Technology could redefine doctor-patient relationship | Richard Vize

Advances in clinical uses of artificial intelligence (AI) could have two profound effects on the global medical workforce.

AI, which mimics cognitive functions such as learning and problem-solving, is already making inroads into the NHS. In north London it is piloting use of an app aimed at users of the non-emergency 111 service, while the Royal Free London NHS foundation trust has teamed up with Google’s DeepMind AI arm to develop an app aimed at patients with signs of acute kidney injury. The hospital claims the project, which uses information from more than 1.6 million patients a year, could free up more than half a million hours annually spent on paperwork.

AI raises the prospect of making affordable healthcare accessible to all. According to the World Health Organisation, 400 million people do not have access to even the most basic medical services. Hundreds of millions more, including many in the world’s most advanced countries, cannot afford it. A key factor driving this is the worldwide shortage of clinical staff, which is getting worse as populations grow.

At last month’s DigitalHealth.London summit, Ali Parsa, founder of digital healthcare company Babylon, argued that mobile technology coupled with AI makes universal access a realistic goal, while replacing doctors with intelligent systems will slash costs.

“There is no solution which can fundamentally cut the costs of healthcare as long as we are reliant on humans,” he said.

So the second impact of artificial intelligence could be not merely augmenting the pool of medical talent but beginning to replace it. Big claims are being made for the clinical power of AI. Last year IBM’s Watson supercomputer was credited with diagnosing in minutes the precise condition affecting a leukaemia patient in Japan that had been baffling doctors for months, after cross-referencing her information with 20m oncology records.

However, the same system has just consumed five years and $ 62m (£51m) in an unsuccessful attempt to transform care at the University of Texas MD Anderson Cancer Center, showing how difficult it is to connect these digital behemoths to everyday hospital work. With the NHS still struggling to introduce electronic patient records, the idea of plugging the UK healthcare system into an all-knowing digital brain any time soon is fantasy.

While there is no doubt that AI will enable faster and more accurate diagnoses, a more realistic prospect than replacing doctors is to redefine their role.

That will be to put machine-generated information into the context of the unique life and needs of the individual patient, which cannot yet be reduced to an algorithm. As Dr Ameet Bakhai, consultant cardiologist at the Royal Free trust, told the summit, machines making clinical decisions on their own without that human context could fail to meet Isaac Asimov’s first law for robots of “do no harm”.

Digital evangelists argue that intelligent machines will be able to incorporate the latest data and research immediately, but that is both questionable and a potential weakness. Clinical trials vary in scale and quality, and indiscriminate inclusion would inevitably lead to mistakes. Digital hardliners would argue that machines should judge the quality of the research, but for the foreseeable future the expertise of doctors will be essential to deciding the validity of new approaches.

So perhaps one of the most powerful effects of artificial intelligence will be, perversely, to make healthcare more human and personal. It will remove the dependency on doctors’ fallible memory and incomplete knowledge, and free them to use machine-generated information to work with patients to shape their specific treatment.

This has profound implications for medical training and what defines a leading clinician. It will be those who can harness AI to their own medical knowledge and their human skills of context and empathy who will be the leaders of their profession. In the new world there will still be a great deal for highly-trained humans to do.

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Technology could redefine doctor-patient relationship | Richard Vize

Danish childminder"s discrimination case may possibly redefine weight problems as disability

In the United kingdom, 64% of grownups are classified as getting overweight or obese. Photograph: Paul Ellis/AFP/Getty Photos

An overweight Danish childminder, mentioned to be unable to bend down to tie up shoelaces, could make legal history this week by calling for employers across Europe to treat weight problems as a disability.

The discrimination situation brought by Karsten Kaltoft against his regional authority will be heard by the European court of justice in Luxembourg on Thursday and could set a far-reaching precedent across all EU states.

Kaltoft, who weighed far more than 158kg (25st) at the time, was sacked by the council, Billund Kommune, since it deemed that he could not perform his duties due to his dimension, citing the truth that he needed help from a colleague to tie up children’s shoelaces. The Danish courts referred the concern to the ECJ.

If effective in redefining obesity as a disability, Kaltoft’s attorneys could force widespread adjustments in the way employers deal with employees and what assistance – for illustration, reserved parking – they may be necessary to supply.

