NHS to reward hospitals for replacing clinicians with AI

Targeted financial incentives will span services such as diagnostics and outpatient appointments

Machines replacing clinicians in the NHS

The NHS will financially reward healthcare providers that can successfully use artificial intelligence (AI) systems to replace clinical tasks conventionally performed by humans.

Services like screening and diagnostics will be "carefully targeted" by a formalised rewards structure in a bid to fast-track the deployment of machine learning and similar technologies in front-line healthcare settings.

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NHS England's chief executive Simon Stevens teased the policy at the Reform Health Conference this week, confirming that financial payments will be adjusted by April 2020 based on feedback and consultations.

The UK's most senior NHS manager suggested the payment mechanism could come in the form of a 'best practice' reward for machine learning in diagnostics and one for a reduction in outpatient appointments.

This will complement the NHS's Innovation and Technology Payment (ITP) programme, which came into force at the start of this financial year. The ITP is a competitive process designed to reduce financial barriers to adopting tech proven to be successful in clinical settings.

Speaking at the Reform Health Conference this week, Stevens said there was evidence that clinicians could be substituted with machine learning for a host of tasks such as radiography, where there is currently a severe workforce shortage.

"We are seeing an artificial intelligence revolution that will be a big part of our future over the next five years, with technologies that can cut the time patients wait for scan results and ease the burden on hard-working staff," said Stevens. 

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"We're therefore kicking off a global 'call for evidence' for NHS staff and technology innovators to come forward with their best ideas for how we should adjust our financial frameworks to best incentivise the use of safe and evidence-based AI and machine learning technologies across the NHS."

NHS England also announced the deployment of four new innovations supported through the ITP, including 3D heart modelling and advanced blood tests. This also includes a handheld gadget that uses low-levels of electric current to reduce pain in those who suffer from cluster headaches.

Up to now the bulk of digital transformation across the NHS, including the use of automation, has been happening in the back office to increase efficiencies in this more traditional workplace setting. But there are a number of early indicators that AI will be rolled out in the front-line arena in the coming years, which is more challenging to infiltrate.

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Nvidia, for example, announced a partnership with King's College in March to build an AI platform that will allow specialists to train computers to automate radiology workflows. This is exactly the sort of area of innovation that Simon Stevens referred to in his comments.

The prime minister Theresa May also allocated millions of pounds last year for the NHS to use AI in early diagnoses of cancer and chronic disease. She also called for the industry to come together with charities and healthcare providers to create predictive algorithms to underpin this.

IT Pro asked NHS England was asked whether there has been a relatively slow uptake of AI technologies so far, given the need to introduce financial incentives. NHS Digital and the Department for Health and Social Care (DHSC) were asked what work is being done to promote AI deployment in front-line healthcare settings.

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