Tyler O'Neal, Staff Editor HEALTH

Imperial College London prof Zhang suggests the failing IT infrastructure is undermining safe healthcare in the NHS

Poorly functioning IT systems “a clear and present threat to patient safety,” warn experts

Joe Zhang at Imperial College London and colleagues point to a recent 10-day IT system outage at one of the largest hospital trusts in the NHS and warn that increasing digital transformation “means such failures are a no longer mere inconvenience but fundamentally affect our ability to deliver safe and effective care.”

The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom.

They argue that, unlike the procurement of electronic health records, for example, investment in IT infrastructure is rarely prioritized and easily viewed as a cost to keep down rather than an investment that increases productivity.

Yet the consequences are substantial, they write. A recent survey of NHS clinicians commissioned by NHS England shows that user experiences of electronic health records are generally poor, resulting from unreliable, slow IT.

The British Medical Association (BMA) estimates that a substantial proportion (27%) of NHS clinicians lose over four hours a week through inefficient IT systems. The BMA report also found deficiencies in investment and a lack of clinician engagement in procurement.

Outdated infrastructure is a risk to data security, they add. It is unclear how many providers conform to national guidance by keeping multiple back-ups of data, including ‘off-site.’

There is also a growing disconnect between government messaging promoting a digital future for healthcare (including artificial intelligence) and the lived experience of clinical staff coping daily with ongoing IT problems.

“This digital future will not materialize without closer attention to crumbling IT infrastructure and poor user experiences,” they write.

There is no one-size-fits-all solution, but the NHS can learn from approaches taken elsewhere, they say. In the US, for example, the effect of health IT on end users is an active area of research, particularly on how the functionality of IT systems affects clinician burnout and effectiveness, while federal oversight of healthcare IT infrastructure can identify problems and coordinate a response.

To facilitate a transformation of IT infrastructure in the NHS “we need to include systematic and transparent measurement of IT capabilities and functionality at the level of clinicians – the people using the systems” they explain, “as well as at the level of those procuring the systems.”

Armed with this understanding, quality improvement cycles must become routine in IT governance, as they are in clinical care, and government must provide the investment needed to identify and rectify poor performance but also demand accountability, with minimum standards for IT function and stability, they add.

“We must not tolerate problems with IT infrastructure as normal,” they conclude.

“Poorly functioning IT systems are a clear and present threat to patient safety that also limit the potential for future transformative investment in healthcare. Urgent improvement is an NHS priority.”

University of Sydney geoscientists find the future health of coral reefs is written in the sand

Tyler O'Neal, Staff Editor HEALTH

University of Sydney geoscientists deploying instruments into sand aprons at One Tree Island, Great Barrier Reef [Credit: University of Sydney]How are coral reefs responding to climate change?

University of Sydney geoscientists develop a technique that reveals the health of coral reefs from space.

How healthy are coral reefs? And how are they responding to climate change? After more than 10 years of monitoring the Great Barrier Reef, University of Sydney geoscientists have developed a technique that allows them to answer these questions using satellites. And it all relies on sand aprons.

It turns out that sand aprons, deposits of sand along the shore of a lagoon that is ubiquitous in coral reefs, can give a reliable estimate of how coral reefs are growing as well as their rate of carbonate sediment productivity – key to establishing their overall health.

“The traditional way of collecting such data is very work intensive,” said Associate Professor Ana Vila-Concejo, who led the study, published today in the journal Geology. “It requires actively measuring the chemistry of water or taking thousands upon thousands of photos to calculate how much each creature in the ecosystem is contributing to carbonate sediment productivity.”

But the study also found more signs of trouble for coral reefs: carbonate productivity today is half what has been for thousands of years of sand apron formation in the southern Great Barrier Reef. “Our results suggest that ecosystem health was much better then, so we’re likely seeing the effects of climate change in our present-day data,” added Associate Professor Vila-Concejo, Co-Director of the University’s Marine Studies Institute.

How corals grow and recede, under what conditions, and how healthy they are, are dependent on an incredibly complex combination of factors – such as waves and storm surges, sedimentation rates, seawater chemistry, land-based runoff, and even fish populations. Hence, predicting the health of any single coral reef group, and how they will behave in response to climate change, is an intricate puzzle.

However, the researchers found that sand aprons – formed as waves and currents from reef crests carry sediment that becomes trapped in the reef lagoons – can be used to estimate carbonate productivity over time, and therefore the health of a coral ecosystem.

