The rising cost of health care is driving providers to explore less expensive solutions in an attempt to slow rising prices. Patients are being presented with a potentially uncomfortable choice: deal with a computerized nurse-avatar or increase the wait time required for certain administrative procedures - and potentially pay more.
Aside from concern about health care issues, one can only imagine the legal questions: what if the computer is down or makes a mistake or malfunctions? Is the patient going to be required to sign a waiver? Will those provisions be enforceable? Given the record health insurance and medical records companies have already, one can envision both rising frustration, stress and dissatisfaction associated with the process.
While there is no doubt that we, as a society, are becoming more comfortable with technological interfaces, the ethical, medical and legal implications of this latest development are daunting. JL
Ben Schiller reports in Fast Company:
Getting patients discharged from hospitals is time-consuming, but not if you have a robotic nurse give the patients all the info they need (and banter with them about baseball).
Meet Elizabeth, your virtual nurse. She can tell you what medication to take, and when to take it. She can raise her eyebrows to emphasize words, and she can show empathy. And, to make you feel at ease, she can even ask you questions like "Are you a Red Sox fan?" One of a growing band of "relational agents" that act as stand-ins for front-line staff, Elizabeth is designed to help with the discharge process at hospitals.
She was developed by computer scientists at Northeastern University (hence the Red Sox question), and trialed at Boston Medical Center. Following commercialization by a startup in San Francisco, she could soon be appearing in hospitals around the country.
Tim Bickmore, an assistant professor professor of computer science at Northeastern University, says agents like Elizabeth are not meant to replace nurses, but to supplement them. "Nurses are a scarce resource, and you don’t always have one available. You certainly don’t have one available to spend an hour with you to review everything you need to know."
Patients relate to the agent by pushing on-screen options. If there is something they don’t understand, or something they want further information about, they can indicate it so a real nurse can ask them about it later. The session lasts about 30 minutes.
Elizabeth may lack a certain charisma compared to a real-life nurse. But in fact, the Boston Medical trial found that 74% of patients would opt for the virtual version, given a choice.
“”Nurses are a scarce resource, and you don’t always have one available.
Bickmore says the benefit for hospitals are two-fold. First, they don’t need to hire extra staff. And two, agents potentially do a better job of relating key information, helping to cut readmission rates. Across the board, up to 20% of patients are readmitted—and a third of those cases are considered "preventable".
"The way we like to look at it is that if we do a better job about informing patients about how they have to take care of themselves before they leave the hospital, the less likely they are to develop complications and have to get readmitted. So it decreases the overall care costs, and increases the health outcomes," he says.
Bickmore is now at work on a follow-up involving Elizabeth’s sister, named Tanya. Instead of being wheeled in at discharge time, this "Hospital Buddy" will sit permanently at the bedside, acting as a full-time patient aid. Among its functions, it can inform patients what certain noises in the room mean (alarms, say) and introduce doctors when they enter the room ("This is Dr. Smith, your cardiologist").
"There are whole explored areas of providing patient-facing technologies in the hospital," Bickmore says.
For better and worse, he is probably right.
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