Rise of the machines; will AI replace doctors?

Dr Amandeep Hansra is a GP and Digital Health Consultant. At the recent Demystifying AI, machine learning and robotics in healthcare conference, she presented on the ‘Rise of the Machines: Will AI replace doctors?’

Artificial Intelligence (AI) and machine learning are in a prime position to alter clinical workflows and physician training. With the market growing the way it is, implementation is inevitable. A recent Accenture report estimated that the AI health market will hit $6.6 billion by 2021. That’s up from $600 million in 2014.

Dr Hansra is excited by the applications of technology because she can see all the pain points every day in her practice and she is keen to improve them.

Like many GPs her reality consists of a long, busy days, juggling a large patient load and insufficient time to manage the multiple layers of patient data prior to providing care. She paints an intriguing picture of a typical day.

‘I started eight o’clock in the morning. By eleven o’clock, I’m already an hour behind. I have a patient who turns up in the waiting room – 50 year old lady with diabetes and other chronic medical problems. She has been waiting an hour. She has been a very diligent patient and has fasted because she thinks that I might order blood tests. So here I’ve got a diabetic who’s fasted for an hour – that’s really bad news. But I can’t help it. I’m always running late.

I call her into my room and I open her patient file. I’ve never seen her before but she’s been to the practice 236 times. How do I know that? Because there are 236 entries in her Patient Management System. While she’s talking to me I am skim reading all those 236 entries to gain an understanding of her past medical history. I then look over at the next tabs to review her pathology and radiology results in addition to any correspondence from other healthcare professionals.

All the while the patients is talking at me. I have 10 minutes. I’m already an hour behind. And then I remember My Health Record. The patient says “I’ve been a really good patient and I have printed off my excel spreadsheet that has all my blood sugar level data from the last year. I also have a medication management app that NPS told me to download when I got my last prescription, so you can see how compliant I’ve been.”

At that point I just have to say ‘stop’. I have hundreds of data points to consume in my head. On top of that I need to start examining her. Now I have the blood pressure cuff in one hand, I am looking at the screen and typing to document the consultation. You can imagine how much of my 10 minutes consultation is left. I have one minute to tell her what’s wrong with her, diagnose her, provide her education, prescribe and give her a pathology referral. Meanwhile, she’s getting frustrated because she’s starving.

Of course, I didn’t take a minute. I took 20 minutes to do all that, and then I’m an hour and a half behind and so you can imagine my Saturday morning becomes my Saturday afternoon, becomes my Saturday evening.’

Australia does not have the resources to support our aging, chronic population because the healthcare resources that we have are limited and the number of people that we have to deliver healthcare services is in short supply. We also have financial constraints. Additionally, there are 400 million people across the world who don’t have access to even the most basic medical services.

Dr Hansra’s vision in 5-10 years is that the patient is provided a mobile device upon presenting to the practice reception. The patient uses the tablet to document her symptoms. The system prompts the patient for consent to link in her My Health Record data. The patient is then invited to see the nurse to complete all her vitals and any necessary blood tests. The fasting patient is then fed prior to seeing the GP. The GP would see a summary of all of the information that has been pulled from all the various sources in to the patient file, be provided prompts for further investigation and a suggested plan of care. Dr Hansra would spend a minute digesting the summarised information and spend nine minutes interacting with the patient, building rapport, teaching her preventative health.

‘We really need to get healthcare professionals involved in the technology, in designing it, using it, understanding it, and being part of the thought leadership. We need the private sector to invest in it because this isn’t something we can rely on Governments to do. Then the Government, policymakers and regulatory bodies need to be able to support it, invest in it, and allow it to be incorporated into existing healthcare models.’

Dr Hansra would like to see AI remove mundane tasks so the time-saving intelligence frees her to spend more time with her patients, showing empathy and delivering back that human touch.

Artificial intelligence is an empowerment tool. It presents healthcare professionals with an opportunity to significantly improve the delivery of healthcare and enhance patient outcomes, particularly in high-disease or low-resource settings.

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