Digital Health - Q1 2022

Q1 2022 | A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its content

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Digital Health

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“Technology could speed up access to NHS services.”

Dr Rishi Das-Gupta Chief Executive, Health Innovation Network

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“Remote monitoring is helping to reduce hospital admissions.”

Andrew Davies Digital Health Lead, ABHI

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IN THIS ISSUE

“Robotics are assisting NHS staff across England.”

Russ Watkins Commercial Director, AHSN NENC Jo Bangoura Digital Transformation Manager, West of England AHSN

How technology could speed up access to NHS services

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“AI is supporting greater efficiency within the NHS.” Eleonora Harwich Head of Collaborations, NHS AI Lab

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“Multi-way collaboration can help tackle some of the crises facing the NHS.” Julian David CEO, techUK

Online

@BusinessandindustryUK

Accelerating the adoption of technology in health and care during the pandemic has exposed challenges and opportunities for patients and clinicians.

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rom the introduction of machinery which heralded the Industrial Revolution to the many promises held by artificial intelligence (AI) in the 21st century, new technology has always been greeted with a mixture of excitement and uncertainty.

Fair access to tech for all The pandemic demonstrated the importance of advances in health technology. Almost overnight, services were switched from in-person support to video calls and apps. While this provided great support, it also exposed gaps and raised important questions.

Can everyone afford to access the technology? Do they have the confidence to use it? Where algorithms are used, are we inadvertently building in systemic bias?

Patients and carers working together As CEO for the Health Innovation Network in London and as Digital and

@MediaplanetUK

AI lead for the wider AHSN Network (established in 2013 by NHS England to help spread innovation at pace and scale) I have seen demand for health tech support soar.

However, as we begin the work of recovery after the worst of the pandemic, we must use our learnings around technology responsibly.

Development of technology in care We also see many opportunities in technology and AI to reduce the time taken to carry out administration activities and to make sure the right things happen at the right time.

In the next 12 months, we aim to speed up the spread and adoption of care technology creating a future where everyone benefits from the best in health and care.

For more information, visit ahsnnetwork.com

However, as we begin the work of recovery after the worst of the pandemic, we must use our learnings around technology responsibly. As a network, we will be concentrating on technologies which support patients to manage their own conditions and on clinicians delivering care remotely.

WRITTEN BY Dr Rishi Das-Gupta Chief Executive, Health Innovation Network

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Using data to personalise, predict and empower patient care Data offers an opportunity to create a more proactive healthcare system and a better experience for patients.

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n October, we started a five-week conversation with NHS and social care staff, industry, patients and academics to hear about their learnings from the last five years and the opportunities for the next five years in digital health.

WRITTEN BY Jenny Thomas Programme Director, DigitalHealth.London

The potential of data The final report, Driving digital: Insights and foresights from the health and care ecosystem, identified five key opportunities. One of these was using data to personalise treatment, predict health issues and empower patients to take ownership of their care.

It is vital that we keep working to give patients access to their medical records and the opportunity to manage their own care.

Personalised and predictive care Data can be used to provide personalised treatment for patients and to predict healthcare issues, shifting the system from being reactive to proactive. The recent increase in the use of wearables and remote monitoring of patient data, accelerated by the pandemic, is a key contributor to this shift.

Cibiltec is a company on cohort six of the DigitalHealth.London Accelerator programme.

Their product uses data and artificial intelligence (AI) to predict issues in kidney transplant patients to enable earlier, personalised treatment and avoid complications, ultimately reducing pressure on the health system.

To find out the other four key opportunities in digital health identified in the report, visit DigitalHealth.London

Empowering patients with data In the report, Liz O’Riordan, author, speaker, broadcaster and person living with breast cancer, says: “My own biggest learning in digital health has been the ability to have a patient portal where I can easily access all my results, appointments and letters, and being able to sync this with Apple health.”

The value of data for patients is enormous. It is vital that we keep working to give patients access to their medical records and the opportunity to manage their own care. Ben Wanless, Consultant Physiotherapist at St George’s University Hospitals NHS Trust, took part in the DigitalHealth.London Digital Pioneer Fellowship programme and focussed his project on scaling the getUBetter solution across South-West London to enable effective self-management of musculoskeletal (MSK) conditions. This benefitted approximately 100,000 patients and over 200 members of staff.

As patients realise that they can own their health information and use it to advocate for their healthcare, there will be an increased demand for access. A data revolution is on its way and the healthcare system must prepare.

