Barts article

Question 1

What is Babylon health?

Answer 1

• UK tech start-up
• is a digital health company that offers online consultations, prescriptions, and wellness tools

Question 2

What services does babylon currently offer?

Answer 2

• GP, Physiotherapy, Mental Health appointments
• weight management program

Question 3

When was babylon founded?

Answer 3

2013

Question 4

How much was babylon origionally valued for?

Answer 4

around $2 billion

Question 5

When did babylon collapes? what does collapse mean?

Answer 5

-August 2023
- An economic collapse is a breakdown of a national, regional, or territorial economy that typically follows a time of crisis.

Question 6

What services did it offer?

Answer 6

An AI-based chatbot used for triaging patients, as well as a digital-first medical practice called GP at Hand, in which registered patients can chat to a doctor via video calls.

Question 7

How did matt Hancock view Babylon health? and who is he?

Answer 7

panacea to cutting NHS waiting times
- panacea: solution or remedy for all difficulties or disease
- health secretary 2018-2021

and the future of the NHS

Question 8

What is a health secretary?

Answer 8

government official responsible for formulating and implementing healthcare policies, overseeing the allocation of healthcare budgets, and ensuring the efficient functioning of healthcare services.

Question 9

What did Ali Parsa claim about its chatbot?

Answer 9

its chatbot was better than a real doctor; that it had passed a medical exam with a score of 81%, when the average mark for human doctors at the time was 72%.

Question 10

What is a telehealth service? Is it used currenty?

Answer 10

the provision of healthcare remotely by means of telecommunications technology

Question 11

What is TECS?

Answer 11

Technology enabled care services refers to the use of telehealth, telecare, telemedicine, telecoaching and self-care in providing care for patients with long term conditions that is convenient, accessible and cost-effective.

Question 12

How can TECS be positive?

Answer 12

We recognise the potential of these solutions to transform the way people engage in and control their own healthcare, empowering them to manage their care in a way that is right for them.

Question 13

What s NHS England TECS programme?

Answer 13

focussed on delivering a set of practical tools and resources to address the demand from health and social care professionals for support and guidance on how to commission, procure, implement and evaluate

Question 14

Benefits of telehealth services include:

Answer 14

Time-saving: allow patients to save time by eliminating the need to travel to a physical medical facility, which can be beneficial for those with mobility issues or who live far away.

Increased patient engagement: Telehealth services promote patient engagement by enabling patients to take an active role in their care, including scheduling appointments, accessing their medical records, and communicating with healthcare providers.

Improved health outcomes: Telehealth services have been shown to improve patient health outcomes, as they enable patients to receive more frequent and consistent care, monitor their symptoms, and receive real-time feedback and support from healthcare providers.

Reduced hospital readmissions: Telehealth services can help to reduce the rate of hospital readmissions, as patients can receive timely follow-up care and support from healthcare providers after leaving the hospital.

Increased cost-effectiveness: Telehealth services can be more cost-effective than traditional in-person care, as they reduce the need for expensive medical equipment and facilities while enabling healthcare providers to see more patients in less time.

Question 15

telecare services available in the UK include

Answer 15

• Personal health records
  Electronic personal health records like myCareCentric allow patients to securely access, manage and update their own health data.This empowers individuals to be more actively involved in their health management and care planning

-emote Patient Monitoring
Remote monitoring enables healthcare professionals to remotely monitor a patient’s health in real-time, increasing the clinician’s capacity and improving patient outcomes.

• ePROMs (Electronic Patient-Reported Outcome Measures)
  ePROMs allow care providers to collect information directly from patients about their health, symptoms and well-being.

Question 16

benifits of telecare on Improved Independence

Answer 16

Improved Independence: TECS can empower individuals, especially the elderly and those with disabilities, to live more independently. For instance, by implementing fall detection devices, telehealth services and virtual ward solutions, elderly people can continue living at home for longer, with a higher level of safety and support.

Question 17

benifits of telecare on Efficient Healthcare Delivery:

Answer 17

Telecare services can streamline healthcare delivery by reducing the need for frequent hospital visits and minimising unnecessary healthcare interventions. The technology allows professionals to track progress, allocate resources more efficiently, and proactively intervene to see patients before conditions worsen.

Question 18

benifits of telecare on Increased Access to Healthcare:

Answer 18

TECS can help in providing healthcare services to people living in remote or underserved areas. Virtual consultations and remote monitoring can expand access to medical expertise, particularly in areas with a shortage of healthcare professionals.

Question 19

benifits of telecare on Preventive Care and Early Intervention

Answer 19

Authorised technology-enabled care solutions can track patients’ health conditions in real-time. This proactive approach can improve early detection of issues, help prevent the progression of chronic conditions, enable timely interventions, and reduce the burden on the healthcare system.

