Artificial intelligence (AI) and other emerging technologies can be empowering instead of fearsome by enabling healthcare practitioners to put greater focus on patient care. This viewpoint, IHS Markit finds, is increasingly voiced throughout the healthcare industry as it adjusts to disruptive changes wrought by digital and transformative technologies.
The most recent expression of this perspective was at HIMSS 2019, where more than 40,000 health IT professionals, clinicians, executives, and vendors from around the world had gathered to discuss cutting-edge products and trends in healthcare. The event, an annual conference organized by the Chicago-based Health Information and Management Systems and Society, took place this year in February in Orlando, Florida.
Beyond this positive sentiment, which will help to spur the development and uptake of machine learning tools, there are good reasons for increased integration of machine learning in clinical settings. The inexhaustible powers of AI can be harnessed, for instance, to digest reams of clinical material that can then be made available to AI-powered devices and instruments for medical analysis and operations.
With AI trained to fulfill mundane administrative tasks and complex procedures alike, medical and healthcare practitioners of all stripes—from clinicians to radiologists—can be free from burnout and other similar debilitating conditions, brought about by stress and dysfunction.
AI at work in healthcare
Among the many AI applications in development are those from GE Healthcare. The Optima XR240amx automatically detects and prioritizes critical cases—pneumothorax was the example cited. For its part, the Voluson E10 (SonoCNS Fetal Brain) displays measurements of the fetal brain.
Both GE Healthcare applications align with the top use cases for AI in medical diagnostics, as identified by IHS Markit and shown below:
- Alleviate repetitive, high-volume tasks (e.g., cancer detection and screening)
- Reduce imaging time (MRI)
- Reduce radiation dose (computed tomography)
- Provide triage, prioritizing urgent cases
- Provide automatic quantification to replace manual measurements
- Facilitate non-invasive imaging techniques
- Facilitate faster drug discovery
- Increase patient engagement on treatment
- In medical diagnostics, new platforms serving as “marketplaces” are helping providers obtain access to a pre-vetted assortment of machines in the industry’s continuing quest to improve support for clinical decisions and to ameliorate health outcomes. These marketplaces, or exchanges, may also serve imaging IT vendors as an expedient method of bringing a wide range of machines to their customers without incurring development costs.
A marketplace that is already active is the Philips HealthSuite Insights Marketplace, which provides a clearing house for machines in addition to managing data-science projects and enabling the deployment of client models, either within the premises or in the Cloud. Models being developed include brain tumor segmentation, brain anatomy segmentation, and TB detection; currently available is the bone-age assessment model.
Besides Philips, other marketplaces include Blackford Analysis, EnvoyAI, MDW, Nuance AI Marketplace for Diagnostic Imaging, and NVIDIA Clara/OSU Wexner Medical Center.
Among the new players pushing AI beyond imaging is Medial EarlySign, which has been developing a patient risk-scoring system using AI to extract information from the electronic health records (EHR) system and lab data. The company’s clinical solutions rely on machine learning to help identify patients at high risk for specific medical conditions, which enables healthcare organizations to focus on preventative care. Partnering with Medial EarlySign is the SLUCare Physician Group to implement LGI Flag, a tool that identifies patients at risk for lower-GI disorders associated with chronic occult bleeding.
The figure below from IHS Markit research provides a breakdown of machines developed for medical diagnostics by application; approximately 15% are US FDA approved.
AT&T and IBM on healthcare AI
Participating likewise at HIMSS 2019 was AT&T, which is undertaking work involving mixed reality, or the mingling of real and virtual worlds to produce a hybrid reality of new environments and visualizations.
Driven by 5G and edge computing, networks within the next decade will “become an overlay on top of our physical world.” AT&T believes. Working with partners German technology group Brainlab and US start-up Magic Leap, AT&T showed how remote surgery could be done in a demo at the conference.
The demo included a mixed reality experience of pre-surgery disease exploration based on a patient’s own imaging, PACS—or picture archiving and communication system—files displayed via the headset, and options for the technology to be used as guidance during the procedure. While still in development, this is worth noting as one of the best-rendered and most responsive mixed reality demonstrations we have seen to date.
For its part, IBM Watson Health announced a $50 million investment in healthcare AI to explore improvements in patient safety and health equity. Through a 10-year investment in collaboration with Brigham and Women’s Hospital alongside the Vanderbilt University Medical Center, efforts are ongoing to find the best applications of AI to address major health issues, such as improving EHR utility and claims data, given current concerns on patient safety and precision medicine.
Meanwhile, Tennessee-based Change Healthcare announced its new Claims Lifecycle AI, which works with the company’s Intelligent Healthcare Network to improve revenue cycle management by reducing denials. The solution also cuts the time to adjudicate and identifies missing charges. Change Healthcare, which currently has 8 AI applications and 20 more in the pipeline, built the new functionality in Amazon Web Services (AWS).
Healthcare IT in the Cloud
More than any other service, it is healthcare that mostly still utilizes private cloud storage today, IHS Markit research shows. This is because cloud services are perceived to carry risks, especially on issues of authentication and the safeguarding of health data.
Nonetheless, healthcare implementations on the Cloud are increasing, going beyond the early adopter stage in various application areas. These areas include digital pathology, EHR, health information exchange, population health management, revenue cycle management, and vendor-neutral archives (especially for disaster recovery). At HIMSS 2019, the largest global cloud providers—Microsoft, Google, IBM, and Amazon—all had significant presence.
