London NHS trust using Google AI tech to treat patients

Doctors at a London hospital say lives could be saved and patient safety dramatically improved thanks to a partnership between the Royal Free London NHS Foundation Trust and British technology company DeepMind.

The five-year agreement will see some of the best minds in healthcare and technology working together to transform care through a mobile clinical application called Streams, which will deliver improved outcomes by getting the right data to the right clinician at the right time. Like breaking news alerts on a mobile phone, the technology will notify nurses and doctors immediately when test results show a patient is at risk of becoming seriously ill, and provide all the information they need to take action.

As the technology is developed, the Royal Free London and DeepMind – the artificial intelligence arm of Google – believe Streams will:

Speed up the time to alert nurses and doctors to patients in need, down from hours to a few seconds, helping to reduce the 10,000 people a year who die in UK hospitals through entirely preventable causes.

Free up clinicians’ time from juggling multiple pager, desktop-based and paper systems, redirecting over half a million hours per year towards direct patient care at the Royal Free London. This is the equivalent of having over 150 more nurses focusing on patient care.

Work on Streams started just over a year ago, and in that time clinicians from the Royal Free London and technologists from DeepMind have taken it from idea to reality, designing a prototype version of the app to help clinicians detect acute kidney injury (AKI) at its earliest stages, to prevent serious illness and death. It is estimated that treating AKI costs the NHS in excess of £1bn a year.

Following prototype testing, as well as registration with the Medicines and Healthcare products Regulatory Agency (MHRA), this first version of Streams is ready to be deployed to clinicians across the Royal Free Hospital sites early in 2017. It is expected to result in an immediate improvement in AKI-related patient safety and outcomes.


Task management

Under the new five-year partnership, additional features such as clinical task management will be added to Streams and it will be used to support doctors and nurses in caring for patients at risk of other illnesses such as sepsis and organ failure.

It will also put the most important patient information in the palm of clinicians’ hands, allowing them to view and update records and assign clinical tasks to each other from their mobile – with no more shuffling through paper, pager alerts and multiple desktop systems. The Royal College of Physicians has reported that two in five doctors in training consider the administrative burden of their jobs to have a serious negative impact on patient safety in their hospital. Streams technology could substantially reduce this, enabling doctors and nurses at the Royal Free London to redirect an estimated 500,000 hours per year into direct patient care.

David Sloman is chief executive of the Royal Free London which was recently named as a ‘global exemplar’ in health technology by the Department of Health. As part of this, the trust pledged to invest in technology, digital infrastructure and training for staff, which will help make its services more efficient and easier for patients to access.

Sloman said: “We are hugely excited by the opportunity this partnership presents to patients and staff. We want to lead the way in healthcare technology and this new clinical app will enable us to provide safer and faster care to patients – which will save lives.

“Doctors and nurses currently spend far too much time on paperwork, and we believe this technology could substantially reduce this burden, enabling doctors and nurses to spend more time on what they do best – treating patients.”


Data security

The partnership will also introduce an unprecedented level of data security and audit. All data access is logged, and subject to review by the Royal Free London as well as DeepMind Health’s nine Independent Reviewers. In addition, DeepMind’s software and data centres will undergo deep technical audits by experts commissioned by its Independent Reviewers.

Furthermore, DeepMind is developing a new infrastructure that will enable ongoing audit by the Royal Free London, allowing administrators to easily and continually verify exactly when, where, by whom and for what purpose patient information is accessed. This is being built by one of the world’s leading security engineers, Ben Laurie, co-founder of the OpenSSL project which enables encrypted connections to websites around the world (familiar to millions through the padlock in their browser bars).

The infrastructure that powers Streams is built on open and interoperable standards, allowing the Royal Free London to have other developers build new services that integrate more easily with their systems. This will dramatically reduce the barrier to entry for developers who want to build for the NHS, opening up a wave of innovation – including the potential for the first artificial intelligence-enabled tools, whether developed by DeepMind or others.

DeepMind co-founder Mustafa Suleyman said: “We’re working with the Royal Free to give clinicians the information they need at their fingertips, saving time and alerting them to patients in need in seconds not hours.

“Privacy and trust are paramount, and we’re holding ourselves to an unprecedented level of oversight by publishing our agreements publicly and engaging nine respected public figures to scrutinise our work in the public interest.”

David Myers, president of the Royal Free Kidney Patients Association, said: “As a kidney patient for more than 25 years I am really excited about the potential of the Streams AKI app. This seems to me something that will revolutionise the speed with which AKI patients will be cared for. I think this system could not only save lives but could improve patients’ chances of living longer whilst reducing their stay in hospital. This must not only benefit patients by ensuring that they receive the correct care immediately but also should reduce the cost of caring for patients if AKI incidents are recognised at an early stage.”

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