UK has innovation to share with India in creating effective healthcare
A healthcare expert explores the ways in which the use of technology by the UK’s state-run National Health Service (NHS) can lead to greater health-tech collaborations with India.
I recognise that India has some of the best hospitals in the region and is already quick to take up and use new technologies. But there are a few things that the experience of using technology in the National Health Service (NHS) has taught us. I hope these may be of value to India.
We have big ambitions as we build what our current Secretary of State for Health and Social Care, Matt Hancock, has hailed “the most dynamic health-tech ecosystem on the planet”.
In the NHS, we want to ensure that the clinical staff have access to a patient’s medical history, test results, diagnosis, allergies and treatment plan. This is the primary value of electronic clinical records: they can be available to the whole team of people treating a patient, not just in secondary care but also in rehabilitation services and primary care.
We do this by linking hospitals and GP practices via a national information “spine”. This links over 28,000 IT systems in more than 20,000 organisations, has over 250,000 users accessing the system at any one time and handles over 6 billion messages every year. It holds over 500 million records and has over 1.1 million smart card users.
Increasingly, we are making use of the cloud to make records more available to clinicians and where appropriate, the patient too. The future of records is to make them as mobile as possible. For example, a phone app called CTheSigns collects details of a patient, measures their risk of cancer, recommends and books tests and keeps the clinicians up to date with the results by linking with the hospital and primary care main systems. We can support India in linking your information systems in this way to create “seamless” care.
We have also learnt the value of interrogating big data both to understand diseases and what helps reduce them and treat them and to create diagnostic tools using artificial intelligence. Our UK Biobank collects the health and treatment data of half a million people and is accessed by researchers all over the world. Our hospital and population statistics, going back decades tell us about the activity in hospitals and the clinical and patient related outcomes. This enables us to give feedback to clinicians about their effectiveness, identify the most successful treatments, devices and consumables, plan for the future and know where we need to target our efforts to improve our health results.
But we are also seeing a proliferation of applications that sit on top of these major systems and make the whole process of healthcare more accessible, speedy and effective. Many of these are driven by artificial intelligence (AI) acting on the data collected. AI is an exciting area with great potential to support clinicians in making better decisions and empowering patients to take greater charge of their health. Even our prime minster wears a diabetic patch to monitor her blood sugar levels.
The challenge to the acceptance of these solutions lies in the level of trust that people will place on them. We are at a stage where we are cautiously optimistic. In the UK, the design and development of AI-based systems pays great attention to the quality of the knowledge and evidence base they incorporate as well as their analytical capability and the way users interact with them. Where the evidence suggests they can outperform humans, it is a clear-cut case in favour of their use.
The use of AI could also drive forward personalised medicine by analysing genomic data to suggest the most effective medication or treatment pathways, generating better outcomes at lower costs.
Many of the companies who are accompanying me on our “Innovating for a Healthier World” Trade Mission to India in December as part of the India UK FutureTech Festival exemplify the innovation that AI can bring. They include:
- diagnostic apps and tests for early identification of eye disease, respiratory diseases, cancer and CVD (some of which can be used by local health workers and patients)
- clinical decision systems
- automated treatments e.g. insulin therapy for diabetics
- remote monitoring systems for respiratory diseases
- early detection of problems in the course of an illness for patients and their clinicians
- personalised advice to patients based on monitored signs and progress of the condition e.g. pregnant women
- improving outcomes by analysing patient reported data
- better customer experience for bill payments and
- using modern energy sources and smart windows to reduce carbon emissions of hospitals
Healthcare UK, part of the UK’s Department for International Trade (DIT), is currently collaborating with NITI Aayog in implementing several AI pilots in healthcare. The Healthcare AI Catalyst as the initiative is called, will take leading AI companies from the UK into India to play a role in the delivery of India’s healthcare ambitions of the future.
Both countries are looking for ways to use telemedicine to help support patients without high cost face-to-face clinical interactions. In India in particular, this has the potential to transform the way healthcare is delivered to the two-thirds of the population living in rural areas. 2017 was a crucial year for telemedicine in the NHS, with patients being offered routine GP appointments via a mobile phone app for the first time and the launch of an online version of our 111 telephone advice service.
Our two systems also face shared workforce challenges. The NHS’ recent workforce plan has committed to training significantly higher numbers of clinical staff in the coming years, whilst it is estimated India has shortages of 74 per cent for nurses and 43 per cent for doctors. Neither country will be able to achieve their goals by adhering solely to traditional training methods, and advances in augmented reality and e-learning have the potential to remove many of the current barriers we both face. Increasingly, we are using technology to make buildings and facilities “smart” and to track patients, staff activity and assets throughout a facility to increase efficiency and flex assets accordingly.
The NHS has coped with the challenges of growing demand, an ageing population and new treatments only through the constant innovation of its staff and institutions. Many of these innovations were internationally renowned achievements of British science: stem cell transplants, the ECG, or CT scanners. Others took place as quiet, steady revolutions in practice: the introduction of cancer screening, the movement of mental health care into the community, or the widespread shift to day case surgery.
We have a substantial programme that promotes innovation across the NHS. For example, we have set up Academic Health Science Networks across the country that bring industry, academia and healthcare providers and commissioners together to promote the spread of best practice, clinical innovations and new technologies
We have selected 104 clinical entrepreneurs to design and deliver new technological solutions and innovations in healthcare. This includes the appointment of five healthcare scientists, tackling conditions including sickle cell disease and allergic reactions.
Just this month, the UK government announced backing for five new centres of excellence in Leeds, Oxford, Coventry, Glasgow and London for digital pathology and imaging, including radiology, using AI medical advances.
It is only though innovation that we will be able to respond to rising demand, increasing costs of some treatments and a constrained public purse.
These examples are, of course, just a small number of the many opportunities that exist to learn from each other. Whether it be the use of electronic patient records, wearables and self-management apps, or the accelerating progress in 3D printing, predictive analytics and personalised medicine, there is little doubt that both of our health systems will transform radically over the next decade.
The UK has innovation to share with India in creating effective healthcare: award-winning designs and smart facilities management, efficient, technology enabled clinical processes, sophisticated simulation programmes for training staff to the highest standards and of course, technology to put patients in control and provide intelligent systems to help patients and clinicians to manage the patients’ care efficiently.
Sir Malcolm Grant is UK Business Ambassador and former Chairman of NHS England.