The digital health space refers to the integration of technology and health care services to improve the overall quality of health care delivery. It encompasses a wide range of innovative and emerging technologies such as wearables, telehealth, artificial intelligence, mobile health, and electronic health records (EHRs). The digital health space offers numerous benefits such as improved patient outcomes, increased access to health care, reduced costs, and improved communication and collaboration between patients and health care providers. For example, patients can now monitor their vital signs such as blood pressure and glucose levels from home using wearable devices and share the data with their doctors in real-time. Telehealth technology allows patients to consult with their health care providers remotely without having to travel to the hospital, making health care more accessible, particularly in remote or rural areas. Artificial intelligence can be used to analyze vast amounts of patient data to identify patterns, predict outcomes, and provide personalized treatment recommendations. Overall, the digital health space is rapidly evolving, and the integration of technology in health

Wednesday, November 30, 2022

The Bot and Artificial Intelligence

 Zendesk, a SAAS platform, is a customer relations management service, published a result of their study on customer service and its effect on success. It is only one of many platforms delivering this service. Many of the results are applicable to healthcare services. Ultimately health care is a service delivering technology, medical devices, testing, and hospital care to patients.

High on their list is customer service and the use of artificial intelligence using chatbots to filter and distribute patient needs to the appropriate human being for disposition.

Human-to-human exchanges are critical to engagement and resulting satisfaction on the part of patients.  Healthcare is the most personal experience for people. Chatbots will increase automation however a chatbot can be impersonal if not implemented correctly. It can result in a quick and very satisfying experience with your company, or result in a very negative experience resulting in the loss of a patient.  Many chatbots can be customized to fit into your customer service interface.

Like the endearingly stiff robots, we’ve seen in countless movies – tragic, pitiful machines tortured by their painfully restricted emotional range, futilely hoping to attain a greater degree of humanity – chatbots often sound almost human, but not quite. Their speech is awkward, the cadence somehow off.

Love them or hate them, chatbots are here to stay. Chatbots have become extraordinarily popular in recent years largely due to dramatic advancements in machine learning and other underlying technologies such as natural language processing. Today’s chatbots are smarter, more responsive, and more useful – and we’re likely to see even more of them in the coming years.

How do chatbots work?


Chatbot Vendors

Chatbots are only one means of marketing your healthcare entity  

Here’s Everything You Need in Your Healthcare Tech Stack

Wednesday, November 23, 2022

Telemedicine’s Moment

by 

The ascendance of virtual and distanced care has taken place with extraordinary speed. Lee Schwamm discusses which innovations are likely to stick and some bumps in the road ahead.



THE STATISTICS ON TELEHEALTH DURING THE PANDEMIC have told a consistent story—within the first few weeks of the global pandemic, virtual visits more than tripled in the United States and continued to growth after that. But while telehealth is likely to have gotten a permanent boost from the pandemic, its most significant growth may be from the thousand small inventions that were born out of necessity.


“One of the greatest tragedies we saw was the isolation that COVID-19 patients faced,” says Lee Schwamm, executive vice chairman in the Department of Neurology and the director of the MGH Center for TeleHealth. “Only staff were allowed to enter their rooms, and they wore several layers of personal protective equipment, including masks and goggles and often face shields. So patients’ experience in the hospital was one of no visitors, and only seeing the eyes of a few people.”


The solution at MGH was the virtual intercom—a low-tech hack that involved stringing an iPad to an IV pole and positioning it by a patient’s bedside. “The clinicians could spend 10 minutes in the room with the patient doing certain physical maneuvers, and then 40 minutes talking to the patient—face uncovered and unmasked—outside the room. It was a face-to-face interaction. Patients found this extraordinarily meaningful. And it helped our staff keep themselves safe.”


Dr. Schwamm discusses that and other innovations at MGH, including virtual rounds and new ways to virtually connect patients to emotional support and translation services. He also explores the bright national future of virtual care—and the danger that this will miss vulnerable populations that aren’t digitally equipped or savvy. “How do we make ourselves an open space where people can equally share in the benefits of the wonderful medicine we have to offer?” he says.


Listen to the podcast below. Subscribe to future episodes on iTunes, Stitcher, and other platforms.

The COVID Pandemic of 2020-2022 revolutionized clinical medicine. A change had already allowed health information technology to evolve using computers, remote monitoring, and electronic health records. Prior to 2020 health payers and CMS resisted including telehealth for reimbursement. The hesitancy was about whether it would be overutilized and abused and whether the quality of care would decline.

None of the above occurred and now telehealth is accepted as a standard of care.

