Professor Arkadiusz Kazimierz Wójs, DSc, EE, Rector of the Wrocław University of Science and Technology, had no doubts. ‘It's definitely a success. It's only a matter of time before a Nobel Prize is awarded for research using artificial intelligence in this area', he said during a debate at the Economic Forum in Karpacz. In his opinion, modern technologies are another powerful tool with which ‘humans can process data and think more effectively’. He emphasised that thanks to its ability to analyse enormous amounts of information, beyond the capabilities of the human mind, AI opens up new areas. ‘I am very optimistic', he stated.

Wójs pointed out the fundamental difference between human cognition and the capabilities of machines. ‘The human mind can only solve relatively simple problems. The number of concepts and pieces of information that the brain can handle is limited. New AI techniques can analyse and test connections between huge amounts of data’, he said. In his opinion, this is only the beginning.

This optimism is shared by the business represented by Dr Karolina Tkaczuk from AstraZeneca. Her company established an AI department back in 2017, and two years later began a partnership with Benevolent AI. ‘It allowed us to use artificial intelligence to select molecules that have the potential to become the next medicine. These molecules are currently in the early stages of research’, she said. Tkaczuk emphasised that the key benefit is the reduction in the time needed to discover new compounds. In her opinion, Poland has enormous potential to participate in this process. ‘‘We have many scientists who are incredibly well prepared to do this. I think we to some extent underestimate the potential we have in our country in terms of the use of computational science. It is an area in which we can compete with scientists from all over the world', she said.

Valuable medical data

She drew attention to the need for cross-sector partnership. ‘Partnership between science and business is certainly a huge challenge. The public sector also has a role to play in ensuring that such partnership develops more quickly and more effectively’, she said. She also emphasised the role that pharmaceutical companies can play in implementing good practices, drawing on their own experience. ‘Of course, this is not about applying these practices down to the last detail, but about how we deal with, for example, data standardisation or cybersecurity', she said.

The key to exploiting this potential is medical data and its efficient, secure sharing for secondary use, i.e. for scientific and business purposes. This is what the EU regulation on the European Health Data Space (EHDS) is intended to make possible, and its implementation in Poland must be completed by 2029.

Grzegorz Borowiec from the Ministry of Health admitted that although the legal framework has already been defined, a huge responsibility rests with the Member States. ‘The situation is both fortunate and unfortunate. Fortunate because the exchange of health data, at least in primary circulation, is nothing new to us – we already exchange e-prescriptions with more than half of Europe, for example (…)’. It is also a bit unfortunate because we have our own standards and we do a lot in various aspects related to data sharing’, he said. He described the upcoming challenges in detail. ’We will have to create a system that focuses on patients and their rights. And these are far-reaching rights, because they allow patients to remove their data from any circulation. However, we have outlined the area of data that should be made available for secondary circulation. This is a really broad area, because it is not only strictly health data, but also statistical data, administrative data, etc.', he explained.

'The most important thing in all this is to build a system in which patients do not escape with their data', said the deputy director of the e-Health department at the Ministry of Health, announcing the establishment or designation of bodies responsible for data access. ‘These must be independent bodies that can recognise the interests of patients, but at the same time understand what all other stakeholders in this whole process should receive', he said.

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Put your trust in the system

The issue of security and trust in the system was one of the key topics raised in the discussion. Radosław Maćkiewicz, director of the Central IT Centre, which manages, for example, the PESEL (Personal Identification Number) register, emphasised that the scale of the challenge is enormous. ‘We store large collections of sensitive data about our citizens. Now imagine that a large collection of medical data is being created, one that is much more sensitive and has a much larger scale. (...) This brings us to the core issue, namely trust, because it is the basis for the development of such systems', he explained. He pointed out that although we are technologically capable of handling this, appropriate regulations, procedures and implementations are crucial to ensure that citizens feel safe.

Maćkiewicz vividly explained the benefits of having large data sets. When we teach a new model, for example, we show it an apple and a pear. Later, the model begins to respond, we correct it or tell it that it has given the correct answer, and the more iterations there are, the better the results. ‘Imagine how this is going to affect development and research in the field of medicine when we have a huge amount of medical data', he said.

At the same time, he expressed optimism about accelerating progress in medicine thanks to artificial intelligence. ‘I think that development is going to happen quickly (...). Thanks to huge data sets and increasingly cheaper, more efficient infrastructure, the pace of discovering new medical procedures and drugs will definitely accelerate', he insisted.

Education, not excessive regulation

Jacek Oko, President of the Office of Electronic Communications, warned against both over-regulation and underestimating the threats. ‘Let's regulate, but without over-regulating. (...)’ Fortunately, today we tend to deregulate, or rather simplify regulations. And that is good. At the same time, let us not be afraid of threats – they will be there, that is for sure. We have a simple message: ‘click wisely’. Let us act the same way online – wisely. But let us act. We should not wait for over-regulated systems', he said.

