In this age of 'always on', the occasional illness we experience can be a real chore. Convincing ourselves we're ill enough to make that doctor's appointment is the first hurdle. The second is getting an appointment in a reasonable period of time.
Wherefore Art Thou, Doctor!
I'm one of the lucky ones, my doctors is a teaching surgery and operates a 'call first thing and see a doctor the same day' approach, and in 95% of cases if you call at 08.00 and are prepared to wait for 10 minutes, you can get an appointment to see a doctor that same day. I find this really useful, and I've known friends at other surgeries that have to wait days - sometimes more than a week to see their doctor.
The problem is set to get worse, with a reduction in the number of doctors choosing to go into general practice following qualification, and patients now seeing their doctors twice as many times as ten years ago.
Change is Coming
In a bold move to change the norm, we've recently seen the advent of 'virtual surgeries', using technologies such as video conferencing to allow patients to meet one of a bank of doctors over the web. Personally, for minor ailments, I'd be happy to take this route. I guess the line starts to get blurred when access is required for detailed patient notes, when patients perhaps are not able to recall or disclose issues they've experienced previously, so it's certainly not a ‘one size fits all’ approach.
A key challenge in order to provide access to digital diagnoses is the digitization of your patient notes – the ones that are often seen packed into brown envelopes on the desk of your doctor. Digital Transformation of patient records would appear to be key to providing efficient services by these new types of organization in order to quickly share patient notes prior to online appointments.
Many questions spring to mind. Could diagnosis get smarter using Cognitive AI and Machine Learning AI-based systems? Are there ethical questions to ask if a doctor placed reliance on such Artificial Intelligence-based systems which subsequently proved incorrect? Part of the challenge will be a traditional patient-doctor relationship that is so important for many people. The benefit though for many is that they can see a GP early and are happy to 'see' a different doctor each time they call for an initial appointment, this will work well.
Well, elements of the service are already here.
Organizations such as Babylon's 'GP at hand' www.gpathand.nhs.uk allow NHS patients to switch from their current GP Practice and register with them for remote, video-based consultations which are typically provided within minutes (not hours or days) with a choice of virtual, video-based consultations, or face-to-face appointments at a number of locations. Whilst these locations are currently limited to Central London, the service could be easily rolled out to other locations.
Doctors follow the classical medical cycle of initial presentation observation and measurement, interpret, classify, plan, and cycle back around to observe and measure. Cognitive AI has the capability to assist with each of these phases, but are there ethical issues in using it?
AI in the NHS
In the UK there are millions of records that are available to the NHS, anonymized but valuable in establishing patterns that are useful for learning and can be made available to doctors. Currently, unless you opted out, your anonymized patient data is being returned to the NHS as part of their Big Data for them to use to help establish such patterns. Areas of major disease that already use cognitive computing tools include cancer, neurology and cardiology. Just think about how this data and enhanced learning from it using Artificial Intelligence could be aggregated with other countries in order to accelerate benefits even more.
So how long before we move to more automated diagnoses? The NHS spent £124bn per annum on primary care in 2017-18, if we could save just a fraction of that and help accelerate treatment it would have benefits for the service and patients alike.