A blog by Dan Housman, director, Deloitte Consulting LLP
Fantasy? Fiction? The future?
Health care isn’t the only industry realizing the challenges and benefits posed by advances in cognitive technologies, machine learning, and artificial intelligence (AI). But it is an industry quickly leveraging these cutting-edge advances, especially in the areas of research, diagnostics, treatment, and patient outcomes. Alarmists worry that smart machines will replace highly skilled practitioners in everyday health care encounters. They fear a depersonalized and invasive experience that could interfere with their health and personal lives.
Fantasy? Fiction? The future? In 2013 the movie “HER” was released in theaters featuring an AI operating system able to relate and integrate itself into the main character’s life so completely 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.
Humans and machines: Better together
Picture Scarlett Johansson whispering in your ear, telling you not to eat that second donut. She will know your behaviors, sensor outputs, preferences, and will offer useful whispers of wanted suggestions to keep your health on track. She will suggest that you grab an apple when you are about to eat that second donut, find the right messages that motivate you to exercise after the holidays, and remind you not just of which medications you forgot to take–but also of how important it is to take your medication daily.
In truth, smart machines aren’t likely to take over our lives, but advances in AI, cognitive, and machine technologies will augment human thinking and specialized skill sets. This should be welcome news to patients, many of whom enjoy a love-hate relationship with technology at home, but could benefit from those same technological advances to improve their quality of health care.
An apple a day–plus machine learning and artificial intelligence (AI)
Patients realize that their electronic devices help them with their day-to-day lives, including their health care consumer products, such as fitness bands. 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 neither disruptive nor burdensome to my world, and highly personalized to me, is the ultimate expression of a consumer experience. An AI avatar can provide this.
We are at the dawn of yet another AI era, equivalent to the integration of multiple devices into a single smartphone. 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, just as you would text a friend. Another example: Cognitive Scale has constructed a health application called Cognitive Concierge focused on specific conditions. It uses a cloud approach to data, absorbing it from many facets and recommending insights on the user’s condition and the environment. So if you have asthma or chronic obstructive pulmonary disease (COPD), Cognitive Concierge 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.
Taking the pulse of cognitive apps
Machine learning is also providing extensions to physicians’ ability to interpret images with viewing diagnostics such as medical imaging. Enlitic is using advanced machine learning to find signals in medical images that radiologists might miss. Unlike machines, the human mind cannot effectively look across all images of all patients and identify critical patterns. Welltok and Watson Health are also heavily investing in the generation of cognitive applications, with early interest in high stakes decisions, such as helping to review protocol selection options for oncologists. The race is on to make an advisor that patients will welcome into their world.
Other applications available today are cognitive tools that are working behind the scenes to match content with need. For example, the ability to offer education or entertainment to an individual is being adapted to optimize prioritization of the videos that can help patients better understand a disease based on their level of understanding, and at what stage they are battling the disease. Some offer cartoons illustrating how protected their cells are based on their adherence to HIV medication regimens.
Breaking through adoption barriers
Roadblocks to reaching the state of machine nirvana are 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 regarding operating procedures? They either need to have an army of people reading every legal document and every internal policy for discrepancies, or they have to train a cognitive assistant to help highlight where potential gaps occur, and then use humans to confirm gaps and figure out how to remediate issues.
Just as cognitive computing is taking center stage for the banking industry, it will take center stage for health care, helping to address issues around privacy and compliance with Health Insurance Portability and Accountability Act (HIPAA) requirements. These compliance rules will be embedded into the AI that communicates with patients about their health. As a result, reporting of adverse events and dangerous health situations can be streamlined, getting the information to qualified professionals who can mitigate issues quickly.
Put me in, coach!
So here is a summary of why my Cognitive AI health coach is coming and accelerating as it comes…
The patient wants to be engaged in his or her preferred context and not have to actively seek out health and behavioral information
Gleaning the patient’s intent and reality of mood will best come from hearing things he or she says and being able to cognitively process speech vs. asking for complex forms to be completed
Knowledge bases are consolidating in clouds that an AI assistant can pull from
Sensor devices are everywhere, and only an AI can really make sense of them
Speech recognition is coming online for hearing what we are saying
Image recognition technology needed to identify useful information in our world is progressing rapidly
The large volume of potential recommendations for non-critical decisions will be a ripe place to filter using a cognitive AI
The rest of consumer components are going down this path, so health care would be well advised to piggy back on the progress of these other industries
Compliance issues are going to be some of the first cognitive use cases, so this important area will be embedded into the Cognitive AIs
The researchers’ idea was simple: improve mum’s and dad’s parenting to improve the social skills of the child.
Dr Catherine Aldred, a consultant speech and language therapist with Stockport NHS Trust, stressed it was not about blaming the parents.
“We’re taking the parent’s interaction with the child and taking it to a ‘super’ level, these children need more than ‘good enough’, they need something exceptional,” she said.
