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NHS and Amazon

robert88robert88 Posts: 2,706
edited July 2019 in The cake stop
Should the NHS allow Amazon to get into bed with it?
People will be able to get expert health advice using Amazon Alexa devices, under a partnership with the NHS, the government has announced
.

Is this the start of a pay at point of use instead of free at the point of use?
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  • pblakeneypblakeney Posts: 11,075
    Who thought doctors would have been amongst the first victims of AI?
    The above may be fact, or fiction, I may be serious, I may be jesting.
    I am not sure. You have no chance.
    veronese68 wrote:
    PB is the most sensible person on here.
  • slowbikeslowbike Posts: 8,476
    Depends what it's returning.

    If it is purely regurgitating what is already available on the NHS website, I don't see the problem (initially) - although I guess it'll be the entry point into AI diagnosis ... but didn't the GMC have an issue with some doctors running a web only surgery?
  • PhilipPirripPhilipPirrip Posts: 616
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.

    As for the other initiatives there doesn't appear to be anything technologically groundbreaking; access to care at home and electronic record keeping being two other big budget items.
  • Stevo_666Stevo_666 Posts: 39,611
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.

    As for the other initiatives there doesn't appear to be anything technologically groundbreaking; access to care at home and electronic record keeping being two other big budget items.
    This.
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  • joenobodyjoenobody Posts: 540
    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.
    I don't think it's even as involved as that, as far as Alexa is concerned. My understanding is that 3rd parties just expose their own AI-based services through Alexa, so all Alexa is really providing is the voice to data conversion and relaying it to the service, then receiving back the responses and converting them back to speech. It's not reading info from NHS sites and making its own decisions about how to respond. Assuming I haven't misinterpreted what you're saying.

    I guess there's scope there for Amazon to capture certain data from the interactions and use it to drive advertising or product recommendations. I don't know what their ToS are like with regards to 3rd party integrations with Alexa. I believe using Alexa like this is free for 3rd parties, so using the data taken from interactions would certainly be how Amazon would extract value from opening up the service.
  • step83step83 Posts: 3,668
    Stevo 666 wrote:
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.

    As for the other initiatives there doesn't appear to be anything technologically groundbreaking; access to care at home and electronic record keeping being two other big budget items.
    This.

    As above, previously is bounced off various sites which may or may not have been giving correct info. Now its using basically a known source.
    I can't see a problem with it its not replacing anyone the information is freely available from the NHS direct website, it's just another way to access the information.
  • rick_chaseyrick_chasey Posts: 46,744 Lives Here
    Stevo 666 wrote:
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.

    As for the other initiatives there doesn't appear to be anything technologically groundbreaking; access to care at home and electronic record keeping being two other big budget items.
    This.

    Is the concern not about what amazon is doing with the data it receives as the broker between the patient/customer and the NHS?

    They don't have the best reputation on discretion and surveillance.
  • As per usual the loony OP views this from his own echo chamber rather than the real world!

    Technological improvements are what is needed to save the NHS as the service that we want it to be.

    Here's a simple example. imagine the time and cost savings that can be redirected to other parts of the service if a machine can take your height, weight, HR, blood pressure, etc ahead of your seeing your GP.

    or

    Injections dispensed via robot rather than the practice nurse.

    Without these and other technological improvements, of which there is huge private investment being made to develop solutions, the NHS risks collapsing.

    Resisting these changes will cost more money and/or reduce the effectiveness of service provided to patients.
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  • rick_chaseyrick_chasey Posts: 46,744 Lives Here
    Ah yes, of course the debate divides on culture wars lines.

    I'm as bad as anyone.
  • pblakeney wrote:
    Who thought doctors would have been amongst the first victims of AI?

    Well I would for one although this probably isn't the mechanism.

    AI consistently outperforms medical professionals in diagnosing health issues in trials, won't be long before it's rolled out hopefully. Remote health monitoring and AI are some of the great opportunities to manage the fact that demand for healthcare is outstripping resources at the moment.
  • pblakeneypblakeney Posts: 11,075
    pblakeney wrote:
    Who thought doctors would have been amongst the first victims of AI?

    Well I would for one although this probably isn't the mechanism.

    AI consistently outperforms medical professionals in diagnosing health issues in trials, won't be long before it's rolled out hopefully. Remote health monitoring and AI are some of the great opportunities to manage the fact that demand for healthcare is outstripping resources at the moment.
    Medical diagnosis, lawyers and accountants are among the most trials.
    It will be interesting to see how soon it comes in. Baby steps.
    The above may be fact, or fiction, I may be serious, I may be jesting.
    I am not sure. You have no chance.
    veronese68 wrote:
    PB is the most sensible person on here.
  • Stevo_666Stevo_666 Posts: 39,611
    Stevo 666 wrote:
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.

