‘Biggest obstacle’ in digitising healthcare is privacy, Wachter warns
One of the “biggest obstacles” we face in the move to digitise healthcare is public concern about privacy, Dr Robert Wachter has warned.
The NHS “failed epically” to digitise 15 years ago, he said, but the cash-strapped health service is now making better progress, though there are still remaining challenges.
Writing for Wired UK Dr Wachter added the move to digitise healthcare was “essential” but it will be “incredibly hard” to take advantage of the digital revolution if data can’t be shared.
“Privacy campaigners have expressed concern over partnerships such as the recent UK tie-in between the NHS and DeepMind, that gave the latter access to the (partially anonymised) records of 1.6 million patients,” he wrote.
“By sharing data we will be able to use AI to analyse the data of millions of patients to reveal patterns and insights that I, as a practicing clinician, couldn’t possibly have discovered on my own. These will guide me to make better predictions, and patients to take the right actions.
“In the next ten years we will have no choice but to develop secure ways to share data between health systems and companies with digital expertise.”
But this isn’t an easy challenge, he argued. New methods of identifying records; new approaches to patient consent; and strong ethical oversight by professionals and patients will be essential.
Simply “building a firewall” between healthcare systems and digital companies that have the potential to transform care will only ensure a “future where we are unable to innovate”, he concluded.
The US “digital doctor” conducted a review into NHS IT, with the final report handed down in 2016 calling for the “unrealistic” 2020 paperless target to be discarded.
Instead, the review said, a target should be set for all trusts to be “largely digital” by 2023.
Other recommendations on focusing funding on trusts that were likely to be digital leaders led to the implementation of the Global Digital Exemplar and Local Health and Care Record Exemplar project across the NHS.
In the same year, Dr Wachter also said a successful implementation strategy; a network of clinical information professionals; and interoperable systems should be the top three things on the government’s digital to-do list.
He was also a key playing in the roles of chief clinical information officers’ (CCIO) and chief information officers’ (CIO) roles becoming professional roles reporting to hospital boards.
3 Comments
As a patient and carer all I want is more engaging and open communication so that I understand what the NHS would like to use my data for and how I can view it, use it, add to it to make certain that it’s put to good use.
There’s a quote that says ‘we suffer more from imagination that reality’ and we have all been lousy at communicating the reality of how poorly existing data is used to improve patient safety.
Let’s hire the likes of people and patients like the wonderful Michael Seres, Di Readman and Ingrid Brindle to lead this and not wrap ourselves up again in more tortuous debate, information sharing agreements and national data opt-outs et al.
Let’s opt-in to making this topic relevant, simple and engaging for patients.
We would like to think we are ahead of the curve on this!
The secret here, as I have said before, is to ask. Recognise that rich EHR data cannot be effectively anonymised, manage this risk and seek informed consent.
If you ask people honestly and nicely most will agree to share their data despite the privacy risks. Those that don’t wish to should have their decision respected.
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