Artificial intelligence and empathy in digital health can create a future in healthcare that empowers patients, focuses on prevention, and fosters a nurturing environment. In this episode, Julia Walsh, CEO of Brand Medicine International, discusses how online health searches can be a crucial tool in early diagnosis and treatment. She explores the groundbreaking potential of positive digital information experiences in transforming patient journeys from symptom to diagnosis and beyond. She talks about the future of healthcare, explaining how it is changing from focusing on treating illnesses to prioritizing prevention and promoting public health and longevity. Julia’s vision for the future entails AI-powered chatbots that provide concise and relevant answers, minimizing confusion and ensuring patients receive accurate guidance. Join us on this inspiring journey where technology and empathy come together to improve patient engagement, empower proactive health decisions, and create a more caring and accessible healthcare system.
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The Future Of Searching For Health Information – A Conversation With Julia Walsh
In this episode, we have Julia Walsh, who is a thought leader in the intersection between search engines and healthcare, and how people are getting all of the different information that they’re able to make their healthcare decisions. Julia, thank you for coming. Can you tell us a little bit about yourself and how you got into this space?
It’s a pleasure to be here, Dr. Awesome. I got into this space inspired by my own experience as a carer. I started to understand, it was put home to me how important the information that you get online is when you turn to the internet to exchange questions for health advice. I wanted to add an expansive view of that and understand the impact of this channel of exchange of information on the broader healthcare ecosystem. Also, to stay to date with how it’s changing because the digital landscape is rapidly evolving in front of our eyes now with the advent of AI-driven chips. That’s how I started getting into it.
I wanted to speak with you because we’re at an inflection point now where, in the past, I felt like most people were going to Google and they were looking at the ten different websites and making an educated guess based on the information that they ascertained from those ten different websites. Now, a lot of people are going to ChatGPT, which is a one-source model. It’s been shown to be not as effective in giving accurate and legitimate answers to their questions. Tell us a little bit about that, what you’re seeing, and how people are using AI versus how people have used it in the past.
We’re bearing witness to the biggest disruption to the way health information is exchanged since the advent of the internet itself. You are correct in saying that people are starting to turn to ChatGPT. A lot of the focus on that particular tool has been the generation of content and the saving of time. There’s going to be a very quick adoption of it as well in terms of like, “I’ve got this niggling symptom. I’ve been diagnosed with this disease. I’m going to turn to that instead of my traditional chat.” It is the normal menu of ranked websites that we’re so accustomed to being offered and we love it. There are a billion health-related questions put into Google every single day.
We’re very accustomed to that particular method and process of getting health advice, but the search engines themselves are also in a race to integrate tools like ChatGPT in their search experience. You’ve got new Bing and Google’s search generative experience, and you are right. Going into those at the moment, they’re still in their infancy.
While we’re being forced to transition across, there are still some inherent glitches that are going to need to be ironed out with these tools because, on one hand, they can scrape all of the wide knowledge from the entire internet and put it into one succinct answer. That is powerful and super useful. Especially, if you have low health literacy. We don’t have a lot of time. On the other hand, they do make stuff up. We’ve seen that in our research on brand medicine as well.
When you say your research, what is it focusing on? Is it just focusing on the creation of false information from artificial intelligence? Is it how people are using a church engine? What are you looking at now?
We wanted to take a point in the future and understand what the trajectory is going to look like. We could all put our heads in the sand as a healthcare industry and figure it’s going to evolve in its own way, or we could proactively lean into this change and shape the future digital landscape so that we can ensure that patients and doctors, in fact, like yourself, get the locally relevant evidence-based information that they need. We want that to turn up where and when they look for it. We wrote a white paper on AI disruptions in search to look at it from a broad perspective and understand not just the challenges but also the opportunities for improving healthcare.
Particularly, there are benefits for people who don’t have the traditional affordability to get actual healthcare in a normal fashion. This is going to offer them a running start to understand what’s going on with themselves as well as people who are in rural and remote areas. There are going to be opportunities to address and equalize the diversity challenges that some groups have with respect to accessing healthcare. We are seeing this change, and there are lots of positives, but at the same time, while we were writing that white paper, we wanted to do some real research and understand what’s going on with these hallucinations and what is happening when we ask for sources.
