{"id":44618,"date":"2019-05-16T09:16:03","date_gmt":"2019-05-16T08:16:03","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=44618"},"modified":"2019-05-23T16:28:21","modified_gmt":"2019-05-23T15:28:21","slug":"tom-hardie-the-promise-of-greater-automation-in-healthcare","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/05\/16\/tom-hardie-the-promise-of-greater-automation-in-healthcare\/","title":{"rendered":"Tom Hardie: The promise of greater automation in healthcare"},"content":{"rendered":"<p><span style=\"font-weight: 400\"><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/05\/Tom_Hardie.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-44620\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/05\/Tom_Hardie.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/05\/Tom_Hardie.jpg 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2019\/05\/Tom_Hardie-150x150.jpg 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/a>There is an urgency around the use of technology to transform healthcare at the moment<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">with Matt Hancock\u2019s technology vision, the development of NHSX, and clear aspirations for technology articulated in the <\/span><i><span style=\"font-weight: 400\">NHS Long Term Plan<\/span><\/i><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The greater use of automation is part of that vision.<\/span><\/p>\n<p><b>What is the potential of automation in healthcare?<\/b><\/p>\n<p><span style=\"font-weight: 400\">Automation is not a new concept and has its roots in the industrial revolution. Traditionally, routine repetitive manual tasks were performed by machines with minimal human input. Think of car assembly lines and ATMs. In health, computers and other technology have been used to automate billing, pill counting, and the continuous monitoring of patients\u2019 vital signs in hospital.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Advancements in robotics and AI (aided by big data and increased computing power) are extending the boundaries of what is possible, both in the realm of automating physical tasks, and increasingly, tasks that require cognitive skills and abilities to perform. [1]<\/span><span style=\"font-weight: 400\"> At the <\/span><a href=\"https:\/\/www.health.org.uk\/about-the-health-foundation\"><span style=\"font-weight: 400\">Health Foundation<\/span><\/a><span style=\"font-weight: 400\">, we are seeing the potential of automation in a range of areas of healthcare:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Reducing the burden of administrative work: <\/span><a href=\"https:\/\/healthautomation.oii.ox.ac.uk\/\"><span style=\"font-weight: 400\">Research by Oxford University<\/span><\/a><span style=\"font-weight: 400\">,<\/span><span style=\"font-weight: 400\"> due to publish in the next few months, shows that automated systems could be particularly helpful in high volume and frequent tasks such as telephone answering, letter writing, and information filtering. Many believe this could release time for clinicians to care for and interact with patients<\/span><span style=\"font-weight: 400\"> and make workloads more manageable. [2]<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Improving diagnosis and treatment: <\/span><a href=\"https:\/\/www.health.org.uk\/improvement-projects\/personalised-medicine-analytics-dashboard-for-triaging-patients-in-emergency-departments\"><span style=\"font-weight: 400\">Barking, Havering and Redbridge University Hospitals NHS Trust<\/span><\/a><span style=\"font-weight: 400\"> is developing a system to assist the emergency department triage process by quickly identifying high-risk patients needing urgent care.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Improving the management of resources: In the context of patient flow, <\/span><a href=\"https:\/\/www.health.org.uk\/improvement-projects\/a-learning-health-system-approach-to-avoiding-acute-occupancy-crises\"><span style=\"font-weight: 400\">Northwest London CLAHRC and Imperial College London<\/span><\/a><span style=\"font-weight: 400\"> are building a model to analyse a range of data in real time and make predictions about when high levels of acute bed occupancy might be likely, automatically alerting staff in advance.<\/span><\/li>\n<\/ul>\n<p><b>Getting automation right<\/b><\/p>\n<p><span style=\"font-weight: 400\">Although it is tempting to be swept up in the promise of automation, there are some important questions to consider<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">taking a holistic view<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">if we are to reap the benefits.