Digital Health: Using AI to improve patient care

Call overview and agenda

On 16 February 2021, Erik Mayer and Ben Glampson presented to the Imperial BRC Public Advisory Panel via an online Zoom meeting. The meeting focused on “Patient and public perception and thoughts on how ‘algorithms’ can be used to improve patient care through Electronic Health Records.”

The aim of this particular online session was to:

• Introduce the topic and area of research
• Q&A
• Facilitate small group discussions exploring the topic further with panel members

Summary of Key Insights

The following is a summary of the themes identified in breakout room discussions, more details of which are in the full Digital Health Theme Report.

A zoom poll identified that algorithms that diagnose new conditions and algorithms that aid clinical decision-making were considered to be most valuable and should be prioritized by the proposed Digital Health Theme. They both received equal numbers of votes i.e. 53% (n= 9/17). Panel members identified that algorithms which had the most immediate effect on patients were a priority including identifying disease risk, diagnosing conditions, and aiding clinical decision making. However, they also considered it important that algorithms need to be developed in a way that is meaningful and responsive to both clinicians and patients.

When presented with a scenario about algorithms being used to determine risk of heart disease and the concerns and benefits of this, Panel members considered the benefits to include the assistance algorithms provide to decision making which benefits the patient. They could also see possible uses for algorithms which included alerts for vaccinations and National Early Warning Scores. However, the following were considered as needing to be addressed: transparency about, and accessibility to, their data, uncovering additional health issues and communicating this ethically to the patient and the need for follow on support, consent is required to use the algorithm and some patients may wish to opt out of an algorithm being used in relation to them. Patients would still want the medical professional to have discretion to overrule an algorithm and there is a need for a relationship with a medical professional whom a patient trust.

Their concerns about algorithms being used to determine risk of heart disease or other conditions included the limitations of algorithms including how their accuracy is monitored, the algorithm validity including how comprehensive and accurate the patient record information is and the generalisability of the data used in the algorithm and whether it represent all members of the population.

Patient Involvement in Theme

In relation to how patients should be involved with informatics projects in the BRC Theme, panel members considered that large and diverse groups should be involved in inclusive ways, processes should be embedded for feedback, language used should be public facing including providing for languages other than English,and algorithms should be co-designed with patients. However public trust needs to be built about artificial intelligence.

How we used the insights

This insight report summarising key points from the session was made available to Theme Leads and the BRC Executive in order to shape the BRC application. The report was also provided to the Panel members who took part in the involvement activity. A full report on all public involvement activities undertaken in preparation for the BRC application can be found here.

We would like to thank all those members of the public who gave their time and thoughtful insights through these activities, and the researchers who engaged enthusiastically in the process.