The robot doctor will see you now

A recent PwC survey showed that UAE residents are more willing to trust robot doctors for major and minor surgeries compared to other developed countries. So is the healthcare sector responding with the cutting edge techniques, and regulations, that its patients are ready to trust in?
By Tahani Karrar
Thu 02 Nov 2017 05:30 PM

Artificial Intelligence (AI), has been officially embraced in Dubai. At the end of October, Sheikh Mohammed Bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE and Ruler of Dubai, announced that the UAE Strategy for AI is a major part of the UAE Centennial 2070 objectives, and appointed Omar Bin Sultan Al Olama as the first minister of state for Artificial Intelligence.

In healthcare, a field where the concerns of customers – or patients –is paramount, it’s interesting to note the findings of the PricewaterhouseCoopers (PwC) survey. It found that 62 percent of participants surveyed in the UAE are willing to replace human doctors with AI and robots. The result was attributed to a combination of clinical workforce shortages and a young, digitally savvy population in the Middle East.

The survey also found that, even in the operating theatre, 50 percent of UAE respondents are willing for a robot to perform a minor surgical procedure, compared to only 36 percent in the UK. The situation does not change dramatically when it comes to major surgeries. Forty-four percent of UAE respondents are willing to undergo complex procedures performed by a robot, compared to just 27 percent in the UK.

Hamish Clark, PwC Partner in the Health Industries practice, tells Arabian Business: “AI has the potential to properly disrupt how healthcare is delivered, moving away from a hospital-based bricks-and-mortar model to offering proper digital services.”

He points to the US healthcare industry, which is already seeing a rise in virtual hospitals for chronically-ill patients who need continuous monitoring but do not need to be physically in a hospital. The San Diego-based Qualcomm Life, which describes itself as “enabling new connected care models by securely sharing vital patient data and unlocking insights throughout the hospital, home and all points in between” has a virtual hospital network, where patients with chronic conditions are monitored remotely.

The Dubai Health Authority’s (DHA) electronic patient medical record project known as ‘Salama’ is on track and by the end of 2017

“In the Middle East there is a big gap between clinical demand and the availability of doctors and nurses to deliver traditional, hospital-based healthcare,” Clark says. “AI could work in partnership to allow the doctors to be more patient-facing,” Clark adds, explaining this could help solve the shortage of human resources.

Dubai in particular is in a privileged position. With a can-do approach from its public and private sectors, the emirate could leapfrog other, more institutionalised, centres of medical excellence. If it integrates AI successfully, it could realise its vision to become a global healthcare hub.

“The next big disruption will be in healthcare, we are working towards becoming a part of this constructive disruption,” Prasanth Manghat, CEO of pan-UAE healthcare provider NMC Healthcare, tells Arabian Business.

He adds that NMC is studying how AI can be implemented, and there are already many areas where it can help. Machines can be used for research, developing algorithms that use deep learning, correlating patient data, clinical documentation and record-keeping to highlight areas of probable interest for an NMC physician. Overall, Manghat sees the role of AI as one of making diagnostic assessments as accurately and as early as possible.

Mediclinic Middle East (MCME) also recognises that the healthcare landscape is changing at an unprecedented pace. In order to take advantage of emerging trends, MCME recently began a programme to implement a fully integrated top-tier Electronic Health Record (EHR) suite of products. “We branded this programme as ‘Bayanaty’, My Medical Data,” says Donna Lunn, chief information officer at Mediclinic Middle East.  “As well as voice recognition, Bayanaty automates the documentation process and sophisticated ‘Decision Support’ logic, which alerts physicians to potential complications when placing medication orders.

“Additionally, with Bayanaty’s advanced analytics and forecasting modules, over time MCME will be able to automate the analysis of terabits’ worth of medical and social data. The aim is to influence treatment patterns resulting in, among other things, shortened hospital stays and better outcomes for our patients,” Dunn says.

UAE AI minister Omar Bin Sultan Al Olama

Smart pharmacies

This year, the Dubai Health Authority (DHA) inaugurated the country’s first smart pharmacies. The latest, unveiled in August at Dubai Hospital, features an AI robot that can store up to 35,000 medicines and dispense around 12 prescriptions in less than one minute. Furthermore, the robot dispenses the medication with a click of a button based on a barcode, minimising human error.

