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#EAPM - #AI ir #Robots sveikatos priežiūros kontekste: už ir prieš

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On 19 February, the ENVI Committee's Health Working Group organized a workshop on robots in health care, rašo Europos aljansas už Pritaikomo Medicina (EAPM) vykdomasis direktorius Denisas Horgan.

The purpose of the workshop was to inform participants as well as ENVI members about the current status and potential applications of robotic and artificial intelligence (AI) in healthcare.

An MEP who has been active with EAPM, Alojz Peterle, (EPP, SI) got the meeting underway with a tale of robot use in Japan, in care and nursing homes. These robots number around 5,000 and are there to help meet demographic challenges that are leaving all developed countries with a greater number of elderly in their populations.

He suggested that a European agency for robotics could be useful, while pointing out that citizens are still uncomfortable with the idea that robots are being used in everyday life.

EP Mady Delvaux then told the workshop about recommendations to the Commission on Civil Law Rules on Robotics in respect of European values in the use of robots and AI. She was disappointed with the impact of the report because she thought that the Commission was too slow to react.

However, two years after the report, the Commission created a High-Level Expert Group on Artificial Intelligence, and the MEP said she hoped that Europe would finally get the necessary ethical guidelines, which should cover all aspects of AI and robotics.

The workshop was told that humans should be at the centre of research, and this is as true in AI as any other area of healthcare. There may be robots, but there will always be humans.

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As mentioned, some people remain uncomfortable with the idea that robots are being used in everyday life and in medicine. So a human presence shows patients value, and often they feel better for it. But the robots are, for all that, here.

With EAPM’s 7th annual conference coming up in early April, the topics outlined will be up for discussion among MEPs and other stakeholders.  Norėdami užsiregistruoti pagrindinėje konferencijoje, spustelėkite čiaTo view the agenda, please spauskite čia.

Praktinis taikymas

Attendees were also given an idea of some practical applications. For example, Europe has such things as robotic urologists. Among machines being used by them are ones that are not exactly robots Rep, but they allow the movements of the surgeons to be miniaturized and very precise.

Many health-care professionals say that surgery today is not good enough, and that there are too many complications. Going forward, improvements in surgery and, of course, education are needed, the workshop heard.

Meanwhile, there are many different kinds of surgical robots, and such innovative tools make surgery safer and ultimately cheaper as well.

Robots in general service at healthcare establishments include back office, such as pharmacy dispensing, semi-autonomous service robots, which interact with more humans than before, and even autonomous robots.

In a nutshell, many healthcare professionals have found that robotics can bring significant opportunities for improving safety, quality and efficiency.

And there are potentially more applications. Attendees were told about ‘Project Dream", in which doctors try to use a robot in the treatment of children in the autism spectrum.

Children in this autism spectrum have difficulties in learning social habits through observing human adults, but it turns out that they are very open with robots. Basically, the healthcare professionals wanted to see whether using robots would help teach social and psychological behaviour to children with such issues.

Another study has been undertaken related to using AI in the treatment of patients with major depressive orders. The clinical problem seems to be that, between sessions and after treatment, patients fail to follow the suggestions and recommendations of the therapist.

It is impractical to have a therapist at the patient's home, but perhaps an artificial intelligence system can play the role of therapist, and maybe this will help.

In this case an avatar was used which was able to deliver different psychological tests and take in data. If the client had a problem, the avatar started going through basic methods to try to solve the situation.

In robotics, AI and healthcare Europe has processing and analysis of medical data, including imaging, as part of 4P medicine (predictive, preventive, personalised and participative).

This is becoming more and more important, and includes telemedicine and virtual consultations in which the patient is not directly in contact with a medical professional.

Ethics, patient trust and more…

There are several major barriers to the use of robots in health care, including the actual appearance of robots, plus changes to health-care work, and new ethical and legal challenges.

The workshop heard that there are perceived threats to professional roles among health-care staff, especially against a backdrop where patient trust as an aspect of care is perceived to require human input. Putting a robot in a caring role causes problems sometimes.

Meanwhile, if a robot looks too ‘robotic", then a fear arises concerning death and the replacement of actual human beings. On the other hand, if they look too human, perhaps expectations will be too high.

Changes to health-care work also provides an obstacle in that this can cause tensions between standardization through automation and the unpredictable nature of healthcare work. Essentially, the use of robotics can also be seen as impinging on human professionalism.

With regard to new ethical and legal challenges, the workshop heard that there are currently no existing liability and ethical frameworks in what is a rapidly evolving field. Regulation is clearly key to promote routine use without stifling innovation.

Overall, there are clearly significant social challenges, and experts, scientists, and lawyers need to be brought together to look at the practical questions which arise where AI is being used.

Attendees were reminded that, in medicine, the classical principles are beneficence, non-maleficence, autonomy and justice. But the workshop heard that perhaps there is a need to add other principles when addressing robotic systems.

There are other issues, too, specifically those that deal with data. These need transparency because the system used is based on certain principles and values and every stakeholder needs to understand and agree upon which ones those are.

And when it comes to accountability, there is the issue of responsibility. Clearly, the workshop heard, responsibility and liability are with the humans and not the machines. This is an important issue that needs to be defined.

Further issues include explicability, auditability and traceability. This, in this context, means the capacity of the system to state the reasons for which it decides to take a particular decision. Such a capacity enables transparency and responsibility.

On top of all this, cybersecurity is a big concern. Protecting patient data and personal data is essential in healthcare and, in these circumstances, there may be a need for specific approaches.

Addressing patient data as special kind of data may be the only way to address this issue.

To register for the EAPM Presidency conference, click čiaTo view the agenda, please spauskite čia.

Mokymas ir švietimas

It is already clear, as the workshop heard, that there is a need for improvement in training, as well as for standardization, a validation of training pathways, licensing and relicensing.

This should produce safer surgery and become less costly for health systems down the line.

Generally speaking, robotic surgery has proven its advantages over other types of surgery in several ways. The higher costs of robotic surgery can be offset by health gains resulting from lower risk of early harms, while quality-assured training will probably lower complication rates by over half, attendees learned.

More AI and MEGA

With EAPM’s 7th annual conference coming up in early April, the topics outlined will be up for discussion among MEPs and other stakeholders.

Not only that, but they will be out on the table during the Alliance’s ongoing engagement with politicians before the conference, and afterwards going forward.

AI applications in health care are particularly promising and, in 2020, the European Commission will support the development of a common database of health images (anonymized, and based on patients voluntarily donating their data).

This image database, which will be built under the auspices of Horizon 2020 in coordination with member states, will initially be dedicated to the most common forms of cancer, using AI to improve diagnosis and treatment. The work will meet all necessary regulatory, security, and ethical requirements.

MEGA (Million European Genomes Alliance) which began life as an initiative to build a cohort of one million genomes across Europe, has now been expanded to include all valuable health data sharing, including imaging.

Norėdami užsiregistruoti pagrindinėje konferencijoje, spustelėkite čiaTo view the agenda, please spauskite čia.

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