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WRITTEN BY Andrew Davies Digital Health Lead, ABHI

Remote monitoring good for the patient, NHS and environment

With record waiting lists, the NHS needs to deploy technology and utilise data to make best use of their clinical resource and support patients in their home environment.

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he pandemic has had many technology, and in particular, the use direct consequences on our of remote management systems and society, economy and health virtual wards. Virtual wards combine system. It has also had some predictive modelling with a ‘hospitalindirect consequences, not least the at-home’ approach to reduce hospital growing number of people waiting for admissions in a relatively low-cost elective surgery. The waiting list is now manner. around 6 million, with forecasts that it As well as reducing admissions the could grow to well over 10 million over approach can also be used to support the coming years.1 earlier discharge, freeing-up beds and This growth has a number of factors resources. These are supported by behind it. Firstly, let us not forget remote patient monitoring, using IT to that the waiting list was growing even collect, share and analyse patient data, before the pandemic. Secondly, a usually in the home or work setting. huge number of operations had to be This data collection can help clinicians cancelled in the first get a better picture of and second waves their patient’s status (and to a degree the by providing constant third wave). Thirdly, data in a real-world Reducing admissions is not citizens making environment. just a benefit for the health their own choices about not wanting Supporting patients system, it also means less to interface with the only does this visits for patients to hospitals Not health system during approach improve and clinics, attending only the pandemic. the efficiency of the health system by when necessary.

Chronic staffing issues making better use of The other dynamic staff, reducing length that was present pre-pandemic, but of stay or preventing admission, it also has been significantly exacerbated encourages and supports self-care and by the arrival of COVID-19, is the patient empowerment. workforce crisis within the NHS. The Reducing admissions is not just NHS currently employs around 1.6 a benefit for the health system, it million people and whilst this figure is also means less visits for patients growing, it is not sufficient to keep up to hospitals and clinics, attending with demand.2 This situation has been only when necessary, which in turn compounded by staff absences which helps reduce the carbon footprint of have sky-rocketed during the latest delivering health and care services.

Omicron wave.3 References Technology is a vital tool Dealing with this situation is multifactorial, but one of the tools in the NHS armoury is utilising

1. https://ifs.org.uk/publications/15557 2. https://www.kingsfund.org.uk/projects/nhs-in-anutshell/nhs-workforce?gclid=CjwKCAiA55mPBhBOEiw ANmzoQm26vY46cuIB7Mf8ZsYLMvh0Q0Xarz8ykOa58 sknA1fMK_8Dwx9jKRoCxLIQAvD_BwE 3. https://www.theguardian.com/world/2021/dec/23/nhsstaff-sick-days-absence-england-covid

How digital innovation is freeing up precious time for NHS staff From repetitive yet vital backroom work to helping surgeons hone their skills, robotics are assisting NHS staff across England.

WRITTEN BY Russ Watkins Commercial Director, AHSN NENC

WRITTEN BY Jo Bangoura Digital Transformation Manager, West of England AHSN

To find out more about how AHSNs are supporting the spread of innovations, such as robotics, across England, see: ahsnnetwork.com/ about-academichealth-sciencenetworks

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ach year, 10 million patients undergo surgery in the UK. Improving the results of operations is key to ensuring effective patient recovery as well as the best productivity levels for highly skilled staff.

XR gives surgeons a cutting edge The Academic Health Science Network (AHSN) for the North East and Cumbria (NENC) and, part of the AHSN Network, has supported the use of extended reality (XR) to give surgeons more effective training in the use of robotics.

“As technology has developed, we have helped push the boundaries when it comes to offering vital training that has enabled surgeons to make full use of robotic assistance,” explains Russ Watkins, Commercial Director of AHSN NENC. Automating administrative tasks As well as this form of digital ‘upskilling’, other parts of the AHSN Network have worked to promote robotic process automation (RPA) which automates some clinical and backoffice administrative functions, freeing staff time to add greater value to their services.

Across the country, cloud-based software scripts – robots - have undertaken routine work, ranging from printing job offer letters to checking the demographic data for patients on waiting lists and scheduling appointments asking for patient feedback.

Promoting health technology developments “There are two main Centres of Excellence in the NHS, The Royal Free Hospital Intelligent Automation Centre and the Northampton General Hospital Automation Accelerator, which have used robotics extensively and are supporting NHS organisations around the country to get started with RPA,” says Jo Bangoura, Digital Transformation Manager at West of England AHSN, part of the AHSN Network. “While it may be seen initially as an expensive investment, the overall business case for using RPA is compelling as systems generally pay for themselves within two to five years.”

