Deep empathy: How AI can strengthen doctor-patient connections
Some experts may worry that AI will depersonalize health care, but others see its potential to deepen relationships.
- Today's rate of innovation and change has made it difficult for patients and physicians to effectively integrate technology into medical best practices.
- Experts agree that physicians need more time in their day to build bonds with patients.
- Dr. Eric Topol believes that artificial intelligence may help restore that time, creating what he calls "deep medicine."
Today's rate of technological change is as unprecedented as it is unpredictable. This speed of innovation has created medical marvels that improve and save lives. Other technologies, however, have proven more difficult for physicians and patients alike to integrate successfully into health care practices.
"Exhibit A is the electronic health record (EHR), which has made the blood of countless physicians boil with frustration," writes Michael Dowling, president and CEO of Northwell Health, in his book Health Care Reboot. Created to store, track and share patient records, "[t]he EHR can be a cruel taskmaster, demanding a doctor's attention during a patient visit and requiring numerous clicks to enter even basic data."
Physicians spend an average of six hours per workday logging clinical data into the EHR—and face-time with patients suffers. The average doctor-patient consultation clocks in at 18 minutes, and a fair amount of that time goes to logging information.
Like it or not, technology is part of the patient experience. One study found that barriers to widespread adoption of electronic personal health records will likely include computer anxiety and concerns for security and privacy.
For better or worse, technology is affecting the doctor-patient relationship. According to Eric Topol, executive vice president of Scripps Research, the most beneficial change can come if we properly navigate artificial intelligence.
Will AI replace doctors?
Photo: Tom Werner/Getty Images
With AI taking on the routine work, doctors will have more time to be actively involved with patients and referring physicians.
That may sound counterintuitive. Technology like EHRs have affected doctor-patient interactions, and when we speak of AI entering a job market, it's with premonitions of the robopocalypse. Consider America's roughly 2 million truckers, who may lose their jobs to self-driving vehicles.
Yet blue-collar jobs are not the only ones subject to AI takeover. Some jobs that require the most advanced education are more likely to become obsolete, according to entrepreneur Andrew Yang. "Doctors, lawyers, accountants, wealth advisers, traders, journalists, and even artists and psychologists who perform routine activities will be threatened by automation technologies," he writes in The War on Normal People.
Day-to-day workplace routines will determine whether AI can perform a job, because the technology can perform routine tasks faster and more accurately than people, without needing a break.
To pick one example from medical practice, radiologists spend much of their time analyzing patient films. It takes years of education to develop that skill. Even then, certain diagnoses can be tricky and human deficiencies, such as confirmation bias and inattentional blindness, can lead to mistakes.
Deep learning could streamline the process of analyzing medical images. One day, AI may be able to read more medical images more quickly and compare them to a catalog exponentially larger than anyone could memorize. It may also detect anomalies too fine for detection by the human eye. And you only have to develop an AI once, as opposed to the extensive costs of training and maintaining human radiologists.
AI is unlikely to eliminate the need for radiologists, but rather it may enable radiologists to be more actively involved with patients and referring physicians as part of the care team. We're years away from AI becoming commonplace in radiology departments. However, the principles are sound and the technology is already under development. Some day, when AI can manage standalone diagnosis for routine cases, radiologists will be free to focus on the most challenging cases.
Photo GERARD JULIEN/AFP/Getty Images
AI will free up radiologists' time to work on the most challenging cases. Here, neuroradiologists in Paris operate on a patient affected with an arteriovenous deformation.
Deep learning, deeper empathy
In Deep Medicine, Topol suggests that well-implemented AI can free physicians from repetitive tasks, providing more face time to meet, inform, reassure and follow up with patients. It can also minimize burnout and improve health care quality. Topol cites one study from the National Bureau of Economic Research that found for every extra minute a home visit lasts, risk of readmission was reduced by 8 percent.
The same gains may be possible with EHRs. Integrated AI can make it easier to log entries, consolidate records, and draw data from external sources such as a patient's smartwatch or mobile device.
"Human performance is unlikely to change materially over time. But machines will progressively outperform humans for various narrow tasks," Topol writes. "To take humans to the next level, we need to up our humanist qualities, that which will always differentiate us from machines." He calls deep learning's potential to support medical empathy and outcomes "deep empathy."
