AI in Social Welfare
Role of AI in rural health
Current state — Healthcare in rural India
Rural areas have matured a lot but despite digitisation around our nation, unattended medical emergencies and prevailing health issues are still around. Budget allocation for National Rural Health Mission (NHRM) has been increased by 7.11% for the financial year 2018–2019, with the allocation being fixed to 27,039 Crore Rupees. The Economic Survey 2018–2019 as of July 4th 2019 puts forth doubts as to whether the allocated budget would be enough for the development in rural healthcare because the survey shows that sixty percentage of Primary Health Centres (PHCs) in India are still run by only one Doctor while about five percent have none [1]. According to the survey, “States with large number of PHCs functioning with just one doctor or without a doctor are indicative of relatively higher rural Infant mortality rates (IMR) and maternal mortality ratio (MMR),”. The survey also reveals the Gross Domestic Product (GDP) percentage in allocation of healthcare was just 1.5 percent. Medications were not at an affordable price which thus influenced the Out-of-pocket expenditure (OOPE) to all individuals. With only countable number of Doctors and a handful of staff for treating people, their involvement and dedication towards their duty is far from what was expected. The survey also stated, “What this data does not reveal is that even if the personnel are present, their level of participation in providing health services, may not be at desirable levels due to lack of supplies, inadequate infrastructure facilities, poor monitoring of the staff.” [1]. Despite government schemes for support of healthcare programs like Jan Aushadhi Yojana things still remain the same [2]. The National Health Profile 2018 says that there is just one allopathic government doctor available for around 11,082 people across the country, a figure more than 10 times the WHO recommended ratio of 1:10 [3].
From the above survey, it’s clear that people from rural areas are still in an out of reach zone. With only one Doctor available for more than a few thousands of people its very essential to get them connected with their nearest PHCs or Doctors practising in urban localities and also give them awareness about any outburst of diseases or precautions to be taken in cases needed or even helping them realise the need for proper sanitation in and around. In reality this would actually seem to be a myth but it is indeed a feasible solution if AI takes up the responsibility. Let’s see how AI can bring about this plan to action. Before seeing that lets also have a glimpse on some of the current AI trends that are happening around us.
Current trends of AI in healthcare
China has started its way to reach all corners of their country using AI. The AI medical assistant, launched in March last year by Chinese AI firm iFlytek, is becoming an important partner for grassroots doctors making diagnoses in rural China [4]. This system assists Doctors in diagnosing diseases even which a Doctor might go wrong with. The CEO of iFlyHealth, Mr. Tao Xiaodong said that after the system has been used in four countries and a district in Anhui, the AI medical assistant has made more than 1.5 million auxiliary diagnoses. It has the capability to diagnose more than 900 diseases with an accuracy rate of 97 percent. There is yet another way of progress that has taken place in China. This system has been beneficial for more than twenty million rural residents is what the news update states. The reports that have been generated by this system is then sent to Doctors in urban areas to make effective decision making and this process is more or less likely to be cut down in the near future by improving AI and other advanced technologies is what Liu Xiaohui, from Jiangxi province’s Health Commission said.
Jonathan Guo and Bin Li have stated the current statistics of the percentage of rural people left out without proper medications and other facilities. Their paper on The Application of Medical Artificial Intelligence Technology in Rural Areas of Developing Countries have clearly mentioned the existing AI techniques that have been made use of in some of the rural areas. They have found the following updates. China has come up with a system that can diagnose about eleven tests (blood pressure, electrocardiographs, urine test, blood analysis etc.,) which has been used in village healthcare zones. They have also found that there exists a low-cost swallowable endoscopic capsule with AI techniques that have been used to identify gastrointestinal cancers which are very common in rural areas of developing countries. They have also given that Escalante et al. has made use of AI methodology to classify acute leukemia based on the morphological properties of bone marrow images that could be used in developing countries to replace advanced methods that are not affordable to the common man from remote areas. A system that provides solutions for rural patients with peripheral neuropathies in the absence of specialists was put forward by Kunhimangalam et al. The ultimate focus was to diagnose and treat people in the absence of expert neurologists [5].
