the bot will see you now · 2018-02-14 · the bot will see you now how bots & ai are...

The bot will see you now

How bots & AI are transforming healthcare

www.pwc.se

13 February 2018

Sarah Lidé

PwC

AI is posed to transform healthcare


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13 February 2018

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People are becoming older, sicker, fatter…

60% 7%12%

Global share of older people (aged 60 years or over) in 2014

% of all deaths worldwide caused by NCDs

% of the world’s children aged less than 5 years who were obese in 2012

Ageing populations Non-communicable diseases

Obesity and lifestyle diseases

Economic impact of diseases: Non-Communicable diseases

CVD COPD Diabetes Mental healthLoss over the

next two decades

47 trillion

USDCancer

Source: The Global Economic Burden of Non-communicable Diseases (September 2011)

13 February 2018How bots & AI are transforming healthcare

PwC

65%56%

18%

20%19%

16%

15%25%

66%

Persons < 65years

Entirepopulation

Persons ≥ 65 years

Diagnosed with multiple chronicdiseases

Diagnosed with one chronic disease

No chronic disease diagnosis

The incidence of chronic disease is related to age…

Source: Vårdanalys (2014), ”VIP i vården”

…and chronic illnesses contribute80-85% of healthcare costs

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How bots & AI are transforming healthcare 13 February 2018

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Threatening the sustainability of healthcare systems and organisations

Fiscal pressures on the government

Healthcare costs rising as a % age of GDP

Lack of individual health coverage

Healthcare outcomes not commensurate

Deepening crisis of cost and confidence Bloated costs

`

Uneven quality Mismanaged access

Threaten the sustainability of health organizations


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Personnel shortage in healthcare

Vård och omsorgsutbildade Grundutbildade ssk Specialistutbildade ssk

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Other industries have undergone similar shifts

Industry Past Present

Banking Limited bank teller hours and locations

ATMs and mobile banking available 24/7

TravelLimited travel agency hours and locations

Online Booking with real time pricing and on demand booking

RetailStandardized marketingand inventory

Customized website with targeted, data-driven promotions

Industry Present Future

Health Services

Limited office hours and locations

Standardized treatment plans

Personalization of treatments and protocols

Availability of on-demand services

PharmaBlockbuster drug model

Personalized medicines with a focus on outcomes

1980s –

2010s

Ongoing shift


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Consumers are ready to receive care in new ways and in new places

“Control”

“Convenience”

“Connected”

“Choice”


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The doctor-patient relationship is changing

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The doctor will see you now

The patient will see you now

The bot will see you now

The doctor will be you now


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Healthcare will continue to shift towards outcome-based and preventive care

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Differentiation is solely through product

innovation. Focused on historic and evidence

based-care

Last Decade

Medical Products Equipment, Hardware,

Consumables

Current Decade

Medical Platforms Wearables, Big Data,

Health Analytics

Differentiation by providing services to

key stakeholders. Focused on real time outcome based-care

Medical SolutionsRobotics, AI,

Augmented Reality

Next Decade

Differentiation via intelligent solutions

for evidence/outcome based health. Focused

on preventive care

Evolution of technology and digitisation in healthcare

ResearchEarly

Detection

End of Life Care

Diagnosis

TreatmentDecision Making

TrainingKeeping

Well

Robotics Artificial

Intelligence & Virtual Reality

AI is transforming every aspect of healthcare delivery in innovative ways…


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What doctor? Why AI and robotics will define new health

This research was conducted in November 2016 by YouGov, the world’s premier qualitative and quantitative research suppliers. 11,086 people participated in an online survey.

Who we surveyed:

• Nationally representative samples for Belgium, Germany, the Netherlands, Norway, Sweden, Turkey and the UK;

• Urban representative samples for Nigeria, Qatar, Saudi Arabia, South Africa, and the UAE

• 1,008 respondents from Sweden


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Swedish residents are generally willing to engage with AI in diagnosis and treatment recommendations

Willing to talk to/engage with an advanced computer or robot with AI if it was more accessible and could process health information faster and more efficiently than a human doctor.

