BT Healthcare’s bid to leverage its corporate heft to help support the digital transformation of the NHS is moving to its next stage as it expands its partnerships in the areas of diagnostics and strengthening the patient pathway.
In a series of presentations for journalists and clinicians in November at its London headquarters, the company introduced its newest partners, deepC, a supplier of AI radiology platforms, Axon Diagnostics, a supplier of centralised diagnostic reporting hubs for remote sharing of images and Soprano, which develops patient concierge and messaging systems.
At the same time, the company made it clear that it believes BT, as one of the UK’s largest companies with strong contacts to central government, is well positioned to help instill change in the health service.
BT already plays an important role in the NHS, noted Professor Sultan Mahmud, director of BT’s healthcare business. “We’re about 35% of the infrastructure and have a very deep customer base,” he added. But the company views its job as helping the NHS to use technology to reduce costs and improve productivity by leveraging the scale of the health service.
With some 1.7 million on diagnostic waiting lists, however, the advent of AI and digital streaming have the potential to produce “game changing” capabilities, enabling the health service to effectively extend, if not expand, its radiology workforce, Mahmud said. Digital transformation and cutting-edge technologies are also key to retaining the health service’s clinicians, he said.
“We need to systemise success and not make an artefact of having really bright people,” he said. “With AI, clinical productivity can be magnificently accelerated, the experience of work can be improved and patients can feel really engaged in control of their care – that is worth fighting for.”
Taking advantage of digital streaming
One of BT’s partners in the space is Axon Diagnostics, which the company says has the capacity to stream high-fidelity images to a £500 laptop anywhere in the world. Axon’s platform is designed to solve the shortage of trained radiologists and the proliferation of imaging simultaneously. “The workforce expansion we think we can address with Axon,” Mahmud said.
From a data transmission perspective, moving data from a hospital to a radiologist over a VPN network comes with a number of challenges, ranging from operational efficiency, security and GDPR, said Axon co-founder Rahul Mehta.
Using technology to design a platform to allow the NHS to do diagnostics remotely – with radiologists able to look at images from their own computers – falls in line with NHS strategy, which is to allow care to be delivered remotely as much as possible. The Axon platform has been tested as far away as from Australia back to the UK, using a 4G cellphone.
“So, literally, you could be sat anywhere in the world and still add value back into the NHS,” he added. Previously, he said, six hospitals in the same region might have 50 radiologists, all of whom were restricted to reporting to their own institution, in part to a lack of system interoperability. Installing Axon’s centralised hub in hospitals and connecting with remote users can be done very quickly, within around four weeks, Mehta said, adding: “We’ve made it as quick and plug and play as possible.”
“This way, you’ve got one piece of technology, a dumb terminal effectively because we’re not getting the data, a couple of screens, and because they’re connecting into a hub they’ve now got access to everything that’s connected into that environment.
“There’s multiple efficiencies in that journey. You’ve made the radiologists more efficient and you’ve now unlocked the capacity within the network and radiologists and across the hospitals,” he explained.
Where AI can make a difference
Both Mahmud and Bohgal acknowledged that AI is unlikely to be a “panacea” for healthcare; the relatively new technology of generative AI, Mahmud suggested, will primarily be applicable to back- office operations or population health for the near future.
By contrast, natural language algorithms are already showing benefits when paired with diagnostics for conditions such as lung cancer and some brain injuries, such as stroke.
BT is working with Munich-based deepC to use AI to look at images and report on them with a high level of accuracy.
“We think that productivity with both Axon and deepc working in collaboration together in a system can be hugely increased,” Mahmud said. “The workforce and the technology and the training need to come together, because you have been hearing for 10 years that healthcare is going to be transformed by technology and it has not been in the seismic way that we all need.”
Dr Paul Bhogal, a consultant interventional neuroradiologist and member of BT’s clinical advisory board, helped to build one of the country’s largest mechanical thrombectomy units at the Royal London hospital, but struggled to get a single, free-of-charge AI application into his unit.
Working with deepC, he said, provides a platform with access to more than 50 third-party “best-in-breed” applications that trusts can use to select the best options for their needs and streamline the process of scaling up. As a result, company officials say, deepC has been described as “Amazon for radiologists.”
It can take a year to get the NHS to sign off data privacy compliance for just one trust, a factor that has dramatically slowed the implementation of AI radiology solutions up to this point, Bhogal noted; the fact that deepC is vendor agnostic enables it to integrate into any hospital environment, and also provides access to AI tech for NHS hospitals that might otherwise be overlooked.
“You have an NHS, apparently a national health service,” he says. “But, why do you have to go through information, governance and all of the rest at every single hospital? You’re not leveraging the size of the beast. It’s bizarre.”
Patient-centred design
A focus on the patient in the diagnostic pathway is the final strand of the way BT Healthcare views its role. With Soprano, it is developing a patient concierge system that seeks to accompany the patient on a procedure or pathway, allowing them to ask questions about the procedure, likely outcomes and process using non generative, conversational AI.
With a backlog of around eight million patients waiting for appointments and the costs for each “do not attend” for procedures such as colonoscopies costing around £1000, Patient Concierge aims to accompany patients along care pathways, helping to manage accessibility, language and online rebooking of appointments using text messaging.
Over the past two years, BT has been developing its healthcare business, setting up a clinical advisory board to help it design products matched to the needs of the NHS, and its Vanguard Programme – a collaborative space” to help frontline healthcare workers try out and evaluate technology to ensure it fits local requirements.
The company’s vision has also articulated its plans to develop products in three main areas: health navigation, which helps to define patient relationships with the healthcare system; patient flow, which allows hospitals and healthcare providers to move patients efficiently through the system; and remote care.