Podcast transcript


Friday, November 18, 2022

Overcoming the barriers to AI education and adoption

Article content is contributed to. Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs

From theory to reality------to infinity and beyond............












Here are the barriers to biomedical and clinical artificial intelligence dissemination and implementation and here are some ways to overcome them Using AI in medical research comes with other challenges, including Privacy and confidentiality 

Rules, regulations, and rights

  1. Transparency and explainability
  1. Legal issues
  2. Ethical issues
  3. Cultural, process, and workflow redesign
  4. People and winning the war for talent
  5. Leading change
  6. Aligning the AI stakeholders, like healthcare executives, clinicians, vendors, investors, patients, entrepreneurs, and other staff to overcome technofatigue and technoskepticism
  7. Data challenges
  8. Closing the digital divide

  1. How to close the doctor-data scientist digital divide
  2. Eliminating technology adoption errors
  3. The lack of AI clinical trials
  4. Vendor selection, piloting, integration, and scaling challenges
  5. Eliminating the barriers to using AI in clinical trialsThree steps to digital/AI transformation | LinkedIn
  6. AI education and training
  7. How doctors and patients can win the 4th industrial revolution
  8. The AI entrepreneurship roadmap
  9. Digital transformation

Are you having problems getting someone's attention? How about using AI to pitch your AI product or recruit clinical trial subjects?

Integrating artificial intelligence into the design, execution, and analysis of clinical research sits on the precipice of help, hype, and hope. The outcome will depend on how AI tenderpreneurs build and scale their ecosystems.


How AI works in healthcare

AI is able to analyze large amounts of data stored by healthcare organizations in the form of images, clinical research trials and medical claims, and can identify patterns and insights often undetectable by manual human skill sets.

AI algorithms are “taught” to identify and label data patterns, while NLP allows these algorithms to isolate relevant data. With DL, the data is analyzed and interpreted with the help of extended knowledge by computers. The impact of these tools is huge, considering a Frost & Sullivan analysis indicated artificial intelligence and cognitive computing systems in healthcare will account for $6.7 billion this year from the market compared to $811 million in 2015.

1. AI supports medical imaging analysis

AI is used as a tool for case triage. It supports a clinician reviewing images and scans. This enables radiologists or cardiologists to identify essential insights for prioritizing critical cases, to avoid potential errors in reading electronic health records (EHRs) and to establish more precise diagnoses.

A clinical study can result in huge amounts of data and images that need to be checked. AI algorithms can analyze these datasets at high speed and compare them to other studies in order to identify patterns and out-of-sight interconnections. The process enables medical imaging professionals to track crucial information quickly.

For example, Hardin Memorial Health (HMH) needed to find a way to extract relevant data from EHRs in a concentrated form for imaging professionals. The hospital’s Emergency Room (ER) was handling more than 70,000 patients per year and decided to partner with IBM to implement “The Patient Synopsis”. This product identifies patient information relevant to the imaging procedure conducted on that patient.

Patient Synopsis digs into past diagnostics and medical procedures, lab results, medical history and existing allergies, and delivers to radiologists and cardiologists a summary that focuses on the context for these images. The product can be integrated with any medical unit system structure, accessed from any communication workstation or device in the network, and upgraded without affecting the daily activity of the medical unit.

Detecting relevant issues and presenting them to radiologists in a friendly summary view enables the design of more customized, targeted and accurate report used in diagnostic decision process.

2. AI can decrease the cost to develop medicines

Supercomputers have been used to predict from databases of molecular structures which potential medicines would and would not be effective for various diseases. By using convolutional neural networks, a technology similar to the one that makes cars drive by themselves, AtomNet was able to predict the binding of small molecules to proteins by analyzing hints from millions of experimental measurements and thousands of protein structures.

This process enabled convolutional neural networks to identify a safe and effective drug candidate from the database searched, reducing the cost of developing medicine.

In 2015, during the West African Ebola virus outbreak, Atomwise partnered with IBM and the University of Toronto to screen the top compounds capable of binding to a glycoprotein that prevented Ebola virus penetration into cells in an in vivo (in the living body of an animal or plant) test. From the tested compounds, the one selected was chosen because it acted on other viruses with a similar mechanism of cell penetration. This AI analysis occurred in less than a day, a process that would have usually taken months or years, enabling the development of a treatment for the Ebola virus.

3. AI analyzes unstructured data

Clinicians often struggle to stay updated with the latest medical advances while providing quality patient-centered care due to huge amounts of health data and medical records. EHRs and biomedical data curated by medical units and medical professionals can be quickly scanned by ML technologies to provide prompt, reliable answers to clinicians.

