- Real time remote patient monitoring
- Automating workflows and decreasing administrative burden
The future of healthcare is bright. Out of a global pandemic arose the possibility of humans and machines working together to deliver better health. Creative genius and hard work combined to solve a wicked problem that had previously baffled most health services. For those health systems that want to survive and flourish, AI will deliver digital health.
