Patient care set for AI shot in arm
By using data to unlock valuable insights, there is an incredible opportunity to accelerate medical breakthroughs
The demonstration by nurse Florence Nightingale of the link between poor sanitary conditions and high mortality rates in hospitals, and her pioneering use of data collection and visualisation, still resonates today.
In 2018, medicine faces a different set of challenges, with longer life expectancies and population growth increasing the number of patients suffering with chronic conditions requiring ongoing care.
This has led to the cost of delivering health care increasing faster than GDP and quickly becoming unsustainable.
More than 160 years have passed since Nightingale was a British Army nurse, but addressing these challenges still depends on data.
By using it to unlock valuable insights, there is an incredible opportunity to accelerate medical breakthroughs and improve patient care.
Over the past decade, much focus has been on digitising records. While this has improved operational performance, it has not really transformed the way services are delivered to patients.
Health is data rich and information poor. By applying cognitive technologies such as artificial intelligence (AI) to the data, the sector can shift from traditional reactive treatments to a more proactive health system that is based on prevention, wellness, faster diagnosis and precision medicine.
Nicholas McQuire, the vice-president for enterprise research at analyst firm CCS Insight, sees AI "radically transforming the health-care industry over the next five years.
"AI will bring important improvements in operational effectiveness, care delivery and, above all, patient outcomes.
"It will also be a vital tool in helping solve some of our most challenging health-related problems, not least how to balance restricted budgets and reduced workforces against the growth of chronic conditions," he says.
Evolving approaches to cancer illustrate the way in which AI can revolutionise the health-care sector. Historically considered an acute terminal illness, medical knowledge is improving to the point where most cancers are classified as highly treatable conditions.
According to the World Health Organisation 30%-50% of cancer deaths could be avoided with prevention, early detection and treatment.
With cancer costing the global economy an estimated $1.16 trillion a year, oncology has become one of the most advanced areas of precision medicine. Project InnerEye, used by Addenbrooke Hospital in Cambridge, UK, uses two core branches of AI — machine learning and computer vision — to analyse radiological images.
Designed to identify tumours in seconds, Project InnerEye can help speed up diagnosis and improve the delivery of treatments by providing exact delineation between cancerous tissue and healthy anatomy.
It also promises to provide better monitoring of disease progression during treatments so they can be adjusted in line with how patients respond.
This has the potential for more targeted and effective chemotherapy with fewer side-effects for patients.
Advances made in genetic medicine now include the genome sequencing of individual patients and tumours, allowing personalised diagnosis and treatment. Due to the complex range of genetic mutations responsible for cancer, the specialist skills needed to interpret genome information and the high volume of new cancer cases, it is not currently scalable for use with every patient.
St Jude Children’s Research Hospital in Memphis, US has turned to the cloud to facilitate data sharing with global research communities. Working with Microsoft Research’s genomics group, computational biologists from the hospital developed an online platform that can manage vast quantities of anonymised genomic data.
By comparing raw genomic data with reference genomes to identify where they differ, researchers hope to identify the variants responsible for cancers, and make progress towards eventually finding a cure.
Discovering that only 8% of heart surgery patients were following doctor’s orders after leaving hospital, the Helsinki and Uusimaa Hospital District tackled this issue by creating several online "hubs" for the management of remote-care plans. These range from monitoring the use of medication and therapies, to providing virtual consultations with specialists.
"We have no way of analysing what’s happening, what’s useful … and how people are accessing and experiencing these services," says Uusimaa hospital district’s director of strategic development, Visa Honkanen. "By using machine learning to analyse the data, we will be able to direct patients to the right place right away, see which of our digital tools work best, abandon the tools that aren’t working, and focus on the most promising ones."
While AI presents many benefits for health care, there are important considerations that need to be taken into account. Former WHO director-general Margaret Chan warns that "artificial intelligence is a new frontier for the health sector… The potential of AI in health care is huge, but so is the need to take some precautions."
Delivering real value with AI depends on access to a bank of patient information — a sensitive resource that needs to be safeguarded. The EU’s new General Data Protection Regulation guidelines provide a great benchmark standard, but medical professionals, regulators and policymakers will need to address the issue of "secondary" uses for health data — not relating to the patients direct care.
Ensuring that privacy and data protections are systematically implemented will be vital for continued improvement of health care and public health. Microsoft was the first major cloud provider to incorporate an international code of practice for cloud privacy, ISO/IEC 27018, and backs those protections with contractual commitments.
Technology and health care are collaborating to create a medical sector fit for the 21st century. By helping the public play a more active, informed role in the care relationship, and empowering health professionals with the best information, AI will drive services that are more effective, efficient and accessible than before.
• Kos is Microsoft’s chief medical officer.