For example, on one hand, we asked for a PubMed reference that would support the use of Ivermectin in COVID. As you can imagine, it’s a very controversial topic. When people are arguing on social media, which is downstream of search, they will pull whatever they can find to support their argument. ChatGPT offered us an incredibly valid-looking reference with a PubMed number and everything. When you took that PubMed number across and put it into PubMed to verify it, it was a paper on stroke and had nothing to do with Ivermectin or COVID. Collectively, we know we’re going to step backward before we can step forward into this space.
I noticed that too. I have been leaning on it and have led my own presentations and lectures, and that requires a certain number of resources to be coming from peer-reviewed papers. When you look up those peer-reviewed papers, they’re not real. I don’t think that people realize that when they’re looking at this stuff. How do we fix that? Is it the responsibility of the AI companies? I don’t know how to fix that.
You asked such a good question. Who is accountable? Poor health advice can have pretty dramatic outcomes in the real world. It can mean someone doesn’t check a symptom that urgently needs to be checked. It can mean they can take their medicine incorrectly or they stop taking their medicine. There are all kinds of things. I often also see in search people being redirected down pathways where they’re getting crazy advice like, for tinnitus, putting garlic oil in your ear, and stuff like that. These are the contents that are served back on page one in traditional Google search AI tools, scraping the content with high domain authority on the visible web.
The other thing that compounds this in most markets of the world regarding prescription therapies is that there are regulatory restrictions that prevent the pharmaceutical companies from being able to publish answers to questions like, “Can I crush this tablet or can I drink alcohol with that?” Everything sits behind a firewall, so the AI tools are not going to get them. Who is responsible? That’s why we are recommending off the back of our white paper that as an industry, as patient advocacy groups, and as government regulators, we lean into this and work together in a collaborative way with the search engines to improve the quality of this experience. Genies out of the bag, we’re not going back to traditional search. This is a one-way pathway, I believe.
I see a lot of positive future potential for it. From the point of view, you could be walking down the street chatting with your AI search tool to quickly try and understand something that’s going on with your health and you’ll get an answer back through your headphones. The other thing is that it’s infused with empathy as well, and that’s nice for someone who’s worrying about their health. In the short term, we need to make people aware that the content could be bad. Since it looks so credible, we are going to see across the whole healthcare ecosystem an impact from people believing what they get served through these tools, when in fact there isn’t the evidence to underpin that advice potentially.
What are some other things that you looked at in the white paper that you would hope the general public would know? I know that this is something that you work hard on and you have put it out there with the interest of people using this as a resource to prevent some of the downstream effects that you’re seeing. What are some of the things that you wish your family members would know about using this software?
We were looking at the pharmaceutical industry and how it could adapt and undertake its necessary internal digital transformation to account for the importance and influence of the exchange of information on these platforms as well as how to respond to it. They can be slow as an industry to dabble in these areas because they don’t have a framework for how to do it. Meanwhile, it’s like a runaway fire. A lot of what we looked at were critical success factors for different internal departments from IT to medical, marketing, to leadership, and things like that. From a patient point of view, we were recommending this support put into making sure that the search engines have some form of accountability and that we work collaboratively with them.
If someone asks about an oncology treatment or any prescription medicine within a market, we would like to see the search engines as mandatory to attach the local PI or Product Information and CMI or Consumer Medical Information that’s more accessible for patients to read that answer as a reference, which currently we’re not doing. From our research in the white paper, what we saw was that Drugs.com is a very influential website that is often driving a lot of the time the content. Wikipedia is another one that’s being popularly scraped and consolidated or concentrated into these answers. Also, Reddit.
What’s happening is we’re seeing a swing from evidence-based, from clinical trials that are well controlled across to aggregated summary of individual reviews which have, one, we don’t know the comorbidities of that patient, what dosing they were on, and what other medications they were on. It’s unverified and we’ve seen that spin. For friends and family, I would say take it with a grain of salt. Don’t make a decision based on that advice that you get online and act on it without talking to your doctor first.
Don’t make a decision based on the advice that you get online and act on it without talking to your doctor first.
When you say how the genie is out of the bottle, I feel like I initially thought that about ChatGPT and any AI offering in general, but now I find that people have realized some of the things that you’re talking about that it’s not as great as we initially thought it was. I’m still using it on a regular basis to write emails and things like that, things that are just mundane tasks that don’t have a lot of necessity for accuracy. When it comes back to accuracy, I feel like myself, I’m going back to Google and I’m doing the traditional method. A lot of people that I had introduced this to are doing the same thing. Is that backed up by user data or is that just my own feeling? I wonder if it’s the adoption is as significant as people are making it out to be.
