The NHS announced at the top of this month that it would test Babylon Health‘s ‘chatbot’ app for the next six months to 1.2 million people in north London. During the call to the 111 medical hotline number, they will be prompted to try the app, which invites the user to text their symptoms. The app decides through the series of texts, through artificial intelligence, in minutes how urgent the situation is and will recommend action to the patient up to an appointment with their GP, or if acute to go to Accident & Emergency (US=emergency room or department) if the situation warrants. It will launch this month in NHS services covering Barnet, Camden, Enfield, Haringey, and Islington, London. TechCrunch.
The NHS’ reasons for “digitising” services through a pilot like Babylon’s app is to save money by reducing unnecessary doctor appointments and pressure on A&Es. It provides a quick diagnosis that usually directs the patient to self-care until the health situation resolves. If not resolved or obviously acute, it will direct to a GP or A&E. The numbers are fairly convincing: £45 for the visit to a GP, £13 to a nurse and £0 for the app use. According to The Telegraph, the trial is facing opposition by groups like Patient Concern, the British Medical Association’s GP committee, and Action Against Medical Accidents. There is little mention of wrong diagnoses here (see below). The NHS’ app track record, however, has not been good–the NHS Choices misstep on applying urgency classifications to a ‘symptom checker’ app–and there have been incidents on 111 response.
Babylon’s founder Ali Barsa, of course, is bullish on his app and what it can do. Employing 100 AI researchers, he intends “to create the world’s largest repository of medical knowledge, a superhuman doctor who can triage, diagnose and even treat you via your phone” using billions of data points collected from the thousands of test consultations it has done every day since its launch. Babylon claims for the full app (which includes video consults) a 92 percent accuracy rate. (The NHS version does not include the video consults.)
The Financial Times writer seems to be equally bullish on the possibilities, having successfully resolved her indigestion. She views the Babylon/NHS service as a ‘reliever’, pointing out that one in five Britons can’t access care when they need to, one in eight are misdiagnosed and medical errors are as bad as in the US with 1,000 people a month dying in the UK and the third leading cause of death in the US, citing the British Medical Journal 2016 study.
The rest of the FT article extends into the Dr Topol-esque vision of ‘The Patient Is In’ charge of their own health, with the phone being a hub of medical records, lifestyle, location and physical environment monitoring. Included with Dr Topol are AliveCor, Philips‘ new body scanner Lumify, miniaturization of fluid analysis such as Biomemes for STDs and Zika virus, IBM Watson Health and–excitingly for fast sepsis diagnosis, Oxford Nanopore Technologies’ MinION, a USB-stick-powered device that can sequence DNA in real time to spot anomalies. Also included are CliniCloud’s digital stethoscope and Cupris Health for ear visualization. Even data security is touched on here. If the FT article is paywalled, search on the title “How smartphones are transforming healthcare”. Hat tip to reader Susanne Woodman, our leading contributor on UK tenders.