Author: Miguel Ramirez Hernandez Edited by: Emil Fristed
Digital technologies are revolutionising industry after industry. Manufacturing, retail and banking industries are implementing technologies including automation, robotics and complex algorithms to optimise numerous tasks, provide new services, and increase revenues. Behind concrete breakthroughs from facial recognition using a simple iPhone camera to autonomous vehicles, are the broader technologies of Artificial Intelligence (AI), automation, and “big-data” analysis.
Similarly, in healthcare, digital technologies have the potential to make significant impacts. Currently, healthcare is suffering from numerous inefficiencies, in particular financial ones. (1) Thus, finding ways to improve healthcare practices by implementing current digital technologies is a top priority. Applications such as preventive care, personalised medicine, and robot-assisted surgery would greatly benefit from the use of digital technologies.
In the UK, the National Health System (NHS) is working on the implementation of such technologies. In a recent event hosted by SIU Oxford, and organised in cooperation with Saïd Business School - Oxford Business Network for Healthcare, we invited Prof. Neil Sebire to elaborate on some of the NHS efforts.
Prof. Sebire is the Director of the Digital Research, Informatics and Virtual Environments (DRIVE), a recently created unit at the Great Ormond Street Hospital (GOSH). DRIVE is a government program that, as part of the UK’s National Health System (NHS), is intended to study and incorporate innovative technologies in healthcare, including those involving AI and big-data.
Re-imagining healthcare with data
In the information age, data is becoming a highly valuable asset, with some leading industries and finance firms referring to it as “the new gold”. (2) In healthcare, huge amounts of data are regularly collected in the processes of receiving, diagnosing and treating patients. The NHS has over 420 clinical IT systems that have been collecting and storing data for decades. However, according to Prof. Sebire, the NHS does not have an official and formal structure for data analysis, sharing or collaboration. Although most hospitals have implemented digital records systems, data are not being widely used beyond traditional referencing material. Moreover, data tends to be formatted and stored differently across institutions and departments, increasing the level of difficulty for comprehensive analysis. Consequently, the high value of data in healthcare is not being extracted. This is because healthcare data is messy, and a lot of work is required before valuable information can be obtained, Prof. Sebire explained.
With this in mind, Prof. Sebire and a team of researchers set out to determine how to maximize the value that can be extracted from healthcare data. Specifically, they wanted to determine how new digital technologies such as AI and big-data analysis could be used to improve on healthcare practices.
The team approached this task without preconceived notions of what healthcare should “look like”, or what aspects of technology should be implemented in healthcare. Without limitations on resources or technology, they visualised an idealistic healthcare system that could take advantage of all available computational and technological tools.
For instance, Prof. Sebire noted that many of us already use wearable “vital sign monitors”. Our smartphones and smartwatches can track our daily steps, our heart rate, and our sleep patterns. These devices then process and convert the data into a user-friendly report. If the healthcare system were to have access to this type of data, early signs of anomalies of vital signs could result in early disease diagnosis and prevention.
In a recent study by Prof. Michael Snyder (3) several portable biosensors were used to monitor a range of vital signs and metabolite levels in 43 individuals. The analysis of over 250,000 daily measurements resulted in accurate prediction of health indicators and diseases. Using these methods, for example, Professor Snyder diagnosed himself with Lyme disease.
Infrastructure: Challenges and Progress
One of the major obstacles for the implementation of new technologies in healthcare is the lack of suitable infrastructure, including the computer facilities and physical space for data collection and analysis. Even if we had access to the same devices used in Prof. Michael Snyder’s study (3), there is no infrastructure to collect or analyse the data in the NHS. Moreover, we would not know what to do with the data, as no algorithms for their analysis exist outside of academic environments.
Fortunately, Prof. Sebire noted that progress is already underway. In the UK, the NHS recently launched the Health Data Research (HDR) UK . HDR UK is an effort to collect and store healthcare data across the UK in a comprehensive database. Information including existing and future patient data, as well as drug-trial information, is expected to be included in this platform. HDR’s database is intended to be the main source of information for researchers, pharmaceutical companies and medical personnel.
HDR is an NIH proprietary system hosted in the “cloud”, and can be used for multiple objectives. Tasks ranging from diagnosis, research, or drug trial analysis can be carried out remotely. The platform is designed to work with open source software allowing the development and use of analytical tools without having to manipulate the database itself. In other words, the platform allows researchers and medical practitioners to develop their own analytical tools and apply them directly to the data, keeping patient confidentiality safe – “Bring your own tools to the data”, Prof. Sebire emphasized.
