NHS 75 – Professor Shafi Ahmed on the potential of VR, AI and the metaverse in healthcare

In the third part of our series of interviews with leading figures in UK healthcare communications to celebrate NHS 75, we spoke with Professor Shafi Ahmed. Recently named as one of the top ten surgical pioneers in history by the Royal College of Surgeons of England, amongst other accolades, Shafi has used virtual and augmented reality to stream surgeries to students across the globe. 

Here’s what he has to say about health tech as a communications tool, the potential of the metaverse and how the NHS can incorporate AI and LLMs into its practice. 

Q1: Why should the NHS care about strategic communications? 

Shafi Ahmed: I think communication is so vital in medicine. The NHS has to have an effective communication strategy to allow patients to understand their treatment options, the plans for the health system and how to access some of these services across the UK; as well as [a communication strategy] for the providers who will be treating patients on a daily basis to understand the requirements and how they communicate better some of their policies and ideas around treatment strategies. 

Q2: How should the public’s expectations be managed with regards to concepts and ideas being realised (or not) within the public health system? 

SA: The way healthcare is changing with new ideas about therapies, treatment [and] prevention for example, in clinical practice would mean a different way of working for not only doctors and healthcare workers, but also for patients to access that healthcare system. As we move to more personalised healthcare system with patients being responsible for their own health and being more autonomous and having freedom of choice and being independent, I think it’s absolutely vital that this information is passed effortlessly through the system. 

If you look at secondary care, primary care and the end user/the patients – social care – this breadth of the NHS needs to be more integrated so that information passes freely and it’s as accessible as possible. We’ll look at the patient journey. It’s always been difficult sometimes when there’s friction through a system – there might be a miscommunication and there also might be a struggle in terms of language barriers etcetera. So it’s essential that, when we bring out new ideas, those are conveyed in a way that the patient understands them. [It] might be different languages, it might be for example across television, across radio and across of course information leaflets that might be handed out at primary care services. 

And I think it’s essential that that communication is done properly to ensure compliance and to bring the patient on that journey with the system. Otherwise you get non-compliance and bad outcomes. Ultimately, better communication improves the patient’s journey experience and improves the outcomes. 

Q3: You’ve done a lot of “firsts” during your career. What drives you do push boundaries in this way and have you achieved what you envisaged? 

SA: One of the great things about the NHS is its role in innovation and implementing new ideas – that could be technology – into the healthcare system to allow patients to have better experiences and outcomes. From my experience as an innovator and a futurist, for example, when I did the world’s first Google Glass operation, streaming live across the world or indeed doing the first operation in virtual reality, is to ensure that we were scaling the ideas to a large population. 

For me, it’s about how do you educate a lot of people rather than one or two people that might be close to you? How do you scale and teach hundreds and thousands of people around the world to allow us to improve global health [and] improve access? And so I felt that technology would allow us the way to improve access across the world. 

I think innovation lies at the heart of medicine. Over the last many centuries, there’s always been innovations in healthcare to drive change, whether it’s cancer care, diabetic care [or] cardiovascular care, we’ve always brought new interventions in, such as stents in vascular surgery for example which replaced open heart surgery, we’re now using virtual reality for training the future generation of nurses and doctors. 

It’s absolutely necessary that the NHS maintains its foothold in innovation and becomes a leader around the world in showing how we can implement these changes and new ideas into clinical practice rapidly. And the COVID pandemic has actually forced us to think differently, has asked us to innovate much more quickly and what I’m pleased about is that the healthcare system and the NHS is ready for change finally. And that’s only going to be good for the patient. 

When I streamed the live operation back in 2014, that’s nine years ago, I streamed to 14,000 students across the world – these are medical students and nursing students in 118 countries simultaneously using a smartphone and a streaming app. Immediately that showed the scale that you could connect with people across the world, in any part of the world. Running the virtual reality operation, I trained 55,000 people in 140 countries of 4,000 cities simultaneously showing again the benefit of connecting people across the world. 

And when I did the operations for example using social media, we connected over 56 million people across the world. So using kind of [these] tech solutions, the low cost, high-tech solutions allow everyone in the world to benefit from knowledge of clinicians from other parts of the world. So it’s about equity, it’s about access and also makes healthcare and education more affordable. That’s been my ambition — how do I use my knowledge to [reach] a much wider audience and leave that legacy for future generations. 

The NHS has now embraced what’s called extended reality. That includes augmented reality, virtual reality, mixed reality and over the last few years has now put aside funding to allow new training methods to be developed using virtual reality and augmented reality. And now we are training nurses, doctors, surgeons, medical students across the UK using these latest technologies. And I think that adds some value from traditional models of learning like books and e-learning platforms. We’re just moving seamlessly onto the next generation of tools that allow us to learn better, faster, quicker, and retain more facts. It shouldn’t be replacing traditional methods. It should be supporting or augmenting what we use already to improve people’s experiences with education. 

Q4: You’ve streamed surgeries on a number of platforms. Has VR as an education tool taken off in the way you imagined? Are there other ways that the NHS should be using technology to engage with staff better? 

