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Prof. Fei-Fei Li | Illuminating the Dark Space of Healthcare with Ambient Intelligence

Michigan AI Lab53:36

Transcription

[Music]

and now on to our first

kino talk for today i am delighted to

have professor fei-fei lee from stanford

university

join us today it is typical to have

someone introduce the keynote speakers

and in fayette's case i find that to be

both hard and easy

it's hard because i will need her entire

one-hour slot

maybe more to talk about all her

achievements

fa is currently serving as co-director

of the human center air institute at

stanford

um having previously served as director

of the stanford ai

lab and also chief scientist of ai and

ml

at google cloud she has had a huge

impact on the

field of ai broadly and computer vision

in particular

where she made numerous contributions we

will probably be sufficient to just

mention

imagenet which changed how object

recognition is done

but there are many other research

projects that define new directions in

computer vision

and for instance visual genome activity

that and many others

i'm also really admiring fei fei for

everything that she has done for

diversity in ai

through the ai for all program which she

co-founded and which spans

now many institutions including michigan

i mentioned that introducing feipe is

both hard and easy

it's easy because fife doesn't really

need an introduction it's sufficient to

say

here is faithfully welcome pepe the

screen is yours

thank you radha and thank you michigan

really an honor to be here let me just

uh try to share my screen first thank

you again

and i i think when i was thinking about

your introduction i think the most

important piece

is that i feel like part of the michigan

family i spent a

sabbatical in michigan in the early half

of 2013

and just loved living in ann arbor

visiting uh

zingerman's and you know the north and

central campuses it's just a gorgeous

place so

too bad this is virtual but i do feel

very honored to be back to michigan

today

and i want to share with my colleagues

some of these latest work we're doing in

ai

and healthcare before i just even get

started i

want to show this slide to really uh

drive home that this is

quite a team effort everything i'm going

to

present is kind of a result of years and

years of collaboration

among computer science ai researchers

mainly my students and postdocs

as well as a number of incredible

clinicians and clinical researchers

throughout stanford medicine as well as

our

partner hospitals and health care

systems like

unlock utah's intermountain stanford

children's hospital stanford

adult hospital and the list is still

ongoing

i especially want to highlight the two

people in red boxes

professor arne milstein who is a pioneer

in thinking about health care this

country's healthcare policy healthcare

excellence research and quality

improvement as well as cost reduction

i owe everything of my health care

knowledge

to arne who introduced me to this

incredible field about 10 years ago and

then

for this particular talk i want to

acknowledge

my graduating phd student

albert hawk he is one of the heroic

ai students behind a lot of the work

as well as a main paper that i will be

going over

uh today so without their work i

wouldn't be able to uh

do this talk so it's important for me to

acknowledge them

so let's just get to the you know the

main talk

and we're here that uh because most of

us are passionate about healthcare

um and in the past 100 years modern

medicine has gone through

incredible advances whether you look at

drugs and

medical imaging medical devices genomics

you just name it

you know our increasing life expectancy

as well as quality

owe a lot to the improvement of health

care system

and also a personal note i happen to

have taken care of my

mother who has been very sick for almost

40 years and

all my entire adult life

i am the sole caretaker of my mom and

i've been through

every single healthcare you know

environment from icus to ers to

operating rooms to

to home care with her and it gives me

a personal perspective of how important

healthcare is and what kind of

incredible advances

there has been and and how all of our

livelihood

owe it to modern medicine and its

advance

but despite this important advances

it is still incredible to think in 2020

or 21st century medical errors are still

the

third leading cause of death and there

has been

extensive studies by nih since 20 years

ago

as well as researchers around the world

that studies

unintended medical errors you know in

the healthcare delivery system there

have been

a lot of important protocols written

about

how to avoid errors how to execute in an

intended way

to both standardize but also keep the

quality of care

but you know unintended

errors still happen in fact there's way

more

an order of magnitude and more

death and fatalities caused by health

care than say car accidents

in united states annually so this is a

big

issue and um and why

is it so you know why is is the error

rate so

so huge well partially it's because