In many cases, health data and medical records of patients are stored as complicated unstructured data, which makes it difficult to interpret and access. AI can seek, collect, store and standardize medical data regardless of the format, assisting repetitive tasks and supporting clinicians with fast, accurate, tailored treatment plans and medicine for their patients instead of being buried under the weight of searching, identifying, collecting and transcribing the solutions they need from piles of paper formatted EHRs.

4. AI builds complex and consolidated platforms for drug discovery

AI algorithms are able to identify new drug applications, tracing their toxic potential as well as their mechanisms of action. This technology led to the foundation of a drug discovery platform that enables the company to repurpose existing drugs and bioactive compounds.

By combining the best elements of biology, data science and chemistry with automation and the latest AI advances, the founding company of this platform is able to generate around 80 terabytes of biological data that is processed by AI tools across 1.5 million experiments weekly.

The ML tools are created to draw insights from biological datasets that are too complex for human interpretation, decreasing the risk for human bias. Identifying new uses for known drugs is an appealing strategy for Big Pharma companies, since it is less expensive to repurpose and reposition existing drugs than to create them from scratch.

5. AI can forecast kidney disease

Acute kidney injury (AKI) can be difficult to detect by clinicians, but can cause patients to deteriorate very fast and become life-threatening. With an estimated 11% of deaths in hospitals following a failure to identify and treat patients, the early prediction and treatment of these cases can have a huge impact to reduce life-long treatment and the cost of kidney dialysis. 

In 2019, the Department of Veterans Affairs (VA) and DeepMind Health created a ML tool that can predict AKI up to 48 hours in advance. The AI tool was able to identify more than 90% of acute AKI cases 48 hours earlier than with traditional care methods.

The partnership between VA and DeepMind Health continues. Its next target is to identify how this ML tool can be installed in medical units. A user-friendly platform is also targeted in order to support clinicians in their treatment decisions that would improve the quality of life for Veterans suffering from AKI.

6. AI provides valuable assistance to emergency medical staff

During a sudden heart attack, the time between the 911 call to the ambulance arrival is crucial for recovery. For an increased chance of survival, emergency dispatchers must be able to recognize the symptoms of a cardiac arrest in order to take appropriate measures. AI can analyze both verbal and nonverbal clues in order to establish a diagnostic from a distance.

Corti is an AI tool that assists emergency medicine staff. By analyzing the voice of the caller, background noise and relevant data from medical history of the patient, Corti alerts emergency staff if it detects a heart attack. Like other ML technologies, Corti does not search for particular signals, but it trains itself by listening to many calls in order to detect crucial factors.

Based on this learning, Corti improves its model as an ongoing process. The technology Corti is equipped with can detect the difference between background noise, such as sirens, and clues from the caller, or the patient sounds in the background.

In Copenhagen, emergency dispatchers are able to identify a cardiac arrest based on the description provided by the caller around 73% of the time. But AI can do better. A small-scale study conducted in 2019 revealed that ML models were able to recognized cardiac arrest calls better than human dispatchers by using speech recognition software, ML and other background clues.

ML can play an essential role in supporting emergency medical staff. In the future medical units could use the technology to respond to emergency calls with automatic defibrillators equipped drones or with CPR-trained volunteers, which would increase the chances for survival in cases of cardiac arrest that take place in the community.

7. AI contributes to cancer research and treatment, especially in radiation therapy

In some cases, radiation therapy can lack a digital database to collect and organize EHRs, which makes the research and treatment of cancer difficult. In order to assist clinicians to make informed decisions regarding radiation therapy for cancer patients, Oncora Medical delivered a platform that collects the relevant medical data of patients, evaluates the quality of care provided, optimizes treatments, and provides thorough oncology outcomes, data, and imaging.

Automatic generation of clinical notes integrated with EHRs led to a reduction of time spent by clinicians in managing patient documentation, which improves medical operations and health outcomes.

8. AI uses data collected for predictive analytics

Turning EHRs into an AI-driven predictive tool allows clinicians to be more effective with their workflows, medical decisions, and treatment plan. NLP and ML can read the entire medical history of a patient in real-time, and connect it with symptoms, chronic affections or an illness that affects other members of the family. They can turn the result into a predictive analytics tool that can catch and treat a disease before it becomes life-threatening.

In essence, chronic diseases can be predicted and their progression rate tracked. CloudMedX is a company that focuses on decoding unstructured data – data stored as notes (clinician notes, discharge summaries, diagnosis and hospitalization notes, etc.).

