Insights

Mark Raeburn: 8 minute read

Artificial Intelligence and the possibilities of billions saved in health and social care

2050. It seems like a long way off but like the impending storm that is Brexit, it will be here sooner than we know. Experts in the sector believe that this will be a key year for Artificial Intelligence (AI) as this is the year that experts predict AI will be able to perform any intellectual task a human can perform.

Anything and everything any person has ever done in all of history — all of it doable, by 2050, by intelligent machines. Whether or not this is realistic is not the question, what AI can realistically do today is what everyone should be focused on. We are.

What can AI do today?

The biggest consumer example of Artificial Intelligence that is available commercially in today’s society is the Google Home and the Amazon Echo. The electronic assistants can learn from your speech, deliver results on your questions, set reminders and make phone calls. They are widely available and represent the first generation of this technology.

Other variants include the NEST Doorbell in which you can take deliveries and answer the door when away. The NEST Thermostat allows you to control the temperature of your house with the click of a button and your car can be controlled through intelligence. The latter of which has yet to be launched commercially but has been tested.

From Japan, we have artificial intelligence in robotic form. One of the prime examples of this is Pepper the robot. He can perceive emotions and adapt his behaviour accordingly, being primarily designed as a companion. From this initial starting point, Pepper has been used across the world for various applications.

In Belgium, he guides patients to different hospital departments, welcomes bank customers in Canada and sells coffee machines in Japan. He is able to speak 12 different languages and can remember personality traits, even being known to dance to Gangnam Style. It is a promising piece of technology that is in its early stages but even in its early stages can have wide-reaching benefits.

How can this be applied to health and social care?

A report by the Taxpayers Alliance highlighted that a tenth of the NHS budget could be saved through the automation of more services. This is a staggering figure and would, in practical terms represent a saving of £13.4 billion, based on estimates from the 2019-20 budget. This amount of money is not to be taken lightly and could be re-applied to other areas of the service and help to fund additional nursing staff.

In an era when the number of nursing staff in health and care is spread dangerously thin, extra staff is essential. The whole purpose of the health care industry is to provide support for those who need it and to do that you need nurses and doctors in addition to care providers. These are the people on the frontlines and those who will be providing person-centred care. We need more of them and saving money from the budget at this time will help us to increase staffing levels and increase the quality of care available.  

AI is next-level automation where the software makes decisions based on complex algorithms, rather than the cause and effect paradigm of standard automation tools. By utilising technology and Artificial Intelligence we can automate some of the tasks that take up clinician’s time and take them away from what they trained to do. In country’s such as Japan, care is becoming integrated into the community and technology has become a key part of this.

What does this look like?

Sensors can be placed on the individual that monitor their heart rate and blood pressure, with any deviation in normal levels triggering an alert. On top of this, motion detectors and AI can analyse how people walk, and recorded facial analysis, helping to identify risks of fall or stroke. All of this would have an initial cost but in the long-term, saves money as you need fewer nurses on-site.

In addition to requiring less staff on-site, it gives those in care a measure of freedom back, as well as peace of mind for the relatives. Family members can be alerted at the same time as the clinician and be provided with updates on their loved one. The individual in care is provided with access to technology throughout the room too, such as Skype to call a loved one.

Technology such as this can be used in the care provider setting, in addition to keeping people at home. They could be provided with iPads that link to Skype and virtual assistants that remind them to take their medications, in addition to sensors that monitor their movements and check their vital signs.

All of this technology is currently available and can be applied to people’s homes today. It comes with it a number of privacy concerns such as how secure are the feeds and who would have access, as well as how it would this be monitored. On top of this, it would include a cost to implement but there are always downsides to everything in life.

These are just a few of the options currently available but the future holds far greater possibilities with it.

The use of Pepper in Southend-on-Sea

The future has many exciting possibilities associated with it in regards to health and social care but for some, a part of that future is here and in use at Southend-on-Sea borough council. There they have set Pepper to work and not just for his dancing skills. He has many of the skills and characteristics of a model social care employee.

Pepper was initially chosen in the hopes that he could be used for community engagement, awareness-raising and to facilitate reminiscence activities. During his demonstration, Pepper displayed video clips of the 1966 World Cup final and the Moon landings on the in-built android screen. In addition to this, they were developing a memory game for older people that could be displayed on his screen. As the technology and people’s imagination continue to grow, so will the tasks that Pepper and others like him can complete but do they have a limit or is the future endless in terms of possibilities?

