The healthcare system of today functions more as a “sick care” system.
Worldwide, the system is weighted towards downstream issues, i.e. treating symptoms, managing chronic illnesses and emergency care.
However, healthcare should really be about proactive, preventive primary care and wellness.
Prevention, as we all know, includes exercising, managing stress, eating and sleeping well to reduce your risk factors of developing non-communicable diseases, like cancer, heart disease and diabetes.
When healthcare is mentioned, most people immediately think of the relationship between the doctor and the patient, but it is much broader than that.
“If you count the number of staff within a hospital, the largest population is not doctors and nurses – it’s everybody around – the administrators, porters, supply chain workers, etc.
“Healthcare is not confined within a hospital, it’s also in the community, and this is where artificial intelligence (AI) and digital technologies can help fill the big gaps upstream.
“With the right AI, we can give more scientific support to the entire population on how to be well, live better and use resources to determine when it is necessary to see a doctor,” says Dr Alex Ng, president of Tencent Healthcare, a Chinese company specialising in digital health ecosystem integration.
The problems are similar worldwide: a lack of nurses and doctors, long wait times, higher demands from the ageing population, burgeoning chronic diseases and increasing cost of drugs and surgery.
City dwellers have easy access to see a healthcare professional if they’re unwell, but for those in rural areas, access to care is not as readily available.
Dr Ng shares: “You have to travel quite a bit and might have to take half a day off work, which for a lot of people, can mean half a day less salary or taking their kid out of school.
“So, there’s a lot of family dynamics involved and AI can be a good tool to help reduce the anxiety and the trade-off that people will have to make.”
‘Invisible’ presence
Robots are increasingly involved in teleconsultations, and together with AI, can transform healthcare by enabling remote, high-fidelity physical assessments, reducing infection risks and alleviating administrative burdens on professionals.
These technologies, often deployed as telepresence robots or AI-driven conversational agents, are crucial in providing 24/7 care and specialised services in underserved regions.
Telepresence robots are remote-controlled, wheeled devices equipped with cameras, screens, speakers and microphones that allow users to have a physical presence in a distant location.
Dr Ng says: “Even in China, there are some very remote regions where road access is unavailable.
“You have to walk for five hours, climb mountains and cross rivers to get there.
“Here, we are sitting in large cities designing and working on AI, and so, sometimes, we don’t see the issues that are being faced by certain populations.
“The biggest benefit that AI can bring, even down the line to radiology, is to bridge the gap bet-ween the ‘haves’ and ‘have-nots’.”
For example, take the job of a pathologist who looks at slides, detects, analyses mutations in cells and tissue, and infers what kind of targeted treatment the patient should undergo.
“I would never challenge the molecular genetic pathologist, because according to the workflow, you take a tissue sample, send it to a genetic lab where the pathologist is, and two weeks later, you obtain the result.
“But now, our research shows that within three seconds, AI can tell you the result with 95% accuracy.
“This is where a lot of AI is going to create tensions with traditional healthcare about the boundaries of work and professionalism,” he says.
Still, Dr Ng reckons AI can act as a sort of safety net; if a doctor has missed something that AI has detected, he can then look at the slides again to be sure.
While the lines are getting blurred due to AI’s capability, especially in pathology and radiology, it’s not always a bad thing.
Dr Ng adds: “People don’t realise that when doctors – myself included – are strained and tired at work, we make mistakes.
“AI can alleviate work in a lot of areas that are already at a breaking point.”
Acting as ‘co-pilot’
In the future, Dr Ng sees more people getting comfortable with the implementation, accuracy and reliability of certain controllable AIs.
He cites how haemoglobin was measured in the past using manual, colour-based techniques.
When automated instruments entered the picture and were proven reliable and trustworthy, machines became the accepted standard used to measure haemoglobin levels.
“Just like how we transfer certain paper calculations to Excel and calculators, once we get comfortable with what AI can do, we can transfer certain tasks to it.
“But it needs to have a well thought through process, not out of desperation or because you cannot handle pressure,” he emphasises.
Dr Ng is quick to point out that the healthcare sector will still require the human touch for the next decade or two, especially when it comes to the clinical parts.
Often, it is the doctors in city centres who are overworked, and here is where AI can act as a co-pilot in terms of alleviating the administrative tasks, e.g. typing out summaries.
He says: “AI can generate a very good draft for doctors to review, but you can’t simply use a generic AI you pluck off the street.
“The AI has to be very methodical to reduce or eliminate hallucinations, and only pull in data.
“It literally reduces the typing and copy/pasting that a doctor has to do, because not all of them are good at typing.”
Elderly left behind
Globally, small innovations are being developed daily, faster than anyone can keep track of, but Dr Ng says these need to be guided to ensure they have the momentum and right foundation to scale to a country, region and beyond.
As Malaysia is actively transforming into a leading digital nation, with a strategic goal to become an AI nation by 2030, he says society must be ready to embrace this.
“In China, patients have a physical insurance card that you tap to pay.
“Despite China being great with digital payment, 50% of transactions are still made with this card, and they predominantly belong to the elderly and people in rural areas, because going digital doesn’t save them time as they may press the wrong key or something,” he points out.
Technology is moving so quickly with apps and mobile devices that the elderly are being left behind.
Dr Ng says: “It’s unfair to force them to use it, so what we have done in our company is build in family features in apps.
“While insurance payment is an individual account, we have an account management system for the sons and daughters to manage their families, not only their own kids.
“But you need to authenticate and authorise that so-and-so is your mother or father, so that children can register, make appointments, make payment and receive reports on their parent’s behalf.”
Vaccine passports
Dr Ng also contributes to global health as a member of the World Health Organization’s Digital Health Technical Advisory Group, where he advises on ethical AI and digital health policies.
Instead of focusing on individual countries or individual innovations, the group is tasked with policy settings addressing important cross-national healthcare issues.
Even in the digital world, there are interoperability issues within and across countries.
“One of the initiatives that we’ve been discussing is how to make public health more accessible, as there are still a lot of international transits.
“Passengers fly all the time, but specific groups, such as seafarers, are obliged to have a vaccine passport because they go from port to port and disembark.
“During their rest, they’re required to have all vaccinations and health records with them.
“So, we are thinking about digitising the records in a digital wallet, which is not only interoperable, but verifiable across nations.
“It’s not the ‘glamorous’ AI that everybody seems to focus on, but a very important digital infrastructure that is still not in place,” he says.