The AHSN Network acts as the innovation arm of the NHS and the collective voice of the 15 Academic Health Science Networks (AHSNs) across England.

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How knee surgery is being transformed by robotic-assisted technology Robotic-assisted technology is enabling surgeons conducting knee replacements to work with greater accuracy than traditional surgery1,2,3 and facilitates a rapid recovery.4,5,6 INTERVIEW WITH Mr James Gibbs Consultant Orthopaedic Surgeon, Nuffield Health, Haywards Heath (Specialist interest in hip & knee conditions)

INTERVIEW WITH Mr Paul Gibb Consultant Orthopaedic Surgeon, The Knee Clinic, Tunbridge Wells

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ore than 100,000 knee replacements are completed in England and Wales every year and an increasing number are done so with the help of robotic technology.

“This is not about more surgery with less experienced people. This is peace of mind for patients and surgeons.

Using the CORI™ System, a total knee arthroplasty (TKA) study found surgeons can precisely plan and execute TKA procedures with reproducible accuracy within 0.5mm and 0.5 degrees in all three planes7-13,” confirms James Gibbs, who has been using a robotic-assisted system developed by medical tech leaders Smith+Nephew for the past two years.

Paul Gibb explains: “For patients, surgery enhanced by handheld robotics changes little apart from the outcomes.

When they enter the theatre, flat markers are placed on a patient’s leg and a surgeon will create a patient-specific 3D virtual model using a smart mapping feature that eliminates the need for CT scan or x-rays.”

Surgeons then develop a real-time plan inside the theatre using the software to optimise implant position, alignment and balance the knee through range of motion (ROM).14

While it’s too early to say whether robotic technology can help to extend the lifetime of an artificial joint, Paul Gibb feels that: “The initial findings are encouraging and reports that physiotherapists are telling us patients are more mobile and patients are telling us they are recovering faster.”

Page paid for by Smith+Nephew

Future surgical enhancements Robotic-assisted technology is already helping implant companies to rethink the implant model and offer patients more bespoke options. “It means we can use precision milling instead of saws and remove less bone, so it’s less damaging for the patient. It feels like we’re only scratching the surface of what robotic technology has to offer the healthcare sector” says James Gibbs.

References 1. Batailler C, White N, Ranaldi FP, et al. Knee Surg Sports Traumatol Arthrosc. 2019;27:1232.

2. Herry Y BC, Lording T, Servien E, Neyret P, Lustig S. Int Orthop. 2017;41:2265-2271.

3. Bollars P, Boeckxstaens A, Mievis J, Kalaai S, Schotanus MGM, Janssen D. 77 cases compared with a matched control group. Eur. J. Orthop Surg Traumatol. 2020;30(4):723-9 4. Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Arch Orthop Trauma Surg. 2018;138:1765-1771.3.

5. Shearman AD, Sephton BM, Wilson J, Nathwani DK. Arch Orthop Trauma Surg. 2021; 021;141:2147– 2153 4.

6. Sephton BM, Shearman A, Nathwani D. Poster presented at: European Knee Society Arthroplasty Conference;2-3 May, 2019; Valencia, Spain 7. Smith+Nephew 2020. CORI◊ and NAVIO◊ Technical Specification Comparison. Internal Report. ER0488 REV B. 8. Gregori A, Picard F, Lonner JH, Smith JR, Jaramaz B. 15th Annual Meeting;2015; Vancover, Canada.

9. Gregori A, Picard F, Bellemans J, Smith JR, Simone A. Poster presented at: 15th EFORT Congress;4-6 June, 2014; London, UK. 10. Bollars P, Boeckxstaens A, Mievis J, Janssen D. Poster presented at: 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery2019; New York, USA. 11. Kopjar B, Schwarzkopf R, Chow J, et al. Poster presented at: ISTA 2-5 October, 2019; Toronto, Canada.

12. Geller JA, Rossington A, Mitra R, Jaramaz B, Khare R, Netravali NA. European Knee Society Arthroplasty Conference;2019; Valencia, Spain.

13. Kaper BP, Villa A. European Knee Society Arthroplasty Conference;2019; Valencia, Spain.

14. Smith+Nephew 2020. CORI◊ and NAVIO◊ Technical Specification Comparison. Internal Report. ER0488 REV B. References 4-5 provided are only applicable to UKA.

Find out more at roboticssurgery.com

Improved patient outcomes As James Gibbs points out: “While knee replacement surgery already has a high degree of success, we all know someone who has had a suboptimal experience.” Robotic-assisted technology aims to address this.

