In November 2016 the Royal Free London entered into an exciting five-year partnership with the British technology company DeepMind.
The landmark agreement means that some of the best minds in healthcare and technology will be working together to transform care through the use of a mobile app called Streams.
The app delivers improved care for patients by getting the right data to the right clinician at the right time. Similar to a breaking news alert on a mobile phone, the technology notifies nurses and doctors immediately when test results show a patient is at risk of becoming seriously ill, and provides all the information they need to take action.
Work on Streams started in 2015 and the app is now helping clinicians detect a condition called acute kidney injury (AKI) at its earliest stages. AKI affects one in six in-patients and is an indication that a patient is deteriorating but it can be difficult to diagnose. Streams uses a range of patient data to determine whether a patient is at risk of developing AKI and sends an instant alert to clinicians who are able to take appropriate action promptly.
Because patient information is contained in one place – on a mobile application – it reduces the administrative burden on staff and means they can dedicate more time to delivering direct patient care.
One patient who has benefited from Streams is Afia Ahmed, 38, from Hampstead, who suffered complications following the birth of her daughter Aleeza by emergency caesarean in January 2017.
Afia developed sepsis (an infection in the blood) during her labour, which then led to AKI. Using data from Afia’s blood test, the Streams app detected a problem with her kidney function and an alert was sent to a specialist kidney doctor.
The kidney specialist was able to provide guidance to the obstetric team on Afia’s condition and advised them to adjust the antibiotics, intravenous fluid treatment and pain killers that might put a strain on her kidneys. Afia continued to be monitored by a kidney specialist until her kidney function recovered and she was discharged home with baby Aleeza.
It is thought that the number of extra deaths in England each year associated with an episode of AKI may approach 40,000. The financial burden of AKI on the NHS in England alone is also believed to be in excess of £1 billion every year, which is greater than the annual cost of treating breast cancer.
The next stage of the partnership with DeepMind will see Streams being developed to help clinicians diagnose conditions such as sepsis and organ failure.
The partnership introduces an unprecedented level of data security and audit. All data access is logged, and subject to review by the Royal Free as well as DeepMind’s nine independent reviewers. In addition, DeepMind’s software and data centres will undergo deep technical audits by experts commissioned by its independent reviewers.
Furthermore, DeepMind is developing an unprecedented new infrastructure that will enable ongoing audit by the Royal Free, allowing administrators to easily and continually verify exactly when, where, by whom and for what purpose patient information is accessed.