Certainly, it was the most rapidly adopted tech in history with over 100 million users within the first three months. Looking at ChatGPT on its own is not taking into account what’s happening in Bing and Google itself. They are actually pushing this type of search platform to users. I feel like it’s not going to be very long and they may also phase out the traditional menu of ranked websites where you have the opportunity to do your own research. I don’t know how long in the future that’s going to be. The place to be keeping your eye on is new Bing and Google’s SGE which is where people are having those exchanges like what you experienced on ChatGPT in their search engine.
It’s driven by the same mechanisms, so that’s why it’s pretty much a one-way road toward generalized adoption of this. You are a doctor so you will have more sense of the need for verifying the references that he used. We saw that lawyer, the very high profile case in the US where he cited in court precedents for a particular case and it had just been made up. His whole research team, including himself, overlooked that it wasn’t real.
That’s helped people like yourself and myself who are in health to take another look and do a bit of a double take. Your average patient who maybe works as an electrician or in a completely other industry doesn’t think that we can count on them to question it. As a movement, we need to start to shape the digital landscape ourselves in a proactive way to make sure that they’re getting the right information.
I certainly think that it’s more natural to ask someone a question as opposed to typing in a question and doing research. It seems something that human beings are ingrained into doing. It’s something that we’ve probably been doing for a lot longer than we’ve had a written history. I want that experience of being able to talk to somebody and going down this thought process similar to what we’re doing now. It is a little bit concerning.
I just feel like I’m optimistic about it that people will figure it out, and I’m glad there are people out there like you who are pushing the policy in such a direction that these factors will be taken into account. It is something that is going to happen. It’s just a matter of time. I feel like the best process is going to win out. Maybe that’s a naive way of saying it.
It will, ultimately. We are on a journey where it’s going to correct itself through market forces as well as feedback and regulatory framework and ethical guardrails that all need to be put in place. It’s hard for governments at the moment because how can you regulate something that is changing so fast? It’s like a double exponential change. It’s crazy. People will start to approach it with a grain of salt and hopefully get the answers that they deserve to get at different points in the patient journey from these tools.
The thing about them as well as you say about the natural language is that in my work as a search listening specialist and pioneering the concept of search listening health, looking at the digital information experience from the view of our patient and healthcare professional stakeholders is that I see all of the time that people don’t turn to the internet with a URL. They start with a question asked in their own natural language and are infused with the feelings that they have at that point in time as well. Traditional search has been woeful at responding to this, and we often see a real big digital disconnect between the type of question that’s asked in the support that that person maybe needs at that moment and the content served back to them in those website options.
This tool, as it’s been integrated into search engines, is perfect to reflect back, and I think we’re going to find greater engagement and greater reliance and trust in the concept of Dr. Google as we move forward. That is one thing about the way that people ask the questions and these machine learning models respond back that we’re going to see that’s going to drive a deeper relationship between the two than what’s been had to date.
Out of all the companies that are in this space now, which one do you feel is doing it the best?
Google always has that market leadership position. We had an estimated 92% of internet users around the world using Google. Bing has been attracting a lot of user traffic because they were very quick to integrate the ChatGPT platform into the new Bing. People were curious and wanted to try it. That’s an indicator of what’s going to be happening as people are embracing this way of exchanging information and seeking advice.
Google always has that market leadership position.
The other thing is that when you ask a follow-on question in a traditional search, you have to go back and it starts again. In this model, you’ve got a conversation that just follows and it knows that you’re on the same topic. You can ask it a follow-up question and it knows that you’re talking about that topic. Whereas traditional search would be like, “What are you asking?” because each query is a start from scratch.
I’ve tried the Bing interaction, and I feel like it’s a little clunky now. When do you think that it’s going to start to get to this point where it’s a little bit more user-friendly and a lot more analogous to having a conversation with an actual human being?
These changes, if you think about where we’ve come from November 2022 when ChatGPT first launched, think how much has changed in that short period of time. When I wrote the white paper, it was almost impossible to publish it because things kept changing. You’ve got Med-PaLM 2 and tools like that coming out that are going to be specific for healthcare. It’s like, “We were talking about this and now we need to talk about this.”