Patients are embracing tech for better care Healthcare providers are turning to technology to support patients through the complex surgery pathway more effectively.

W INTERVIEW WITH Mr Edward Tayton Consultant Orthopaedic Surgeon PAGE WRITTEN BY Kate Sharma

hen it comes to surgery, the healthcare pathway is complex. The latest health apps guide patients at every step of their journey while giving healthcare professionals the information they need to support them.

Alex Gilbert from healthtech company Huma explains: “With our software, you have different elements that you can put together depending on the patients’ needs. They include those for data collection, patient education and support.”

Software in practice Edward Tayton is a Consultant Orthopaedic Surgeon who has been piloting a patient companion app developed by Huma and medical technology company Smith+Nephew, with patients undergoing knee replacement surgery.

As soon as one of Mr Tayton’s patients has a date for surgery, the app initiates a series of tasks ranging from tracking their health and symptoms to preparing them for their stay in hospital. These tasks continue post-surgery alongside physiotherapy and mental health clips.

“Normally surgeons aren’t sure how a patient is doing until

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With the app, you can keep an eye on them in terms of an early warning system or a method for the patient to contact you if they think there’s a problem.

they are reviewed at six weeks,” explains Mr Tayton. “With Huma, I can remotely track their recovery and see, using a traffic light system, if they have any problems.”

Increased patient engagement Digital support has been helpful for the growing number of patients receiving knee replacements. “With the app, you can keep an eye on them in terms of an early warning system or a method for the patient to contact you if they think there’s a problem,” says Mr Tayton.

A silver lining of the COVID-19 pandemic has been the embrace of technology. As Mr Gilbert explains, “The barrier in digital health hasn’t been hospital adoption but a lack of consumer engagement. COVID-19 has led to people becoming more comfortable with utilising digital technology to understand and manage their care.”

Mr Tayton has been impressed with the willingness of his patients to engage with the app and can already see its potential within other areas of healthcare.

INTERVIEW WITH Alex Gilbert Life Sciences, Huma

Find out more at info.huma.com/ periop-solution

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AI training is needed to support digital transformation within the NHS Training and collaboration are needed to ensure healthcare professionals are equipped to keep up with innovations in artificial intelligence (AI).

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he COVID-19 pandemic resulted in unprecedented demands on health services with widespread alterations to the way healthcare was delivered, creating backlogs at never before seen levels.

Limited AI understanding However, the pandemic has also driven rapid digital transformation within the NHS and the use of digital tools and AI are increasingly being proposed as potential solutions to pressures.

Despite the promise of AI, academic progress is rarely translated into real world services. There are reasons why this may be the case, but at the heart of many is the fundamental reality that AI knowledge amongst clinical professionals is often limited. It is nonsensical to expect healthcare staff to evaluate, commission and trust technology that they do not understand.

AI needs integrating into training for all healthcare professionals, just as clinical trial training already has been.

Providing support and training Although some healthcare professionals will need advanced AI training, the workforce as a whole needs to understand the key underlying concepts - AI literacy as opposed to AI expertise. AI needs integrating into training for all healthcare professionals, just as clinical trial training already has been. To date, healthcare AI training has remained the purview of a motivated and interested minority, with schemes lacking scalability.

Investment is critical If the UK is to equip its health and care workforce with the skills to meet the demands of the rapidly evolving world of AI in medicine, it will require investment, prioritisation and expertise from the Government, professional regulators, professional bodies and AI experts to develop and scale training materials for healthcare workers. Failure to do so is not a simple workforce issue, but one of failing to deliver the best care to patients.

WRITTEN BY

Dr Kieran Zucker Clinical Lecturer and Honorary Clinical Oncology Specialist Registrar

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How AI innovations are improving clinical pathways for cancer diagnosis

WRITTEN BY Dr Sumeet Hindocha Clinical Oncology Specialist Registrar & PhD Candidate in Artificial Intelligence, The Royal Marsden Hospital & Imperial College London

It’s estimated that 50% of people will experience cancer at some point in their lives. New AI technology could play a pivotal role in identifying at risk patients early on and improving cancer diagnosis.

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arlier diagnosis is linked to better outcomes and the NHS has set out an ambitious priority for 75% of patients with suspected cancer to have a diagnosis within 28 days by 2028.

which cancer a patient may be at risk of and suggest the next best step such as blood tests, a scan or urgent referral.

