We know that obesity is an “urgent public health crisis” and a global matter of public emergency. We also know that obesity is taking its toll on Britain’s healthcare system. With more than 700,000 obesity-related hospital admissions in 2017 and 2018, placing increased pressure on an already strained NHS workforce, the status quo isn’t delivering, so it’s time to innovate and try something new.
At the crux of the issue is finding a way to help people change their behaviour for the better. This is when they will start building a healthier relationship with food and exercise, placing less pressure on the healthcare system as doctors simply do not have the time, capacity and energy to fix it all on their own.
One solution that experts are exploring combines two pre-existing ones: face-to-face consultations and the ingenuity of AI. From this we get conversational AI primed for delivering ‘nudges’ via AI-powered cognitive assistants to help steer patients towards healthier decisions.
As many private sector organisations are already seeing, AI comes with varying levels of “maturity.” In this instance, the NHS would be deploying a cognitive assistant with outstanding Machine Learning and Natural Language Processing capabilities, which enables it to learn from previous interactions, share insights with doctors based on recorded data and engage tactfully with patients.
What is the nudge theory?
The nudge theory – made famous by the Nobel Laureates in Economic Sciences, Richard Thaler and Daniel Kahneman – has been proven to influence behaviour in all sorts of situations and bring about real change: for example, having footsteps printed on the right-hand side of the escalator, placing green arrows on the floor of a supermarket leading to fruit and vegetables or serving food in smaller plates to reduce food waste and over eating.
The theory posits that subtle encouragements and gentle reminders are more effective in moulding positive behaviour than plain instructions. It’s found that, for yielding the best results, frequent communication and engagement is vital.
With the NHS facing significant staff shortages of up to 250,000 by the year 2030, health professionals would welcome AI for delivering high-touch support through regular nudges. That’s where conversational AI comes in, standing in as a behavioural coach, nudging overweight or obese patients to follow a healthy lifestyle plan at home, ensuring they stay on track between appointments.
How can AI deliver the nudge theory?
Step 1: Designing a personalised weight-loss plan
Working in line with a regimen is key here. After gaining initial insight into the patient’s lifestyle and diet, the doctor can carve out a health plan, apportioned into smaller, achievable goals – which the AI assistant will then be programmed to help deliver.
A top benefit of integrating AI into one-to-one patient care is that there is a clear data trail which can feed into the advice given by the doctor (adhering to relevant data protection guidelines). This means that the plan will be constantly readjusted to fit the needs of the patient.
Step 2: Enacting strategy
Through a continuous, positively reinforcing presence, the cognitive assistant will provide helpful nudges in conversation. This could start at breakfast for example, with the cognitive assistant letting the user know about the difference in calories between a bowl of porridge and a fried breakfast. The patient can then see a clear path to easily making healthier choices in their daily life.
Step 3: Making the most of the feedback loop
The cognitive assistant doesn’t only play the role of nudging the patient but also in feeding back to the doctor, who will then use this information to improve the weight-loss plan. Crucially, the assistant will know to flag symptoms or habits which might escape the doctor, whose knowledge of the patient’s daily routine is limited to what is shared during appointments.
For example, if a patient starts reporting worrying complaints – such as self-deprecating comments, symptoms of risk-taking and obsessive preoccupation with food – the cognitive assistant will alert the doctor to the need for a face-to-face appointment. As we can see, these regular interactions provide key insights which are often not revealed during short visits to the doctor.
Not replacing humans, but enriching their roles
NHS trusts must re-evaluate how they are using technology to support both their employees and their patients. Cognitive AI assistants have the power to address both current and future public health emergencies. Part of addressing the obesity epidemic is a matter of reinventing how the NHS engages with patients through embracing new technologies.
People like to have a health professional reassure them. The move to integrating AI into healthcare may be daunting, so it is vital that patients see the positives in engaging with cognitive assistants: supplementary advice, care and support at home to steer them towards a healthier lifestyle. The doctor ultimately remains the primary carer, but they will be more informed and therefore better equipped to serve their patient.
In light of worsening resource issues and longstanding budget constraints, AI powered cognitive assistants will be a welcome addition to the UK’s healthcare system. Through the power of the nudge theory and the reliable presence of a cognitive assistant, more positive results can be delivered both in and outside of the doctor’s office.
Behavioural changes, which take time and effort, will see overweight or obese patients start building an enduring, positive relationship with food and exercise. On the other side with the assistant’s data and insights, the doctor can provide more targeted and effective care and help more patients maintain a healthy weight and lifestyle.
By Dr Vincent Grasso, Director of Cognitive Healthcare Services, IPsoft