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Artificial intelligence and digital are already transforming medical service delivery in China and it’s heading west rapidly

By Katie Osborne on Mar 13, 2020

Imagine a world where you are sitting at your desk in the offices of a large company and you start to feel unwell. You take the lift to the ground floor to a vending machine in the lobby. You login and explain your symptoms to the machine. It gives you a diagnosis, prescribes your medication, you pay for it and it dispenses it on the spot.

 

Far-fetched? No. This is the Ping An Good Doctor ‘One Minute Clinic’ launched by Chinese health-tech company Ping An Healthcare and Technology in April last year.

 

Powered by Artificial Intelligence (AI), when a patient makes an inquiry, an algorithm identifies and sorts the symptoms into a diagnosis, which is confirmed by a human doctor behind the scenes.

 

Ping An’s plan is to install its One-Minute Clinics in shopping malls, airports and other public spaces providing onsite medical and pharmaceutical services around the clock to as many people as possible.

 

In 2018 the Chinese government gave the legislative green light for online hospitals and many companies in China have since started using internet-based solutions and AI to meet the country’s medical and health service needs, contributing to relieving the imbalance between supply and demand. 

 

Scaling up

Clearly these services are from being in the pilot stage and this approach is rapidly becoming mainstream. According to China Daily, PingAn in concert with Ali Health, Dingdang Kuaiyi and 3gujk.com, attracted 400,000 visits within 24 hours to free online consultations and livestreaming information from health professionals in the fight against the coronavirus.

 

Recent figures show that more than 10%, which equates to more than a billion, of all medical consultations in China are now taking place in an online hospital setting. This figure is expected to grow exponentially in the coming months. 

 

Last year Ping An also set up a JV to expanding these services into Southeast Asia, targeting the region’s 600 million people. 

In December Ping An signed a strategic collaboration with Merck to explore integrated solutions to advance intelligent healthcare in China.

 

What does this all mean for pharma outside China and Southeast Asia?

 

The healthcare landscape outside China is, of course, very different. Despite some attempts to use digital innovations including AI in telemedicine and online pharmacies to improve efficiency, regulatory authorities and medical agencies do not allow the use of AI in the way China does.

 

But there are pioneers exploring its potential outside of China. In Denmark Leo Pharma’s Innovation Lab is developing digital health solutions and products to improve the lives of people affected by chronic skin conditions.

 

It has set up its own ‘online hospital’ to improve efficiency and free up the resources of time-pressed healthcare professionals and its Chief Medical Officer John Zibert believes it is just a matter of time before the ‘online hospital’ model transforms the healthcare landscape in the West too.

 

A sustainable model

“The World Health Organisation estimates that by 2035 there will be a shortage of 13 million healthcare workers globally,” he says. “This, combined with an ageing population and one in three people currently living with a chronic condition, is putting enormous pressure on our health systems. It is simply unsustainable and it has to change.

 

“The solution in my opinion is not to recruit more doctors but to make the ones we already have better at what they do. And we can do that using AI. Most of the problems the healthcare system faces today can be handled with the proper technology.”

 

Research has shown that in dermatology GPs only get the right diagnosis about 50% of the time. This results in large numbers of referrals to specialists and long waiting lists. Patients sometimes wait months, or even years, to receive a correct diagnosis.

 

In addition to this, GPs in the UK often see more than 40 patients a day, despite recommendations from the World Health Organisation on safety grounds that they should see no more than 30. “That is not an optimal healthcare system and it is unsustainable,” says Zibert. “Imagine if those doctors had a tool that could help them diagnose more quickly and more effectively and thereby free up their time to actually talk to patients and reduce referrals to dermatologists?”.

 

The Innovation Lab has developed just such a clinical support tool that enables a doctor to scan a skin condition using a smart phone. The image is analysed using an AI algorithm which gives an immediate diagnosis. Diagnostic accuracy rates range from 75% for acne to 90% for psoriasis, says Zibert.

 

To enable this capability the company has over the past few years developed one of the largest databases of images in the world, collected from consenting adults in many countries. Every image that has been used to train the AI has been validated by at least three dermatologists to ensure correct diagnosis.

 

“What is important for us is data,” says Zibert. “By helping doctors to increase their diagnostic accuracy, they can prescribe the right treatment to the right patients. If the right treatment is prescribed, patient adherence goes up and payers are happy because the last thing they want to do is pay for a drug that’s ineffective.”

 

Tech phobia

Zibert and his team are investigating whether the online hospital clinical support tool could be a potential new revenue stream for Leo. But he says one of the main hurdles to overcome is an inherent scepticism of AI among doctors who are reluctant to adopt the technology. “We have to change the terminology around AI,” he says. “It needs to change from this idea that the robots are taking over. That's not what is happening. 

 

“We are simply doing things in a different way, we are practising medicine 2.0 and we are actually augmenting the intelligence of doctors and enhancing their existing capabilities. We have already seen it in the field of radiology, where doctors almost always use AI to make or confirm a diagnosis.”

 

He believes that if doctors endorsed AI, regulators would follow suit and a similar online hospital model could evolve in the West as it has in China. In fact, he believes it will happen anyway due to patient demand for faster access to healthcare.

 

“The landscape is changing and will look radically different within a decade,” he says, “and we have got to be prepared.”

 

To this end the Leo Innovation Lab has signed a Memorandum of Understanding with Ping An in China to enable the two companies to work collaboratively to further explore the online hospital concept. 

 

“We can learn from what they are doing in China and they can potentially use some of our AI to expand their work into Caucasian skin,” says Zibert.

 

This collaboration will help place companies like the Leo Innovation Lab well ahead of the game if and when doctors and regulators embrace the use of AI in healthcare.

 

As Zibert says, disruption in healthcare is slower than in other industries but as patient demand increases, medical resources diminish, and healthcare systems become more strained, there seems little doubt that the online hospital concept and AI technology could one day become the norm rather than the exception.