It is an ordinary afternoon at the General Hospital of the People’s Liberation Army in Beijing, and an elderly gentleman walks up to the receptionist.
“Hello, how do I get to the osteopathy department?” he asks, studying the hospital map. The receptionist is a robot and the map is on a screen on its chest. His friend has already given up trying to get help, overwhelmed by the cutting-edge technology.
“Some elderly people show little interest in the robots,” said Zhang Yong, an iFlytek product manager based at the hospital. iFlytek is one of the leading companies in artificial intelligence (AI) language technology in China.
Zhang said the company’s medical department looks for ways to apply AI technology to China’s healthcare system. Its robots are stationed at hospitals in Beijing, Shanghai and Guangzhou where they help patients find the correct department for their symptoms based on voice recognition and images. They also have a wide vocabulary and algorithms to help ease the communication process. When they were first implemented in August 2017, they could only answer 3,000 questions. After daily updates and constant machine learning, they can now answer as much as 20,000 different questions.
Zhang thinks the robots give the hospital an open atmosphere and that future AI technology will help “decrease waiting and treatment time and increase efficiency.”
Not just gadgets
Robots can do much more than answer a few questions at a hospital reception. They can also diagnose, serve and give companionship.
“Robots are designed to be your friends. With self-learning and data analysis, they can study what you like, memorize it and use that to make interaction with you much smoother and more enjoyable,” the founder of a Chinese nursing home that tested caregiving robots, told the US news website Quartz.
Termed in-home voice assistants, robots can help the elderly adjust the height of their bed or the temperature in a room, remind them to take their medicine, make video calls with family members and alert them when their relatives are at risk of falling down.
Eldercare is increasingly important in China, and AI technology is seen as a real solution to the problem of caring for an aging population. The Chinese government plans to turn the development of service robots into a 30 billion yuan industry ($4.35 billion) by 2020 and become a global leader in AI by 2030, according to reports from Quartz and Financial Times in 2017.
The AI industry is a point of hope for China’s aging population. The number of people aged 60 and over in China is rapidly increasing. By 2050, the elderly population is expected to skyrocket to 459 million or approximately one-third of China’s total population, according to a research paper titled Health and Health Care of the Older Population in Urban and Rural China: 2000 published in 2007.
According to a 2013 report in the Diplomat, a current affairs magazine that focuses on the Asia-Pacific region, nearly 23 percent of China’s elderly depend on some form of assistance. However, less than 2 percent uses institution-based care. Nursing homes for the elderly are unpopular and expensive, and many people prefer to stay at home as long as they can, fully dependent on their pension and family, the report said.
For every 1,000 seniors, there are only 30 beds available in nursing homes at an average cost of 42,400 yuan per year, the South China Morning Post reported in 2016, citing a Ministry of Civil Affairs report.
The absence of tailored insurance schemes also discourages elderly Chinese from spending money on healthcare, the article said. It’s a problem of high demand and low affordability.
Replaced by robots
In-home caregivers are not enough, and taking care of aging parents is also seen as a filial duty in China, which makes many people reluctant to seek help from a professional caregiver.
Zhu Yanxia, 56, spends at least three days a week taking care of her sick parents. Despite struggling to balance caring for them and her part-time job, she remains reluctant to get help from outside the family.
“Even old people don’t want to use outsiders to take care of them,” she said. “It’s easier if we just do it ourselves.”
Zhu’s 77-year-old mother had a stroke more than 15 years ago, and her father, 86, has problems with his lungs. Both parents have diabetes, and her father can’t leave the house anymore.
“I cook for them, clean the house, accompany them to the hospital, get their medicine and so on,” said Zhu. “I tell them to take their time. I am patient with them, and I comfort them.”
She gets a little help from her husband and brother, but AI is so far out of reach in her world that she would not dare to think of using it.
“I’m used to taking care of them by myself,” she said. “The majority of Chinese are like this.”
Even if she wanted to employ a professional caregiver, finding a well-trained and affordable one is a hard task. She already fired a caregiver from her parents’ hometown due to a lack of professionalism and too much resistance from her parents.
One million Chinese work as caregivers for the elderly, but 10 million are needed, China Radio International reported in December 2017, and only five percent of caregivers are educated in the field.
Du Peng, the director of the Gerontology Institute at the Renmin University of China in Beijing, believes that “AI will replace human caregivers as soon as the technology becomes cheaper.”
He said more skilled and educated caregivers are needed, but human labor is expensive and the demand is high. “AI will start to transform the eldercare system in as little as two to three years when the technology moves out of the laboratories and into people’s lives,” Du said.
He believes that the effect of AI on elderly healthcare is twofold. First, it helps improve their autonomy and privacy at home, and second, it speeds up the disease diagnosis process.
A startup at Tsinghua University, Theoros, has made early diagnosis using deep learning in medical image analysis their mission. Their AI elastography medical device can diagnose cirrhosis of the liver, which could save lives. Men over 60 are at the highest risk of getting the disease.
As China becomes the innovation hub for breakthrough AI technology, startups like Theoros have mushroomed. Chinese academia has already established itself as a global leader in AI research. In fact, two Chinese organizations are among the top 10 sources most frequently cited in research papers about AI between 2012 and 2016, according to the Financial Times. Not only are China’s Internet giants Alibaba, Baidu and Tencent embracing AI but more and more startups like SenseTime, Face++ and iFlytek are also developing cutting-edge technology.
Zhang Xiao, 25, is a master’s student in biomechanics at Tsinghua and the chief technical officer at Theoros. She believes that the AI diagnosis machine can improve the experience of patients and doctors.
“In China, the real problem for hospitals is that there are too many patients. People line up or make appointments a few weeks before the actual diagnosis,” said Zhang Xiao.
“A single machine may not change the whole medical system, but it is a tool that can save time and do better analytical work than a human being.”
Theoros only needs a million pictures to create a complete diagnosis system for liver cancer. The images are equal to five to 10 years of clinical experience in image diagnosis for a human doctor. But the device is still in the testing phase. It is not expected to hit the market until June 2019, said Zhang Xiao.
“AI is a huge trend in eldercare, and we are on the pathway to letting AI help us under the condition that it will continue to develop and become closer to our daily lives, be affordable and easy to use,” Du said.
Until the day when AI is mass produced and easy to access, people like Zhu will continue to look after their sick and aging parents on their own.
“I am worried about whether my parents’ health will improve. I’m so tired after all the things I have done. That’s why I’m waiting for them to be fine. Then I can finally relax too,” she said.