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Some of these revolve around quality and safety. For patient-facing application of automation technologies, such as symptom checkers, evidence from real-world testing will need to demonstrate they are safe, effective, and provide a good user experience for all. It is crucial that new technology does not entrench or worsen health inequalities, for example, by excluding people with low levels of digital literacy. As the Good Things Foundation note, 11.3m people in the UK do not have basic online skills, and are more likely to be older, poorer, live with disabilities and to need healthcare services. [3]<\/span><\/p>\n<p><span style=\"font-weight: 400\">Another important question relates to the impact of automation technologies on the workforce. While much of the broader debate on automation assumes technologies will replace human roles, in healthcare it is more often about automation augmenting what staff can do. In this context, how do we ensure that automation is useful and empowering for staff and does not have an adverse impact on their workloads or their ability to perform their jobs?<\/span><\/p>\n<p><b>How do we successfully embed automation?<\/b><\/p>\n<p><span style=\"font-weight: 400\">Finally, how do we successfully embed automation which has been evaluated, and shown to be successful, on the frontline? Experience shows that effective implementation of technologies in a highly complex sector like health care is challenging and will not be achieved quickly. This goes beyond technical issues that will need to be addressed such as software, hardware, interoperability and training. Critical also will be ensuring staff have the time to engage in the work of redesigning clinical pathways and workflows to accommodate the technology, a crucial factor that is often underestimated. [4]<\/span><\/p>\n<p><span style=\"font-weight: 400\">More work is needed to address the many challenging questions that automation presents while at the same time capitalising on the benefits. Alongside the BMJ, we\u2019ll be exploring these issues as part of <\/span><b>Twitter chat on Tuesday 21 May, 20:00-21:00.<\/b><span style=\"font-weight: 400\"> (#NHSautomation <a href=\"https:\/\/twitter.com\/HealthFdn\">@HealthFdn<\/a> <a href=\"https:\/\/twitter.com\/bmj_latest\">@bmj_latest<\/a>). I hope you can join us.<\/span><\/p>\n<p><b>The opportunities and challenges around AI, automation and other emerging technologies in the NHS will be discussed at <\/b><a href=\"https:\/\/www.health.org.uk\/event\/the-health-foundations-annual-event-2019\"><b>the Health Foundation annual event 2019<\/b><\/a><b> on Thursday 23<\/b><b>rd<\/b><b> of May.<\/b><\/p>\n<p><b>Keynote sessions from the event will be livestreamed and you can register now to watch them <\/b><a href=\"https:\/\/www.health.org.uk\/about-the-health-foundation\/get-involved\/events\/livestream-sessions-the-health-foundation-annual\"><b>here<\/b><\/a><b>. <\/b><\/p>\n<p><span style=\"font-weight: 400\"><em><strong>Tom Hardie<\/strong> is the Health Foundation&#8217;s Improvement Fellow<\/em>. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Twitter: <\/span><a href=\"https:\/\/twitter.com\/tlhardie1?lang=en\"><span style=\"font-weight: 400\">@tlhardie1<\/span><\/a><\/p>\n<p><em><strong>Competing interests<\/strong>: None declared<\/em><\/p>\n<p><strong>References:<\/strong><\/p>\n<p>1] A Future that Works: Automation, Employment, and productivity. McKinsey Global Institute, January 2017<br \/>\n2] Willis, M., P. Duckworth, A. Coulter, E.T. Meyer, and M. Osborne. (2019). The Future of Health Care: Protocol for Measuring the Potential of Task Automation Grounded in the National Health Service Primary Care System. Journal of Medical Internet Research Protocols, vol. 8, no. 4. doi:10.2196\/11232. Topol E. The Topol Review: Preparing the healthcare workforce to deliver the digital future. Health Education England, 2019; Fogel, Alexander L.Kvedar, Joseph C, Artificial intelligence powers digital medicine npj Digital Medicine 2018\/03\/14<br \/>\n3] Davies, R. Topol v Marmot. Medium. https:\/\/medium.com\/@roz.davies_16098\/topol-v-marmot-a954d19bd87c<br \/>\n4] The Spread Challenge, Health Foundation, September 2018.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>There is an urgency around the use of technology to transform healthcare at the moment\u2014with Matt Hancock\u2019s technology vision, the development of NHSX, and clear aspirations for technology articulated in [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/05\/16\/tom-hardie-the-promise-of-greater-automation-in-healthcare\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":43601,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236],"tags":[],"class_list":["post-44618","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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