Category Archives: Technology

Britain, Culture, Government, Society, Technology

Whose job is it to keep us nice online?

SOCIETAL: SOCIAL MEDIA

Imagine and visualise a debate that you’ve just had on stage at the Cheltenham Literature Festival concerning a neat little modern conundrum: ‘Is social media the curse of our age?’ Imagine, too, that you and your fellow panellists have agreed that it probably is. In this scenario, should you, or should you not, tweet about it?

We would assume that people normally would. But maybe you would be unsure. What would be your motivation? Would you be publishing an event that you’d found fascinating? Quite likely. Or would you just be craving the sort of “like”-induced serotonin surge you and your fellow panellists had just been talking about, given your addiction to social media networking? What demons were ruling you? What damn tech tricks made you feel that you ought?

And so it goes viral after comments from the Festival audience stick with you. The young woman who saw social media as the vector of the eating disorder she suffered from as a teenager, but who now was using social media platforms to rebuild her sense of self-worth. The older man who, after tweeting in support of Boris Johnson’s comments on burkas, had been shocked to find himself subject to an onslaught of fury, including people trying to get him sacked. Or, another man, say, active on platforms but tired of competing with screens for attention and convinced that the world around him was narcissistic and utterly crazy.

There might be a sense of social media acting the heavy beast squatting upon all our shoulders, forever seen in the corner of an eye. It might also be an overdue reminder that your own thoughts about all this can get a little lofty. Yet, we could trot out the gotcha about the billionaire moguls who run these platforms banning their own children from using them, even while marketing them to yours. We could talk for hours about the damage being done to the fabric of our democracy.

For most people, however, concern about social media has nothing to do with any of that. Instead it is about obsession and compulsion. It is about self-worth and self-harm. It is about friends and relatives developing new violent politics that seem to have come from nowhere. It is about teenagers living their lives as a constant performance on apps that their parents barely comprehend, for audiences that they can scarcely imagine. It sits in the lives of many as an ever-grinding mill of misery, even when they cannot imagine life without it, and they feel that something must be done.

 

EARLIER this year the Government let it be known that it was working on a white paper of proposals to tackle the nebulous business of online harm. Matt Hancock, then culture secretary, declared that Britain was to become “the safest place in the world” to be online. You’ll maybe understand the urge of ministers and can probably see where this is going: “something must be done”. But does this rule out making anyone less fearful?

In some areas, certainly, legislation is desirable and overdue. Criminal hate speech, libel, grooming, copyright violation, fraud and violent radicalisation are all areas that technology companies should be taking far more seriously. We really should have no objection to them being forced to do so. Likewise, there is growing evidence that the chemical hits of serotonin, dopamine and adrenaline that drive online behaviour creates a dependency culture, in the manner of nicotine or cocaine. The notion of a cigarette packed-style warning on your Snapchat or WhatsApp might seem ludicrous today but it could become a necessary measure to help improve physical and mental wellbeing.

The pervasive public miseries of social media, though, are more low level. They involve not hate speech but vitriol and nastiness; not extremism but political polarisation; not libel but rudeness and disrespect. Not grooming, even, but sexualisation. They involve, in other words, forms of speech that today are free and uninhibited, and where the government almost certainly plans to make less free.

Who will complain? Feel the way the wind blows. The public sees a harm and worries about it. Paradoxically the users of social media are increasingly censorious, blocking undesirables and avoiding certain platforms. In parliament, the very bedrock of democracy, you have a cohort of MPs radicalised against popular free speech by some 100 tweets a day threatening rape or murder, or by calling them traitors or fascists.

Many will wish that social media giants should be policing themselves more effectively, yet simultaneously doubt they ever will. Tell those same people that the state ought to do it instead and they will balk, hard. You will remember the instinctive illiberalism of so many politicians in the Leveson battles over press regulation. You might be feeling it is coming back.

Next time, when it’s those hated tech behemoths who pilfer the revenues from traditional media organisations, will even the press be prepared to put up a fight? They must. Like it or not, what was true with the press is even more true for social media. Except in areas of outright criminality, liberal democracies do not curb your freedom of expression. They may fret about it, lambast it, implore others to close their ears. Yet the moment they shut it down they are liberal no more.

