PAL 4 Future Health

On wednesday February 6th 2019, we organized the “PAL 4 Future Health” event to share and discuss the results of the European PAL-project (http://www.pal4u.eu/ ). This project has developed empathic educational technology to enhance the diabetes self-management of children. The PAL system consists of a NAO robot, an avatar of this robot on a tablet with a time-line and game environment, and progress dashboards for the children, parents and health care professions.

PAL 4 Future Health was simultaneously hosted as an event in Italy and in the Netherlands. In both locations, we started with an introduction to PAL, showing a illustrative video and elaborating on the project’s results. Later, a live demo was performed; in the Netherlands by Gert Jan, a pediatrician,  and Marjolein, an actual user of PAL (a twelve year old girl, who participated in multiple PAL experiments). Marjolein showed some interactions with the robot and MyPAL application on the tablet.

 
The picture above shows Gert Jan en Marjolein. During playing a game with the NAO, the pediatrician commented ‘She has put the game in easy mode, else it would go so quickly you would not be able to understand what is happening’. The NAO robot asked the child during the demonstration if she would like him to dance, someone in the audience replied abruptly: ‘Dance? Yes we would like to see that!’

Robert Jan Sips (CTO bij MyTomorrow) gave a keynote lecture, with the title ‘The machine is a liar who always speaks the truth’. Robert Jan enlightened the audience on the history, state-of-the-art and challenges in Artificial Intelligence (AI). The speaker managed to deliver an in-depth presentation in a lay-person language. Two notable quotes were: “AI is rational and humans are irrational. How teach AI about humans?” and “AI and humans form a natural symbiosis. However, this needs mutual acceptance.”

Then the panel discussion took place with the following members in the panel:
•    Robert Jan Sips; CTO at MyTomorrow
•    Jon Pluyter Ph.D; Sr. Usability Engineer at Philips Design Healthcare
•    Jeroen Crasborn; Senior Advisor Zorgstrategie at ZilverenKruis
•    Dr. Gert Jan van der Burg, Pediatrician Ziekenhuis Gelderse Vallei
•    Prof. dr. Nico L.U. van Meeteren; Executive Director and Secretary General, Top Sector Life Sciences & Health

There were five propositions, and the composition of the panel made for a good discussion with an interactive audience:  
1.    Children are persuaded faster by robots than by parents or health care professionals.
‘This way a child gets an emotional bond with a robot, that is not ethical’
‘What is the difference in bonding with a doll? Children bond with objects either way. It is important to closely look at its function’
‘Interaction with a social robot has proven to stimulate to interaction with others.’
‘Persuasion of a child through a robot depends on successful personalization. The robot has the means to get to know the child and personalize the interaction.’

2.    Each child should be allowed to make his or her own choices on when and how to use PAL, versus monitoring and controlling by parents and caregivers.
‘Ask the patient has been the foundation of this project, that is one of the main successes of this project’
‘Here the situated application of PAL is important, for example the Netherlands versus Italy. A blended care solution, in which the system, the child and caregivers collaborate can offer a solution’.

3.    Robots and AI should always be able to explain their behaviors, versus, if they do what is required, it’s just fine.
‘I would not be interested in an explanation if it works, but when it does not work!’
‘Need for explanation from AI seems to correlate with need for explanation from your health care professional’.
‘In the light of events with Facebook and other tech-giants, most importantly, the system needs to be transparent for the user.’

4.    PAL implementation is completely justified when it proves to advance children’s self-care knowledge and subjective experiences, versus, it needs to show clear medical benefits.
‘If you enhance self-care, that in itself is the advantage’

5.    Health insurances, versus, government, versus, industry should invest in preventive and quality-of-life technology (like PAL).
‘‘We should consider an transition to a health care system in which we mainly reward a healthy lifestyle or changing to a healthy lifestyle’
‘It is important that in this transition, all stakeholders (health insurance, government, industry, and patients) are involved.’

A live connection was made with Italy, to share our mutual conclusions of the day. These were: results of the project are promising and for further implementation and enlarging its impact, it is important to validate the findings and work on a sustainable business model. The day ended with a wrap up and closure with some drinks and bites.

 
For the children! In the Netherlands, the event took place at the Amersfoort Zoo. During our official health program, the children who took part in the experiments, and their parents and siblings, could come by and say goodbye the robot Charlie by playing a quiz with Charlie, this time not about diabetes but about the Zoo. They could also play the PAL-games memory and break & sort one more time on a large tablet table with their siblings or with the other children. They could also walk around in the Zoo (location of the end event) and take home a small PAL back pack with a puzzle.