Willing to use an “intelligent healthcare assistant” without a clinician’s involvement to have their diabetes monitored and advise on any changes on treatment

48%

53%

Willing to use an “intelligent healthcare assistant” to make a diagnosis based on symptoms, medical history and vital signs and advise what treatment is needed

45%


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Similar levels of acceptance across EMEA except for Germany and the UK

Willingness to engage with a robot with AI to answer health questions, diagnose condition and recommend treatment

94%

85% 82%

66% 65% 62%55%

51% 50% 48%41% 39%

6%11%

16%

24% 24% 26%

39% 43% 39%44%

51% 50%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Willing Unwilling

All countries showed willingness to engage with

robotics with the UK and Germany exhibiting the lowest willingness.


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Advantages and disadvantages for use of AI in healthcare as perceived by Swedish residents

The four biggest advantages for using AI in healthcare:

The four biggest disadvantages for using AI in healthcare:

Respondents perceive

accuracy and

accessibility as the main

advantages to the use of AI in health

The main deterrents are the

absence of empathy and

lack of sufficient trust in a robot’s decision-

making

Ability to access and analyse more information than a human

and can make a diagnosis faster and more accurately

Healthcare would be easier and quicker for people to

access

It would be like having your own healthcare specialist at

any time

Ability to access and analyse more information than a human and make better treatment

recommendations

If something unexpected is found, people don’t trust

robots to make decisions on what to do

Only a doctor or human healthcare professional can make the right decision

Robots are impersonal and people need the “human

touch”

People don’t understand this kind of technology

enough to know if it can benefit or be dangerous

!


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Chatbots in action in healthcare


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Staying connected throughout the patient journey

Symptom checker

“Am I sick?”

Triage

“Do I need to see a doctor?”

Find doctor & book appointment

“When and where can I see a doctor?”

Decision support

“How does my historic health data fit in? How have my lifestyle habits affected my health?”

Treatment and support

“How can I get better?”

Post-visit care

“What can I eat and what should I avoid? What symptoms can I expect?”

Health status

“Is the medication helping? Are there any side effects? Are the symptoms becoming less severe? What are my lab results?”

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Patient-healthcare communication

“Do I need a followup visit?”

Medication support

“How much medication should I take, and when should I take it? Can I take another medication at the same time?”

Need

Care

Aftercare

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A case in point: babylon


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From healthcare…

Pre-care Care After-care

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13 February 2018

https://www.youtube.com/watch?v=LYq55fnHA4U&authuser=0


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From healthcare…

…to health


Predictive & Preventive care

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13 February 2018

From healthcare…

…to health


Predictive & Preventive care

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Symptom checking chatbots in action (1)


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• Dynamic questionnaire• Pre-defined options; “I don’t

know” option missing• Conversation aimed at keeping

engagement going• Simple treatment info• Ends with an option to

message a clinician or book an appointment

• 14 touchpoints

• Choice of more than one symptom

• Conversation is to the point• Pre-defined options; “I don’t

know” option missing• Provides more detailed info on

the proposed ailment• 7 touchpoints

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Symptom checking chatbots in action (2)


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• Option to further specify your symptoms at the beginning

• “I don’t know” and explanatory option available

• Further explanation available

• Treatment recommendation and information

• Provides an indication of how accurate the diagnosis may be

• 27 touchpoints

• Option to add more than one symptom at the beginning

• Explanatory and “unsure” option available

• Option to indicate experienced severity

• Treatment recommendation and information

• Provides an indication of how accurate the diagnosis may be

• 27 touchpoints

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Chatbot-based symptom checkers have value…and limitations as well

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What is its true value?

How does this fit in in the patient journey? What is it complementing or

substituting?

When is it suitable and when is it not?

Does the solution elicit trust?

