Artificial intelligence has a long way to go to become a fixture in healthcare, but there already are hints of what’s to come.

Harvard Business Review has summarized recent findings. “Consider three issues that get a lot of attention: the use of medical records, the “human touch” in medical care, and the future of jobs in the industry. On balance, are people more glass half-full or half-empty? Our research points to an optimism that may surprise expert observers,” H. James Wilson and Paul Daugherty write in HBR.

The Use Of Medical Information
Patients want their healthcare data protected – and we are required by HIPAA law to do that – but patients will voluntarily share their medical data when it’s in their best interest to do so. Consider the data produced by wearable devices as more people are utilizing wearable healthcare devices.

A recent Accenture survey gave these results showing people are willing to share their medical data with healthcare providers or even health insurers.

• Eighty-eight percent of people are willing to share data from their wearables with either their doctor, nurse, or other health care professional.

• Seventy-two percent are willing to share their data with health insurers.

• Only 38 percent are willing to share their data with employers.

It’s estimated that more than 75 million Americans would use an activity tracker by the year 2021. As we see an increase in wearable devices capable of transmitting medical data we need to consider how we can utilize this information in our patient management protocols. This is important because even though the use of wearables has more than doubled in the U.S. in the last two years, it’s estimated that only 15 percent of doctors say they’ve discussed wearables or health applications with patients.

Wearables give the ability to continuously capture data such as heart rate, sleep patterns and glucose levels. This produces vast amounts of data. Contrast this with a single reading taken on a single doctor visit. Comparing the data taken from wearables with readings taken at a doctor’s visit raises the issue of the accuracy of the data. Wearables do not yet have the accuracy of the gold standard measurements taken in the doctors’ office. This will improve over time. AI gives us the tools to sort through the mountain of data and extract pertinent trends.

The “Human Touch” vs AI In Medical Care
Anyone who’s been frustrated by an automated phone tree when calling a tech company for support, knows how much we desire to talk to a human, but research done by Wilson and Daugherty showed that convenience and efficiency often trumps “Human Touch” care. Their survey revealed:

• Seventy-five percent of people said that AI technological advances (including mobile apps, wearable monitoring devices and smart scales) were important to help them manage their health.

• Sixty-six percent of people said they would use AI-based after-hours services.

• Sixty-three percent of people said they would use AI agents to help them navigate the health-care system.

• Fifty percent-plus said they would use AI-based systems to diagnose their symptoms and to receive emergency advice.

Clearly, patients feel there is a place for the use of artificial intelligence when it provides convenience and efficiency.

The Future Of Jobs In The Industry
There are at least three ways that AI will impact our practices.

1) AI has the ability to analyze copious amounts of data. Consider these two uses of AI.

a. The ability of AI to read the patient record in real time and suggest differential diagnoses, as well as suggest additional tests to administer.

b. The ability of AI to analyze the new drug you want to prescribe and evaluate it for incompatibility against all other pharmaceutical agents the patient is taking, all nutraceuticals the patient is consuming, and all supplements the patient is using, plus considering the patient’s history of allergies.

2) AI has the ability to interact with people through novel types of interfaces such as voice, emotion, or gesture recognition. AI can be used to remind patients to take medication. Chatbots can used to triage patients calling into the office. Machine learning tools can used in the diagnosis and treatment of visual problems such as amblyopia, convergence insufficiency and low vision.

3) AI is able to extend people’s capabilities beyond their natural limits. Robot-assisted surgery is a good example of this in the eyecare world. AI can eliminate involuntary tremors while a surgeon utilizing robot-assisted surgery is operating on the retina.

Click HERE to watch a short video that shows the potential power of AI for conditions like autism, Parkinson’s and epilepsy.

AI is already here. The power of human-machine collaborations is amazing. AI is causing us to re-imagine our work processes. We are excited to see what the near future holds for AI and its use in health care.

 

MARK WRIGHT, OD, FCOVD

Dr. Wright is the founding partner of a nine-partner, three-location full-scope optometric practice. As CEO of Pathways to Success, an internet-based practice management firm, he works with practices of all sizes. He is faculty coordinator for Ohio State’s leading practice management program.

CAROLE BURNS, OD, FCOVD

Dr. Burns is the senior partner of a nine-doctor full-scope optometric practice that she built with her husband, Dr. Wright. She is also the COO of a state-wide nursing care optometry practice. Dr. Burns lectures nationally on practice management and staffing issues. Dr. Burns authored the Specialty Practice section of the textbook, Business Aspects of Optometry.


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Artificial intelligence is unlikely to produce a robo-eye-doc who will replace you, but it is likely to add a new dimension to the service we can provide to our patients.

