UNIT V

Future of AI in Healthcare
Mining Records

Mining of healthcare information systems holds tremendous potential for medicine. Systems
hold considerable information about patients and their health, prescriptions, doctor’s notes, and more.
Healthcare data within such systems can be used to improve the quality of healthcare, reduce costs,
mitigate mistakes, and improve and democratize healthcare quality. However, knowledge discovery
from the data contained in such systems is currently challenging due to variations in complexity,
vocabulary, and standardization. Data mining provides an opportunity to extract relevant information
from both textual and image-based archives. Mining also enables the discovery of patterns from data
that can be used to build predictive models.
Conversational AI
Conversational AI refers to systems that can talk. Rather than a user interface based on text or
code input, individuals can interact with conversational AI system with their voice. Users are
increasingly using chatbots to communicate with products and services. Voice-driven AI such as
Amazon’s Alexa can synthesize natural language to provide recipes or exercise tips, order products,
or call a cab. The technology is catching on: 1 in 5 Americans owns a smart speaker, and there are
over 100,000 Facebook messenger chatbots.[147]
As AI chatbots develop, so too are their capabilities. Intelligent personal assistants will act as
healthcare assistants. By virtue of being voice-controlled, there are immediate applications for those
less-abled, where only the voice needs to be used to perform tasks or instructions. Within health,
conversational AI enables simple questions that do not need the attention of a doctor to be answered.
For instance, new parents could bombard a conversational AI with questions without fear of
embarrassment or consuming healthcare professional’s time. Questions such as what temperature a
baby should bathe in, how often a baby should sleep, or whether there are developmental milestones
taking place can all be instantly answered by an AI speaker. Many individuals turn to search engines
to find the answers to their questions. However, most patients who query symptoms are unaware how
to discern research quality and may come across conflicting evidence in addition to misleading
information (or fake news) that can leave patients confused. With the assistance of a medical AI
chatbot, patients can receive immediate assistance. Continuing the preceding example, if a child’s new
parents had a medical question or were concerned by a symptom (say, a chesty cough), it would be
burdensome for them to visit the doctor for a response to every question. However, there is a need for
medical confirmation. This cannot currently be detected through algorithmic means; and hence, the
evolution of conversational AI in healthcare will be digital health assistants supported by and learning
from healthcare teams and the world around them.
As conversational AI develops, cognitive systems will analyze conversation to detect early
signs of mental, physical, or neurological illness. Voice-enabled devices such as Alexa will one day
be able to identify symptoms of Asperger’s, anxiety, psychosis, schizophrenia, and depression from
conversational tones. This will assist doctors to predict better and monitor and track disease.
Imagine how much time and resources will be saved when virtual assistants, healthcare chatbots, and
digital tools give answers to basic medical questions that do not require the intervention of a medical
professional.
Making Better Doctors
AI will transform what it means to be a doctor. AI’s integration into medicine is making better doctors
and saving lives. From waiting times to prioritization, finding of evidence to maintaining
productivity,or supporting decisions—AI will assist doctors and healthcare professionals in making
informed decisions.
 Virtual and Augmented Reality
In the not too distance future, surgeons performing CT scans will be able to layer their scans over a
patient’s body via augmented reality; medical students will use virtual reality to explore the inside of
the heart and burn victims will be virtually transported to a snow-covered mountain top as a form of
pain relief therapy. Immersion into a completely digital environment, virtual reality, has mainly been
used for games. Innovation in augmented and merged reality means that we can now entwine the
virtual and physical worlds and manipulate both environments simultaneously. Virtual, augmented,
and mixed realities are increasingly being implemented in a wide range of medical applications. It is
already evident that as it is incorporated further into healthcare, it has the potential to change the way
many healthcare services are delivered.

Virtual Reality
Virtual reality (VR) is typically associated with gaming. In virtual reality, the user’s reality is replaced
by an immersive, entirely digital environment. This is currently achieved through a headset and
handheld sensors, which enable interactions within the environment.

