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Use of Streams app lawful and compliant with data protection laws, insists NHS trust

Health iStock 000005083391XSmall 146x219An independent audit carried out by law firm Linklaters for the Royal Free London NHS Foundation Trust (RFL) has concluded that the trust’s use of Streams, an app intended to deliver improved care to patients with acute kidney injury (AKI), is lawful and complies with data protection laws.

The Royal Free was required to carry out the audit to comply with undertakings it gave following an investigation by the Information Commissioner in July 2017.

The watchdog found that the NHS trust had failed to comply with the Data Protection Act when it provided personal data of around 1.6m patients to Google DeepMind to test the app.

In its ruling the ICO found shortcomings in how the data was handled, including that patients were not adequately informed that their data would be used as part of the test.

The Royal Free admitted that the Linklaters audit, which can be viewed here, had suggested that further improvements could be made. However, the trust highlighted the report’s conclusions that:

  • DeepMind only used patient information for the purpose of providing Streams. “It does so under the direction of RFL and in strictly controlled conditions. DeepMind is not permitted to use patient information for any other purpose.”
  • Streams did not use artificial intelligence. “Instead, it implements a simple decision tree used across the whole of the NHS.”
  • The audit revealed nothing that cast doubt on the safety and security of the patient information used in Streams. “The audit confirmed appropriate systems and controls are in place to protect patient information.”

The trust said that, similar to a breaking news alert on a mobile phone, the Streams technology notified nurses and doctors immediately when test results showed a patient was at risk of becoming seriously ill, and provided all the clinical information they needed to take action.

Dr Chris Streather, RFL group chief medical officer, said: “The Information Commissioner’s investigation last year identified a number of areas of improvement. We accepted those findings and took a number of remedial steps to address them.

“We welcome the outcome of the audit which confirms our use of Streams complies with data protection laws and would like to thank the Information Commissioner’s Office for their assistance throughout this process.”

Dr Streather added: “We passionately believe in the power of technology to improve care for patients and that has always been the motivation for our Streams app.

“This project is one of the first of its kind in the UK and we have learnt important lessons which will be applicable to the whole of the NHS. We are pleased that the audit concludes we are getting it right and hope that will reassure our patients.

“We are proud of our partnership with DeepMind and look forward to continuing to work closely with them in the future to ensure that the NHS has the opportunity to benefit from the technology we all use in our everyday lives.”

Responding to the publication of the Linklaters report, Steve Wood, Deputy Commissioner at the ICO, said: “What’s important now is that [the Royal Free] use the findings to address the compliance issues addressed in the audit swiftly and robustly. We’ll be continuing to liaise with them in the coming months to ensure this is happening. 

“We cannot endorse a report from a third party audit but we have provided feedback to the Royal Free. We also reserve our position in relation to their position on medical confidentiality and the equitable duty of confidence. We are seeking legal advice on this issue and may require further action.

“It’s important that other NHS Trusts considering using similar new technologies pay regard to the recommendations we gave to Royal free, and ensure data protection risks are fully addressed using a Data Protection Impact Assessment before deployment."

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