Streams (app)

Streams (app)
Name	Streams
Developer	Google Health
Initial release	2017
Operating system	Android, iOS, Web
Genre	Clinical decision support, Health informatics
License	Proprietary

Streams (app) Streams is a clinical mobile application developed to assist healthcare professionals in detecting and managing acute kidney injury and other clinical alerts. It was designed to integrate electronic health record data, laboratory results, and clinical guidelines to streamline workflow for clinicians in hospitals and trusts. The app's development, deployment, and reception intersected with major institutions, technology firms, regulatory bodies, and academic centers.

Overview

Streams was created as a clinical decision support tool linking patient data from Royal Free London NHS Foundation Trust, laboratory services such as NHSBT and hospital information systems including Cerner, Epic, and InterSystems. The app leveraged algorithms influenced by research from University College London, Imperial College London, King's College London, Oxford University Hospitals and other academic health science centers. It aimed to notify clinicians about laboratory derangements related to acute kidney injury episodes treated in settings overseen by bodies such as NHS England, Care Quality Commission and National Institute for Health and Care Excellence.

History and Development

Streams originated from collaborations between Google subsidiaries and NHS partners under initiatives promoted by figures associated with Francis Maude-era health IT policies and advocates in the UK Department of Health and Social Care. Early pilots involved partnerships with Royal Free Hospital clinicians and technologists who worked alongside teams with experience at Google DeepMind, DeepMind researchers, and engineers who had prior roles at Google Brain. The project drew on prior work at institutions including Moorfields Eye Hospital, Great Ormond Street Hospital, Guy's and St Thomas' NHS Foundation Trust, and drew scrutiny from oversight organizations such as the Information Commissioner's Office and parliamentary committees including the Health and Social Care Committee.

Development milestones referenced software engineering best practices used at Alphabet Inc. affiliates and sought to integrate standards promoted by HL7 and initiatives like FHIR. Academic evaluations compared Streams' alerting logic with studies published by researchers at University of Cambridge, University of Edinburgh, University of Manchester, and metrics applied in trials registered with entities like National Institute for Health Research. High-profile public discussion involved healthcare leaders such as executives from NHS Digital, NHS Improvement, and corporate representatives from Google Cloud.

Features and Functionality

Streams provided real-time push alerts for abnormal laboratory values, clinical prioritization lists, patient timelines, secure messaging, and team coordination tools similar to platforms used by Microsoft in clinical settings and rival products from Siemens Healthineers and Philips Healthcare. The app used analytics models inspired by research teams from Cambridge University Hospitals NHS Foundation Trust and deployed mobile interfaces comparable to products designed at Apple Inc. and Samsung Electronics. Clinical workflows incorporated guidelines from NICE and condition-specific pathways developed at Guy's and St Thomas' NHS Foundation Trust and Royal Brompton Hospital. Streams supported integration with laboratory providers including Public Health England-affiliated labs and pathology services run by trusts like Salford Royal NHS Foundation Trust.

Privacy and Security Concerns

Privacy debates around Streams engaged regulators including the Information Commissioner's Office and watchdogs like Healthwatch England. Concerns echoed discussions about data governance handled by organizations such as Caldicott Guardian offices in NHS trusts, and parliamentary scrutiny by the Science and Technology Committee. Critics compared data sharing arrangements to controversies involving Cambridge Analytica and questioned compliance with frameworks such as the General Data Protection Regulation and policies overseen by the Department of Health and Social Care. Legal scholars from institutions including London School of Economics and King's College London analyzed contractual relationships tied to cloud providers like Google Cloud Platform and contractual models used by Accenture and Capgemini in public sector outsourcing.

Reception and Criticism

Reception to Streams combined praise from clinicians at pilot sites such as Royal Free Hospital and University College Hospital for potential improvements in response times with criticism from patient advocates, media outlets including The Guardian and The Times, and commentary from think tanks such as The King's Fund and the Nuffield Trust. Academic critiques appeared in journals involving contributors from BMJ, The Lancet, and conference presentations at meetings like British Medical Association conferences and Health Informatics Society of Ireland gatherings. Parliamentary hearings featured testimony from NHS leaders including executives from Royal Free London NHS Foundation Trust and civil servants from NHS England, while independent reviews drew on expertise from Naomi Richards-style commentators and legal analysts advising bodies such as House of Commons Public Accounts Committee.

Platform Availability and Integration

Streams was deployed on mobile platforms including Android and iOS and designed for integration with enterprise health IT systems from vendors like Cerner, Epic, InterSystems, and cloud infrastructures provided by Google Cloud, competing with offerings from Amazon Web Services and Microsoft Azure. Pilot rollouts and procurement discussions involved regional NHS procurement teams, local clinical commissioning groups and integrated care systems such as those managed by trusts including Barking, Havering and Redbridge University Hospitals NHS Trust and Brighton and Sussex University Hospitals NHS Trust. The app's lifecycle intersected with national digital strategies coordinated by NHSX and implementation frameworks promoted by NHS Digital.

Category:Health software