This fight is coming. It is likely to be ugly and all the nicest people will be on the wrong side. Trolls, those ugly creatures who once lived under bridges, now reside right behind the screen you’re looking at. Prowl they will. But you have a choice.

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Britain, Government, Society, Technology

Artificial Intelligence (AI) is the future of the NHS?

HEALTHCARE

TIME is money, and for the NHS crucial in how it operates. A government which cannot get waiting lists down, for example, risks public ire. Gaping chasms in service provision would mean shelling out on locum doctors and private procedures.

Commonly, the government bows to popular pressure and loosens the purse strings, which might involve unpopular tax rises.

Yet, there is another way – one that would put an end to long waits, understaffing and bed-blocking. Artificial Intelligence (AI) could transform the NHS into a lean, hyper-efficient, cost-effective modern medical system. It may sound far-fetched and even sinister, but the age of automated medicine is already upon us. The question is, will we benefit from it or retreat through lack of will or vision?

Some 40,000 patients in London have signed up for this brave new world. They are registered on GP at Hand – a chatbot, or online conversation simulator, capable of screening symptoms and referring patients either to a GP for diagnosis or another service.

Babylon Health, developer of the technology, announced earlier this year that the latest version of its app could diagnose ailments with at least as much accuracy as a GP, in some cases more.

The chatbot was tested against 100 patient scenarios and assigned questions from the Royal College of General Practitioners (RCGP) membership exam, the assessment all GP trainees must pass to be fully accredited. On its first attempt, the chatbot achieved a pass rate of 81 per cent, which Babylon has been keen to contrast with the average score of human GPs – 72 per cent.

 

THE next generation of GPs could look more like an animated robot that pops up on your smartphone or other electronic device. GP at Hand cannot prescribe medicine, for now, but the scope is there to develop products such as this into an autonomous all-round primary care service. In the GP surgery of tomorrow, the app will see you now.

Dr Ali Parsa is founder and chief executive of Babylon. He says his company’s product makes primary care more affordable and accessible but not everyone is convinced of the case for robot-GPs.

The RCGP is by no means Luddite but it makes sceptical noises when asked about AI annexing large parts of the primary health terrain. Every day the NHS delivers care to more than a million people across the UK, taking into account the physical, psychological and social factors that impact on a patient’s health. When formulating treatment plans, medical practitioners consider the different health conditions a patient is living with and the medications they might be taking. Some may say that no app or algorithm will be able to do what a GP does.

Much of what GPs do is based on a trusting relationship between a patient and a doctor. Research has shown that when GPs have a gut feeling something is wrong with a patient they are frequently right, even where there is a lack of obvious clues to a diagnosis.

Despite such misgivings, momentum is with the tech pioneers. A world of choices is opening up. Apps and chatbots are putting control in the palm of our hand and, once patients get a taste of choice, they will not give it up easily. In fact, they will only want more.

The hospital operating theatre is also at the vanguard of the medical tech revolution.

The da Vinci robot, in use in parts of Scotland, replaces the surgeon’s scalpel with a computer console. The surgeon guides robotic arms, which perform all the necessary moves. This allows operations to be carried out more quickly, less invasively, and patients can be discharged in days.

In the future, surgical robots could be controlled so remotely that the finest surgeons in the United States perform the most arduous operations on patients thousands of miles away in some of the world’s poorest countries. Eventually, surgeons could be removed from the equation – or see their role changed to one of programming and overseeing fully autonomous surgical bots.

Technology is also our best defence against some of the biggest killers out there. Consider, for instance, the work of Memorial Sloan Kettering, the leading US cancer clinic, who have combined with computer giant IBM. Together they have developed Watson Oncology, which runs a patient’s symptoms through a database and arrives at the optimal treatment plan.

At the high-end of oncology, this may reduce the time spent selecting the right treatment from months to minutes. In a field where time is a matter of life and death, programmes such as Watson allow doctors to share information, begin therapies sooner and, it is hoped, improve survival rates.

Imagine what such a system could do for priority waiting times and survival rates in the NHS. The effect would be transformative. It would be a game-changer and life-saver.

In Scotland, meanwhile, the mental health crisis has finally been acknowledged and even assigned a dedicated minister, but progress can only be described as achingly slow.

Support for those who suffer from depression, anxiety and other related conditions still takes too long to access and too many frontline staff know too little about the subject.

