Tuesday, April 24, 2018

The role of technology in health: the Artificial Intelligence conundrum


Abstract
                                                                             
Technology in Healthcare is the use of systematic information for functional purposes in healthcare. Technology for all intent and purpose has been a part of various industries and our daily lives for decades and with its ever-advancing capabilities, a constantly increasing presence should be expected and the paper’s focus being its use in health and welfare of individuals. From activities as relatively  menial as taking body temperature to full-on surgeries on human beings; the said advancements in healthcare technology has led to inventions of not only human-operated devices but to systems that do not require humans to operate.  For example, in the past, one would need to go to the hospital to have one’s blood sugar level and heart rate checked, but now there are devices like the Omnipod and FitBit capable of all that and much more without human operation. As humans are innately habitual beings, the changes being brought to healthcare through the use of Artificial Intelligence are sometimes resisted. Reasons range from “Ethics” to “Increase in Unemployment rate due to AI replacing Humans” to “Algorithms can not mimic consciousness” to “Widening the economic gap between Business Owners and Workers” and so on. Though there are also those vehemently in support of increased use of Artificial Intelligence in healthcare. Despite the divided reactions, Artificial Intelligence is here to stay.
                                                              





Outline

Abstract                                                                                                     2

Introduction                                                                                               4

Artificial Intelligence                                                                                6

State of Healthcare Today                                                                         8

Artificial Intelligence in Healthcare: Pros and Cons                                10

Managing Expectations Within and Without Healthcare System            12

Bottom-line Drivers                                                                                  15

Future of Artificial Intelligence in Healthcare                                         15

Conclusion                                                                                               17

References                                                                                                20

Bibliography                                                                                             21
Introduction       

Health is the condition of one’s physical and mental state. Monitoring one’s health is a lifelong commitment to ensure avoidance of malady, but in an eventuality seek treatment and cure for the disease(s).
Technology is the application of scientific knowledge, a branch of engineering and applied sciences for practical purposes, for the development of machinery and equipment. Going by Arthur “Technology is a means to fulfill a human purpose” (2009).
Technology and Health intersection started centuries ago, the point where technology was used in improving or maintaining the health of people; some notable points from recent centuries includes but are not limited to: “the advent of glasses in Italy (1752), invention of stethoscope by a healthcare professional (1815), Wilhelm C Röntgen, a physicist from Germany, came up with the X-ray (1895), W. Einthoven, a doctor from Netherlands devised the initial working electrocardiogram (1903), Willem J. Kolff, a Dutch physician, built the first dialysis machine (1943), Ultrasound- Doppler monitor used on a woman's abdomen to detect fetal heartbeat (1958), M.R.I, (1978)” (Bakalar et al, 2012).
How, what, and when data is collected is pivotal to the extent of functionality of technology in healthcare, The Electronic Medical Records has been central to this development.
Data collection has exponentially aided health through technology, by ensuring the compiling of loads and loads of data, which is then used for the improvement of patient’s health in various ways and the increased patient involvement in their own care. For example, Technology has gotten healthcare providers access to real-time patients’ information to help in making the right decision at the right time, which is ultimately time saving and an improvement in health for the patient.
In addition, Technology enabled Data collection has allowed healthcare professionals the ability to accumulate results plus records from laboratory tests and vital signs with other important client data into a main area/system, this in itself has transformed the care to be expected by clients and the actual care they get when they go to a hospital, pharmacy, urgent care, ambulatory services and other forms of service.
An eventuality of data collection software upgrade and advancements is higher efficiency in the collection and storage of data which means that vast online resources of medical historical data are available to those in healthcare research and development, who are looking into new methods of studying trends and this increases the rate plus frequency of breakthroughs in the industry.
Technology in health has gone from being only “man operated machinery and equipment” that assist procedures to full fledge “self-operating” or automation work, these are called Artificial Intelligence because they mimic life form, that is, man.









