Last year the movie Her was released in theaters featuring an Artificially Intelligent (AI) operating system able to relate and integrate herself into the main character’s life so much that he fell in love with her. With a year to reflect on this, and increasingly with an earpiece or headphones already in my ear from my phone or computer, I am convinced that the future of patient health will engage me like the computer in Her.
How will listening to “her” affect your care? Picture this… Scarlett Johansson whispers in your ear telling you not to eat that second doughnut. She will know where I am, my behaviors, my sensor outputs, my preferences, and will offer me useful whispers of wanted suggestions to keep me on track with my health. She will suggest that I grab an apple when I am about to eat that second doughnut, find the right messages that motivate me to exercise after the holidays, and remind me not just of which medications I forgot to take, but also the importance of taking my medications for my health. She will present to me on the screen – mobile or immobile — evidence or educational videos that will validate my choice, or an illustration of what is happening in my body that makes me a medical apprentice in my own care.
She will elegantly focus on the part of health care that is not the domain of the physician, yet has an impact on the cost of health care – having timely and personal communications that modify the behaviors for healthy choices. Here is why… it is ultimately all about what the patient wants. And the patient as consumer when it comes to their health.
Patients realize that their electronic devices help them with their day-to-day life including their health care consumer products. As a consumer, I am concerned with the “pain points” of health care including my interactions with health care professionals, convenience, utility, and price. A health coach that is not disruptive or burdensome to my world, and highly personalized to me, is the ultimate expression of a consumer experience. An AI avatar provides this.
We are at the dawn of yet another AI era, equivalent to the integration of multiple devices into a single smart phone. The applications of cognitive computing are about to assemble themselves into solutions that will march rapidly towards my best friend, my AI health advisor.
For example, the application Lark is now on the market as a health coach that chats with you on the phone. It chats using advanced learning and presents information against the context of your daily experience. You don’t pick from a complex list of foods to represent your lunch. You enter something in free text like you are texting a friend. Cognitive Scale has constructed a health application called Cognitive Concierge focused on specific conditions that uses a cloud approach to data absorbing it from many facets to be able to recommend insights on your condition and the environment. So if you have Asthma or chronic obstructive pulmonary disease (COPD) it knows to warn you when there is a high pollen count. It can be customized and deployed by health systems to integrate into their care management processes.
The machine learning is also providing extensions to physicians’ ability to interpret images viewing diagnostics such as medical imaging. Enlitic is using advanced machine learning to find signals in medical images that radiologists might otherwise be unable to see because they can’t compete with a computer that can look across all images of all patients to find patterns. Welltok and Watson Health are also heavily investing in the generation of cognitive applications with early ones in high stakes decisions such as helping to review protocol selection options for oncologists. The race is on to make the advisor that patients will welcome into their world.
Other applications available today are cognitive tools that are working behind the scenes matching content with need. For example, offering the education or entertainment to an individual can and is being adapted to optimize prioritization of the videos that would help me with my understanding of disease based on my level of understanding and at what stage I am battling the disease. Some offer cartoons illustrating how protected their cells are based on their adherence to HIV medication regimens.
Among the big blockers in getting to this state will be the many concerns about ethics, risk, and compliance. But compliance will rapidly become the space of cognitive computing. Let’s look at the banking industry for illustration… how does a global bank determine that their thousands of locations are in compliance with global, regional, and local legal requirements on operating procedures? They either need to have an army of people reading every legal document and every internal policy to read for discrepancies, or they will train a cognitive assistant to help highlight where potential gaps occur with humans confirming gaps and figuring out how to remediate. Just as cognitive computing is taking center stage for the banking industry, it will take center stage for health care to address issues around safeguarding privacy and complying with HIPAA. It will be embedded into the AI that communicates with patients about their health to limit interactions in the AI dialogs or to report adverse events and dangerous health situations to qualified professionals who can mitigate issues.
So here is the list of why my Cognitive AI health coach is coming and accelerating as it comes…
1. The patient wants to be engaged in their preferred context and not have to actively seek out health and behavioral information
2. Gleaning the patient’s intent and reality of mood will best come from hearing things they say and being able to cognitively process speech vs. asking for complex forms to be entered
3. The knowledge bases are consolidating in clouds that an AI assistant can pull from
4. The sensor devices are everywhere and only an AI can really make sense of them
5. The speech recognition needed is coming on line for hearing what we are saying
6. The image recognition needed to identify useful information in our world is getting ready
7. The large volume of potential recommendations for non-critical decisions will be a ripe place to filter using a cognitive AI
8. The rest of consumer components are going down this path regardless so medical will be able to piggy back on the other industries
9. Compliance is going to be some of the first cognitive use cases so it will be embedded into the Cognitive AIs
As discussed in the paper, Cognitive technologies for health plans: Using artificial intelligence to meet new market demands, developments in cognitive technologies and artificial intelligence could help improve cost-effectiveness, customer service, and population health. But to anyone working anywhere in the provider, pharmacy, or consumer wearables markets – get ready for how to adapt to a new world where a few blue ribbon AIs dominate the patient’s spare attention and your own products and services must integrate to generate artificial mind share in the AI health coaches. I can’t predict the exact date when this will cross over into mainstream like wearables did in the past few years. I believe that we will see the pieces clearly assembling themselves over the next three years and emerge with winners in less than seven.