healthcare is a very complex human

behavior endeavor

and it takes place in very complex

environment

and there are many different people and

roles

involved and you know eras can be

introduced

in so many ways whether it's procedural

or you know incorrect

coding or or wrong prescription

or sometimes you know hand hygiene

compliance

induced errors just so many ways

that the errors can be um introduced and

it's really

not intended but can have grave

consequences

so at this point for those of you who

are in ai especially in

the broad area of ai and technology

research

i hope they remind you of another space

that is full of complex human behavior

and that space is driving and

you know michigan is a leading

university

in in autonomous driving technology and

as well as robotics technology

so i think we have a lot of colleagues

who appreciate

how complex driving is and and a lot of

driving's

behavior boils down to complex human

behavior and

the potential um errors or unintended uh

problems with with driving so

about 10 years ago just around the time

i

met with arnie milstein

autonomous driving was one of the most

exciting

revolutionary ideas and it was going

from academia to commercialization

even though it's there's still a lot of

research and what

excites me as a technology about

autonomous driving was

the emergence of a bunch of technology

that's enabling a whole new

way of transportation the sensor

technology

the machine learning algorithm

technology the system integration

technology the gps technology all this

is reimagining helping us to reimagine

autonomous driving and that was the time

that arne and i

serendipitously got together and

really made that intellectual connection

between what we see in autonomous

driving

and the technology behind it and what we

hope to see

in healthcare that just similar to

transportation

healthcare is a complex

human behavior endeavor situated in very

complex spaces

from hospitals to homes that

to a large extent what's happening in

these spaces with human behavior

is still very much in the dark we don't

know much about

what patient is going through unless we

you know take their labs or stick them

in a

some kind of imaging device

or we don't know much about clinicians

behaviors

unless they chart and

charting means documenting what they do

on a

electronic hospital record or medical

record

but all this is actually affecting the

outcome of healthcare

so what we kind of uh boldly

envisioned is endowing healthcare space

with the kind of mba intelligence we see

in smart cars

and with smart sensors and machine

learning algorithm

and transform this so-called dark space

of healthcare

into a visible and visualizable space

that we can really try to

help improve the outcome of

patient care and roughly speaking

the transformation of this physical

space

involves in enabling it with sensors

and i'll get into the details of what

kind of sensors we're talking about

and then of course for those of you who

are deep in

machine learning ai research um just

data itself doesn't speak much um

much insight so we have to go through um

machine learning computer vision uh

technology to recognize what's going on

in uh with human behavior and then at

the end this

should shouldn't be a standalone

technology should be integrated into the

clinical data ecosystem so that's the

kind of broad picture

we imagined um fast forward um

almost a decade later we just published

a

relatively comprehensive nature review

article

on what we have learned on this journey

as well as

many incredible research that has

concurrently

happened in this short period of time so

for today

the rest of the talk will be just kind

of a summary

of what we touched in this nature paper

especially

two critical health care space one is

hospital space one is daily living space

i'll go over briefly

what are the what are the potential

opportunities to use

ambient intelligence to improve the

healthcare delivery

and also rada please just tell me if i'm

going to over time because i do want to

leave

time for discussion so thank you um

so let's just start with healthcare

space in the paper we actually touch on

several

health hospital space icu

inpatient unit operating rooms and other

clinical

settings in the hospital i'll try to

quickly go through just two

scenarios to give a give a flavor of

what's happening

and what we can use ambient intelligence

for so icu

i see you as an important area of

healthcare delivery

in fact um you know

i i don't know if most people know this

number almost

one percent of our national gdp goes to

icus along

and uh and the cost of

icu is in hundreds of billions of

dollars

every year and in this covert setting we

hear

a lot of stories coming out of icu

that underscores the importance and this

is where

our patients fight for their lives this

is where our clinicians

are just by and large overworked

but yet the the health care what's

happening icu is so critical to every

single patient and their family

so um in icu

setting there was one project we we

participated and spearheaded which is