Exceptional is hard work. Parents were recorded with their child, who might have been sitting, playing alone.
But mum and dad were then shown a highlights package of the easily-missed moments when the autistic child subtly moved to play with their parents.
Communication specialists then worked with the parents to give them the skills to get the most out of these brief moments.
In small steps, it eventually moved on to getting the child to speak more.
Louisa told the BBC: “You notice things you wouldn’t notice in real time.
“Things like waiting, giving Frank plenty of time to communicate and commenting rather than questioning him, which puts on pressure to respond.
Connie’s comments: When I was a childbirth educator, I stressed the importance of conscious parenting, being attentive to your children, use massage, sleep with your babies and communicating with them in positive and healthy ways.
We cannot leave our seniors at home without a compassionate and caring caregiver 24/7. We also need to senior safe our house to avoid falls and other accidents/emergencies. Leave contact information and medication list/schedules to a caregiver and another copy in your refrigerator and a copy of medication list in the purse of your mom or dad.
When choosing a caregiver, trust and compassionate care are important. Call 408-854-1883 or email at email@example.com if you need a caring caregiver for your seniors at home alone.
In promoting my senior care services, I asked others where to advertise. Caregivers hotline, newspaper, craigslist and other online social media can help promote a business. I started with word of mouth and giving out seminars on Caregiving tips. Meeting seniors in senior centers and their homes also helped in finding clients who need caregivers because they have hospice care or living alone with Alzheimer’s or Parkinsons. Their family would call me from my craigslist ad. I will go to their house and give tips on senior proofing the house to avoid falls and ask them what they are looking for in a caregiver and what the needs of their parents are.
Some of my business owners friends like and dislike YELP.com
And I am trying yelp this time to have a good start for my business in 2016.
Motherhealth caregivers for hourly or live in care, 408-854-1883
Many seniors are in a dilemma to downsize or not considering the cost of living in the bay area. Health wise, seniors are not mobile as they used to be. In case of any medical emergency, they need to act fast and be close to a hospital or health care facility. Many emergencies happen during the night and early morning and signs and symptoms cannot easily be detected by family members.
The cost of houses in the bay area skyrocketed that it is common sense to sell an expensive home and live in a small unit and use the sale of the house for health care costs and retirement income.
Many young couples opted for smaller affordable homes to be able to have enough money for other important expenses.
It is sad that many families in the bayarea are spending half of their income on house rent. Many older generation plans to move out of the bay area to downsize and spend their retirement money wisely.
In care homes, many seniors have sold their homes to pay for nursing homes.
In the bay area, half of the jobs are contractual and families have to move from city to city to find an affordable place to live.
Some of those who stayed prefer their parents, who are now grandparents, to care for their babies and waiting for the time when they do not need babysitter to move away from expensive houses in the bay area.
Many take two jobs and spend less time with family to pay for house rent.
Others use every room in their house as rental income to supplement their income and pay for mortgage or get extra retirement income.
Others use airbnb or live in a rented room while they have their house being rented out for income.
What will you do to afford the housing costs in the bay area? Email firstname.lastname@example.org
For caring caregivers for homebound bay area seniors, call 408-854-1883.
We need a companion, home helper or caregiver for our 70plus mom and dad who live alone to avoid emergencies, to allow us to function and take care of our bodies too in the same way we care for our parents, to give more quality time to our aging parents and to provide the necessary care (non-medical) such as exercises, walking,massage,assistance in daily living (bathing, feeding, others).
Having an Alzheimer’s or Parkinson’s disease is very challenging. We want to avoid the following when caring for seniors with degenerative disease:
Many medications have side effects such as dizziness, headaches, feeling tired, contipation and more. When the legs are weak due to health issues and exacerbated by lack of exercise and over medication, fall can happen when there is no assisted device such as cane or rollator, living alone and lack of energy from the body (lack of iron, mental health issues, digestive health issues, lack of sleep, others).
Sometimes older adults are addicted to pain killers or other medications when not supervised and can result to emergencies for them and the people around them. Living alone can also exacerbate the issue.
Lack of assistance in daily living leading to more issues
Just having a companion can mean a lot to a senior who lives alone. They need constant interaction and be read to and have someone to walk or exercise or drive around town. Bathing and dressing will be more difficult based on the health condition. Many times during the night, seniors get up or need to be changed (diaper changed) and have to be calmed due to anxiety issues (major issue). Caregivers know that constipation can lead to many more health issues (mental,physical and aggrevation of current health issues). They constantly monitor whether the client is breathing properly, responding well, has appetite, need to be warmed or has a UTI.
Stories from caregivers
One client was told by his doctor that he has only 6 months to live. His caregiver started him on a healthy diet of greens and healthy protein. He lived for 5 more years. You will hear the caregiver talk to him daily, Do you need anything Henry? Are you cold? Do you need your food now?
Contact Motherhealth caregivers at 408-854-1883 for holistic caregiving to your homebound bay area seniors. email@example.com