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London hospital replacing doctors with AI to improve patient care According to Nuffield CITATION Nuf18 l 2057 , The University College London Hospital (UCLH) is one of the leading National Health Service Hospitals (NHS) in London that formed partnership with Alan Turing Institute to allow Artificial Intelligence Systems and robots perform the tasks of doctors and nurses.
The UCLH started to collaborate with UK's Data Science Organization on a vision to apply AI in almost all their departments; but first, is to be implemented in the Accidents and Emergency (A&E) Department.
The head of the department claims that something needs to be done regarding the issue they face daily which is the issue of patients waiting time for being checked-up by clinical staff and doctors. Professor Marcel Levi, Chief Executive in the UCLH, stresses that they have tried other solutions and despite their short-living success, they had to resort to AI technology systems since they struggled with the same problems on certain occasions, and that he is responsible to come up with a long-term solution, claiming that saving minutes means saving lives.
Levi also mentions CITATION Nuf18 l 2057  that the employees in UCLH can make use of the partnership and use AI systems to assist them in diagnosing and treating serious conditions, like cancer. Another objective of the partnership is to enhance the service between patients and staff members. Alan Turing Institute will apply AI and other technical systems to existing data and procedures to discover where does barriers formed and to enable patients to be seen by their doctors quicker.
Marcel also states that AI nursing is another way the UCLH can make use of the partnership to help patients in many ways such as patient-nurse interaction and directing them to the best caring situation CITATION Nuf18 l 2057 . By being around 24/7, virtual nurses can provide patients with immediate responses and answers to their questions and monitor their health condition without having to be present at the hospital.
Machines at the UCLH are never going to take the tasks of doctors and staff members, Levi mentions, but the data compilation, expert skills and knowledge performed by the system may change how the hospital run and control its services. CITATION Mil18 l 2057 1.
Technology, and Robotics to be precise, has been a debatable topic to IT specialists and researchers. Artificial Intelligence (AI) is a field of Robotics that made people all around the world question if one day IT systems will be able to think like and perform tasks of human beings. Today, Artificial Intelligence is being used in wide ranges of fields of jobs including: industrial, medical and manufacturing fields. This report is based on a case-study from one of the National Health Centres in London, The University College London Hospital (UCLH), where AI will be used to perform regular tasks of doctors and staffs.
The report will answer the research question (topic) in the light of the case-study and the purpose is to increase the awareness among the society on the possible impact of Artificial Intelligence systems; people use systems and devices throughout their day but are ignorant to its side-effects.
I have always been fascinated to the rapid developments in technology and this is an opportunity to dive into the topic; however, Human Tasks is a broad topic to write about, thus to narrow it and focus on a specific field of human activity, I have decided to emphasis on the implementation of AI in the medical sector and what are the possible societal and moral issues that are associated with it, and that is the objective of this report. The structure of the report is as follows: in the first section of the report, key terminologies will be defined and explained followed by the applications of AI in hospitals and clinical centres. After that, the main focus of the report will be explained and evaluated in detail, which is the social and ethical concerns of AI implementation on primary and secondary stakeholders. Then, in the penultimate section of this report, a relation with the role of tertiary stakeholders (management and government) in handling situations shall be evaluated. Finally, at the end of the findings section, solutions to the addressed problems are to be discussed.
The definition of Artificial Intelligence, according to K. Oliver CITATION Oli12 l 2057 , it is the branch of computer science that attempts to design machines that show intelligent behavior. Intelligent behavior in Oliver's definition of AI refers to the Human Performance and conduct like thinking and creating. He also describes robots as a mechanical system that appears to act on its own. CITATION Oli12 l 2057  To show the relationship between both the terms, Robotics requires the building and creation of robots whereas Artificial Intelligence is the programming of and implementing mankind's intelligence, such as thinking and creating, to a robot.
Artificial Intelligence is one of the many aspects of IT that has showed tremendous changes and developments in its sector and made most people wonder what will come next? Todays technologies are developed to ease people's lifestyle and help them with their day-to-day routines and tasks. However, these progresses may rise many issues that concerns the society in a multiple of ways, that will be discussed later in this report, including moral and societal issues. Moral or Ethical issues are those issues that are evaluated as right or wrong and one can assess this kind of issue by various rubrics including behavior and manners, cultural or even based on religious matters CITATION Oli12 l 2057 ; Societal, on the other hand, or Social issues are those which influences the society, it can be positive or negative effects, depending on the use of the IT system or technology CITATION Oli12 l 2057 .
In the case of The University College London Hospital, the CEO of the health centre has decided to make use of Artificial Intelligence Systems to help various stakeholders, which includes: doctors, nurses and staff employees, to perform their tasks efficiently and allow patients to be checked by their doctors without the need for extended waiting in hallways.
Hospitals can make use of Artificial Intelligence and Robotics in various tasks, some of which are mentioned in this section of the report.
Usually, hospitals produce a huge amount of data that needs to be carefully evaluated and analysed CITATION Nuf18 l 2057 ; human can make careless mistakes when attempting complex calculations and analysis, thus the use of well-programmed AI interfaces can help in reducing such human errors. Not only that but with Artificial Intelligence doctors can compare massive streams of data with just a few clicks on the keyboard. However, further upgrades of the system can be expensive which may rise social and financial concerns.