    As for the other initiatives there doesn't appear to be anything technologically groundbreaking; access to care at home and electronic record keeping being two other big budget items.
    This.

    Is the concern not about what amazon is doing with the data it receives as the broker between the patient/customer and the NHS?

    They don't have the best reputation on discretion and surveillance.
    Fair point, but the main point that the OP is making is not the same.
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  • bianchimoonbianchimoon Posts: 3,939
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.
    Not a lot could be, NHS 111 is for people who haven't got the ability to google/learn about their symptoms and make and educated choice of what to do next. The checklist they run through is no different to what Ai would do, if you don't stick to the expected script the operator has to pass it up to the next level, where they will tell you, if there' isn't a doctor on call for your area, go to A&E, MIU etc after you've wasted half an hour on the phone. Quiet interesting watching programmes such as 24 hrs in A&E/Ambulance etc, some people seem to use A&E departments rather than go to a GP (or wait for a GP appointment) and get very good treatment, relatively quickly. These programmes work against all that the NHS preach about self help, Chemists, GP and leave A&E for 'life threatening' injuries
    All lies and jest..still a man hears what he wants to hear and disregards the rest....
  • rick_chaseyrick_chasey Posts: 46,744 Lives Here
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.
    Not a lot could be, NHS 111 is for people who haven't got the ability to google/learn about their symptoms and make and educated choice of what to do next. The checklist they run through is no different to what Ai would do, if you don't stick to the expected script the operator has to pass it up to the next level, where they will tell you, if there' isn't a doctor on call for your area, go to A&E, MIU etc after you've wasted half an hour on the phone.

    This is not strictly true.

    I have found it incredibly helpful after hours and have been given emergency GP visits at the local hospital that I could not have got any other way.

    It can be urgent but neither an accident or an emergency.
  • bianchimoonbianchimoon Posts: 3,939
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.
    Not a lot could be, NHS 111 is for people who haven't got the ability to google/learn about their symptoms and make and educated choice of what to do next. The checklist they run through is no different to what Ai would do, if you don't stick to the expected script the operator has to pass it up to the next level, where they will tell you, if there' isn't a doctor on call for your area, go to A&E, MIU etc after you've wasted half an hour on the phone.

    This is not strictly true.

    I have found it incredibly helpful after hours and have been given emergency GP visits at the local hospital that I could not have got any other way.

    It can be urgent but neither an accident or an emergency.
    The NHS has Out of Hours Centres, Urgent Care Centres and Minor Injuries Units. A&E are for life threatening injuries, the fact that people will not get turned away from A&E for relatively minor illnesses and injuries doesn't mean people use the system correctly. I quiet understand why people do it, but it's not what A&E Depts are for
    All lies and jest..still a man hears what he wants to hear and disregards the rest....
  • rick_chaseyrick_chasey Posts: 46,744 Lives Here
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.
    Not a lot could be, NHS 111 is for people who haven't got the ability to google/learn about their symptoms and make and educated choice of what to do next. The checklist they run through is no different to what Ai would do, if you don't stick to the expected script the operator has to pass it up to the next level, where they will tell you, if there' isn't a doctor on call for your area, go to A&E, MIU etc after you've wasted half an hour on the phone.

    This is not strictly true.

    I have found it incredibly helpful after hours and have been given emergency GP visits at the local hospital that I could not have got any other way.

    It can be urgent but neither an accident or an emergency.
    The NHS has Out of Hours Centres, Urgent Care Centres and Minor Injuries Units. A&E are for life threatening injuries, the fact that people will not get turned away from A&E for relatively minor illnesses and injuries doesn't mean people use the system correctly. I quiet understand why people do it, but it's not what A&E Depts are for

    Eh?
  • bianchimoonbianchimoon Posts: 3,939
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.
    Not a lot could be, NHS 111 is for people who haven't got the ability to google/learn about their symptoms and make and educated choice of what to do next. The checklist they run through is no different to what Ai would do, if you don't stick to the expected script the operator has to pass it up to the next level, where they will tell you, if there' isn't a doctor on call for your area, go to A&E, MIU etc after you've wasted half an hour on the phone.

    This is not strictly true.

    I have found it incredibly helpful after hours and have been given emergency GP visits at the local hospital that I could not have got any other way.