It is a constantly changing landscape. The goalposts are constantly moving. I would not underestimate how quickly these changes are going to come about and I would urge everybody across the healthcare network to be proactive in responding and, at the very least, understand the tools that have played with them, and consider the impact on the decision-making that your patients are having.
What is that Med-PaLM? I haven’t heard of it.
Google’s Med-PaLM 2. It’s designed just for medical queries.
Interesting. I’ll have to check that out. That’s great to talk to somebody like you because you learn all sorts of new things like that. I’ve just been using Google and PubMed. Those are my primary go-tos. Let’s take a step back for a second and talk about artificial intelligence in general. I know that there’s a lot of negative connotations with artificial intelligence. How do you feel about it? You’re in this space and you’ve seen how it affected search and raised a few red flags for you. How do you feel about it in general?
Overall, I’m super excited about it. If we harness it in a productive way, it’s got huge potential. One of the ideas that came out of the roundtable that we undertook to inform the genesis of the white paper was the concept of hybrid consultations. We are seeing some startups start to adopt that and derive that certain medical centers starting to dabble in that. Rather than the patient going away, and this I’m sure happens for you, Dr. Awesome, they go away and look things up and don’t necessarily disclose to you what they’ve looked up. It’s sitting there in their mind when they’re having a conversation with you and it’s influencing the way they respond to your advice.
What we are suggesting with hybrid consultations is that since you’ve got all of the knowledge that’s been published on the entire worldwide web at your fingertips, you may as well harness that. Bring it in and use it when you’re having a consultation with a patient to understand a series of symptoms to consider what may be blood tests they might need, what other diagnostic tools, and what other alternative healthcare steps they might be able to take with diet and lifestyle. Draw upon all of that knowledge in the consultation itself. By doing that, you take this activity that’s happening in a blind spot out of the dark, put it in the light, and bring it into real-time during that consultation with them.
Since you have all the knowledge that’s been published on the entire world wide web at your fingertip tips, you may as well harness that.
The benefit of that is that they’ll feel like, “I was going to do that anyway, so now it’s here and we’re using this tool.” They’re going to appreciate that. The most important thing is, you as their healthcare provider, would have an opportunity to discredit misinformation in real time. You’ll be a digital antibody as it were and educate them by saying, “Let’s check this reference is verified,” put it into PubMed, and check that it does come up, and then you’ll see them have that a-ha moment.
Hopefully, you’ll start to mitigate their secret consultation with these tools that are driving their decision-making around their health and give them a bit of a sense of, “I do need to make sure that I verify the advice that I get here before I act on it.” That was one of the big ideas, and that’s something I’m super excited about. I would encourage the healthcare community to adopt it.
I hope that’s something that happens as a culture shift. Now, I feel like the trust of the patient is more so given to the internet than it is to the doctor that they’re going to. I would hope that enough information gets out there so that they use the internet as a preliminary analysis and then they come to see me as a trusted healthcare professional to guide them. Now I feel like it’s the reverse. They come to see me and they get information and then they verify that through the internet to make sure that that’s something that’s accurate. I’m guilty of it as well. When I go to specialty appointments for myself, my wife, or my daughter, I get the information, I sit there, and I nod my head yes. As soon as I walk out the door, I’m verifying everything that person said on the internet.
I was going to ask you. Doctors google too.
When people look towards a physician, they look at them now as this is a singular person on the island and they may not know everything that there is to know. The internet knows everything that there is to know. They use the internet as something that is much more trusted and much more reliable than an actual person in front of them. I agree to a certain extent because we are somewhat on an island as individual practitioners because we’re only limited by our own experience. I see the value more so in wadding through information by a trusted advisor like your physician. That’s where the flip should go. I don’t know. Is it something that you’ve talked about in your industry as well? Have you seen that situation play out?
We can tell people not to google things until we’re blue in the face and we’re never going to change the behavior. They’ve got a digital itch and they’re going to switch it. The more that we just accept that, work with it, and integrate that behavior into our approach, the more successful we’re all going to be. Particularly with the changing way that this information is consolidated and served to them, playing a role together to consult that entity is the best way through this next little period of time while the system rebalances itself in favor of evidence. Let’s do it. If I was a physician, I’d be throwing a big screen up in the consultation room where you can see it very clearly, type it yourself with them, and show them that you are looking at it too and you accept that they have this need.
