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Pioneering NHS trust using AI to help doctors make right treatment decisions

Global Digital Exemplar, Royal Liverpool and Broadgreen University Hospitals NHS Trust is using artificial intelligence (AI) to improve the treatment of patients who have had a heart attack, in a project that could see wider use of AI to inform treatment decisions across the Trust.

The Trust, which was named as the NHS’ Global Digital Exemplar of the year at the 2017 EHI Awards, will use technology from award-winning healthcare firm Deontics. This will enable doctors on the Trust’s acute cardiac unit (ACU) to access AI-driven evidence-based clinical treatment recommendations that are tailored to a patient’s individual needs.

Deontics will encode the appropriate guidelines from the National Institute of Health and Care Excellence (NICE) and other bodies, and make these specific to a patient’s risk factors, which will help doctors avoid medication that could increase risks of bleeding and recurrent heart attack. 

Some of our most frail and elderly patients with acute coronary syndrome are getting some of our most powerful drugs,” says Liverpool chief clinical information officer (CCIO) Mike Fisher.

Using AI-technology means we should reduce the potential for overprescribing such drugs for patients at lower levels of risk. Instead of giving some patients the maximum treatment, we can make sure patients are given the most appropriate treatment.” 

Deontics uses cognitive computing technology and advanced healthcare-specific logic to act like a ‘clinical sat-nav’ for doctors. This enables them to make treatment decisions that are dynamically informed by relevant standards and guidelines such as those issued by NICE, and the latest good practice from published papers and reputable sources. These are then applied directly to the precise needs of individual patients according to their condition.

Expected benefits include greater clinical compliance with standards, leading to increased care quality, enhanced patient outcomes, and reduced length of stay. Such compliance is a major driver for the NHS through activities such as its “Getting It Right First Time” programme and following recommendations from Lord Carter’s report into NHS productivity. 

There is much evidence to show that the most effective hospitals are those that follow guideline-based treatments more closely,” said Fisher, which is using Deontics as part of the trust’s Digital Liverpool initiative. Deontics will help the Trust achieve greater compliance with those standards, and record any justified variation from the treatment recommended in accepted guidelines.

Deontics is to be used on the Royal’s ACU over summer 2018, initially linking to the Trust’s electronic notes system, with a view to integrating with other key clinical systems, including the forthcoming electronic patient record system. Then, once a patient is given a diagnosis of acute coronary syndrome, the decision support system will present personalised evidence on relevant treatment options and the best clinical pathway to use. Doctors can then follow that advice, or record why they provided alternative treatment.

Once it proves itself in the ACU, Deontics could be used across the hospital in support of its Advancing Quality programme, which looks to provide high quality care for a range of high impact conditions such as heart failure. “We aim to start within something relatively simple, and then build up from there,” said the CCIO. 

Deontics is one of the smartest decision support systems out there,” said Fisher. “It has been used to individually recommend different chemotherapy regimes based on complex research. No other system can do this. It is a very interesting firm, and we are hopeful for a continued relationship.” 

Guy Wood-Gush, CEO of Deontics, said: “It is very exciting to be working with the Trust on realising the possibilities of using AI to enhance clinical treatment decisions using Deontics technology. We have spent many years working with clinicians to develop a platform that fits with their needs and workflow. We have shown how our healthcare AI technology can increase patient safety, reduce unnecessary clinical variation, and deliver high quality, cost-effective care and we look forward to bringing these benefits to patients in Liverpool.”

Deontics technology is the result of long-term academic research in medical artificial intelligence. Its innovative software has helped it win the London Mayor’s MedTech business award, and seen it shortlisted for this year’s Patient Safety Awards. Deontics is also only one of seven companies worldwide named in Gartner’s “Cool Vendors in AI in Healthcare” report in 2017.