Augmented Reality
Augmented reality (AR) overlays a digital or 3-D environment in the form of objects, video, or data
into the user’s environment. The user’s real-world experience remains central to the user’s experience,
and the information is added to the user’s existing reality to enhance their experience.
Information is distinctly digital and does not seek to emulate real-world objects. AR does not
necessarily require additional hardware and can be achieved through technology such as the mobile
phone. AR’s popularity was confirmed by the Pokemon Go app phenomenon in 2016. The game,
downloaded more than 800 million times, overlaid 3-D characters within the user’s real-world
environment through the user’s GPS location and inspired a wave of AR innovation.
Merged Reality
Merged reality seeks to emulate digital objects that can be interacted with. This requires additional
technology such as a headset. Separate sensors track hand gestures and movement. In a mixed reality,
the user can manipulate both the real-world and digital environment.
Pain Management
Research demonstrates that virtual reality environments can be used to reduce the amount of
pain a human feels versus a control distraction condition.[157] The somatosensory cortex and insula,
found in the brain, are linked to pain. Hence, through immersing patients in a virtual reality, VR will
be used to enable patients to endure painful surgery. Amputees often report pain in their amputated,
missing limbs. VR environments can be used to immerse the patient within an environment to better
cope with their phantom pains.[158] VR also works as a distraction. In the future, children and adults
alike will be given a VR headset from their doctor when receiving an injection to distract them from
the impending prick. Hermes Pardini Laboratories and Vaccination Centres piloted the use of a VR
headset that immerses the patient into a fictional, gamified environment.[159] The patient is distracted
in a virtual world to the point that they are often unaware they have received their injection.
Physical Therapy
VR can track human movement, allowing patient movements to be monitored and analyzed.
VR gyms have been opened in San Francisco and Ohio.[160] Rehabilitation will become gamified,
for instance, through kicking a virtual ball or catching a ball. Recovery exercises can be delivered and
tracked in a VR environment and retold to the patients if they were not to get it right.
Cognitive Rehabilitation
The application of VR and AR in fears and phobias is apparent. Performed as a medical
treatment, patients can be gradually exposed, known as graded-exposure therapy. Data from sensors
will be assessed to ensure patient safety and develop best practice.
Cognitive function can be improved for patients struggling to perform everyday tasks. For
instance, through monitoring the performing of patient tasks in a VR environment, a doctor could
determine declining memory loss and identify areas of concern or priority. Similarly, patients with
injuries to the brain or those that struggle with tasks can have digital environments created to represent
real-life scenarios. Patients can practice tasks and regain or develop cognitive function. Patient
engagement can be monitored and analyzed to observe areas of difficulty or reduced attention.
There are few randomized controlled trials that have been conducted into VR in cognitive
rehabilitation. However, some applications of VR are effective in treating cognitive deficits in people
with neurological diagnoses.
Blockchain
Transitioning of traditional patient health records to the EHR is considered to be enormous
progress for healthcare. The digitalization of patient records mitigates some of the traditional risks of
centralized data stores. However, this model still places the medical records in the hands of the
provider. Blockchain technology, popularized by the bitcoin cryptocurrency, has the potential to
revolutionize data access, privacy, and trust. Currently, blockchain is yet to be deployed for
mainstream healthcare.
Blockchain, fundamentally a collection of data records, is a piece of software formed by the
combination of several preexisting technologies that provide blockchain with its characteristic
features: an immutable, distributed public ledger whose authenticity can be verified by anyone: those
who validate the data on the ledger are rewarded with value, which helps create trust in a trustless
environment; distributed peer-to- peer control, which provides a high level of security; and the ledger
can be programmed to trigger automatic transactions in the form of smart contracts, allowing for a
widespread application of this technology.
PayPal, Visa, and Mastercard, for instance, act as central authorities for financial transactions:
trusted institutions that act as intermediaries. The land registry acts as the trusted store for details on
homeownership. These centralized databases are subject to being hacked or manipulated. Blockchain
technology aims to solve data management, privacy, and security issues, improving interoperability
and easing the flow of data between doctors, hospitals, healthcare systems, and insurance providers
through the use of a decentralized, immutable database. Patients are demanding increased access to
their medical health records, with iOS 11.3 even including an EHR feature.[163] Data from EHRs
IoT, wearables, and devices can be used within the ledger, in a trusted, secure, transparent, and
interoperable environment.
The blockchain is an immutable database that is stored and maintained by all those using it. Each new
transaction or piece of data is encrypted and then approved by a particular proof-of protocol
(consensus, work, stake) by other nodes on the networks that authenticate the transaction or verify the
stored piece of data.
Each node on the network has an identical copy of the blockchain; and thus, the transaction is
permanently recorded and linked to previous records. The links, known as hashes, are traceable back
to the very first block in the blockchain. Therefore, any attempts to tamper with a block in the present
would require the transaction and all related blocks to be also altered, on all records, distributed among
the nodes holding a copy of the ledger simultaneously. The longest chain of events is considered valid.
Blockchain implements crypto-economic and game-theory techniques. Any attempt to create a rival
chain would need to be created faster than the current version of the truth to be accepted. This would
require tremendous computing, energy, and resource commitments. Miners compete to validate
blocks. This good behavior is expensive regarding electricity and computing power, and so miners are
incentivized to validate blocks, rewarded with bitcoin (BTC; in the BTC scenario). Through creating
a common, distributed, immutable database of healthcare information, doctors and healthcare
providers have the potential to access medical data from any system, with improved security and
privacy, less administration, and better sharing of results.
Single points of failure are eliminated by decentralizing and encrypting the data.
The blockchain is democratized. Anyone can contribute or store a version of the truth.
Through ensuring consensus on events, the most likely version of the truth is held.
A transparent and auditable ledger of events is provided through time-stamping.
Game theory, crypto-economics, and hashing incentivize good behavior and ensure the events are
without censorship.
Blockchain technology has many applications in healthcare, with most technology currently in pilot
or proof of concept stage.

