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Real-world Health AI Applications in 2018 and Further

Posted on August 29, 2018 I Written By

The following is a guest blog post by Inga Shugalo, Healthcare Industry Analyst at Itransition.

In contrast to legacy systems that are just algorithms performing strict tasks, artificial intelligence can extend the task itself, creating new insights from the information fed to it. Current healthcare AI is powerful enough to undertake such complex challenges as automated diagnosis, medical image analysis, virtual patient assistance, and risk analysis, supporting health specialists in making more swift and informed decisions.

In 2016, Frost & Sullivan predicted the healthcare AI market to reach $6.6 billion by 2021. Meanwhile, 2017’s Accenture report estimates AI saving $150 billion annually for the U.S. healthcare economy by 2026. “At hyper-speed, AI is re-wiring our modern conception of healthcare delivery,” researchers from Accenture say.

Standing in the middle of 2018, the industry already hints on its course regarding further AI expansion. Spoiler alert: as well as with blockchain AR, VR, and any other kind of innovative custom medical software, the adoption challenges persist.

Current and prospective AI directions in healthcare

Diagnosis support

One of the most fascinating and valuable directions for AI to evolve is its ability to help providers diagnose patients more accurately and at a higher pace. We are thrilled to see how 2018 erupts with many healthcare organizations adopting artificial intelligence and creating unprecedented cases of assisted diagnostics with it.

Geisinger specialists applied AI to analyze CT scans of patients’ heads and detect intracranial hemorrhage early. Intracranial hemorrhage is a life-threatening form of internal bleeding, affecting about 50,000 patients per year, with 47% dying within 30 days.

Geisinger was able to automatically pinpoint and prioritize the cases of intracranial hemorrhage, focusing the attention of radiologists on them and thus allowing for timely interventions. This approach reduced the time to diagnosis by 96%.

Mayo Clinic currently uses IBM Watson’s superpowers to match patients with fitting clinical trials. The clinic’s officials stated that only 5% of patients enrolled in trials in the U.S., which significantly hinders clinical research and innovation in cancer therapies. On the other side, manual patient-trial matching is a time-exhausting process.

Watson runs this process on the background, comparing the patients’ conditions with available trials and suggesting the appropriate trials for providers and patients to consider including in a treatment plan. Since its implementation in 2016, Watson was able to deliver about an 80% increase in enrollment to Mayo’s trials for breast cancer.

Patient risk analysis

“…Healthcare is one of the most important fields AI is going to transform,” Google CEO Sundar Pichai noted during the Google I/O 2018 keynote. Last year, the event presented Google AI, a “collection of our teams and efforts to bring the benefits of AI to everyone.”

In 2018, Google uses their AI to tap into critical patient risks, such as mortality, readmission, and prolonged LOS. Cooperating with UC San Francisco, The University of Chicago Medicine, and Stanford Medicine, they analyzed over 46 billion anonymized retrospective EHR data points collected from over 216 thousand adult patients hospitalized for at least 24 hours at two US academic medical centers.

The deep learning model built by researchers reviewed each patient’s chart as a timeline, from its creation to the point of hospitalization. This data allowed clinicians to make various predictions on patient health outcomes, including prolonged length of stay, 30-day unplanned readmission, upcoming in-hospital mortality, and even a patient’s final discharge diagnosis. Remarkably, the model achieved an accuracy level that significantly outperformed traditional predictive models.

According to Pichai, “If you go and analyze over 100,000 data points per patient, more than any single doctor could analyze, we can actually quantitatively predict the chance of readmission 24 to 48 hours earlier than traditional methods. It gives doctors time to act.”

Of course, researchers don’t claim that their approach is ready for implementation in clinical settings, but they are looking forward to collaborating with providers to test this model further. Hopefully, we will see field trials and, who knows, even early adoption in 2019.

EHRs “on steroids”

HIMSS18 was all about artificial intelligence and machine learning. Surprisingly, all major EHR vendors – Allscripts, Cerner, athenahealth, Epic, and eClinicalWorks – came up with a promise to include AI into upcoming iterations of their platforms.

At the event, Epic announced a new partnership with Nuance to integrate their AI-powered conversational virtual assistant into the Epic EHR workflow. Particularly, the assistant will enable health specialists to access patient information and lab results, record patient vitals as well as check schedules and manage patient appointments using voice.

