Artificial Intelligence in healthcare: Human evolution or regression?

While travelling in the Delhi metro recently, I was as usual excitedly observing the happenings around me. It’s a great way to get from point A to point B and is quite amazing the way the train literally zips past and takes you to your destination on time. We were a small group of three friends excitedly chatting amongst us when I suddenly noticed that we were the only ones doing that! The train had plenty of people some known to the other and the others sitting with complete strangers but all were engaged in one common activity. Can you guess what it was? You guessed it right! All were glued to their phone screens. Most had ear phones on and no one had any sort of interaction with the other. Strange, I thought as I have not really observed this phenomenon otherwise. There was one couple however who were watching something together sans ear phones blasting some popular bhojpuri reels to all who cared to listen but that again was interaction over the phone. The journey lasted some 30 minutes and when I alighted I felt strange as though to have arrived at a different time zone or an era. An era I’m personally not very comfortable but yet forced to accept and imbibe. An era of no human interaction!! In this blog I will discuss about artificial intelligence in healthcare focusing on its various pros and cons to help you make an informed decision about it.

I was in Delhi for a conference and its theme was focused upon wellbeing, wellness and making organisations future ready. At the venue there were several stalls put up advertising their products and I again noticed a change in what they were selling/ advertising this time around. Gone were the days when stalls sold stethoscopes, digital thermometers and blood tests or advertised their hospital facilities. I noticed that now most stalls had products that utilised artificial intelligence (AI) and technology that can be beneficial in medicine. There were hand held ECG machines which delivered instant results which could be personally mailed to you within a span of one minute, a device to measure our blood haemoglobin levels without the hassle of pricking for blood and most interestingly there was an AI enabled interactive goggles which spoke to me about my hearts’ Health score!! I felt like being in the meta verse and transported to some futuristic universe where everyone had their own virtual ‘avatars’ and what we performed there had a bearing on our actual health and life! Kind of like the movie ‘avatar’ where you have a parallel self living a whole life in pandora. While I am sceptical about the said reach of artificial intelligence in healthcare, I do wonder if slowly but surely my job as a doctor would be replaced by some AI bot in the future!

Look around you artificial intelligence is everywhere! When I google for a property that interests me on the papers, I get called by the property dealers enquiring my availability for site visits. When I watch a particular YouTube channel on healthy living, the next few days I would be shown more and more such videos harping on holistic wellbeing and healthy living!! Once I was called by a loan agency enquiring if I need loans anticipating my future purchase of property! Sometimes it’s very comical but most times quite annoying. Do I have any control over my thoughts and actions any more that are my own? Not influenced by AI or technology? I’m sure the advertisements you will get to see on this post will be something concerning AI and there is nothing to be done about it. In this environment what’s the best we can do is to embrace technology and AI in healthcare and utilise it best for our future health needs. In this light it would be great to revisit one of my earlier blog posts on :How medicine has changed in the modern world during the last century and see how far we have come. If what has been achieved seems phenomenal what is yet to come will be even more incredible and artificial intelligence or AI will have a huge impact in healthcare.

12 future areas where artificial intelligence in healthcare might play an enormous role.

1. AI in radiology– one of the biggest areas where AI is showing promise in healthcare is in the field of radiology. The aim is to reduce human errors and identify hidden lesions on scans and X-rays which might have otherwise been missed by a radiologist. I see a particularly potential role of AI for cancer diagnosis. Imagine if cancers are caught earlier than usual, it would make a world of difference for our patients. But on the flip side the radiologist often correlates the findings with clinical history and then takes an informed decision and diagnosis which would be difficult to expect from a machine.

2. AI to automate workflows– this is another promising field in health care where AI and machine learning can develop intelligent workflows and processes which will help remove several bottlenecks usually expected while visiting the hospitals. Long queues at the counters can become a thing of the past as physicians, pharmacists and other staff work more efficient to deliver quality healthcare faster to you.

3. Healthcare at your fingertips– the millennials and the Genz’s are used to getting everything at their doorsteps with just a click of their phones so why not healthcare too! Now AI can help a person to identify his main symptoms and give him a probable diagnosis as well as redirect him to the nearest doctor in his locality. All this without the effort of actually even getting up from the couch! Isn’t this amazing?

4. AI at the physicians aid– a physician working in a remote corner of the world might not have the time and access to high quality recent and relevant medical information. With the use of AI and natural language processing feature the physician can simply ask his questions and he will be provided with a wealth of information wherever he is. It’s just like consulting your colleagues for a complicated case. This can help him make up to date and informed choices in patient care.

5. Data management– with AI the seemingly mundane jobs like writing discharge summaries, collecting reports and documenting medical history can become faster and more efficient. Data management and data mining to get meaningful interpretations from the available wealth of data can become the next best use of AI in health care. A lot of precious time of our interns, junior doctors and nursing staff will be saved for actual patient care if this becomes a reality.

6. Medication adherence– non- adherence to medications by the patients once discharged to their homes are the single most common reason for flare ups and re-admissions to hospitals. Now imagine if an AI assisted app equipped with webcam tracks your medication adherence and prompts you to take your medications on time quite like a nagging family member. This could prove very useful especially for those who are living alone and the elderly!

7. Triaging and primary care– in a country like ours where the government hospitals are filled to the brim and the health system is overwhelmed, an AI assisted health care system will come in handy. All patients can be initially screened for their symptoms using an interactive device which recognises voice and then triaged according to their severity. Prioritise those who really need admissions while sending back the others with minor symptoms to be managed at home. We especially saw this at a few places during the COVID pandemic where the interactive screens decided if the patient required to be tested for COVID or not.