Artificial Intelligence

Artificial Intelligence started small, as a way to solve simple mathematics and logic problems, evolved into “knowledge representation” and now its current state of “expert systems” it has spread into many industries including health and now in various aspects of health pertaining directly to patients and patient care
Examples are Robot for Interactive Body Assistance RIBA for helping patients move around (not wheel chair).
When a patient sees below 20 degrees outside of central vision due to loss of peripheral vision they are considered legally blind, there is new technology called artificial retinas (chip implant and glasses) that can adjust and replace functionality to full vision.
Patients without a pacemaker will not live full lives and are restricted in their actions, due to a risk of their heart beat and rhythm loosing sync” (Reed, 2017).
Patients without arms and/or legs, with the aid of technology can now neurally control state-of-the-art prosthetic limbs
For the detection of sleep apnea, Motio HW is a personalized A.I. which studies the wearer and improves sleeping quality (“The 10 Best Health”, n.d.)
Medical devices and wearable are now available for patients’ use to monitor and record basic bodily function and movement. The smart phone provides a platform for thousands of software applications with healthcare functions, there is an application for monitoring menstrual cycle for women, complete with alert and dietary advice, there is another for tracking personal hydration level, even some for mental health like “Headspace” for motivation, relaxation and focus etcetera. Over time they are increasing in their complexity and functions for example fitbit, Samsung gear, Motiv ring, Apple nike sensor, Smart Nicotine Patch and others.
 Medical devices through their trackers and the Internet of things allows physicians and clinicians tracks patient’s welfare even location, this ensures prevention and monitoring
 Pharmacogenomics can help patients avoid drastic mistakes like misdiagnosis, adverse reaction to wrong medication, through use of artificial intelligence in genome sequencing; this could further tailor medication and diagnoses to meet individual needs.
 















State Of Healthcare Today

The healthcare industry despite being a highly regulated industry, does not suffer restriction in its access to technology and breakthroughs within the sphere. Technology has become part and parcel of every facet of the industry from diagnosis to provision of healthcare, to the billing of patients, to records, to supplier relationships, to third party; it is an intertwined relationship. Though worthy to note that, these breakthroughs are subject to F.D.A. approval before use by patients.
Even with the continuous shift of power among the players: from patient and provider to payor (insurance companies, government, employers, H.M.O. etcetera), the relevance, continued use and reliance on technology has not waned in the past decades.
Infact the paradigm shifting changes come hand in hand with technology advancements, be it in response to the technology advancement or technology advancements instigates the change. For example, moving out of fee-for-service based reimbursement to value-based reimbursement requires analytics and tools to aid performance measurement, monitoring, even improvement on the side of the provider.
Communication in today’s healthcare industry has become quite improved for all parties involved, the doctors, nurses, pharmacists and clinicians go through their day/work with handheld computers to communicate on patient’s condition, the suppliers use electronic messaging, phone calls, tracking tools and others to arrange supplies and shipments, patients can call for ambulance services on their mobile phone from various locations with any health issues, even for those patients healthcare professionals can not access technology has ensured  they have access- telehealth/telemedicine allows for face-to-face clinical services to be brought to them through teleconsulting. Patients also use apps to rate services which is the basis for certain hospital rating systems. There are even self-functioning devices that communicate with the physician on behalf of the patient for example the pace maker.
There are many more advances in healthcare due to technology that have contributed in the work towards better patient health. Such as, “Food and Drug Administration approved first digital pill in the U.S.. In China, some researchers made gene-edited embryos (first of a kind). Amazon has joined the healthcare industry with a bang, Bill Gate’s company has opened a healthcare division. (“What To Expect”, 2018)
Proactivity for health improvement has increasingly started to incorporate artificial intelligence, companies are adding technology to their employee work-life balance goals through wearable technology. Studies have shown healthy staff produce optimal output, have less absent days from work due to illness and have higher job satisfaction rates than unhealthy employee. Also companies spend less on staff health.
Companies like Google, John & Johnson lead the charge; Last year, UnitedHealth in collaboration with Qualcomm, Samsung and Quarim started a national wellness program using wearable health technology on people with certain insurance plan to achieve some health targets, with the possibility of winning 1,000$ each at the end of program.