the mobile patient mobilization project

it turns out if we can properly

make patients move in icus in a proper

way

evidences say they recover better they

get out of icu faster

and they recover from the grave

situation uh better so patient mobility

is really important um

how do we ensure patient mobility and

how do we know the quality and frequency

of patient mobility is proper by and

large right now it's direct observation

and

nurses and clinicians charting and this

you can see

introduces a lot of issues charting

itself is erroneous

and it's also labor intensive a lot of

clinicians

complain about spending more time

charting than spending time caring for

patients and also charting is very brief

it doesn't have that nuances that we

we hope to see and there's a lot of

errors that can be introduced

so we worked with two hospitals utah's

intermountain and stanford

children's hospital to put sensors

into the patient rooms and

the orange dots you see are sensors

in you in a floor map of a icu

unit in the intermental hospital in utah

and then

what you see in a blue video is the

quality of data we capture

through a special kind of sensor called

depth sensor

if you're not familiar with depth sensor

i hope to draw a connection between

xbox video games and and the sensor

in fact this is a um

lidar base sorry it's an infrared based

sensor that um

that captures depth information in the

in the uh environment it does not

capture rgb pixels so it's actually

naturally a good sensor to try to

respect and protect privacy in the

clinical setting

and it's obviously noisy and

what we can do is to take these videos

and then use machine learning algorithms

to learn what kind of

human behavior has taken place in this

particular setting

for mobility we care about activities

such as

getting patients out of bed sitting

patients in a chair

getting patients back to bed getting

patients out of chair these

are clinically relevant mobility tasks

and then we learn to label them by our

ai algorithm behind the scene

and then what we can do is to start

collecting data insights

we not only can can in computer visions

technically

called action detection in long videos

rather than just action classification

of an

entire video so we can get into this

kind of

action detection um tasks where

in say 24 hour stretch we can

collect data insights about how patients

have been moved

over that uh over that uh um temporal

stretch

and um um this is just

to show you it's getting uh finer and

finer and we can actually identify the

the

the people um and hopefully in the

in the future the rose and the actors

and

this kind of quantitative

data insights is is

um the first step to provide a very

continuous objective measure of patient

mobility in icu

which has never done before it as i said

it related

relied on clinician charting which is

extremely sparse

and the specificity and sensitivity of

the

quantitative results are really really

high which

really is important for for our

clinicians

and of course in the ongoing work we're

going to extend this to

more finer grained human activities

including turning oral care putting on

compression stockings to avoid pressure

ulcers

and so on and then we can we can

tabulate these kind of data insights and

uh

um and provide clinicians the important

uh data for our patients so that was

one um icu project

another related icu or inpatient project

is hand hygiene

um you know eight years ago we started a

hand hygiene

project and and frankly not too many

people cared

but when kova 19 happens hand hygiene

compliance suddenly becomes such a front

and center

issue not only in hospitals but also in

our homes

in fact hospital-acquired infection is

one of the leading killers

of patients nationwide not just during

coffee but

just during entire healthcare times

and almost a hundred thousand patients

die

of hospital acquired infection every

year

three times more as car accidents and

so what have we been doing to ensure

hospital hand hygiene compliance

mostly through human observers or secret

shoppers

and as you can see it's subject to so

much

issues right it's very sparse it's

time-consuming it's expensive it's

subject to

human biases people have tried rfid

as a way to you know

automate the system but rfid is very

coarse it doesn't really observe human

behavior it's a proximity measure

and it also disrupts workflow if

clinicians have to

have to you know go to scan their their

badge

so again we installed some sensors

in this case again in utah's

intermountain hospital and the

children's hospital in stanford

this is what the physical depth sensor

looks like

and this is the kind of data we could

can collect and you can see that uh

clinicians stopping by before entering

the patient room

to to perform hand hygiene protocol

and what we do is to take the video data

and go and devise a

convolutional neural network action

detection algorithm to try to locate

both temporally as well as spatially

where the hand hygiene

prop behavior to take place

there are some technical challenges that

i'll just gloss over

including how to um

[Music]

