Meet Joe. A 60-year-old man, previously fit and well.
A regular attender at his GP surgery for six months with vague symptoms: non-specific, as they say. Joe’s health declined month-on-month. He woke up one day with jaundice, attended his local emergency department. Three weeks later, he died.
Joe’s case stuck with Bea Bakshi through her GP training. It’s a case which inspired her to develop a new mobile app and online device to aid diagnosis.
‘During the time I cared for him, at no point did he say: “Why was I diagnosed with cancer,”’ she told the BMA annual representative meeting in Brighton (webcast below). ‘Instead, he asked, “why was my cancer picked up so late”.’
‘This really riled me,’ Dr Bakshi added.
After qualifying, she saw the scale of the issue. ‘GPs are not specialists. We will only see six to seven new cases of cancer each year and rare cases of cancer once in our lifetime,’ she says. ‘Within the constraints of a 10-minute appointment, it is near-impossible to take vague, subtle and non-specific symptoms and put them together to identify the risk.’
Her app, ‘C the signs’, aims to help doctors diagnose patients’ cancer risks, based on the symptoms and demographic data that they plug in. It can signpost GPs to cancers in under 30 seconds, using evidence compiled with the help of the National Institute for Health and Care Excellence.
‘C the signs’ was just one of the technological innovations discussed at the Disrupting Healthcare event at the ARM.
Another app, developed by plastic surgery trainee Jean Nehme seeks to improve surgery by breaking down the process of operating and assessing performance into simple steps. The company he co-founded, TouchSurgery, has employed 150 people, including animators from filmmaker, Pixar, to turn surgery into an ‘interactive, process-based game’.
‘When we first built it people, especially my own mother, referred it to as a toy,’ he told the ARM.
‘So we were adamant to get the research to show that it worked and had an impact.’ And that’s just what he’s done.
As Touch Surgery works on mobile phones or tablet computers, it can be used by operating teams to prepare and rehearse procedures, then taken into theatre to improve coordination.
AbilityNet accessibility and usability consultant Adi Latif told the debate that home-based tech had already improved the lives of people with disabilities. Artificial intelligence tools, such as Alexa and Google Home, were ‘a real source of independence for people who are not able to leave their home’. His mocked-up interaction, with a somewhat paternalistic one from a near future, could book appointments, advise on health scares, and connect with heart rate monitors attached to their owner (see below).
But all this technology and innovation in healthcare, and the benefits it brings, was not without risks, said Julian Sheather, BMA special adviser in ethics and human rights.
He spelled out two ways of thinking about the morals of innovation. One saw ethics and innovation as uncomfortable bedfellows. ‘They don’t really comport with each other. Innovation is all about what is new, disruptive, emergent. Ethics tends to more about the longer view, the more considered approach.’
The other considered innovation as carrying its ‘own moral baggage with it’. ‘It is simply a good thing in itself. Like hope and optimism. It is human ingenuity at work. Why would you want to get in its way?’
But he then gave an example, from the financial world, of when innovation went wrong, so wrong it prompted the global financial crisis, which began in 2008.
‘There was extraordinary financial innovation,’ he added. ‘Collateral debt obligations. Dicing and splicing AAA debt with junk and garbage, releasing huge amounts of money into economy, making a small number of people extremely rich,’ Dr Sheather said. ‘And then as we all know, Boom! So it seems that we do need to think about regulation and ethics.’
Maybe innovation all by itself isn’t enough, he suggested. It’s a point of which doctors in the forefront of healthcare innovation will be well aware.
Keith Cooper is a senior staff writer with the BMA
Healthcare imagined: how AI might help in the near future
‘Alexa, I’ve had splitting headache for over two weeks. Can you help?’
‘Validating account… I’m sorry to hear about your headache. You don’t usually get headaches. I see your blood pressure is up and your stress levels have been abnormally high over the last two weeks.’
‘I see you haven’t been sleeping too well.’
‘What do you recommend?’
‘I recommend you see a G… P.’
‘Can I see a GP tomorrow afternoon?’
‘Do you want to see the same one or are you OK to see someone else?’
‘I don’t care. Whatever is the quickest.’
‘You can have a virtual appointment tomorrow at 3pm or you can see your G… P, next week.’
‘I’ll take the virtual appointment please.’
‘Are you OK for the doctor to view your medical details?’
‘Sure, no problem.’
‘Your appointment has been confirmed tomorrow at 3pm with Dr James Wiggins. I’ve added to your calendar. Would you like to hear some lifestyle suggestions that can help? No thanks.’
‘Will that be all?’
‘Yes, all done.’
‘Before I go, just to let you know, there is a really bad cold going around London. Would you like some tips on how to avoid it?’
‘Nah, not bothered.’
‘Your social life is having an adverse effect on your health. Would you like some advice?’
‘No way, Jose, captain.’
As imagined by Adi Latif, AbilityNet, accessibility and usability consultant, and presented to the ARM