The goal is to eventually populate the database with all types of relevant information, including data from wearable devices, omics (genome, proteome, and metabolome), drug trials, etc., in an organised and structured platform. Then, researchers can use advanced computational tools to extract valuable information. Some examples include finding new drugs for current diseases, determining drug interactions, early diagnosis via omics-analysis, etc.
Healthcare practice involves interpretation of data. Currently, decisions such as diagnosis and treatment are made by an individual based on his/her interpretation of data, with a significant level of uncertainty. Ideally, we would like to bring the decision of a doctor to the simplest yes/no interpretation; where he/she will have access to algorithms that will facilitate diagnosing a disease, identifying the best treatments, and minimising side effects with low uncertainty.
Personnel: new job categories, new collaborators
Moving away from the status quo of healthcare resides heavily on doctors and healthcare practitioners as they are the principal point of contact between patients and healthcare systems. These individuals, for the most part, are not proficient in using data analytics and see data as a source of reference for traditional tasks such diagnosing an illness based on symptomatic observations. Thus, the first steps into technological adaptions would consist on “doing what we do now, but with technology”, making current processes quicker and more efficient.
“Do what we do now, but with technology”, however, will not revolutionise healthcare as we imagine. Real change will come from new key players. Job titles such as Chief Data Scientist, Chief Technologist, Roboticist, etc., will have to emerge in clinics and hospitals, where these individuals will be staffed alongside doctors.
What is happening now?
“DRIVE: A place for the collaboration of computer scientists, clinicians and technology experts”
One of Prof. Sebire’s roles is as director of the Great Ormond Street hospital (GOSH) Digital Research, Informatics and Virtual Environments (DRIVE) program. This project is the first of its kind in the world, and it is intended to provide a place where the individuals and technologies aiming to shape the future of healthcare will come together.
DRIVE consists of a physical space within the grounds of the GOSH hospital. However, it is purposely designed to NOT look like a hospital. Instead, it resembles a high-tech facility staffed by medical doctors and nurses alongside computer scientist and technologists. This is a visionary’s version of what healthcare could look like in the future.
DRIVE was created in collaboration with a number of leading industry experts in technology, AI and digital innovation. These industrial partners are expected to provide expertise, allowing efficient and successful adaptation of current technologies into healthcare applications. “We do not need to re-invent technologies, instead we can partner with the leading experts”, Prof. Sebire emphasized.
A significant collaboration in the DRIVE program is with University College London (UCL). UCL students can participate in DRIVE projects as part of undergraduate and master’s degree portfolios. Students work with computer scientist, industrial supervisors, and medical professionals developing solutions for real problems. Ultimately, these students could be the individuals carrying on the development of the program after graduation and beyond.
As GOSH is a children’s hospital, current DRIVE efforts focus on the well-being of children. Project Fizzyo is an example; a program intended to improve the lives of children with cystic fibrosis by using sensors inside airway clearance devices. Information obtained in real-time will lead to better understanding of the disease and more effective therapies. Children, Prof. Sebire noted, will be the main users of “the new healthcare in 20 to 50 years-time”.
Projects like HDR UK and GOSH DRIVE are examples of the way healthcare will evolve. This will take some time, nevertheless. At this moment, our main task is to digitize information ranging from patient records, drug trials, omics, etc. We are not doing it yet. We will need a commitment from healthcare’s end users. Ultimately, we hope that technology will enhance healthcare by reducing costs, facilitating the development of new therapies, and improving the overall wellbeing of individuals.
Navigating through the start-up journey
Prof. Sebire’s presentation describing how technology will be shaping the future of healthcare, was followed by a very insightful presentation by one of the individuals fuelling the rapid change in healthcare: Charlotte Casebourne. Charlotte is the CEO and co-founder of Theolytics, an Oxford University Oncology Department spinout with the mission to “Harness viruses to combat disease”….
Find Part 2 here.
Other related articles: The Internet of Things- Missing Link to Smart Healthcare
1. World Health Organization. ‘Health financing for Universal Coverage’ https://www.who.int/health_financing/topics/efficiency/system-inefficiencies/en/
2. Deloitte. ‘Data is the new Gold- the future of real estate service providers ‘ https://www2.deloitte.com/global/en/pages/real-estate/articles/future-real-estate-data-new-gold.html
3. Li, X., et al. (2017). "Digital health: tracking physiomes and activity using wearable biosensors reveals useful health-related information." 15(1): e2001402. https://doi.org/10.1371/journal.pbio.2001402