Cognitive Behavioural Therapy (CBT) is scientifically proven to treat severe anxiety, but for many health boards across Scotland this form of promising treatment simply isn’t an option, or if it is waiting times can be as lengthy as 18 months.

Of course, for every troubling experience with the NHS, others will have nothing but praise for the care received. But when it comes to mental health services, the NHS still has a lot of work to do.

Once again, AI provides part of the answer, this time in the form of Tess – a mental health chatbot designed by San Francisco start-up X2AI.

 

ITS founder Michiel Rauws drew upon his own struggle with depression to devise a bot that talks, listens and processes information like a therapist. Already being trialled in Canada, Tess is more than a Q&A programme: she records patients’ symptoms, emotions and experiences and stores them for future mental health episodes.

Tess remembers which stressors are likely to bring on a panic attack in a given patient and recalls what helped to lift another patient’s mood during their last depressive incident. Patients who lack the time, finances or confidence to see a regular (human) therapist can pull out their phone and be supported instead by Tess.

Such apps could give the healthcare industry the upper hand in the treatment of mental ill-health. For the NHS, it could dramatically cut waiting lists and buy the health service time to retrain medics to deal with mental health patients.

The tide of progress is rapid but turbulent, too. You need not be a clinical expert to recognise the dangers inherent in a dreamy techno-utopia of automated medicine.

Would software have built-in assumptions in favour of retaining a patient and therefore not making necessary referrals? How does AI replicate a doctor’s ability to spot warning signs of which a patient is unaware? Could an app, with enough autonomy and data, begin to play God and ration care according to a patient’s financial burden on the system or estimated longevity?

That’s not to mention the inevitable teething problems when any major tech programme is rolled out – except, with people’s lives on the line, mistakes cannot be undone with the click of a button. Then there are concerns over data security and patient privacy. Theoretically, patients could game the algorithm to jump the queue for a hospital referral or to access unnecessary prescription drugs.

These are among the primary hurdles which AI advocates must overcome, but most have a technological solution and can be tweaked out of the system as they arise.

More difficult is convincing those wary of the technology. Yes, AI could be the saving of the NHS – but for patients not au fait with apps and data and bespoke digitisation, all this talk of robotic surgery and GP chatbots may be confusing and unsettling.

Some are quite content to pop along to visit the GP they have been seeing for 40 years and do not relish the brave new world of Dr Finlay’s Chatbot.

AI has the potential to transform the NHS, but it must be implemented in an equitable way that enhances traditional GP services and doesn’t benefit some patients at the expense of others. Some patients love technology, whilst many others don’t. The health service must ensure that its use does not inadvertently widen healthcare inequalities.

Undoubtedly, this is going to take gradual reform, patience, and lots of public information programmes. The human dimension – of patient and doctor – must remain at the heart of the NHS ethos.

Ultimately, however, change is inevitable and technological innovation is arguably the NHS’s best chance of avoiding managed decline. Not only can it slash waiting times, reduce bed-blocking and improve patient care, technology is an answer to an increasingly unsustainable funding model.

Using AI to bring patients fast, cutting-edge treatment finally opens up an honest debate about cost. The private version of the Babylon app offers a free symptom checker but charges £4.99 monthly for unlimited access to a real GP. Included in the price are consultations via text message or video chat software FaceTime, 12 hours a day, seven days a week. One-off check-ups cost £25.

If the NHS can commission apps that meet all the basic requirements for primary healthcare consultations or outpatient services – reducing waiting times and freeing up staff in the process – there is a powerful case for offering patients the choice of faster care subject to a modest monthly fee. The principle of “free at the point of use” would continue, while such a scheme of rolling payments would not be very different from National Insurance, only voluntary.

Here is why the inherent conservatism of the public sector, quietly grinding its teeth up until now, would burst forth in full, Nye Bevan-quoting indignation. Such charges would be “a betrayal of the NHS”, “back door privatisation”, and all the other maledictions cast in the direction of even modest reform. There would be marches against a “two-tier NHS” and petitions for every smartphone in the land to be smashed to pieces.

It will take a great deal of political will to overcome vested interests and guide new ideas through the swamp of dirigiste group-think that passes for health policy in the UK. Any attempt to secure the long-term future of the NHS through reform, innovation and efficiency is met with wails of odium. Far from saving the health service from the evils of the profit motive, the reactionaries make it more likely the service will eventually collapse.