AI-Powered Patient History Interview
I can foresee a future in which AI will be able to talk with patients about their reason for their visit when they book their appointment online. Advanced AI systems, with voice activation, would be able to talk to patients to take a case history, gathering the important information, analyzing it and then providing the doctor with a preliminary finding, which the doctor can explore in greater detail when the patient comes in for an in-person appointment.

 Click the image above to view two videos on how artificial intelligence might impact eyecare from a presentation given at the 11th Annual VM Global Leadership Summit that took place at Vision Expo East 2017.

Before the Patient Ever Gets to Office

When the patient makes an appointment, AI technology could take information-finding to the next level. The patient would not just fill out a form online prior to their visit detailing their health history and eyecare needs. It would provide an interactive interview.

The system would have a “voice” that would ask the patient questions, such as family history of eye diseases like macular degeneration and glaucoma, and then would ask the next question based on the response it received. For instance, if the patient said “yes” to having a family history of a particular eye disease, the system would then ask which relative(s) in their family had the disease.

Or the system might ask the patient if they participate in sports, and then if the patient said “yes,” the system might ask the patient to say which sport. Then, the system might ask the patient if they were interested in learning more about the sports sunwear the practice sells specifically for that sport.

The key to effectiveness will be the ability of the doctor and optical staff to sit down together and come up with the most helpful questions to input into the system to ask. It’s like the old saying, “garbage in, garbage out.” AI systems are, by definition, “intelligent,” but not so intelligent that they don’t require the inputting of the right information to use as foundation for its interaction with patients.

Click the image above to watch Andy Karp of Vision Monday and 20/20 magazine share his preview of new and emerging technology presented at the 2017 Consumer Electronics Show.

Lay the Groundwork for a More Productive Visit
Before the patient gets to the office, the transcript, in both written and recorded form, would be sent to the patient’s EHR file, with the eyewear-related information sent to opticians.

In addition to giving the doctor detailed information about family history that they could use to ask more informed questions of the patient, opticians would get a jump start on the sales process. They would know ahead of time to have a tray of sunwear specific to that patient’s favored sport ready to show them during their visit.

Interactive Displays in the Optical
The opticians will be better armed with information about each patient’s needs, and the displays themselves could “talk” to patients.

A patient could pick up a frame to try on, and when they pick it up, and when they put it back on the board, an AI system could say: “We have that frame in other colors” or “If you liked that frame, you may also be interested in X frame.”

The system could have an “Ask me a Question” button for every section of the frame board in which the patient can ask questions about the merchandise like they would type a question into Google, and then the system would either give a response or summon an optician to answer the question.

Data Interpretation Help
Diagnostic equipment produces data that historically the doctor reviewed and interpreted. AI would be able to analyze the data and would provide the doctor with a working diagnosis and treatment plan.

AI might be able to run more in-depth analysis on the data than a human doctor could. AI may be better at looking at images than a human doctor both in terms of speed and precision. This would lead to better patient outcomes and the ability to process patients more efficiently.

For example, fundus imaging. AI would be able to track subtle changes to blood vessels, optic nerves and retinal lesions over time. AI would be able to alert the doctor to these changes earlier. This is essential as early intervention often leads to better patient outcomes.

Boost Marketing Efforts
AI would be able to tap into your EHR data and look for marketing opportunities. It would then be able to generate marketing content to take advantage of that information, and would be able to tell you the ideal channels to broadcast those marketing messages based on information stored in the system on what’s worked best in promotion efforts for your practice and other practices.

You and your staff can already use your EHR to mine data to use for marketing your products and services. What AI offers is a helping hand doing that work. Rather than you having to search for, and then look through the data, yourself, an AI system could do that work for you. It might be able to automatically conduct searches for marketing opportunities, and then analyze the data on its own, to let you know, without searching yourself, of needed products and services that your patients may not be receiving as much of as they should be.

This kind of advanced, data-driven marketing would help build practices. Patients would more easily be given marketing messages that were most relevant to them.

How Expensive Will This Technology Be?
With all the great promise of AI technology, a question still remains of how costly it will be to purchase and implement.

It may be that as the technology emerges, it will be prohibitive for all but the biggest, and most profitable, practices, but that five-to-10 years after its widespread availability, it will become affordable for smaller practices.

The important point is to be aware of the coming opportunities to better serve our patients–and to develop plans to eventually optimize that technology so patients are better served, and our practices get a springboard to growth and profitability.

Have you thought about the role AI could play in our practices? What ideas do you have of how you could use this technology in your own practice?

 

 

JUSTIN BAZAN, OD

is the owner of Park Slope Eye in Brooklyn, N.Y. To contact him: dr.bazan@parkslopeeye.com.


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