Improved patient outcomes Workforce pressures Patients referred for a scan or biopsy require COVID-19 has placed huge pressures on the health radiologists or pathologists to interpret and service and coupled with longstanding workforce report the results. Shortages in these specialities shortages in primary care, oncology and diagnostic and significant backlogs are leading to delays specialities, such as pathology and radiology, will in diagnosis. AI is being employed to triage make realising this goal even investigations to determine more challenging. which require urgent specialist The Royal College of review so that the large Radiologists estimate a 44% volume of normal tests are not shortfall in the number of AI tools are being piloted to help unnecessarily escalated. radiologists and 29% shortfall breast cancer, AI tools identify which cancer a patient toIndetect in the number of clinical abnormalities on oncologists by 2025. Whilst mammograms have shown may be at risk of and suggest important in the longer term, comparable to the next best step such as blood performance owing to the length of specialist radiologists. Similarly, tools tests, a scan or urgent referral. that can determine which training required, increasing recruitment will not be enough abnormalities on chest CT to solve immediate workforce pressures. scans are likely to become lung cancer, or which can automatically detect prostate cancer from a biopsy Enhancing cancer diagnosis with AI are entering the clinic.

Innovations in artificial intelligence (AI) present Of course, these exciting advances should not be a promising solution. Research continues to met with pure, unguarded enthusiasm. They require demonstrate numerous examples of AI being used to robust validation and regulation to ensure safe and improve cancer diagnosis. Diagnosing cancer can be effective use. However, by facilitating data analysis tricky as early symptoms may be vague and overlap at a level far beyond the limit of human capability, with less serious conditions. GPs are often the first AI has the potential to dramatically enhance cancer port of call for patients with worrying symptoms diagnosis and lead to better outcomes for patients. and here, AI tools are being piloted to help identify READ MORE AT BUSINESSANDINDUSTRY.CO.UK

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How advanced simulators help to support hospital MRI training MRI simulators are helping radiographers and technologists gain the skills they need to acquire high-level clinical images to support patient diagnosis and treatment.

M INTERVIEW WITH Erik Jacobsson CEO, Corsmed WRITTEN BY Mark Nicholls

Paid for by Corsmed

agnetic resonance imaging (MRI) scanners are a mainstay of modern medical care. They are a critical part of the diagnosis and treatment process by providing images that enable doctors to better assess a patient’s condition and tailor care to ensure the best clinical outcomes.

Key to this is the quality of the images obtained from an MRI scan, but to deliver this, radiographers and MRI technologists need to have the correct skill levels and relevant training. Radiologist and MRI expert Erik Hedström explains: “MR images serve as data to make analysis and decisions on diagnosis and treatments - the better the data, the better the treatment.”

Hospitals use the simulator to train their staff to run the scanners better, to get results more efficiently, and make fewer mistakes.

Two-step process MRI is a two-step process: with radiographers/MRI technologists running the scanner to acquire images; and then analysis of those images by radiologists.

However, if the radiographer does not have the relevant skills, practice or training to create those images, that can lead to low quality images. Dr Hedström points out: “Low-quality images are expensive as they mean the radiologist either has to take a risk on the patient’s diagnosis, making a call with insufficient data or examine the same patient again, which is time-consuming and costly.” Re-scanning the patient is a common approach and figures suggest this may be happening in 5–15% of cases.

“To avoid this, radiographers have to become better; they have to practice and specifically, practice handson at a scanner,” he adds. “Yet hands-on practice can be difficult to get because MRI scanners are one of the most expensive items of equipment in a hospital, and dedicated training time is sparse.”

One to one experience The MRI simulator delivers the same image output as an actual scanner by simulating the MRI signal. “This effectively gives a one-to-one experience compared to practising on real scanners, but with infinite practice hours, available from anywhere, without patient or scanner risk, and for a fraction of the cost,” adds Jacobsson.

“Hospitals use the simulator to train their staff to run the scanners better, to get results more efficiently, and make fewer mistakes. They also use it to retain personnel. Personnel leaving is a huge cost and continuous education is one of the best ways to keep personnel, and to have personnel feeling invested in being a long-term member of the team.”

MRI simulation To address the lack of hands-on training availability, Corsmed offers an MRI simulation platform that allows radiographers and technologists to train, without taking up valuable dedicated time on the hospital’s MRI scanning resources, meaning they can be used at a higher intensity for direct patient care.

Describing the platform as the “flight simulator for MRI”, Erik Jacobsson, who is CEO of Corsmed, says: “In short, our product is a virtual MRI scanner and training platform for MRI. It allows radiographers, MRI techs and other people to better train, practice and learn through more accessible hands-on practice.”

