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Key terms
Telemedicine (telehealth)
When medical colsultations to take place hwen the doctor and patient are in seperate physical locations
- Ex. telus babylon health, where you can see a doctor via mobile conference
Telesurgery
Operating surgery on a remote patient via technology (use of robots?)
Remote patient monitoring
A form of telemedicine which allows patients to return home while still being closely monitored by medical staff
- Ex. Diabetics draw blood and have a machine that records their blood sugar level, which then sends it electronically to a medical clinic
Wearable medical devices
Offer continous, real time data to improve treatment, diagnosis, and the monitoring of patients by medical professionals
Electronic Medical Records (EMR)
Patients data is stored in a computerised database which can be accessed by medical staff at all times
Personal Health Records (PHR)
Medical data that is provided and managed by the patient themselves, not a hospital or healthcare provider
- Data can be stored via cloud or your own computer
- Ex. Apple’s health app, Fitbit health app, shoppers optimum health system that they have set up at the pharmacies
Who does the R&D for health
Key stakeholders
- Universities, government (World Health Organization/WHO)
- Non-profit organizations (Red Cross)
- Private corporation and philanthropic donors (pharmaceuticals companies like Johnson & Johnson)
Many of the countries and communities most impacted by disease and other health risk factors often have fewer resources to spend on R&D than healthier communities
- Exemplifies digital and economic divide
Design and delivery of medical diagnostics and care
Medical Diagnostics:
The equipment, tools, and processes that professional medical personnel use to make a diagnosis
- Ex. Stethoscopes, blood pressure monitors, EKGs, etc.
Ai’s involvement in health?
Artificial intelligence is being used to analyze and monitor images, scans, and data
(The Pastry A.I. That Learned to Fight Cancer | The New Yorker )
Note
False positives are a common issue in many of these tools
- Hence often times their recommenders and diagnoses will ended to be re-evaluated by a human medical professional (ex. Doctor, surgeon, etc.) once an irregularity is identified.
Ai in predicative medicine
The Pain Was Unbearable. So Why Did Doctors Turn Her Away?
Why does it matter?
The US DOJ spends millions of dollars in order to maintain prescription drug databases to track the prescriptions of specific controlled substances in real time.
This was contracted out to a company called Appriss, which used machine learning algorithms to generate data insights
- Ex. Narxcare, which is one of Appriss’s databases, identified patients at risk of opoid abuse by analyzing the patients drug shopping behaviour, along with medical claims data, EHR, and criminal justice data. It then uses this data to assign patients an overdose risk score
- Appriss stated that NarxCare’s score was not designed to replace a doctors diagnosis
- But with physicians - accountable to the federal law on how they handle patients with high scores - were pressured to act on the score
- In one case, the algorithm was responsible for the patient Kathryn being denied medical treatment that was prescribed by their doctor nad the cancelling of the opioids that were being used to alleviate pain while the hospital was monitoring their condition.
- Occurrence of a false positive, as it was the patients dogs that were being prescribed the opioids for pain alleviations.
- This made the ai assume that it was instead kathryn who had an opioid addiction, as the pet’s medical bill was under her name
Key stakeholders include
- Government - they approved of the AI
- The patients who were victimized - Their scored were affected by the AI unreliability
- Doctor - job’s on the line, workflow becomes more efficient because the AI does the grunt work
- The programmer who made the AI - The AI’s reliability affects their business operation
IT system of the article mentioned
Internet Connection
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Expert system: knowledge input by database (server), the system retrieves the data and makes a conclusion based on their input
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AI gives a scored based on past medical supply purchases
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It may not be the most accurate as the purchases could be for someone or something else (ex. A pet)
Social and Ethical Concerns?
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Misdiagnosis of a patiend based on data that may be inaccurate
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False positives
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Black box algorithms (ITS BACK!!!!!!!)
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Liability issues
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Digital divide
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US is one of the few countries untilizing AI to increase efficiency in medical diagnosis
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Unfair for other countries with less resources
Future recommendations
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Extensive AI training to refine and advance its capabilities to enhance the diagnosis. Also important to utilize an extended database
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Takes time and money to build though
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Review and verify the results produced by the AI with human intervention (aka second opinion)
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Simplify the process to reduce the steps required the AI
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Simplify the Ai and turn it into a clear box algorithm
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Completely remove the AI steps?
