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  • Hello lovely people,

  • I'm not feeling my brightest so today we're going with a quick but slightly complex and

  • sticky topic!

  • As you may have seen in the news, Amazon's AI-powered voice assistant Alexa has teamed

  • up with the British National Health Service

  • (commonly known as the NHS)

  • to help people easily search for health advice via the internet. When asked a health query

  • by a UK user Alexa will automatically search the official NHS website

  • I'm going to take you through the good points, the bad points and this disabled persons thoughts

  • but it's really a subject open to debate so I'm sure there will be some great discussions

  • in the comments.

  • I asked about this topic on my Twitter and there were a variety of

  • opinions.

  • Don't click away if you're not in the UK or think that 'healthcare' doesn't

  • affect you because-

  • - we all have a level of health, just because yours isn't down here doesn't mean it

  • won't ever be.

  • Although the service is only available in the UK currently, it's a test case that

  • Amazon could soon replicate around the world.

  • The British government have said it could reduce demand on the NHS and some disabled

  • people have hailed it as a lifesaver- particularly those who are blind or elderly or find using

  • the internet a struggle.

  • However, many privacy campaigners note that digital devices invading healthcare could

  • be a dangerous attempt to save the NHS money. Read:

  • welcome to the UK if you attempt to

  • privatise our healthcare we will revolt!

  • And although Amazon say all information will

  • be kept confidential, there are still data protection concerns.

  • - important note for uptight rightwing newspapers: the NHS will not be giving anyone an Alexa device

  • you can unclench.

  • The partnership was first announced last year and now talks are underway with other companies,

  • including Microsoft, to set up similar arrangements.

  • It's important to note that Alexa has already been providing health information based on

  • a variety of popular responses.

  • - which have no medical basis!

  • So basically; she's going to do this anyway, might as well regulate it…?

  • [awkward shrug]

  • The use of voice search is on the increase and is seen as particularly beneficial to

  • vulnerable patients, again such as elderly people and those with visual impairment, who

  • may struggle to access the internet through more traditional means.

  • As someone who is very dyslexic I struggle often with the correct way to word a question

  • or even typing out very basic things.

  • A few months ago I saw my friend Stevie tell her

  • phone to set an alarm and it was a revelation to me- even though I have the exact same phone!

  • Technology!

  • I forgot that was an option because since I don't listen to my phone, I also forget

  • that it can listen to me.

  • - that's a creepy thought actually...

  • So if people are already accessing health information through the internet and using

  • voice activation, doesn't it make sense to bring experts into the process?

  • Let's be honest, aside from giving the correct time and date, can Alexa really be relied

  • upon to be correct about important things?

  • Looking at this from a real world perspective, we can see how helpful it could be in taking

  • pressure off the already overburdened health service-

  • - and no, I am in no way linking disabled people and the word 'burden' in this.

  • I'm talking about those people who go to the GP about a splinter.

  • Amazingly those fools really do exist.

  • - so sorry to the one person in the comments who went because their splinter got horribly

  • infected and they almost lost a leg. You definitely should have gone to the GP sooner.

  • Apparently more than 50 million GP consultations each year are unnecessary and could have been

  • handled better somewhere else. The government are thus trying to encourage people to judge

  • their symptoms and be wise about when they go to the doctor.

  • One part of me says:

  • 'yay, budget cutting that isn't aimed at the hardest hit in society',

  • the other part of me says

  • 'but you're coming for disabled people again next, right?'

  • - I can't help it. I'm disabled and thus live in fear. It's cheerful fear.

  • But it's fear,

  • Gadgets such as wearable pulse and heart rate monitors like fitbits are already doing a

  • great job of this. Maybe you didn't notice that weird way your heart beats until you

  • got a fitbit for Christmas and now you have a reliable way of tracking it that your GP

  • can easily see.

  • Hey, I know some people who managed to diagnose themselves with POTS through affordable health

  • tracker gadgets originally intended for fitness types. The data they stored made it easier

  • to get a formal diagnosis.

  • This partnership means people can access reliable medical information as Amazon's algorithm

  • uses information from the NHS website to provide answers to questions such as,

  • "How do I treat a migraine?"

