What I Read This Week (w/c 9th Sept 24)
Alastair Allen
Partner, Head of Healthcare Technology at EY | Board Member at openEHR UK
Lord Darzi's independent investigation of the NHS in England, a speech by the Prime Minister on addressing the current state and future of the NHS, and insights into the HSE's AI trial aimed at reducing winter admissions. Plus, announcements from Apple, Workday and Cerner.
Lord Darzi's independent investigation of the NHS in England
In an investigation for the Secretary of State for Health and Social Care, Lord Darzi provides a comprehensive yet critical overview of the NHS. The report highlights that the NHS is in a dire state, with substantial issues in areas such as patient access, the quality of care, and overall performance. Public satisfaction is at an all-time low, waiting times have surged across GP, community, mental health, and hospital services, and there are severe backlogs exacerbated by the COVID-19 pandemic.
Factors contributing to this situation include underfunding, lack of capital investment, the aftershocks of the pandemic, insufficient patient and staff engagement, and inadequate management structures. Despite these challenges, the NHS remains fundamentally strong, sustained by a dedicated workforce and strong clinical standards. The report calls for substantial reforms, including better capital investment, enhanced patient and staff engagement, technological upgrades, and improved productivity in hospitals. Although recovery will take time, the report stresses the importance of reviving the NHS for future generations.
PM speech on the NHS
Following the publication of Lord Darzi's report, Prime Minister Keir Starmer delivered a speech at the King’s Fund addressing the current state and future of the NHS. Lord Darzi's independent report highlighted severe failings within the NHS, demonstrating a significant decline in public satisfaction and the overall condition of the service, resulting in avoidable deaths and mounting economic costs. Starmer emphasised the critical need for long-term reform rather than short-term fixes, stressing that the NHS is fundamentally the right healthcare model but not effectively harnessing technology and data. His proposed "Ten-Year Plan" focuses on three primary areas: transitioning to a digital NHS, shifting more care to community settings, and prioritising prevention over treatment. He underscored the role of technology, integration of health and social care, and robust prevention measures. Starmer reaffirmed the commitment to the NHS’s founding principles, promising necessary investment contingent on substantial reforms, and called for collaborative efforts with healthcare professionals and patients to revitalise the NHS.
HSE uses AI in trial to reduce winter admissions, says tech head
The Health Service Executive (HSE) is trialling the use of artificial intelligence (AI) to reduce winter hospital admissions, according to Damien McCallion, the HSE's chief technology and transformation officer. The trial aims to identify patients most at risk of hospitalisation during the winter and pre-emptively link them with appropriate care teams. This initiative uses data from various sources, including primary care reimbursements and hospital records.
McCallion highlighted that the HSE is rolling out numerous innovative digital projects, particularly in data and analytics, to enhance healthcare services. The analytics team is also leveraging healthcare data for population health planning, considering demographic and health information variations across different regions.
The HSE's digital healthcare framework, introduced earlier this year, includes the implementation of electronic health records, a patient mobile app, and increased telemedicine services. Despite concerns about data security following the major 2021 cyberattack, the HSE has strengthened its cybersecurity measures and hired external expertise.
Ireland has been considered slow in digitising its health service, but McCallion is optimistic about ongoing improvements in digital healthcare access.
Patients may be able to opt out of sharing their data with the FDP
NHS England may need to allow patients to opt out of sharing their data with the Federated Data Platform (FDP), following legal advice that key components lack a lawful basis. The issue centres on privacy-enhancing technology (PET) provided by IQVIA, which reportedly requires a separate legal basis to process personal confidential data. Without a solution, patients must be given the option to opt out under current legislation. The FDP board is seeking further legal advice and working on an approach to address the legal challenges. Despite these concerns, NHS England maintains that the FDP has the potential to significantly improve healthcare by integrating various data sources.
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Workday Sees Continued Momentum Across Healthcare
Workday, Inc. has reported continued momentum within the healthcare sector due to increased demand for its solutions, aimed at advancing the future of healthcare. Numerous mid-sized healthcare organisations are adopting Workday's financial management, human capital management, and supply chain management solutions to improve efficiency, attract talent, and enhance patient care. John Kravitz, Vice President of Healthcare at Workday, highlighted that addressing supply chain issues, staffing shortages, and patient-centred care are driving the need for updated data and technology systems. Is this the start of a wider play into healthcare for Workday?
How Oracle Health differs from Epic, per Larry Ellison
Oracle Health distinguishes itself from its main competitor, Epic, in the EHR market through its advanced user interface, according to Oracle co-founder and CTO Larry Ellison. During a recent earnings call, Ellison highlighted the integration of artificial intelligence across Oracle’s healthcare software, enabling functionalities such as pre-visit summaries and voice-activated commands. For instance, doctors can request patient X-rays using voice commands, and the system employs facial and voice recognition for user authentication.
Oracle Health, previously known as Cerner, has been in a public dispute with Epic, criticising its rival’s lack of interoperability. Despite this, Epic has continued to increase its market share among hospitals, reaching 39.1% in 2023 compared to Oracle Health's 23.1%. Epic has also recently acquired nine new health system clients from Oracle Health.
Addressing a question on monetising generative AI software, Ellison clarified that AI is integral to all Oracle Health applications, including diagnostic systems, pharmacy systems, and user authentication. He expressed disbelief at companies charging separately for AI features, emphasising that Oracle Health’s applications are inherently AI-driven.
Apple introduces new health features
Apple has unveiled new health features for the Apple Watch and AirPods Pro 2 intended to support sleep and hearing health, addressing conditions that affect billions globally. The Apple Watch now includes sleep apnea notifications utilising a new Breathing Disturbances metric and expected to gain regulatory approval soon.
The AirPods Pro 2 introduces an all-in-one hearing health experience, featuring active Hearing Protection, a clinically validated Hearing Test, and an over-the-counter Hearing Aid capability. These hearing features, expected to be authorised and available in over 100 regions this autumn, include software that simplifies access to hearing assistance.
Small Language Models vs. Large Language Models in Healthcare
I believe the future of AI will see the integration of smaller more specialised models, that solve specific problems, leveraging Retrieval-Augmented Generation to retrieve relevant content from external data sources. This article explores the idea of Large language models (LLMs) vs Small Language Models (SLMs). LLMs such as ChatGPT, use AI to answer a wide range of queries due to their extensive data parameters. In contrast, small language models (SLMs) specialise in specific tasks with smaller datasets, offering efficiency in computation and better data privacy. For example, hospitals can use SLMs to enhance clinical documentation by extracting relevant patient data, which can then be saved into electronic health records.
Thanks Alastair. Great to read about stuff I haven’t read but also to compare your interpretations and analysis of things I have. The SLM v LLM is very interesting as I hadn’t seen it.
Honorary Professor in Engineering & Applied Science at Aston University
2 个月Great review. Thanks for sharing Alastair