HTN at HETT North 2024: tackling AI risks and tips for virtual care

We rounded off our February with a visit to Healthcare Excellence Through Technology (HETT) North, bringing together professionals to discuss health tech topics.

We attended a variety of sessions to hear views and discussions – here are some of our highlights.

Artificial intelligence: how to mitigate risk and building trust for the future

The Digital Maturity Forum was home to a host of discussions and debates around digital in health, including AI in clinical safety, the impact of digital on pathway improvement and preventative care, and putting trust in AI.

One panel discussed AI in clinical safety and how to mitigate risks when integrating AI for the positive benefit of patients, with panellists including Keith Gomes Pinto (NHS Dorset), Dean Mawson (Leadership Committee for Clinical Safety at the Faculty of Clinical Informatics), Lucy George (AstraZeneca UK) and Avi Mehra (Doctorpreneurs).

The panel first identified challenges in this space, such as keeping pace with the rapid expansion of AI and new AI capabilities, lack of regulation or compliance with AI clinical safety standards, delays in introducing incident reporting mechanisms, and the knowledge gap existing relating to AI standards and regulations.

On things that need to change in the clinical AI space, Dean urged manufacturers and developers to work with clinicians and patients, whilst Avi talked about regulating use cases, rather than the technology or overarching principles. From a big pharma perspective, Lucy talked about how, in the regulatory landscape, she had been working toward encouraging simplicity in frameworks and emerging AI.

The panel offered advice to anyone looking to start their implementation of AI, with Keith referring back to enterprise architecture, highlighting the best process as defining your need, involving the right stakeholders, building your requirements, and then going to procurement. “We can be gateway keepers to assuring that that tool is safe,” he said. Dean’s advice was to invest in a business analyst, as he noted that a lot of the surfacing work needs to be done up front.

On building trust in AI applications for the future, we heard from Dr Salah Ghazal Hammouche, ST8 Trauma and Orthopaedics, Clinical AI Fellow & Topol Digital Health Fellow at Imperial College London. Salah discussed the lack of economic evaluations of AI products along with the need to conduct post-market surveillance on AI applications, assessing them against set criteria, and providing databases to help clinicians assess.

He also noted that ensuring safety in AI should include effective validation, taking steps to reduce bias, and introducing benchmarking and post-deployment evaluation measures.

Virtual care: pathways and outcomes

During our visit to HETT, we listened to Sue Armstrong from the University Hospitals of Leicester NHS Trust as she discussed the Leicester Atrial Fibrillation (AF) virtual ward as a blueprint for digitally enabled acute care in AF.

Sue highlighted the process that the trust had followed, starting with a clinical audit, establishing a framework, linking in with the local CCG who provided funding for proof of concept, developing a platform to manage patients supported by an IT project manager, and working on a pathway for AF patients.

Once assigned to the pathway, Sue shared how patients are given pulse oximeters and blood pressure monitor, which are integrated into a software platform, where patients can also send messages, have video consultations and “be managed how they want to be managed”.

Sue went on to share some of the outcomes from the programme, describing how it has an average stay of 13 days, with only 18 out of 332 patients requiring readmission.

She also briefly touched upon ongoing challenges with integrating systems and making sure everyone has access to relevant information, as well as getting clinician support in trusting the pathway.

To close the day, we attended a panel presented by Cathy Salisbury (Blackpool Teaching Hospitals NHS Foundation Trust); Kathryn Best (Fylde Coast Medical Services); and a team from Alder Hey Children’s NHS Foundation Trust including Jemma Blake, Wendy Blumenow and Alan Bridge.

Cathy and Kathryn spoke first on their experience of remote care and virtual wards in paediatrics at Blackpool Teaching Hospitals, supporting children to recover in their own homes, taking referrals from children’s acute wards and tertiary partners such as Alder Hey and Manchester Children’s Hospital. After referral, children go through a consultation to ensure that they are the right fit for virtual wards, before they are given the equipment and taught how to use it, enabling them to complete their monitoring at home.

Getting support for the pathway was identified as a challenge by Cathy and Kathryn, and they spoke about how they focused on raising awareness wherever possible, developing clear guidance, having a clear safety net in place to step back up to acute care if needed, and ensuring clear responsibilities were set out from the beginning.

Wendy and Alan then took over to talk about their experience at Alder Hey, leveraging data to help meet patient needs without bringing them back for face-to-face appointments, using patient-submitted data to improve care pathways, and to ensure that patients receive the right care, at the right time.

They next presented some statistics showing that at Alder Hey, their ISLA platform has been rolled out across 28 specialities, with more than 27,000 submissions in total. Wendy shared that the solution has had a positive impact on waiting time for face-to-face appointments.

Alan next talked about using ISLA in surgical site infections surveillance monitoring, with results including a 58 percent reduction in emergency department attendances, and a 100 percent decrease in readmissions.

Jemma went on to highlight about Little Hearts at Home, Alder Hey’s remote monitoring platform allowing young children to be discharged home, with community nurses inputting data which is visible straight away to digital teams. Cardiologists can set parameters using the platform, to ensure that deteriorations are picked up quickly, which Jemma highlighted as important in the platform’s success.