Question 20

challenges of TECS on Digital Exclusion and Inequality

Answer 20

A significant challenge in implementing TECS is the unequal access to technology, particularly for people in rural or low-income areas who are statistically more likely to experience digital exclusion and health inequalities.

As health technology becomes more common, it’s crucial for organisations to make sure that those who aren’t digitally connected – for any reason – aren’t left behind and are still able to access care.

Question 21

challenges of TECS on Digital Literacy and Training

Answer 21

not everyone is comfortable with using technology. Lower levels of digital literacy can make it harder for people to adapt to new health technologies. Bridging this gap is crucial as it’s often older people, who have increased healthcare needs, that struggle most.

Graphnet solutions are user-friendly and offer clear accessibility options, but organisations might also consider offering free educational programmes to cover basic digital skills, online safety, and training for using technology-enabled care services.

Question 22

challenges of TECS on Resistance to Change

Answer 22

Both healthcare professionals and patients may resist the addition of new technology to their established routines, due to unfamiliarity, skepticism or concerns about data security.

Addressing these concerns through education, training and involving stakeholders in the implementation process can help overcome resistance to change.

Question 23

What were the perceived benefits of the Babylon chatbot?

Answer 23

By performing triage and assessing symptoms, the chatbot would reduce pressure on doctors’ time, and help them make diagnoses, it claimed – thereby cutting waiting lists and slashing care costs.

Question 24

What did Ali Parsa say that the chatbot would do?

Answer 24

would “do with healthcare what Google did with information” – making it “accessible and affordable to every human being on Earth”.

Question 25

how much did babylon raise beteen 2013-2021

Answer 25

$1.2bn (£876m) from investors

Question 26

What were babylons investors?

Answer 26

Saudi Arabia’s sovereign wealth fund and Demis Hassabis, the founder of DeepMind, Google’s AI arm

Question 27

from 2018-2021 how much funding did babylon get from the NHS?

Answer 27

at least £22m

Question 28

What went wrong with the virtual GP?

Answer 28

The GP at hand service expanded fast to serve 100,000 patients, via deals with various NHS trusts.

But its “ease of use” meant its patients asked “for far more appointments than is typical”. Because the NHS pays GPs a flat fee per patient a year, of around £160, regardless of how much care they require, Babylon was soon losing money on every patient it saw.

Question 29

Who is doctor Watkins? what did he say about the chatbot?

Answer 29

• a consultant oncologist who anonymously critiqued about the flawed technology of the chatbot, its fraudulent claims and regulatory failings

Question 30

example of the flawed chatbot?

Answer 30

A 60 year old 20 a day smoker with sudden onset central chest pain and nausea

sex MALE = heart attack
sex FEMALE = panic attack and depression

provided by Dr David watkins

Using NHS111 via babylon health chatbot- a 48 year old 40 a day smokers wakes with left shoudler pain raidiating down his arms and is instead reassured.\

Question 31

What did The Lancet conclud?

Answer 31

• there was no evidence that Babylon’s chatbot worked better than a doctor, and there was “a possibility that it might perform significantly worse”.

Babylon claimed that their Babylon Diagnostic and Triage System outperformed the average human doctor on a subset of the Royal College of General Practitioners exam. They supported this claim with an internal evaluation study, the results of which were met with scepticism because of methodological concerns.,

In particular, data in the trials were entered by doctors, not the intended lay users, and

no statistical significance testing was performed.

a subset of the Royal College of General Practitioners exam

Question 32

How did it all end?

Answer 32

• Babylon failed to make a profit and burned through hundreds of millions of dollars in funding

withdraw from its loss-making NHS contracts; a move into the US market was even more disastrous

• company’s accumulated deficit spiralled past $900m earlier this year, leading it to file for bankruptcy in the US in August, and in the UK soon afterwards.

Question 33

How much was babylons UK assets sold off for?

Answer 33

£500,000.

Question 34

What does this sentence mean . And there was a growing sense that the chatbot was a triumph of aggressive Silicon Valley-style marketing – or just old-fashioned smoke and mirrors – over substance

Answer 34

suggests that there is a perception or belief that the success of the chatbot was not based on its actual capabilities or substance but rather on effective and assertive marketing practices, akin to those associated with Silicon Valley, or it might be just a deceptive presentation without a substantial foundation (“old-fashioned smoke and mirrors”). In other words, the success was attributed more to marketing tactics and illusion than to the genuine value or effectiveness of the chatbot.

Question 35

Other examples of similar businesses to Babylon

Answer 35

blood-testing firm Theranos, and IBM’s Watson Health

Question 36

what does this mean “There’s an inherent mismatch between the move-fast-break-things culture of tech startups and that of healthcare, where caring for patients requires thoughtfulness and context.”

