AI and robotics will shape the future of healthcare delivery, but only if we let them, argues PwC’s Brian Pomering.
Would you trust a diagnosis if it was given to you by a robot? How about letting that robot draw blood, stitch a wound, or operate on you by itself? According to research by PwC, more than half (54%) of people surveyed in Europe, the Middle East and Africa are willing to engage with AI and robotics for their healthcare needs, and close to half and up to 73% would even be prepared to undergo minor surgery performed by a robot.1
There is no doubt, then, that AI and robotics will come to have a dramatic effect on the way we deliver and experience healthcare in the future. AI and robotics could make healthcare more accessible, treatment more affordable and diagnoses more accurate, but unlocking this potential will require a step-change in the way governments, health professionals, businesses and the public alike think about healthcare provision, and a significant number of obstacles will need to be overcome if the true power of technology is to be realised in practice.
Here, Brian Pomering, health industries consulting leader at PwC, shares his thoughts on the future role of AI and robotics in healthcare and explains why failing fast might well be the key to turning new technologies into a success.
Which areas of healthcare do you see AI and robotics as having the biggest impact on?
We’re still in the very early days of the influence that AI and robotics is going to have on healthcare, but it’s accelerating at the most frightening and amazing pace, and every day something new is emerging.
Indeed, their impact is already beginning to permeate in lots of ways: Apple watches are saving people’s lives,2 and AI is being used to diagnose cancer and heart disease.3
This can’t come soon enough. In the UK, the pressures on the NHS – particularly the big increase in the number of patients needing care – exemplify the need for something that’s going to be a radical change and something really different.
In the week leading up to Christmas, NHS Scotland saw 20% more A&E attendances than it did over the same period last year. We simply can’t afford to put another 20% worth of funding into our NHS. AI and robotics will allow more care to be delivered within the current cost envelopes – but whether that’s sustainable will I think depend hugely on how exactly AI and robotics are used.
First we’ll start to see AI and robotics have an impact in terms of physician support. That is, before the benefits translate to consumers, they will help doctors to make better sense of complex diagnostic information and enable better decision making. This is a great advantage: the rate at which our medical knowledge is developing makes it impossible for any doctor to ever truly be at the cutting edge, but AI and robotics can change that.
The second healthcare area I expect to see AI and robotics have an impact in is manual processes, i.e. helping to process financial transactions or health records. That could be in the form of machine learning, robotic process automation, or so on, and should contribute to cost and time savings.
We already know that the public is largely willing to engage with AI and robotics for their healthcare needs; what factors are influencing that decision?
Willingness certainly varies depending on which country you ask. We know that the UK is far more sceptical about using new technologies than countries in Africa or the Middle East, for example: just 39% of the people we surveyed in the UK said they were willing to use AI and robotics as part of their care compared to 94% in Nigeria and 85% in Turkey. Ultimately what that comes down to is access.
At the macro-level, our research also found that people in Scotland and Wales are generally more willing to embrace the use of AI and robotics than those in England, which relates back to how easy it is to gain access to the healthcare service in your area and how long you have to wait for appointments.
We in the UK shouldn’t look away from the fact that we have a wonderful health system: our healthcare service is the best in the world in terms of outcome delivery relative to proportion of GDP spent, and the Commonwealth Fund has consecutively ranked it the best, safest and most affordable. Perhaps because of that, there’s a reluctance to change.
People in the UK like what they have, whereas in Nigeria, which we found to be the most willing to embrace AI and robotics, people’s attitudes are very different. Over there, people understandably feel that being able to interact directly with a machine or a robot is better than not being able to interact with anything or anyone at all, and the clinicians, who are significantly overworked, see AI as a way of alleviating the pressures they’re under and enabling them to achieve more. The more the NHS begins to come under pressure in this country, the more willing physicians and patients will become to embrace and engage with AI and robotics.
What will also prove critical to this is whether or not we have the robust infrastructure in place to make these technologies work. I’ll give you an example: one of my colleagues has a damaged ankle. She has private healthcare funding, but she needs a GP referral in order to see a specialist. She linked up to an online GP to see whether she could get that referral online, but the broadband infrastructure wasn’t sufficient, so three consultations in a row were interrupted. And of course that severely detracted from the personal experience of using a digital interface. Reliability is key to inspiring confidence in clinicians and citizens, and that is instrumental to adoption.