  • and, "What are the symptoms of chickenpox?" Rather than whatever the top

  • question in a Google search history waswhich

  • definitely not a credible source.

  • The Health Secretary Matt Hancock says that it's right for the NHS to "embrace" technology

  • in this way, and predicts it will reduce pressure on "our hard-working GPs and pharmacists".

  • Whilst I'm still talking about good things: Amazon is pretty handy for disabled, elderly

  • and housebound people. I can't leave the house and go into town by myself, I also have

  • to conserve my energy. If I need envelopes to send a letter I have to ask either, Claudia,

  • my wife, to get some on her way home from work, or Clara, my carer, to get some on her

  • way into work.

  • That means they're either going out of their way or they have

  • to take me there andit can make me feel a little out of control.

  • I envy the luxury of the commute home from work

  • where you can just nip into a shop-

  • - again, this is a medical inability to go places, not just because I work from home-

  • Being able to order something from Amazon and pay for it myself and have it arrive the

  • next day feels like a little slice of independence to me.

  • It's not just envelopes either, Amazon sells pretty much everything.

  • It's one of those small conveniences that seems unnecessary unless it's really, really

  • necessary to you... like

  • pre-peeled oranges.

  • Or straws.

  • And do I wish I wasn't giving money to a massive conglomerate? And do I try to buy

  • from smaller retailers wherever possible? And do I really passionately want to support

  • my local high street and shop ethically?

  • Of course!

  • But putting my heavy feelings of guilt aside for the moment...

  • The hope with this new collaboration is that the money it will save in GP visits can then

  • be funneled into providing better care for those who really need it. Especially when

  • the advice will be clinician-led anyway.

  • But will it really work as intended?

  • Whilst it's great that patients can research symptoms online and try to work out what may

  • be wrong, the deluge of information, opinion and quackery online can muddy the waters.

  • This partnership means that at least the information will be correct.

  • BUT, there is a larger concern that is less about whether the information is correct and

  • more about how it is used.

  • I mean firstly, people are more likely to believe a voice telling them something

  • Than they are something they have read on the internet.

  • So could the use of this technology actually lead to an increase in the number of patients...?

  • Will people misinterpret what Alexa is saying and then worry they have a potentially fatal

  • disease when really it's nothing?!

  • Secondly, how can Alexa help people to build up a profile of what might actually be wrong?

  • It doesn't have the situational awareness to investigate further. Alexa may tell you

  • how to treat one symptom but won't be able to assess whether that one symptom is also

  • a warning about a broader condition. Our current technology doesn't have the ability to diagnose

  • that a doctor does and

  • - will it ever? Should it ever?

  • And further to that: one major caveat with health information technologies, whether that's

  • Alexa or Fitbit, is that they are not regulated;

  • People with serious health concerns turning

  • to them for advice isnot great.

  • this technology is being hailed as especially useful for disabled and elderly patients.

  • But it can't properly assess whether the information it gives is actually useful in

  • their specific case. What if they have arthritis and Alexa advises that you try a specific

  • stretch for the toe you just stubbed but it actually sets off your back pain?

  • Granted there is no evidence of benefit yet and that's fine, but there is also no evidence

  • that they don't cause harm.

  • Equally, human medical professionals make mistakes and also cause harm.

  • - I'm sure we can all share our stories about terrible doctors who have given awful

  • advice in the comments below...

  • There just needs to be a safety net, a way for Alexa to notice that you've asked about

  • these five individual symptoms in the last week and together they're a sign of cancer.

  • BUT then we come to the tricky topic of handling data

  • If Alexa creates a patient profile and stores your medical information as she's fed it

  • to better help you keep on top of symptomsthen where exactly is this information stored?

  • Is it subject to confidentiality?

  • Who owns it?

  • Who is allowed to then sell it onwards?

  • In the UK we have state funded healthcare for all so your medical history has no bearing

  • on whether you can access care or how much tax you pay towards it.

  • But what if this technology

  • starts to be used in America or other countries with privatised healthcare

  • - could the medical history data Alexa could potentially

  • store then be used against a person when they apply for cover?

  • Could an insurer saywell, you've searched for these four symptoms of heart disease in

  • the past month so we're going to put your premiums up”?

