Mark Frankish, data scientist, SAS UK, writes about the challenges the NHS must overcome before reaping the benefits of new technologies.
New technologies promise to achieve what no politician has yet managed in the 70-year history of the UK’s National Health Service: improving patient care while simultaneously saving money. In the Government’s ten-year-plan announcement, far-reaching new technological measures were announced that demonstrate just how key digital transformation will be to the future of the health service. The national rollout of the NHS App has begun, referrals are being centralised into the NHS e-Referral Service and GP appointments via Skype are set to become more commonplace – to name but a few changes in the pipeline.
It’s telling that the government webpage hosting the plan reads: ‘digitally-enabled care will go mainstream across the NHS’. That it hasn’t done so already is a concern – but it indicates that digital solutions are now a frontline concern. Technology will help the NHS make best use of its much-stretched resources and staff.
Thanks to advances in artificial intelligence (AI), machine learning (ML) and analytics, we can now use historic and real-time data to build a range of predictive models that can be applied to everything from clinical to administrative questions.
These range from reducing readmissions through a better understanding of the different clinical and non-clinical factors that cause patients to return to hospital, to assessing the efficacy of different drugs and treatments.
Technology also has a huge role to play in solving longstanding operational inefficiencies – for example in administration, where ‘robots’ have been found to be eight times more efficient than human workers. But the NHS will only gain these capabilities if it can effectively manage its data.
The data dilemma
The UK healthcare budget will rise by £20 billion by 2023/24; it currently accounts for around 30 pence out of every pound spent by the government and is set to rise still further. It’s imperative that this money is spent wisely.
However, public sector technology projects have a patchy record – not least in the NHS. This makes it all the more important that the health service learns the lessons from similar AI and ML applications in the private sector.
There are serious challenges that the NHS needs to address before it can start reaping the benefits of these new technologies. Earlier this year, the House of Lords issued a report citing a concerning lack of organisational preparedness for AI in the health service, including an absence of vision and proper planning to embrace digitisation and the latest solutions.
This shouldn’t be surprising. Over time, the NHS has built up a complex technological infrastructure, with new systems layered upon old. While the resulting silo-isation of data, with information distributed among countless legacy systems, is certainly an obstacle to implementing AI / ML technologies, it’s by no means an insurmountable one. What’s more, the dividends of untangling this technological Gordian knot will be repaid many times over through greater efficiencies and improved health outcomes. All that is missing is the will to take up the challenge.
Without access to historic, recent, and real-time data, these technology platforms are starved of the fuel they need to make optimal, evidence-based decisions.
To improve outcomes and achieve a truly integrated, multidisciplinary system of care and transform the way the NHS works towards the outcomes it desires, data management must therefore be top of the agenda. The NHS must invest in new systems that will have a positive effect on care and organisational efficiency – but these cannot be built on sand. The foundations must rest on a single, centralised system where all data, including from outside the organisation, can be accessed by every clinician, administrator and application. Only then can organisations reap the benefits of better demand forecasting, enhanced clinical pathways, or the ability to undertake other projects that would help improve personal, technical and allocative value.
We should not underestimate the scale of this task. It involves integrating data between primary care, ambulance services, urgent care centres, pharmacies and mental health teams (among others). To quote from the government’s plan: ‘the burden of managing complex interactions and data flows between trusts, systems and individuals too often falls on patients and digital services and data interoperability give us the opportunity to free up time and resources to focus on clinical care and staying healthy.’
When politicians talk about NHS strategy, it’s usually about apportioning limited resources for the biggest benefit. But new technologies aren’t just about making marginal improvements to clinical outcomes – they promise a range of benefits that will revolutionise the whole of healthcare. The NHS has been the big winner from the most recent budget; we must ensure, however, that this extra money is spent wisely and strategically. Investing in a secure foundation must therefore be an urgent priority if we are to deliver a health service for the next 70 years.