Scotland’s Artificial Intelligence Strategy, released in 2020, notes that Scotland has the potential to become a “go-to location” for the AI and healthcare market. Today, there are multiple AI pilots taking place across NHS Scotland, and a small number of AI tools are already used in clinical practice.
SPICe has recently published a briefing on Artificial Intelligence and Healthcare in Scotland. This blog summarises some of the key themes from that briefing, with a focus on current and potential near-future uses of AI in NHS Scotland. This is the second blog in a series of publications on AI from SPICe. You can read the first part here.
What is AI?
Scotland’s AI Strategy defines AI as:
Technologies used to allow computers to perform tasks that would otherwise require human intelligence, such as visual perception, speech recognition, and language translation.
AI is based on algorithms, which are sets of instructions used to perform tasks, such as analysis or calculations, usually on computers. Recently, AI has advanced significantly through machine learning. In machine learning, the AI system is first given a large amount of training data (e.g. pictures of x-ray scans with and without tumours). The AI uses statistical methods to infer rules from the training data, and then uses these rules to perform tasks (e.g. classifying scans to benign or worrying). This method allows AI systems to successfully perform tasks in areas where achieving the same results through traditional programming would be very difficult, such as image and speech recognition.
For a more detailed explanation of how AI works, see this recent blog from SPICe.
How is AI used in NHS Scotland?
At the time of writing, a small number of AI tools are already used in clinical practice in NHS Scotland. This section outlines most of these but may not be a comprehensive list.
BoneXpert is a tool that uses AI to automatically determine a child’s bone age from radiographs of a hand. This helps clinicians spot potential growth disorders and other medical conditions. The tool is used widely in the UK, including at NHS Greater Glasgow and Clyde, and the Royal Hospital for Sick Children in Edinburgh.
Ethos is a system that uses AI to automatically target and adapt the delivery of radiotherapy in cancer treatment. When a patient has cancer, the tumour and the surrounding tissue typically change as the treatment and/or the disease progress. Traditionally, this has required a lot of time from clinicians to continuously adjust treatment plans. The Ethos system uses AI to allow clinicians to make these changes more quickly. Ethos is currently used at the Beatson West of Scotland Cancer Centre.
Some of the newest medical imaging devices utilise AI as an in-built feature. For example, the CT (computerised tomography) scanner at the Golden Jubilee Hospital in Clydebank uses AI to achieve clearer images in less time than was previously the case.
Speech recognition software has also improved significantly with recent advancements in machine learning. Healthcare professionals across Scotland and the rest of the UK now use such software to speed up repetitive tasks relating to clinical notes and letters.
What else could AI be used for soon?
In addition to the small number of AI tools already being used, many AI applications are currently being tested in NHS Scotland. These include applications in medical imaging, predicting and preventing illness, and automation of administrative tasks. This section highlights one current example from each of these areas.
Medical imaging
NHS Grampian has recently tested an AI tool called MIA, created by Kheiron Medical Technologies, for reading mammographs. The hope is that using AI in breast screening could make the process more accurate, cut waiting times and reduce workload. Currently, the standard practice is that at least two professionals read each scan. In the future, AI could potentially replace one of the two human readers.
According to early findings reported by the BBC, MIA spotted signs of cancer missed by human doctors in 11 women during the trial. Data from the trial is currently being analysed by researchers at the University of Aberdeen, with final results expected later this year. The study received funding from NHS England’s AI in Health and Care Award.
Predicting and preventing illness
NHS Greater Glasgow and Clyde is currently running a project which aims to find out if an AI tool called Dynamic-AI can improve the care of people with COPD (chronic obstructive pulmonary disease). This illness affects around 120,000 people in Scotland and is the second most common reason for emergency hospital admissions. The idea is that AI could predict flare-ups, allowing early interventions to prevent hospital admissions.
The Dynamic-AI study is run together with the University of Glasgow and the industry partners Lenus Health Ltd and Storm ID, with funding from the AI in Health and Care Award. It will continue until January 2025.
Administrative tasks
In May 2024, the Scottish Government announced that a new type of operating theatre scheduling software will be rolled out nationally to tackle waiting times. This comes after a successful trial in three NHS Boards and an assessment by the Scottish Health Technologies Group.
The software, developed by Infix, uses machine learning to optimise theatre scheduling. During trials, it improved operating room efficiency by up to 25%, with no additional medical staff or rooms required.
Who drives AI development in Scotland?
The development of AI tools for healthcare often involves academic, industry and NHS Scotland partners. To promote collaborations like this, NHS Scotland has three Regional Innovation Hubs, covering all 14 territorial NHS Boards. The hubs are funded by the Chief Scientist Office.
Many national NHS Boards also play a role in AI innovation. For example, NHS Golden Jubilee, which includes the Centre for Sustainable Delivery (CfSD), is involved in multiple AI pilots. The CfSD also runs the Accelerated National Innovation Adoption (ANIA) Pathway, which aims to fast-track the adoption of new, proven technologies across NHS Scotland.
Health Improvement Scotland (HIS) runs the Scottish Health Technologies Group (SHTG), which assesses and makes recommendations on new technologies, including but not limited to AI. SHTG’s evaluations are based on multidisciplinary health technology assessment methodology (HTA). Sometimes the ANIA Pathway refers technologies for the SHTG to evaluate.
Challenges
Despite promising developments, the use of AI in healthcare also raises some challenges. These include issues relating to safety, bias, explainability, data protection and legal liability. As many of the promising results relating to AI have not yet been widely replicated in real-life clinical settings, there are also challenges relating to local adoption.
These issues are discussed in more detail in the recent SPICe Briefing on AI and Healthcare in Scotland and in the third part of this blog series.
Karri Heikkinen, Researcher, Health and Social Care Team, SPICe