Cohen Kas, futurologist - about hospital robots and trust in virtual doctors

“If there are no robots in your hospital, then I don’t want to go there”

- Older people would like to be in the usual

surrounded, but we can’t always be near them. For example, now, during the coronavirus pandemic. What solutions or devices can help with this?

- Many people use speech technology toin order to find out what, for example, is the weather in Moscow now. Suppose I set a reminder to my father to take a pill at five o’clock, but he doesn’t like the voice of assistants like Alexa or Siri. Then you can turn to technology help at one of the companies, for example, Lyrebird, where they will let me talk to the computer for only two minutes and write me down. After that, any text for the father will be pronounced by my voice. That is, now at five o’clock my father will hear me, reminding me that the time has come to take the medicine. We think this is fantastically correct, because a familiar voice makes the process much more human.

One of the main problems of old age isthat people forget to drink water on time, which means they lose moisture. Therefore, we made a patch that measures the level of saturation with water. This, of course, is good, but not enough - because at the age of 85 I can forget what to drink, or not understand what the plaster is saying to me. But I watch TV quite actively, so every three hours it is he who should tell me that it is time to go drink some water. This approach has already been implemented.

- Hospitals in Japan are well-robotic. In your opinion, does this not make the hospital an even sadder place than it really is?

- Not in Japan. This is the only country on the planet where people are quite ready to die in a hospital. Do you know why? Because Japan is the most robotic country on the planet. There in the hospital, a RIBO robot nurse can drag me out of bed, take me to the bathroom and transfer me to a wheelchair. This is absolutely amazing because there are two little doctors and two of the same nurses to take care of me.

I do not want to die alone. Technology can improve people's lives, and robots can become more human. And if there are no robots in your hospital, then I don’t want to go there, because there I will die on my own, right?

Cohen Kas, futurologist

RIBO Robot (Robot for Interactive Body Assistance, "Robot for Interactive Human Assistance") developed in Japan at the Institute of Physical andchemical research in conjunction with Tokai Rubber Industries. It is made in the form of a polar bear, which can lift a patient weighing up to 60 kg from a wheelchair and put him into bed. Equipped with tactile sensors that do not allow you to work with excessive forces that can cause pain in patients. Wheels allow you to move in any direction. The robot is equipped with an intelligent system for recognizing faces and voices of patients, it can execute voice commands.

- You gave a lot of examples of innovative gadgets. Do you have any fears that they will increase the number of oncological diseases?

- Most of these days have cars, in themthere are airbags. When people started developing airbags, they were not perfect either. Of the 100 cars, for example, five pillows did not work and there were accidents. There are positive and negative things in any technology. And so technology needs to get better. Then we will not have fear and anxiety, and this will give a good marker for health!

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- Deciphering the genome will help defeat cancer?

- Now there are two important topics in oncology. The first is due to the fact that we better understand why in the past our immune system did not recognize the tumor. There was an opportunity to re-educate the immune system so that it does. And we create a medicine by removing immune cells from the body and then returning them back, teaching them to “fight”. The main problem is that we do not yet have a good enough tool to understand what consequences this therapy will bring in the future.

We also need to make profiles of ourpatients: get as many genomic transcripts and protein data as possible in order to understand how the tumors respond to our actions. For this reason, we have a huge field of immune oncology. We still need to develop some sensors that will allow these technologies to really realize their capabilities.

A doctor using technology will be the best

- Does the patient’s personal contact with the doctor really need now?

- Yes, this is the next step. There is a hospital in St. Louis, Missouri - it looks normal from the outside. But there is not a single patient or bed inside. All patients are monitored with the help of doctors, nurses, but physically remain at home. The absolutely amazing thing is that it is not just technology, but a level of trust. The hospital is built for doctors because they are still deciding whether I can stay at home or not.

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In Belgium, if you come to the doctor, he will beI’m constantly typing something on the computer, but he doesn’t look at the patient at all. What I do: I use a kind of column, which, when I talk to the patient, records the conversation and automatically sends the information to the medical record. Which doctor do you like best? Of course, one that uses technology to become a better doctor.

- And can virtual objects be useful in reality?

- Imagine that you need to meet with the doctor in person, but right now this is not possible. You can use the virtual image of a doctor and talk with him as if with a real person.