Artificial Intelligence In Health: Pros And Cons

Augmented/Virtual/Mixed Reality provides learning opportunities with minimal amount of physical invasion eg it provides 3D human anatomy for test runs instead of cadavers hence more and more medical schools continue to incorporate A.R., M.R. and V.R. in classrooms as the learning with these media is more hands-on and immersive for the students.
Artificial Intelligence affords the patient cheaper alternative to certain care for example blood pressure using blood pressure cuff which can be done at home instead of going to your primary physician or urgent care, also patches for taking of temperature anywhere anytime0 etcetera.
Artificial Intelligence adds billions of dollars to the U.S. economy, due to tech innovations and upgrades flowing into the market daily either as hardware or software. This is done especially through the growth in G.D.P. of the health sector.
Artificial Intelligence, even technology in general (with human-machine interface) is still far from reaching equitable distribution among patients. The flip-side being just because a device is highly accessible should not translate to excessive use. For example, using technology by caregiving professionals on clients in heroic measures when it would be kinder not to do so (Funk, 2011).
Technology gives patients the ability to research their health and symptoms which may be useful in determining whether to go see a doctor or not. Also, this has been abused as patients tend to use unscholarly write-ups, misdiagnose themselves and still not see a physician; even when required and because anyone can write on the Internet (due to lack of regulation), the chances are high that some are not even in the healthcare profession.
Artificial Intelligence can be a preventive tool against illness and diseases, we now have devices that can calculate how many steps a person needs to walk to stay healthy, sensors with phones that functions as a heart rate monitor, machines for testing for cancerous growth and/or its likelihood in a person.
Artificial Intelligence aids in mental health welfare of patients but the obsession with digital media can diminish social skills like understanding people’s feelings through face-to-face interactions, even cause loneliness.
Technology saves time with health procedures. Artificial Intelligence saves even more time for example; the use of TREWS AI in hospitals has shown/proven that the use of AI in diagnosis may be faster than other methods. (Saria, 2016)
The unfettered access of young people to health tools and information provided by technology, through phones, devices, wearable technology and especially the internet has often resulted in behavior/habits that are dangerous to the health for example a national survey by Northwestern University called “Teens, Health, and Technology in June 2015 46% of the teens ages 13 to 18 have been exposed to anorexic and bolimic habits even 34% of survey population translated to participation within 30 days. Worthy to note, technology has also promoted better eating habits in some.






Managing Expectations Within and Without Healthcare System

Bernard Stiegler defined technology by calling it “The pursuit of life by means other than life” cited by Thierer (2014). The choice to both verbally and psychologically distance themselves from A.I. is quite often the topic sentence for discussions on the subject, but with change/innovations, resistance is to be expected despite the droves of people and investment in support and pursuit; which reflects that at the very least, it might be worth our time given the application of even a pinch of objectivity.
There are people who have embraced technology with a caveat, “no artificial intelligence allowed”. As if to say artificial intelligence did not spun out of technology. Some of those reasons are:
Ethics: ethics is a branch of philosophy focused on morality principles governing human behavior. This subject area poses existential questions to various aspects of society, actions, innovations etcetera. In that vein many questions have been posed to this ever-evolving development, called technology, a couple being;
1. Can technology really tell the difference between good and evil?
2. Can it apply discretion or have empathy?
For example, if Siri was told to call 911 in a jovial tone (as a prank), can it ever recognize such despite constant upgrades and attempts to mimic human life, cognition and intelligence? Menuge, Angus (Evangelical Philosophy Society’s President and a Professor) last year in an interview with European Leadership Forum said, “the human mind has a number of intrinsic characteristics, such as subjectivity, intentionality, teleology and rationality which a computer can only simulate” (2017).
With the warp speed onward-journey of the AI tech innovation exponentially gaining momentum, same should be said of the ethics surrounding it. (Bharaj, 2018)
 Widening the economic gap between Business Owners and Workers is an often discussed topic, the fear being that, business owners in the healthcare industry will slowly and gradually replace staff with artificial intelligence, for example, the use of electronic medical records in performing the role of book keepers like medical record technicians, clerks and typists has made the storing of information on paper, filling in cabinets and having multiple staff designated to these is a thing of the past. Hence with less capital spent on staff costs, business owners can make more profits, further widening the economic gap and even reducing the number of those in the employment bracket. A corollary of this is an effect on the G.D.P and economy through a rise in unemployment.
Technology advancements gave us the making and use of dentures, for patients without teeth, same technology later brought the regeneration of tooth in humans as found in Cichild fish.
“Technology is central to critical/intensive care, this grants clinicians a chance to achieve the miraculous but it can also be self-perpetuating and a seductive force that requires careful monitoring by users”. (Funk)
Technology gives scientist a chance to engineer and even reverse engineer the brain to better understand pathology. (Kraft, 2011)
“The internet has definitely advanced research capabilities of people. The newfound reliance on search engines like Google, with some describing it as Dr. Google, which allows you type in symptom(s) to find out the disease with inputted symptoms” (Reed, 2017).
 Another very popular opinion about the Artificial Intelligence development is that of concern about a further rise of unemployment, due to Artificial Intelligence taking over human jobs which did not suffice the population in the first place. With the proven results of Artificial Intelligence functioning in human roles with less error, more speed, better quality, higher output quantity and less cost on the long run in sub sectors like drug manufacturing; it is expected that business owners and managers have started to increase investment and use of robotics in production. Services like “Nurse-Assistant” are roles that have been created for robots in the last several years, for functions like carrying, moving patients, because some hospitals have found it as an alternative to relieve nurses due to injuries sustained by human nurses during such tasks. There is fear that the technology will further develop to replace nurses altogether,
Artificial Intelligence is programmed to perform beneficial acts, but with machines it is possible that the artificial intelligence may develop a destructive way to achieve its assigned work. Hence the onus is on the manufacturer and operator to enter correct the parameters into the artificial intelligence to ensure not only accurate results but a safe route to achieving said results.