    It can be urgent but neither an accident or an emergency.
    The NHS has Out of Hours Centres, Urgent Care Centres and Minor Injuries Units. A&E are for life threatening injuries, the fact that people will not get turned away from A&E for relatively minor illnesses and injuries doesn't mean people use the system correctly. I quiet understand why people do it, but it's not what A&E Depts are for

    Eh?
    Ahh, sorry, you were talking about the 111 service not using A&E apologies
    All lies and jest..still a man hears what he wants to hear and disregards the rest....
  • slowbikeslowbike Posts: 8,476
    It can't be any worse than calling 111.
    Not a lot could be, NHS 111 is for people who haven't got the ability to google/learn about their symptoms and make and educated choice of what to do next.
    Out of hours medical advice when your GP is unavailable ... we've used it ... we could've googled it, but I'd rather a 2way conversation with someone who has a clue.
    I'm rather glad we did - because they sent an ambulance and whilst the paramedic was doing his checks, Little Slowbike had a fit (febrile convulsions) - which if you've ever experienced it is rather upsetting - NHS (website) advice in our situation was to dial 999 or go to A&E - which is where we ended up.

    I have no doubt that some people use 111 for seemingly obvious issues, but before condemning our 111 or 999 services - consider who is using them, and why.
  • bianchimoonbianchimoon Posts: 3,939
    slowbike wrote:
    It can't be any worse than calling 111.
    I have no doubt that some people use 111 for seemingly obvious issues, but before condemning our 111 or 999 services - consider who is using them, and why.
    point me to where I've condemned 999 services?
    My point was about 111 and speaking to a trained advisor as a filter
    https://www.digitalhealth.net/2018/04/i ... e-of-time/
    All lies and jest..still a man hears what he wants to hear and disregards the rest....
  • chris_basschris_bass Posts: 4,913
    what would be really interesting is if it could store your health related questions and refer back to them.

    If you are asking about a fatigue, then the next week week you ask about always being thirsty, then blurred vision sometime later in the year etc these symptoms may seem completely unrelated to the person asking but Alexa would suggest getting checked for diabetes.

    i'm sure there is some huge risk to data theft with storing health data but if it was purely on an opt in basis it would probably be useful, especially for the elderly.
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  • slowbikeslowbike Posts: 8,476
    slowbike wrote:
    It can't be any worse than calling 111.
    I have no doubt that some people use 111 for seemingly obvious issues, but before condemning our 111 or 999 services - consider who is using them, and why.
    point me to where I've condemned 999 services?
    My point was about 111 and speaking to a trained advisor as a filter
    https://www.digitalhealth.net/2018/04/i ... e-of-time/
    It's easy to pick holes in a telephone service sending, what turns out to be unnecessary services to an otherwise healthy patient - as a recipient of a 999 called ambulance when I fainted I agree, it was a total waste of time & resources - had I been conscious at the time I could've said that... but the point is, I wasn't and the caller didn't know why I'd fainted (3 times - heavily - bashing my head in the process).

    Will the 111 operators get it right every time? I doubt it - but this is where they have to play the statistics - for every one they get wrong - how many do they get right - and quite frankly, isn't it better to play it cautious when you're talking about someones life?

    If you look at the NHS website, it quite often refers you to a GP and/or A&E - because it's generally better to be passed fit by a doctor rather than a benign website.
  • robert88robert88 Posts: 2,706
    The problem with free-at-the-point-of use services is that it is extremely expensive and open to abuse by people who perhaps aren't in need of treatment at all.

    The benefits of pay-at-the point-use are that people will only call if they really feel they need treatment. And they will pay accordingly; people will surely receive the treatment they deserve?

    I would expect it is possible to save well over £350 million a week by making the change. Why should health be exempt from monetization?

    As things stand it is extremely likely we will entering into ever closer union with our greatest ally, the USA. We could show that administration that we are onside by a gradual process of removing so called 'free health care' from our welfare system. i.e. demonstrating our abhorrence of socialism.

    I can't understand why the Conservative administration can't see the advantages of that and that Amazon (a company in which I own shares) are best placed to get the ball rolling.
  • TheBigBeanTheBigBean Posts: 9,289
    I've only glanced at this story but Im perplexed why you think this will be a paid for service.

    Essentially, when someone asks Alexa a health related question Alexa will use symptom/diagnosis/treatment info from the NHS sites, the same information that you're already free to read by just going to the websites.

    It can't be any worse than calling 111.
    Not a lot could be, NHS 111 is for people who haven't got the ability to google/learn about their symptoms and make and educated choice of what to do next. The checklist they run through is no different to what Ai would do, if you don't stick to the expected script the operator has to pass it up to the next level, where they will tell you, if there' isn't a doctor on call for your area, go to A&E, MIU etc after you've wasted half an hour on the phone.

    This is not strictly true.

    I have found it incredibly helpful after hours and have been given emergency GP visits at the local hospital that I could not have got any other way.

    It can be urgent but neither an accident or an emergency.
    The NHS has Out of Hours Centres, Urgent Care Centres and Minor Injuries Units. A&E are for life threatening injuries, the fact that people will not get turned away from A&E for relatively minor illnesses and injuries doesn't mean people use the system correctly. I quiet understand why people do it, but it's not what A&E Depts are for

    A&E is for accidents and emergencies, you don't need to be dying.