SA: Virtual reality has now found its place in medical education and also medical therapy. We’re now using virtual reality to treat patients. For example, in the US they treat patients with chronic back pain with VR therapy showing an outcome that’s improved. In terms of education, we are now seeing medical schools, nursing schools [and] postgraduate training programmes in virtual reality as well as interactive platforms allowing people to now engage with avatars that look like patients, for example, using other technologies to allow them to improve their communication, to improve diagnosis and improve the clinical outcomes. 

So now we’re seeing a huge change in the way that the future generation of students are being taught and also for people who are health workers who are now looking for postgraduate training or continued professional development, using these tools for further learning. 

Q5: You’re a believer in the metaverse – how do you see that being used in health and care in the future? 

SA: The Metaverse is clearly in its early phase, we call it the 3D of the Internet. It’s a number of technologies coming together to create a kind of immersive experience. And what I think the Metaverse as being is an additional way of interacting with patients in a virtual environment. Also for education purposes: it might be that patients can learn about drug therapies or which drug to take and the complications and see graphic representation in a 3D virtual environment.  

We see also a way of collaborating. For example, doctors around the world could collaborate for a multidisciplinary team meeting [to] talk about patient care. We also see it for example in education, for example. Anatomy teaching in the future could be based around different specialists coming together with students around the world connected with 3D objects, animations letting you train people virtually. 

So the metaverse is certainly an interesting concept. I think it will find its place over the next few years as people look for other ways of accessing their healthcare system, their doctors and nurses, and also different ways of learning and have [improved] experiences of the healthcare system. But hopefully it will also improve outcomes. So I do see the Metaverse being rolled out at some stage in the next few years, maybe as pilots initially and maybe then a wider rollout. 

At the moment we have conventional face-to-face which is amazing and it’s still the right way of seeing our patients. As a cancer surgeon of course there’s that physical contact, the closeness that’s very important when breaking bad news for example. We’ve now moved to telephone calls and Zoom calls and remote kind of ways of seeing patients which adds value and puts patients at the centre. 

[They] control their healthcare because it’s that their convenience at their time at home, that’s been a game changer for all of us. And the last bit is where do you go with that? The metaverse adds the additional way of being virtual and seeing people in different environments. So it’s going to be a natural fit at some stage offering patients the choice of how they’re seen, where they’re seen and how they get their education and treatment. 

Q6: Do you see any future role of AI or LLMs in public healthcare communications? 

SA: So the current buzzword in medicine and technology is artificial intelligence and large language models, things like ChatGPT and Bard and Google. You can’t open any social media platform without seeing evidence of this. So I think very important in communication. 

First of all, AI will be the powerhouse of the health system — the chat bots, the triage systems work in the background to allow us to see many more patients much quicker [and will] also be used in diagnostics like radiology, X-ray, CTs etcetera being helpful with diagnosis at a rapid pace. So definitely AI would be helping supporting healthcare in the future. 

Also, if you look at the current technologies like the LLMs, we’re now seeing people converse [and] communicate using chat bots [and] give information. You can now ask ChatGPT4 for example around your diagnosis and options for what kind of treatment should you have. You have interactive discussion with ChatGPT. That’s great for patients it will empower them more with the evidence with information they might have. 

It might also help in literature, [with] research articles being written through some of these LLMs. It will help us to define our communication strategies of how you communicate with a patient with X for example, it will tell you about what the framework might be. It’ll make our life much easier as healthcare workers. It’ll help communication and I think it would make things a lot better going forward – much faster and much more rapid. And I think the access to knowledge and information is going to be key. The future of healthcare is data-driven, it’s going to be personalised and I think doctors like me will have more time spent with our patients face-to-face. 

And the question of course, will AI technology make us more human? I think would give us much more time to be human and spend time with the patients as we are trained to be. 

Q7: One of the key themes of NHS 75 is looking forwards. What do you see as the challenges and opportunities for strategic comms within the NHS in the coming decades? 

SA: So the next two or three decades, communication will also have to evolve and change. We have now many different ways of communicating with either clinical staff or the patients. We have, of course, online platforms. We have the news, we have the social media platforms which are now proliferating. We have the social media channels, we have image databases. So you think about where we are now, people want information immediately that’s accurate, that they can actually respond to [and] they want it at their fingertips in a few seconds – one or two clicks only on the Internet. 

Communication has to reflect who we are as people now wanting things immediately fast, reliable and that we can trust. And that’s going to be key going forward. How do you trust information now that we see through those platforms. And as long as we have suitable platforms that we have trust in and that have the background that we kind of can use as a patient for example, I’d want to make sure I can access that information in the correct manner that validated and also that I can rely on to make my own decisions. 

So there’s a huge challenge out there to get it right and I think the communication strategy has to be…it’s almost like a science of its own now, an evolving science, and how do you communicate effectively given the current constraints of the world that we live in to ensure that it’s accurate, reflective and transparent and that’s all that you can do. 

 

You can follow Shafi on X and LinkedIn. For more on our celebration of NHS 75, follow Blue Lozenge.