The other thing is the reality of time. People don’t have the time in the consultation that they need to fully wrap their heads around a big diagnosis. This pool offers a way to extend that consultation and get more understanding of what’s going to happen to them and how to prevent it from getting worse and all of those things that they have. The other thing is available at 3:00 in the morning when they can’t sleep and they’re catastrophizing. We think at least start during the consultation to bring it in because, like you say, you are an island. Particularly in the general practitioner space where they’ve got to be on top of treating so many diseases from pregnancy, depression, asthma to chronic ulcerative colitis and all of these other things.
How can a general practitioner on the frontline know how to triage and direct all of these things and what are the initial prescriptions they need to be writing? It’s impossible for them to keep in their head. Letting them leverage these tools and doing it in front of patients is a great start. Some of the information they’re going to get is very valuable to them and some ideas that they hadn’t thought of because they’re doing it anyway. The doctor and the patient are all turning away from each other and going online, so you may as well come and do it together.
Can I tell you the part that I’m most optimistic about? I am most optimistic about the administrative work to be done by these days. Not just for me personally as a physician writing notes and everything like that, but checking in, getting your insurance card out, and typing it in. All of these little nitpicky tasks are so important for us to get right so that the patient gets billed appropriately, etc., I cannot wait till AI takes that over. To me, that is the biggest breakthrough that’s going to happen.
That’s going to change not only my life but the patient experience. They walk in and like, “We already got all the stuff.” You go to the clinic like, “Everything’s already been updated.” All of this behind-the-scenes administrative work. Have you seen much in regards to AI working on that stuff? Can you comment on that at all?
I haven’t been so focused on its potential for content generation and for saving time because there’s so much depth to one angle of this that if you tried to stay across all of them, it would be hard to do. My area of expertise is as a search listening specialist, so it’s focused on the exchange of information between search engines, doctors, and patients and how to optimize that so I haven’t focused on that. The positive domino effect of what you are talking about is that potentially physicians will have more time for the consultation itself. There are pages of paperwork.
The other thing that’s great to use is the Dictaphone feature where you can transcribe from a voice. It’s so fantastic. It saves so much time and then you quickly edit it afterwards. In fact, there were big sections of the white paper where I had notes from our workshop and I was like, “Rather than trying to type this, I’m going to read it out and then I’m going to edit it.” Those things do save a lot of time and it’s pretty exciting.
I agree. Even voice detection has increased exponentially over the past few decades. It’s not utilized as much as it should be, but I do think that it’s not quite there yet. Especially in the medical field, when you’re talking about very specific terms that are not used very frequently, the editing process might take a little bit longer than you would expect. Personally, I have a scribe or a physician assistant that’s writing all that stuff. That gives me a certain sense of intelligence that’s worked into writing the right stuff. That’s what I hope that is eventually replaced. I agree with you. I looked at my own practice and I said, “A lot of this admin stuff is taking away from my day. I don’t want to do it anymore.”
I have incorporated a little bit more human resources into my practice to do a lot of that stuff. I feel like it takes away from the whole patient experience. It’s a necessary evil of healthcare these days. There’s so much administrative work to get done. Physician burnout, I don’t want to get to that point. I did want to ask you specifically about searching because I know that’s your area of expertise. When people are looking to the internet to get advice, what is it that they’re looking for? Are they typing in, “Do I have this disease or drug interactions?” What are the common things that people are looking for?
Patients are searching right throughout the patient journey. That’s why I’m quite passionate about the power of positive digital information experience to accelerate that patient’s journey from niggling symptoms to diagnosis and getting them on the right treatment. Dr. Awesome, you would know the best way to intervene and correct a patient’s health condition is to get it early. We’re still seeing people diagnosed with stage 4 cancer or diagnosed 5 or 10 years late with MS and other diseases. We know they’ve had those symptoms and they’ve searched for those symptoms to understand them. We can turn up better for them.
The thing that was an a-ha moment for me in the development of my methodology around search to seeing health was realizing the way people feel at all of those different stages. If you think about the stages of grief and we go from denial and bargaining to anger to acceptance, we see the way that patients are asking questions based on all of those emotions as well. In denial, they might be like, “My HIV test is wrong,” and in bargaining, they might say, “Can early diagnosed diabetes or newly diagnosed diabetes be reversed?” in all of the different stages up until they start to talk about the disease at the acceptance stage. They call it cancer, high blood pressure, or scoliosis.
