At the turn of the century, healthcare companies were at the zenith of an ‘innovate-manufacture-sell’ business model. It was a good time to be in medical technology. European and American companies were leading the way. While for many companies, this model is still alive and well, those at the forefront of the AI and robotics curve know they are part of a new revolution in healthcare. In the not too distant future our measurements of success won’t be in units sold, but instead in dramatically better outcomes for more patients everywhere, as well as in software programmes being used, numbers of surgeons trained, and millions of euros saved for health systems. This is all because of the promise artificial intelligence (AI), robotics and big data hold to improve clinical outcomes, reduce health system costs and heighten the patient experience. These just so happen to be the core challenges facing mature healthcare systems in the 21st century.
AI, robotics and big data: Bigger than the sum of their parts
It’s important not to see AI, robotics and big data as one amorphous ‘digital’ concept. They are concrete, separate advances in technology that, when applied to healthcare deliver results bigger than the sum of their parts.
Increasing computing processing power means larger and larger data sets can be collected. In the past, medical research considered a few thousand patients a large study. Hospitals often conducted their research in isolation. Today, data sets on clinical outcomes for entire populations can be collected to provide powerful insights.
Robotics started to take off in the late 2000s as a means of driving forward the advances made during the laparoscopic revolution of the 1990s. With ever increasing precision of robots, robotic surgery is being expanded to delicate eye surgery, neurosurgery and re-constructive microsurgeries (e.g. blood vessels).
AI is the most recent, and arguably most exciting, development of the three technologies. AI involves building software and algorithms to approximate human cognition and therefore support decisions in a way that previously only humans could. In the future, advanced AIs may leverage machine learning to support and improve the capabilities of every surgeon anywhere in the World. All three can be used separately, but the real win in health is when artificial intelligence, robotics and big data come together.
“Globally, it’s a two-horse race in AI”
Michael Chui, a McKinsey partner, recently warned in the Financial Times, that globally, it’s a two-horse race in AI. In the 20th century and early 2000s Europe co-led the world into a new era for life sciences with the US, as shown by the number of Med Tech companies headquartered in either the US or Europe. Fast forward to the late 2010s, and China and the US are firmly in the driving seat for AI. In many senses, Europe isn’t set up for the AI revolution. Fragmented national data sets make it harder to compete.
However, there are some green shoots coming from Europe. Europe’s multiannual financial framework (MFF) will prioritize research and innovation, allocating the largest budget yet for research. Industry is playing a role too. Start-ups like the Surgical Process Institute in Germany have developed software that minimizes care variability and improves operating room efficiency. Orthortaxy in France is leveraging robotic assisted surgery platforms in orthopeadics to personalize procedures and optimize surgery. I’m proud that both of these start-ups are now part of Johnson and Johnson to achieve scale and take the innovation to the next level. There’s no doubt however, that without significant investment and government driven co-ordination in Europe, there is a risk that Asia and North America will take the lead in AI innovation.
Need for key enabling factors and trust-building
One quick win where Europe can lead, is in building societal trust which will foster these technologies and their uptake. An absence of heavy regulation can sometimes be helpful in allowing space for innovation. But ‘Wild Wests’ are not. In Europe initiatives are already taking place to build a Code of Ethics for AI in healthcare. This is welcomed, particularly in healthcare, because European ethical guidelines would help set world standards for AI, and simultaneously give the reassurance needed to society to trust these technologies as well as for industry to invest further.
However, many legitimate questions need to still be explored. Such as who owns the health data? Where does liability ultimately fall? Is our healthcare workforce ready and trained for these revolutionary changes? These questions need to be resolved through a democratic process of consultation, strong political leadership and the deployment of ambitious policies. Many countries, such as Germany, UK, Ireland and France have started initiatives and earlier this year, President Macron launched the starting gun for this process by calling for policies that build trust in AI.
The time is right for Europe to lead
The late British physicist, Stephen Hawking, famously warned that artificial intelligence could overtake human thinking. What is less well reported is his support for both AI in health, and for improved regulation and European cooperation. Indeed, speech prediction software, aided by AI machine learning, helped Professor Hawking cope with the impacts of Amyotrophic lateral sclerosis.
For Europe to have a chance at competing with the US and China on AI, we need to harmonize our approaches, attract back to Europe talented programmers and put in place a framework based on European values. In this spirit, Johnson & Johnson is proud to be one of the founding members of Artificial Intelligence 4 People, an European multistakeholder platform which will work on the social impact of artificial intelligence and propose recommendations for ethical guidelines. The time is right for Europe to take a leadership position again and Johnson & Johnson is fully committed to contributing to it.