combine multi-sensor views and this is a

combination of tracking and and and

tracking issue as well as recognition

and we have to

find a common uh space to project

our uh uh our people

in the in the video so that we can

combine the multiple views

across a large hospital or or

inpatient space and here's the

the detection result that a person

was about to enter the room and the the

uh

sensors and the algorithm behind

shows when they do the hand hygiene or

they don't

and so on and then of course we can also

collect big data analytics

over time and over people and this is

invaluable

insight for optimizing the location of

hand hygiene dispensers

for our clinicians um of course if you

are familiar with this space who says

hand hygiene

is not just about entering room it's

about five points of the five moments

of interacting with patients before

touching patients before touching

patient bed and all that

so um again without uh belaboring

um delivering this system i just want to

say that we're doing additional research

on the five moments that who has a

protocol

of hand hygiene that gets into the finer

understanding of

hand hygiene compliance and and this is

some preliminary work to

show in the patient room where you know

potential touch points happens and and

how people are behaving

so um that was a quick uh uh

overview of icu i'll just quickly go to

the operating room and try to speed up

operating room again very complex

environment very complex human behavior

there are a number of work done by other

groups

that are already looking at ambient

sensors

this is a group that are looking at

human 3d pose

in in

in a surgical environment in the hope of

training and tracking surgical staff

and and let me just fast forward this

but in addition to people people also

interact with

objects and objects is actually a big

deal tracking them and knowing where

they are

in surgery room and some objects can be

tracked by rfid and

barcodes but many objects cannot and

these are the objects that are actually

more prone to errors including getting

lost in the patient body

so um you know nurses have to spend a

lot of time

counting them and at the station next to

the

next to the patient and

we have started to pilot an idea of

using

um depth sensors and cameras to help

automate this counting process

i'm gonna warn the audience of the next

slide

it doesn't have blood but it does have

real life

surgery um so if you're screaming about

it

uh here's the warning okay in another

um in another uh

work in working with surgeons we

actually go

into the laparoscopic um videos

and try to track uh surgical

instruments uh inside the body and and

by tracking that

we can learn oh sorry this is just the

algorithm

system flow we can learn how the

the the usage of different

uh different surgical objects this is

actually critical

information keep in mind this has never

ever been

observed without this technology

surgeons just

um train through human apprenticeship

and and go through this um you know

more like a artful training rather than

objective training and this

is a very good quantitative information

for for surgeons in training as well as

for

surgeons to understand what happens and

what are the instruments

used uh in a surgery so this is also

ongoing research

um okay so i'm gonna switch gear

and quickly go through the daily living

space

the paper has more details about

hospitals i'll just invite everybody to

read on your own

daily living space is another space that

has

a lot of implication to our health care

and well-being

i'm personally passionate about senior

care

and but also physical rehabilitation

mental health are all

important part of daily living space

just to get into senior care independent

living

is really really important to our

seniors

and independent living involves

activities of daily living

and there is a standard list of what we

call adl

adl impairments indicates a lot of

potential diseases

and decay decline cognitive neurological

and other ones

and it has tremendous physical

as well as physical mental implications

and typically caregivers are the first

to identify

impairments but we do have a world

global dilemma coming up is that our

population is aging

the ratio of caregiver to seniors is

um is

declining we have fewer and fewer

capable

care givers compared to the number of

seniors

and and this industry in general has

other issues that is not well um um

well established that we need to help

our care givers

and one way to help our caregivers is to

go through smart sensors and mba

intelligence there is no way i want to

say

upfront we we do not believe in

replacing clinicians and help help

caregivers but we really believe in

helping them and helping our singers

and wearables is actually a good

supplement and there is a lot of good

research coming up and commercialization

but there are a lot of issues wearables

cannot

address it's inconvenient seniors don't

necessarily wear them all the time

and when it comes to nuanced human