Clark says this demonstrates that market conditions in the UAE’s private healthcare sector are favourable for further AI integration. There is significant investment behind the idea and it has already attracted revered brands such as IBM, the provider of IBM Watson technology that combines AI and sophisticated analytical software. Furthermore, the time and money it takes to train doctors and build hospitals can be greatly disrupted with the right AI technology.

Mazin Gadir, Senior Specialist at the Dubai Health Authority (DHA), says translating the strategy of AI into implementable policies will be the main hurdle for businesses. “The challenge is on how to operationalise AI into healthcare,” Gadir says, adding that all healthcare facilities are working alongside the authorities towards putting together plans and finding partners, such as IBM Watson, to activate operational projects for AI integration.

Other areas that need to be addressed include AI legislation, infrastructure required to support implementation and how insurance companies can work with AI, says Gadir.

Job losses?

While some leading thinkers fear that AI technology could evolve so highly that it becomes an existential threat to humanity, there are more immediate concerns. Job losses are anticipated in every industry that AI is integrated into. While it will particularly impact routine roles, the risk to more skilled work of doctors and nurses cannot be discounted.

Prasanth Manghat, CEO of NMC Healthcare

Jamal Abdulla Lootah, CEO of Imdaad, the Dubai-based integrated facilities management company, says he sees the worker demography in the UAE changing with AI replacing less skilled labour. “We are bringing the technology to make life easier for the people living in Dubai,” Lootah says. “The type of people working in Dubai might change and there will be more skilled people than technicians.”

However, there will also be new revenue streams from incentivising the economy, Clark says. While the role of a doctor may become one of a facilitator, with the AI doing most of the analysis and prescription, other doctors may find themselves moving from curative to preventative healthcare. “The best health systems are the ones where they manage the population and keep people out of hospitals. And if the health provider incentivises its senior clinicians or surgeons to work differently it will be a win-win [situation],” Clark says.

AI Regulation

While the UAE AI strategy includes the appointment of an AI Consultative Council and a law on the safe use of AI, Andrew Fawcett, senior counsel at law firm Al Tamimi & Co, points to an almost total absence of specific laws on AI with regards to healthcare at present. “There are no regulations that expressly contemplate AI,” he says.

That doesn’t mean the sector is lawless. There are regulations that the AI must comply with; “However the law is generally reactive rather than proactive and disruptive changes that do not readily fall within existing concepts of treatment could potentially face regulatory compliance hurdles,” he says of the multitude of grey areas that exist at present.

Donna Lunn, CIO at Mediclinic Middle East

As Fawcett points out, “the medical sector in the UAE is well-regulated, especially with regards to data, and there are laws to protect patient confidentiality.” But if AI caused harm to a human, where would the liability fall? On the healthcare provider, or the AI manufacturer in line with general product liability laws?

AI Personhood

Current laws assume there will be human supervision over AI, and therefore legal responsibility is linked to the supervisor. But what happens if AI becomes fully autonomous? “We need to look at who should be responsible in those situations,” says Fawcett.  “For example, if the manufacturers were completely responsible then this economic burden would likely discourage them from developing AI.”

Unless you can give the AI some kind of legal personhood – the way a company is treated as a separate legal person – then it will be difficult to sue an AI entity. And even then, suing an AI would be pointless if the AI had no means to pay compensation.

These might seem like distant, perhaps even fantastical notions, but if the technology continues to develop exponentially then they must be tackled. More issues will surely arise further down the line if an AI approaches autonomy.

Jamal Abdulla Lootah, CEO of Imdaad

As UAE industries grapple with how to best integrate AI to increase efficiencies and quality of services it is clear a one-size-fits-all approach towards regulation will not work. Just as the integration of AI is disrupting our traditional industries so too is there a need for a disruptive legal and regulatory framework.

As PwC’s Clark notes, “There needs to be a regulatory environment that can sanction and manage threats before and when they go wrong. The risk is that there could be misdiagnosis and we would know only if there was a serious incident,” Clark says. “We need regulation to be proactive as opposed to reactive.”

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