AI in Healthcare: Will it work for you? - E721

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What is the overall impact of AI on healthcare and its current limitations?

Unknown 0:00
What is technology actually doing to healthcare? And what can it still not touch? Here are five conversations from the archive, Dr. Thomas Kelly of Heidi, on why a doctor's paperwork is a patient safety problem. Jay Fajardo on Pyjama Time, the 40% of a doctor's day that disappears into admin.

How does Dr. Thomas Kelly explain that paperwork steals clinical capacity?

Unknown 0:20
Ed Booty of Reach 52 on why a tech platform alone won't reach a rural village. Joshua Wang on Why We Keep Catching Cancer Too Late. And Dr. Tom Again on making medical AI work across Malay, Hokkien, and Singlish.
Jeremy Au 0:40
So let's talk about, you know, what you're talking about, which is I think product market fit or discovery of that. I mean, what's so bad about doctors having to do paperwork? You know, I do paperwork, everybody has paperwork, uh you know. A little bit of a straw man here, but what's so bad about it in a way that, you know, something like this needs to happen, yeah?
Dr. Thomas Kelly 0:58
Yeah, I mean, there are parts of it that are good to lean into the question. So the good parts are that it helps you form synthesis and you spend time thinking through the case. Um, so there's certain aspects that are good, I think. I think the bad part is just it's the capacity problem. So when like me as a doctor, you know, on when I was a trauma doctor, I would have a hundred patients on our list. So it's a hundred patients waiting on me and maybe two other doctors to help them. Um get care done for them.

Why does Jay Fajardo call 40 % of a doctor’s day ‘pajama time’ and how can AI fix it?

Dr. Thomas Kelly 1:25
And yeah, when you're sitting in hospital, like you're waiting for things to happen, like the physio to see you, or the uh CT scan to get done, or the uh referral to a different specialist. So there are all these jobs. We used to call it the uh ward round list. So you do the ward round and then there's all these jobs to be done. And of those jobs, probably like 20% of them really required like clinical judgment, like they needed a doctor. To actually figure it out and do the job. But majority of the other tasks were just purely administrative. Like someone had to refer to this person, or someone had to draft a letter, or someone had to, and these are patients who are like sitting in beds, getting sicker.
Dr. Thomas Kelly 2:02
Hospitals are not a good place to be, like you can get pneumonia, ulcers, all sorts of bad things. And those beds could be used by other people who are waiting in the emergency to be seen.

Why can’t a pure‑play tech platform reach rural patients, according to Edward Booty?

Dr. Thomas Kelly 2:11
But I am the choke point. Like as a doctor, I I'm the only one that can do these tasks because they're clinical enough that it needs me to do it, but not like really what I went to medical school to do. And there's a lot of stuff that sits in this bucket of it needs my oversight, but it doesn't need like my highest clinical aptitude and it's the least enjoyable bit of the job. Like no one wants to, you know, call up and wait on hold to talk to the cardiology registrar and have like a kind of grizzly. conversation trying to get them to see for them to see your patient. Um and it's like I already, if Heidi was there or like I had some partner in care who like knew what happened in the initial ward round, it's very easy for that system to draft a summary of the case and just share it with the registrar.
Dr. Thomas Kelly 2:54
But but without that system, the current standard today is that doctor has to do it. So the doctor has to make the call. But that's job 200 in the list.

How does Joshua Wang describe the problem of catching cancer too late?

Dr. Thomas Kelly 3:02
So when does that Get done. And then that person probably doesn't get seen by cardiology for two days because they refer late in the day and then the cardiologist is already busy. So basically, like if you think about a healthcare system, the choke point is a doctor's time and attention. And anything that takes that up has direct impact on patient outcomes because it slows down bed movement, reduces the speed to different interventions happening. And you actually constantly Constantly triaging your own time. So you end up only seeing the sickest patients. And basically, patients have to get sick enough for you to pay attention to them. And anyone who's low acuity basically just sits in the hospital, sort of rotting, waiting for something to happen.

What challenges does multilingual localisation (Malay, Hokkien, Singlish) pose for medical AI?

Dr. Thomas Kelly 3:42
So I think basically paperwork is like stealing the capacity away from an already very tightly constrained system.

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