“We solve the gap of available and needed MRI training hours by creating a ‘flight simulator for MRI’, which can be used in the same way as a real scanner with vendor-neutral interfaces, and the same process of setting up sequences, slice positions, and parameters.”

Education and upskilling Beyond the clinics, the MRI simulator has value for other user groups, such as in education for the training of college students before, during and after clinical placement and for individuals looking to refresh or upskill their MRI expertise.

Jacobsson adds: “We have seen many different settings in which the simulator have been valuable, inluding students who want to use the simulator to understand MRI more. In-depth, in-clinic practitioners who want to faster cross-train from CT to MRI and users wanting to learn more can become more knowledgeable or even position themselves for employment.”

The simulator may also assist professional societies and course providers in giving their members and participants “more hands-on practice in MRI” where they otherwise are not able to gain enough access to scanners and patients to facilitate training.

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Fast, accurate, safe and autonomous clinical diagnosis is provided by AI technology Artificial intelligence innovations are being introduced to help the NHS tackle a massive - and growing - elective care backlog resulting from the COVID-19 pandemic.

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ore than six million people are now on hospital waiting lists for planned treatments, while the NHS faces chronic staff shortages and too few radiologists.

Artificial intelligence One area where artificial intelligence (AI) is being applied is to read chest x-rays for suspected lung cancer patients. At present, all scans are reported manually by radiologists, which take up considerable time and valuable resource, particularly given the lack of radiologists.

However, a new AI algorithm ‘trained’ on 150,000 images to identify normal lung scans is dramatically speeding up the process and freeing up radiologists’ time to focus on abnormal cases.

Autonomous diagnosis Simon Rasalingham, CEO of British start-up Behold.ai, outlined the support his company is providing the NHS in highlighting normal chest x-rays using AI. Currently, a diagnosis of lung cancer can take over 30 days, whereas the new approach sees chest x-rays read within 30 seconds with an initial diagnosis, helping to quickly rule out those who are not at risk and significantly reduce patient anxiety. As a result, patients with suspected lung cancer can be prioritised for a CT scan which can significantly reduce the whole diagnostic process to under two hours.

Behold.ai, has won an AI award to introduce this novel innovation - initially to 22 sites, with a plan to roll-out to a further 100 this year. The Behold.ai algorithm is 40-times better than the human eye at ruling out normal chest x-rays.

Increased accuaracy With 8.3 million chest x-rays performed each year in the NHS, Behold.ai believes the algorithm can rapidly report on 4 million of those with increased accuracy to significantly help reduce misdiagnosis.

“With a backlog of 6 million patients, if we remove the normal chest x-rays, that adds a large amount of extra radiological reporting capacity into the system,” adds Rasalingham.

Behold.ai is also registered with the Care Quality Commission as the first and only AI diagnostic provider of its kind, delivering a safe framework for AI services to patients.

“Our mission is to save lives from lung cancer and stroke, by significantly reducing the time to diagnosis and treatment,” he says.

INTERVIEW WITH Simon Rasalingham, Chairman and CEO, Behold.ai WRITTEN BY Mark Nicholls

Paid for by Behold.ai

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How artificial intelligence is supporting greater efficiency in the NHS Artificial intelligence (AI) has the potential to alleviate some of the pressures the NHS is currently facing, from long waiting lists to lack of capacity, holding the key to create a more streamlined and efficient service.

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ospitals and health centres are continually trying to maximise their resources, squeezing the greatest number of surgeries and consultations into each day. AI could help make the most of existing resources by automating tasks, triaging patients to the most appropriate services and allowing them to self-care.

AI can be trained to identify patterns and suggest optimal solutions, for example, finding the most efficient way of scheduling to maximise operations whilst complying with safety standards. AI can be used to alleviate the strain on managing and planning care across the UK. Maximising time and resources The gastroenterology consultants at Western General Hospital in Edinburgh manage around 30-40 referrals a day. Complexities in the decisionmaking mean that there is likely to be significant variation in the route that each patient takes through diagnosis and treatment.

In January 2020, Western General ran a live trial of an AI-driven triage support tool with two low-risk patient groups. The trial automated the triage of GP referrals by analysing the information from GPs and identifying patterns that could influence the best pathway for each patient.

WRITTEN BY Eleonora Harwich Head of Collaborations, NHS AI Lab

By the time of its completion, the specialists were pleased to see faster triage and a reduction in the variation of decisions. Further trials aim to drive down patient waiting times and improve joint working between GPs and consultants. In this example, as with all health and care solutions, the technology is used to enhance existing systems.

