NHS hospitals are using algorithms to sort patients waiting in the vast backlog of appointments caused by coronavirus, Sky News has learned.
Officials have warned the number waiting could reach 10 million by Christmas.
Some of the largest hospitals in England and Wales have started ranking patients using algorithms which prioritise the most urgent appointments with a traffic light or scoring system.
The trusts include Nottingham University Hospital, the Christie in Manchester and Aneurin Bevan Hospital in Wales, according to a company that provides the software, which says that dozens of other hospitals are planning to adopt it.
“We’ve got 27 acute trusts who are all interested,” says Tom Whicher, CEO of DrDoctor, who estimates that if every hospital in the country adopted his technology, the time needed to get through the backlog could be cut from four years to 10 months.
DrDoctor’s tool automatically rates patients’ responses to digital questionnaires to assess the urgency of their medical need, giving each patient a red, amber or green score.
Mr Whicher says the system, which uses machine learning technology to “read” the questionnaires, can identify unnecessary appointments and help shift patients who don’t need to be seen face-to-face towards virtual interactions.
“About 12% of patients on waiting lists don’t need that appointment and they can be seen somewhere else,” he told Sky News.
“That leaves 88% of patients. Of those, about half you can risk-stratify and keep them at home. Remember, for every surgery, you probably have four follow-up appointments. This is about reducing those.”
The questionnaires are developed with clinicians, who review the responses before deciding whether a further appointment is needed.
Cancer specialists who have used the scoring tool say it has helped reduce the time of a follow-up appointment from 10-15 minutes to 4-5 minutes.
“We can look at that information in a fairly quick way rather than sieving through the raw questionnaire data,” says Dr Ananth Sivanandan, a consultant in clinical oncology at Nottingham University Hospitals Trust, which has conducted a year-long trial with the technology.
Dr Sivanandan said the system had “huge potential” for freeing up doctors’ time, adding that patients welcomed the opportunity to think more deeply about their responses to clinical questions.
Yet researchers cautioned that digital tools such as this could exacerbate health inequalities, because some groups have greater access to digital technology and are more fully reflected in the data.
“There are cultural differences in how likely someone is to rank their pain as severe or not severe,” said Carly Kind, director of the Ada Lovelace Institute.
“That may mean that those who are culturally less likely to say that they have severe pain are less likely to get seen face to face and more likely to be relegated to a digital consultation.”
Rob Martinez, who has had an urgent operation for a double knee replacement postponed until next year due to coronavirus, says he wouldn’t want a computer deciding when he would see a surgeon.
“Expecting a computer to decide who’s going ahead of you and whether to put you up or down, I can’t believe that could be the case,” he said.
“I would prefer it coming from a human being.”
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Waiting lists have grown hugely as a result of the coronavirus crisis, with hospital bosses warning that 10 million people could be waiting for treatment by Christmas.
Analysis by the Labour Party showed recently that 470,000 people are currently waiting more than six weeks for diagnostic tests, up from 29,832 in February.
According to DrDoctor, Aneurin Bevan is using the service across around 20 specialisms, including urology.
The Christie cancer centre in Manchester has been using the technology since before the coronavirus crisis.
The use of predictive algorithms has been growing in public services. Last year Sky News revealed that 14 police forces and 53 councils were using the technology to deliver key public services.
The technologies have also been adopted in healthcare, although this has proved controversial.
Babylon Health, a digital healthcare solution championed by health secretary Matt Hancock, has been criticised for claiming that its symptom checker could diagnose health issues as well as a human doctor, although the company says its statement was misinterpreted.
UPDATE: this piece has been changed to remove a mention to Guy’s and St Thomas’ Hospital in London, which uses digital forms but not automated scoring