Answer 36

The implication is that the fast-paced and potentially disruptive nature of the tech startup culture may not be well-suited for the nuanced and patient-centered environment of healthcare

Question 37

What is an example of AI in brain scans?

Answer 37

Brainomix e-StrokeusesAIto analyse brain scans of people who have had strokes to assist doctors with diagnosis and treatment decisions.
Early studies have shown Brainomix can reduce the time between a patient arriving at hospital after they’ve had a stroke, to receiving treatment by more than one ho ur through providing instant interpretations of brain scans to help guide treatment and transfer decisions for stroke patients faster

Question 38

what is AI-Airlock?

Answer 38

The Medicines and Healthcare products Regulatory Agency (MHRA) has announced AI-airlock a regulatory sandbox. in april 2024. partnership between government, regulators and industry will see advanced AI technology used in NHS settings, with strict safety controls, ahead of navigating regulatory approval.

This will support innovators to work within the current regulatory system, identify where their products need to build more evidence needed for a safety and efficacy assessment and help resolve these issues.

Question 39

How is AI used in earlier diagnosis?

Answer 39

A great deal of diagnosis is about recognising patterns. For example, radiologists will look at X-ray images to spot potential disease. However, if we spot subtler patterns earlier, perhaps the disease could be diagnosed at an earlier stage.

This is where AI comes in – computers can be programmed to read data. Using algorithms, very subtle changes can be detected, either as the precursor of a disease or before it has propagated.

Question 40

What Is Artificial Intelligence?

Answer 40

Artificial Intelligence (AI) is “the ability of a computer or other machine to perform actions thought to require intelligence.”

for a computer being able to make decisions. The way in which ‘it’ does this, how it gathers data, interprets and produces an output, is brought about in different ways.

Many systems we use today have technology supported by AI infrastructures, which often go unnoticed. Amazon’s Alexa is an example. The computer recognises spoken word and can respond. AI is beginning to be used in Medicine and has many potential applications.

Question 41

How Is AI Being Used in Medicine Already?

Answer 41

Medical Diagnosis- designed to accurately diagnose disease from medical imaging scans and microscope slides.

Virtual Nursing= Virtual nurses are robots designed to monitor health

Robotic Surgery-

Radiotherapy

Information Services-

Question 42

Examples of AI in medical diagnosis

Answer 42

Cancers and other diseases can be detected at earlier stages, offering better long-term outcomes.

AI is also being used to assist in screening processes. This includes in IVF, to determine how likely a fertilised embryo is to result in a successful pregnancy.

Question 43

How Is AI Being Used in Information Service Already?

Answer 43

The NHS is working with Amazon’s Alexa to offer health information by voice search.

Question 44

How Is AI Being Used in Robotic Surgery Already?

Answer 44

Robotic Surgery- Robots have been developed which are able to carry out routine operations. Recent research has shown that these surgeries can have up to a five-fold reduction in surgical complications. This, partnered with the decrease in staff required and time saved, could be a promising investment for the future.

Question 45

How Is AI Being Used in Radiotherapy Already?

Answer 45

Radiotherapy = an AI framework has been developed to use a patient’s CT scans and electronic health records to create a specific individualised dose.

Question 47

How is AI used in earlier diagnosis?

Answer 47

A great deal of diagnosis is about recognising patterns. For example, radiologists will look at X-ray images to spot potential disease. However, if we spot subtler patterns earlier, perhaps the disease could be diagnosed at an earlier stage.

This is where AI comes in – computers can be programmed to read data. Using algorithms, very subtle changes can be detected, either as the precursor of a disease or before it has propagated.

Question 49

Examples of virtual nursing?

Answer 49

Wearable devices offering advice and guidance to patients in their own homes, as well as reminding people to take their medications on time.

There is a wearable device, called Current, which measures a patient’s pulse, temperature, respiration and oxygen saturation, giving doctors regular updates on their patient’s health, and can be used both in hospitals and at home.

Researchers have also developed a way of incorporating AI into smartwatches to detect hypertrophic cardiomyopathy, which is often not picked up.

Question 50

Information about NHS and alexa

Answer 50

By integrating the NHS website content directly into Alexa’s core knowledge base, it is able to reach a far wider user base as users do not need to enable this skill in advance.

The aim is to reduce demand on Doctors and particularly benefit elderly people, blind people and people who cannot easily search for health advice on the internet. Some people are concerned about how any confidential data relating to patient queries will be stored, but Amazon has confirmed all data will be kept confidential and encrypted.

Question 51

How did Babylon affect the Hammersmith & Fulham Clinical Commissioning Group?

Answer 51

40,000 people across London have joined the Babylon-owned NHS practice with the vast majority leaving their existing GP, creating one of the largest and fastest-growing surgeries in the UK.