It is also important in order to getimmediate advice on how to stay healthy. There is such a movie “City of Heroes” - there such a virtual doctor is in a small box, but can turn into a big inflatable person. And he knows everything about his patients.

"Doctors taught to be gods"

- Why are technologies so slowly introduced into the real healthcare system, not only in Russia, but around the world?

- There are two key reasons: the first is the level of trust, doctors still need to decide what is best for patients, and the second - doctors were taught to be gods. You thought that you know everything better than anyone, and suddenly something suddenly appears that can make it better.

Therefore, initially a large number of technologies,that have been introduced into healthcare do not work. The community needs to run them in first, to make sure that doctors, nurses and the hospital itself can say: "Yes, this is what we really need."

- What needs to be done with the health care system in order not to get sick and, relatively speaking, live forever?

- When I say that we need to build a world inwhich people will no longer be sick, I do not mean that we will live forever. Death is the best invention. She helps us to strive for something. Imagine that we would live forever. We would endlessly put things off and never do them in the end. But even if we do not hope for immortality, we need to fight to stay healthy.

- Then what is the new concept of healthcare?

- This is a concept of pleasure. People don’t associate health and healthcare with pleasure, as a rule, they say: “Oh my God, fu, fu, fu, I want to leave the hospital as soon as possible.”

So, I am a hospital and I tell you that you do not need to come to me, you can stay at home. Or imagine that I am the doctor who says: "I will maintain your health." Nice, huh?

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Sometimes this is generally not related to technology, but tosimple things. For example, to children who need to make droppers, we say that we give them super power. We call an MRI device a pirate ship, and then it is no longer so scary. We tell the guys that they are pirates who shoot cannons. Children just drag on it.

We have a patient who is 85 years old, Achilles. To give pleasure, we deliver him to the hospital by car, and when he gets into the waiting room, a musical group plays for him. He has a dog, and he can bring it with him to the hospital. When they will make a dropper, we will allow him to use a mobile phone and so on.

This is the hospital that you will like and canprovide pleasure. That's why you need to hire a person who will monitor this. Maybe you don’t even have to hire: I think that the pleasure of patients can be provided with the help of modern technologies.

- What else can the introduction of digital technologies in medicine give, in addition to things that have already become familiar?

- Development of digital technologies in the fieldHealth care will allow, first of all, to realize two things: remove the constant friction between the doctor and the patient and create a new experience for the latter. This will contribute to the mental comfort of a person and reduce the negative burden on his body.

“The most important gift from parents is the genetic code”

- What tools can change the quality of medical services?

- I will talk about three digital “guardian angels” that will change the healthcare system for the better.

The biggest gift you've ever hadreceived from your mom and your dad - a genetic code, about 3 billion different DNA characters. Using a special device, you can sequence your genome in three hours. And with the help of the program, find out, for example, how many factors a person has, indicating potential heart problems. Then the patient understands that if he takes medications, timely diagnoses, implants a defibrillator, he can extend his life and maintain its quality.

First of all, we get from our parentshealth. By the way, you know what are the two best indicators of life expectancy? This is the age at which your parents will die, and your social status. That is, the environment plus your heredity - and you can predict the age at which you die.

The second “angel” is the toolsanalyzing our current state. Suppose there is a gadget to which you can press your finger, and within 10 seconds he will conduct a complete analysis of the state of the cardiovascular system. If something goes wrong, then the information is sent to the cardiologist. Of course, only the patient decides what information to share.

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But if people trust, doctors cancreate larger and larger patient records, constantly have more information than if they were just asked how they feel. You need to combine biomarkers, sensor data and all sorts of other components to create a digital twin of a person who will know a variety of things, possibly not available to you, but known to your virtual doctor.

And the third “angel” is the digital experience. I can take a picture of the menu in the restaurant, the algorithm recognizes the ingredients and, based on my biological profile, gives me recommendations on what to eat and what is ideal for a diet. If, for example, you want to walk a dog, and somewhere there are plants that cause allergies, then a warning will come that you should not be there.

- What is the most important thing in the new digital life and what is the main problem you see in it?

- The most important thing in our life is trust. If you trust me, then we can change the whole world. To do and achieve what we want. Trust is what drives innovation.

The main problem is loneliness, especially forpeople who are now 20 years of age or older. We are in an era where we constantly look at our phones and interact only with them, use social networks in order to find out what is happening.

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