Delivering high quality care with ethical technology

Posted / 27th April 2020

Oliver Harrison, CEO, Alpha Health


The COVID-19 pandemic has truly put a spotlight on the immense pressure the NHS is under. Every day stories emerge about the lack of testing, shortage of personal protective equipment, or the likelihood of post-traumatic stress disorder developing. Each of these is a reminder that more must be done to ease the burden on the entire NHS and protect it and its workers as they tackle the biggest health crisis of a generation. There are many ways in which we can help our frontline NHS staff, but I am a passionate advocate of one in particular: technology.


How technology can ease the burden


I truly believe that for all of the pain this pandemic has caused, it is rightfully accelerating the adoption of technology in healthcare systems. Last year it was almost unimaginable for the NHS to be collaborating with Google and Apple on a new contact tracing app, but this is just the latest of many innovations. Over 1.25 million people requested for their prescription to be sent electronically in March alone, while registrations to use the NHS App increased by 111%. These figures clearly indicate that the move to the digital health era is rapidly accelerating.


It’s not just about prescriptions and apps though. Technology has the potential to play a huge role, not just now but well into the post-COVID-19 NHS, and can unlock predictive, preventative and integrated care, of the kind I’ve advocated for years. But as with any good technology innovation the usual principles must apply and we cannot rush to introduce technology for the sake of it. Firstly, there must be a genuine problem with a clear set of people impacted. The problem must then be developed into a simple ‘job-to-be-done’ in which multiple stakeholders work together to create a focussed technology solution to address it. The output must then be tested rigorously in order to be optimised before deployment. And underpinning everything must be a rigorous set of ethical frameworks to ensure the technology adopted will serve healthcare providers, clinicians and patients in the future.


Alpha Health’s role in the digital health revolution


And what does this look like in practise? We’ve been closely working with the NHS to tackle a huge ongoing issue – the mental health crisis. Approximately 1 in 4 people in the UK alone suffer a mental health crisis each year, and last year the rate of suicide hit a 16-year high. This problem is predicted to worsen following the pandemic too.


At Alpha Health we are focused on building solutions for individuals and clinicians tackling different stages of mental health. Since 2016 we’ve worked closely with the Birmingham and Solihull NHS Mental Health Foundation Trust (BSMHFT) on a project that explores how we can harness technology to help identify and prevent mental health crises. The Predictive Analytics project aims to achieve predictive, preventative, integrated and efficient mental health urgent care services for patients, which will in turn enhance the quality of care clinicians can provide.


We used five years of anonymised historical health data, that could not be linked to an individual patient, from the Trust to create an algorithm capable of identifying patterns that suggest when a person is about to enter a crisis. Our pilot phase integrated the algorithm into the existing workflow and practice of clinicians, and saw some promising results. In 64% of cases, clinicians reported that the prediction tool either helped prevent a crisis, identify a patient’s condition deteriorating, or manage caseload priorities. We also received positive feedback in how the algorithm easily supported their clinical practice in reviewing cases, as well as ideas for how we can improve the predictive tool. We have continued to test and iterate the algorithm to optimise its performance in order to better support clinicians. Moreover, we have begun to plan a clinical trial with the Trust, which will aim to give us the regulatory go-ahead from the MHRA to move beyond piloting, allowing this tool to become available to mental health trusts across the NHS.


The importance of ethics


If we are truly to reap the benefits of healthcare technology innovation, such as the algorithm we’ve developed, we must always put the user first, and bring ethics to the very front and centre of what we do. At Alpha Health, everything we do is channelled through our ethical framework, which we strongly believe is the only way to create a successful solution that puts the user and their privacy and safety first.


This can take many forms, but looking at the Predictive Analytics project as an example, we only handled data anonymised from the perspective of Alpha Health, meaning we could not identify any individual patient. Naturally we also followed data minimisation best practice, ensuring only the minimum amount of data needed for the research was actually used. In addition, no data ever left the Trust’s secure servers, where all of our algorithms were built and deployed. Finally, we ensured the algorithm was designed to appropriately integrate into existing clinician workflows and to support and enhance existing clinical practice in reviewing cases. We never intend for it to replace the services clinicians provide patients with currently.


We believe the only way in which we will be successful and improve people’s mental health, is by putting transparency and simplicity at the very core of our products in this manner. Technology companies, like Alpha Health, have a responsibility to work together with the likes of the NHS to create solutions that work for service users and clinicians alike, putting their needs first.


2020 will be a big year for digital health; Covid-19 is accelerating trends that were already apparent. But it’s critical that this is done in the right way; a way that puts the public’s privacy and health at the front and centre. We must act with caution and integrity and rise to support those who have looked after us so effectively in recent weeks.