Intended for healthcare professionals


Technology will improve doctors’ relationships with patients, says Topol review

BMJ 2019; 364 doi: (Published 11 February 2019) Cite this as: BMJ 2019;364:l661
  1. Abi Rimmer
  1. The BMJ

Doctors should be trained in genomics, artificial intelligence (AI), and digital healthcare technologies, the government commissioned Topol review has said.

The review, led by Eric Topol of the Scripps Research Institute in California, was commissioned by Jeremy Hunt, former health secretary, to explore how NHS staff can make the most of technology to improve services and help ensure a sustainable NHS.

The final report said that the UK has the potential to become a world leader in healthcare technologies and that these would affect the way doctors and other clinicians work.1

It added that, while technology will not replace healthcare professionals, it can “enhance them” and give them more time to care for patients, leading to “a marked improvement in the patient-clinician relationship.”

Future roles

The report included a hypothetical case study setting out how a doctor’s role may change in the future. In 2019 “Sarah” is a paediatric consultant with a specialist interest in metabolic medicine. She is “frustrated by needing to use fax machines and bleeps” and “wants to use more streamlined, intelligent communication with colleagues and patients, which maximises the amount of time she can spend with patients.”

In 2029 Sarah is a consultant with a portfolio career that combines clinical work with a national coordinating and oversight role at Genomics England. Developments mean that “most of her patients have their whole genome sequenced at birth,” and her clinical team includes bioinformaticians and computer scientists, who support the use of AI technologies.

Sarah’s patients wear sensors that remotely monitor their metabolic markers to predict their health trajectories and to model personal care plans. As a result, early intervention and personalised treatments have markedly improved outcomes in conditions such as diabetes.

The report said that all healthcare professionals should receive core training in genomics to help them understand the basis, benefits, and ethical considerations associated with genomics. It added that clinicians working in “key clinical specialities” needed training to incorporate genomic testing and genomic counselling into their practice.

Clinicians should also have access to training resources and educational programmes in digital healthcare technologies to “assess and build their digital readiness,” the report said. It also called for more specialist roles giving clinicians dedicated time to work in partnership with academia and the health tech industry, “to design, implement and use digital, AI and robotics technologies.”

Welcoming the review, Andrew Goddard, president of the Royal College of Physicians, said that immediate action was needed to ensure that the workforce was fully equipped to make the best use of advancements. He added, “But we must also make sure that the roll-out of technology across the NHS is measured, responsible, and done safely. Regulation and critical appraisal are vital in ensuring constant evaluation and improvement—which doctors must play an active role in.”

Adam Steventon, director of data analytics at the Health Foundation, argued that it would require a “Herculean effort” from people at all levels of the NHS to make the review’s recommendations a reality.

He said, “The NHS is overstretched and has a shortfall of 100 000 staff. Unless the government and NHS leaders take radical action and prioritise the recruitment of new staff and the development of the existing workforce, the NHS will struggle to sustain current services, let alone take advantage of the benefits new technology can bring.”