UK will use Alexa to give medical advice: an agreement between Amazon and the NHS marks the near future of digital medicine

On July 5, 1948, the British NHS became the first national system to offer a complete, universal and free health service for the entire population. There were some partial precedents such as the Soviet health network of the 1920s or the hospital systems of New Zealand or Queensland in Australia, but the NHS spearheaded a movement that wiped out similar systems in almost all developed countries in a couple of decades.

Since then, the NHS has been fond of leading the way, and in recent years has launched a series of programs to embrace technology and lead the "digitization" of healthcare. The agreement with Amazon for Alexa to offer health advice is just the last step in a bid that wants to make the United Kingdom a huge laboratory for the health of the future.

Dr. Alexa

From this week, Alexa will use the official website of the NHS to answer the medical questions that British users ask on a daily basis. The project was announced last year and during these months negotiations have been started with other virtual assistant companies to reach similar agreements.

The change is important because it's not that Alexa hasn't answered medical questions until now. Rather, Amazon's assistant offered information based on numerous internet sources (and considering the popularity of the response). Now, questions like "How do I treat a migraine?" or "What are the symptoms of chickenpox?" They will have responses produced and reviewed by NHS specialists.

"We want to empower each patient to take better control of their medical care," said Health Secretary Matt Hancock. He has also explained that this initiative is a response to the voice search boom. Above all, in especially vulnerable patients such as the elderly or people with visual disabilities who often have extra difficulties when using the internet. However, no one escapes that the government's decision has weighed heavily the possibility of using these technologies for demand and decongesting services.

In that sense, the Government promoted a unit, NHSX, to pilot this entire digital transition that includes things like the expansion of electronic prescription or the use of artificial intelligence to analyze certain types of medical tests. A transition that has raised many expectations, but also many concerns.

Shadows in digital paradise

Although Amazon was quick to confirm that the data will be encrypted at source, will not be shared with third parties, or used in the elaboration of user profiles, the criticisms have not been long in coming. The Big Brother Watch association led by Silkie Carlo has denounced that "medical care becomes inaccessible when trust and privacy disappear." "It is a data protection disaster waiting to happen," added Carlo.

Beyond the rhetorical excesses, the successive privacy problems that we have experienced in recent years have sparked an understandable mistrust of the way in which the technological giants treat the personal data of their users. Hence, the government program, just at a time when privacy is on the table for the success of FaceApp, has been received with some unease.

But privacy (and possible misuses of medical data) are not the only problems with digitizing health. On the one hand, a few months ago, we defended ourselves that the famous "electrocardiogram" of the Apple Watch Series 4 was "a perfect metaphor for all the problems and opportunities of digital medicine that is about to come."

It is a very clear example that technology can offer us interesting opportunities, but that health systems have to integrate those opportunities so that they do not become problems that end up damaging the health of their users. Because what is the use of all this data if we cannot extract information and only end up generating noise?

As if that were not enough, security and the inability to manage this new technology add security. We have seen that as medical devices become increasingly connected to the network, vulnerabilities increase. In recent years, there has been no shortage of attacks to turn off insulin pumps or hack pacemakers.

What awaits us?

Interesting times, that without a doubt. Because there is something Matt Hancock is right about, this is not going to stop anyone. Today, there are already many examples of hospitals, health centers and insurers that use technology intensively. And that is a great challenge.

The first is the challenge of realism. In other words, to flee from both "gloomy pessimism" and "technological solutionism" (thinking that all problems in health systems will be solved only by adding technology). In fact, professors like Helen Stokes-Lampard of the Royal College of General Practitioners insist that independent research is vital to ensure that the steps we take are truly effective and not a way to "prevent people from seeking adequate medical help. "

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