Clinicians reviewed each decision in the trial, keeping a human always in the loop.

Harnessing the power of AI Using AI to improve the efficiency of health and care organisations can have a hugely positive impact on the frontline. It is the NHS AI Lab’s mission to showcase the potential of AI as well as ensuring a robust regulatory system is in place. The Lab also aims to demonstrate that AI is trustworthy and provide the public and clinicians the confidence to use the technology.

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Clinicians from all over the country can dial in, which gives people easier access to specialist care.

Image provided by Pexip

The field-based video tech solution that could revolutionise healthcare The use of secure video technology in the field gives NHS front line staff instant, virtual access to clinical specialists.

This can reduce admissions to hospitals and improve outcomes for patients.

INTERVIEW WITH Tom Jones Head of Healthcare UK, Pexip

WRITTEN BY Tony Greenway

Paid for by Pexip

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uring the pandemic, many of us became used to using video conferencing technology on a regular basis. In lockdown, talking to people via our computer screens was an important way to keep in touch with friends and family, or hold office meetings with colleagues.

For the NHS, however, this type of digital innovation offers more than just a convenient method of connecting people. It could have revolutionary benefits for patients and clinicians alike.

“Video conferencing tech gives staff the opportunity to virtualise any clinical interaction,” explains Tom Jones, Head of Healthcare UK at communication platform, Pexip. “For example, if you’re a first responder using wearable tech — be it chestmounted or a pair of glasses — you can have access to the right clinical specialists while the patient is still in the field or in an ambulance.”

Benefits for patients and NHS clinicians Jones gives examples of an elderly patient who may have broken a bone after a fall, or a person who has suffered burns in a road traffic accident. “Getting them to hospital for assessment may be traumatic and time-consuming,” he says. “In the current climate, it could also increase

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their risk of infection. It would be better if a first responder, who has virtual access to a clinical specialist, could triage the patient in the field so they can be taken directly to the right unit for treatment.

“That’s a big benefit for the patient and the patient’s family, who don’t have to wait around in hospital while they are assessed. It’s also a plus from the hospital’s perspective because it reduces admissions and frees up precious resources.”

It doesn’t replace the need for face-to-face appointments, but a lot of preparatory and followup appointments can be made virtually to reduce the burden on the NHS. It’s useful in other healthcare settings too. For instance, GPs can use video tech to make home consultations easier. “People can now have a video consultation in their lunch break via their handheld device,” he says. “There is no need for them to take half a day off to sit in a waiting room. It doesn’t replace the need for face-to-face appointments, but a lot of preparatory and follow-up

appointments can be made virtually to reduce the burden on the NHS.” Jones also knows of at least one NHS Trust that has created a secure virtual consultation room in a hospital for patients to use. “Clinicians from all over the country can dial in, which gives people easier access to specialist care,” he says. “So the possibilities are exciting.”

Secure, accessible and reliable technology Video tech has been available for some time in clinical settings; yet it’s only now that more healthcare staff are seeing it in action. “I think there may have been a hesitancy about adopting this type of technology in the past because some clinicians were worried about the security/privacy aspect,” he says. “But now there’s a realisation that it is secure, easy to use and — with the availability of 4G and 5G networks — very reliable.”

It’s compatible with existing systems and platforms, too, so users don’t have to invest in new equipment; plus it’s customisable and can fit in easily with a clinician’s workflow. “If they prefer to, they can join a call with one touch of a button or with a voice command,” says Jones. “When clinicians see it and use it, their reaction is usually: ‘How did we not know this was available? It’s exactly what we have been looking for.’”

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How efficient digital methods are supporting healthcare needs More than half of the adults in England now have access to digital healthcare, according to the latest statistics from NHS Digital.

D WRITTEN BY Barry Cassels Head of Product for the NHS App, NHS Digital

igital healthcare has been a lifeline for many over the past two years as the pandemic has provided a catalyst for change within the NHS when it comes to the integration of digital healthcare.

The NHS login service, which is managed by NHS Digital, provides people with a quick and secure single point of access to a variety of digital healthcare websites and apps using just one email address and password. It now has more than 28 million registered users, up from 2.2 million in September 2020.

A total of 52 apps and e-health services are available through NHS login, including e-Referral services, COVID-19 support and advice, maternity and child health services, online pharmacies, and services to monitor and improve health and wellbeing.

Through the services integrated with NHS login people can book GP appointments, order lateral flow tests, register their organ donation preferences and much more.