Medical monitoring, recording, and tracking
Cyberchondriacs
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A term that has been created to describe Web-savvy individuals who go online to learn about the symptoms they are experience
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They end up feeling even more anxious about the state of their health
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You cough, search it up online, find out you have corona 582 when in reality you have a cold.
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Example of a site: https://www.webmd.com/
Example:
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One day you wake up, you found yourself feeling fatigued and your body is aching all over. You are feeling fever, chills, sore throat, swollen lymph node, headache
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You googled all these keywords and you found the following three situations that describe exactly your symptoms
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Covid-19
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Flu
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Cold
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AIDS
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Cancer
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You panic: WHICH ONE IS IT
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Digital Devices deprive the brain of much needed downtime
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Key article findings:
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“periods of rest are crucial for processing experiences, solidifying them, and converting them into long-term memories. Frank posits that constant stimulation can inhibit this critical learning process, implying that taking breaks is essential for effective learning and memory formation.”
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“A study conducted at the University of Michigan discovered that individuals showed improved learning after walking in a natural setting compared to walking in a busy urban area. This suggests that being overwhelmed with information can lead to fatigue, implying the restorative effects of nature on cognitive functions.”
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“emphasizes the necessity of incorporating exercise into our sedentary lifestyles for health benefits. He advocates for physical activity as a crucial element of well-being. Ratey particularly recommends exercising away from electronic devices, suggesting that outdoor workouts offer greater advantages for mood enhancement and working memory improvement, thereby maximizing the benefits of physical activity.”
VR therapy
Pros:
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Helps those who suffer from social anxiety in various situations where you are exposed to human expressions/need to interact with other humans
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You can access this resource from any location (at home, at the library, at they gym, etc)
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Can help simulate various scenarios without actual exposure (ex. Simuilating a rubber room filled with rats)
Cons:
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Often times not realistic enough to induce a sense of immersion in the users (you can literally count the pixels while wearing a Quest 3)
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Often too expensive, not worth given current technology (low resolution, depth perception on 360 cameras not realistically rendered, etc)
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AR in most scenarios is better at simulating scenarios, as it uses your surroundings to simulate scenarios
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This can be more expensive however (cough cough apple vision pro)
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VR technology is still very limited, not only in resolution, but in other senses as well
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Ex. trying to get over fear of height, VR can only simulate the visual aspect of falling, but you wont feel gravity accelerate you, the wind against your skin, etc.
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Moving in VR can be very disorienting because from your visual perspective you are moving but in reality you are standing still
Patient simulators
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Computerised system that would mimic the functions of the human body
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Customizable: age, gender, scenearios, injuries, etc
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Barriers:
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There is a limitred amount of situations that they could replicate (not all injuries are predictable)
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They are expensive, and not all places can afford them (digital divide)
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They are too “perfect”
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The human body isnt perfect, there are small defects here and there, each body is unique. Your skills gained from practicing on a simulator might be unusable on a actual person
Surgical Robots (Robot assisted surgery)
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Ability to perform many types of complex procedures with more precision, flexibility, and control than human hands
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Lack of shaking hands, easier to make microadjustments, etc.
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These robots often include several mechanical arms that each contain a different surgical tool, along with a camera arm for visual information
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These are often employed for minimally-invasive surgeries
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Ex. Surgeon uses robotic arm to fold paper crane during laparoscopic surgery practice 🫣
Pros of robots in health industry
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high precision, easy to replicate the same movements
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health care professionals are able to get more practice with less repercussions
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If you mess up the consequences are more minor considering how the surgerys are less intrusive
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Reduce muscle fatigue on the surgeons
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Easier to record data
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The AI within the machines cna record it rather than have a person manually record everything
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Possibility of remote access surgery
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Use of VR technology?
Cons of robots in the health industry
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Expensive
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Intimidating
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Most humans would rather have a physical surgeon operate on them rather than have the surgeon operate on them via a machine
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Trust issues, most people think the robots are not reliable enough, or that they are subject to mechanical failures/errors
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Constant and pricy maintenance
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The amount of HR required/spent for these machines
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Again, reliability issues
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Inequality of access (oh hey its digital divide again)
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Questions of responsibility
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If the patient dies, who is responsible?
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The doctor operating the robot?
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The person who built the robot?
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The person who programmed the robot?
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The inventor of the robot?