We do see them asking questions at every stage of the journey. In fact, I would go as aspire to say that Dr. Google in whatever form she is turning up or being used is a virtual member of every single multidisciplinary team. We need to accept that and take account of that. I want to add that it’s aggregated, anonymized data that I’m looking at. I don’t want people to feel like they can’t use this tool because someone’s looking at my questions, it’s not like that at all. It’s aggregated, anonymized data and it’s about trying to make sure that content that is served back to them is appropriate and meeting their emotional and factual needs in that moment.
It’s really about trying to make sure that content that is served back to them is appropriate and meeting their emotional and factual needs at that moment.
I know it’s anonymized and aggregated data, but what are the top things that people are looking for? Is it mainly to confirm their own diagnosis, or are they looking to confirm what the doctor is telling them? What are some general categories of what they’re looking for?
There’s a parallel consultation going on alongside their interaction with their healthcare practitioner. Depending on the category, you’ll see them asking questions at all of the different points of the journey. When you go and see a specialist or you’re talking to a doctor about your daughter, you are going back and checking and verifying that. It’s almost every single point. In some of our market surveys, we were able to confirm that approximately 8 out of 10 patients are asking questions about a newly prescribed medication. Despite the touchpoint with the healthcare professional who prescribed it as well as the pharmacist who dispensed it, and the packaging itself and any inserts that might be in the packaging, they’re still turning to the internet more generally and going, “Where should I inject this?”
Honestly, it probably has been answered, but it’s not delivered in a way that is as accessible as Google. I’m a surgeon. I give postoperative instructions that are very detailed, and all they have to do is read that. I get probably 3 or 4 calls a day from people that call the office again and have no idea what to do with the postoperative instructions. Many people, when I follow up with them later, are saying, “I looked on the internet and I think it might be this.” I feel like I don’t have the answer or a way for me to do it better than what I’m already doing it. Correct me if I’m wrong because you’re the expert, but I think it’s easier to use Google than it is to read through something that people are used to. Is that the reason that people are doing this? That was just my own thoughts on the subject.
I think it is. For patients, if instructions are delivered directly to them, they’re still groggy from the general anesthetic. They’re still wrapping their heads around what just happened. They’re not in a good space to take in that advice that you’re getting to them. They get home and they’re like, “Now I’m ready to focus on it. What was it that I need to do?” Even if you’re delivering that information to carers, they’ve probably not slept for 3 or 4 days doing the around-the-clock shift caring for that patient at their bedside. They’re probably a bit confused too. The easiest in that fog of sleep deprivation is to go, “I’ve got this one specific question, four pages of instructions here, put it into Google. I want that one succinct answer.”
That’s where these new methods of delivering advice are going to be powerful because they do get one succinct answer on these new platforms. I know that I’ve been a carer for immediate family in the hospital and looking up random questions may be about the catheter in the middle of the night because I can’t get a nurse to come. You’re not finding the answers on page one. These AI tools will find an answer for you and will deliver a response. That’s why people are doing it. What we’re going to probably find is we’ll be moving towards tools that accept that this is the behavior and reflect it with the way that we work on it.
Our team is in the process of designing some chatbots where we program exactly the information that is used to inform that chatbot. If you’ve given your patient four pages of instructions, we can take those instructions, plug them in as the source content to the tool, and then it should, in a perfect world, only give answers from that.
That’s cool. I would be interested in that. Let me know when that comes out.
We could try it with you. We’re dabbling with it at the moment. The flip side of that, from my point of view, thinking about medical indemnity and things like that, what if it takes this content and spits out an answer that’s like, “That’s not what my patient should be doing?” Have a shower and then leave the bandage on for six weeks. How did it get that? We won’t know until we try it how good it is, and if it can prevent people from going on the broader internet where they may not get locally relevant advice or they may serve some hallucination, then it’s a good solution, at least in the interim.
I know you have kids, and I have kids. Have you noticed their interactions with search? Is it different than yours? For example, my kid’s pretty young so she exclusively uses voice-activated. She’ll press the button and she’ll say, “Google, play Miss Rachel,” which is her favorite show. How are your kids using the search as different from the way that you’re using it?
We’re seeing at the two ends of the spectrum a greater adoption of voice-debated queries. Originally, when I was looking at search data before the voice-activated search was more common when this was a couple of years ago, I could see questions were a younger patient who’s taken the time to type everything out versus an older male around symptoms of prostate cancer or things like that where you know that that’s a male, it was more truncated and abrupt. Now with voice, we’re seeing more full sentences, more natural languages coming through in the search query data. That’s happening initially with younger and older people. My older friends and family can’t see so well the on the screen and it’s uncomfortable to type so much so they use the voice.
