Robots, robots, everywhere…even when they’re NHS 111 online algorithms

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”150″ /]The NHS continues to grope its way towards technology adoption, gets slammed–but is it justified? The Daily Telegraph (paywalled–see The Sun) revealed a draft December NHS report that recommended that the NHS 111 urgent non-emergency care line’s “enquiries will be handled by robots within two years.” Moreover, “The evaluation by NHS England says smartphones could become “the primary method of accessing health services,” with almost 16 million inquiries dealt with by algorithms, rather than over the telephone, by 2020.” (That is one-third of demand, with one-quarter by 2019.)

Let’s unpack these reported statements.

  • An algorithm is not a ‘robot’. This is a robot.[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”100″ /]
  • What is so surprising about using algorithmically based questions for quick screening? Zipnosis in the US has been using this method for years as a pre-screener in major health systems. They call it an ‘online adaptive interview’ guiding the patient through branching logic of relevant questions; a provider can review the provided clinical note and make a diagnosis and treatment recommendation in 2 minutes. It also captures significant data before moving to an in-person or telemedicine visit if needed. Babylon Health uses a similar methodology in its chatbot-AI assisted service [TTA 26 Apr 17].
  • Smartphones as a primary means of accessing health services? How is this surprising when the Office of National Statistics says that 73 percent of adults use the internet from their mobiles? 51 percent go online for health information.
  • Based on the above, 66 percent would still be using telephonic 111 services.

It seems like when the NHS tries to move forward technologically, it’s criticized heavily, which is hardly an incentive. Over New Year’s, NHS 111 had a 20 percent unanswered call rate on its busiest day when the flu epidemic raged (Sun). Would an online 111 be more effective? Based on the four-location six-month test, for those under 35, absolutely. Yes, older people are far less likely to use it, as undoubtedly (but unreported) the disabled, sight-impaired, the internet-less, and those who don’t communicate in English well–but the NHS estimates that the majority of 111 users would still use the phone. This also assumes that the online site doesn’t crash with demand, and that the algorithms are constructed well.

Not that the present service has been long-term satisfactory. David Doherty at mHealth Insight/3G Doctor takes a 4G scalpel to its performance and offers up some alternatives, starting with scrapping 111.

Chubb upgrades fall detector to identify, cancel a false alarm (UK)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/11/Chubb_07112016_Comm-Care-independent-living-image-wrist-fall-2.jpg” thumb_width=”150″ /]Chubb Community Care on Monday announced an upgraded fall detector which can both identify and if appropriate, cancel a fall alert alarm. “During the first 20 seconds of an incident, cutting-edge algorithms perform silent analysis of the situation, recognising if an individual is back on their feet,” according to David Hammond, general manager, in describing how the system differentiates a fall from a false alarm.

The self-cancellation software has been improved to help differentiate between types of movement, for example if the person is moving on the floor where help is needed, which may apply to epileptics having seizures, versus standing up and mobile. The wrist-worn device also has a standard button alert to summon help. If an alarm happens, it has a confirmation feature that indicates that help has been called by flashing a red light and vibrating for 20 seconds. The user at that point can manually cancel the activation or let it continue. According to Chubb, the product is presently in-market.  Release.

Diagnosing Parkinson’s in a 30 second phone call

…and with 99 percent accuracy is the claim made in this TED video by Max Little, an applied mathematician who has devised a voice test/analysis explained in this video. The challenge is to enable early diagnosis as there is no blood test and other diseases can mimic Parkinson’s disease. Neurological tests must be done in a doctor’s office and cost $300. This is algorithmically based, non-invasive and uses precision voice analysis. Parkinson’s is one of the most widespread neurological diseases, affecting 6.3 million people worldwide (the Parkinson’s Disease Foundation estimates 7-10 million) with at least 1 million in the US and 127,000 in the UK (Parkinson’s UK). He now is examining 10,000 voices gathered on his website, the Parkinson’s Voice Initiative with Aculab and PatientsLikeMe. Mr. Little is a TEDGlobal 2012 Fellow and a Wellcome Trust-MIT Postdoctoral Research Fellow. TED Talks page. Hat tip to readers Bob Pyke and Wen Dombrowski, MD.

[This video is no longer available on this site but may be findable via an internet search]