Thursday, July 07, 2005

New idea - online robot doctors

[See previous]

The idea of an "expert system" for medical diagnosis has been around for a long time. But it has been hard to find public examples. Here's a simple one that has come online recently in the "vitamins and minerals" space.

Health Web site launches online diagnosis

From the article: This is an incredibly primitive system (not an expert system at all...) but it is getting press and it definitely shows that people are interested.

What this has me wondering is the following -- could several teams or companies (Google? Microsoft? WebMD?) put full-blown digital doctors online to analyze symptoms and attempt diagnoses? These systems could compete against each other in the Grand Challenge sense and improve over time, until we come to the point that they are right 50% of the time, then 60% of the time, then 70% of the time...

Eventually these systems would become better than human doctors, because they would be able to account for all sorts of drug interactions, side effects, etc. that the human brain cannot manage. These robotic doctors would eventually replace human doctors and improve health care in the process.

We've been hearing about this as a possibility for 30 years. How long will it be before something like this actually happens?

I do not see this as particularly likely to replace flesh and blood doctors. Most folks want the one on one interaction with a physically present doctor because a lot of their ailments may be hypochondria or something not all that serious. It is a lot more reassuring to have a doctor tell you you are fine than a machine.

Having it as a service would be nice, though.
This isn't an expert system any more than your page is an expert system on making money. This is just a web page with (possibly) useful information.

MYCIN was an early medical diagnosis expert system, and you will learn about it in any undergraduate AI class. Research continues in expert systems. The biggest cost is gathering the expert knowledge. That cost could be reduced by creating system that can read texts or learn from experiential evidence. AI researchers have been working on those problems for decades too. There may be a huge breakthrough just around the corner, or we could keep getting incremental improvements for several more decades.

It is more likely that human doctors in cheaper economies would be used as cheap expert systems in the near future.
Marshall is right, you could save hundreds of dollars with this system instead of going to the doctor. Obviously people won't be able to diagnose every problem, but if I had a chance to save a few hundred bucks I would do it in a heartbeat.
I think the reason this has not been done so far has to do with liability issues. None of the big companies probably want to risk the lawsuits that would inevitably pop up. Of course, maybe some enterprising insurance carrier could start offering "internet malpractice" coverage?

Another issue seems to be that doctors as a whole seem to be fairly net illiterate (at least the ones I know). Other than playing golf video games, my sense is that the majority of docs leave the "techie" stuff to their staff or kids. I'm still looking for a doc that I could email a quick question to or schedule my appointment on-line.

I think that a paradigm shift could happen if some young, tech savvy doctor wrote a "best practices" book that showed doctors how to use computer and internet technology to their advantage, and how they might be able to actually make money and serve patients better.

In answer to Marshall’s question: 5 years.
I don't think this is a technological problem; it’s a matter of economics. It’s all about money. We don’t have a truly free market in health care. The price system is currently not being allowed to function properly.

If it cost a person $20 for an online diagnosis, but $50 for a face-to-face one, it’s clear that over time people would choose the cheaper option. Correct me if I’m wrong (I’m Canadian), but people generally don’t pay directly for medical services in the US. The insurance companies pay, and in general employees have their employers select and pay for their insurance policies.

The consumer of health care is disconnected from directly paying for the final service. If the consumer can’t save any money by going online vs in person, why not just visit a doctor in person?

From the doctors perspective, they are less likely to setup this type of service because the market for it is much smaller than it should be or perhaps doesn’t exist at all.

A possible fix would be to end the tax exemption that companies get when they provide health insurance to employees. Let people decide themselves what is worth paying money for. The result could be faster progress and more innovations in health care.
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