How do you expect AI and robotics to redefine the role of the health professional?
According to a piece of research we did last year at PwC, 17% of health and social care jobs in the UK are likely to be impacted by AI.4 We can’t shy away from that fact, but my feeling is that a lot of people will find that AI and robotics actually enable them to do their jobs better, to deliver more and better care, and to relieve pain quicker and more efficiently.
At the same time, those who don’t embrace new technologies may well find themselves being left behind, and they’re the ones whose jobs will be most at risk.
Some GPs are very nervous about new technologies because they don’t like the idea of non-medically trained patients having all this health data. A colleague of mine, who is also a part-time GP, is worried that this will actually increase the volume of work he’ll have to do because lots of worried well will be coming into GP surgeries, thinking they have such and such a disease because of something they’ve read on Google. This is where I think AI will be really key.
Really intelligent AI that can understand individual diagnostic data and analyse it according to all sorts of different variables – that might well be how we bring onboard sceptical clinicians who have been frustrated by the number of patients who’ve come across their desk and sought to diagnose their own condition without having any real medical understanding.
How can we best prepare the future healthcare workforce for the impact of AI and robotics?
It might well be that many of the things we teach student nurses and doctors today will in the future be performed by AI and robotics, so there is a big question around how we train people going forwards. Equally, the future use of AI and robotics might necessitate the teaching of new skills that we haven’t yet envisioned.
I think in addition to that, we’re moving now to a way of working where the career you initially train for might not be the career you ultimately end up in. That means that we need to create much more of a lifelong learning culture and society, wherein people are taught new skills on a regular basis.
To give you an example, the UK is short of something like 200,000 bricklayers. Originally, the thinking was that we could probably bring in a lot of the necessary workforce from other countries, but Brexit has complicated that. Now, it might well be that in ten or 15 years’ time, we won’t need many bricklayers, because the building industry will make use of more automated processes. Nonetheless, we still need to fill that short-term gap in order to deal with the housing crisis.
What we need, then, is to get into a culture – and this is true across all industries, not just healthcare – whereby we retrain people for multiple careers over their extended lifespan. The 1950s attitude of ‘job for life’ has been changing, but we’re still not where we need to be.
With these necessary changes in mind, can we keep up with the pace that technology is moving?
The NHS boasts some of the most advanced pieces of technology, but it doesn’t have the greatest IT infrastructure supporting it, and that’s holding us back. If clinicians are going to embrace AI and robotics, then we’ll need to develop a much more agile technology infrastructure and it might well look very different to the ones we’ve seen in the past. For instance it will be much more Cloud based, which will mean having fewer big data servers to manage but also new cybersecurity risks – and that brings further challenges. Again, we need investment to make that transition possible.
In terms of IT programmes, something that’s proved a problem in the past is that simply introducing a new piece of technology doesn’t necessarily change the way people use it. Instead of just digitising the old way of doing things, we need to invest in change management to retrain people to actually do things differently.
Innovation is accelerating at a rapid pace, and more and more opportunities are coming forward; at the same time, we have a system that is unable to cope with all of the demands that are being placed on it, that is struggling financially, and that simply doesn’t have the bandwidth and headroom in place to enable the transformative change that’s needed. There’s opportunity for real transformation, but we’ll have to overcome some big obstacles in order to get there.
How can healthcare realise the full benefits of AI and robotics moving forwards?
First of all we need to identify some visionary leaders who can see beyond the way things have always been done and truly imagine what’s possible. The NHS has a handful of these already, but they need to be better supported.
Second, it’s important that we don’t fall into a habit of pilotitis. A lot of hospitals have become almost paralysed by the speed of the innovation that’s happening. They’re scared to make a decision in case what is currently considered the best in class will next year be out of date, so rather than risk making a wrong decision they don’t make any decision at all. My advice would be to pick something specific, prove the return on investment, and keep rolling it out.
My last recommendation would be to just get out there: have a go, fail fast, and move on to the next thing. History has shown us that the most successful organisations in any industry are those that are constantly transforming themselves, those that are never satisfied with the status quo and are always pushing to do better. By contrast, organisations that aren’t prepared to adapt are the first to fold. Again, this is why having those visionary leaders is so important, because they are the ones who will inspire real change.
Health Industries Consulting Leader
This article will appear in issue 4 of Health Europa Quarterly, which will be published in February.