Artificial Intelligence and Doctors

A single 10 minute consultation with your local GP costs the NHS £39.  If you visit the nurse it will cost them £13.  A five minute consultation with the Babylon app will cost virtually nothing.

The Babylon … collects billions of data points from the thousands of test consultations it has done every day since its launch in April.  With an average GP doing about 7,000 consultations a year Babylon’s founder Ali Parsa says “I think that it is going to be 10 times more precise than a doctor.  No human brain is ever going to be capable of doing anything of the sort.”

The NHS is testing the Babylon artificial intelligence app on about one million North Londoners who can assess how urgent their medical problems are.  They type in their symptoms into the app, the app will “judge the urgency” of the would be patient and advise them what to do next.

Physicians are using smartphones to conduct traditional examination of organs, perform ultrasound scans, measure heart rhythm, blood pressure, glucose levels, do lab tests such as liver and kidney function, infection diagnosis and DNA sequencing. Keith McNeil, NHS chief clinical information officer says “in five years time, smartphones will take the burden away from the limited number of human specialists we have.” Here we describe some of the latest portable technologies out there which can help physicians with diagnosis:

Philips have developed a mobile ultrasound scanner Lumify that can image your whole body with, at a fraction of the cost of an ultrasound machine in a hospital.

Biomeme have developed a piece of hardware that attaches to your iPhone turning it into a miniature laboratory.  It will detect the genetic material of interest by DNA amplification of a drop of body fluid such as blood, urine or saliva.  The results are displayed in an app in about one hour.  Results are equal in accuracy to conventional methods but much easier to use.  It works well when a single microorganism is being tested for and allows anyone to have simple access to complex lab testing.  However, it will not work out complex infections such as sepsis that can be caused by a variety of pathogens.

MinION is a hand-held DNA analyser, which runs off a laptop USB port, introduced by Oxford Nanopore Technologies in 2014.  It is a good way of analyzing bacteria and viruses but in 2016 the first human genomes were sequenced.  SmidgION is even smaller, easier and quicker to use and is designed to work with smartphones but has not yet been released.

AliveCor/Kardia Mobile is a phone case embedded with sensors that detect the heart rate via the fingertips, providing an instant ECG which is as accurate as the Holter monitor, the current first-line diagnostic tool used.  At £99 it is both cheaper and less bulky.

The NHS is planning to test CliniCloud a microphone that slots into a phone to record sounds of the heart and lungs  and turns it into a digital stethoscope.

Cupris Health has made a clinical-grade otoscope that clips onto a phone and takes high-resolution images of inside of the ear.  These images can be accessed remotely by a doctor who can diagnose an infection.

With the NHS facing a funding gap of up to £30 billion by 2020 and demand on services increasing as people live longer the patient is moving towards being the record keeper of their own health through their smartphone.  As data is retained, machine-learning algorithms will be able to pick up if the patient’s body is behaving atypically and may refer the patient to a human GP or specialist.  This data will also enable trends to be monitored at the population level and even to predict and prevent diseases before they occur.

It is important however that each new digital tool and app is thoroughly validated and reviewed to avoid fraud or misdiagnosis as has been the case with the blood test kit invented by Theranos.

As sensitive healthcare information is stored through your phone, cyber security is important. But maybe it is safer decentralised from large health databases where the patient has full control over their data.

As diagnostic apps become more accurate, cheaper and quicker the role of doctors will evolve and become less diagnostic but allow more time for the human side.

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