In Automated Medical procedures, a specialist who is situated far away can work on a patient utilizing a remote-controlled robot. The specialist works similarly as though they were working on a genuine patient rather, just by moving controls. However, surgeons must have completed training sessions before attempting to use the technology in real-life situations. Furthermore, with today's developments, patients can recover their damaged organ, for instance: hands, legs, ears ,and fingers, with an artificial one, this is called Prosthesis. CITATION Oli12 l 2057 
Many computer analysts and programmers thought of extending hospitals to a more portable and convenient way to ease a patient's struggle. They have developed AI-controlled Apps to create a virtual chat-room between a patient and his /her consultant. The interface also collects patient's symptoms and compares it with possible illnesses or diseases to allow early detection of a severe issue. CITATION Nuf18 l 2057 
Any specific scenario may develop controversial issues that make people from all over the world to either praise or criticize it. Likewise, based on The University College London Hospital (UCLH) case-study, there are handful of concerns that forms clouds of doubts and uncertainty that makes the management and CEO of the hospital question whether to implement the new IT System or not?
Many of the qualms against Artificial Intelligence that worries people is related to the storage of data, privacy and reliability. As stated by B. Smith and S. Harry CITATION Smi18 l 2057  in their book of The future Computed, Artificial Intelligence is human-programmed, thus at some point, the system may fail to function efficiently and may produce errors; this may cause a serious issue of unreliability which is a major ethical concern for the patients. For instance, an AI-programmed App that must collect data from patients suffering from blood in urination; the app mistakenly collected and sent half of the list of patients suffering from kidney failure due to inability to receive a huge amount of data, thus the system had to remove the previously stored sufferers. That was one aspect of unreliability, the next concern addresses a societal issue which focuses on security and integrity.
Due to the rapid development in technologies, hackers and other third parties found their roots through and started to misuse them. Hackers, as being defined by K. Oliver CITATION Oli12 l 2057 , they are people who gain unauthorized access into a computer, network or systems. The data within a hospital is confidential and needs to be highly secured to avoid them from being stolen; stolen records of patients invades ones privacy.
True that The University College London Hospital (UCLH) will show some positive feedbacks, however, with the introduction of Artificial Intelligent Systems, the secondary stakeholders might get affected. Although AI could help employees at the UCLH, many of them worry about the dangers of the humanizing systems that will be implemented within a short period of time. This compilation of societal issue and immoral behavior may have jobs fully eliminated from the ground, thus more people will be left without work CITATION Smi18 l 2057  which is a great societal concern.
On the contrary, the management and CEO of the UCLH will benefit from the implementation of AI systems, since this automation of human activities will be produced faster and more efficient which will increase the profitability of the hospital; but, we can't say the same to its employees (doctors and nurses) because their tasks job will be taken away from them. But then again, doctors must keep in mind the words said by Levi, the Chief Executive at the UCLH:
Machines will never replace doctors, he added, but the combination of data, expertise, and new technology could radically change how the hospital manages its services. [1:1]
Tertiary stakeholders are also affected by the progress made in the field of technology. Management in companies, in this case, the UCLH hospital, play an important role in sustaining a balance between people and machines to reduce the overall humanitarian and social concerns. As mentioned earlier, the managerial levels will benefit from the use of AI systems, but they must also consider its consequences. Such firms are also responsible for providing a secure way of the flow of data to prevent hackers from invading the records of primary stakeholders patients . Moving to another stakeholder on the same level of the management firm is the Government. Concerns of AI Systems that are an address to data protection and security is the duty of the country's government. The government must record and catch any misuse of any kind of information as they must ensure a protected stream of safety and privacy for its citizens CITATION Smi18 l 2057 .
There are few solutions that can scale down the issues associated with the AI Systems, especially in the case of the UCLH hospital. One conceivable solution to the concern related to reliability is to not show complete reliance on the technology system. Firms at the UCLH must not fully depend on robots and machines to perform their tasks since a single damage might cause a massive loss of records, thus a loss to the company. CITATION Oli12 l 2057 
Furthermore, regarding issues with security and privacy, the hospital and government must ensure a secure pathway for information sending and receiving; this might include installing firewall software and put in a more secure way of identification like biometrics. Finally, are solutions that approach the issues dealing with people and machine which is concerned with transparency of the system. As was mentioned by B. Smith and S. Harry CITATION Smi18 l 2057  that the AI systems that are responsible in decision-making and data analysis must be well explained to patients and other stakeholders to get a clear knowledge on how their data is being processed, to build trust between the system and stakeholders. Moreover, doctors and staff can use the system, however, the system must be transparent to them to allow easy track of the tasks performed and can still have their jobs.
It can be concluded that the ideology behind AI is not to replace human with systems and machines but to extend human activities and tasks to give them more value and make huge data analyses faster with increased efficiency. However, there are some societal and ethical consequences that are associated with the application of AI those concerned with reliability, security and privacy, and people and machines that must not be neglected.
The image of the future of Artificial Intelligence both enthuses and worries people all over the world and it will have a change on the society. As demonstrated in this case-based report, AI systems in The University College London Hospital might rise societal and moral issues; however, by considering the solutions and ensure a positive and a healthier use of the technology, the addressed problems will be reduced. Further research on this topic is vital and recommended so that people living in the society recognize other impacts of today's technology including the positives and negatives, which might include: political, economic and environmental concerns.
Taken together, people must be well-trained on how to use the technology in a positive way and the managerial firms must balance between work done by AI and tasks to be given to employees and not to depend fully on these technologies to sustain the jobs of the employees in general and doctors in specific to the case-study.
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