Unless you have been living under a rock, the chances are you have been happily interacting with various AI systems for the past few years. Tasks that were typically thought to require human intelligence can be completed almost instantly, by computer systems using large language models (LLMs).
Perhaps the most well known LLM is Chat GPT, which was launched by Open AI in 2022. There are similar programs from Microsoft, Apple, Google, Samsung and more and AI bots are embedded into most search engines, smartphones and computer systems. AI can be used to help draft and answer emails, write essays, plan a holiday, write computer code, develop a research proposal, draw pictures and even write music and create videos.
AI is now everywhere. What is it's relevance within expedition medicine?
Risk Assessments
AI platforms are the new search engines of our time. Why "Google" something when you can ask Chat GPT and get a personalised bespoke answer, which you can then fine tune and question ad nauseam.
Travellers and potential expedition participants can now use these LLMs to find out about travel destinations. Expedition companies may do similar. Importantly the accuracy and relevance of the information generated depends hugely on where these platforms "mine" their data from. Generating a brochure for clients is one thing, but what happens if an AI platform is used to generate a risk assessment?
Risks assessments are time consuming. They involve lots of spreadsheets. They are not a sexy part of expedition medicine and they can be tediously boring. But they are absolutely essential.
By design they will help you identify and mitigate for potential risks. They will allow you to develop an expedition plan and ultimately decide whether a project is viable from a safety and security perspective.
This process only works if the right information is reviewed. Much of this information, for example terror threats and disease outbreaks, is changing in real-time.
Take the M-Pox outbreak that threatened to impact on our Livingstone Revisited Expedition in 2024; would AI have been aware of this?
Maybe. I don't know as we did not use AI as part of our risk assessment strategy. I suspect that the answer would depend on various factors, for example the refresh rate of any LLM. How often does it review it's sources? How accurate are these sources? How are they fact checked?
Any AI generated report will require a level of scrutiny and expert review that in my mind can only be done by a human. AI will undoubtably get better as we are very early on in it's development, but problems will arise if an unconsciously incompetent individual or organisation blindly places it's faith in an AI based risk assessment without knowing any better.
AI Consultations
Up until this point, I have largely focused on AI programs being used in the pre-expedition phase. This is largely due to perceived connectivity issues, however many expeditions now have better connectivity than many areas of rural Wales where I live, whether this is the result of mobile phone masts, Starlink or other satellite messenger platforms.
This therefore means that Chat GPT and other similar platforms can be used during an expedition, in a similar way to traditional search engines and web browsing.
With the caveats above notwithstanding, an expedition participant now has the ability to ask an LLM about a set of symptoms they may be exhibiting. In terms of empowering health within expedition teams, this is hopefully a good thing. Similarly, a team without a designated medic may do similar, although this should not replace a discussion with suitable top cover.
For the time being top cover should be human, but perhaps one day this will be done via AI?
Advanced AI models can pass the United States Medical Licensing exam with a score equal to that of an average third-year medical student and similar performance has been found when these AI bots attempt board-style questions from a range of postgraduate exams including MRCS, MRCP, RCPCH, RCOG, RCOopth, MRCPsych, FRCA, and MCEM.
AI Scribing
One area that can be tricky from a medico-legal perspective is keeping accurate and contemporaneous patient records. As expedition medics we are often on the move, battling the elements and simple paper notebooks often fail to hold up to the abuse of the job. Ways around this include waterproof paper or keeping electronic records on a phone, but what if your phone or tablet could take notes as you were reviewing that patient in the dark at 3am half way up a mountain?
If you had signal (or Starlink etc) then this can now be an option. Whilst I prefer keeping things simple, there are now several AI apps that promise to do exactly that and write up your consultation. Granted they have been used moreso in GP surgeries and outpatient clinics, but why not stretch the boundaries of what is possible and use AI note taking in the wilderness? This is something that would be particularly useful if an offline mode was available- something for the future perhaps?
Obviously with any systems such as these, we must also be mindful of where this data goes and who owns it, but it will be interesting to see how this area develops.
AI Diagnostics
Alongside AI, medical technology continues to advance. Previously taking POCUS devices on expedition would be an expensive endeavour, however devices such as the Butterfly IQ+ (pictured) are getting more portable and more affordable and they can plug into any compatible Apple or Android phone or tablet.
As with all medical devices, there is only a benefit to be gained if what it can show will somehow alter your management. This is obviously expedition and situation specific, and whilst having appropriate skills is important, the latest Butterfly devices have FDA-cleared AI guidance and interpretation built in.
Overall
This short blog has touched on some of the possible applications that I can think of for AI within expedition and wilderness medicine. AI is fairly early on in it's journey and much of what it does depends on connectivity. When working out in austere environments, often getting away from technology is one of the most appealing aspects, but it does seem like AI is here to stay. How do you think it might impact on expedition medicine? Are there any other cross-over applications? Let me know in the comments.
Comments