If we were to believe most things we see in the movies about humanity’s future interactions with Artificial Intelligence, or AI, and robotics we may not perceive them to be events to eagerly anticipate. “The Matrix” and “Terminators 1,2,…n” immediately spring to mind. Thinking of examples that specifically imagine robots and AI in human health care, without creating too many plot spoilers, having an automaton like Michael Fassbender’s android character “David” in the Alien movie prequels, perform any clinical intervention on you would be…ill-advised. However, the unavoidable advance and willing acceptance of technology in our lives and our healthcare environments, in addition to an increased desire for health outcome reliability and expansion of clinical capacity, suggests that having the full spectrum of technological advancements will be a necessity. Indeed, the trajectory towards this brave new world of healthcare delivery and access is already upon us. This claim is supported by the remarkable advances I saw while presenting research on the Persuasive Experience of Wellness Technologies I’ve conducted with Huiyang Li of SUNY Binghamton (https://www.binghamton.edu/ssie/) and Catherine Bass of Onlife Health (https://www.onlifehealth.com/) at the first ever American Psychological Association’s (APA) Technology Mind and Society conference (TMS) http://pages.apa.org/tms/.
Now, before any of you become overly alarmed by my willing acceptance of this technological tsunami and start to craft a comment about the devolvement of the humanity in healthcare thanks to the wanton encroachment of technology it is important to know two things about the developments I am specifically referring to:
1) The health and wellness technologies including AI, VR, AR, and robotics presented within this context were part of research and development being conducted by psychologists, clinicians, systems analysts, and engineers. Their focus is on how we extend human capability through technological advancements. In other words, Human Factors in Healthcare Technology design.
2) The driving force of the research and innovation presented at APA TMS were those that were firmly rooted in developing assistive technologies through actual human experience and exchange discovery within care settings. In other words, design for technologies that help to support Humanity in Healthcare instead of those that seem to have been designed in a vacuum and without meaningful input from subject matter experts entrenched in the frontlines of health and long-term care access and delivery.
For example, MIT Media Labs is doing some masterful work with clinical staff that uses “huggable robots” driven by human sentience that is trying to lessen the stress, anxiety, and pain of children in pediatric care settings (http://robotic.media.mit.edu/portfolio/pediatric-companion/). In the United Kingdom, there are some great strides being made in research and development of robot use in long-term care settings to perform Comprehensive Geriatric Assessments, assist residents with retention of their cognitive capabilities and facilitating social connectivity and personal autonomy (https://youtu.be/tJOYDgXAgUM ; http://www.mario-project.eu/portal/vision/why-mario). All the research presented indicated that most of these technologies are still very much in the “beta” stage and are not meant to be a replacement for, but rather an extension of human beings in healthcare. Thus, the necessity of continuing to test them in actual care environments with clinical provider teams. The promise that this truly Human-Centered Technology holds for extending human capability in care settings is difficult to deny and not to be, at least a little bit, excited about.
Interestingly, there was a common anecdote that seemed to manifest in many of the human to technology exchange case studies presented at this conference. It is also a developing theme that Huiyang, Catherine, and I have begun to notice in our own research on wellness technology usage and uptake patterns. This was that technology sometimes does not make people feel “judged” in the way other human beings can. Although perhaps a reframing of awareness around this issue in human care providers may be helpful in certain instances, most of us who have spent any appreciable time working in and around care settings understand that to accomplish 100% reliability in human response in every circumstance is simply not realistic. Furthermore, sometimes the “negative judgment” we may be personally perceiving is due to our own internal sensitivities and not necessarily to anything a care provider may be communicating. Additionally, there is a growing body of research on assistive technology that suggests that people seem to flourish with collaborative technologies that allow them to feel more autonomously capable regardless of their age or mental physical capacity. For those of us involved in the design of these care and wellness technologies and environments and processes that surround them, it’s important to remember that our end goal should be not just to support but optimize human capability.
It was no surprise that the Human Factors and Ergonomics Society (https://www.hfes.org/) was a support partner in the development of the APA TMS conference. The opportunity for human factors expertise to help successfully shape AI, VR, robotics et.al. as well as the environments that they occur within is key to these innovations being implemented in a way that sets us all up for success. It now seems in many high-risk industries that having human factors engineers and/or psychologists actively helping to shape the environment, technology, and equipment design is a given. For instance, we are beginning to see the adoption of the practice of applying human factors to design, testing and implementation become the norm in safety-critical industries such as medical device design. However, healthcare in general despite its direct impact on human health and wellbeing has been relatively slow to adopt the integration of human factors into performance management as a standard practice. To be able to fully and successfully integrate human supportive technologies that can exponentially expand human capacity in care settings comprehensive human factors-based strategic development and implementation will be imperative. This will include consideration of elements such as enhancing natural language processing in healthcare AI as well designing technology and environments of care that mitigate the interference of ambient noise in human to robot exchange performance.
It seems that what humanity’s future interactions with advanced autonomous technologies in healthcare may look like is contingent upon the design dependent parameters we prioritize in them. If thoughtfully designed and implemented with full consideration of human wellbeing, they could exceed our hopes for creating optimal human-centered care. If not…who knows what the outcomes may be. Perhaps, if designed and implemented the right way, these technologies could even help us to be better humans than we ever thought we could be. The promise is there, but it’s up to us to determine how we will move forward.