It was a privilege to be asked to lead an independent review to advise on:
We are at a unique juncture in the history of medicine, with the convergence of genomics, biosensors, the electronic patient record and smartphone apps, all superimposed on a digital infrastructure, with artificial intelligence to make sense of the overwhelming amount of data created. This remarkably powerful set of information technologies provides the capacity to understand, from a medical standpoint, the uniqueness of each individual – and the promise to deliver healthcare on a far more rational, efficient and tailored basis.
From late 2017 to the present, our cross-disciplinary team of experts, including clinicians, educators, ethicists, computer scientists, engineers and economists, reviewed the available data and projected into the future what impact these technologies would have on the NHS workforce over the next two decades. Such an undertaking with experts from multiple disciplines and a country-wide perspective has not, to our knowledge, been undertaken previously.
The Review has been predicated on the following pre-suppositions:
There are, of course, considerable uncertainties in projecting anything, no less such a precious part of our lives – our health. There are three noteworthy changes that we expect to take hold: a much greater proportion of the population will have their genome sequenced; the empowerment of individuals who will increasingly be generating their own health data with the help of algorithms to interpret that data; and a marked improvement in the speed, accuracy and scalability of medical data interpretation afforded by artificial intelligence, which will provide robust support for all types of clinicians. Taken together, this will lead to an evolution of the patient-doctor relationship that we hope can be greatly strengthened, along with the alleviation of burnout that currently affects a significant proportion of clinicians.
Ultimately, embracing and implementing these technologies (including genomics) throughout the NHS, while clearly representing a challenge, is likely to prevent diseases and their complications and produce an overall improvement in health outcomes. We offer a number of recommendations for you to consider. These will require early implementation by education providers, as well as by arm’s-length bodies and employers on behalf of the NHS, if we are to gain the benefits these digital healthcare technologies offer.
I would like to personally thank your Department for encouragement, my extraordinary Review Board and Panels for their expertise and commitment, Health Education England and the secretariat for their work on the Review, not forgetting all those who shared insights and experience in response to our call for evidence.
Eric Topol, MD
Executive VP and Professor, Molecular Medicine, The Scripps Research Institute
Founder and Director, Scripps Research Translational Institute