U.K.’s Massive Diagnostic IT Project

The U.K. is planning a massive project – worth close to $1B – to procure new IT tools for medical diagnostic use. While details of the plan are still sketchy, it involves the acquisition of both radiology and cardiology PACS, as well as AI.

The U.K.’s NHS has become one of the world’s hottest test beds for medical IT adoption as the service struggles to reconcile a static workforce with rising demand for healthcare services.

  • For example, the NHS last year issued the AI Diagnostic Fund, which provided £21 million ($28M) for a variety of AI implementation projects across 64 NHS trusts.

But the new tender offer dwarfs that investment. NHS has proposed a Digital Diagnostic Solutions project to serve as “a route to market for departmental wide diagnostic IT solutions.”

  • The value of the project is pegged at £700M ($923M), a massive investment in medical IT by any metric. 

The offer is being led by NHS Supply Chain, the governmental agency responsible for procuring medical equipment within the NHS. 

  • The program’s tender offer states that the Digital Diagnostic Solutions project “is to be the new Framework for the Medical IT Departmental Software and Hardware Solutions framework within NHS Supply Chain.”

It includes the following provisions: 

  • Acquisition of radiology PACS, cardiology PACS, RIS, cardiovascular information systems (CVIS), laboratory information management systems (LIMS), and vendor-neutral archives (VNAs).
  • Software acquired through the program “will sit alongside” other capital equipment like X-ray, MRI, and CT systems.
  • It will also include 3D software, diagnostic AI software, and endoscopy image management applications.

Publication of an invitation to tender will happen in December 2024, and the contract award will be in July 2025, with the framework itself starting in August 2025. 

The tender offer was published just a few days before a government-commissioned report that said the NHS was in “serious trouble” and that was harshly critical of the system’s transformation to digital operation.

  • And that report came after a July election that saw the Labour party win power for the first time in 14 years – raising hopes that it would approach NHS funding differently than the previous Conservative governments. 

The Takeaway

Does the Digital Diagnostic Solutions project represent a new commitment to funding IT innovation from the Labour government? Or is it simply a rebranding of the NHS’ existing procurement activities? Stay tuned. 

More Work Ahead for Chest X-Ray AI?

In another blow to radiology AI, the UK’s national technology assessment agency issued an equivocal report on AI for chest X-ray, stating that more research is needed before the technology can enter routine clinical use.

The report came from the National Institute for Health and Care Excellence (NICE), which assesses new health technologies that have the potential to address unmet NHS needs. 

The NHS sees AI as a potential solution to its challenge of meeting rising demand for imaging services, a dynamic that’s leading to long wait times for exams

But at least some corners of the UK health establishment have concerns about whether AI for chest X-ray is ready for prime time. 

  • The NICE report states that – despite the unmet need for quicker chest X-ray reporting – there is insufficient evidence to support the technology, and as such it’s not possible to assess its clinical and cost benefits. And it said there is “no evidence” on the accuracy of AI-assisted clinician review compared to clinicians working alone.

As such, the use of AI for chest X-ray in the NHS should be limited to research, with the following additional recommendations …

  • Centers already using AI software to review chest X-rays may continue to do so, but only as part of an evaluation framework and alongside clinician review
  • Purchase of chest X-ray AI software should be made through corporate, research, or non-core NHS funding
  • More research is needed on AI’s impact on a number of outcomes, such as CT referrals, healthcare costs and resource use, review and reporting time, and diagnostic accuracy when used alongside clinician review

The NICE report listed 14 commercially available chest X-ray algorithms that need more research, and it recommended prospective studies to address gaps in evidence. AI developers will be responsible for performing these studies.

The Takeaway

Taken with last week’s disappointing news on AI for radiology, the NICE report is a wakeup call for what had been one of the most promising clinical use cases for AI. The NHS had been seen as a leader in spearheading clinical adoption of AI; for chest X-ray, clinicians in the UK may have to wait just a bit longer.

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