It has been more broadly adopted across everybody as we all go, “That’s just a lot easier.” The possibility of entering a specific URL is almost becoming less and less. It is going to be reliant entirely upon the AI machine to identify which websites they think are offering the right answers to then be scraped and concentrated across into those answers.
It’s interesting. Our kid will have a totally different experience with AI than you and I will have. I always think about how my kid will have a relationship with an AI robot that is as significant as a real friendship. We’re on the cusp of that. Any type of social interaction is good. It activates parts of your brain that otherwise might not be available to you. I hope that’s the same thing with search. I hope that it becomes a much more natural and much more human experience than what it is now, which has served its purpose and done a good job. Like everything, with technology, it can always be better. Now it’s not necessarily better, but I do think it has the capacity to be better in the future.
The quote that I always say is, “The Stone Age didn’t end because we ran out of stone. We have to be providing a better product for us to gain the next technological level.” Julia, we’re getting to the end of our time and there are so many things that I wanted to talk to you about but wasn’t able to because we’re going with the flow of the conversation. I did want to ask you the three questions that I normally ask all my guests. Number one, where do you gain inspiration from? For me, it is science fiction. I think about the future and I get hopeful, especially with all of the different utopian science fiction that are available to us.
When I think about society, it would be great if we lived in the Star Trek society without any money and everybody was able to fulfill whatever wish they had. When it comes to robots, I look at Isaac Asimov. I can’t wait until robots are watering my plants and walking my dog and all that stuff. What draws inspiration for you when you’re doing all of your work?
One of the biggest shifts that is happening across the world, and particularly among young people, is the recognition of the importance and value of our natural environment. People stepping up and running rather than considering development to be leveling and building over everything, protecting biodiversity and wildlife corridors, and understanding the critical role that forests and wide open spaces play in our global climate and our overall global ecosystem. I get excited that I feel finally there’s a movement where we’ve ignored the importance of that aside from a few people in the peripheral of society who’ve been advocating for this for a long time.
It gives me hope that environmentalism is now becoming mainstream. I want to thank the younger generation and encourage them to continue to do this because health is nothing without a healthy environment, clean water, clean air, and the avoidance of catastrophic storms that we’re seeing as a result of a warming climate. We are at a tipping point where there’s still a chance with a huge movement to change the course of history. I am getting a lot of hope from that.
It has to be balanced. With all the technology, there is that shift towards understanding how it fits in with our lives as human beings who are animals and from this earth. I had a biological anthropologist on the program. He was saying that the tallest we ever were and the largest brain size that we ever were during the Stone Age.
Granted, you had a lot of risks of trauma and all sorts of other diseases that might have affected you, but from a health perspective and the fossil record, that was the time of most health. There is going to be some balance between how we lived back then and all of the technology that’s available to us now. I agree with you. The second question is you’ve lived in a lot of different places. You’ve lived in America, in Italy, and Australia. Whom do you feel delivers the best healthcare?
This is very clear to me.
If it’s clear to you, then feel free to answer, but I feel like it’s a loaded question because everybody has their strengths and weaknesses. How do you feel about the whole situation?
I lived for ten years in the USA. My children were born there. We had operations there. We had emergency room visits. I’m familiar with that health system from a first-person using it point of view. What is wonderful about the US health system is the individual people and the work that they’re doing on the ground, and there’s an overall vision for it being the best in the world. What happens is a hand break on that potential is the financial machine that is looking to extract value and profit out of the healthcare system. What’s happening in a fully privatized health system is you’re losing sight of the value of public health.
Public health is what makes the economy go around. Someone not having to be in the hospital caring for them means that that person is back in the community producing and adding value to their friends and family by being there and not being completely distracted by a health issue. I’ve seen the downside of that in the US as well. Coming back to Australia and looking at the Australian health system through that lens, we have state-of-the-art healthcare, but here it is next level. I’ve had to care for my family through eight major orthopedic operations in six years. Not one of them cost a cent. I did not need to use my health insurance for any of them. That pressure takes off families.
