NHS watchers hoping for a single technology that can solve the many challenges facing the health service are likely to be disappointed.
"It's quite tough – I don't think there's any one specific technology," says Dr Sam Shah, director for digital development at NHS England. "The reason I say that is the NHS deals with 56 million patients, all of whom have very different and disparate needs. I think we'll see that different emerging technologies are best-suited to individual use cases."
But the stakes are high with the increasing demands on the NHS in an age of austerity.
"If we can't offer timely care that meets the requirements of everyone in the system, then we've already failed," says Shah. "There's data in the system and across broader society that we need to use to create the best NHS we can. Single-lens solutions aren't what we're looking for – we must think about society in the round."
Shah sees four key use cases for technology in the NHS. First, allowing patients to manage their own care, such as through apps, devices and connected technologies. "That's about allowing patients to be empowered to do as much as they can where it's right to do so," he says.
The second key element is data connectivity, so that – when a healthcare interaction takes place – it can take place in an informed and optimal way. The third element is medical technology – what can the NHS do to improve the way in which it delivers medicine and care; that could be prescribing at one end, diagnostics at the other, or even improving surgery through the use of different forms of AI.
Finally, says Shah, the health service must consider the out-of-hospital setting and use cases where it might be possible for the NHS to use connected technology to manage patients in a virtual way. "This could mean patients are discharged sooner and cared for in a way that is designed around individual needs," he says.
Across all four of these areas, from self-care to connectivity and onto medical tech and patient management, Shah believes the right technology matched with the right use case can have a transformation impact. Yet clinicians and IT decision makers in the NHS must be careful to avoid being blinded by choice and then seduced by vendor promises.
"There's lots of technology out there that I've already seen which makes you feel a bit like a kid in a candy store," says Shah. "But, at the same time, we've got to really focus on the needs of our clinical users and citizens. All the interactions with our services create data points that we need to try and measure to ensure we focus change on the right areas."
Shah says creating effective care through digital and data is all about achieving a balance – and that's a significant challenge because of the mixed demands of health service staff and patients. He says the NHS is constantly looking for ways to measure effectiveness, which might include feedback from users, data on activity, or wider clinical outcomes.
The NHS Long-Term Plan addresses this focus as part of a forward-looking strategy for the future of healthcare. This includes more patient-facing services that use digital channels, a patient-care record that an individual or their carer can access, and – much further into the future – the use of artificial intelligence to support healthcare decision-making.
"While we know AI has its use cases, it's an umbrella term that means a lot of different things to the health service," he says. "Any use of AI means we also need to think about standards, regulation, safety and privacy."
In terms of the application of AI, Shah says the NHS – and business at large – is still at an early stage, but use cases for healthcare are already being developed, whether that's in radiology, such as recognising patterns and trends in images, or in natural-language processing, to help recognise patterns in conversations during consultations.
Shah says he knows of instances at a global scale where natural-language processing is being used in a consulting room. That type of evolution doesn't mean the health service will replace the consultant with technology; that's not going to happen, says Shah, and the NHS doesn't want that to happen.
"The human interaction is important and fundamental to what we do in the health service," he says. "But the technology does give us – as Professor Topol refers to – the gift of time. It might mean the conversation I've had as a clinician with my patient is – for example – much more readily transcribed, so I can spend time editing rather than inputting."
Shah says emerging technologies like AI should help the NHS to personalise care. The NHS should know where patients live, what's meaningful to their lifestyles, and how it can personalise medicine and healthcare around the lives of the patient.
He envisages a future state where the heath service can predict why a patient makes contact based on previous interactions. In a connected world, the NHS should be able to put standards in place that allow innovators to connect up and to allow empowered citizens to decide through their own devices what they want to share.
"So, could individuals in the future take their own asthma readings via a device and send that information to me as a clinician, so that I know whether they're about to come in unwell? We all live in an omni-channel world now and surely we should be able to do that in the NHS, too," he says.
Shah suggests a broad spectrum of hyped technologies could find use cases in the digitally enabled health service, be that the distributed ledger of the blockchain to help create certainty in patient records, the use of Microsoft HoloLens to help train staff, or even the use of quantum computing to help power new research.
Funding all this innovation still remains one of the biggest issues: according to think tank, The Health Foundation, funding increases of four percent a year are required to generate modest improvements in NHS services over the medium term, and five percent annual increases needed in the short run; last year the government offered the NHS 3.4% and called it a 'birthday present'.
Shah says where the NHS is now is a starting point. "We're at the beginning of our journey. In three to five years, we'll start seeing some of the innovations that are now in test mode coming to fruition," he says.
"The rate and pace of tech change means that we can set out some ambitions, but I also have to accept – like everyone else – that the things I believe are important right now might be far exceeded in another two years. But the key point is data can help us change peoples' lives and improve what we offer as a health service in England."