As part of a series of briefings to mark the 70th anniversary of the NHS, a new report What will new technology mean for the NHS and its patients? has been released today by the Health Foundation, Institute for Fiscal Studies, the King’s Fund and Nuffield Trust.
It identifies four trends that could lead to improvements in health:
- genomics and precision medicine
- remote care
- technology-supported self-management, and
- data with AI.
The report raises a series of questions for the NHS to consider, including for governance, ethics and investment. Here are some key issues most relevant to the collection and use of patient data.
Patients are increasingly able to monitor and better manage their own health thanks to a growth in patient-facing apps. There are potential benefits to individual care (for example, through monitoring health management more reliably) and for health research (through the generation of longitudinal health data).
There is potential for technology companies to target both patients and the healthcare system with apps and wearables. This raises the question of what balance there may be between NHS investment and individuals investing in health products, as well as how differing products may or may not link up. New opportunities for patients generating and using their own data may have an impact on their relationship with healthcare professionals.
The report outlines a wide range of potential uses for data in the NHS in the future, as well as barriers to their uptake, including:
- Embedding best practice in clinical protocols, for example through Electronic Health Records prompting clinicians to take a stepwise approach to booking scans, arranging lab tests and administering drugs.
- Linking data to better understand disease in different population groups.
- Using patient data from larger groups who are typical of the population as well as patients enrolled in Randomised Control Trials (RCTs) to better study the safety and effectiveness of new treatments.
- Enabling early intervention for at-risk patients through better patient monitoring.
The report includes results of a survey into public attitudes towards data use. It says “people are generally happy for their data to be shared between professionals who are caring for them – and indeed many assume that this is already the case”. This aligns with other public attitudes research, which we summarise here.
The polling found low support for commercial organisations accessing health data to undertake health research. It shows a decrease in support compared to a similar survey conducted by Wellcome and Ipsos MORI in 2016. It also found that “relatively few people know much about how commercial organisations use data”. Knowledge of how the NHS uses data was also “fairly poor”.
This low level of awareness “suggests transparent public dialogue is needed over how data is used currently; what the opportunities are for the future; and how risks can be mitigated”. Understanding Patient Data exists precisely to help support this kind of public dialogue.
Artificial Intelligence (AI)
Looking to the immediate and longer-term future, the report outlines the potential of several branches of AI technologies to offer health improvements. These include automating back office functions, potentially providing triage services and using algorithms to interpret images and scans more efficiently. Overall, the polling showed broad support for computer analysis of medical records to aid diagnosis.
However, the ethics and governance of AI technologies are complex and it will be important for the NHS to carefully consider how these technologies should be developed and deployed.
Governance, infrastructure and acceptability
The report concludes that where technology could to lead to fundamental changes in health care much of that potential “depends on legislation, NHS infrastructure, the political context and public expectations.”
The full report can be found here.