Similarly, eClinicalWorks puts AI into work on voice control but also prioritizes telemedicine, pop health, and clinical decision support. According to the company’s CEO Girish Navani, “We spent the last decade putting data in EHRs. The next decade is about intelligence and creating inferences that improve care outcomes. We can have the computer do things for the clinician to make them aware of actions they can take.” The new EHR’s launch is expected in late 2018 or early 2019.

Athenahealth also added a virtual assistant into their EHRs to improve mobile connectivity and welcomes NoteSwift’s AI-based Samantha technology to enhance clinical workflows by introducing robust automation. Samantha can grasp free-text and natural language, process information, structure it, assign ICD-10, SNOMED or CPT codes, prepare e-prescriptions and orders.

Pre-existing challenges for healthcare AI adoption

Gartner predicted that 50% of organizations will miss AI and data literacy skills to gain business value by 2020. Certainly, a lot of healthcare organizations will get in this 50%, and there are two reasons for that.

Regulations and security concerns are the main pre-existing challenges that delay practically any technology adoption in healthcare and entail an array of new challenges along with them.

First, an AI application or device has to be approved by the FDA. The catch is that the existing process focuses on the hardware or the way that algorithms work, but not the data it should or would interact with.

Speaking of data, another challenge is security breaches. Safeguarding sensitive information is a must for healthcare because patient data is a constant target for identity theft and reimbursement fraud. In Accenture’s new report, nearly 25% of healthcare execs admitted experiencing “adversarial AI behaviors, like falsified location data or bot fraud.” While this doesn’t mean AI threatens patient data, such claims do increase the concerns related to its adoption.

Still, artificial intelligence is growing in healthcare and will continue to do so. Maybe not at rocket speed, but the most recent cases show consistent improvements in major care delivery gaps. Healthcare AI’s future appears bright.

About Inga Shugalo
Inga Shugalo is a Healthcare Industry Analyst at Itransition. She focuses on Healthcare IT, highlighting the industry challenges and technology solutions that tackle them. Inga’s articles explore diagnostic potential of healthcare IoT, opportunities of precision medicine, robotics and VR in healthcare and more.

Competition Heating Up For AI-Based Disease Management Players

Posted on May 21, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Working in collaboration with a company offering personal electrocardiograms to consumers, researchers with the Mayo Clinic have developed a technology that detects a dangerous heart arrhythmia. In so doing, the two are joining the race to improve disease management using AI technology, a contest which should pay the winner off handsomely.

At the recent Heart Rhythm Scientific Sessions conference, Mayo and vendor AliveCor shared research showing that by augmenting AI with deep neural networks, they can successfully identify patients with congenital Long QT Syndrome even if their ECG is normal. The results were accomplished by applying AI from lead one of a 12-lead ECG.

While Mayo needs no introduction, AliveCor might. While it started out selling a heart rhythm product available to consumers, AliveCor describes itself as an AI company. Its products include KardiaMobile and KardiaBand, which are designed to detect atrial fibrillation and normal sinus rhythms on the spot.

In their statement, the partners noted that as many as 50% of patients with genetically-confirmed LQTS have a normal QT interval on standard ECG. It’s important to recognize underlying LQTS, as such patients are at increased risk of arrhythmias and sudden cardiac death. They also note that that the inherited form affects 160,000 people in the US and causes 3,000 to 4,000 sudden deaths in children and young adults every year. So obviously, if this technology works as promised, it could be a big deal.

Aside from its medical value, what’s interesting about this announcement is that Mayo and AliveCor’s efforts seem to be part of a growing trend. For example, the FDA recently approved a product known as IDx-DR, the first AI technology capable of independently detecting diabetic retinopathy. The software can make basic recommendations without any physician involvement, which sounds pretty neat.

Before approving the software, the FDA reviewed data from parent company IDx, which performed a clinical study of 900 patients with diabetes across 10 primary care sites. The software accurately identified the presence of diabetic retinopathy 87.4% of the time and correctly identified those without the disease 89.5% of the time. I imagine an experienced ophthalmologist could beat that performance, but even virtuosos can’t get much higher than 90%.

