This week, the Prime Minister went to Macclesfield to pledge her support for greater use of artificial intelligence (AI) in the country’s fight against disease. According to her speech, the United Kingdom will use AI to “transform prevention, early diagnosis and treatment”, as Mrs May referred to the technology as a “new weapon” in our armoury.
There is no doubt that the transformative effect of AI in healthcare is wide-reaching. The technology has the potential to streamline drug discovery by using machine-learning algorithms to identify those molecules most likely to have a therapeutic effect; facilitate earlier detection of malignant cell growth resulting in a greater number of cancers being diagnosed at the earliest possible stage; and enable clinicians to develop a deeper understanding of disease progression to identify those patients most at risk and deploy suitable interventions to support these patients to live healthier lives for longer. However, these feel like just the tip of the iceberg, with many of its future applications still unknown.
The potential of AI has been well recognised by industry, leading to a number of pharma and biotech tie-ups, including Roche’s acquisition of Flatiron Health, as well as Pfizer’s partnership with US-based XtalPi. However, the NHS isn’t being left behind.
The Secretary of State for Health, Jeremy Hunt, has appointed Eric Topol, a renowned figure within digital medicine and genetics, to review the opportunities the NHS can unlock through harnessing AI and machine learning technologies. On Monday, UCLH NHS Foundation Trust announced it was collaborating with the Alan Turing Institute “to harness the power of data science and artificial intelligence to support clinical decisions,” and the NHS’ 111 service recently entered into a partnership with Babylon Health to pilot an AI ‘chatbot’ to effectively triage the vast number of patients currently using the service.
However, this technology brings challenges too.
NHS England’s Chief Executive, Simon Stevens, has committed to the development of two to five regional Digital Innovation Hubs to enable the NHS to maximise the potential of anonymised clinical data for driving research and innovation. However, utilising NHS data has long been discussed, and several attempts have tried, and failed, to encourage members of the public to consent to their data being used for research purposes. It would appear that the Government has now settled on a framework to allow this to happen, and it is expected that at least one Digital Innovation Hub will be up and running by the end of the year, although many expect there to be teething problems.
In addition, the NHS has historically struggled to adopt innovation at pace and scale and the Government must act now to ensure that the right infrastructure is in place to support widespread use of this technology. When App-based technology first started being developed for the NHS ten years ago, firms were told that Trusts simply did not have enough money to invest in bringing their IT infrastructure up to speed. A similar picture is already emerging in pathology as laboratories across the country struggle to become ‘digital’, a key precursor to the adoption of AI. Much of this may unravel as the country moves towards a network pathology model, enabling greater concentration of this technology in a smaller number of specialised centres.
The NHS will also have to attempt to unpick the hype from the genuine innovation. Much of the potential is currently just that – hypothetical rather than proven. The NHS as a whole has previously been wary of adopting unproven technologies. The problem is that the current assessment process for evaluating new medicines and medical devices seems ill-equipped to evaluate this type of technology. This may prove key, if the NHS is to adopt AI at the pace and scale set out by the Government’s ambition.
For now the Government must focus on ensuring the right incentives are in place to encourage biotechs to test, develop and commercialise these technologies in the UK. The Government is clearly seeking to maximise its assets - namely its world-leading academic and research institutes and the NHS itself – and has also made modest amounts of funding available. But, it must also ensure that the NHS is able to invest in these technologies in the long-term, if patients in the UK are one day to benefit.