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NHS Digital has announced that it plans to launch a new open application programming interface (API) lab in partnership with the INTEROPen collaborative. The initiative will bring together developers from the industry and NHS Digital to speed up developments of open source APIs. This will improve integration between the NHS and social care, says NHS Digital, addressing problems around information exchange for clinicians and patients. The lab will be located in Leeds and it is expected that contributors will work on a pro bono basis. All the APIs developed will be open source, building on the FHIR standards from HL7, and they will be made available through an open source licence. NHS Digital says the lab will open towards the end of this year, with interested parties invited to get involved in order to shape governance principles. Richard Kavanagh, Head of the initiative at NHS Digital, said: "I'm really excited by the API Lab's potential to drive forward work on a number of significant open source APIs. By partnering with INTEROPen we will be able to create APIs even faster, delivering real benefits for the health and care system.” INTEROPen brings together individuals, representatives from the industry, standards organisations and health and care providers that want to accelerate development of open standards for interoperability in the field, focusing on data exchange and validation and defining APIs. The INTEROPen board said the new lab will help the community build the ‘methodology for taking a service need through to first of type implementation using open standards adopted by supplier members’.

National Audit Office investigation into the WannaCry attack finds NHS organisations ‘had tended to overestimate’ their readiness to deal with cyber attacks.

[East Anglia, UK] Norfolk and Suffolk NHS Foundation Trust has appointed the first Chief Clinical Information Officer (CCIO) to help drive use of digital technology and information, improving outcomes for patients. Dr Toral Thomas, Consultant Forensic Psychiatrist at the trust, has now taken over the new role. He will be focusing on improving the use of the Electronic Patient Record system and extending e-Prescribing services. In their latest report, Care Quality Commission (CQC) inspectors said the trust should further review the ‘performance’ of the EPR in order to ensure all employees have access to medical records: “When we last inspected the trust in July 2016 they had introduced a new electronic records system. We were very concerned about the performance of this system. Since then the trust had undertaken various improvement initiatives and some progress had been made. “However, at this inspection we observed that it remained difficult to establish a contemporaneous record of patient care in some services. We also observed that technical problems with the system, particularly in community services, meant staff could not always access records. “We acknowledge the trust had attempted to resolve these issues but we remained concerned about the risks to safe patient care.” Dr Bohdan Solomka, Medical Director, said the development of the new CCIO role ‘directly responds’ to concerns previously raised by the CQC: “Toral will focus on what we can to do help our frontline clinicians use technology to improve the quality of everything we do and the care which our patients receive. “He will act as a conduit between the IT team and our frontline clinicians, who use the systems every day, and will feedback their views on our current systems as well as ideas for improvements.” Norfolk and Suffolk NHS Foundation Trust is the seventh largest mental health trust in the UK, providing services for adults and children across Norfolk and Suffolk. Dr Thomas said: “The technology will not replace the kindness and dedicated service we provide, but will hopefully serve to enhance it. “In my new role I want to help take the great ideas which staff have on the clinical frontline forward and find ways to share some of the fantastic practice that happens every day throughout our Trust.”

What are the main digital workstreams the trust will be looking to deliver through the Global Digital Exemplar programme? AC: The Trust is focused on four main workstreams: a) The delivery of an infrastructure upgrade as the underpinning item for an upgrade to the latest version of our Epic system. In addition this will deliver even stronger enhanced cybersecurity aspects. b) Working towards the enhanced analytics and reduction in unwanted clinical variation with associated quality improvement that will support us in achieving HIMSS EMRAM Stage 7status by building on our current stage 6 status. c) Working with our community partners to foster new and meaningfully different ways of working collaboratively to communally deliver high quality care to our patients supported by technology. We see true standards based interoperability as the ultimate goal with portal type infrastructure as a temporary stepping stone to that. d) The extension / further development of our research capabilities in conjunction with a whole range of partners including the University of Cambridge, the European Bioinformatics Institute, the Wellcome Trust Sanger Institute and others including technology and pharmaceutical partners building on the very rich structured and unstructured phenotype data that we know have on our patients after essentially three years of live use of our Epic system. Have you started working with University College London Hospitals as part of the fast follower scheme on their deployment of Epic? AC: The Trust has been working closely with UCLH as it has developed its Fast Follower agreement. We have agreed a strategy for defining a programme of work; multiple conversations and face-to-face meetings between the two institutions involving all staff groups and all grades of staff have already taking place and continue to do so. We believe that this will be a very fruitful relationship between the two hospitals.  Have you identified any sites that you'd like to work with as part of the Global Digital Exemplar programme on an international level? AC: The wider Epic customer community is a very supportive one and we have been learning from a whole range of international hospitals. In return we have shared our learning and configuration with others. We are though working more closely with Duke University Hospital at present and would expect to develop this relationship over time. It has recently been announced that Dr Zafar Chaudry is moving on in November from his role as Chief Information Officer at the trust to become the Senior Vice President and CIO of Seattle Children's Hospital in the US. What approach will you take to appoint a new CIO? AC: At present the Trust is reviewing its approach to our current work programme in respect of digital. A number of significant changes are planned particularly around the current infrastructure retender and our Global Digital Exemplar programme. We will in due course be looking to appoint a new CIO but no firm decisions regarding the exact timing of that have been made whilst we finalise our longer-term approach. Certainly Zafar's impact on the Trust has been both striking and beneficial and we are extremely sorry to see him leave - it will be hard to find a new CIO of a similar calibre. Lastly, how will you support the HIMSS UK organisation and its strategy through the advisory board to accelerate the development of a digital health ecosystem across the UK and Ireland? AC: I am firm believer in sharing our experiences with others, and in return hearing from them about their challenges, approaches and successes. We all have much to learn and deliver in this arena if we are to deliver sustained high quality care for our patients. Communal learning, without each of us reinventing solutions for the same problems each time has to be the way forward especially as the population ages and the demands on healthcare systems grows. Both the Trust and I are deeply committed to facilitating this learning whether it be for individuals or the wider system through meetings, onsite visits, supporting the new Digital Academy and the Faculty of Clinical Informatics, and beyond. Engaging with all grades of staff, all professional groups and, most important of all, with the patients themselves will benefit us all and I believe that HIMSS UK is ideally placed to facilitate all of this going forward. In this context I am therefore delighted to accept a place on the new HIMSS UK Advisory Board.