These notes are used alongside EHRs as a source to generate clinical insights for medical professionals, allowing for data-driven decisions to improve patient outcomes. CloudMedX solutions have already been applied in several high-risk diseases such as renal failure, pneumonia, congestive heart failure, hypertension, liver cancer, diabetes, orthopedic surgery, and stroke, with the stated objective to lower costs for patients and clinicians by assisting in early and accurate diagnoses of patients.

9. AI accelerates the discovery and development of genetic medicine

AI is also used to help rapidly discover and develop medicine, with a high rate of success. Genetic diseases are favored by altered molecular phenotypes, such as protein binding. Predicting these alterations means predicting the likelihood of genetic diseases emerging. This is possible by collecting data on all identified compounds and on biomarkers relevant to certain clinical trials.

This data is processed, for example, by the AI system of Deep Genomics. The company designs proprietary AI and uses it to discover new methods to fix the consequences of genetic mutations while developing customized therapies for people suffering from rare Mendelian and complex disease.

The company tests identified compounds in order to develop faster genetic medicine for conditions with high unmet need. The company's experts are working on “Project Saturn,” a drug system based on AI molecular biology that assesses more than 69 billion oligonucleotide molecules in silico (conducted or produced by means of computer modeling or computer simulation) against 1 million target sites in order to monitor cell biology to unlock greater potential treatments and therapies. 

The discovery and development of genetic medicine brings benefits to patients and clinicians by decreasing the costs associated with the treatment of rare diseases.

10. AI supports health equity

The AI and ML industry has the responsibility to design healthcare systems and tools that ensure fairness and equality are met, both in data science and in clinical studies, in order to deliver the best possible health outcomes. With more use of ML algorithms in various areas of medicine, the risk of health inequities can occur.

Those responsible for applying AI in healthcare must ensure AI algorithms are not only accurate but objective and fair. Since many clinical trial guidelines and diagnostic tests take into account a patient’s race and ethnicity that a debate has arisen:

Is the selection of these factors evidence-based? Is race and ethnicity data more likely to solve or increase universal health inequities? It is established that ML comprises a set of methods that enables computers to learn from the data they process. That means that, at least in principle, ML can provide unbiased predictions based only on the impartial analysis of the underlying data.

AI and ML algorithms can be educated to decrease or remove bias by promoting data transparency and diversity for reducing health inequities. Healthcare research in AI and ML has the potential to eliminate health-outcome differences based on race, ethnicity or gender.

CONCLUSION

AI adoption in healthcare continues to have challenges, such as lack of trust in the results delivered by an ML system and the need to meet specific requirements. However, the use of AI in health has already brought multiple benefits to healthcare stakeholders.

By improving workflows and operations, assisting medical and nonmedical staff with repetitive tasks, supporting users in finding faster answers to inquiries, and developing innovative treatments and therapies, patients, payers, researchers and clinicians can all benefit from the use of AI in healthcare.

https://www.linkedin.com/pulse/medical-research-ai-integration-barriers-arlen-meyers-md-mba/

Tuesday, November 15, 2022

Children's Electronic Health Record Format | Digital Healthcare Research

Despite the use of electronic health records throughout clinical medicine, there are several niches in which current EHRs do not perform well.  This may be due to costs of specializing EHRs for small market shares.  Many subspecialties are ignored, such as pediatric ICUs.  Fortunately, a national standard already exists. 

The pediatric NICU has special requirements not addressed in standard EHR.

The Children’s Electronic Health Record (EHR) Format was developed to bridge the gap between the functionality present in most EHRs currently available and the functionality that would more optimally support the care of children. Specifically, the Format provides information to EHR system developers and others about critical functionality, data elements, and other requirements that need to be present in an EHR system to address healthcare needs specific to the care of children, especially those enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). To address these needs, the Format includes a minimum set of data elements and applicable data standards that can be used as a starting point or checklist for EHR developers seeking to create a product that can capture the types of healthcare components most relevant for children. The child-specific data elements and functionality recommendations are sorted into various topic areas, including—

Prenatal and newborn screening tests
Immunizations
Growth data Information for children with special health care needs
Well child/preventive care

The Format allows for interoperable exchange of data, including data collected in school-based, primary, and inpatient care settings; is compatible with other EHR standards; and facilitates quality measurement and improvement through collection of clinical quality data. The Format was authorized by the 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA) and developed by the Agency for Healthcare Research and Quality (AHRQ) in close collaboration with the Centers for Medicare & Medicaid Services (CMS). For more information on other AHRQ-supported work related to the CHIP Reauthorization Act, click here.










Children's Electronic Health Record Format | Digital Healthcare Research