Part 4 How decisions will be made in the future

Care in the future

Scaling technology to spread better decisions, if it is designed well.

The final chapter imagines how AI, wearables and sensors could spread better decision-making, provided the tools are built with metacognition in mind. It organises the future around five themes: matching each decision to the right support, a two-way learning health system where clinicians and machines learn from each other, health records that treat the patient as a co-author, a broader idea of what research counts and protecting genuine patient choice. Proposals include capturing the reasoning behind a decision as it happens, an always-on coaching avatar that works like a living logbook, federated learning across hospitals and patients setting their own appetite for risk and human contact. It warns against importing the misaligned incentives of social media.

Three takeaways

  1. Decision support can harm if it is used at the wrong moment
  2. Patients should help write their record, not just read it
  3. Everyday care data may come to rival big randomised drug trials

Reflection

Questions for this chapter

Prompts to consider on your own, in a journal club or in a teaching session. All questions are optional, so you can read them without submitting anything. If you choose to submit answers, they are collected through Google Forms.