Welcome and Introductions:
The President of the Royal Society of Medicine (RSM) welcomed attendees to the second Sir Name Dangoor lecture on “How Digital Innovation Can Improve Healthcare.” The Dangoor family, supporters of the RSM, the Westminster Academy, and representatives from the Patients Association were acknowledged. Lord Darzi of Denham and Mr. Mustafa Suleyman, the guest speakers, were introduced.

Lord Darzi’s Unique Distinction:
Lord Darzi holds the distinction of resuscitating a fellow peer in the House of Lords, emphasizing his expertise as a heart surgeon.

Sir Name Dangoor and His Legacy:
The lecture is named in honor of Sir Name Dangoor, who passed away at the age of 101 in 2022. Sir Dangoor’s background and accomplishments were highlighted, including his birth in Baghdad during Ottoman rule, studies in engineering in London, and successful business ventures in Iraq. He won the first contract to bottle Coca-Cola in Iraq, further emphasizing his business acumen.

Philanthropic Contributions of Sir Naeem Dangour:
After moving to Britain, Sir Naeem established a thriving commercial property business and used his success to give back to various organizations and charities. He focused on education and health, providing scholarships for students with no family history of tertiary education and donating to institutions like the Royal Society of Medicine, the Francis Crick Institute, and Cancer Research UK. Sir Naeem’s philanthropic efforts extended to supporting students from low-income backgrounds and funding the Westminster Academy in London.

Medical Innovations at the Royal Society of Medicine:
The Royal Society of Medicine (RSM) hosts a flourishing program in medical innovations, with over 180 presentations to date. The RSM encourages youthful enterprise, energy, and innovation, as seen in the participation of a 15-year-old winner of an innovation prize for Alzheimer’s research. The upcoming April Summit will feature 13 speakers, including a large faculty from around the world and a 15-year-old from Britain.

Introduction of Speakers:
Lord Darzi of Denham, a renowned surgeon and global health advocate, will be the first speaker. Mustafa Seliman, co-founder and chief product officer of DeepMind Technologies, will follow Lord Darzi.

Lord Darzi’s Background and Achievements:
Lord Darzi holds the Paul Hamlin Chair of Surgery at Imperial College London and has conducted extensive research in surgical technologies. He has published over 800 peer-reviewed research papers, contributing to surgical practice and patient safety. Lord Darzi has received numerous accolades, including an Honorary Fellowship of the Royal Academy of Engineering, a Fellowship of the Academy of Medical Sciences, and a Fellowship of the Royal Society. He was knighted for his services in medicine and surgery and served as Parliamentary Under-Secretary of State at the Department of Health.

Mustafa Suleiman’s Background and Achievements:
Mustafa Suleiman co-founded DeepMind Technologies, a leading artificial intelligence company acquired by Google. He is now head of applied AI at Google DeepMind, integrating the company’s technology into various Google products. At a young age, Suleiman dropped out of Oxford University to help set up a telephone counselling service, which became one of the largest mental health support services in the UK. He also worked as a policy officer for the mayor of London and helped start Rios Partners, a consultancy specializing in large-scale, multi-stakeholder change labs.

Early Warning Signs of Deterioration:
Despite advancements in healthcare, patient safety remains a significant challenge. One in ten patients experiences harm during hospitalization, with over 10,000 preventable deaths annually in the United Kingdom. The main causes of preventable deaths are poor monitoring, diagnostic errors, and medication errors.

Detection of Deteriorating Patients:
Detecting deteriorating patients in a hospital setting is challenging due to: Team-based healthcare delivery, leading to coordination issues. Multiple complex interventions and fragmented healthcare pathways. Overreliance on paper-based data collection, leading to difficulties in monitoring and identifying subtle changes. Delayed escalation of care, resulting in poorer outcomes.

Communication Challenges:
Traditional communication methods, such as BLEEP systems and handwritten handover notes, are inefficient and contribute to delays in patient care. Junior doctors receive numerous calls and tasks during their shifts, making it difficult to prioritize and respond effectively.

