Technology in healthcare is increasingly becoming big business. According to a recent report from Markets and Markets, the global healthcare IT market is projected to reach $280.25 billion by 2021, up from $134.25 billion in 2016, representing a compound annual growth rate of 15.9 per cent.
It’s not surprising that some of the world’s biggest IT players are turning their attention to this rapidly expanding field. Big data, artificial intelligence (AI) and the internet of things all have clear applications in the world of healthcare, and the major players are getting in on the act.
Owned by Google’s parent company Alphabet, DeepMind Technologies has recently been in the news for a pioneering partnership with Moorfields Eye Hospital in London. Machine-learning has been applied to thousands of anonymised eye scans to identify signs of eye disease and recommend how patients should be referred for care.
Artificial intelligence as effective as a human health expert - but much quicker
And, says Moorfields, the system can make the right referral for more than 50 different eye diseases with 94 per cent accuracy, making it just as good as the top experts in the world. Perhaps more importantly, it can make its decisions extremely quickly, which is vital in a field where scans are now being generated at a faster rate than experts can analyse them.
“The results of this pioneering research with DeepMind are very exciting and demonstrate the potential sight-saving impact AI could have for patients,” says Professor Sir Peng Tee Khaw, director of the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology.
“I am in no doubt that AI has a vital role to play in the future of healthcare, particularly when it comes to training and helping medical professionals so that patients benefit from vital treatment earlier than might previously have been possible. This shows the transformative research that can be carried out in the UK, combining world-leading industry and NIHR/NHS hospital/university partnerships.”
Technology companies can make leaps where the NHS cannot
It’s not hard to see how similar techniques could be applied to other diagnostic and referral challenges. Indeed, DeepMind is already working with the NHS and Cancer Research UK on the early detection of breast cancer, as well as exploring the use of AI to improve radiotherapy mapping for head and neck cancers.
As Matthew Howard, director of artificial intelligence at Deloitte, points out, big tech companies are in a far better position to collect and process this data than cash-strapped NHS trusts.
“They have scale and they know how to manage big data in a way other people don’t,” he says. “These are people who are better than anyone else because they can manage data and make it accessible in a way that will be useful. They can provision the technology that you need to mine, and slice and dice this data.”
Microsoft, too, is making big strides in using AI and big data in healthcare through its intelligent cloud service Azure, and last year set up a new healthcare department at its Cambridge research facility.
“Most healthcare organisations record only episodes of care, blind to the full journey of health that connected technologies and smarter models of personal health could reveal,” says Iain Buchan, the lab’s director of healthcare research.
“By providing a fuller picture of patient journeys, Microsoft can help patients to self-care and communities to self-organise for better health. This high-resolution approach could provide more timely, personalised care and help target scarce clinical resources to the neediest patients – key to better value healthcare.”
Big tech firms looking to break into healthcare
The company is already using machine-learning and computer vision in a project aimed at increasing the reliability of cancer scans, as well as improving understanding of cancer development and identifying optimal treatments, including personalised medicine.
And other big tech companies are looking for their own ways into the health market. While Amazon, for example, has invested in a cancer-detection startup called Grail, its main efforts, as you would expect, concern selling medicines. The company recently announced the acquisition of online pharmacy PillPack, having already won approval in some US states to distribute drugs.
Despite recent controversy over the accuracy of treatment recommendations by its Watson AI, IBM continues to develop the platform through collaboration with, for example, US cancer institutes including Memorial Sloan Kettering and Mayo Clinic.
As for Apple, its healthcare plans are largely shrouded in secrecy. A hint of its ambitions is the company recently opened a series of primary care clinics for its employees, offering what it calls “a unique concierge-like healthcare experience… enabled by technology”.
The tech giant, of course, already offers health-tracking through the Apple Watch, and provides its HealthKit and ResearchKit platform to researchers and doctors to help track patient health.
Quantity of health data could lead to personalised healthcare
US customers can also view, manage and share their medical records on iPhones running iOS 11.3 as part of the company’s health app, an important development in America, where health data may be held by several different hospitals and clinics, and isn’t automatically shared. Organisations including Johns Hopkins Medicine, Cedars-Sinai and Penn Medicine are already taking part in the initiative.
There are rumours that the company may be considering producing a specialist healthcare wearable that, presumably, would be aimed at improving the quantity and quality of health data on individuals.
“We are increasingly now walking data streams,” says Deloitte’s Dr Howard. “Making use of this is as much a big computing problem as anything else.”
AI has the potential to increase a clinician’s understanding of a patient’s unique care requirements to such an extent that personalised patient care could one day be possible
In years to come, and in principle, such individual health monitoring could lead to truly personalised medicine.
According to DeepMind: “Over the long term, AI has the potential to increase a clinician’s understanding of a patient’s unique care requirements to such an extent that personalised patient care could one day be possible.
“However, this will require close integration with new, innovative medical disciplines, such as biopharmaceuticals and medical genetics, that are themselves a long way from achieving their full potential. As a result, we believe that we are still many years away from these developments.”
Implementing new tech in the NHS must be done one trust at a time
And there are other problems that need to be overcome. It’s notable that the successful projects in the UK so far have been tightly focused. There’s no serious talk as yet about introducing any universal health monitoring programmes that could exploit individuals’ full suite of health data.
“I think the NHS is very interested in furthering itself in terms of technology and the big companies have a lot to offer,” says Sara Siegel, head of healthcare at Deloitte. “But the NHS is hundreds of different organisations and that can be a challenge. You have to start with an individual trust. Things can seem to take a bit longer with the NHS, but that’s the way it’s structured.”
Meanwhile, issues of privacy and security are liable to plague any organisation that is gathering and processing personal data, and such national health databases would contain more information, and of a more personal nature, than others.
“What we haven’t got yet is a consent framework and data ownership model that everybody is happy with,” says Dr Howard. “I think there is still an extant conversation about who is the owner of that data. We haven’t yet as a society in any geography worked out quite how this model is going to land.”