Artificial intelligence has reached medicine: it is already helping to decipher X-rays, and will soon take on ultrasound. Senior Vice President for Innovation at the Skolkovo Foundation Kirill Kayem spoke about how Russian healthcare is changing under the influence of new technologies, how it has been changed by the coronavirus pandemic, and what other threats humanity may face in the near future. Interviewed by Anna Shavyrina.
– How is the situation with biological safety in Russia now?
– In Russia, from this point of view, everything is fine. This concerns, first of all, of course, the preservation of public health. We have just experienced COVID-19, which clearly confirmed that those mutations that occur in the simplest microorganisms can dramatically change their pathogenicity and epidemic situation, which leads to global, catastrophic consequences.
– Looking back, what prevented the spread of the virus from being contained?
“Unfortunately, the pandemic has shown that several negative trends have emerged in the world over the past 20 years. Firstly, this is a reduction in the link itself, which monitors the occurrence of the epidemic. Secondly, pharmaceuticals have become very focused on non-communicable diseases. This is due to the fact that it was largely pumped with money from Western economies, including the United States. The system made it possible to bring drugs to the market at enormous prices, and, of course, pharmaceutical concerns were focused on releasing drugs in the most expensive segment. And infectious diseases are not the most profitable option from the point of view of one treated patient. This has led to the fact that, for example, the volume of development of antibiotics and antiviral agents has decreased from year to year. At first it’s not very noticeable, but then it’s noticeable. Now the situation is changing. This also applies to systems for rapid diagnosis of infections, the production of which was also reduced, because everyone concentrated on oncological diagnostics, on diseases where there was a very large check.
And the third, paradoxically, is that the treatment of patients has become more effective and correct – the patient spends fewer days in the clinic, and the economic systems of many countries, seeing this, have reduced the number of beds and hospitals. Therefore, when the pandemic arrived, hospitals were overcrowded.
– And in Russia?
– Our country, in fact, has a large reserve associated with additional capacities. In Russia, the number of doctors per thousand patients is higher than in many European countries. But even we didn’t have enough of them, we had to urgently retrain doctors in infectious diseases specialties, and in Europe it was simply a disaster. The pandemic is a lesson for all countries, which has led to the fact that healthcare systems are now being rebuilt and reserve hospitals are being built. I think the number of doctors and paramedics will increase. Humanity has learned that the safety margin was not enough in the moment.
– Is it a “medic in reserve” system?
– Yes, exactly like that.
– What other conclusions have been drawn from the epidemic situation?
– The pandemic is a global thing, and at the current moment we clearly understand that it is absolutely difficult to act without international cooperation in the field of biological safety. But, nevertheless, each country, including Russia, must have developed tools that allow it to respect that very “sovereignty” – when it is possible to solve its own problems and help its neighbors. In terms of biological safety related to epidemics, viral and other infectious diseases, our country, together with its neighbors, is doing a lot.
– Does COVID transmitted by a person increase the risk of “catching” some disease in the future? Does it hit your immune system hard?
– If you answer as a doctor – I am a doctor by first education, then yes, of course. A mild illness increases your immunity and allows your body to cope on its own. The disease, which you suffered without a prepared immune system in a severe form, damages and leaves a mark on the main systems, which can then lead to chronic diseases. And COVID is very unpleasant in this regard.
– Do the previously announced changes in the healthcare system reduce the chances of a recurrence of the pandemic in the future?
– They are reducing it. The regulator changed its position regarding the speed of decision-making – in Russia a special resolution was adopted, which made it possible to bring to the market what was important in an accelerated manner and with a reduced volume of clinical trials. We hope that these fast tracks will continue in the future.
Plus a story related to investments in medicine. Previously, it was always long, expensive and with a high percentage of failures. Yes, the multipliers are good, that is, if you invest a ruble you get ten, but the risks are high. So, we saw a significant increase in interest from private investors, including non-specialized ones. Those who previously invested in IT began to invest in medicine – people saw that developers can indeed respond quickly and quickly produce a good product.
In addition, when the need arose to communicate remotely with a patient, to quickly make a diagnosis, to process a large number of medical images in order to see the very damage to the lungs, the regulator quickly registered all these solutions and put them into practical medicine, this was a big impetus for digital medicine.< br />– How and where is artificial intelligence used in domestic medicine now?
– If you live in Moscow and have had a CT scan, then in most cases this image will “fall” for a second opinion to AI – it will be double-checked by one or two algorithms so as not to miss the doctor’s mistake, and you won’t even know about it, you’ll just get a conclusion . In the capital and some regions, special centers are being created for this purpose, where artificial intelligence operates.
– What are the prospects for this in terms of scaling?
– Big ones. Such solutions scale quickly; there is no need to import heavy equipment – this is software. In many regions, Skolkovo residents are already implementing them. Where does this go next? If we talk about medical images, this is a new development in the field of dynamic medical images, because in addition to static cards – CT, MRI, X-ray, there are, for example, ultrasound images that are difficult to recognize and require a qualified doctor. I think we will see a lot of developments in this part.
Another interesting thing is that a pathologist studies changes in human tissue, which greatly depends on his qualifications. With the help of AI, he will receive an excellent hint that allows him to make a more correct diagnosis.
But, in addition, artificial intelligence can be used as a medical decision support system in terms of general approaches. When it is possible to load into the system the patient’s medical history, his anamnesis, the data of his laboratory tests, the conclusion that another AI made based on his x-ray and, based on this, offer the doctor a decision tree. This reduces the number of errors and improves the doctor’s qualifications.
– Do you think neural networks can already replace doctors in some aspects?
– We are currently running a competition, together with the National Technology Initiative, which is dedicated to decision-making system using artificial intelligence. Within its framework, AI will compete with real doctors.
We will look at how well the specialist’s qualifications correspond to what the AI does; whoever beats the doctor will receive a cash prize.
– If we talk about “new products” in the field of biotech, then what else is worth waiting for?< /strong>
– In my opinion, due to the rapid growth of humanity and the need to feed it, we will, one way or another, work with genetically modified organisms. They produce active substances – proteins – for the production of a number of medicines. But from the point of view of food products in Russia this is not yet allowed. I think we are moving towards this, but these risks need to be properly regulated.
– Have any new risks also emerged in this industry?
– There is a risk that is little considered now. This is the so-called garage synthetic biology. We always talk with interest about Bill Gates, who began building his computer empire in a garage (smiles), but at the moment young biologists are trying to create their own biological species. Including due to the fact that that set of reagents and instruments for creating and changing the properties of organisms used to cost several million dollars, but now it costs less than 100 thousand.
That is, de facto garage synthetic biology has become a real threat when a person, having spent the cost of an expensive car, can create new DNA in the garage by sorting out amino acid sequences, and given the fact that the qualifications of some of these inventors may not be high enough, they will not even be able to predict the resulting properties.< br />
Plus, as I said, the development of artificial intelligence will allow people to better predict properties, but their intentions may not always be positive. That is, the risks associated with bioterrorism and biocrimes can seriously increase in the absence of appropriate regulation.