Microsoft, for instance, announced its Azure for FHIR (Fast Healthcare Interoperability Resource), which offers the exchange of data through an FHIR applications programming interface and a managed Platform-as-a-Service in Azure.
Flywheel, an imaging informatics platform from the Minnesota-based company of the same name, said it was integrating Google Cloud’s Big Query to enable scalable analysis of medical imaging metadata, biomarker data, and tabular data.
Not announced at the conference but new in the industry is Amazon Comprehend Medical. A natural-language-processing (NLP) service, it makes use of machine learning to extract relevant medical information from unstructured text. It also gathers information, such as medical condition, medication, dosage, strength, and frequency, from a variety of sources including doctors’ notes, clinical trial reports, and patient health records.
The offering is a new service from the Seattle-based behemoth, whose AWS is a leader in cloud computing. AWS fits into a broad healthcare strategy for Amazon by moving more patient data within its ecosystem and by partnering with some of the most prevalent vendors in healthcare technology and life sciences. These vendors include Cerner Corp., Philips, and GE Healthcare.
Digital health, virtual care, and remote patient monitoring
Telehealth, telemedicine, and remote-patient-monitoring technologies have been a top topic of conversation for more than 20 years, and their presence at HIMSS continues to build.
An important part of discussion surrounds diffusion determinants: While adoption is inevitable, significant scale has yet to be achieved. Diffusion is a key process for all innovations, as it implies a growing level of meaningful use. Diffusion is commonly measured by its level of commercial success, but before success can be attained, the value proposition of the entity in question must first be communicated to—and then embraced by—the market.
In the case of virtual healthcare, IHS Markit has identified four determinants that can either support or substantially undermine the overall value proposition of telehealth and remote-patient-monitoring solutions. These determinants are clinician willingness, regulatory support, technology, and consumer awareness. The United States has been found to have one of the highest aggregate diffusion determinant scores of 2.5 out of 5.0, which means there are mixed near-term signals for the US market, one of the world’s largest markets for digital health devices and services.
Note: IHS Markit subscribers to our service can get more details in this area by referring to our report on HIMSS 2019.
Increased presence of digital health
The growing presence of digital health technologies at HIMSS was clear at this year’s conference.
On telemedicine and virtual consults, Children’s Mercy of Kansas City, Mo., has recently increased the number of specialties it offers to 30 through the InTouch Health telemedicine platform. The hospital has found that pairing the technology with highly trained RNs enables it to provide Level 3 and Level 4 new-patient exams while meeting care standards with nearly 100% patient satisfaction.
For its part, the GE Healthcare Centricity TeleICU service is now extending multispecialty hospital treatment to the critically ill in remote areas of the US, in line with the provider’s goal of reducing the cost of care, mortality rates, and length of stay of patients. A small team of clinicians can monitor on a continuous basis as many as 75 patients located in a satellite facility. Competitor Philips eICU also offers a scalable, centralized tele-ICU solution combining A/V technology, predictive analytics, data visualization, and advanced reporting capabilities.
Cisco is focusing on care-team collaboration on virtual tools in videoconferencing, where medical records, images, and other data can be viewed and shared via WebEx; the videoconferencing can include clinicians, patients, and extended-care givers. The endpoints can be room or desk systems, phones, and peripherals such as tablets, cameras, and headsets. The company has also introduced DNA Spaces, which digitizes physical spaces by using Wi-Fi infrastructure to help providers understand patients and staff within their facilities.
Other digital health technology providers exhibiting at HIMSS 2019 included American Well, Ambra Health, eClinicalWorks, GlobalMed, MDLive, Novotalk, Snap MD, Teladoc Health, TeleHealth Services, Tellus, TytoCare, and GE Healthcare, among others.
In wearables, a few new solutions for telehealth were showcased at the conference, including those from Current, Somatix, VivaLNK, and WellCare Today.
Companies in the news
On the corporate front, companies rebranded, and there were also mergers and acquisitions.
Qualcomm Life exhibited at HIMSS 2019 under its new name Capsule Technologies, which had been a subsidiary of Qualcomm. Capsule is expected to continue selling the 2net cloud-based mobile device connectivity platform, currently used by more than 2,000 hospitals. Although the terms of the deal have not been discussed, it appears that Qualcomm will focus on its core business while Capsule continues to scale the health platform.
In M&A activity, the merging of EHR vendors Virence Health and athenahealth has resulted in an organization that will have an estimated 13% share in revenue of the North American market for EHR, with an installed base of 160,000 providers—mostly 10-and-under provider groups. IHS Markit expects the inpatient and ambulatory EHR market will grow at a CAGR of 4.7% from 2017 to 2023, passing $21 billion by 2023.
Among telcos, Verizon continues to develop its end-to-end solution for connecting patients to health-related environments. The solution includes maps, wayfinding, in-hospital tracking, virtual consultations, appointment setting and tracking, retail-pharmacy-targeted marketing, and prescription filling.
Spectrum is also competing for the best interactive patient experience while the patient is in the hospital room. Beyond entertainment, the system can be used for education, treatment planning, and clinical review of images. There is also a relaxation application for pain management.