Full adoption of technology and a sustainable transformation of the NHS will require closer coordination, consistency and an improved contractual incentive structure, participants at a BT-sponsored roundtable heard last week.
The event, which was held at the King’s Fund, sought to highlight the barriers to digital change and develop a set of solutions likely to achieve backing from stakeholders in the healthcare system. Attendees included clinicians, consultants and digital health suppliers.
Professor Sultan Mahmud, director of healthcare for BT, identified the challenge of scaling up projects and achieving interoperability as just two of the clear obstacles to the digital transformation agenda. He added: “How do we address the fact that some of the finest clinical digital start-ups in the globe are wanting to work in the UK and are very frustrated.”
The roundtable organisers also highlighted the need to improve productivity in the NHS. Dr Amrita Kumar, a consultant radiologist and chair of the AI Working Group at Frimley Health NHS Foundation Trust, described how her hospital is using AI in conjunction with clinicians to identify breast images that suggest possible cancers and need the most urgent follow-up, thereby ensuring that clinical backlogs do not endanger patients.
At the same time, typical challenges include trusts procuring technology in isolation rather than choosing it with an eye to clinical interoperability. In addition, participants noted, it is crucial for digital leads and trust boards to have a more strategic vision about how technology can be used to improve outcomes for patients.
“Just because you have the technology doesn’t mean you have a better use for patients,” Kumar said. “The data is not linked up and we need a team of people to extract actionable insights.”
Other barriers include human factors, said Dr Paul Boghal, a consultant interventional neuroradiologist at the Royal London Hospital, who recounted his experience trying to convince his trust to sign up for a free AI solution to accelerate the diagnosis of stroke and more quickly identify candidates for mechanical thrombectomy, part of its 10-year strategic plan.
“A year of my life was wasted trying to get this solution in for stroke,” he said. “I shouldn’t have to be chasing information governance. That adds to the stress levels. I have no extra remuneration. What is my incentive for doing this? What is the incentive of any doctor and nurse, and why does it always fall on the busiest and most stressed people in the system?”
Participants in the roundtable agreed that working out how to make pilot projects more easily scaleable across the NHS should be a key goal going forward. In addition, they said, the NHS should take further steps towards mandating standards and governance for digital technology, such as ensuring that data is more easily shared between systems.
Adapting general practice contracts to reflect and incentivise the need to open up data will also be part of the wider conversation, participants agreed. Ultimately, the roundtable concluded, technology will also need to be more patient-centric, allowing patients more access to their own data, and incorporate an appetite of business and cultural change within the health service.
Survey shows public, NHS staff bullish about tech
Over the past year, BT has been laying claim to a central role in the debate over how to more rapidly modernise the health service. In November, 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.
BT surveyed 2,000 patients and hundreds of frontline NHS staff from across the country about their views of technology use in the NHS and found that 74% of NHS staff agreed that technology delivers better quality care, but that the current standard of technology at work is a source of stress for just under half of those (49%).
More than half of those working in the health service (59%) said they believed pilot projects are taking too long to be widely adopted and nearly half (48%) think there are too many pilots that fail to roll out across the NHS.
Survey respondents identified a number of technology solutions that they believed were deserving of further backing, including digital diagnostics, digital consultations and solutions that reduced waiting times and encouraged faster diagnosis.
More than three-quarters of NHS staff (77%) said they thought virtual wards would improve patient outcomes and 71% said they would cut costs. Most NHS staff surveyed agreed that AI had the potential to cut wait times (63%), improve patient outcomes (65%) and cut the cost of patient care (56%).