By Teodora Pampu-Romanescu, 2nd year medical student at Queen's University Belfast
Personalised, accessible and affordable healthcare for all – the universal ideal that became Babylon’s mission.
Image credit: HER Intelligence
What is Babylon and what is the basis of its innovative aim?
Founded in the UK by Dr Ali Parsa in 2013, Babylon, the so-called ‘pocket doctor’ is a digital healthcare provider, a complex system of artificial intelligence based digital platforms that allow the patient to access customised healthcare assessments, remote consultations with a doctor and receive prompt treatment advice.
Name origins & significance.
The name was inspired from one of the earliest forms of health democracy, when Babylon citizens in need of medical advice would gather in the town square to share their knowledge around common illnesses. This ancient form of peer support proved to be highly effective, resulting in Babylonians having the longest life expectancy at the time. The history of this forgone world inspired Babylon organisation to create services that can improve the quality of care that people receive today and become a global leader in the healthcare industry.
How do the ‘Babylon’ digital platforms work?
Designed around a doctor’s mind, artificial intelligence (AI) stands at the core of Babylon platforms and allows the digital computer to perform certain human tasks, without fatigue. The gap in communication between the patient and the machine is bridged by the use of ‘Natural Language Processing’ (NLP) which enables the software to understand, interpret and analyse the human language and meanings. The AI is able to carry out a history taking procedure using the interactive symptom checker, analyse the findings, explain the resulting condition and give practical health advice accordingly. The Babylon monitor then tracks the patient’s health evolution. But the computer’s knowledge does not stagnate overtime. The ‘knowledge graph’ (the huge database of information that the machine already has about symptoms, diseases & risk factors) combines with the ‘user graph’ (the information that the patient enters in the system) and uses machine learning to generalise, adapt to new data and manage novel cases – in other words, the computer actively ‘learns’ from experience, continuously improving at the set task[1,4].
However, the software responds to the patient based on statistics and provides only health information, not at the quality of a personalised assessment expected from a healthcare professional. According to the Babylon’s website disclaimer, the platform should not be used in emergency or seen as a doctor substitute, its role being to support an already strained global healthcare system.
Babylon’s territorial expansion is remarkable, covering the UK, US, Canada, Rwanda and multiple countries from Asia-Pacific region and the Middle East. Its universally accessible nature brings the one solution that solves the different issues faced by both low income and developed countries.
In the UK, a country with a growing population and where the life expectancy is longer, one of the Babylon’s services, the ‘GP at hand’ is tailored for the NHS. As a free tool for the registered patients from certain areas to use, it provides online and video primary care consultations, with a full-England coverage aimed by 2021. In the effort to tackle the hurdles faced by NHS (such as budgetary and human shortages), a future ambition is to build an all-in-one app, that integrates both hospital and primary care that will not only provide diagnosis but also ensure a constant monitoring of chronically ill patients, remotely. Additionally, the users will be able to access their own records and review their consultations digitally.
Image credit: BabylonHealth.com
In countries such as Rwanda, where the healthcare system is under constant pressure and access to quality healthcare and internet is limited, ‘Babyl’ service by Babylon became a popular tool. With more than 2 million registered users and 1.1 million consultations provided since its launch in 2016, it allows patients to discuss with a doctor, receive prescriptions, lab requests and referrals only by using text messages and voice calls.
Moreover, people in Rwanda will benefit from a new healthcare delivery model named ‘Digital-First Integrated Care’ that promises easy access to quality healthcare, after the Government has signed a ten-year partnership with Babylon. Faster delivery of care is linked to a reduction in costs associated with long-term complications of illnesses that would be preventable by early intervention and discourage the common practice of self-medication. Additional plans are for the integration of ‘electronic medical records’ into the Babyl digital platform, that are expected to improve patient information transfer and the efficiency of patient referrals, all contributing to improved health outcomes for users. ‘Babyl’ is seen as revolutionary tool for the healthcare, that will support people of Rwanda to became more autonomous by gaining control over their health, which is predicted to drive economic growth.
Concerns over safety and privacy
The worldwide growing integration of the Babylon platforms in the national healthcare systems doesn’t come without its concerns at multiple levels.
One primary matter would be that the use of randomised controlled trials (RCT) and peer review are not an acceptable standard for evaluation. As the platform is directly interacting with humans, and the technology is constantly changing, strict regulations and ethical directives are required. With this need for standardisation in mind, the emerging health tech is currently assessed using guidelines published by an independent body, The National Institute for Health and Care Excellence (NICE) and takes in consideration the risks, affordability and sustainability rather than consumer satisfaction and app rating.
Another issue arises with the analysis of the socio-economic status of the average Babylon Health ‘patient’. Young educated, urban-living professionals, with low health needs tend to use the digital platforms disproportionally more than older individuals with poorer health, illustrating the inverse care law principle.
As privacy is one of the main elements in the professional doctor – patient relationship, it is essential that it is safeguarded while the healthcare digitalisation occurs. The recent data breach on Tuesday 9th of June 2020, when three UK users have had inadvertent access for two hours to other patient’s consultations has been swiftly tackled by Babylon Health Team, with a public statement explaining that the privacy violation was due to a now resolved server error rather than a cyber-attack.
In conclusion, achieving good quality and sustainable global health requires undoubtedly the integration of new technologies in our daily life. Babylon Health is a complex of digital platforms that uses artificial intelligence as a real weapon to fight global health inequalities and compliment the traditional healthcare service, but not to completely replace it. It is designed for the universal patient, that in a rapidly changing world needs an affordable, reliable and accessible tool that can keep up with his 21st century healthcare needs.
1. Dr Ali Parsa. Babylon Health UK - The Online Doctor and… | Babylon Health. 2013 Available from: https://www.babylonhealth.com/
2. Ben Sweiry. Startup Profile: Babylon Health. Tech Round Website. 2020. Available from: https://techround.co.uk/startups/startup-profile-babylon-health/
3. Paul Barba. Machine Learning for Natural Language Processing - Lexalytics. 2019. Available from: https://www.lexalytics.com/lexablog/machine-learning-natural-language-processing
4. Artificial Intelligence – What it is and why it matters | SAS. Available from: https://www.sas.com/en_us/insights/analytics/what-is-artificial-intelligence.html
5. NHS England and NHS Improvement London » GP at Hand – Fact Sheet. Available from: https://www.england.nhs.uk/london/our-work/gp-at-hand-fact-sheet/
6. Babyl – Rwanda’s Digital Healthcare Provider. Available from: http://www.babyl.rw/
7. Government of Rwanda, Babyl partner to provide digital healthcare to all Rwandans | Official Rwanda Development Board (RDB) Website. RBD Website. 2020. Available from: https://rdb.rw/government-of-rwanda-babyl-partner-to-provide-digital-healthcare-to-all-rwandans/
8. Oliver D. David Oliver: Lessons from the Babylon Health saga. BMJ. 2019;365(June):1–2. Available from: http://dx.doi.org/doi:10.1136/bmj.l2387
9. Leo Kelion technology desk editor. Babylon Health admits GP app suffered a data breach. BBC News. 2020. Available from: https://www.bbc.com/news/technology-52986629