The bot will see you now · 2018-02-14 · The bot will see you now How bots & AI are transforming...
Transcript of The bot will see you now · 2018-02-14 · The bot will see you now How bots & AI are transforming...
The bot will see you now
How bots & AI are transforming healthcare
www.pwc.se
13 February 2018
Sarah Lidé
PwC
AI is posed to transform healthcare
How bots & AI are transforming healthcare
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People are becoming older, sicker, fatter…
60% 7%12%
Global share of older people (aged 60 years or over) in 2014
% of all deaths worldwide caused by NCDs
% of the world’s children aged less than 5 years who were obese in 2012
Ageing populations Non-communicable diseases
Obesity and lifestyle diseases
Economic impact of diseases: Non-Communicable diseases
CVD COPD Diabetes Mental healthLoss over the
next two decades
47 trillion
USDCancer
Source: The Global Economic Burden of Non-communicable Diseases (September 2011)
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65%56%
18%
20%19%
16%
15%25%
66%
Persons < 65years
Entirepopulation
Persons ≥ 65 years
Diagnosed with multiple chronicdiseases
Diagnosed with one chronic disease
No chronic disease diagnosis
The incidence of chronic disease is related to age…
Source: Vårdanalys (2014), ”VIP i vården”
…and chronic illnesses contribute80-85% of healthcare costs
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Threatening the sustainability of healthcare systems and organisations
Fiscal pressures on the government
Healthcare costs rising as a % age of GDP
Lack of individual health coverage
Healthcare outcomes not commensurate
Deepening crisis of cost and confidence Bloated costs
`
Uneven quality Mismanaged access
Threaten the sustainability of health organizations
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Personnel shortage in healthcare
Vård och omsorgsutbildade Grundutbildade ssk Specialistutbildade ssk
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Other industries have undergone similar shifts
Industry Past Present
Banking Limited bank teller hours and locations
ATMs and mobile banking available 24/7
TravelLimited travel agency hours and locations
Online Booking with real time pricing and on demand booking
RetailStandardized marketingand inventory
Customized website with targeted, data-driven promotions
Industry Present Future
Health Services
Limited office hours and locations
Standardized treatment plans
Personalization of treatments and protocols
Availability of on-demand services
PharmaBlockbuster drug model
Personalized medicines with a focus on outcomes
1980s –
2010s
Ongoing shift
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Consumers are ready to receive care in new ways and in new places
“Control”
“Convenience”
“Connected”
“Choice”
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The doctor-patient relationship is changing
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The doctor will see you now
The patient will see you now
The bot will see you now
The doctor will be you now
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Healthcare will continue to shift towards outcome-based and preventive care
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Differentiation is solely through product
innovation. Focused on historic and evidence
based-care
Last Decade
Medical Products Equipment, Hardware,
Consumables
Current Decade
Medical Platforms Wearables, Big Data,
Health Analytics
Differentiation by providing services to
key stakeholders. Focused on real time outcome based-care
Medical SolutionsRobotics, AI,
Augmented Reality
Next Decade
Differentiation via intelligent solutions
for evidence/outcome based health. Focused
on preventive care
Evolution of technology and digitisation in healthcare
ResearchEarly
Detection
End of Life Care
Diagnosis
TreatmentDecision Making
TrainingKeeping
Well
Robotics Artificial
Intelligence & Virtual Reality
AI is transforming every aspect of healthcare delivery in innovative ways…
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What doctor? Why AI and robotics will define new health
This research was conducted in November 2016 by YouGov, the world’s premier qualitative and quantitative research suppliers. 11,086 people participated in an online survey.
Who we surveyed:
• Nationally representative samples for Belgium, Germany, the Netherlands, Norway, Sweden, Turkey and the UK;
• Urban representative samples for Nigeria, Qatar, Saudi Arabia, South Africa, and the UAE
• 1,008 respondents from Sweden
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Swedish residents are generally willing to engage with AI in diagnosis and treatment recommendations
Willing to talk to/engage with an advanced computer or robot with AI if it was more accessible and could process health information faster and more efficiently than a human doctor.
Willing to use an “intelligent healthcare assistant” without a clinician’s involvement to have their diabetes monitored and advise on any changes on treatment
48%
53%
Willing to use an “intelligent healthcare assistant” to make a diagnosis based on symptoms, medical history and vital signs and advise what treatment is needed
45%
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Similar levels of acceptance across EMEA except for Germany and the UK
Willingness to engage with a robot with AI to answer health questions, diagnose condition and recommend treatment
94%
85% 82%
66% 65% 62%55%
51% 50% 48%41% 39%
6%11%
16%
24% 24% 26%
39% 43% 39%44%
51% 50%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Willing Unwilling
All countries showed willingness to engage with
robotics with the UK and Germany exhibiting the lowest willingness.
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Advantages and disadvantages for use of AI in healthcare as perceived by Swedish residents
The four biggest advantages for using AI in healthcare:
The four biggest disadvantages for using AI in healthcare:
Respondents perceive
accuracy and
accessibility as the main
advantages to the use of AI in health
The main deterrents are the
absence of empathy and
lack of sufficient trust in a robot’s decision-
making
Ability to access and analyse more information than a human
and can make a diagnosis faster and more accurately
Healthcare would be easier and quicker for people to
access
It would be like having your own healthcare specialist at
any time
Ability to access and analyse more information than a human and make better treatment
recommendations
If something unexpected is found, people don’t trust
robots to make decisions on what to do
Only a doctor or human healthcare professional can make the right decision
Robots are impersonal and people need the “human
touch”
People don’t understand this kind of technology
enough to know if it can benefit or be dangerous
!