And I shouldn’t forget the 1,000-ton presence of Google, which according to analyst firm CBInsights is making big bets that the future of healthcare will be structured data and AI. Among other things, Google is focusing on disease detection, including projects targeting diabetes, Parkinson’s disease and heart disease, among other conditions. (The research firm notes that Google has actually started a limited commercial rollout of its diabetes management program.)

I don’t know about you, but I find this stuff fascinating. Still, the AI future is still fuzzy. Clearly, it may do some great things for healthcare, but even Google is still the experimental stage. Don’t worry, though. If you’re following AI developments in healthcare you’ll have something new to read every day.

$100k Investment for Every Rock Health Company

Posted on August 28, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s been a busy week for the people at Rock Health. First, they had the Rock Health Boston Demo Day. Yesterday and today they’re doing the Health Innovation Summit in San Francisco. And now Rock Health is announcing that Kleiner Perkins Caufield & Byers alongside longtime supporters Aberdare Ventures, Mohr Davidow Ventures, and the Mayo Clinic are upping their investment in Rock Health startup companies from $20k to $100k per company.

This is a good move by Rock Health. Just yesterday I was reading a Ycombinator founder describe how the added investment that each Ycombinator company got relieved some of the pressure that was associated with the program. Basically, he could make good long term decisions as opposed to forcing decisions because the funding and time frame were so short. I’m sure we’ll see that in Rock Health as well.

For those interested in Rock Health, they just opened their 3 week application period for their Fall cohort in San Francisco. I assume that they’ll be going back to the 5 month program again after doing only 3 months in Boston.

It’s worth noting that NYDHA (New York Digital Health Accelerator) offers $300k to health startup companies. I’m sure there’s going to be a lot of competition to get the best healthcare startups to participate in the various health IT accelerator/incubator programs.

Mayo Clinic Social Media Residency, EMR Selection, & EMR License Transfers

Posted on July 8, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While the Twittersphere is flooded with tweets about the #HIT100, I still was able to take a look through all the volume of tweets and find a few good topics that are well worth discussing on this site.

There are some real doozies in this EMR and Health IT Twitter round up. I’d love to hear your thoughts on each of the topics.

Let’s start with this announcement from the Mayo Clinic:

That’s pretty amazing news to consider. I imagine that most doctors won’t like the use of the name “residency” when it comes to this program. It kind of diminishes how much work, effort and learning happens in their residency. In this case I have to agree with those doctors. Use of the word residency for this short “social media residency” is in poor taste. Although, I do like that the Mayo Clinic is placing such value on the use of social media in healthcare.


Amazing counsel!! Read it again and post it on your wall if you’re going through an EHR selection. The other way to deal with this is to not buy until the requested features is implemented. Although, if you go that route, you might be sitting around forever since they may never implement your requested feature.


I’m glad to see Jim Tate tweeting again. I think he was on hiatus for a while. Or maybe I just hadn’t seen him for a while. In the above tweet he links to an article by William O’Toole that does a great job looking at the issues associated with EMR licenses. Well worth a read if you’re purchasing an EHR or if you plan to one day sell or transfer your practice to someone else.

GoHealth Gets $50 Million Investment, mRemedy and Palomar Health Acquired

Posted on June 20, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

FUNDINGS:

A Chicago-based company, GoHealth, created the website GoHealthInsurance.com. This website helps consumers comparison shop for health coverage. With the decision coming soon on Obamacare, GoHealth has been prepping for the large amounts of US adults who will be looking for health insurance if it is passed.

GoHealth has taken a $50 million equity investment from Norwest Equity Partners in case it does pass. In the event that it doesn’t, the equity will be put toward accelerating its growth in the market, where it is already a major player. The company currently has 125 employees, and they hope to be able to hire more.

Consumers can easily enter their information and be given a list of insurance providers that fit their needs. From there, they can sign-up online with the company that fits their needs best or contact agents for any insurance provider that is on the website. GoHealth works with more than 100 insurance carriers and 100,000 licensed agents and has, on average, 1 million customers each month.

