Algorithms based on NHS records could seed an ‘entirely new industry’ in AI-based diagnostics and mint billions for tech companies, strategic review reveals
The government must act urgently to ensure that patients and UK taxpayers – not just tech companies – gain from new commercial applications of NHS data, an independent review of the UK life sciences industry has said.
Sir John Bell, a professor of medicine at Oxford university who led the government-commissioned review, said that NHS patient records are uniquely suited for driving the development of powerful algorithms that could transform healthcare and seed an “entirely new industry” in AI-based diagnostics.
However, Bell highlighted a “very urgent” need to review how companies are given access to NHS data and the ownership of algorithms developed using these records.
“What you don’t want is somebody rocking up and using NHS data as a learning set for the generation of algorithms and then moving the algorithm to San Francisco and selling it so all the profits come back to another jurisdiction,” he said.
Bell said this concern had been largely overlooked due to a widespread misconception that recent advances in AI have sprung from the development of new, sophisticated machine-learning algorithms. “People have played up the need to have great machine learning. It turns out that’s all baloney,” he said.
In fact, Bell argues, the most significant value lies in the datasets used to train algorithms on tasks ranging from speech recognition to diagnosing diseases. As the world’s largest publicly funded health service, the NHS has one of the most comprehensive health datasets in existence.
“What Google’s doing in [other sectors], we’ve got an equivalent unique position in the health space,” he said. “Most of the value is the data. The worst thing we could do is give it away for free.”
Bell describes the recent controversysurrounding the Royal Free hospital in London granting Google DeepMind access to 1.6m patient records as the “canary in the coalmine”. “I heard that story and thought ‘Hang on a minute, who’s going to profit from that?’” he said.
Bell gave the hypothetical example of using an anonymised data for chest radiographs to develop an algorithm that eliminated the need for chest x-rays from the analytical pathway. “That’s worth a fortune,” he said. “All the value is in the data and the data is owned by the UK taxpayer. There has to be really serious thought about protecting those interests as we go forward.”
One option, he said, would be for the Department of Health to ultimately retain ownership of algorithms developed using NHS data.
The report raises the possibility of hospital pathologists being replaced by image processing algorithms and of software being used to grade tumours with the aim of giving patients a more accurate prognosis.
The report notes that “existing data access agreements in the UK for algorithm development have currently been completed at a local level with mainly large companies and may not share the rewards fairly”.
The review, commissioned by the government following the launch of the industrial strategy green paper in January, also calls for the investment of millions of pounds in high-risk projects, with the goal of creating “two or three entirely new industries” in the next decade.
This life sciences “moonshot” initiative would be led by a newly created body, the Health Advanced Research Programme (Harp), which would aim to emulate the role played by Darpa (the Defence Advanced Research Projects Agency) across the technology and engineering sectors in the US.
“These programmes need to be well resourced, sufficient to undertake the necessary R&D but also to effectively commercialise products globally,” the report states. “Scale is important. We expect each of these programmes will require several hundred million pounds in investment each.”
Genomics, early diagnosis of chronic diseases and cancer, and artificial intelligence are all highlighted as areas with significant potential.
Bell said that “engineering solutions to ageing” also represented an area of under-explored commercial opportunity, citing the need for better products to help people get around their homes, sit comfortably or cook with osteoarthritis.
“The first thing that anyone did when they had a baby was they’d go to Mothercare and spend a fortune,” he said. “It would be interesting if when you hit 70 you went down to an equivalent commercial entity.”
The UK must remain attractive to scientists and skilled workers from Europe and elsewhere after Brexit, the strategy says. The UK should aim to attract “up to 100 world-class scientists”, with substantial financial packages and support, and “2,000 discovery scientists from around the globe” to work in British labs on early stage research.
The strategy also calls for an end to handwritten prescriptions and calls for all hospitals to have fully electronic prescribing, noting that many hospitals still lack any digital record of what is prescribed and for what conditions.
“Why in the world the NHS has not made it mandatory for all hospitals to have digital prescribing yesterday is beyond me,” said Bell. “It’s a terrible way to run the NHS and it has quite profound knock-on effects for how the NHS can engage sensibly with industry.”
He said the lack of digital records was hampering the ability to develop pricing agreements for drugs based on outcomes, and to perform monitoring of drugs to spot any long-term safety issues.
“You can’t do that unless you know who got the drug, and what disease they had and whether they got better or not,” he said.
The recommendations have been broadly welcomed by industry and those working in biomedical research. Prof Sir Robert Lechler, president of the Academy of Medical Sciences, said: “The Life Sciences Industrial Strategy recognises the importance of funding across basic and discovery science, and translational research. Importantly, the strategy highlights the potential of the NHS, which we are not currently capitalising on. We must use the NHS as an engine for innovation, embedding a culture of research, improving the adoption of new ideas and technologies and ensuring timely access to these.”
By: Hannah Devlin Science correspondent