Bottom-line Drivers

Technology increases the number of patients attended to daily, process that would take longer hours are now down to a percentage of the time allowing for more patients to be seen by physicians; this will increase revenue/turnover.
There are groups from various industries out there who are cross straining and leveraging on exponential technology to impact the health industries (Kraft)
The cost savings of new technology also a driver for investors and managers, though its returns is often not immediate for healthcare providers to reap, but for patients, their health and welfare is often cared for speedily without less strain and less invasion. The quality of life is sometimes the argument for new technology expenses, as the true benefits of healthcare is priceless, hence some technology innovations are not ventured into for financial gain, quantifiable or not. The observation with tech item prices is that; it is high when it first hits the market, but in months variation or mass versions are often produced and released to the general populace, hence its pervading the market is often an eventuality.


Future Of Artificial Intelligence In Healthcare

Health applications are endless with technology.
The future of technology in health will have a lot to do with 3D printing of organs, advanced bypass machines, surgery robotics and various A.I. to help support patients.
 According to Morse law, an exponential increase in capacity is expected of today’s technology hence it is safe to say, the number of lives tech will reach and improve will not be quantifiable, as with every drama, there are protagonist and antagonist involved, those who believe Artificial Intelligence is not the way forward with health challenges and those who vehemently stand behind it. Still, the stage is set and it is abundantly clear that artificial Intelligence is here to stay.


















Conclusion And Recommendations

Conclusively the fact that there have been giant strides in health through technology; is not in doubt, there has been a steady decrease in mortality caused by minor illnesses, even major ones are better handled for example H.I.V.,  sickle cell, polio, ebola etcetera.
It is however essential to note that today’s Artificial Intelligence is actually narrow Artificial Intelligence as each algorithm or device or program performs particular function, the general/strong artificial intelligence encompasses a vast range of cognitive functions as many as a human if not more, but this is yet to be invented.
Previously, the technologies were human-machine interfaces, even with that it was startling for many people especially the baby boomers. In the past few decades, these technologies have transitioned into machine-machine interfaces all the more harder for a significant portion of the members of the older generation(s) to grasp much less embrace. These people alongside some un-accepting people of different ages are the loudest voices against Artificial Intelligence in health.
The recommendation to nay-sayers will be to replace technology-paranoia with cautious optimism, it clear the advantages/pros outweighs whatever downside(s), both perceived and real. This is not to fully dismiss their fear as baseless; technology leaders like Bill Gates, Elon Musk, Steve Wozniack, late Stephen Hawking and a few others continue to draw public attention to the dangers of artificial intelligence, which in turn has intensified the research into Artificial Intelligence safety.
What if Artificial Intelligence bots can be sent into war as field physicians instead of endangering some of the already inadequate number of physicians currently available to serve the population. The debate is ongoing while artificial intelligence continues to grow simultaneously, this says one thing, technology might loose a few battles but will win the war; because at the end of the day “result” make the case for the Artificial Intelligence conundrum.
According to Bennett, “Health is not something that happens two or three times a year, it is something that happens every day”, so if the use of AI can make the process easier, faster, cheaper and better, then “let humans do what do well, and let machines do what they do well, in the end, we may maximize the potential of both” (2016).
















Reference

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Bibliography

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