The field team, coordinated by Dr. Sarah Hamylton, an Associate Professor at the University of Wollongong and an Honorary Associate at the University of Sydney, worked from a 12-meter catamaran to visit 21 reefs in the southern Great Barrier Reef, collecting over 100,000 records of reef bathymetry and composition.

The team later worked with satellite imagery to measure the sand aprons and estimate their volume for each reef. They then matched that data with carbonate production measurements taken over more than a decade to try and understand sand apron evolution, and how it correlated with productivity.

“The formation of sand aprons by lagoon infilling is a function of reef size, and a self-limiting process controlled by the surrounding hydrodynamics and in response to the ebb and flow of sea-level changes,” said Associate Professor Vila-Concejo, who is also Deputy Director of the One Tree Island Research Station, located in the Great Barrier Reef. “If we can understand the evolution of sand aprons in each reef over time, we can use the data to manage coral reefs and prepare for climate change.”

As coral reefs around the world respond to warming oceans, it will change how corals behave. The climate effects on the drivers for sand apron development – sediment production, hydrodynamic forcing, and the infilling of lagoons – are not yet clear. But the study indicates that understanding their behavior and evolution provides a powerful shortcut to determining overall reef health.

In addition, by combining modern analysis of sand apron accretion with data going back 8,000 years, the researchers can establish the background rate of coral productivity.

“Our findings show that the carbonate production was much higher during the Holocene – the last 11,700 years of Earth's history – but that the average rate of production today is down 50 percent on this. That is a cause for concern,” Associate Professor Vila-Concejo said.

“Our current research involves modeling what this will mean for the future of the Great Barrier Reef, and these data are going to be essential for that,” she added.

Mizzou engineers win Army grant to build an explainable AI framework to speed up innovation

Tyler O'Neal, Staff Editor HEALTH

A nearly $4.9 million grant from the U.S. Army Engineer Research and Development Center (ERDC) is supporting the project by University of Missouri engineers

More than a century has passed since Thomas Edison developed the first electric light bulb, yet Edison’s hallmark approach of ‘trial and error’ to reach his discovery remains a large part of today’s inventions. Now, a team of engineers at the University of Missouri is embodying the age-old adage of “work smarter, not harder” by using artificial intelligence (AI). While Matt Maschmann (left) focuses on the integration of AI and machine learning into materials processing, Derek T. Anderson is working alongside him to help make AI more intelligent by determining how to better integrate human knowledge into the artificial world.

Supported by a two-year, $4.875 million grant from the U.S. Army Engineer Research and Development Center (ERDC), the team from the MU College of Engineering, including Derek T. Anderson and Matt Maschmann, is developing a theoretical framework around “explainable AI” to describe how the next-generation of AI can be integrated into the innovation process for designing new and existing materials — while also securing the trust of humans along the way.

Maschmann, an associate professor of mechanical and aerospace engineering, knows this process well. For example, he’s been working with carbon nanotubes since 2003, yet Maschmann said their full potential as an engineering material is far from being realized. The same, he said, can be true for many material systems. Therefore, one of the MU team’s goals is to find a way to accelerate the discovery process by helping make better quality materials in a shorter period.

To do this, the team is starting with how to integrate AI and machine learning into the process, said Maschmann, whose passion for developing materials began in the early 2000s during graduate school.

“One of the more pressing challenges in the development of new materials, or optimization of existing materials, is the time required by the processing and characterization steps,” Maschmann said. “Making discoveries takes quite a bit of time and money. For instance, each step of a process may take a day or longer to accomplish. Therefore, in a traditional laboratory environment, scientists will repeat a process multiple times in an attempt to obtain a specific structure or property for a material guided by intuition and previous knowledge. However, if we can introduce machine learning algorithms and AI into the process, it could drastically reduce the time needed to obtain material properties of interest. My hope is this project will greatly increase the rate of discovery for developing materials while also increasing our fundamental understanding of these processes.”  

While Maschmann focuses on the integration of AI and machine learning into materials processing, Anderson, an associate professor of electrical engineering and computer science, is working alongside him to help make AI more intelligent by determining how to better integrate human knowledge into the artificial world. For instance, Anderson said while material scientists, chemists, and physicists have vast knowledge about the physical world, most AI and machine learning do not yet share that same level of intelligence.

“Therefore, we’re looking at how do we design the next generation of AI and machine learning to take advantage of the existing knowledge that people have,” Anderson said. “Then, we want to use that knowledge to intelligently grow AI to be able to design smarter materials. While our efforts are focused on the ‘explainability’ side, and helping scientists and domain experts understand how these processes work, we hope to make AI smarter for everyone’s benefit in the process.”