Hypothesis of the Work:
The research team’s hypothesis is that better detection systems and intervention systems can improve patient safety. The focus is on developing early warning signs to identify deteriorating patients and improving communication methods to ensure timely intervention.

Challenges in Patient Safety:
Ara Darzi emphasized the need to improve patient safety in hospitals. He highlighted that despite advancements in life sciences and technology, patient safety had not seen a significant improvement.

Using Digital Technologies for Patient Safety:
Darzi emphasized the importance of digital technologies and data in improving patient safety. He noted that other sectors, such as road traffic safety, have successfully reduced accidents and fatalities by utilizing technology.

Limitations of Current Information Technology Systems:
Darzi criticized the current IT systems in healthcare for being cumbersome, time-consuming, and user-unfriendly. He shared examples of the challenges faced by doctors and nurses in using these systems, leading to poor data quality and engagement.

Engaging Clinicians and Utilizing Simplified Technologies:
Darzi stressed the need to involve clinicians in identifying gaps and developing simplified technologies. He highlighted the collaboration between Imperial College and the Royal College of Arts in establishing the Helix Center, which brings together designers, engineers, and software writers to address clinical problems.

The HARC System:
Darzi introduced HARC (Healthcare Activity Recommendation Center), a system that combines various inputs, including blood tests and physiological monitoring, to provide early warning systems for clinicians. He presented data showing improved communication, information transfer, and response time using HARC.

Scaling Up Innovations:
Darzi discussed the need for scaling up innovations and the role of partnerships, such as the collaboration between Imperial College NHS Trust and DeepMind, in facilitating this process.

Patient Safety and Translational Research Centre:
Darzi acknowledged the contributions of the Patient Safety and Translational Research Centre, the NHS Trust, NIHR, and Imperial Innovation in supporting these initiatives.

DeepMind’s Approach to Patient Safety:
Mustafa, co-founder of DeepMind, discussed the company’s focus on understanding complex data streams to address global challenges. He presented DeepMind’s achievements, including Nature front covers for their work in Atari DQN and AlphaGo, and their upcoming match against the world champion in Korea.

DeepMind’s Unique Position and Approach:
DeepMind combines the strengths of long-term research, academic expertise, and the pace, scale, and agility of a company. This unique combination enables DeepMind to work effectively within the NHS, leveraging resources, technical expertise, and a social impact orientation.

Challenges in Healthcare Technology:
One-size-fits-all or top-down systems have dominated health tech, failing to meet the specific needs of nurses, doctors, and patients. Large-scale step change introductions of technology, with slow updates and improvements, have been the norm. Proprietary standards and closed systems have hindered interoperability, data access, and innovation by startups and researchers.

Problems with Proprietary Standards:
Proprietary standards create closed systems, defining their own database schemas and hand-curating data. This approach prevents academic researchers, clinical epidemiologists, startups, and doctor hackers from accessing data, experimenting, and deploying prototype apps.

Common Complaints:
Complaints about using pages, desktop computers, faxes, and delays in transferring x-rays between hospitals. NHS needs new technology to improve efficiency and patient care.

Technology’s Role:
Technologists need to find new ways to work with the NHS. Ask the question: What does the user need? Doctors and nurses know the problems and often the solutions.

User Needs:
Doctors and nurses need mobile access to patient data. Data should be shareable across teams. Systems should be easy to learn and use.

Innovative Workarounds:
Many doctors and nurses use WhatsApp to communicate patient data. This is a taboo topic, but it highlights the need for better solutions. Clinicians are motivated to make a difference and use tools that make their lives easier.

Challenge:
Deploy top user designers, engineers, and machine learning researchers to work on NHS problems.

Recognizing Physiological Deterioration:
Physiological deterioration often goes unrecognized, leading to delayed reporting and limited real-time data access. Hand-amended charts hinder information sharing, making it difficult to interrogate and retrieve data proactively.

The Case of Acute Kidney Injury (AKI):
AKI contributes to substantial mortality, with 25% of cases potentially preventable. NHS England estimates direct NHS spending on AKI to be approximately a billion pounds. A patient safety alert from the NHS aims to improve clinical response to AKI, but its effectiveness is limited due to its distribution as a PDF document.