You’re not mortgaging your house. You’re not using your entire disposable income for a health issue for one member of your family on how you pay for the car repayments, mortgage, food, and school. It is game-changing. I am a very strong believer in the value of a strong public health system. Here in Australia, I’ll protect it until the day comes. I’m very happy to pay an additional tax that is specifically for the Medicare levy because it’s not one where there’s an insurance company that needs to cover these costs and deliver profit to shareholders, siphoning off money in that process just for capital growth. The bigger picture is about public health outcomes and getting people back on their feet.
It’s not a model where you want to make money because, “The people are still 6 months from now or 3 years from now.” You see that in the health data in the US. You spend more on healthcare than any other country in the world and you’ve got poorer health outcomes. To me, it’s clear even though I know what you’re saying the question can be loaded and the answer can be contentious, but I mostly believe let’s call it what it is. It needs to be fixed.
Personally having worked in the system, we’re still stuck in the 20th century. There is a lot more focus on this now, especially post-COVID. In the 20th century, a lot of focus was on sick care, which is when you get sick, we take care of you. Now, preventive care is more in the limelight and it’s more in the focus. My niece is in medical school. I feel like the real exciting stuff is happening in public health because she’s taking gear off and getting her Master’s in Public Health. She knows that’s something that is more in the limelight. Even on a cultural level, we’re all more focused on preventative health and longevity and stuff like that. I do think that the system needs to catch up. I agree with you. We need to prevent people from going to the hospital in the first place.
That’s nice to hear your perspective. The last question, we touched on this a little bit already, but what do you feel the future holds for your field in regard to church and healthcare? If you could wave a magic wand and create the vision that you want for the future, what would the future look like in ten years?
Genuinely, I am a search listening specialist and I spend all day, every day looking at search data. I get very excited about the fact that we’ve shone a light now to illuminate an aspect of the digital landscape that we didn’t previously understand. Now we can look at it through the end user’s lens. By knowing the problems that are there, we can address them and fix them. The biggest thing coming through is the need for empathy, and these AI tools are doing that. I put in my presentation at the HITLAB Conference in New York some examples to compare like, “I’ve hurt my knee. What can I do?”
In normal search, you get your menu of ranked websites, and in New Bing, it’s like, “I’m sorry to hear that,” and gives you a succinct list of actions that you can take and then says, “I hope you feel better soon.” We’re seeing a shift towards empathetic delivery of health advice online, and that’s exciting because it’s going to drive patient engagement and the accessibility of that. As an industry, we can try and shape it to ensure quality content is delivered to ensure accountability for poor answers is somehow processed.
We can make sure that people, whether they can afford it or geographically access it or not, are able to get quality health advice to describe their decision-making. Focus on preventative health, intercept their processes and their queries earlier in the patient journey, and get them to have the right tests at the right time. Get them onto the right treatment or preventative measures at the right time to stop it from becoming a big problem down the track.
I hope that we get to that vision of the future for search. That’s going to be an exciting time to live in. Thanks, everybody, for joining the show. For our audience, Dr. Awesome will be back with another show. Julia is going to be available on lots of her different media outlets. If you want to check her out on the internet, you can search for her very easily. Nice to speak with you, Julia. For the audience, I’ll see you in the future. Have a great day everybody.
Thank you so much, Dr. Awesome.
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About Julia Walsh
Julia Walsh, CEO Brand Medicine International, is a global pioneer in the analysis of big search data for strategic health insights (aka #SearchListeningHealth). Her work has been hailed as a ‘gamechanger for Pharma’ and recognised by Reuters as a Top Trend in Patient Engagement. In 2021 she was a keynote alongside Dr Norman Swan at the annual ARCS conference on the topic of Science in the Age of Misinformation.
Her work has illuminated one of the key factors influencing the patient journey: what really happens as people turn to the internet to exchange questions for health advice. Her methodology assesses the associated search engine results pages to map the real-world Digital Information Experience, revealing the online dynamics influencing the offline healthcare ecosystem. Currently, she is leading the way to understand how the transformation of the digital information landscape will impact the content served to patients and HCPs online as search converts from a menu of ranked websites to a conversation driven by AI. Julia is seeking to crack the code on her concept of #SearchChatOptimisation which she believe will be the necessary evolution from SEO.
Julia recently published her book What We Really Ask Dr. Google – the definitive guide to healthcare insights in the digital age, and it offers further inspiration on how this novel approach to insight harvesting can inform a strategic, patient-centric approach to market.
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