Abhishek Anand

@abyshake

Healthcare is a serious business. Should chatbots help?

It is more than just an internet research. You can’t (and shouldn’t) provide medical advice using a bot. So, can chatbots help in healthcare? Let’s try finding out.

When it comes to the health and well-being of your loved ones, what will you do? (img)

I am being a bit dramatic with that image, aren’t I?

But we do need to look at it this way itself. For any business to succeed, it needs to make sure that the psycological aspects and concerns of the customers are met before anything else. There is a reason why parents keep the number of a pediatrician handy and give them a call even for a runny nose or a prolonged hiccup. Are they overdoing it? Maybe. But when it comes to the health of your loved ones, you really don’t want to leave anything to chance. That is the same reason why people hire nurses for their parents who come via referrals from friends/family. You want to feel the assurance that you are putting the care of your loved ones in capable hands.

Just for fun, do this. Research three symptoms you have ever had on Google. The results would be the worse than the best horror movie you have ever seen. As a matter of fact, in my opinion, if you look long enough, every symptom research would lead you to ‘cancer’. And I have no intention of getting scared by a bot posing to be a proxy doctor.

CAN BOTS BEAT THAT?

Simply put — I don’t see that happening. I don’t know a single person who would be willing to live with the guilt or the fear that comes strongly attached to such a dramatic change in the modus operandi that has been prevelant in the healthcare industry for decades.

I wasn’t even comfortable with the attending giving me sutures for crying out loud. Despite the fact that the guy would have been doing the procedure at least a few dozen times every week, I didn’t care. I wanted a surgeon to do it and finally got the head of the department himself to take care of it.

Apples and oranges, I know, but conceptually speaking, it is the same thing. I would not want a bot making a medical suggestion for anyone.

ARE BOTS DOING THAT TODAY?

Not that I have seen, and Good Lord, I hope they never do.

There are bots out there that are ‘kinda’ trying to do that — Healthtap and Your.MD being two prominent ones. But I am not sure if this is something that can or should be done by a bot. More on these chatbots in a story on Monday — July 24.

SO WHY THE HELL AM I MAKING A FUSS?

Health bot.
Healthcare bot.
Medical chatbot.
Chatbots for patients.
Chatbots for health.

Have you come across these terms in recent past? Chances are, you have. And that is why I am being fussy.

When you think of health, when you have a medical problem, when you think of a clinic or a hospital, what is the first picture that comes to your mind? It is that of a doctor. (Followed by the image of a needle. Yes. The needle flashes even before you can think of the nurse.) And that is the whole point.

When we talk of a healthcare bot or a medical bot, there is some expectation that on some level, you would be getting the kind of services that a doctor offers you. And as soon as that thought has crept in, you think — But that’s insane. How can a bot prescribe medicines? Turns out, it was not going to; but it doesn’t matter, does it? As soon as you think health, you think doctor, and the way these bots are being named, the ambiguity and confusion is bound to set in.

As preposterous as it may have sounded — think. If I were to ask you to name the first five people you can think of when you think of a hospital, how many of you would name the legal counsel, the guy handling the accounts, the guy who hands you the in-patient check-in form etc in those top 5? Your ‘healthcare bots’ of today essentially belong to the same group — support staff.

WHAT IS IT THAT BOTS CAN DO?

The bots can indeed be very helpful in this domain. There are numerous activities that happen in your healthcare process that have zero inolvement of the doctor, and most of those processes are time consuming. A bot can ease up on the pain and hassle associated with every single one of them (and then some).

Some examples from the top of my head:

I’ll dive deeper into the first point, but to prevent this story getting really long, I would be skipping on the others. If you want, you can read a detailed note on each of the points, you can find them in the second part of this story — published tomorrow, July 23. (Link would be updated in the story once it is live)

#1. Finding a doctor, and making appointments

There are multiple routes to setting up an appointment, the most useless of all being the scenario where a patient is asked “Which doctor would you like to set an appointment with?

