Sheffield Children’s NHS Foundation Trust

Professor Paul Dimitri

Early-Care Technology Steward

We invest so much of our time in ensuring our children reach their best potential, but who is investing in their healthcare? There are 1.8 billion young people in the world, and 40% of the global population is under 24 1. These children and young people are the future; they are the future workforce and parents and will become the future elderly population. Our future global health and prosperity depend on their health and their healthcare. Technology is rapidly improving how we design and deliver healthcare, improving healthcare efficiency and effectiveness, accelerating diagnosis through artificial intelligence (AI) applications, providing the ability to deliver healthcare in the home and community, and personalizing healthcare through data acquisition and analytics. Technology is a normal part of life for any child born in the last decade. Yet, despite this, of the $21.6 billion invested in digital healthcare in 2020, only 0.7% of this was invested in children’s digital health 2. Simply speaking, children were forgotten in the health technology revolution.

Support for child health tech development

Despite a slow start, the private and public sectors are waking up to the importance of investing time and money into developing health technologies that improve the health and healthcare of children and young people. Over the last decade, child health technology networks in the UK, US and Europe have been established to support the development, evaluation, deployment and adoption of technologies that have revolutionized the healthcare of children with long-term conditions and genetic diseases, cancer, rare diseases, those undergoing radiological and surgical procedures, children with mental health problems, and the health and healthcare of preterm babies and sick neonates. 

These networks include KidsX (USA, global), the NIHR (National Institute for Health and Care Research), Children and Young People MedTech Cooperative (UK), i4KIDS (Spain), the National Technology Innovation Transforming Child Health (TITCH) Network (UK), the International Society for Pediatric Innovation (ISPI) and the EPTRI (European Pediatric Translational Research Infrastructure) Medical Devices Platform. In 2025/26, the UK will open the National Centre for Child Health Technology; cited by multinational industry as a global first, this 42,000 ft2 technology centre is set to bring industry, academics and healthcare professionals together to focus on the most challenging needs in paediatrics and child health. This is a significant step forward for children’s healthcare, but it took six years to acquire funding for this centre – far too long given the pressing need for paediatric innovation. New investment funds are emerging from VC groups such as Springhood (US), Par Equity (UK) and Ship2B Ventures (Spain). All these networks and collaborations are motivated by the same endeavour – to accelerate health innovation to transform paediatric healthcare. To achieve this goal, greater focus and investment are needed, and the societal benefit is immense; we can prevent the onset of disease in adult life through health prevention in childhood, improve the quality of life of those with long-term conditions that will ultimately minimize long-term healthcare utilization and cost, prevent mental health issues through earlier low-intensity interventions, personalize healthcare to stratify those most in need, and deliver care in the home to reduce pressure on hospital services.

Involving children and young people in health technology development

Before leading the charge in focusing on the development of novel health technologies for children and young people, the fundamental questions to ask are what children want and what they need. Without an in-depth understanding of specific unmet needs and without involving children and young people from the outset of a novel invention or technology application, there is a much higher chance of failure. Adopt the principle of ‘no health technology for us, without us’ by involving children in designing, developing and evaluating products used for their health. Young people are clear about how health technology can be woven into their daily lives and how they can best utilize new technologies to enhance their care. Children are not ‘mini adults’. They have specific needs that are governed by developmental, physiological, anatomical, and social changes as they mature. Health technology for children needs to be versatile, adapting to physical, physiological and psychological development whilst shifting from use by parents to autonomous use by adolescents. Also, consider how you reach those in most need. Health inequalities often mean that technologies may only reach those who can afford to use them and those who are digitally literate. 

Challenges with Artificial Intelligence in Paediatric Populations

Artificial Intelligence (AI) is rapidly reshaping healthcare, offering unprecedented opportunities to enhance patient care, streamline operations, and drive medical research. AI algorithms reduce diagnostic errors and enhance the efficiency of healthcare workflows. AI helps tailor treatment plans based on an individual's genetic makeup, medical history, and lifestyle, leading to timely and accurate diagnoses, personalized treatment plans, proactive monitoring, and more effective and targeted interventions thus creating a patient-centric personalised approach to healthcare. Despite its potential, the integration of AI into paediatrics presents several challenges. Data privacy and protecting children's health data is crucial. Robust data encryption and compliance with privacy regulations are necessary. Efforts are required to mitigate algorithmic bias and ensure equitable healthcare outcomes, especially in paediatric populations, and AI algorithms must undergo rigorous clinical validation to demonstrate their safety, efficacy, and reliability in the context of age-specific populations. Algorithmic bias in paediatric data may result from the use of small homogenous data sets, failure to document age, lack of representation of children in population data sets, and inference about paediatric data extrapolated from adult data sets. Given the physiological, anatomical and developmental differences across the paediatric age range and between paediatric and adult groups, failure to train the technology on these differences can create algorithmic outputs that are not valid, applicable, effective or generalisable across age subgroups. The ACCEPT-AI framework has been developed to address these issues by defining age-specific measures to prevent algorithmic bias and attain equitable, ethical, and appropriate AI outputs on paediatric data sets 3.

"Over the last decade, technology has changed how we deliver specific healthcare areas for children and young people."

What’s new for children’s healthcare?

Over the last decade, technology has changed how we deliver specific healthcare areas for children and young people. For example, virtual reality (VR) immersive rehabilitation has improved patient engagement and accelerated recovery, augmented reality has improved the patient experience in hospital settings, AI in facial recognition software is accelerating disease diagnosis, and telecommunications and home monitoring has supported healthcare at home meaning children have more time in education and with their families. Severely partially sighted children can now use new technology to vastly improve their vision, allowing them to integrate better in schools. Social robots are improving communication in children with autism and reducing anxiety in children coming to the hospital, 3D printing has revolutionized pre-surgical planning for children with complex life-threatening disorders, and VR has vastly reduced pain through immersive distraction during procedures to the point where some children only need local rather than general anaesthesia for more invasive procedures, biosensors have allowed children with critical conditions to be managed at home, novel drug devices have improved compliance monitoring and drug delivery. Teams are now looking at how data captured from environmental changes can influence and modify healthcare. 

As we look to the future, regulators need to ensure that specific guidance and regulation are in place to ensure that technology is developmentally and anatomically appropriate for children and that data sets are sufficiently robust for AI applications. Funders need to ringfence money specifically for child health technology development to prevent further major bias towards adult health tech development. Industry needs to work closely with paediatric healthcare providers and service users to identify the most pressing needs supporting areas of focus for new technology investments and developments. Fundamentally, an investment early in life is an investment for the next 100 years – after all, if we start early in life, we change more.