    A&E always has a trained triage nurse who is qualified and should turn away people who do not need assistance. That they rarely do is a separate issue which has nothing to do with the untrained consumer.
  • TheBigBeanTheBigBean Posts: 9,289
    pblakeney wrote:
    Who thought doctors would have been amongst the first victims of AI?

    Well I would for one although this probably isn't the mechanism.

    AI consistently outperforms medical professionals in diagnosing health issues in trials, won't be long before it's rolled out hopefully. Remote health monitoring and AI are some of the great opportunities to manage the fact that demand for healthcare is outstripping resources at the moment.

    Doctors rely on knowledge. Computers are good at that.
  • itboffinitboffin Posts: 19,582
    formed in 1979 VAMP health held the largest database of its kind in the world, holding the anonymised records of some 4 million patients. VAMP became a pioneer of off-the-shelf multi-user computer systems. Doctors paid about £25,000 for systems, encouraged by the prospect of saving time with computerised notes and prescriptions, and side-benefits such as automatic reminders to monitor repeat prescriptions and do preventive tests.

    This information was shared with many many doctors and companies, I was involved in this but about 10 years later, health data has and will always be of interest for medical reasons or otherwise.

    One example from those days Docs would receive notifications about outbreaks in their regions and therefore make assumptions that anyone presenting with similar symptoms of that particular condition, give them the currently promoted medicine and onto the next customer, all in less time than ever.

    Folks that was back in the 1980s pre public internet what to you think its happening today?
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  • Stevo_666Stevo_666 Posts: 39,611
    robert88 wrote:
    The problem with free-at-the-point-of use services is that it is extremely expensive and open to abuse by people who perhaps aren't in need of treatment at all.

    The benefits of pay-at-the point-use are that people will only call if they really feel they need treatment. And they will pay accordingly; people will surely receive the treatment they deserve?

    I would expect it is possible to save well over £350 million a week by making the change. Why should health be exempt from monetization?

    As things stand it is extremely likely we will entering into ever closer union with our greatest ally, the USA. We could show that administration that we are onside by a gradual process of removing so called 'free health care' from our welfare system. i.e. demonstrating our abhorrence of socialism.

    I can't understand why the Conservative administration can't see the advantages of that and that Amazon (a company in which I own shares) are best placed to get the ball rolling.
    Keep on speculating (and I'm not talking about the casual reference to the shares that you just happen to own) :wink:
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  • PhilipPirripPhilipPirrip Posts: 616
    It's not that long since the government were looking to monetize patient data for the purposes of research - they claimed - until it was revealed several of the interested parties were insurance companies.

    Despite claims of anonymization, the potential existed for individual patients to be identified and the costs for, and their access to treatment or insurance affected.

    Whilst Amazon could collect data from this in a broad 'Health of the Nation' overview type way it's hard to see how they could collect the right types of personal and health data that could be monetized outside of their own interest in offering tailored promotion of their own goods and services.
  • slowbikeslowbike Posts: 8,476
    TheBigBean wrote:
    pblakeney wrote:
    Who thought doctors would have been amongst the first victims of AI?

    Well I would for one although this probably isn't the mechanism.

    AI consistently outperforms medical professionals in diagnosing health issues in trials, won't be long before it's rolled out hopefully. Remote health monitoring and AI are some of the great opportunities to manage the fact that demand for healthcare is outstripping resources at the moment.

    Doctors rely on knowledge. Computers are good at that.
    But only if the computer understands the question - something that a human can do better (at the moment). It’s quite tricky searching for something you don’t know the name of.
  • shirley_bassoshirley_basso Posts: 3,007
    slowbike wrote:
    TheBigBean wrote:
    pblakeney wrote:
    Who thought doctors would have been amongst the first victims of AI?

    Well I would for one although this probably isn't the mechanism.

    AI consistently outperforms medical professionals in diagnosing health issues in trials, won't be long before it's rolled out hopefully. Remote health monitoring and AI are some of the great opportunities to manage the fact that demand for healthcare is outstripping resources at the moment.

    Doctors rely on knowledge. Computers are good at that.
    But only if the computer understands the question - something that a human can do better (at the moment). It’s quite tricky searching for something you don’t know the name of.

    It doesn't need a question. The computer can ask questions to the patient about symptoms and narrow it down like a decision tree. With remarkable accuracy.
  • awaveyawavey Posts: 2,368
    Despite claims of anonymization, the potential existed for individual patients to be identified and the costs for, and their access to treatment or insurance affected.

    no the potential existed for certain medical conditions to be data mined, such that when individuals requesting insurance policies from these companies and meeting certain data markers, could then be given entirely tailored insurance based on the outcomes from the anonymised data research.
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