Innovation, Sustainability and the Future of Healthcare

The days of healthcare as we know it may be limited. Recent advances in biomedical research are paving the way to precision medicine, shifting the historical medical paradigm from the search for a universal solution to the development of personalized treatments. The availability of large volumes of digitized clinical data, combined with the arrival of powerful artificial intelligence (AI) algorithms, may have even deeper implications. From diagnosis to clinical decision-making, from empowering the patient to redefining the role of the physician, big data is becoming one of the cornerstones of medical research and practice. At the same time, the world is seeing dramatic changes in demographics, life expectancy and the prevalence of certain diseases. Together, these three elements (precision medicine, big data and a rapidly changing society) are profoundly transforming the healthcare landscape. The challenge is great, and the opportunities many; and yet the details of the actual implementation are far from clear.

The studies included in this report (6 research papers and 4 case studies) show that the integration of Artificial Intelligence (AI) technologies in the European healthcare setting presents a series of unique challenges that will require large, collaborative and transparent efforts crossing boundaries of profession and geography. Although the technology is advancing quickly, issues of data sharing, privacy, biases, patients’ experiences, training and integration need to be carefully and continually addressed. The COVID-19 crisis has exposed some of the most pressing challenges affecting healthcare, and highlighted the benefits that a robust integration of digital and AI technologies in the healthcare setting may bring.

The Project

How is Artificial Intelligence reshaping Healthcare in Europe?

"Innovation, Sustainability, and the Future of Healthcare" explores the status of healthcare AI in Europe, and analyses the challenges, hurdles, opportunities and possible ways forward. The results have become particularly significant, as the current health crisis is triggering an unprecedented surge in the development and demand of digital and AI technologies worldwide. This report aims to be a step forward in the necessary discussion around healthcare AI in Europe.

Four countries dominate the digital health patent landscape in Europe: Germany, the Netherlands, the United Kingdom, and France, with Sweden following closely behind.

Germany, the Netherlands, the United Kingdom and France lead the way in patent filings in digital health, followed closely by Sweden. While in Germany and the United Kingdom big data analytics is the dominant type of patent of the three, in the Netherlands AI leads. The spread between big data analytics and AI is more equal in France and Sweden. Health patents in the Internet of Things are always a minority.

Data sharing, curation, standardization, anonymization and validation remain some of the biggest hurdles for the development of health AI applications in Europe. The percentage of health data collected digitally instead of analogically increased dramatically in the past two decades. However, most health-related datasets are unstructured and unstandardized. New initiatives and regulations are moving in the right direction, but they need to be able to adapt quickly and involve cross-disciplinary efforts.

There is little data on how the general public and professional communities perceive the potential benefits and drawbacks of healthcare AI. The success or failure of AI in playing a part in patient care, treatment or management will hinge on patient and professional acceptance of these technologies on a practical level. All available studies provide a strong and consistent message that AI innovations should be fully integrated within healthcare systems and should complement healthcare professionals, instead of replacing them.

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A proactive approach to address the education and training of the healthcare workforce is needed to realize the potential of AI.

Healthcare professionals and allied health professionals across Europe will require a spectrum of key digital literacy skills to navigate the data-rich environment of a digital healthcare system supported by the AI revolution. The strategy must take into account the changing nature of the tasks involved, the attractiveness of the career path, and the constant evolution of AI in itself.

The deployment and integration of AI-based technologies with the potential to significantly change the patient care pathway should proceed in a controlled way, with continuous monitoring and adjustment. AI applications that directly affect the patient care pathway and patient-doctor communications have the potential to be particularly disruptive and therefore require special attention. Funding schemes may need to be re-evaluated to ensure high-quality care for everyone, particularly the most vulnerable.

A series of case studies (Babylon Health, DeepMind, Aitopya and AI in the Fertility Clinic), ranging from symptom checkers to fertility applications, suggest that rigorous studies of clinical effectiveness are often lacking.

This is a global challenge that requires a concerted European effort.

1. There is significant potential for AI to revolutionize the way we experience care.

If technology is to help us address the challenges of this century, then it has to not just improve care but change how it is being delivered and experienced. It needs to change the pathways of care, for example moving treatment out of hospital into the community or into people’s homes. And for this much more collaboration is required across systems and sectors, in terms of data sharing, collaborative ways of working, and a willingness to leave behind decades-old traditions of how care is being delivered.

2. The step change in technology in healthcare has so far not reached anywhere near the same level in social and personal care.

However, the potential benefits here are no smaller than in healthcare: revolutionizing home care through digital care observations and records, connecting people to their families, upskilling carers to monitor health conditions with mobile aids, and sensor monitoring technology could genuinely make home the first place of care and even treatment. However, only if technology advances in both health and social care will we see the full benefits of integrating pathways across the two.

3. The exciting benefits of technology described in our report come with risks

These range from difficulties in testing, potential biases, the explainability of solutions, and the perceived threat to professionals and the caring relationship they have with patients. Most importantly, unlike other technology sectors, healthcare does not allow us to “move fast and break things”—people’s well-being and lives are not the right subject for agile iteration. But these risks cannot become a reason to not pursue technology’s benefits. As discussed across the multiple studies included in this report, what is required is an open, mature conversation between policy makers, professionals, technology developers, patients and the general public about the benefits and risks of this exciting future.

 

The Center for the Governance of Change is fully committed to producing scientifically rigourous research, conducted with integrity, full transparency, and outside of any commercial interests. None of the funding bodies have, or wish to have, any power over the results of the research, outputs, and final conclusions of the programme.

Research Team

Mireia Crispin

University of Cambridge

Javier Lezaun

University of Oxford

Arantxa Unda

Sigesa

Javier Ellena

Talento Farmacéutico

Malte Gerhold

Care Quality Commission

Saif Ahmad

University of Cambridge

Samantha Law

London School of Hygiene and Tropical Medicine

Stevan Cirkovic

Human Fertilisation and Embryology Authority

Amanda Sissons

League Inc

Filippo Pesapane

IEO Istituto Europeo di Oncologia

Chris Goldsworthy

University of Oxford

Adam Berman

University of Cambridge

Brent O'Carrigan

University of Cambridge

Dina Halai

Human Fertilisation and Embryology Authority

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