Collaboration with Dr. Chris Lang and Team at the Royal Free:
A collaborative effort between researchers and clinicians at the Royal Free seeks to address patient safety challenges. Dr. Chris Lang, a consultant nephrologist and kidney expert, leads the collaboration.

Co-Design Process:
User understanding is prioritized through focus groups, one-to-one interviews, and shadowing of clinicians. Identifying unmet needs helps researchers prioritize requirements for system development. Rapid prototyping, wireframing, and testing enable continuous feedback and refinement. Iterative learning and improvement cycles occur every 48 hours.

Mapping the Complexity of Patient Pathways:
The complexity of patient pathways in the hospital system can be overwhelming. From the patient’s perspective, numerous events occur throughout the care process. A closer examination reveals distinct pathways, such as the red pathway, which represents a patient’s journey through various departments and interventions.

Overview:
The vast majority of AKI activity occurs when patients develop life-threatening complications. The app was designed to assess risk and monitor data in real-time to intervene proactively and drive patient experiences towards a more stable pathway.

App Features:
Patient list sorted by ward, specialty, or consultant. Retrospective trend analysis of creatinine, potassium, CRP, and lactate levels. Detailed view of blood test results, including who ordered it, when, and the value. Patient details such as comorbidities, presenting symptoms, and diagnosis. Contact information for next of kin and general practitioner.

Benefits:
Early identification of patients at risk of developing AKI complications. Proactive intervention to prevent life-threatening complications. Improved patient outcomes and experiences.

Example:
A patient with a severe AKI level three is presented. Retrospective trend analysis shows a tripling of creatinine, high potassium, and elevated CRP, indicating hyperkalemia and sepsis. Lactate levels at 5.1 suggest sepsis as the cause of AKI. Patient details reveal type 2 diabetes, hypertension, abdominal pain, and a diagnosis of acute appendicitis.

DeepMind Health Collaboration:
Clinical teams value collaboration with experts to solve problems. Collaboration between hospital and DeepMind Health has led to streaming clinical data to mobile platforms, supporting the mobile nature of clinical work.

Implementation Science and Iterative Testing:
Implementation science is used to test clinical changes in practice. DeepMind Health follows this model of planning, doing, and studying to improve the design and effectiveness of their tools.

App Design and User Experience:
Clean and user-friendly design of the app makes it easy to use and understand. Technology should support healthcare professionals’ work and patient care, not hinder it.

Hark: Managing Tasks and Improving Communication:
Hark supports nurses and doctors in delivering care more effectively. Clinicians responded 37% faster with Hark than with traditional paging systems. Hark will join forces with DeepMind Health to become an integral part of their services.

Example of Requesting a Medication Order:
Current process involves multiple steps and communication channels. Doctors should be able to prioritize and manage tasks on their phones, reducing delays and improving efficiency.

New Platform:
Introducing Streams by DeepMind Health, an innovative platform that combines detection and task management for improved patient care. Designed for ease of use and accessibility, Streams aims to transform the healthcare experience for clinicians and patients alike.

Proactive Care:
Streams strives to shift the focus from reactive to proactive healthcare by delivering the right data to the right clinician at the right time. Its goal is to prevent adverse events and promote preventative measures.

Machine Learning and Analytics:
Cutting-edge analytics and machine learning capabilities enable Streams to prioritize alerts, identify the most suitable clinical team member for a task, and ensure timely follow-ups.

Patient Empowerment:
Streams recognizes the importance of patient involvement in their own treatment. It seeks to empower patients by providing access to data, facilitating an active role in their care, and promoting accountability.

Partnership and Collaboration:
DeepMind Health emphasizes the significance of partnering with clinicians in the design and implementation of Streams. Clinician-led technology is a novel approach to co-designing interventions that revolutionize patient safety.

Call to Action:
DeepMind Health invites healthcare professionals and individuals with ideas to share their thoughts and collaborate on the development of Streams. The goal is to create a platform that addresses real-world challenges and improves patient outcomes.