  • The NHS announcement drew criticism from civil liberty group Big Brother Watch.

  • - A+ name there

  • Director Silkie Carlo said: "Any public money spent on this awful plan rather than frontline

  • services would be a breathtaking waste. Healthcare is made inaccessible when trust and privacy

  • is stripped away, and that's what this terrible plan would do."

  • Others, including doctors, have pointed out that it's a data protection disaster

  • waiting to happen.

  • Amazon has said that it does not share information with third parties, nor

  • does it build a profile on customers.

  • An Amazon spokesman said: "All data is encrypted and kept confidential. Customers are in control

  • of their voice history and can review or delete recordings."

  • Butdo we all remember to clear our browser histories?

  • Do we not all have thousands of

  • nonsense pictures on our phones that desperately need clearing out and are still there?

  • Can anyone be bothered to 'review' their voice history? And once you delete something

  • is it really deleted or is it stored forever like Facebook photos?

  • Amazon responded to criticism by promising that it would not sell products or make product

  • recommendations based on the data collected as part of the NHS partnership.

  • And if all Alexa does is read sections from the NHS website then

  • it's probably not that helpful!

  • But it's also not that controversial.

  • I can see how useful it could be for those who struggle to use our heavily text-based

  • internet. Especially since Alexa already responds to health queries from users.

  • This is just making sure that the advice is better,

  • more accurate and comes directly from clinicians.

  • The worry is what may come next

  • Amazon is known to have ambitions in the healthcare

  • industry. In 2018 the firm paired up with Omron Healthcare to allow a blood pressure

  • monitor to be controlled via Alexa. And it also announced software that could automatically

  • analyse electronic health records for information that could be useful to doctors, including

  • hospital admission notes and a patient's medical history

  • Whichkind of seems like the exact thing people are worried about with Alexa and the NHS

  • - As someone with a complex medical history that defies easy categorization- that's

  • not great. I once discharged myself against medical advice because I thought the doctor

  • was wrong, and he was later proved to be wrong. But I worry often that having done that will

  • reflect really badly on me in future.

  • So who's side am I leaning towards?

  • Firstly, I'm very much not the target audience for this.

  • Hi, this is my Google Dotthing. I was given it as a gift. I… am deaf however.

  • And my wife hates talking to things that are not me or a camera so

  • we haven't really set it up yet.

  • If Alexa stays a simple symptom sorter then that's fine and useful for some but it's

  • also slipping slightly into a grey area.

  • Alexa's advice through the NHS website is not claiming to be a diagnosis. For a piece

  • of technology to actually provide a diagnosis it has to be regulated by the FDA in the United

  • States and by MRHA (Medicines and Healthcare products Regulatory Agency)

  • in the United Kingdom.

  • I think it might be MORE helpful if Alexa was able to handle the complexities of tying

  • two or more symptoms together but I worry about the implications of that too.

  • So I want it to be more worrying, I just want to be less worried about it.

  • I'm also concerned that people will ignore symptoms that could develop into something

  • major just because Alexa told them it's a minor thing- particularly when it comes

  • to elderly people. Reading about symptomswith websites giving you information passively

  • and listening to someone's voice saying the same information out loud can be perceived

  • differently. Will someone who is confused be able to tell the difference between giving

  • their symptoms to get a diagnosis and the blind reading that Alexa does?

  • And, conversely: are people going to panic that they're

  • definitely dying of something terrible

  • because they've fallen down a hole of Googling symptoms via Alexa?

  • At the end of the day though: those who use Alexa are likely going to already be digitally

  • savvy and use the internet to research their symptoms. Ownership of 'home helper' devices

  • is higher in groups that already use the internet more. Is this technology going to reach the

  • marginalised people it's intended to help?

  • It's worth remembering that not everyone is comfortable using technology

  • and not everyone can afford it.

  • My main concern would be that it may prevent people from seeking proper medical help and

  • thus create even more pressure on the system in the long run!

  • What are your thoughts however? Do you enjoy these more topical videos?

  • Let's discuss in the comments below

  • And I'll see you on Friday for my next video.

Hello lovely people,

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