activities wearables are limited

so we're piloting this as smart sensor

ambient intelligence

idea in a senior home facility in san

francisco this is my heroic

graduate students going to the senior

homes installing

both steps and thermal sensors by

themselves

and those of you who are not familiar

with thermal sensors you can see that

the

on the right is thermal sensor data on

the left is depth

they capture quite complementary

information which is really useful for

adl understanding and

our algorithm can start to understand

the

behavior of seniors whether they're

sitting standing walking sleeping

can do a real-time detection of false

which is

extremely life costing and and money

costing in senior care

and then this is the kind of opportunity

we cannot

put into important data analytics

for um for

um different adls that can become

really important clinically relevant

data for caretakers and clinicians

one of the example here to show you more

fine-grained understanding is sleep

pattern

we can actually with this kind of

technology we can go through

different kind of sleeps and and

sleep data on a daily basis

okay there's more in senior care we are

actually now starting a new project in

30 day readmission for seniors

it's been a exciting journey in the

in the time of covet but we're excited

this project will get started

but let me switch gears and just at

least

touch on physical rehabilitation because

i think this

is so relevant to seniors as well and to

show you what this technology can do

of course everybody knows physical

rehabilitation is so important it's a

big industry it impacts a lot of people

uh things like gait analysis is um

is kind of bread and butter for many

many rehabilitation

and treatments but most of these current

physical rehabilitation is done in the

labs and

patients have to get to the hospital get

to the clinics

it involves a lot of overheads

and it's uh also sometimes you have to

use your motion capture systems it's

very expensive and uh

and and and uh cumbersome can you

imagine

if there's just a camera a camera at

home that can start understanding

the gestures the gates the the the

walking

uh details of our patients it'll really

transform

physical rehabilitation and a lot of

people are starting to pioneer that

in the paper we um you know cited a

number of work

in understanding human gesture uh human

uh or using uh depth sensors

to observe um you know different kind of

physical

activities and we are also

doing gait understanding and

humor a human posture and pose

understanding using using depth sensors

and hopefully this can start uh um

in light enlightening the possibility of

uh moving some of the physical

rehabilitation to homes

uh these are just some quantitative

results

okay so um we also did some work in

mental health but i'm not gonna have

time to talk about this

in the last two three minutes i do want

to touch on a

really really important aspect of

ambient intelligence

it's its societal and ethical

implications

um in at stanford we strongly believe in

human-centered ai research

and a large part of this means that we

have to take into consideration of

ethics into the design of our technology

not as an afterthought

and this is where we work with a lot of

bioethicists

legal scholars philosophers and

actually ethicists who

are experts in different angles of this

problem

and we meet regularly with the computer

science team and clinician team

to discuss uh various issues i'm not

going to be able to go through

all the details but i will touch on

categorically some of these issues

privacy of course is a huge thing there

are technical ways to

ensure privacy protection including face

blurring

including video down sampling including

human body masking

these are all examples there are also

ways to you know

make sure there's privacy in data on the

data front

like differential privacy to add noise

to

individual record in machine learning

we're exploring federated learning

to uh so that data don't get neutr

centralized and

can facilitate edge learning we also are

looking at homomorphic

encryption um it's incredibly slow

but uh and and how we can uh put

stronger privacy guarantees and there is

also physical privacy

of devices from devices all the way to

central servers central servers

but of course privacy goes beyond just

technical solutions there

needs to be regulatory considerations

there are other issues in this research

or this technology legal issue

is another ones for example this is just

an example of

psychotherapist patient privilege but

ambiance sensors opens new challenges

like can the data become potential

witnesses

and we are working with legal scholars

or at least providing

our technical insight to legal scholars

who are looking at these

issues and hopefully forecasting and and

getting ahead

in in terms of uh

thinking about laws of course bias

is a big issue and fairness and and the

world

the world of ai has woken up to bias

there's bias introduced in data sets for

