Scottish healthcare needs a ‘fundamentally’ different approach in the AI era

A single patient record is needed to make the most of advances in healthcare AI, it is claimed.

Dr Charlotte Refsum, director of health policy at the Tony Blair Institute (TBI), told attendees at Holyrood’s Transforming Scotland’s Health conference that a new approach was needed to tackle the problems facing health and social care.  

In her speech to attendees, Refsum called for a shift from populist policies that offer easy solutions to a new and fundamentally different approach.  

“Tony always says it's incumbent on us as progressives to come up with a fundamentally different solution because that is what people want,” Refsum told the audience at Dynamic Earth in Edinburgh.  

“They don't want a sort of incremental changes to the status quo. And if that's all we offer them, then they will vote for people who have more populist, easy answers.” 

Refsum’s speech focused on the opportunities that artificial intelligence (AI) offers for innovation in the health care sector, from streamlining workflows to developing new medicines.

“We've got this demand that's coming in constantly and we need prevention,” said Refsum. “Then we've got constraints on capacity, workforce, funding and digital infrastructure and we need productivity. I'm not saying it's a silver bullet, but AI can help.” 

AI systems are being implemented into the daily lives of people across Scotland, from large language models like ChatGPT to project within NHS Scotland to increase efficiency and improve services. 

Earlier this year, Tess Watt, a PhD student at Heriot-Watt University, led a groundbreaking international project to create a portable AI-powered diagnostic system to detect signs of skin cancer from an image. The system works without needing internet access or input from dermatologists and is intended to cut wait times and increase access to healthcare in remote areas.   

“AI is accelerating the pace at which we can discover new drugs and the pace of innovation,” Refsum said. “How do we make sure that our health systems are agile enough to adopt that innovation and are not sort of stuck and fossilized in old models of care?” 

To combat this, Refsum called for a more fully integrated healthcare system, where data is shared between different sections of the health service. By creating a system where all a patient's medical records are easily accessible, the additional admin tasks performed by doctors and other medical professions could be cut, increasing their hands on time with patients.  

To achieve this goal, Refsum and the TBI had advocated for a single patient record, where all data on a patient is accessible through one portal for both doctors and the patient themselves. 

“Obviously, we have plans for a single patient record in England, but other countries are ahead of us,” said Refsum. “I would mention Estonia, where 100 per cent of people have an ID card, everybody has an electronic health record and 20 per cent of the population have their genome mapped. By the way, they earmarked one per cent of their GDP to do that. I'm not saying we should do that in the UK, but I'm just saying people are serious about it.” 

By implementing a single patient record, Refsum says that it would allow for a greater understanding of the underlying problems in the NHS through the application of AI to large amounts of patient data. This would happen through the in-depth analysis of patient data, which Refsum says would allow for NHS services to be allocated more effectively to patients, as spots where funding or services are lacking would be highlighted. 

“This is why we feel that the single patient record is so important in the AI era,” says Refsum. “It is because it helps you to understand each individual's risk, it helps you to manage illness and it also helps you to spend wisely on the health system.”