Mike Miliard

A confluence of efforts from policymakers and tech companies – EHR vendors and consumer giants alike – have set the stage for HL7's interoperability standard to have a breakout year.

Boston Children’s Hospital and MedStar Health Research Institute will use the LEAP in Health IT funding to develop new interoperability applications for clinical workflow and pop health.

In a bipartisan new report on artificial intelligence, Rep. Will Hurd, R-Texas, chair of the House Oversight and Government Reform Subcommittee on IT, and Ranking Member Rep. Robin Kelly, D-Illinois, put forth funding and policy recommendations for addressing AI's impact on the public and private sectors – including healthcare. WHY IT MATTERS As artificial intelligence continues to evolve at an exponential pace and find its way into all manner of technology, it's already having profound effects on all industries and many important facets of society. Healthcare, of course, is no different, with AI making itself felt in fundamental ways – from newly-approved tools to detect diabetic retinopathy, to applications for new techniques for pop health and precision medicine. This new report explores the ways AI could impact four areas, in healthcare and elsewhere: workforce, privacy, data integrity and cybersecurity. Specifically: Workforce implications could include loss of jobs, so the report suggests government agencies boost efforts to improve training and reskilling so workers to be "more competitive in an AI-driven economy." Privacy concerns include the fact that AI depends on algorithms that depend on troves personal data. The feds should review privacy laws and perhaps update them for the era of AI. Biased data poses a big problem for AI's efficacy and, sometimes, safety. Agencies "should ensure the algorithms supporting these systems are accountable and inspectable." Malicious use of AI is an emerging concern, with its potential to vastly increase the scope and risk of cyberattacks. Government should take more proactive steps to know how AI "could be used to harm individuals and society, and prepare for how to mitigate these harms." WHAT IS THE IMPACT The House report about AI is not strictly about healthcare, but each of those four concerns have potential direct impacts across the industry, from lost jobs for radiologists to patient safety concerns. The study offers an exploration about those challenges, but also the opportunities presented by AI, and gives recommendations for how the government can combat them and capitalize on them, respectively. Increased funding for various government agencies will be a big way of accomplishing both goals. The United States "has traditionally led the world in the development and application of AI-driven technologies," they said. "This is due in part to the government’s prior commitment to investing heavily in research and development that has, in turn, helped support AI’s growth and development. In 2015, for example, the United States led the world in total gross domestic R&D expenditures, spending $497 billion. But U.S. leadership in AI is "no longer guaranteed," said Hurd and Kelly. "To maintain American leadership there is a need for increased funding for R&D at agencies like the National Science Foundation, National Institutes of Health, Defense Advanced Research Project Agency, Intelligence Advanced Research Project Agency, National Institute of Standards and Technology, Department of Homeland Security, and National Aeronautics and Space Administration." ON THE RECORD "AI has the potential to disrupt every sector of society in both anticipated and unanticipated ways," according to the report. "In light of that potential for disruption, it’s critical that the federal government address the different challenges posed by AI, including its current and future applications." THE BIGGER TREND Government agencies are increasingly cognizant of the rise of AI, in healthcare and beyond, and their need to get in front of it to properly harness its evolution, deployment and safety. For all the risks it carries, there are also huge benefits to be had when it's properly deployed. That's why, among other examples, the U.S. Food and Drug Administration early this year voiced its qualified support for AI in healthcare, and promised to refine its regulatory approach for the new era, with initiatives such an FDA-supported tech incubator for AI innovation and a new machine learning partnership with Harvard. "We’re implementing a new approach to the review of artificial intelligence," said FDA Commissioner Scott Gottlieb, MD. "AI holds enormous promise for the future of medicine, and we’re actively developing a new regulatory framework to promote innovation in this space and support the use of AI-based technologies." Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

Artesia General Hospital stays focused on building partnerships where it can, optimizing its EHR and enhancing patient and physician experience.

Automation, customization and – above all – an ability to show value and ROI are must-haves for hospitals looking to make promising tech take root.

Mobile, Alabama-based Springhill Medical Center keeps a focus on physician and patient engagement as it works to drive process improvements and stay competitive.

Ochsner Health's chief clinical transformation officer gives us a look behind the curtain, showing how the system makes innovation fundamental to its mission.

Whether developing new digital tools, making strategic investments or partnering with tech startups, hospitals have plenty of ways to innovate.

Post-surgical readmissions were halved at the health system, HIMSS says, driven by EHR optimization and decision support tools – it's also helped combat potential opioid dependency.

Cincinnati-based Mercy Health announced this week that it is investing in San Diego-based NucleusHealth, developer of cloud-hosted picture archiving communications systems and teleradiology services. Terms of the investment were not disclosed. Mercy Health implemented the technology this past year, and apparently liked it so much that it's decided to become a minority investor in the company. It's the most recent instance of a health system embracing that strategy for innovation – partnering with a third-party vendor to help spread technology it believes can help drive improvements for other hospitals. In 2016, NewYork-Presbyterian purchased a stake in telehealth company Avizia, for instance, and UPMC invested in predictive analytics and pop health startup RxAnte. NucleusHealth's Nucleus.io platform leverages secure Microsoft Azure cloud for better scalability and cost efficiency for PACS. The health system implemented the technology in less than three months – and managed to extend out a sharing network of 300 different locations over the next six, said Mike Hibbard, Mercy Health's vice president of IT, applications and service delivery. Mercy Health's IT team now taps Nucleus.io as a backup PACS when the main enterprise system is undergoing updates or maintenance, but may expand its use for other applications, he noted. NucleusHealth will still operate as an independent company, but will work in tandem with Mercy Health to create new features and workflows for system-wide deployment of its browser radiology workstation, Azure-based cloud storage and other image management tools, officials said. "We are very pleased to have this unique opportunity to partner with Microsoft and one of the nation’s best health systems,” said Vishal Verma, MD, NucleusHealth CEO. “This combined team has the unique ability to optimize our platform to create a true transformation of the medical imaging market." Mercy Health, which operates hospitals across Ohio and into Kentucky, is not to be confused with Mercy, the large St. Louis-based health system that spans Missouri, Kansas, Arkansas and Oklahoma. But both have made big cloud-hosted PACS news in the past two weeks. Earlier this month, Mercy Technology Services, the IT division of St. Louis-based Mercy, announced it would commercialize its own cloud-based PACS system for other hospitals to deploy. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com