example

gender skin color and and so on there's

also bias in the

inclusion of different demographies we

care a lot about you know how to sample

patients and of course

regionally we have bias and we have

challenges but at least we want to pay

attention

to these issues um

i'm just gonna oh and then there is you

know

algorithmic uh transparency

accountability

uh there are nice research research has

happened such as model cards

in in in the past couple of years that

are useful tools to ensure algorithmic

transparency and accountability and of

course there is ethical issues

in the scientific research itself even

before the mass

application of this technology and we we

are

taking meticulous care into the

different steps

of our scientific research protocol from

you know irb uh human patient human

subject consent

uh all the way to data storage data

annotation

and so on so i i

i can spend days to talk about ethical

issue but i think the overall message i

want to deliver on the ethics front of

ai research related to ambient

intelligence is the importance of

multi-stakeholder approach

from again bake the ethical design into

the technology before a single line of

code is written

and that's what we have been trying to

do to collaborate with policy

leaders ethicists legal experts

clinicians patients

and of course technologists in this

multi-stakeholder conversation

so that's all i want to share with

everybody today

it's just a very uh

superficial summary of what we feel

so excited by this new wave of ambient

intelligence technology

in ai and healthcare and

what i just want to say is at the end of

the day healthcare

is about humans caring for humans

ai is here to really help enhance

humanity not to replace

the many many hours and days and weeks i

sit in icu or surgical room with my

mother

makes me realize how important and

irreplaceable

our caretakers our clinicians our nurses

are

and our role as technologists

is to make their work better is to

enhance their work

give their time back to the patients and

together to improve the health care

system

thank you so much

so happy thank you and this is great

very insightful and very inspiring

and i see there are a number of

questions um

so there is one question about the

multiple

sensors being used specifically the

question talks about the icu monitoring

where

is there a scope for multimodal data for

instance

including wearables or other devices

that the nurses or doctors could

could use yeah i mean as a technologist

absolutely for those of you who are who

are deeper in computer vision research

you can see that there is a really

exciting new

area of research integrating audios and

videos recently and here in clinical

setting i think multi-modality

does include wearables as well as

potentially audios and and

adapts in thermal in fact in

neurological disorders for example early

detection

of stroke let's say i think audios is

critical right so

it depends on the situation but short

answer is absolutely

uh there is also a question

again with respect to the different

sensors and different

angles um you spoke earlier about the

analogy between the

medical space and the

driving space um and so looking

there there is for instance slider being

considered as one option

and cameras and another option so if you

could speak a little bit more

both about um what do you think about

these

two different approaches um with respect

to the accuracy but also with respect to

privacy

yeah a good question i think it's

probably

pretty obvious to most of us that depth

sensor

and lidar they are not completely

privacy issue free but they go a long

way in protecting

privacy because we don't need color

information we don't see

faces and so on so from that point of

view

we actually chose to use

depth sensors since about 10 years ago

because we feel

it's just so much more respectful but

having said that we shouldn't just

pretend that there is no privacy issue

for example

gate identification is a way to identify

people and you can actually

de-identify the person just through

biological gait

analysis and that you can get that

information from depth and of course

if you're in people's home you know

whether you see the face or not it's

contextualized to identify

individuals so we have to be vigilant

about that

but on rgb camera

we have to go through a lot of good

regulatory guardrails

um to to ensure privacy

is uh is taken care of and the patient

consent and family concern

but i also want to say that there is

value there is a lot of clinical value

in using camera information because a

lot of diseases

and a lot of illness conditions the the

the signal come through the colored

pixels whether it's

nuanced movement patterns

or facial expression of pain or like i

said earlier neurological

early neurological condition detection

like

face drooping in in early stroke

patients

in ambulatory or mobile

medicine case you want that quick

detection and

pixel information is is useful so