Verifying the Supply Chain

The first application of blockchain is verifying the supply chain. As the blockchain is created
in a chronological and auditable manner, it can act as a means of verification for components of every
link in the supply chain. The journey of materials or treatments, for instance, can be logged onto a
blockchain ledger, which could be used to identify fraudulent activity,
anomalies, error, or a break in the chain through data entry or IoT devices. For instance, the cold-
delivery chain of delivering insulin from manufacturer to pharmacy could be confirmed to be
untampered and appropriately cooled. This is currently being used in developing countries to combat
counterfeit medication. It is also being developed to enhance genomic data protection, addressing the
privacy challenges of big genomic data.

Incentivized Wellness
Blockchain technology could be used to incentivize wellness: through the use of a
cryptocurrency as a digital token of value. Engaging people with health services or a healthier lifestyle
could save the global economy a tremendous amount of money in healthcare costs. Health providers
or employers typically see the cost benefit of this in the form of savings or profit, and this is rarely
passed to the individual. By utilizing blockchain technology,tokens could be created and distributed
to patients through the blockchain to share the value of the savings and be treated as a tradable
currency.
Individuals could earn tokens through behaviors such as going to the gym, reaching their step goal,
attending education sessions, engaging in mindfulness, completing a particular sports event, or
adhering to medication or digital therapeutics. The ecosystem rewards positive behaviors with an
asset, or token of value. The value of the token could be fixed. Extending this concept, positive health
behaviors could be extended to the point where patients have health token savings accounts that could
be used to transact in hospitals.

Patient Record Access

 Patients are demanding access to their health record. This poses a significant challenge as to
how to best share sensitive medical data with unknown third parties. For third parties, there is also a
challenge to verify the integrity of the data while ensuring privacy for the patient. Presenting patient
records on an appropriately permitted blockchain would give cryptographic assurance on data quality
without any need for human involvement. Providers or consumers uploading health data would
generate transactions. Users provide a signature and timestamp, alongside a private key to access data.
By using digital signatures, all records stored on the blockchain can be identified and used to create a
comprehensive patient health record. The use of digital signatures and cryptographic encryption
ensures data travel securely and are accessible only by those with the relevant public keys. By using
blockchain technology, each addition to the EHR can be logged, with an immutable, auditable trail of
transactions, while ensuring the most current version of the record is used. Patients would be able to
verify all attempts to access or process data. Blockchain’s decentralized structure enables any
approved stakeholder to join the ecosystem, without the need for data integration or manipulation
concerns.