What could the future look like?

The future will be able to deliver greater change than what is indicated here in this article. We could create robotic nursing staff for each person in care. This would, of course, come with it privacy as well as moral concerns but in the main, it would provide company for those in care. It would never forget any medication required and be able to monitor all of the vital signs of that individual. Having widespread access to this technology would, of course, be years away but it would have serious cost-saving applications and help to deliver person-centred care.

All citizens could be provided with a monitor at birth that records vital signs and any deviation is alerted to a medical practitioner. They can then make a diagnosis based on average vital signs against the registered defect and prescribe a cure before the person knows that they are ill. This technology is in its infancy in a form as those diagnosed with diabetes are able to monitor their blood-sugar levels via a monitor on the arm that links to an app. It can remind the individual to take their insulin and alert them to any spikes.

If large portions of sickness are dedicated in an area then AI could in combination with the aforementioned ‘app’ that monitored all vitals alert nearby professionals to a potential outbreak. It could automatically trigger quarantine protocols, whilst at the same time analysing data and searching for a cure.

The possibilities are endless but that is the future and right now technology is in its infancy and it will be a long time before items are available to everyone. At present, AI is struggling to develop against a wave of budget cuts and so you need to be careful when you are approached by a salesman promising that their AI solution will change your world.

Should I believe all of the promises out there?

No.

As a short response. Not everyone is selling a promise that they can deliver upon and that may not be intentional. As we have mentioned in here, technology is in its infancy and a lot of the analysis and detection is available but pre-emption is not quite there. We are unable to monitor vital signs centrally and pre-empt diseases.

We also cannot predict which children will need to go into care through an algorithm.

Algorithms are the expression of assumptions of those who construct them. By utilising them in the social care context you reduce the problem to one of an accurate fit. To expand on this further, you would create a set of variables and if a child sat within these variables then the algorithm would place them in this box and assign them help.

These variables would be created from data that is placed within a system and would no doubt be based bias relating to poverty and deprivation. Trouble is, considering whether a child needs to be placed into care is more than a simple matter of analysing data. One tool developed in New Zealand was only 25% accurate over the course of five years, leaving 75% who were identified as high risk, having no findings attached to them.

Data is essential for all of us, in any job that we do, it helps us analyse trends and patterns, in order to re-arrange resources to be most effective. At present, it is mainly reactive but still forms a critical part of a social worker’s job. They need up-to-date information relating to that individual and have that available wherever they are. Having to head back to the office to access the administration system is inefficient and AI can help to speed up the process and automate certain tasks.

This is the promise of Artificial Intelligence in 2019, delivering time back to the professional to spend with those in need. An individual should not be held responsible for belonging to a ‘high risk’ group or living in an undesirable area. To judge this individual and take their children away before they have been heard by another human or offered help would be unethical.

In conclusion

Artificial Intelligence and future sight is the long-term promise of technology. To be able to monitor your health from a central point and have a diagnosis and treatment available before you arrive at the doctor’s is the dream. Major benefits from AI in social care is something that we are many years away from implementing with predictive algorithms in their infancy.

There will be more and more ways technology like Pepper and algorithms can be used in social care but should local authorities be investing in it for social care? At the moment we believe no, but in 5 years time when the experts thinking has evolved, we believe our advice might change.

Our recommendation is that there should be clear guidelines on IT decisions that local authorities should be making given the funding position.

  1. Will the tool support me?
  2. Will the new technology dramatically improve the service and deliver savings through changes in processes?

or

  1. Does the new technology create tangible savings, whilst at the same time not creating a detrimental impact on service?

Innovation is important/essential to the sector, but given funding resources, we need to wait for AI to mature and evolve. We see AI as a key part of the future, but at the moment it is not a mature enough industry that can guarantee results. Unfortunately, social care does not have the money, time or resources to invest in areas likely to fail.

As the recent Ofsted report of Children’s Social Care from the London Borough of Lewisham highlights, performance and efficiency are key. The Ofsted report stated the council’s system was “subject to frequent system failures”, which meant that “records may not be up to date, recording takes a disproportionate amount of time, and performance information may be inaccurate".

What we have at present is technology available that can transform your processes, support your workforce and through cloud native technology offer unrivalled availability and processing power.

Social care is a people business. Whilst technology has significant benefits to the sector, there are limits to what it can do at this time. The answer is having the right process, supported by the right technology which will, in turn, reduce administration and enable real conversations. This is what is required in order to maintain person-centred care.