Google’s announcement of Google Duplex – an AI assistant that will make calls on your behalf (seemingly focusing on appointment booking) – seems to have polarised people on many fronts. For some it has raised ethical questions, others foresee it as hailing a new age of phone communications, and many believe it will end up as the next big flop, like Google Glasses or Pixel Buds. At DrDoctor, we don’t profess to have a crystal ball, but there have been some strong opinions buzzing around the office as to how this will affect communications in healthcare, especially within the NHS. The following is my own breakdown of what I believe could be the results of a successful launch.
The first question to answer is whether NHS hospitals will accept calls from the assistant. Currently, only immediate carers or family members would be permitted to make, change or cancel a hospital appointment for a plethora of reasons including data protection. If the NHS determines that these calls are being made not by the individual attending the appointment (such as an assistant or secretary), they may refuse to share any details at all. This would result in a spike of attempted calls with Google Duplex when it launches, but a sharp drop when it is universally accepted that it would not yield the desired result. A more frustrating scenario for patients would be if some hospitals allowed this interaction (by choice or accident), leading to a sustained increase in Duplex calls over a prolonged period of time, with the unsatisfying experience when it doesn’t work.
A fear that Hospitals may have is well articulated by Natt Garun in The Verge “If it’s as simple as telling Google Duplex to make an appointment, it’s just as easy to constantly reschedule or not show up altogether because there’s no connection between you and the human worker who picked up the phone to arrange your reservation. You don’t feel bad for the number of requests and changes when someone (or something) else is doing it for you.” Simply put, if you don’t have to go through the process of booking or rescheduling your appointments, the guilt in rescheduling or not attending (a major issue the NHS is battling with at the moment, costing approximately £1 billion annually) is reduced substantially.
The other scenario would be that hospitals – either by intention or accident – accept these calls as a valid way of booking, rescheduling and cancelling appointments. If we ignore accidental acceptance of these calls (because of the realistic nature of the Duplex voice), intentional acceptance requires some gymnastic thinking, which is likely to take large entities (such as the NHS) time. Duplex calls are not akin to a regular phone call. They are a whole new method of communication – just like the fax machine, email or SMS. It is not an actual assistant making the call (which would not be permitted under current guidelines), but the patient themselves, just using this new mechanism to facilitate the alteration. The new platform for information exchange will need to pass through a barrage of testing from Informational Governance, security and privacy departments before it can be trusted and adopted. I would assume a hesitancy within the privacy circles of the NHS due to the inability to establish the person on the Duplex end is (or is controlled by) who they say they are. New training will need to be rolled out, and A/B testing will be undertaken to establish the usefulness and cost-effectiveness of the innovation – another challenging task.
Although Duplex could remove a large barrier for patients, providing another medium for communicating with their hospital, it would add a colossal load onto administration teams in the NHS, who would now need to deal with the increased incoming calls from the platform. At DrDoctor, we’ve been steadily reducing the amount of strain placed on the already stretched administration teams, primarily using conversational 2-way SMS communication to take time away from person to person calls, or snail-mail-postage. Over the last year, we have assisted in scheduling around 6 million appointments and sent over 22 million messages – the back and forth nature is new and still being adopted by NHS Trusts around the UK, whether or not they are ready to take on a new innovation is yet to be seen.
The most interesting element of this in my mind is the ‘future-proofing’ mindset. Currently, Google is offering this to the general public as a method of booking appointments and making enquiries. The makes the most sense as it is easier for the AI system to lead the conversation (as laid out in Google’s blog about the Duplex launch). To me, the next logical step is the reverse this process and create the second side of the coin – an AI system that fields phone calls related to appointments – effectively the end to hold music. A Duplex system plugging directly into a calendar booking system, finding open slots, sending reminder messages and fielding 99% of enquiries, for multiple callers at the same time, eventually negating the need for a large booking team. This evolution would lead to a lock and key mechanism for people to interact with companies of all shapes and sizes around the world, eliminating language barriers, capacity issues and human error.
Regardless of your stance on the ethical aspects surrounding AI impersonating human beings (goodbye Turing Test). If Google can pull this off successfully, we will see a paradigm shift in the way in which we interact with companies and services. Personally, if it works as well as the demo suggests, I think this could be a commonplace interaction within a year. On the flip-side, you don’t see that many people walking around with Google Glasses every day.