Dr Campbell Rogers, executive vice president and chief medical officer, HeartFlow, explores how technology can help hospitals to reduce waiting times and reach a disease diagnosis more quickly.
The NHS expects its patient waiting list to double from 4.2 million to 10 million by Christmas. This is a consequence of the pandemic where hospitals have been challenged with a backlog of cases, staffing shortages and social distancing while treating patients. The experience has changed the NHS forever.
The situation has forced the public health service to rely on digital technologies in a new way. Much of this strategy has been led by NHS digital, which promoted the use of video and online portals to great success for staff and patients. The plan was clear: patients should be able to get advice and care without visiting a GP practice, unless in-person care is clinically required. As a result, use of services such as the NHS App increased by 111% from February to March alone. Going forwards, virtual appointments and online assessment tools will continue to be important for patients and day to day practises.
The pandemic has also triggered more strategic use of data. For example, Morecambe Bay NHS Foundation Trust now tracks patients and staff throughout the three hospitals it manages with an app it developed alongside technology partner, Qlik. The tool helps the Trust’s information team track the journey of a patient through the facility, so they can monitor and communicate if a patient or staff member has become exposed to Coronavirus.
As lockdown eases and the number of deaths from coronavirus continues to fall, attention is starting to turn to how elective services can resume. Technology and the data it unlocks will become more important to clinicians seeking to offer the best patient care – while juggling high demand.
There’s an opportunity for digital technologies to demonstrate their importance when it comes to triaging patients and using hospital time and resources more effectively. This moves the conversation forward – from maintaining and growing the use of digital services, to NHS Trusts embedding wider use of AI technologies in routine practice and fostering new partnerships with healthtech firms.
The case for AI post COVID-19
AI technologies have already been making waves in the NHS over the past few years, particularly in cardiac care. The HeartFlow Analysis is one of these innovations. Available in over 50 NHS England hospitals, the non-invasive technology takes data from a coronary CT, uses deep learning (a form of artificial intelligence) and a team of highly trained analysts to create a digital, 3D model of a patient’s arteries. The technology then solves millions of complex equations to provide a measurement of blood flow in the coronary arteries, identifying areas where flow may be compromised. It assists medical professionals with the diagnosis of coronary heart disease (CHD), and can negate the need for some invasive procedures such as angiograms.
The availability of this technology has spurred further conversations in the cardiology community on the practicalities of adopting a CT-first approach to diagnosing CHD. The UK is one of the first countries in the world to adopt this approach, which improves outcomes for patients because it reduces the reliance on invasive diagnostic procedures. During COVID-19, when many NHS Trusts have reported anecdotal decreases in the number of patients coming to the hospital despite symptoms of CHD, the HeartFlow Analysis helps medical professionals to shape powerful arguments as to how patients can receive a faster diagnosis with a single visit to the hospital.
Now, new data from the British Heart Foundation has reported half of patients with heart disease have found it harder to get treatment in lockdown, with approximately 28,000 delayed procedures. These are concerning figures, and in light of an inevitable, expanding waiting list because of COVID-19, it’ll become more important than ever to help hospitals to manage their waiting list while ensuring delayed procedures can be scheduled.
The HeartFlow Analysis makes it possible to diagnose CHD accurately with a single patient visit. If cardiologists determine that more information is needed to make a definitive diagnosis, then they are able to directly send images from CT scans to HeartFlow, requiring no additional patient time in the hospital or risk of exposure to staff or patients. Anatomical information from a CT scan and functional information from HeartFlow helps physicians to determine which patients can be treated with medication alone, which means that they won’t always need to come back to the hospital.
The long-term impact of AI
Digital technologies will be key to managing patients in a way that prioritises those most in need of treatment, while improving patient care overall. The use of CT and HeartFlow will help identify those patients who need to go to the catheterisation lab and reduce their reduce wait times. Even before the pandemic, evidence across a number of sites using the HeartFlow Analysis found it was greatly reducing wait times and helping hospitals deliver definitive CHD diagnoses to patients quickly.
Modern healthcare is inexorably linked to technological innovation. HeartFlow is currently working with academics at Imperial College London on collaborative research projects to further develop the application of AI techniques to medical imaging. Developments rooted in AI are leading the way and helping to make the diagnostic process more accurate and efficient. By working with academic institutions, consumer trust in healthtech and use of data will increase, as universities help to improve performance and ensure rigorous research is undertaken.
Technology will undoubtedly play a vital role in helping to tackle the health challenges over the course of the next ten years and there’s almost unlimited scope for further development.
However, AI will not replace the need for healthcare workers. Trained medical minds will always be integral to the interpretation and application of data that such innovations produce. In their hands, innovation truly has the potential to improve and save countless lives.
To this end, medtech will augment the roles of doctors and become a key part of their day-to-day jobs. For example, when it comes to medical imaging, a physician can only realistically process a maximum of 5% of the data from each image they review. Technology helps medical professionals see the bigger picture and hugely increases capacity to interpret what is actually going on in a patient’s body. A better understanding of technology is therefore necessary amongst the medical profession, and digital healthcare modules should be incorporated into medical degrees. Furthermore, as AI technologies are increasingly adopted, we could also see data scientists employed in hospitals to help clinicians with examinations. More broadly, jobs will be created to support these new technologies that we can’t even contemplate yet.
Conclusion
With Al technologies already deployed in hospitals across the country, doctors and medical professionals are seeing first-hand how they can increase their responsivity and agility. Digital tools will become essential when triaging patients in the long term, and right now they will play a critical role in clearing patient backlogs in response to COVID-19.
The NHS works closely with the med-tech sector as part of its ongoing efforts to provide world-leading patient care. This collaboration has created an ecosystem that fosters innovation, and we’ll see greater development across AI and deep learning technologies that don’t just help to control patient waiting lists but improve patient care overall.
