Are you nuts?!?!

I read an interesting article today in IEEE Spectrum titled “Robots Could Act as Ethical Mediators Between Patients and Caregivers”. The article highlights some impressive work done at Georgia Tech in developing a robotic solution that attempts to serve as an ethical mediator during medical encounters between patients and their caregivers. The piece describes how the robot’s software uses voice volume and facial tracking to determine if a “human’s dignity becomes threatened due to other’s inappropriate behavior”. If such an algorithmic threshold is reached, the robot then interjects a mediating voice response into the patient-caregiver interaction. Although in the closing paragraph, the article states that “there’s no way a robot can replace empathetic interactions between two people”, the video examples and descriptions of such a solution had me rhetorically asking “are you nuts?!?!”.

There’s no doubt in my mind that the individuals who developed the solution are extremely bright, and a similar technology may be useful (in a fly-on-the-wall capacity) for secretly giving caregivers feedback on their interactions. However, I continue to find the common sense disconnect between the technology sector and healthcare, well, quite concerning…

To developers: The practice of medicine is an art that combines years of intensive study in the sciences with the common sense and practicalities of human interactions. Clinicians are already inundated with paperwork, regulation, and oversight, and more attention needs to be paid to making technologies more viable in terms of clinician adoption and patient experience.

To clinicians: Developers are keenly focused on innovation in healthcare (in case you haven’t noticed). Clinicians need to actively engage with developers and do a much better job at articulating how technology can provide value for their patients.

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The Patient-Clinician Team

Why You Should Form Your Own Hand-Picked Health and Wellness Team:

In medicine, there are several different buzz-phrases that either relate to or describe what I often refer to as the ‘patient-clinician team’. Whether you call it ‘shared decision making’, ‘patient-centered care’, ‘patient-clinician team’, or perhaps most accurately, the ‘nextgen team’, the most important concept to keep in mind is that individuals need to play an active role in formulating and participating in their own health and wellness. Although seemingly obvious, this point is absolutely crucial, and it serves as a foundational prerequisite for realizing the promises of nextgen health and wellness.

At the heart of the patient-clinician team are several key concepts. First, understand that the patients’ values and preferences are just as (if not more) important than the clinicians’ or coaches’. Second, it should be understood that the team simply will not work without consistent and active communication between an individual and his or her hand-picked team of caregivers. Of course, neither of these concepts are novel, however, recent advances in sensing, and in information and communication technology have enabled this team to become much more of a practical possibility. Finally, as I already alluded to, the true nextgen team is not just a patient and his or her primary care physician (which is often blindly auto-assigned by an individual’s insurance company), but the specific group of people that an individual feels will best help him or her live a better, healthier life. In other words, the true nextgen team is the individual and his or her handpicked ‘all-star’ team of providers, coaches, advisers, instructors, and educators that are best-positioned to deliver the best possible care for that individual.

Recently, there has been an exponential increase in the amount of medical publications that highlight the pros of various ‘digital medicine’ or nextgen health and wellness-related efforts. However, one commonly cited reason for long-term failure in such publications is the lack of sustained, individual-level engagement between individuals and caregivers. In much of the cutting-edge literature, individuals initially gravitate towards technology-centric interventions, but almost universally, both the interest and the associated positive behaviors quickly fade. What’s missing, and what’s needed, are the relationships that effectuate positive behavior change.

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