Number of questions – too many vs too little

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Chatbot therapists tackling mental health


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“Ellie” (2014)

• Research project funded by America’s Defence Advanced Research Projects Agency (DARPA)

• Developed at the University of California’s Institute for Creative Technologies

• Diagnostic tool capable of reading 60 non-verbal cues a second

• Participants who thought they were talking to a robot were more likely to open up

• Potential use case for soldiers

“Woebot” (2017)

• Created by a team of Stanford psychologists and AI experts

• Uses brief daily chat conversations, mood tracking, curated videos, and word games to help people manage mental health

• Deterministic rather than running on machine learning technologies

• Accessible option, “gateway therapy”• Shown to reduce depression in

students

“ELIZA” (1966)

• Created at MIT’s AI Lab by Joseph Weizenbaum

• Designed to mimic a “Rogerian psychologist”

• Considered one of the first programs capable of passing the Turing Test

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Karim, the psychotherapy bot


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Source: X2AI

• Created by Silicon Valley startup X2AI

• Personalised text message conversations in Arabic

• Detects typing patterns to correlate with different emotional states (vs body language)

• Step-wise approach to building trust

• Free from stigma around discussing anxiety and sadness

• Therapeutic assistants - not therapists

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Easing the administrative load


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Source: Kore.ai

• Booking / rescheduling / cancelling appointments

• Patient registration• Lab results• Post-appointment surveys• Billing questions

For patients For healthcare professionals

• Scheduling assistance• Appointment confirmations - reduce no

shows• Proactive follow up• Access to patient records• Clinical messaging (test results,

prescription refills, etc)

InstantAvailable 24/7

GuidedPersonalised

ConversationalSingle Point of Entry

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Robot doctors

carrying out diagnosis and

treatment

Data-driven diagnostics and virtual

drug development

Medical insurance and smarter scheduling (e.g. appointments and operations)

Healthcare holds great potential for AI disruption… but adoption will take time


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13 February 2018

Scores based on PwC’s AI impact index evaluation.

Potential scores range from 1-5, with 5 indicating the

highest potential impact due to AI, and 1 being the

lowest.

Ready to go

Medium term potential

Longer term potential

TimingImpact index & Adoption maturity

Source: PwC (2017) “Sizing the prize”

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The two faces of chatbots in healthcare

Lacks intuition and the human touch

Accessible, conversational and

personalised

Question of trust

Legal and ethical issues

Objective and non-judgemental

Effectiviseadministrative

tasks & resource allocation

• Interactive and better patient experience

• Available 24/7• More focused and relevant

engagement• Only relevant questions based on

specific responses are askedChatbots in healthcare

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• Pre-emptive collection of patient reported information

• Higher response rate from patients – 3% via forms vs 20% via chatbots

• Sync with existing EHRs• Healthcare staff can be redirected

to more value-adding activities

• Objective and up to date assessment and diagnosis• Encourages increased disclosure without fear of

judgement

• May sound scripted and respond with irrelevant answers• May feel impersonal

Benefits

Challenges

• Clinical relevance• Accuracy and reliability• Equality of care or “cherry

picking”• Privacy issues

• Who is liable if something goes wrong

• Risk of unhealthy attachments forming

Let’s chat!

Sarah Lidé

ManagerHealthcare

PwC Sweden

[email protected]

072 584 9208

© 2018 PricewaterhouseCoopers i Sverige AB. All rights reserved. In this document, “PwC” refers to Öhrlings PricewaterhouseCoopers AB or

PricewaterhouseCoopers AB which is a member firm of PricewaterhouseCoopers International Limited, each member firm of which is a separate legal entity.

This publication or presentation has been prepared for general guidance on matters of interest only, and does not constitute professional advice.

You should not act upon the information contained in this publication/presentation without obtaining specific professional advice. No representation or warranty

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the bot will see you now · 2018-02-14 · the bot will see you now how bots & ai are...

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