ACQUISITIONS:

AirStrip Technologies, a company based in San Antonio, offers a suite of mobile patient monitoring apps. These apps allow physicians to access patient information just about anywhere, which in turn enhances workflow and decision making in clinics AirStrip has recently expanded this suite of mobile apps to give physicians easier access to information in EHRs. Along with this expansion, AirStrip has acquired “exclusive rights to market and develop San Diego-based healthcare system Palomar Health‘s EHR agnostic and mobile-enables MIAA (Medical Information Anytime Anywhere) platform. Mobi Health News said that, “while the companies aren’t calling it an acquisition officially, that is what it is in effect.”

With the acquisition of this platform, physicians will have access to any and all records that are relevant to making a decision about a current patient’s condition. The benefit, and main reasoning, behind doing this is so physicians are able to view information that has been generated by other EHR/EMRs that are different from the one being used in their practice, according to Alan Portela, CEO of AirStrip.

mRemedy, a mHealth app company that was created in 2009 by the Mayo Clinic and DoApp, has recently been acquired by Axial Exchange, a care transitions technology provider. Not all the details concerning this acquisition are available, however, the Mayo Clinic and Canaan Partners have both been major investors, as well as Dr. Paul Y. Takahashi and Dr. Nathan Jacobson, both doctors at the Mayo Clinic.

mRemedy has a variety of custom apps that have been developed for clinics, hospitals, and patients. myTality is mRemedy’s core product and helps patients “better navigate a future hospital visit and helps hospitals market their sevices.” The software offered by Axial Exchange, Axial Patient and Axial Provider, will be the service platform for mRemedy.

Other apps currently available through mRemedy are myWeight, mPressure, and myGlucose. Last year, a hospital in Lexington, KY, became the first hospital to offer these apps to its patients. According to Mobi Health News, “that pivot is what led mRemedy to its buyer this week.”

$12.5 million raised for AssureRx Health, Startups Announced That Will Participate at Rock Health in Boston

Posted on June 11, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

$12.5 million was recently raised in Series C financing by AssureRx Health Inc. AssureRx, a personalized medicine company, is an Ohio-based startup. The company is a personalized medicine company that specializes in pharmacogenomics and helps physicians figure out correct drugs for patients who suffer from neuropsychiatric and other related disorders.

Four Rivers Group, Claremont Creek Ventures, and Sequoia Capital led the financing; other investors that participated were Cincinnati Children’s Hospital Medical Center, Mayo Clinic, CincyTech, Allos Ventures, jVen Capital, and Alafi Capital. The funds that were raised will go toward increasing commercial activities for GeneSightRx® Psychotropic and GeneSightRx® ADHD, which are AssureRx’s two flagship pharmacogenomic products.

James S. Burns, president and CEO of AssureRx Health, described the company’s main objectives and what is expected to come from this round of funding:

Our goal is to build the leading clinical informatics company providing pharmacogenomic and other treatment decision support products to help physicians individualize the treatment of patients with neuropsychiatric and other disorderds. Proceeds from the Series C financing will be used to expand sales coverage, sponsor multiple clinical studies, and develop new products to help accelerate our leadership position in psychiatric personalized medicine.

Four Rivers, jVen Capital, and Alafi Capital, some of the investors in this Series C financing, bring along with their investments, connections to help build AssureRx Health’s leadership position in psychiatric pharmacogenomics.

New investors Four Rivers, jVen Capital, and Alafi Capital bring to AssureRx Health further expertise and partnering connections to help AssureRx Health continue building its leadership position in psychiatric pharmacogenomics.

In other news, Rock Health, a San Francisco-based digital health incubator, recently announced which six startups will be participating in the kick-off incubator in Boston this summer. Each of the startups participating will present on August 24th at a demo day. The startups that were selected for the Boston class are:

1. HomeTeam Therapy
2. PrescribableApps
3. NeuroTrack Technologies
4. Neumitra
5. NoviMedicine
6. ZeroSum Health

More information about Rock Health in Boston can be found here.

Doctor Describes 15+- Year EMR Integration Project

Posted on May 11, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Wouldn’t it be great if you rolled your EMR and, bam, all of the problems you hoped to solve were solved, just like that?  Sure, but in most cases the technical rollout will do little to solve workflow problems unless you have them analyzed in advance, according to one doctor who’s taken part in a long, slow rollout. Here’s a quick overview of his organization’s progress: see what you think.