The sheer size of the GP at Hand clinic in Fulham means that the local NHS authority, the Hammersmith & Fulham Clinical Commissioning Group (CCG) is having to pay for the care of scores of new patients, even though the majority of them are based in other parts of London. Documents show the CCG has struggled to cope financially with the strain put on it by Babylon, with other CCGs and NHS England forced to bail it out. Last month, Hammersmith & Fulham warned the cost of the practice would leave it £10 million out of pocket for the current

Question 52

What did Justin Madders, Labour’s shadow health minister, call for?

Answer 52

or an urgent investigation into whether Hancock broke the ministerial code for conflicts of interest.

Question 53

What did the Advertising Standards Authority rule about babylon?

Answer 53

In October 2018, eight complaints to the Advertising Standards Authority (ASA) led it to rule that Babylon’s ads were misleading and made it unclear that patients were required to leave their GP to join Babylon. “The ASA took issue with this claim, insisting for example that Babylon add smallprint highlighting that ’access in minutes’ is dependent on the user registering for the service,”

Question 54

In nove,ber 2018 what percentage of babylons GP at Hand werre from Hammersmith and Fulham.

What does this mean for the CCG?

Answer 54

11%

As of January 2019, GP at Hand had 41,690 patients on its books at Lillie Road, according to NHS figures. In April 2017, the practice had 2,500 patients.

requires £18m of external support from NHSE [NHS England] to cover the GP at Hand accelerated costs,”

Question 55

what is the issue about the kind of patients using GP at Hand. What does this mean for other local surgeries?

Answer 55

three quarters of people signing-up to GP at Hand are between 20 and 34 years old, with 18 per cent aged 35 to 64. Only a small number of older people or children have signed up. NHS England figures show around 83 per cent of GP at Hand’s patients are aged between 20 and 39. Across all GP practices in Hammersmith and Fulham (including GP at Hand) just 49 per cent of patients fall within the same age bracket.

So while Babylon makes less money from easier patients, it’s also attracting easy patients from other local surgeries that are in turn left dealing with more complex cases. While they get more money for more complex patients, the burden placed on clinics with a more complex base of patients can be considerable.

Question 56

How is the GP at hand disconnected to other parts of the social care system?

Answer 56

Applebee says that when GP at Hand’s clinics are spread across London they are also disconnected from other parts of the social care system. “All the other things that go along with general practice, like district nursing, social work, schools – everything works in a geographical community,” she adds. “GP at Hand has no idea what goes on in my part of Tower Hamlets, they don’t have the relationships with palliative care, or schools or the local cafe.”

Question 57

opportunities at Barts? why do they appeal to you?

Answer 57

Intercalation
- BS, MSc and MBPhD are offered where selection is based on exam performance and interview performance
- experimental pathology Int: study of disease and the mechanism of it, opportunity to learn about disease and do a research project
- research placement meant i followed steps to identify causative gene mutation for RSS?3c and if it affects its ability to form a protein complex within the endosomal system -> did leave me wondering how did this then develop into the clinical manifestation of RSS/3c

Early clinical placements in primary care
- once a fortnight there are group primary care placements (Yr3=placement 6-10)
- i learn more effectively when it is something i can observe and carry out, like a placement, for example carrying out chemistry experiments relevant to our curriculum i find means i can reflect on the topic easier after carrying out a experiment relevant to it

-Elective (6 weeks)
- student assistantship

Question 58

what is Barts teaching style?

Answer 58

You’ll learn through:

• lab work
• lectures and symposia
• independent projects
• practical workshops covering clinical skills and patient communication
• pbl

Question 59

opportunities at Barts? why do they appeal to you?

Answer 59

Problem-based learning
- students and a facilitator work together to understand and explain a clinical scenario through teamwork and independent research.
-> i have experience in developing my ability to carry out independent research at my Nuffield research placement where i had to do research on the endosomal system to create my scientific poster and report. i enjoyed the process of problem solving and trying to find relevant information
-> during AS further maths we would have group revision sessions together tackling challenging questions. i found the teamwork great as we were all determined to complete the question and people contributed in there specific ways. and you can learn from them

Question 60

how is the programme divided?

Answer 60

Phase 1 - Body in Health (Year 1 and Year 2), Mechanisms of Disease (Year 1 and Year 2)
normal biological structure and function of cells, organs and body systems
the effect of illness on people and their families
the impact of environmental and social factors on health.

Phase 2 - Clinical Basis of Medicine (Year 3 and Year 4)

Phase 3 - Preparation for Practice (Year 5)

Question 61

Where will you have clinical placements?

Answer 61

Clinical placements will be in a variety of locations including inner city hospitals such as the Royal London, Homerton, Newham, Whipps Cross, Queens. Placement at these sites are classified as in-firms and you would commute there every day.

You will also be placed at out-firms including Southend, Colchester and Princess Alexandra Hospitals. Most students will stay in hospital accommodation while on out-firms.