so they're complementary i would say

i personally would try to push dap

sensor as far as we can

because of its its advantage in privacy

but work with clinicians and

patients and policy makers to enable the

possible use of cameras

and that that makes great sense and i

would follow up with a

question that has been on my mind for a

while with respect to

um ethical considerations including

privacy which you touched upon

so there is this concern that if you

account for personal information there

might be

unethical issues being raised but then

if you look all the way through to the

end application

i'm also hearing and from colleagues

in healthcare that it would be also

unethical to not help somebody who's in

need

so i would be curious to hear your

thoughts on this trade-off between

the ethical considerations say early on

in which kind of data to consider and

then

really to the end application like what

kind of

impact it could have or potentially

would not have if we would

stop working on this kind of um yeah

no rada i think you touched on really

important even deeply philosophical

point

and i think just by you talking to both

clinicians and patients

is the approach i would take it's a

multi-stakeholder approach

you know none of us whether as an

individual or

as technologist have the answer to all

this right

i i wear the hat as a caretaker of

my mother and there are many moments you

know

including now when i work from her

remotely

i want technology to help me

to to give me more insights

of how's her walking gesture today how's

her sleep pattern this week

and for me that information is

invaluable

arnie my my amazing partner always

remind me

and my team of technologists uh let's

not remember we're dealing with the most

vulnerable

one of the most vulnerable of our

population

and there are many ways we can help them

it's

really hard to give a sweeping statement

of what's ethical and what's not ethical

when the forces of privacy but also

health and life are are um

in play together so my my the way i have

been taking this

is first of all be very respectful and

humble

about the space we're working my with my

ai

students when they join the team the

first thing i ask them to do is to

shadow doctors

and and to just feel the human empathy

about the vulnerability of the

population we work with

and to start there take the

multi-stakeholder approach

listen to patients nurses legal scholars

i feel confident given the the

brilliance of human minds

and and if the will of our collective

you know uh community we'll find a good

way to balance technology and human

dignity

and and use necessary policy guardrails

um and technology smarts to solve these

issues

thank you and yeah this this is

something that like i said i'm currently

thinking a lot about and i think it will

require more thinking

from from many and balancing

the sort of the the trade-offs um there

is

another question regarding um the work

talked about

in senior care whether there is concern

that collecting data is infringing on

autonomy

and how do these people feel about their

independence and i will also add my own

follow-up to the question that was asked

to what extent will discourage people to

try to be

autonomous if there are all these

systems that are helping them and partly

doing their work for them

yeah so um really good question and

several

answers there for scientific

research that's what we're doing we're

not building

you know monetizable products for

scientific

research i think patient concern

and subject concern is a huge

part of this this process right like we

would

only work with seniors who understand

what this is about and who do not feel

this is infringing on their autonomy or

privacy and so on and and people are

different

not everybody is the same and their own

situation

is different and they need different

help so at least

we focus on working with the population

that

follows our human subject protocols

in terms of are they the the deeper

philosophical issue

as machines start to

kind of take responsibility of autonomy

what does that mean for

for humans i think this ambient

intelligence technology

is pretty far from taking over

autonomously because it's mostly an

observatory of observing technology

it doesn't actually enact on

um on behalf of people it cannot take

the pills for you

it cannot walk for you it cannot

exercise for you right

it's more a uh a way to

to gain healthcare insight

well-being insight so for you the

patient

as well as for your caretakers to try to

help optimize the the well-being so

from that point of view this particular

technology is

is not um i don't see a strong

danger of uh taking over the the sense

of autonomy

um and again the bigger um

context um even at stanford we often

talk about

i really really believe there's so much

more for ai to augment and enhance

people

rather than replace people whether it's

this particular healthcare we're talking

about or manufacturing or

or other space um of course there are

