How is the NHS embracing Artificial Intelligence?
Moving into the third decade of the 21st century, the pace of technological change is astounding, and in no industry more so than healthcare. This decade already has seen some incredible leaps in health tech, from IBM’s Watson’s oncology computing system that can correctly diagnose 13 types of cancer, to the work of DeepMind Health creating an AI system that recommends patient referrals as accurately as world-leading doctors for over 50 sight-threatening eye diseases. The fact that patients are also becoming more engaged with their own care has sped up the creation of new technologies that can help us live longer, healthier lives. With new technologies helping patients access and understand their personal data and health, the one size fits all traditional hospital-based care is fast becoming unfit for purpose.
So what’s being done to address this change and adopt new tech into healthcare? There are a number of challenges that need to be addressed before the benefits of AI can fulfil their potential in the UK. In my last article I laid out the problems facing the NHS currently with understaffing, extended waits for surgery and a burdened care system. AI can help the NHS with these problems, as we’ve already seen in these case studies, but progress creates its own set of challenges - culture plays a huge part in the uptake of new solutions, from NHS staff being equipped with the right skills and technical knowledge, to how patients view and trust new technologies.
The current state The NHS’s relationship with technology has had its ups and downs; the most notable project being the costly (to the tune of 12bn) digitisation of care records project that was started in 2002. However , the government has increased funding and pledged to support more innovation and partnership with the private sector. One of these initiatives is part of the industrial strategy - around four areas that will put the UK at the forefront of the industries of the future. These are the ‘Grand Challenges’ of our age, Artificial Intelligence, ageing, clean growth and the future of mobility.
The mission for the AI challenge is to;
"Use data, Artificial Intelligence and innovation to transform the prevention, early diagnosis and treatment of chronic diseases by 2030"
Matt Hancock, Minister for Health, has publicly announced that AI will change the face of the NHS, and that "The power of artificial intelligence to improve medicine, to save lives, to improve the way treatments are done, that power is enormous," He has announced £250m will be spent on increasing the use of AI within the health service, and has set up a national AI lab to enhance patient care and research. I believe he’s got a long way to go to fulfil the promise of making the UK a global leader in digital health tech. Considering that the average time it takes for new technologies to filter through the NHS is 17 years, what specifically is the public sector doing to shorten that turnaround in line with this pace of change?
Setting a mission The Department of Health created NHSX in February 2019 , a cross-departmental unit of clinicians, technology experts, policy experts, developers and data scientists. The mission of NHSX is to accelerate the progress of digital in the NHS, and it has three main areas of focus when it comes to building new tech into healthcare; to cut the time it takes to input data, make it easy for patients to access services on smartphones, and have a unified data approach for patient records so wherever a patient is in the system, their records and data can be accessed. These are the basic building blocks of how algorithms can start to streamline and ease the burden on the NHS. They have also created a £35 million fund to support the development of digital interventions. However, investment alone won’t cure the problem. There are a number of new tech companies that have proven they can deliver innovative technology for a fraction of the investment and time that it takes our healthcare system to innovate. Here at Axela we have been paving the way in partnering with other organisations to create better solutions, and have a working culture of sharing technology and learnings to utilise everything we have learnt as care providers. Unless there is a positive and open mindset like this in adopting and sharing technology within the NHS it will always be a stumbling block to growth.
In a recent study of sentiment towards AI, 720 UK GPs were quizzed on various statements about using artificial intelligence for primary care. Most of the GPs didn’t think a machine could show empathy and have the ‘6th sense’ they felt was needed when it came to diagnosing patients properly. A common statement was that a machine would never be able to gather the right data to make a correct diagnosis.