Going live is a far cry from having truly adopted an EMR,  and getting to adoption is a very long, drawn-out process, said Dr. Fred M. Kusumoto, who spoke at a recent meeting of the Heart Rhythm Society.

Dr. Kusumoto, who’s with the Mayo Clinic Jacksonville Electrophysiology and Pacing Services, conceded that EMRs can help smooth communication between systems. The thing is, he noted, integrating systems won’t happen over night. After all, the workflow of doing integration is very complex, so much so that years hardly suffice.  His organization began serving as “guinea pig” for its EMR vendor in 1996 and will as of 2013, will have one database using structured data, he said.

So, the million-dollar question is this: Has all of this effort been worthwhile?  Dr. Kusumoto actually didn’t say, if the CMIO article I reviewed is accurate.  Interesting. But he’s clearly learned a great deal, regardless of whether his rollout works out for Mayo. Here’s some of his suggestions on how to improve returns from your maturing EMR:

*  Make sure all stakeholders are involved as the EMR migration, including administrators and IT staffers.

* Bear in mind that EMR rollouts are at their most flexible in the first few years, so don’t miss your chance to get involved early.

* EMR implementations (typically) involve a scanning phase where the institution captures written records and plans for turning the records into structured data. Make sure you leave enough time to do this right.

Moral Obligation and Tweets

Posted on April 24, 2012 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

I must say this headline from Fierce Health IT gave me a great many giggles today: Healthcare social media a ‘moral obligation’. No shred of irony in the article either, which quotes Farris Timimi, M.D., medical director for the Mayo Clinic Center for Social Media, thusly:

“Our patients are there. Our moral obligation is to meet them where they’re at and give them the information they need so they can seek recovery,” Timimi said. “You’ve got to be ready for it. You build it for the patients; not for yourself.

“This is not marketing,” he added. “This is the right thing to do.”

Are you sure it’s not just a way to log in to Facebook while you’re on the clock, Dr. T?

Not to come down too hard on Dr. Timimi, but I can think of plenty of other medical things which are “moral obligations”: saving patient lives, or low cost accessible healthcare for all. Being able to find a condesed tweet about bunions – um, not so much. I mean, healthcare is already quite a messpool to be in without doctors and hospitals flogging themselves over not being social media savvy enough. And not everyone can be a social media rockstar John D Halamka.

I know I’m being wilfully dense tonight. And the esteemed Dr. Timimi probably had stuff like Facebook pages and cancer blogs in mind when he talked about healthcare info via social media. But I scoured Twitter for “medical advice” and “cancer” and found that there’s some accidental giggles to be had:

Tim Brookman ‏ @T_Brookman
Next person that texts me for medical advice is getting told to apply icyhot directly to their genitals

nicole west ‏ @NicNac19
I love when friends come to me & ask medical advice & I actually know the solution… just don’t quote me, lol.

saintseester ‏ @saintseester
will not be giving free medical advice on anonymous social media. You’d be an idiot to take advice like that anyway.

Official Cancer Page ‏ @Cancer69_
#Cancer is big on trust and if you lie to them they will make sure you regret it
(yeah, yeah, I getit.. they’re talking about the sun sign)

Epion Health poised with health literacy Android tablet

Posted on August 19, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

I was recently introduced to a representative from an interesting company, Epion Health.  Epion is just about to roll out a novel way to take advantage of tablet computers to educate patients while they wait to be seen.  They are planning to use Android tablets to teach patients a variety of medical topics in which they might be interested, an thus promote the area of health literacy.  A captive audience, patients waiting to be seen in a doctor’s office, will be able to choose from a touch screen full of options.  According to their website, 5000 active tablets are estimated to reach a million patients every month.  That’s a pretty impressive number.  Moreover, the source of material is apparently peer reviewed and comes from the Mayo Clinic.

I think this would save me potentially a great amount of time if it were able to educate patients on how to take medications, side effects to watch for, what a particular condition they may have really is and means (in my field, for example, Hashimoto’s thyroiditis).   Although technology like this might automate doctors out of existence one day, for right now it would be a welcome tool for patient education.

By the way, I’m excited to say that I’ve had conversation with a company representative about potentially beta testing a tablet with my own patients once they roll out the first ones, possibly next month.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.