Why is it useless?

  • If this is my first time, I have absolutely no idea on which all doctors do you have, who are the most experienced ones etc.
  • Even if it is not my first time at your establishment, it is possible my last visit was for a simple procedure, but this time I am looking for a specialist. Once again, I have no clue.
  • I noticed you are the closest hospital/clinic, and I simply called or dropped by. Because — surprise surprise — I need medical assistance. Can I just get that please?!
  • If I had a preferred doctor or if it was a follow up visit, I would have said that, wouldn’t I? So, I clearly don’t have a favorite flavor of medical practitioner in mind.

A chatbot can help here.

It will know which route should the process be directed to based on:

  1. The patient straight away asking for a particular specialty.
  2. The patient describing some basic symptoms based on which a few simple rules will help the chatbot know what to do next. For example, I have a sore throat for the past two days and now I am having difficulty swallowing food.
  3. The bot can ask some basic questions and based on the patient’s response the speciality can be determined.

Now. More often than not, a patient would prefer to get an appointment as early as possible. A few simple quick options on the doctor — date — time combo available slots would be good enough for the patient to make a decision.

Processes such as a new registration etc would come under the wide array of services offered here. And unlike filling up a form while waiting in the ER, the patient would be able to do this from home, office or on way to the ER in his/her Uber.

Similarly, services like reminders on scheduled appointments, changing/canceling appointment etc. — everything can be done using the chatbot.

#2. Assistance with procedures recommended by the doctor

Blood tests, suggesting various diagnostic labs, booking a visit for collection of blood sample etc.

Goes on to informing the patient when the lab results are out.

Can include a variety of activities and services here.

#3. Follow up to check on improvement in the state of the patient

Is the medication helping? Is there any alleviation in the severity of different symptoms etc.

Helps in identifying if a visit should be recommended sooner than previously anticipated, and/or if the medicines need to be changed. (and, a less likely but probable scenario of incorrect diagnosis)

#4. Post-op care and answers to questions

What should a person eat, what circumstances to avoid? What to expect post any procedure?

How much dosage of a particular medicine to take, reminders on when it is time to take a medicine etc.

#5. Help with OTC medicines

Can I drive after taking a particular medicine?

Can I take tablet X for my headache while I am on this prescription.

#6. Act as a 24x7 repository to historical health data

What were my blood-sugar levels in the past 12 months?

A good thing to have: A closer interaction with wearable health tracking devices.

#7. Answer questions and provide support on medical equipments etc.

Where can I get my wheelchair serviced from?

Which nebulizer should I get for my condition?

WOULD THIS HELP?

Of course. Just remember the last time you had a medical condition taken care of. You spent maybe 10% of your time with the doctor, the rest was spent dealing with the administrative aspects of it, getting the prescriptions filled, taking care of the billing processes, booking next visits and an array of other activities. A well functioning chatbot can drastically reduce the frustration and time involved in all such activities.

WHAT WOULD BE AN IDEAL SCENARIO?

An ideal system would be one that acts as a central repository — irrespective of the clinic, hospital or doctor the patient is seeing at the moment.

Why?

  1. No need to complete the registration process every time. All the details needed are there (if the patient has registered at any center in past using the bot) and can be exchanged between the chatbot and the clinic’s system.
  2. The complete patient history is available at all times including previous lab results, diagnoses, allergies, pre-existing conditions, genetic history etc. An added layer could be taking a consent from the patient every time, instead of directly sharing it across with the new doctor/clinic.
  3. The bot would be able to recommend other doctors based on urgency, proximity, availability etc.

But probably that would be too much to hope for. After all, no matter how much of a noble profession, clinics and hospitals are businesses at the end of the day and a system that talks of eliminating any and all competitive advantage might not be something that would excite many.

These things are indeed needed, but as I said, may be we need to think of a name more apt and less prone to suggestiveness.

That’s it for today; see you tomorrow.

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