The report on Artificial Intelligence in the Healthcare Industry in India by Yesha Paul et.al has clearly given how AI has started evolving in India and how health sectors in India have started incorporating AI for multiple functionalities. To mention a few on adoption of AI in hospitals as given in the document — The report stated Manipal Group of Hospitals has tied up with IBM’s Watson for Oncology to aid doctors in the diagnosis and treatment of 7 types of cancer. Watson for Oncology is used across its facilities, where more than 2.00,000 patients receive cancer care each year. It has also specified Aravind Eye Care Systems is presently working with Google Brain, after previously helping Google develop its retinal screening system by contributing images to train its image parsing algorithms. After successful clinical trials to detect signs of diabetes-related eye disease, it is now attempting to put it to routine use with patients [6]. Other than hospitals AI has also been practically made use of in pharmaceuticals, diagnostics, medical equipment and supplies, medical insurance and also telemedicine. To know more about this report refer [6].
To list a few current AI use cases in healthcare that I had come across while reading this document [7] are as follows,
- AI along with Data Mining has been used to predict certain diseases
- Medical Imaging for early diagnosis
- Lifestyle management and monitoring
- Nutrition intake to indulge individuals adapt a healthy and fit habitat
- Emergency rooms and surgery for saving lives
- Effective healthcare services by utilisation of Hospital Information System
- AI for Mental Health
- Pharma for finding new diagnostic and treatment measures
- Virtual Assistant
- Research — to come up with new insights
Prototype — AI for Rural Health
Well now we know AI is no more than just a science fiction but has started taking over almost all industries in which healthcare is no way far off from this. Let’s now get into how AI could serve as a bridge between Non Internet Mobile Users (NIMU) in India and the resources that are out of reach in rural sectors. The aim would be to create awareness amongst people in the village about the nearest Public Health Sectors (PHS) available, government policies that would be beneficial for emergencies in health, basic sanitation awareness, women and child healthcare understanding etc. To enable such a facility that could reach out to all people in the villages in rural India one common thought would be to go with a customer care like service. The limitation would be the number of people in charge to support such service 24x7, that would not be easy to acquire and it’s practically not a feasible solution to deal with. This is when AI takes its role of replacing humans with a Bot. Yes! Chatbot will be the whole idea and if it could reply to queries in our own native language it’s all what one needs.
Arnekt has developed a VoiceBot and has been serving multiple industries (Retail, Telecommunication and BFSI) in English language. It has already started working with Indian languages and is in the process of developing a Bot using the same. The sole purpose would be to connect to people using IVR (Interactive Voice Response) with the Arnekt’s Chatbot in its back-end. Languages to start with would be Hindi and Tamil. The motive of this system would be to focus on Primary Health Care for women and children and the main concerns have been listed down. Evidence as to why there is a need for such a system could also be found from the graphs given below.
Interactive Voice Response System (IVRS)
- For non-smartphone users
- Used ‘anytime-everywhere’
- Can potentially provide services to a large number of women over phone
- Women with lower levels of literacy can use IVRS more effectively than applications that require users to read text.
Primary health care
- Routine health screenings by questionnaire
- Quality-of-care for expectant mothers
- Guidance during menstruation
- Under stack of problems reported, direct women in consulting a nearby Doctor immediately.
- Nutrition
Preventive care
- Education regarding prevailing health problems and methods of preventing and controlling them.
- Wellness and preventive measures — For dengue, malaria, jaundice, etc. For diabetes, blood pressure, thyroid disorders, cholesterol, etc. Common cold, headaches and migraines, etc. Communicable diseases — swine flu, nipah, hiv, measles and many more.
Awareness
Creating awareness regarding government schemes
- Sanitary pads
- Pregnant women
- Toilets and sanitation care
- New-born baby health and many more
Creating awareness regarding Reproductive and Sexual Health
- Sexual Harassment(step taken to cure measures, how to report, government policies)
This prototype is still under development and more on it would be jotted down once its full fledged.