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Chatbots in action in healthcare
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Staying connected throughout the patient journey
Symptom checker
“Am I sick?”
Triage
“Do I need to see a doctor?”
Find doctor & book appointment
“When and where can I see a doctor?”
Decision support
“How does my historic health data fit in? How have my lifestyle habits affected my health?”
Treatment and support
“How can I get better?”
Post-visit care
“What can I eat and what should I avoid? What symptoms can I expect?”
Health status
“Is the medication helping? Are there any side effects? Are the symptoms becoming less severe? What are my lab results?”
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Patient-healthcare communication
“Do I need a followup visit?”
Medication support
“How much medication should I take, and when should I take it? Can I take another medication at the same time?”
Need
Care
Aftercare
PwC
A case in point: babylon
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From healthcare…
Pre-care Care After-care
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A case in point: babylon
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https://www.youtube.com/watch?v=LYq55fnHA4U&authuser=0
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A case in point: babylon
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From healthcare…
…to health
Pre-care Care After-care
Predictive & Preventive care
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A case in point: babylon
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https://www.youtube.com/watch?v=LYq55fnHA4U&authuser=0
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A case in point: babylon
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From healthcare…
…to health
Pre-care Care After-care
Predictive & Preventive care
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Symptom checking chatbots in action (1)
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• Dynamic questionnaire• Pre-defined options; “I don’t
know” option missing• Conversation aimed at keeping
engagement going• Simple treatment info• Ends with an option to
message a clinician or book an appointment
• 14 touchpoints
• Choice of more than one symptom
• Conversation is to the point• Pre-defined options; “I don’t
know” option missing• Provides more detailed info on
the proposed ailment• 7 touchpoints
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Symptom checking chatbots in action (2)
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• Option to further specify your symptoms at the beginning
• “I don’t know” and explanatory option available
• Further explanation available
• Treatment recommendation and information
• Provides an indication of how accurate the diagnosis may be
• 27 touchpoints
• Option to add more than one symptom at the beginning
• Explanatory and “unsure” option available
• Option to indicate experienced severity
• Treatment recommendation and information
• Provides an indication of how accurate the diagnosis may be
• 27 touchpoints
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Chatbot-based symptom checkers have value…and limitations as well
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What is its true value?
How does this fit in in the patient journey? What is it complementing or
substituting?
When is it suitable and when is it not?
Does the solution elicit trust?
Number of questions – too many vs too little
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Chatbot therapists tackling mental health
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“Ellie” (2014)
• Research project funded by America’s Defence Advanced Research Projects Agency (DARPA)
• Developed at the University of California’s Institute for Creative Technologies
• Diagnostic tool capable of reading 60 non-verbal cues a second
• Participants who thought they were talking to a robot were more likely to open up
• Potential use case for soldiers
“Woebot” (2017)
• Created by a team of Stanford psychologists and AI experts
• Uses brief daily chat conversations, mood tracking, curated videos, and word games to help people manage mental health
• Deterministic rather than running on machine learning technologies
• Accessible option, “gateway therapy”• Shown to reduce depression in
students
“ELIZA” (1966)
• Created at MIT’s AI Lab by Joseph Weizenbaum
• Designed to mimic a “Rogerian psychologist”
• Considered one of the first programs capable of passing the Turing Test
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Karim, the psychotherapy bot
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Source: X2AI
• Created by Silicon Valley startup X2AI
• Personalised text message conversations in Arabic
• Detects typing patterns to correlate with different emotional states (vs body language)
• Step-wise approach to building trust
• Free from stigma around discussing anxiety and sadness
• Therapeutic assistants - not therapists
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Easing the administrative load
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Source: Kore.ai
• Booking / rescheduling / cancelling appointments
• Patient registration• Lab results• Post-appointment surveys• Billing questions
For patients For healthcare professionals
• Scheduling assistance• Appointment confirmations - reduce no
shows• Proactive follow up• Access to patient records• Clinical messaging (test results,
prescription refills, etc)
InstantAvailable 24/7
GuidedPersonalised
ConversationalSingle Point of Entry
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Robot doctors
carrying out diagnosis and
treatment
Data-driven diagnostics and virtual
drug development
Medical insurance and smarter scheduling (e.g. appointments and operations)
Healthcare holds great potential for AI disruption… but adoption will take time
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Scores based on PwC’s AI impact index evaluation.
Potential scores range from 1-5, with 5 indicating the
highest potential impact due to AI, and 1 being the
lowest.
Ready to go
Medium term potential
Longer term potential
TimingImpact index & Adoption maturity
Source: PwC (2017) “Sizing the prize”
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The two faces of chatbots in healthcare
Lacks intuition and the human touch
Accessible, conversational and
personalised
Question of trust
Legal and ethical issues
Objective and non-judgemental
Effectiviseadministrative
tasks & resource allocation
• Interactive and better patient experience
• Available 24/7• More focused and relevant
engagement• Only relevant questions based on
specific responses are askedChatbots in healthcare
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• Pre-emptive collection of patient reported information
• Higher response rate from patients – 3% via forms vs 20% via chatbots
• Sync with existing EHRs• Healthcare staff can be redirected
to more value-adding activities
• Objective and up to date assessment and diagnosis• Encourages increased disclosure without fear of
judgement
• May sound scripted and respond with irrelevant answers• May feel impersonal
Benefits
Challenges
• Clinical relevance• Accuracy and reliability• Equality of care or “cherry
picking”• Privacy issues
• Who is liable if something goes wrong
• Risk of unhealthy attachments forming
Let’s chat!
Sarah Lidé
ManagerHealthcare
PwC Sweden
072 584 9208
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