These “symptom-checker” services use artificial intelligence; an algorithm sifts through a huge database of previous cases to draw a machine-based conclusion from the information it has been given. In China nearly 50 million people are already using PAGD every month, with the range of its healthcare “ecosystem” extending from an online pharmacy to Chinese traditional medicine and referrals for cosmetic surgery.
The reaction of the medical profession to such apps, and other technology that places more control in the hands of patients, is mixed. Dr Ana Maria Lopez, President of the American College of Physicians, believes it offers a “fabulous” opportunity to free up doctors’ time and to focus face-to-face care on those who really need it. She welcomes patients becoming more engaged with their own healthcare, especially if it encourages them to adopt healthier lifestyles. But she admits there’s also a chance, paradoxically, that it could increase doctors’ workloads if it encourages the “worried well” to seek more medical care.
Dr Andrew Goddard, President of the Royal College of Physicians in London, agrees that new technologies and new approaches are to be welcomed, but worries that some digital innovations are in danger of serving only part of the patient population.
“On the back of my iPhone I have an ECG heart-tracking device. If I have a palpitation I can put my finger on it and measure my own heart rate and email it to the cardiologist. That’s ok for an educated person, comfortable using an iPhone and emailing.
“Imagine if you are 80, living on your own, struggling to use a phone even with big numbers. You haven’t got a computer in the house.
“The worry with this technology is that it will create a greater division in healthcare. It’s empowering to some patients, but not to others.”
But while physicians may have misgivings, the technology sector is forging ahead. As well as the flood of new start-ups, technology giants are investing in medical applications and services.
Apple hopes to exploit the potential of the iPhone and the Apple watch to integrate personal health data with new services, while Google has invested in firms using AI to diagnose disease, such as DeepMind which recently announced progress in machine-based analysis of eye scans. And China’s Tencent has joined forces with London-based start-up Medopad to use AI in the treatment of Parkinson’s disease.
Amazon has teamed up with investment firm Berkshire Hathaway and the bank JP Morgan Chase with the ultimate aim thought to be a shake-up of the healthcare system in the USA. Though they haven’t announced details, Berkshire’s chairman, Warren Buffett, famous for his financial acumen, said the aim was to challenge the “hungry tapeworm” of healthcare costs.
But progress for anyone trying to disrupt healthcare across the board will rely on advances in some underlying structural matters: shifting to electronic patient records, and establishing privacy regulation around that data. For those reasons Lydia Drumright says the development of more AI-based decision-making in medicine has been “slow going” so far. It is poorer parts of the world that would benefit most, she says, if the basic infrastructure could be put in place.