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“People have begun to understand that we can use technology to add new value”

An interview with Matthias Struck, deputy head of the department Image Processing and Medical Engineering at the Fraunhofer Institute for Integrated Circuits IIS.

A T-shirt that measures your heartrate, shoes that count how many kilometers you’ve walked, a fitness tracker that monitors your sleep – these aren’t visions of the future anymore, but reality. TRANSFER interviewed Matthias Struck, who spoke about robots in nursing at the second #techourfuture event, on the opportunities and challenges that these developments present, and why seeing your doctor face to face is still essential in times of AI. Struck’s research at the Fraunhofer Institute for Integrated Circuits focuses on developing technologies that can be integrated into domestic environments to record, analyze, and network health-relevant vital signs on an everyday basis.

Hello Mr. Struck. What challenges does digitalization pose for your work, particularly in medicine and medical technology?

We’re a department for image processing and medical technology as part of the Smart Sensing and Electronics division. Our work revolves around three major medical technology topics. One, medical sensors. This is all about how to record and evaluate people’s and patients’ biosignals on an everyday basis. Two, artificial intelligence. We combine sensor data and evaluate it in detail to provide a basis for forecasting. Three, medical data communication. This is about tackling the question of how to send data from domestic settings to GPs, from GPs to specialists, from specialists to hospitals, and so on. We’re focusing on all-round solutions so that ideally, data can be exchanged in a standardized format.

Why do you believe it is important to inform society about future technologies? What kinds of things need to be taken into account?

That’s a very important question, thank you. I think it’s tremendously important to keep society informed about these topics. What potential does artificial intelligence offer, and where do its limits lie? By setting clear boundaries, you can also offer people more security. In Germany people can be particularly skeptical about things; they worry about the “transparent patient.” But illuminating everything about someone isn’t the aim of artificial intelligence in medicine. Rather, the aim is to help doctors make better diagnoses and select better treatments. Everyone knows that doctors are only human. And wherever humans work, mistakes happen. With the aid of artificial intelligence – which can evaluate and analyze huge amounts of data, then apply the results to other patients and compare these results with the patients’ disease progression – we can succeed in reducing error rates. This is the value that AI adds.

Do you think people are less tolerant toward technology or people?

I definitely don’t think that AI will cause patients to lose trust in their doctors, because AI isn’t intended to replace doctors. It’s there to support them and to ask additional questions and suggest additional options in the background, such as whether any further differential diagnosis would be advisable. Its purpose is to ensure that nothing is overlooked. In the future, doctors will continue to make their diagnoses in person and explain them to the patient in person.

What prejudices do you hear about new technology in the course of your work, and how do you deal with them?

Data protection is of course an extremely important issue. If users and patients are going disclose sensitive information about their body and physical condition – and thus of course about potential illnesses – then they need to be sure it will be handled carefully. Most of all, we need to ensure that it’s patients who decide what information can be seen by whom (which people and doctors), when, and why – and that their information is not misused. At Fraunhofer, we take this aspect very seriously. For instance, we have systems that use images to analyze people’s faces and judge their emotions – whether they’re sad, angry, frightened etc. – in real time. This is of course very sensitive information – for example, it could reveal that a particular person is often in a bad mood, which could be an indicator of depression or burnout. So we’ve developed privacy-by-design technologies to ensure that any images linked to individuals and their names is immediately deleted again as soon as the analysis has been performed, so that only the result is then disclosed. We do the same when recording biosignals like blood pressure and heartrate. This data is encrypted so it can’t be viewed by third parties and only authorized individuals such as doctors can access it. I think Germany’s strict data protection regulations mean that people are much more willing to trust German companies than, say, American ones, which handle data a lot less carefully. I also think that acceptance of such applications has risen in recent months due to the coronavirus pandemic. People have begun to understand that we can use technology to add new value.

At this point, it’s important for me to re-emphasize that technology cannot replace face-to-face contact in person. But especially right now, in the midst of a pandemic, we’re subject to certain restrictions and requirements, such as visits to care homes being reduced or forbidden. This is where technologies like Skype allow us to continue to see our families and interact with them in real time. But I don’t think they’ll be a “substitute.”

Which new technologies in the field of health and medicine would you use yourself, or at least accept, and which would you reject in certain areas?

I’ll start with the latter: Personally, I don’t like having the feeling that I’m being monitored 24/7 without it being strictly necessary. I don’t want to wear a T-shirt that measures my heartrate and blood pressure around the clock. I want to decide things like that for myself and be independent – without my data continually being recorded. So I can understand why people are skeptical of certain technologies. However, I’m very fortunate in that I rarely need to visit the doctor – I feel healthy and hopefully I am. But if I start noticing that that’s no longer the case, I’d be the first to use health and medical technologies because I know the value they add. For instance, vital signs measured in a domestic setting are more telling than those measured at the doctor’s. At the doctor’s, I always have high blood pressure when I see people in white coats – I’m in an unusual environment and it stresses me. So high blood pressure readings in this situation are less relevant than if they’re taken at home. Medical technology also provides a lot more data, and continuous data; at the doctor’s, you only have a one-off measurement, and we’ve all had an off day on the day we saw the doctor – that doesn’t mean you’re ill. This is where technology offers us lots of opportunities.

Contact

Matthias Struck (author)
Assistant head of Smart Sensing and Electronics
Fraunhofer Institute for Integrated Circuits (Erlangen)