Plans to expand digitisation and AI in healthcare could expose the NHS to ‘serious IT-related risks’, doctors agreed.
Doctors and medical students attending the BMA special representative meeting on 14 September have expressed ‘grave concerns’ with the digital and technological aspirations laid out in the Government’s 10-year plan for the NHS in England.
In a series of motions passed at the SRM, doctors warned of the potential risks posed by a mass expansion of digitisation across a health service already struggling with outdated IT infrastructure and of the promotion of poorly understood AI technologies.
One of three shifts set out in the Government’s 10-year plan for the NHS in England is that of moving the health service from its ‘analogue’ present to a digital future.
Under this transition, the Government says patients will benefit from a greatly expanded NHS app while doctors will be able to access new resources such as a fully digital SPR (single patient record).
Technology risks
Across the board, the role of AI will be greatly increased with a view to it helping in preventing ill-health and guiding patients in selecting appropriate medical services, to assisting doctors in areas such as note taking and discharge summaries.
However, not all doctors share in this vision of mass digitised sunlit uplands.
‘This plan leaves our profession dangerously exposed to serious IT-related risks,’ said Buckinghamshire GP James Murphy.
‘We have many reasons to fear what the Government has in store as it chases prestige on the international stage. Our nation risks being an unsuspecting guinea pig for technology that is not properly understood by its creators, never mind the medical profession.’
He added: ‘The scale and speed of this Government’s plans should alarm us all. The Government appears to be harnessing the Silicon Valley mindset of “moving fast and breaking things”.
‘This is not appropriate when overhauling a complex healthcare system, inequalities will widen, people will get hurt and the reputation of the NHS is at risk.’
Lifestyle data
One particular aim of the 10-year plan is the implementation of an SPR which would seek to collate all of patients’ medical records into one digital record accessible to clinicians working in all parts of the health service.
The plan also aims to make this information accessible to patients from 2028 and will ultimately aim to include data relating to lifestyle choices, demographic and genomic information as a means of assessing an individual’s potential health risks.
As a GP and a data controller to her local Royal College of Physicians data usage committee, Penelope Jarrett stated that increasing the amount data within a single record would make finding relevant information more difficult.
She further warned that opening up access to records in the way envisaged by the 10-year plan would make it impossible to effectively structure and curate records and that, as a data controller, she would no longer feel able to shoulder this responsibility.
Access fears
In its own analysis of the 10-year plan, the BMA has stated that ‘significant questions also remain over who will have access to what information via the proposed SPR’, and that it is ‘unclear’ how existing obstacles to technological change in the NHS will be overcome.
The association warns that these obstacles, which include the prevalence of outdated IT hardware and a lack of interoperability between software platforms in the health service, make it uncertain if ‘even the most basic of ambitions of the plan will be realised’.
BMA GPs committee England deputy chair and IT, data and digital portfolio lead David Wrigley, told the SRM that, while evolving technologies such as AI could play an important role in delivering healthcare, doctors had to approach these digital tools with caution.
He said: ‘It only take one disaster story of leaked confidential data or data sold on from profit to result in the loss of trust in this technology and loss of trust from patients in our consulting room.
‘GPs and data controllers need to understand the risks they may be thinking on if using such AI technologies, particularly at this stage, when the regulatory landscape is in a state of flux.
Data use
Alongside increased digitisation the 10-year plan has emphasised how the harnessing of data through such platforms means that it will be ‘unthinkable’ that the NHS will not seek to use patient data to ‘transform healthcare and drive its financial sustainability’.
While doctors backed a motion calling for the BMA to campaign against the plan’s proposals to commercialise data, BMA board of science member David Strain urged members to recognise the distinction between commercialising and selling data.
He said: ‘We want to make it absolutely clear that appropriate use of data and appropriate use of analysis and then exporting those analytics could be to the gain of health service.
‘It could be to the gain of researchers and therefore it makes sense that it’s also to the gain of the NHS in profit-share arrangements.’