Contributed by Charles Taylor, CTO and Founder, HeartFlow
Improvements in modern healthcare are inexorably linked to technological innovation. The NHS is therefore working closely with the med-tech sector as part of its ongoing efforts to provide world-leading patient care. This collaboration is essential for both parties to push forward meaningful development and can have applications across the medical spectrum, from oncology and cardiology to general surgery and maternity care.
One of the ways in which the UK government is seeking to achieve this is through its digital strategy, The Future of Healthcare, which argues that innovation helps to prevent, diagnose and treat illness. One of the key drivers to achieving this goal is the NHS’ Innovation and Technology Payment (ITP) programme.
What is the ITP?
Announced in 2017, the ITP programme aims to accelerate the adoption of market-ready medical devices, diagnostics, digital platforms and technologies across NHS England. For innovations that have been shown to improve patient care, the programme seeks to remove some of the financial or procurement hurdles which may prevent uptake of a product across NHS hospitals.
The ITP’s remit is wide ranging. Successful applicants have included advanced sutures that reduce surgical infections, an attachment for endoscopes which significantly improves detection of bowel cancer and a device that helps combat cluster headaches through nerve stimulation.
The programme also considers advances in machine learning and artificial intelligence (AI), which have the potential to transform the way doctors deliver cost-effective, high-quality diagnostic and treatment services. For example, AI can process and extract data from medical scans at a speed and volume that humans are simply unable to replicate.
It’s this level of sophisticated computing that powers HeartFlow, Inc., which has been a recipient of ITP funding for two years in a row. HeartFlow is a Silicon Valley-based company which uses patients’ coronary CT data to help doctors diagnose coronary heart disease (CHD). Its technology is currently available in more than 40 hospitals in the UK, and it is anticipated to spread to more than 60 hospitals by 2020, with support from the ITP programme.
The partnership between HeartFlow and the NHS is a real success story in demonstrating how doctors and the med-tech ecosystem can work together for the benefit of patient health.
HeartFlow and a CT-first approach to diagnosis
The NHS is a world-leader when it comes to cardiac care, advocating a CT-first approach for the diagnosis of heart disease. This means that before any invasive procedure is carried out, a doctor will order a coronary CT scan to see what is happening in their patient’s heart. If the CT scan visually reveals CHD, the HeartFlow Analysis helps clinicians attain a unique level of understanding about the impact of CHD in their patients’ arteries.
The process starts by HeartFlow analysing data from a coronary CT angiography scan of a patient’s heart. The CT image data is uploaded securely from the hospital to HeartFlow’s cloud-based system, and anonymised before being sent over to HeartFlow. Once the anonymised image data is received, a combination of AI analysis and certified analysts create a personalised digital 3D model of the patient’s coronary arteries. Next the HeartFlow Analysis, using powerful algorithms to solve millions of complex equations, simulates blood flow within the modelled arteries, so that the impact of any blockages on the arteries can be assessed.
The completed analysis is securely transferred back to the hospital and allows cardiologists to interact with the model; selecting specific areas of the coronary arteries to investigate, zooming in and out, and rotating the image to enable a level of examination ordinarily only possible through an invasive procedure.
This means that most patients can be diagnosed without undergoing a surgical diagnostic procedure. For many, their condition can then be managed with medication only as opposed to more invasive procedures such as stenting or a bypass.
Funding is provided on a per case basis, with HeartFlow receiving a fee per Analysis performed. The ITP programme covers these costs, rather than individual hospital budgets. Ultimately the process has been demonstrated to offer the NHS valuable cost savings. In fact, The National Institute of Health and Care Excellence (NICE) estimates the HeartFlow Analysis could save the health service £9.1 million every year.
The future of innovation in the NHS
Technology is constantly evolving, and recent years have seen its pace accelerate rapidly. Med-tech firms like HeartFlow are collaborating with world-class universities to prioritise research and ensure new innovations are brought to market. HeartFlow works with academics at Imperial College London on collaborative research projects to further develop the application of deep learning AI techniques to medical imaging. Developments rooted in AI are leading the way and helping to make the diagnostic process more accurate and efficient. As machine learning improves, its capabilities and applications will continue to increase and provide more data noninvasively to aid physicians in diagnosing disease.
There’s almost unlimited scope for further development and technology will undoubtedly play a vital role in helping to tackle the health challenges of today and tomorrow. Does that mean doctors are soon to be a thing of the past? Absolutely not. Trained medical minds will still be integral to interpreting and applying the data that such innovations produce. It’s in their hands that innovation truly has the potential to improve and save countless lives.
It’s an exciting time to be working in the med-tech space and it’s clear that even greater achievements are on the horizon if the industry continues its close collaboration with public health services like NHS.
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