He also pointed out the need to educate the public about the value and protection of data. There will be phenomena similar to those we know from banking: spoofing and other frauds. They will not be aimed at specialised institutions, because they will know how to deal with them, but at ordinary users, who often have trouble understanding the GDPR or data protection rules, let alone when medical data is involved. Many people do not realise how sensitive this data is and how easy it is to manipulate their consent', he warned.

The topic of education and public trust was also addressed by Professor Wojciech Fendler, President of the Medical Research Agency. As he emphasised, instead of focusing on increasing security measures that make life difficult for scientists, we should build awareness of the benefits of data sharing. ‘People often do not know what is in their medical records. When we ask them if they would sell their data, they do not really understand why. And that's exactly the problem. We need to inform them not only about what they may lose, but also about what they can gain when their data is available and properly secured', he explained. He emphasised that this would benefit both scientists and companies working for the sake of patients.

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Fendler cited an example of research from the United States, where participants were willing to sell their complete medical data for $800. In his view, excessive regulations do not protect data, but primarily slow down progress. ‘Criminals will get the data if they want to. It has always been like this. On the other hand, over-regulation hinders access for scientists and companies, and therefore blocks development. That is why we should focus on opportunities, bearing in mind the threats, but without going too far with security measures. Otherwise, we will throw the baby out with the bathwater: we will halt progress, and we still will not stop criminals', he concluded.

Professor Wójs, in turn, drew attention to a more fundamental threat associated with the development of artificial intelligence. 'We as humans do not yet know what exactly can be predicted or understood based on information collected about humans using truly powerful tools. At least I do not know – and probably no one in the world knows today – what conclusions can be drawn from the analysis of huge data sets about humans when tools that we do not yet have become available', he said. However, he pointed out that this is not a reason to stop development. Research must be conducted with full awareness and responsibility.

Wójs also pointed out the challenges facing Polish science. Universities, because they are underfunded and sometimes organised differently than in Europe or other parts of the world, tend to be less attractive, even to IT specialists who could develop these technologies. As a result, a smaller portion of our intellectual resources is involved in such projects. And we face issues related primarily to infrastructure, energy costs and regulations’, he emphasised.

Key data standardisation

Professor Fendler drew attention to the practical problems that scientists face each day. ‘A simple head tomography of a patient with suspected stroke, performed on the same piece of equipment – for example, in Radom, Łódź or Warsaw – gives results that differ due to what is known as the series effect, despite seemingly similar equipment settings. Thus, the analysis of 100 patients from three cities requires the use of algorithms that transform the data in such a way that, on the one hand, biological variability is not destroyed and, on the other hand, it allows the data to be compared', he explained. He added that problems with the standardisation of equipment and the data obtained are the main obstacle to the creation of interoperable data sets.

Anna Kowalczuk from the Agency for Health Technology Assessment and Tariff System emphasised the crucial importance of standards and access to data in the process of health technology assessment. ‘Currently, huge amounts of data are being collected, for example from medicine reviews, but when they reach us, they are often of poor quality. The data is expressed in different units, doctors report it in different ways – and we cannot process it properly. That is why standards are the key to success', she said. She drew attention to the role of medical professionals who enter the data. ‘On the one hand, we need informed patients who share their data voluntarily, not ‘for £800’; on the other hand, we need committed doctors and healthcare employees who will enter this information. And here's the problem: it is said that doctors simply do not have the time for this, as they have too many procedures to follow. The results in a shortage of data, as there is neither sufficient awareness nor resources', she added.

Karolina Tkaczuk from AstraZeneca emphasised the opportunities associated with the use of big data. 'This is an opportunity to strengthen prevention and diagnosis, as well as to create much more personalised therapies. Ultimately, these will allow us to offer patients better treatment. Everyone's medical data should be used to make the healthcare system work more efficiently and effectively. That is why better data quality and better cross-sector partnership are so important, because this is going to lead to more accessible and effective therapies', she said.

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Key partnership between stakeholders

Grzegorz Borowiec from the Ministry of Health considered trust to be the key to the success of the entire project. ‘It is a delicate balance between patients' fears and the security measures we can offer them', he explained. At the same time, he urged all stakeholders – business, science and medical entities – to support the administration. “I believe that trust is the key to the success of both the EHDS and all the solutions we have discussed today. This requires good, transparent procedures and strong institutions. If we manage to build them, we all will benefit. But from our point of view, the administration also needs support so that such a system can handle the threats and at the same time create opportunities that I hope we will seize', he said.

One of the key and, at the same time, very sensitive issues in healthcare is patient data and access to it

Foto: shutterstock

The discussion ended with the signing of a letter of intent to enter into partnership, which shows a willingness to act despite numerous legal, technological, and ethical challenges. The panel discussion participants agreed on the direction of action – bold but carefully considered steps are needed to achieve the goal of creating a system that, on the one hand, ensures the security of patient data and, on the other, allows it to be used for the benefit of science and the development of modern therapies. As Professor Fendler summed up: ‘Let's take advantage of this opportunity, being aware of the threats, but let's not try to over-regulate'.

Although the panellists' opinions differed in details, the same elements constantly appeared in their statements: the potential of artificial intelligence in medicine, the importance of large data sets, the need to develop standards and build patient trust in the system.