24 August 2019 | New Scientist | 9Climate changeTHE UK is “on the cusp of a
huge health tech revolution
that could transform patient
experience”, said health
minister Matt Hancock when he
announced £250 million to fund
a new AI Lab for the National
Health Service earlier this
month. The lab has been set
up to bring together academics
and technology companies to
work on some of the biggest
challenges in health and care.
But the AI sector has a
reputation for overpromising
on what it can deliver – as do
politicians. I met with Indra
Joshi, head of digital health and
AI at the newly established
NHSX – an organisation tasked
with digitally transforming the
NHS and running the AI Lab –
to ask her how it is going to
achieve these aims.
A former medic, Joshi says
she still knows what it is like
at medicine’s coalface. She
recounts a time her ward ran
out of pillowcases, so staff had
to wrap up pillows in sheets
instead. “As much as in my day
job we feel that we are going to
solve the world, we can’t lose
sight that these are some of the
issues that staff face,” she says.
How is AI going to make a
difference? Joshi tells me about
efforts to develop software
to look at scans, such as
mammograms for breast
cancer screening, and measure
the size of any lump and flag it
for a radiologist’s attention if
necessary. “The more mundane
tasks are taken away, leaving
time to do more complicated
ones,” she says.
Also in the works is a
computer-based check-in
system for emergency
departments. At the moment,
people initially speak to a
receptionist and then a triagenurse, before seeing a doctor.
Instead of those first two steps,
it is hoped people could record
their symptoms through a
touchscreen device that could
also take some of their vital
signs such as heart rate.
One advantage would be that
every person’s data is digitised,
so patterns can be spotted more
quickly. “That allows a hospital
to understand what’s happening
on the ground,” says Joshi.
At a more basic level, her
team is also investigating the
potential for phone apps to let
people book and rearrange
hospital appointments, and
even find out test results.
These kinds of initiatives
may sound promising but some
doctors have responded with
scepticism, pointing to the
recent explosion of commercial
apps making various health
claims without evidence.
Joshi says her team is tackling
this by laying the groundwork
for ensuring all future health
tech is ethical and supported by
evidence. It has drawn up a code
of conduct and has worked with
the National Institute for Health
and Care Excellence (NICE) onsetting the standards for the
levels of evidence required for
different types of technology.
“We need to help the market
understand that when you’re
developing [technology]
you claim is diagnostic or
therapeutic, you need to
go through the same peer-
reviewed process as with any
other product that’s therapeutic
or diagnostic,” she says.
Another criticism from
frontline staff is that the NHS
shouldn’t be working on new
tech without first fixing existing
IT infrastructure problems.
Dominic Pimenta, a cardiologist
in London, has complained that
his computer can take half an
hour just to get going in the
morning. To run his clinic,
he says he must log in to
10 different software packages –
to see someone’s notes, scan
results, ECG and so on. “The
other day it was taking so long
I just gave up and started again
in a different room,” he tells me.
Other problems include a
lack of tech support out of hours
and different hospitals using
incompatible software. I ask
Joshi if founding the AI Lab is
like trying to build an extension
onto a house whose walls areabout to fall down. “This isn’t
an ‘either-or’,” she says. NHSX,
which only launched last
month, is taking measures
to address these problems.
Joshi says she understands
people’s frustrations. “What we
want to do is build frameworks
to ensure we can deploy
[technology] and it works
where we say it will work.” ❚Profile
Indra Joshi is a former junior
doctor in emergency medicine.
She is now head of digital health
and AI at NHSXSUMMER extremes of heat and rain
are likely to last longer in Europe,
North America and Asia if the world
warms by more than 2°C, with
serious effects for agriculture and
human health.
Climate change is expected to
bring more frequent and intense
extreme weather events. How long
they will last isn’t well understood.
Carl-Friedrich Schleussner at
Climate Analytics in Germany
and his colleagues modelled the
persistence of such events across
the northern hemisphere if
temperatures rise by more than 2°C.
They found that countries will, on
average, face a 26 per cent greater
probability of heavy rainfall lasting
for at least a week in summer. That
could lead to devastating floods.The northern hemisphere faces
the prospect of more persistent
heatwaves, with the probability
of warm periods lasting a fortnight
increasing by 4 per cent on average.
Jet stream weakening, driven by
a warming Arctic, is one factor
behind this (Nature Climate Change,
doi.org/c9mn). Heatwaves can
result in a reduced harvest:
Germany saw a 15 per cent
decrease in wheat production
after a heatwave in 2018.
The good news is the increased
likelihood of these extremes can be
avoided – if temperature rises are
kept to 1.5°C or less, the tougher
goal of the UN’s Paris climate deal.
“We can make a difference by
limiting global warming and taking
action now,” says Hannah Cloke at
the University of Reading, UK. ❚High-tech plans for the NHS
Interview: Indra JoshiAdam Vaughan“We need to make sure
technology goes through
the same peer-reviewed
process as other products”What can artificial intelligence really bring to healthcare?
A lot, Indra Joshi tells Clare WilsonGlobal warming will
drive extreme wet
weather in summerMARC
EL^KU
SC
H/AFP/GETT
YHeavy
flooding hit
Duisburg,
Germany, in
May 2018NHS