This blog is a commentary on the recent roundtable discussion "Preparing the healthcare workforce to deliver a digital future. The Topol Review 2 years on" (Parts 1-3, about 1hr 20 mins in total) on YouTube - https://www.youtube.com/watch?v=NTxVB2zxHbw
In 2019 the Topol Review outlined recommendations to ensure the UK National Health Service is the world leader in using digital technologies to benefit patients. It will involve implementing technologies such as genomics, digital medicine, artificial intelligence, and robotics at a faster pace and on a greater scale than anywhere else in the world. In February 2021 the people who led the report discussed progress 2 years on, chaired by Prof Lionel Tarassenko.
With a focus on inclusion, what I will take away from watching this roundtable discussion is:
1) The future NHS will soon look quite different because new technologies such as machine learning can help predict (especially in combination with genomics) and find disease and treat many more people quicker than before. Some types of technology can even deliver care to patients more accurately e.g., precision medicine, or without direct interaction with the patient using remote technologies.
2) Huge amounts of work are being done across the UK by universities and research centres to train health care specialists in how to develop, use and implement new technologies in the NHS. Unfortunately, the demand for their skills sometimes means they do not stay in the NHS.
3) The downside of a digital future for patients is that the technology does not always live up to expectations. There can be problems with the data (e.g., it is patchy or skewed to particular groups of patients) or the information and rules that people use to tell technologies how to work (algorithms). It means that sometimes the technology does not hit the mark or does not come to the right conclusions, or benefit everyone equally.
4) Health care professionals need skills to understand and make use of the technology BUT they also need to be open to the fact that the technology might not always be correct. It is difficult to know when it is or isn’t because it is very difficult to know what goes on inside complex technologies (explainable AI) and how exactly they came to an answer.
5) A better way to approach digital technologies might be to put new technologies into the hands of patients – literally (patients using technologies themselves like wearables and smartphone apps) but also figuratively (having a say in how they are designed and used in the NHS). This way patients could alert professionals to any issues with the design, or changes in the information they are getting from technologies or say to professionals when something does not feel right. After all the patient has the best insight into their own health and situation.
6) The only problem is that is lots of work needs to be done to raise awareness with professionals and the public about what these technologies can do. Covid-19 has raised awareness about social inequalities (e.g., ethnicity and where we live) but alongside this everyone has an individual genetic makeup that makes us more/less likely to get certain diseases. We can tackle disease much better in the future if we look at both social and genetic factors and work more on public health and disease prevention.
7) Lots of work is being done in the UK to ensure artificial intelligence technologies that are developed and used in the NHS are ethical (e.g., data protection regulations). However not all technologies are developed though an accountable process overseen by UK regulators, yet the technologies could be helpful, or not (e.g., many mental health apps). This leaves a bit of a dilemma trying to sort out which technologies are safe and useful for the public and which ones are not.
If these issues resonate with you, please watch the three YouTube videos of the roundtable discussion at the link address above.