In the lead up to the 70th anniversary of the NHS, Digital Health Age reporter Reece Armstrong sat down with Iain Hennessey, the clinical director of innovation at Alder Hey Children’s Hospital.
A strong supporter of digital technologies in healthcare, Hennessey has been championing the use of advanced tech for years and has been involved in programmes using mixed reality, apps and gaming to reduce pain as part of his role at Alder Hey.
Last year, Alder Hey launched an app that uses gaming tools and augmented reality (AR) to guide patients around the hospital. The app includes a chatbot powered by IBM’s Watson technology that enables questions to be answered in real-time and which parents can use to find out information about their child.
Hennessey met with Digital Health Age at the Liverpool Business Festival’s International Health and Life Sciences Day, where he was set to give a talk on the use of AR in paediatrics surgery.
Can you tell me a little bit about why you’re here today and what you’re talking about?
We’re doing a panel session with Proximy who are one of these new up-and-coming augmented reality companies (AR). This is a technology space I’ve been watching a while, to see which one’s going to come out on top – sort of like Betamax versus VHS, only this time AR versus VR – and having used both extensively, most of my money is on AR. I think the key message is that we actually have to start using this technology. What really frustrates me about healthcare, not just the NHS but healthcare in general, is we all seem to be a bit behind the times with the technology that is being applied. So, we know fine well that there are these start-ups in San Francisco who’ve already got AR gaming platforms, but I’ve not yet seen a fully deployed AR platform for healthcare in an NHS hospital. So we need to start grasping these technologies and actually start using them.
You say you see more potential in AR technologies. What about VR for things like surgical training?
The thing with VR is you can’t wear it for too long. So the problem is that for around 20% of the population, they just feel sick when they put it on. And getting more than one person in the same VR environment is difficult. It also comes up to this low-fidelity versus high-fidelity simulation environments and how much extra does it add to look really realistic. I think, looking forward 10 years we might not be using VR for immersive training. I think what we might be using is AR to level up the environment you’re in to make it look more realistic. We’ve got a partnership with Microsoft and we’ve been working with the HoloLens – and of course it’s still very early stage technology – but you can see the potential of it. You don’t get sick, you don’t have that claustrophobic I don’t know where I am kind of thing.
What are the major benefits of using AR in the surgery?
One of the big advantages of it is the customisation of your data sphere. You can decide what you want to see in that room and where you want that information to be, and you can pick it up and place it wherever you want. At the moment we have to have it displayed on high-resolution screens which are sat on pending arms and that’s actually quite difficult and during the operation because I can’t move much, I’m scrubbed, I’m sterile. So I can’t interact with information, I can’t touch it or move it around, I can’t readjust it. If you have AR at a sufficient resolution, theoretically you can have all the information you want but also have it when and where you want it. The ability to tap on things in the air is great for surgery because we’ve got sterile hands we’re not allowed to physically touch anything, so there’s a big advantage there. Also, the example of Proximy, the ability for other people to come into your operative field to give you advice and point things out even when they’re not there, which previously we couldn’t do. And overlaying it on reality is exciting. Obviously it has lots of problems because if you’ve got an AR hand which is pointing at something, you’ve got to be pretty sure it’s pointing at the right thing, but that’s the technological barrier.
Do you think the NHS has had a significant culture change to digital technologies or the adoption of it?
It’s still difficult but at least now everyone has agreed it is something we should be doing. I think my job role as a clinical director of innovation wouldn’t have been possible 10 or 15 years ago. I’m increasingly being asked by lots of hospitals, how do we set this up? People want to do it. So there is that pressure now in the NHS that we should be innovating. We now need to create systems that make it more frictionless.
What do you think technology can do to help alleviate some of the more basic tasks that healthcare professionals maybe shouldn’t be doing?
Oh tons. The application of AI to automate our base level processes would save so much time in any healthcare system. There’s no faster way to release 10,000 doctors than to stop them from doing really mundane low-level admin work and get them doing what they enjoy doing and what they’re good at doing and what is most valuable to the country, which is getting out there and treating patients and coming up with new therapies and new ways to treat people, rather than trying to arrange a patient appointment or trying to get an ultrasound on the same day as a clinic. It’s nuts really when you think about the amount of training that’s went into these people.
How has the Alder Hey app and chatbot with IBM been received?
It’s great! Now we’ve got one of the first AI chatbots for patients. It’s quite simple but it’s around giving people basic information that they would normally ask the nurses and this way they don’t have to ask a question that could be easily answered by a chatbot and that doesn’t need a human to answer it.
Do you think there’s enough awareness around the current digital health tools that are available?
No, there needs to be a marketing, publicity and a culture change to show people this is how we do things. Because people don’t expect an app when they go to a hospital. If they went to Disney Land the first thing they do is download the app. We need to have that change so people expect to have a digital interface when they go to the hospital.
Where do you think new funding would be best spent?
It’s a matter of getting the right mix of things that we have to do, things that we’d like to do and also trying things and asking, “well would this work? I think if you completely concentrate your portfolio on really tried and tested things, then yes that would deliver, but you’ve got to be thinking about the next 10 years. The analogy I like to use is that back in the Victorian times you have the option of hiring another 10,000 doctors or developing penicillin. If you’ve got 10,000 Victorian doctors doing what they’ve always done, they’re still going to be rubbish at treating infection. Whereas if you have that breakthrough, you can validate it. I’ve got this great memory on this train from Stirling, which is where I did my first job as a house officer, where you’re basically locked in a hospital and you need to work for a year. And I met this really, really old lady, she was about 98 and she had this Stirling Medical Society bag. I got chatting to her and it turned out she’d been one of the first female doctors. I said to her what was the biggest thing in your lifetime and she replied saying when antibiotics came in and she said, “we thought we’d cured disease.” She said they were just walking around giving people this penicillin stuff and they were just getting better. Things which had been previously untreatable like syphilis, which was a horrific disease, killed thousands of people, they gave them one shot of it and they were cured. It’s those types of breakthroughs, I don’t think I’ve had that in my lifetime, so I’d like to have that, “cured cancer! There we go.”