https://www.hifa.org/dgroups-rss/dr-bot-why-doctors-can-fail-us-and-how-...
I was very fortunate to be at the book launch of Charlotte Blease's new book "Dr Bot". Dr. Bot - Yale University Press London in London, on the 10th of September.
https://yalebooks.co.uk/book/9780300247145/dr-bot/
Charlotte has written about utilising AI to improve doctors' consultations for both doctors and patients. I have taken the liberty of pasting some details from the book that especially interested me. I really would recommend the book which is a balanced look at the future of AI in health consultations. Charlotte focuses on the justification for technology in healthcare: the physical and psychological constraints associated with traditional primary consultations.
Improving consultations. She states that an upgraded healthcare system could allow many more of us to access reliable expertise more quickly and affordably, and alludes to “death by 1000 clicks”. This is doctors’ typing of 20 to 40 daily consultations which reduces the time that doctor can spend explaining and educating patients, can be laborious and can appear discourteous to patients. Automatic AI transcription of consultations uses AI to transcribe the spoken dictation into text, which the doctor reviews and finalises. It is reported to increase the amount of time that health professionals can spend with patients by 25% - an extra consultation per year. The system. A patient in a developed country has about four ten-minute long consultations (40 minutes a year) with a doctor in a year. A patient in a low or middle-income country may have one to two minutes with a doctor in a year or none if no doctors are available. Dr Bot has many of the consultation skills of a doctor and will be available on a patient’s, community’s, or relative’s phone (525,600 minutes a year).
Patients receiving bad news Page 242 of “Doctor Bot” says that “In a recent American survey, 96% of patients said that they would prefer reading their test results online before talking with a doctor, even if the news is bad”. A patient at the 2008 Department of Health “Copying Letters to Patients” working group said that “Getting bad news is bad, getting it late is worse.” Because was thought that nit might be maleficent for patients to receive bad news when on their own, we have suggested cautioning patients about this when they start access to their records. New research suggest that this may not be so necessary.
A doctor in my pocket. “The divide between those who can meaningfully engage with internet-based technologies and those who cannot is closing.” Charlotte mentions the world’s expanding population, and maybe Dr Bot will be available to everyone on a phone worldwide. Dr Bot will give access to excellent reproductive health, mental and social health educational and advice resources as well as to diagnostic and treatment consultations and algorithms. I would like Dr Bot to have a strong emphasis on planetary health, NCDs and marketing as well as on disease management. One patient presented her story for our potential World Medical Journal article and wrote that “I no longer need to stay close to hospital as my health is stable, and I am starting university in September, studying abroad in my second year, confident that the information that I need to manage my condition is never further away than the phone in my pocket”.
Empathy: Dr Bot has empathy, which may come as a surprise to HIFA readers. Charlotte separates empathy into cognitive and emotional components and defines compassion as acts of empathy, explaining that scientists and philosophers differentiate another component of empathy: “prosocial behaviour” – positive actions on someone’s behalf, or more simply “helping”. The evidence of the effects of doctors’ expression of emotionality and personal disclosure on patients’ trust and respect is revealing. AI does well in these fields of empathy and emotional awareness. As Charlotte goes on to describe, research has demonstrated that it is important to patients that Dr Bot makes it clear to patients whether the empathy is from AI or from a human. ChatGPT 3,5 outperformed real people on the emotional awareness scale.
Reshaping workloads: The AI machine, physician, patient, assistant, re-shaping of workloads may help to reshape the physical and psychological constraints associated with traditional primary consultations. It has been said that “AI will never replace a competent physician. That said, there is little doubt that a competent physician who uses the tools that AI has to offer will soon replace the physician who ignores these tools.”
Patient control and patient online sleuthing: “patients experienced a heightened sense of control, greater confidence, a sense of empowerment, and felt better prepared for appointments. Benefits extended to increased participation in consultations, enhanced understanding of the illness or condition, and a sounder grasp of what the doctor said.”
Patient and professional education: “Surveys in the US and Europe show that older adults are willing to adopt technologies but need advice on how to use them.” We are training volunteer patients to teach adults to use the NHS App in our local Glossop area. This mimics the work of Dr Fernandopulle, who coaches laypeople to remove barriers to patients achieving their health goals. One trained coach can manage to develop the relationship of trust and belief of 200 – 300 people as explained to us by the anthropologist, Robin Dunbar. The lay people really enjoy their work. The March 2024 USA and Canada latest curricula specifications omitted AI. (Maybe the WHO Academy could host the educational content? We used national, free, digital courses on data processing and issued certificates of satisfactory completion when I was a Data Protection Officer for 60 General Practices.) Doctors should perhaps educate their staff and patients, too.
Privacy of data that is processed by Dr Bot. “Who or what should control our health data, and what happens to our privacy in the process? One study revealed that companies offering on-demand telemedicine were “leaking sensitive medical information to the world’s largest advertising platforms. 13 of the sites embedded at least one tracker from Meta, Google, TikTok, Twitter, Bing, Snap, or Linkedin.” We presented thoughts about global privacy standards for patient records at the UN World Data Forum in Hangzhou China in 2023. (TA2.02) Inclusion of the citizen, children, families, disabled persons and primary care team in ...Kirsten Mathieson and Frank Smith of Transform Health Home | Transform Health did too (TA3.33) Maximising the public value of health data whilst protecting individual rights, and we will be speaking about this briefly at the ICEHTMC conference in China next month. Global Clinical Engineering Alliance | Home
The mood phone: Dr Bot can be a mood phone, too which, as for blood pressure machines, peak flow meters, glucose and paO2 monitors changes the consultation dynamic from passivity to, active participation.
HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data Email address: richardpeterfitton7 AT gmail.com