An efficient way to access healthcare needs A peak in the number of people setting up an NHS login took place in May 2021, which coincided with the launch of the NHS COVID Pass. On 17 May alone, when the NHS COVID Pass launched, around 245,000 people created an NHS login account.

Melissa Ruscoe, Programme Head at NHS Digital, says: “We are pleased to see such a massive uptake in people managing their healthcare needs digitally throughout the COVID-19 pandemic, with around half of people in England now able to access digital healthcare services through NHS login.

“Through the services integrated with NHS login people can book GP appointments, order lateral flow tests, register their organ donation preferences and much more.

“This helps free up valuable time for GP practice staff and provides a simple and efficient way for people to take control of their healthcare and access services easily and securely.”

The NHS App offers benefits for all Alongside NHS login, users are benefiting from easier access to NHS services through the NHS App. During the past four months, almost 3.2 million repeat prescriptions were ordered and over 268,000 GP appointments were booked via the NHS app, saving valuable time for patients and clinicians.

The increase in app downloads could also have a lifesaving impact as 1.5 million people have now used the app to manage their organ donation decision, with 265,000 of these registering their organ donation for the first time via the app.

Over 150,000 of these new registrations have taken place in just four months since May 2021.

NHS login follows the UK government’s data storage standards to keep information private and secure. For more information, visit the NHS login privacy policy access.login. nhs.uk/privacy

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New technology is helping to improve management of diabetes care Hi-tech solutions are helping the NHS work closely with patients to deliver more efficient and effective care for diabetes.

N INTERVIEW WITH Dr Waqas Tahir GP Partner Affinity Care & Diabetes Clinical Lead, West Yorkshire Health and Care Partnership WRITTEN BY Mark Nicholls

ew devices can collect data from patients self-managing their condition, with artificial intelligence (AI) algorithms analysing the gathered information to give clinicians a more precise overview of their patients living with diabetes. Combining face-to-face and virtual consultations with data sharing technology offers healthcare professionals (HCPs) a clearer view, as they assess which patients require closer monitoring and care.

Flash glucose monitoring Dr Waqas Tahir, a GP partner in a primary care group with 60,000 patients and a diabetes specialist, says the use of technology accelerated during the COVID pandemic, but he remains concerned that thousands of people remain at large with a missed or delayed diagnosis of type 2 diabetes.

Devices help patients interface with HCPs and enable doctors to deliver care more efficiently, underlining the importance of supporting people in self-management of their type 2 diabetes. The different technologies range from the NHS Healthy Living online platform to help people manage their condition, to flash glucose monitoring which uses a sensor attached to the back of the upper arm to monitor glucose information. It can

log, measure and store sugar level data and securely forward it via a mobile app to HCPs. Diabetes dashboard Patients measuring sugar levels several times a day generate hundreds of readings for GPs to discuss via teleconsultations. But it is the newer technologies that deliver better insight into glucose patterns, allowing doctors to make better-informed and shared decisions with patients.

That data is taken to a new level by a diabetes dashboard, allowing us to stratify and prioritise patients based on their health needs and successfully support those self-managing their condition. “It gives us a red, amber or green rating and allows us to have an overview and see if a patient is doing well or whether they need to be seen by us,” says Dr Tahir, who is also Clinical Lead for West Yorkshire Health and Care Partnership.

Freeing up capacity With the dashboard helping prioritise which patients need to be seen more often, it is having benefits for the NHS in terms of efficiency, capacity and resource. “Now, some people are only seen once a year, others twice, and some three times, so we are using that capacity in a different and more effective way,” he added.

Future care As well as flash glucose monitoring, other technologies include artificial pancreas systems for type 1 diabetes patients and smart insulin pens that record the time and dose of insulin injections. “The next step,” says Dr Tahir, “would be an ecosystem of digitally-enabled diabetes care.

These different layers of technology come together to deliver easier selfmanagement, greater support for the individual, better outcomes, improved quality of life and streamlined risk stratification tools.

“Importantly, this technology is increasing the confidence and skills patients have to self-manage their condition while for healthcare professionals, it allows us to focus our resources on the individuals most at need.”

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Start your free 14-day trial at FreeStyleLibre2.co.uk New customers only. See website for eligibility. †Finger pricks are required if your glucose readings and alarms do not match symptoms or expectations.

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Simulated data for illustrative purposes only. Not real patient or data.© 2022 Abbott. See website for disclaimers and product information.

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AI can be used to alleviate the strain on managing and planning care across the UK. ~ Eleonora Harwich, Head of Collaborations, NHS AI Lab

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