A humane pairing
Busywork and routine labor so severely cut into physician schedules that Danielle Ofri, an associate professor of medicine at New York University School of Medicine, has suggested imposing fines on hospitals that detract too much from patient face-time.
As the National Bureau of Economic Research survey suggests, health care is a field where literally every minute counts.
"Most importantly ... when people are sick, they need empathy," Topol told Big Think in an interview. "They need the person who is their doctor to be with them, to understand what they're going through, because being in pain and being sick is the loneliest thing in the world. And if you don't have a doctor that is empathic, that is the worst-case scenario. We've got to get that back."
But Topol indicates a caveat: Implementing AI in health care just as an efficiency tool would counteract potential gains in doctor-patient relationships.
Michael Dowling agrees. As he told Big Think in an interview: "A lot of publicity has been given to a lot of these [big tech] players. But the core of the care being delivered to people who are very sick is still being done at hospitals and doctors' and ambulatory sites."
And that core must be building a humane — and, indeed, human — doctor-patient relationship.
Technology may soon grant us immortality, in a sense. Here's how.
- Through the Connectome Project we may soon be able to map the pathways of the entire human brain, including memories, and create computer programs that evoke the person the digitization is stemmed from.
- We age because errors build up in our cells — mitochondria to be exact.
- With CRISPR technology we may soon be able to edit out errors that build up as we age, and extend the human lifespan.
The pizza giant Domino's partners with a Silicon Valley startup to start delivering pizza by robots.
- Domino's partnered with the Silicon Valley startup Nuro to have robot cars deliver pizza.
- The trial run will begin in Houston later this year.
- The robots will be half a regular car and will need to be unlocked by a PIN code.
Would you have to tip robots? You might be answering that question sooner than you think as Domino's is about to start using robots for delivering pizza. Later this year a fleet of self-driving robotic vehicles will be spreading the joy of pizza throughout the Houston area for the famous pizza manufacturer, using delivery cars made by the Silicon Valley startup Nuro.
The startup, founded by Google veterans, raised $940 million in February and has already been delivering groceries for Kroger around Houston. Partnering with the pizza juggernaut Domino's, which delivers close to 3 million pizzas a day, is another logical step for the expanding drone car business.
Kevin Vasconi of Domino's explained in a press release that they see these specially-designed robots as "a valuable partner in our autonomous vehicle journey," adding "The opportunity to bring our customers the choice of an unmanned delivery experience, and our operators an additional delivery solution during a busy store rush, is an important part of our autonomous vehicle testing."
How will they work exactly? Nuro explained in its own press release that this "opportunity to use Nuro's autonomous delivery" will be available for some of the customers who order online. Once they opt in, they'll be able to track the car via an app. When the vehicle gets to them, the customers will use a special PIN code to unlock the pizza compartment.
Nuro and its competitors Udelv and Robomart have been focusing specifically on developing such "last-mile product delivery" machines, reports Arstechnica. Their specially-made R1 vehicle is about half the size of a regular passenger car and doesn't offer any room for a driver. This makes it safer and lighter too, with less potential to cause harm in case of an accident. It also sticks to a fairly low speed of under 25 miles an hour and slams on the breaks at the first sign of trouble.
What also helps such robot cars is "geofencing" technology which confines them to a limited area surrounding the store.
For now, the cars are still tracked around the neighborhoods by human-driven vehicles, with monitors to make sure nothing goes haywire. But these "chase cars" should be phased out eventually, an important milestone in the evolution of your robot pizza drivers.
Check out how Nuro's vehicles work:
Here's why generalists triumph over specialists in the new era of innovation.
- Since the explosion of the knowledge economy in the 1990s, generalist inventors have been making larger and more important contributions than specialists.
- One theory is that the rise of rapid communication technologies allowed the information created by specialists to be rapidly disseminated, meaning generalists can combine information across disciplines to invent something new.
- Here, David Epstein explains how Nintendo's Game Boy was a case of "lateral thinking with withered technology." He also relays the findings of a fascinating study that found the common factor of success among comic book authors.
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