字幕表 動画を再生する 英語字幕をプリント 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 was… which… 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 and… it 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 is… not 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 symptoms… then 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 say “well, 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." But… do 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… Which… kind 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 Dot… thing. 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 symptoms – with 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.