The hype around AI is taking over all sectors, but, if we trust the thoughts of some of the most recognised voices, it is raising serious concerns amongst individuals. In September, Russian President Vladimir Putin told students in an open lecture, according to RT, that the leading actor in AI research and application will become ‘the ruler of the world’. But South African entrepreneur Elon Musk warned, once again, that this competition could lead to a third world war. China, Russia, soon all countries w strong computer science. Competition for AI superiority at national level most likely cause of WW3 imo. — Elon Musk (@elonmusk) September 4, 2017 The incredibly transformative potential of new technology has divided opinion in the medical sector, with companies embracing the use of AI now having to specify their software does not intend to replace the work of individual clinicians in any shape or form. Instead, they say it aims to speed up processes and solve system complexity to simply help clinicians care for their patients. At the Health and Care Innovation Expo in Manchester earlier this year, NHS England Chief Executive Simon Stevens said they will invest in AI over the next few months, building on recommendations from University of Oxford Regius Professor of Medicine Sir John Bell, included in the Life Sciences Industrial strategy: “John Bell’s report identified the faster application of AI in the NHS as one of the four big winds that we could potentially support and without doubt we will see as we make the case for public investment and NHS investment in this area, this will be one where NHS England will be backing that with our investment over the course of the next 12 months,” Stevens added. #Expo17NHS @NHSEngland Simon Stevens: there is a 'clear recognition of the importance of the life sciences industry to the UK' — BJHC News (@BJHC_news) September 12, 2017 At a recent King’s Fund event, Dr Dominic King, Clinical Lead at Google’s DeepMind Health, gave an example of how an AI-enabled system could change a patient’s experience. Robert, a patient with poorly controlled diabetes, collapses at home and hits his head, but he is wearing wearable sensors so his doctor is automatically alerted that something is wrong. “AI is just a much better statistical approach to assessing risk and predicting things than anything we’ve ever had access to before, so these wearable sensors predict that there is some issue or problem with Robert that needs escalation or activation,” King explained. Seeing the alert, his doctor accesses the medical record on his smartphone and realises the incident cannot be solved in a community setting, therefore he organises an urgent admission. Another algorithm, King added, could predict what hospital Robert’s care could be best managed at, based on his symptoms, while if he needs a CT a system could ‘intelligently’ trial the order of patients that should be seen first. After a few other interventions and Robert’s recovery, an AI system could help automate the paper-filling process for his discharge form and ease pressure on doctors and nurses. An ‘autonomous’ vehicle could even take Robert home at the end, King laughed. But when will NHS patients see this transformation? “Nothing I showed you is not actually already happening,” King said. “In every example there’s wearable technology, imaging technology, surgical targeting technology that is available, it’s just not joined up in any meaningful way at the moment.” The NHS has a long way to go before AI can be effectively leveraged Dr Vasilis Argyriou, Associate Professor at Kingston University London’s School of Computer Science and Mathematics, emphasised smartphones and wearable devices already incorporate sensors with a digital health monitoring function: “These systems are based on AI and machine learning that help to monitor physiological data of individuals and older people with chronic conditions. “Furthermore, machine learning and AI can be used for safety monitoring (detect falls, seizures and heart attacks in older people), rehabilitation, personalised treatments and early detection of disorders and other conditions (e.g. dementia),” he told BJ-HC. The NHS, it seems, has a long way to go before it can look at AI becoming an integral part of the system. Analysts argue the ‘paperless’ agenda, with an unclear timeframe, presumed to have moved from 2018, to 2020, and ‘unofficially’ to 2023, is unrealistic at this pace.  Trusts up and down the country continue struggling with Electronic Patient Record systems, as a recent HSJ story showed, and the consensus is that the current infrastructure cannot support the use of AI. “The idea that an algorithm from DeepMind or any other organisation is going to sort out some of the issues that are a consequence of the use of outdated technologies is actually fanciful and so this is why so much of our focus is in the work we’re doing on the Streams clinical app,” King told delegates last week. Dr Argyriou argued that this is a ‘multi-dimensional’ issue, based on the readiness of the technology, the public’s perception, economic factors and many others. However, the experts agree that AI-enabled care will become a reality in the future, but will the NHS be the ‘last man standing’ as every other sector embraces technology?

Seven national genomic laboratory hubs will become operational by November 2018.

The funding for the new Lorenzo digital exemplar programme will come out of the Department of Health’s 2013 agreement with CSC, now DXC Technology follwing the 2016 merger with the Enterprise Services portfolio of Hewlett Packard Enterprise.

Chief Inspector of Hospitals Professor Ted Baker has said Royal Cornwall Hospitals NHS Trust should be placed into special measures after failing to make improvements.

Trust goes live with Electronic Patient Record (EPR) system as part of joint programme with neighbouring trust.

England’s Health and Care Chief Information Officer addressed concerns surrounding the Global Digital Exemplar scheme and so-called ‘slow followers’.