Chris Scarisbrick is in no doubt that artificial intelligence is here to stay and that it can transform the efficiency and effectiveness of healthcare. But he also argues that if it is truly to make a difference, procurement processes will need to be changed and vendors closely involved – as he tells us in the second of Digital Health’s Industry Spotlight series.

Ask Chris Scarisbrick for his overall perspective on artificial intelligence and he is unequivocal. “AI is here for the long term,” suggests Scarisbrick, sales director for Sectra.

But whether it will truly become embedded in the NHS – and overcome the view in some quarters that it has been overhyped – will, he argues, come down in the first instance to procurement processes.

“Whether we are applying AI in radiology, pathology, cardiology, or any other profession harnessing diagnostic imaging, should improve accuracy and efficiency for end users, and it should speed up the work that they do,” says Scarisbrick.

“But although the pandemic has shown technology can be deployed quickly in the NHS when it’s urgently needed, the traditional approach is a lengthy procurement process.”

The standard process of evaluating several vendors, shortlisting, making a decision, making a five to 10-year commitment and signing a contract – all before deployment is even considered – is, he suggests, insufficiently agile.

“It is a familiar scene in the diagnostic space, as much as any part of healthcare technology, and it can be a complex and intensive experience both for trusts and for suppliers.”

And while Scarisbrick welcomes the publication, earlier this year, of NHSX’s buyer’s checklist for AI in health and social care, he thinks there is further to go.

“It is a very comprehensive and well thought through document, addressing the challenges we see today for accelerating safe AI adoption,” he stresses.

“But while the document provides a good and clear checklist, it is still quite a burden on both trusts and smaller and emerging AI developers to run through a lengthy procurement process each time.

“Does a commercial function in an NHS trust really want to repeat the same process and payment terms with potentially dozens of different AI imaging providers, dozens of different times?

“And can AI vendors, who might be start-up companies or small businesses and who might never have navigated NHS procurement processes, manage to get their solution through the front door?”

He suggests the answer to both questions is likely to be a no. But he also believes that vendors have a potentially important role to play in changing that. Sectra, for instance, is helping trusts that use its imaging systems to conduct due diligence on AI vendors.

“We want to be a partner in the buyer’s journey,” explains Scarisbrick, “and create a dynamic marketplace from which organisations or individual healthcare professionals can choose from a range of AI apps, safe in the knowledge that those apps meet necessary regulatory standards and comply with information governance standards”.

According to Scarisbrick, he and colleagues are also focusing on conversations with customers about the areas in which it’s felt AI has the biggest potential to make a difference. Those discussions then help inform the company’s approach to artificial intelligence.

“By using the enterprise imaging system provider as the point of coordination for imaging AI acquisition, more thought can be put into standardisation and maintaining user control over how images are displayed on screen for professionals,” Scarisbrick argues.

“Our ethos is to tailor this to a close and ever-evolving understanding of workflow on the ground. We can also ensure an AI app is integrated into the picture archiving and communication system (PACS), where radiologists spend 80% of their working lives, before it is even procured.”

A further part of that ethos is, however, that AI in the most part should be invisible to the user – and never considered a replacement for a clinical professional. “For the foreseeable future a human will always need to remain in the loop in delivering diagnoses, but most of the time our professionals shouldn’t even notice AI is there,” contends Scarisbrick.

“If you are using an AI application that measures lung lesions, for instance, then only scans that meet these criteria should be forwarded on to the AI, and should be sent automatically, without the need for human intervention.

“The AI can then run its analytics in the background and push results back to the PACS to alert the professional to urgent cases and to help them prioritise and improve the quality and efficiency of their work.”

Certainly, Scarisbrick believes that there will be more and more instances in which that sort of invisible AI helps support the effective delivery of the best possible care. And he also believes vendors have a role to play in supporting that shift.

“We as technology partners have a responsibility to help hospitals acquire the best applications to meet their needs. It’s not about what AI we can develop at Sectra, for instance. It is about providing a channel in which the fantastic innovation emerging can reach those working hard to support the frontline of healthcare.”


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