NHS needs a “binding code of conduct” for those implementing AI technologies

Profile picture for user ddpreez By Derek du Preez February 10, 2019
Expert Dr Topol was asked by the Secretary of State for Health and Social Care to carry out an independent review of a digital future for the NHS, with a strong focus on AI.

Health NHS
Health Education England, on behalf of the NHS, has published the independent review into the health service’s digital future this week. Carried out by Dr Topol, the review highlights the need for a “binding code of conduct” for NHS staff implementing AI and data-driven health technologies.

This isn’t the first time that the idea of a ‘Hippocratic Oath’ for AI in healthcare has been touted, given the ethical implications of technology and data driven decision making in the NHS.

Dr Topol’s review is broad ranging and covers much more than the potential and implications of automation, but unsurprisingly it’s the role of AI across the NHS that’s grabbing the headlines.

The review also states that whilst AI has the potential to transform the delivery of healthcare in the NHS, “significant changes to the roles and responsibilities of current and future NHS staff will also be needed”.

The report notes that AI has the potential to streamline workflow processes, improve the accuracy of diagnosis, personalise treatment, as well as help staff work more efficiently and effectively. It adds that a mix of artificial and human intelligences can be deployed to generate a “greater collective intelligence”.

Commenting on the report, Matt Hancock, Secretary of State for Health and Social Care, said:

“I love the NHS and I’m determined to support the dedicated staff that make it what it is today. Our health service is on the cusp of a technology revolution and our brilliant staff will be in the driving seat when it happens.

Technology must be there to enhance and support clinicians. It has the potential to make working lives easier for dedicated NHS staff and free them up to use their medical expertise and do what they do best: care for patients.

“Technology will make the NHS the best in the world and I want everyone who works in the health and care system to be empowered to embrace it – from porters to pathologists, surgeons to social care workers.

“I would like to thank Dr. Topol for his crucial report, which will act as a blueprint as we implement our Tech Vision and Long Term Plan for the NHS, and bring about a brighter future and better NHS for everyone.”

Hancock was previously Secretary of State for Digital at DCMS before being promoted to the Department for Health and Social Care. Since joining he’s brought with him some ambitious tech plans, including a focus on predictive prevention in the NHS, as well as a cloud first strategy.

What’s needed

The Topol Review states that a benefit of systematically implementing AI and robotics in the NHS will be the automation of tasks viewed as mundane or repetitive, that do not require much human cognitive power. Additionally, AI or robotics may automate tasks that go beyond human analytical or physical capabilities.

Both of these applications, the review notes, will leave the workforce to focus on tasks that are considered ‘uniquely human’, especially human-to-human interaction and care.

That being said, Topol highlights that there are significant barriers to the deployment of AI and robotics within the NHS, not least “NHS data quality, information governance and a lack of expertise in AI and robotics”.

The review argues that the following are required in order to make AI implementation a success across the health service:

  • the digitisation and integration of health and care records;
  • the provision of a binding ‘code of conduct’ (a core set of ethical principles and commitments) for those designing and implementing data-driven health and care technologies into the NHS;
  • guidance of ‘evidence for effectiveness’ which helps regulators, commissioners, procurers, managers and clinicians in the NHS to evaluate, regulate, purchase and use data-driven technologies.

In addition, Topol believes that there is also the need for specific workforce learning in three key areas:

  • knowledge and skills in data provenance, curation and governance;
  • knowledge and understanding of the ethical considerations in using data-driven and robotic technologies for healthcare;
  • critical appraisal of digital healthcare technologies – understanding how the technology works, including the statistics underpinning machine learning and its outputs, and the potential biases.

The review adds that “continuing professional development throughout each individual’s career is essential to reinforce and update learning, complemented by deeper dives into specialist training where appropriate”.

Commenting on his report, Dr Topol said:

“Over the next twenty years three changes will inevitably happen: more and more people will have their genome sequenced; patients will generate and interpret much more of their own health data at home; and the speed, accuracy and scalability of medical data interpretation from artificial intelligence will grow exponentially.

“These developments will change patients’ lives, change how clinicians work and change how healthcare services are delivered. This is happening now and the NHS is ideally placed to take it further, faster and wider if we act to give our staff the skills and knowledge they need to make them the norm across the NHS.

“I believe, this revolution has the potential, if grasped, to greatly strengthen patient-doctor relationships, release more professional time to care more, and reduce the burnout we can see in a significant proportion of clinicians today.”