The court, whose rulings are binding during the EU, will have to determine whether it is respectable to discriminate on the grounds of weight problems and regardless of whether the burden of proof in any future situations ought to be on the employer or worker. The ECJ will also consider whether, if there is a duty to avoid discrimination against individuals struggling from weight problems, it applies just to the public sector or across the entire labour industry.

Audrey Williams, head of discrimination at the London law company Eversheds, explained: “The influence could demonstrate important for employers, notably those in the Uk which continues to reveal the highest percentages of weight problems in Europe.” In the United kingdom, 64% of adults are classified as currently being obese or obese.

“Discrimination law in the United kingdom, the Equality Act 2010, has been interpreted as protecting physical and psychological situations which result from obesity, to the extent they meet specified criteria in terms of their nature, effect and duration,” stated Williams. “Weight problems itself has been rejected by the United kingdom courts as a disability in its personal right. If the European court reaches a contrary conclusion, the Equality Act would want to be utilized quite in a different way.

“Obesity, even so it will come to be defined, would need to be approached just like any other physical or psychological impairment, preventing an employer from treating an worker less favourably because of their bodyweight, not due to the fact of consequential health care troubles. This would incorporate the capacity to dismiss.

“The primary change, however, would practically surely come up in the context of the employer’s duties to make realistic adjustments to the workplace or functioning arrangements. For example, entry to the office could be an problem, requiring overview of where the employee is found and their seating arrangements. May well obese employees require to get preferential access to automobile parking, for instance?”

In the USA, several latest cases have resulted in dismissed employees successfully claiming they were discriminated towards for being obese. In 1 case, a employee in Texas who weighed much more than 305kg (48st) received $ 55,000 (£32,800) in compensation for losing his work.

Danish childminder"s discrimination case may possibly redefine weight problems as disability

Cegedim and Docnet Provide "Purposeful Collaboration" To Redefine The Physician Social Network

Cegedim has taken a dive into doctor social networks.  Recently, I spoke with Angela Miccoli, President – North America for Cegedim Relationship Management, to get a better sense of how Docnet will engage physicians and Cegedim’s expectations for the US and worldwide marketplace.  Cegedim has deployed Docnet effectively in almost a dozen other nations, and the investments in Docnet are far more than two many years previous. But its launch into the US market will be each an essential services providing and a important barometer for accomplishment.

A network designed especially for daily life sciences, Docnet is centered on providing time back to today’s occupied doctor. It maximizes crucial providers from income representative engagement and solution sampling – to networking and continuing medical schooling. Miccoli sums up Docnet in basic, however compelling terms:

For doctors right now, there are numerous “distraction activities” they nonetheless have to do in an analog way that take time and attention away from improving their practices and benefitting patients. Docnet gives time back to medical professionals. When a physician can use Docnet to buy samples, discover, facilitate co-pay out cards, look up medication, and go via other processes – in a digital, frictionless, worth oriented method – they can focus much more on individuals and practice transformation.

The bottom line for Cegedim:  Docnet and the doctor audience is worth. Connecting doctor-to-physician like Facebook and LinkedIn is essential, but Docnet will strive, according to Miccoil, to connect doctor-to-articles, physician-to-goal, and sooner or later, physician-to-value.   And it’s this value that can make Docnet much less of another social media network, and a lot more of an crucial practice tool.  And beyond material and engagement, Docnet can make it “safe to be social.” With above 40 many years of compliance information and equipment, Miccoli points out that Cegedim is uniquely positioned to deliver a platform of compliance that meets the strictest expectations and suggestions in the business.

From easy sharing to advancing healthcare care, social networks have the prospective to turn out to be essential equipment for doctors.  Alan Lepofsy, VP and Principal Analyst at Constellation Analysis is a effectively-established advocate of advancing the nature of collaboration, summarizes this central idea in the context of healthcare. “Social networks can be a fantastic way to learn data and connect with men and women, but without having a defined objective, participation in these networks usually swiftly fizzle out. In the healthcare industry, collaboration platforms require to allow doctors to function together close to processes like study, clinical practice and continued schooling.”

In a clinical environment exactly where efficiency is important, Cegedim is leveraging their skills to build a platform that moves past facts and figures to provide the value.  This value will make physicians see social networks with much less apprehension and a greater sense of the two logistical and clinical worth.

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Cegedim and Docnet Provide "Purposeful Collaboration" To Redefine The Physician Social Network