The Healthcare Quality and Access Index, the annual measure of the world’s best medical systems, places the UK 23rd.

This puts us behind Slovenia, with its mandatory and voluntary insurance tracks, and Sweden where patients must stump up co-payments to see a GP, visit hospital or even use an ambulance.

The NHS, while a proud national achievement, is nonetheless not the best healthcare system in the world – not even close.

 

CONFRONTING the reality – and setting aside sentiment and hysteria to accept that, across Europe, universal insurance-based models provide superior quality of care – allows us to ask some taboo questions. Could the NHS be made more cost-efficient, clinically effective and patient-friendly by introducing (modest) co-payments and fees for certain services?

Does AI hand us a laboratory to test patients’ receptiveness to charges? Will digital innovation steamroll over barriers to increased private sector involvement in health provision?

This is the real technological revolution in healthcare. An outdated model of funding and provision may not be able to withstand the momentum of rapid change, rising patient demand, and even buy-in by clinicians. If the NHS accepts the need for change, it can reform of its own accord and harness technology to safeguard Britain’s universal healthcare system for generations to come.

If it digs in its heels and puts roadblocks in the way of progress, it makes it all the more likely that the health service will have to undergo radical, painful surgery down the line. Allow the NHS to drift down that path and it will have a great deal less influence over where it ends up.

An NHS powered by AI could compete with some of the finest healthcare systems in the world. It would be speedy, nimble and sustainable.

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Britain, Business, Economic, Government, Society, Technology

The rise of automated robots is creating fear in the workplace. But why?

ECONOMIC & TECHNOLOGICAL ADVANCES

WE shouldn’t be surprised if trade union’s such as the TUC is waxing lyrical about how robots and new technology will liberate us all to work less for the same money.

After all, no less an authority than Karl Marx claimed automation would help free the miserable proletariat from their mundane drudgery.

John Maynard Keynes predicted in his 1930 Essay, Economic Possibilities For Our Grandchildren, that technology would allow people to work no more than 15 hours a week. “Three days a week is quite enough,” he opined. Keynes didn’t have any grandchildren, but if he had, it’s highly unlikely they would be basking in hours of leisure time.

Employment in the UK is at its highest since 1974, when ABBA won the Eurovision song contest and we actually did have a three-day week (but for all the wrong reasons).

Not everyone sees the advance of robots and technology in the workplace, in warehouses, manufacturing plants or even in new possible areas such as care homes, as a good thing. Fears that machines will make humans redundant or enslave us are as old as technology itself. Crackpot ideas such as Amazon’s robot-driven cage for its employees – now mercifully ditched – is an example that doesn’t exactly help.

In a fascinating speech on the future of work, Bank of England governor Mark Carney said that, in the past, machines substituted for “hands” or manual labour. Now artificial intelligence means they might replace “heads” or brain work, leaving “hearts” to people – or, in other words, work that involves emotion, imagination, innovation, caring and creativity, which could translate into more fulfilling work that adds value to the economy.

 

HISTORY tells us automation does not take away human work, but simply shifts people from one type of work to another.

One of the biggest technological revolutions receives virtually no attention from economists because it has mainly affected women. But, by making housework so much easier, the spread of domestic appliances such as vacuum cleaners and washing machines has arguably changed the workplace and society as much as the smartphone.

The idea that robots will take employment away from humans rests on the “lump of labour” fallacy that there are a fixed number of jobs in an economy, so if a robot takes one, a human being will be consigned to the dole queue. In reality, however, it is not like that. Economies are dynamic, so if robots add to productivity and growth then more, not fewer, jobs will be created for humans.

This doesn’t mean the introduction of technology will be seamless. Overall, technology may be beneficial, but individuals can and do lose out if their jobs are taken over by machines and they are not able to find alternative employment quickly.

What Keynes ignored in his analysis is that many of us, probably including himself, have workaholic tendencies and absolutely don’t want to be idle.

For anyone who wonders why multimillionaire chief executives don’t just put their feet up and enjoy their loot, think of it this way: the higher paid someone is, and the more status and admiration they glean from their work, the less incentive they have in taking more leisure time.

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