However most seemed positive about using AI for admin tasks to ease the red tape that takes GPs away from the care of patients;
“Be useful to develop AI to do analyses of pathology returns, and read all the letters, to provide another presence in the consulting room, and to write the referral letters, organize investigations and the like, ie, act like a personal assistant might do”
If the use of AI is limited to functional tasks, then it’s not fulfilling its potential to help us live healthier lives. The opinions of primary care-givers will be crucial to how these new technologies are adopted by the NHS. At Axela, We have put the individual , not science or even technology at the centre of what cAir ID is about. By doing that we had to make technology easy for the patient themselves and the GPs and care workers who use it to support their patients, regardless of their level of technical knowledge. That’s why we stand behind our statement;
“ Your care enhanced by your data, supported by technology you understand.”
A unified data approach The NHS is made up of hundreds of stand-alone physical presences, from walk-in clinics, surgeries, out-patient departments, hospitals and care homes. This means that patient records rarely transfer effectively which is a real problem when it comes to having an overall view of a patient. Having that view into lifestyle, environment and social factors as well as medical history has a huge impact in diagnosing and preventing illness. This is worrying when it comes to caring for an ageing population and finding the right care for individuals. Having a unified view of a patient’s data is a key priority -and it’s one of the ways that Axela is leading the way with cAir:ID, the connected Patient Health Record system. This is one example of ways in which machine learning can leapfrog existing systems, helping patients have greater visibility and ownership of their care.
It seems like America has the edge in taking up new tech, so taking cues from across the pond could be a clever route for the UK. Take for example the Healthcare startup RDMD which is trying to find new cures for rare diseases using AI to analyse data from medical records. The company then sells that data to pharma companies so they can create treatments, reducing the turnaround time to get from research stage to cure. Or the University of Chicago Medical centre which has reduced turnover time between operations by 20% by using predictive analytics to streamline movements in and out of the operating room. These examples show how revolutionary using AI can be, and maybe a result of the fact that the FDA recently announced that it is developing a framework for regulating self-learning AI products used in medicine. However the US still needs to prioritise the one-view of patient data that’s such a problem here. With the US healthcare system being so fragmented, it’s even more of a challenge to have that unified approach between insurer, provider, policy maker and patient as it is in the UK. Canada, like the UK, has a government-funded healthcare programme, yet they have recently announced an investment grant to create a network of almost 100 partners to establish a country-wide AI health data platform to connect different sources of data to speed up research. This will accelerate partnerships with the private sector, something the UK could learn from.
Make it easier to innovate The UK needs to create an environment where innovation can flourish but also create the conditions where it becomes easy for private companies to access and partner with the right bodies. To answer this, the NHS created the AHSN Network Innovation Exchange, designed to help innovators understand present challenges and streamline partnerships across the country. Some of the successful projects have been the DATA-CAN the Health Data Research UK Hub for Cancer which aims to transform how cancer data can improve patient care, and the Transfers of Care Around Medicine project connecting community pharmacists with patients who have just left hospital to decrease return hospitalisation.
Despite these steps forward, If the NHS can’t adapt to change at the pace required, there are many organisations and start-ups willing to take on the challenge set out at the beginning of this year. Answering the challenge around access to hospitals and giving patients increased access to their records, cAIR ID isn’t based around a location. This means patients can easily access their care and treatment at home, making sure they’re sitting on the same side as their care-givers, not across a knowledge divide. Despite having a healthcare system that wants to partner with the tech sector, there are still huge barriers for start-ups that don’t have the safety net of their own funding.
At Axela we have proven that we can deliver innovative technology for a fraction of the investment that the NHS believes is required. Like many innovative tech companies we want to ‘play nice’ from the start with other organisations and technologies and have a culture of sharing knowledge. Our goal to integrate with many third party health tech products such as fitbit, omron and Kraydel is proof of that. For more companies like Axela to thrive and answer our ever-growing health challenges, the NHS needs to give more insight into the problems they are trying to solve, improve access to the right partners, and offer additional funding. With continued fostering of innovation in this sector we will be able to harness the transformative power of AI technologies in the UK. Let’s hope the current government stands by its promises to put us at the forefront of this brave new era.