8. Health monitoring– most of us wear smart watches and have our smart phone which tracks our step count and activity levels. AI can help keep a track of this data and provide the user meaningful instructions for health monitoring. Walk more, stand up, drink water, eat less- painful but yes, these are some of the daily instructions that I get from my smart watch. Your heart rate and SpO2 levels (blood oxygen levels) and ECG can be obtained in seconds. Apart from easy accessibility, this also plays a major role to make us more health conscious and concerned. Many track their calories and step count quite religiously and push themselves to complete the health targets set by them. Some go above and beyond to detect falls and quickly intimate an ambulance for speedy hospitalisation. So the utility of artificial intelligence in healthcare to the common man is immense.

9. Drug discovery and development– a drug usually takes several years and sometimes decades to be developed against a specific disease. With AI we can quickly identify which drugs will work for which disease process. Saves both time and money for the pharma industry in the long run! Most importantly the suffering patients need not wait several years for new drug development thus ultimately saving lives!

10. Precision public health– large data can be analysed from multiple sources to obtain better information about the personal and population based risk of people. This information can then help policy makers to decide where to allocate our limited health funds and what category of people to be targeted. With the recent COVID pandemic we had used AI for allocating beds across several hospitals in Bangalore, India. This greatly streamlined the process and created fewer errors and reduced waiting times for the patients.

11. AI in rehabilitation– I recently came across an article which talks about AI powered glasses which could transcribe spoken words into texts which can be read by people of the deaf community. This could make communication with them easier and had the capability to transcribe spoken words into 9 different languages too. This could make a world of difference for people who are differently abled to integrate with mainstream society.

12. AI in anatomy and surgery– manual dissections with actual cadavers might become a thing of the past if AI gets integrated into the education curriculum. Simulated teaching with surgeons practicing complicated surgeries first using AI and then real time can greatly reduce risk of complications and failures. A few medical colleges did try virtual dissections when the pandemic was at its speak and students were home but the vast opportunities it holds is yet to be fully explored. Usually dissection is performed only by a few ‘chosen’ students while the others watch over the table. With AI, every student can get a chance to perform virtual dissection and learn from their mistakes and re-do their procedure if it was wrong the first time. Cadaveric dissections do not allow these benefits to the students. 

Cons of artificial intelligence in healthcare:

Well now that we know what AI in healthcare can offer for us, what about the downfalls of this technology? While we can most certainly predict that AI in healthcare is here to stay. However, nothing is perfect, so let’s look at the cons of AI in healthcare:

1. Data privacy issues– this is a real threat for users as individual data can get leaked and misused by unscrupulous agencies. Security concerns regarding sharing sensitive information with computers have always been present but now with artificial intelligence in healthcare will the machines follow the ‘Hippocratic oath’ of confidentiality that all doctors are bound to do? I don’t think so!

2. Creating unemployment– while everything does get faster and efficient with AI the flip side to this automation would be the large levels of unemployment which we will be creating. There would not be any need of clerks, data entry operators and secretaries in the future. More unemployed people create a greater resentful community. While AI will create a shift in demand to certain new skills and will create new jobs it is expected that the traditional job market would be greatly disrupted.

3. No human touch– most of our patients who come to us do so because they just want to talk about their problems and seek someone who listens. Many of them like to be examined and told by a doctor that they are okay and will be fine. Recoveries are proven to be faster when the nursing staff are more empathetic and caring. So with artificial intelligence in healthcare what our patients might miss out the most is that “human touch” and empathy which cannot be taught to a machine!

4. Expensive affair– the cost of healthcare itself is extremely high and out of reach for most people. To create automation and develop AI algorithms will catapult the cost further. Maintenance of machines and computers involves enormous costs which ultimately gets transferred onto the paying patients. Are we willing to pay this much from our pocket for efficiency and speed? Only time can tell!

5. Lazy humans– since AI applications help automate most tasks we are likely to encounter a lazier batch of humans who are ill-equipped to manage common tasks in their daily lives. Writing daily notes, reading and interpreting reports and documenting findings may become a thing of the past for most doctors and nurses. From the patient’s point of view many seemingly simple symptoms might have a sinister cause and unless they are examined at the right time by the physician it could take a catastrophic turn. If all needs of the patients are met at the comforts of their homes then health seeking behaviour will be affected in the future.

6. Creativity crisis– most discoveries in medicine and science for that matter have materialised because someone ‘thought outside the box’. Right from penicillin discovery to the discovery of vaccines and the identification of viruses, they came about because of the human ability to be creative and think beyond what is already known. There is no match for human intelligence and the machines cannot think and do outside what it is asked to do.

There are several other cons to artificial intelligence in healthcare like the introduction of biases and domination of large tech companies creating a monopoly in the industry. There is a risk of AI terrorism with introduction of deadly disease carrying nanobots and the huge environmental impact and carbon emissions that a single AI model can generate. So overall a cautious approach is required when embracing AI in healthcare. But the ultimate question on everyone’s mind is “Will the machines ever overtake us humans?” We have seen it happen too often in the movies but could it become a reality in our lives that we fear the machines for our lives?

Just after my visit to Delhi I had the opportunity to visit and work amongst the forest rangers in Kollegal, a quaint Taluk in Karnataka. The environment could not be more different. The noise and pollution of the metropolitan city was replaced by the chirping sounds of nature and clean air. While on a jeep Safari in the deep forests of the BR Hills, I could not but shake this question from my mind. What made us evolve so fast while the rest of the animal kingdom rests and lives peacefully in the forests? Was it all worth it in the end? Are we going in the right direction? Can all this automation and AI provide us with the same peaceful existence that the animals seem to enjoy? Some food for thought!