situations

ai or robotics can replace people

especially

safety security situation i would like

robots to

to replace people in dangerous places

but by and large this technology has

more

space to work on to enhance humanity

that's that's another angle to think

about this

yes and i i i very much agree that

that's where we can actually make a

difference

now we'll have to see in the futures um

and there one thought i have which will

take me to the to the next question

i i've actually thought about this

augmentation in the context of my own

children at some point i was thinking

about

how could i build technology that would

help small children be understood like

really sort of translate their

baby language into our language so they

are

understood and eventually i gave up just

because i figured that maybe that would

not encourage them to learn the language

that would help them communicate

yeah and there is a question um

which speaks about both um age people

which you talked about

and then um infant health care

um and i would be curious to hear about

your thoughts with respect to transfer

learning

are these algorithms that could be

reused between different population and

what are your thoughts with respect to

that yeah i actually think we have to

use

transfer learning few shot learning long

tail learning is a huge problem in

health care right like for example

senior fall

how much data can you collect of real

senior falling in their homes first of

all i hope none

second these are rare events but have

grave consequences and there's

no way um if you look at today's deep

learning algorithm and how much

supervision it needs

that we can collect enough data at least

not from

our budget and uh and uh

so i think um domain adaptation transfer

learning

um um fuel shot learning these are

situations these are learning methods

that are

so suitable for for health care i

actually

my ai students when we think about the

technical contribution we can do

i think this is a huge area because

almost

every single health relevant

activities we deal with is a long tail

event

and hopefully they are rema they remain

long tail event

and whether it's in the hospital or not

or at home these are ontario events so

we have to evoke these

you know the distribution

disparity you cannot hope for training

data and testing

inference time data to have the same

distribution so

really good technical area to to work in

in my opinion

thank you and just one more question to

wrap it up

um there is a question on what do you

think is the biggest button lack to

introduce ai into healthcare

domain right now there have been a lot

of advances as you highlighted

what do you think is the main button lag

is it

privacy ethical consideration legal um

yeah great question i i do think a lot

about this i

i think there's a couple of things that

i just want to highlight

the first one is public trust i think

a.i

right now as a member of the ai world

i'm concerned about ai's public image

and

and we can debate of about whether we

deserve that

but the the image is not that great

public trust is

very low in about ai and the technology

at in large you know think about the the

the

issues of bias you know there's a lot of

public outcry uh think about uh privacy

issues

so i think um working healthcare

we i personally care a lot about gaining

that

trust in the community and in the

multi-stakeholder

community that we work with and i think

as a

as a field collectively

we need to work very hard to gain

public trust and this is not just a pr

issue it's really about

how we conduct our our research and how

we

um you know help to move

uh the technological or combine the

technological aspiration

with the the the goal of

doing ai for good so that's one issue

the second issue is actually modernize

our

policy and regulatory measures i think

it's

really important that we work with

regulatory

agencies to modernize some of the

um some of the guard rails and and

and and policies surrounding data

machine learning

on one hand it's comforting to know

healthcare

is a highly regularized industry and

for good reasons and as a patient or

patient family

i appreciate that very much on the other

hand

technology has moved ahead for example

data siloing

and data sharing is a big

issue in healthcare research and

can we modernize our regulatory

measures so that while we keep

the protection of our uh patient

health record and data but we also

incentivize

innovation i think and that also will

help

public trust if we have the right policy

measures and guard rails we

we could hope to innovate within the

safe

boundary of trustworthiness and that's

also

very important so these are the two

issues

that uh at least rise to the top of my

mind

oh thank you um and thanks again for a

very insightful talk and

for a great discussion thank you to all

everyone in the audience for your

questions and i will now hand it over to

my colleague and collaborator

professor larian who will share the