Artificial Intelligence In Medicine – Helping us to stay healthy?

Google’s DeepMind artificial intelligence has started working with the doctors and computers at London’s Royal Free Hospital Trust and many of the first questions being asked concentrate on data security and patient confidentiality.  About 1.6m patients a month are seen by the three hospitals that the Trust covers and, according to an agreement seen by the New Scientist magazine, the data includes patient information from the past five years.

That data can’t be used by Google in any other part of its business, it is stored by a third party and will have to be destroyed/given back when the agreement ends, according to the New Scientist.

Google wants to apply machine learning to mine the data and help doctors by predicting care needs - both at the level of the individual patient and the wider community. If the pilot works then implications are huge: clever new algorithms will help make healthcare better and be more efficient at treatment. Artificial Intelligence (A.I.) could predict the outbreak of infectious diseases from scattered hospital admissions data before a human expert has noticed. It could also nudge a GP when he or she is seeing a particular patient, making diagnostic suggestions, but not decisions.

As well as worries about data confidentiality, some are already concerned that Google will establish the sort of market dominance in health that it has established elsewhere. And there remain those issues I raised in my last blog about the as-yet-unknowable effects on the ‘social contract’ of knowing a great deal more about our own genes (and conditions they bring) than we do now.

But it is also worth questioning something else: conceiving of our ‘health’ merely in terms of, in the UK, the National Health Service.

Of course, as any global observer will know, using the word ‘merely’ about the UK’s NHS risks raising a lot of hackles. This Great British Institution occupies a special place in our society and national psyche.

Yet the improvements that DeepMind (and others) can bring to our health will be limited unless the data on which the A.I. operates is extended to cover the whole realm of well-being, and not just the parts that are touched by the NHS.

Health cannot just be about the times we visit the doctor or the hospital and any data-mining that seeks to improve the nation’s health must sooner or later break down the false barriers between lifestyle and treatment.

Take obesity, according to McKinsey it costs the UK about £47 billion a year – or 3% of GDP - and is the second biggest drag on the economy behind smoking.  Enormous improvements in the quality of life of many millions of people could be achieved if UK obesity levels could be cut back from the current prevalence of 25%.

But to do this, DeepMind-type data-mining will need to show us more about what we eat, what we drink, what exercise we take, etc., as well as when and why we visit the doctor.

Then, instead of knowing how to fix a problem (in hospital, with a gastric band) we’ll all know how and where to intervene to stop the health problem occurring in the first place. Such insights might tell us, for example, that investing in sports and exercise for school children, or changing the way tax is levied on certain kinds of food, or using technology to provide people with more relevant information on what they are eating are better ways to keep people healthy, as a population, than building more hospitals.

At the moment we don’t know. But projects like DeepMind’s surely need expanding to include this sort of knowledge. We could start by inviting all patients who have a gym card, a personal health device, or even a supermarket loyalty card to offer that information for use by the study, suitably anonymised at first.

I can see why it makes commercial sense for DeepMind to concentrate on developing insights into datasets that are collected inside a healthcare system, in whichever country., But it would be a mistake to draw the circle too narrowly when so much of our health relates to lifestyle.

The very best treatment is one that is not needed and the best patient is one that is not sick – so any reforms of ‘healthcare’ need to include that as the No1 objective.

This article was originally published as a blog post on the SK Consulting & Investment web site: www.skcinv.com.