Artificial Intelligence

Innovation conference to include breakouts focused on open APIs and the interface revolution, FHIR and the SMART toolbox, and developing technologies with the healthcare end user in mind.

In a new blog for BJ-HC, Eleonora Harwich, Head of Digital and Technological Innovation at Reform, looks at the application of AI in healthcare and argues the hype must not ‘cloud judgement around relevance and design’.

NHS chief executive Simon Stevens has urged the NHS to go faster and further in building on its reputation as a ‘hotbed of innovation’. However it takes a special set of circumstances for this to happen, and the School of Pharmacy at Keele University is showing how it can be done. Its health technology innovations are transforming clinical education and, ultimately, patient care. BJ-HC found out more about two of its most compelling products, its augmented reality (AR) clinical simulator, and its avatar-based pharmacist training. Augmented reality enables better patient care The Keele Augmented Reality Environment (KARE) allows students to practice patient diagnostic and communication skills on virtual patient avatars that respond realistically to the drugs prescribed. In-house developers worked with clinicians to create a mobile app linked to a QR-style card. When scanned, students get to see a 3D pop-up patient to support clinical simulation and communication skills training. “We wanted to use real-world devices with a domestic use so that we could scale quickly,” said Luke Bracegirdle, Head of Digital and Business Analytics at the School. “We had already developed an on-site simulator, but this was limited to one student at a time. KARE can be used on any mobile device, by all our students.” PharmaCard playing card Students have been so impressed that they have invited peers from the British Pharmaceutical Students’ Association to show how they are using augmented reality.  Some even have cards printed on t-shirts, to scan on their phones and see a patient jump out at them. Fostering the right factors for innovation Such innovation is fostered by the special environment Keele has created. Developers work on campus with clinicians and students to understand real-life healthcare problems. They then apply the best technology to solve those problems. They work as part of non-hierarchical, interprofessional project teams and all contribute to the final product. Internal experts inform how the technology meets appropriate clinical standards, and PhD students and researchers are on hand to evaluate the clinical evidence base. This means that Keele School of Pharmacy has a fertile environment for innovation. It can ensure that it is creating solutions that meet the needs of end users, and can provide the evidence and accreditation that show how its innovations work in practice. Avatar-based pharmacist training sees better test scores The School also has impressive connections across health and pharma. These have helped inform its work with pharma giant Bayer on Virtual Patient. This avatar-based interactive training enables community pharmacists to simulate how they would advise a newly-diagnosed atrial fibrillation patient. Students are given options on how they would interact with a patient who comes into a pharmacy with a newly-prescribed oral anticoagulant. The wrong answers lead to a stern rebuke from the patient. Users can take the test until they get the perfect score, long before they need to do so in real-life. This innovation is seeing students helps improve patient communication. It is also helping pharma slash the cost and increase the availability of training, removing the need for staff to attend a physical session, using these technologies as part of distance learning for continued professional development. Luke Bracegirdle, Head of Digital and Business Analytics, Keele University An unofficial academic digital exemplar These are just two highlights of the work happening at the School of Pharmacy at Keele. Its ‘PharmaCard’ app allows students to use AR as a revision guide to explore drugs at a molecular level, by scanning playing cards that present 3D models of a drug. In earlier work, visualising drugs as 3D models led to students achieving 9% higher test results during assessment. It has also launched a Manage Your Health app for asthma patients, showing how its approach to digital health has created the right set of circumstances to enable it to deliver innovations with impact.  KARE, for example, can be used for more than just pharmacy training. “We are looking at how we can adapt it to model heart failure, for use by patients, students and others,” said Bracegirdle. “We could represent any type of clinical condition with a simple card.” When looking to fulfil the promise that the NHS is a hotbed of innovation, global digital exemplars might get the attention. But Keele’s School of Pharmacy is an unofficial academic digital exemplar that is delivering on this vision.

Cabell Huntington Hospital also diminished the average sepsis-related hospital length of stay with machine learning-generated clinician alerts.

Mayo Clinic and IBM Watson Health have announced the results of a cutting-edge project putting the supercomputer to work for patient matching: Watson brought in more patients than before to participate in recent breast cancer clinical trials. Only 5 percent of patients with cancers participate in clinical trials nationwide, according to Mayo Clinic officials, who noted that that low enrollment makes for many clinical trials that are slow to finish or not completed. That delays advances in research and results in less access to better therapies. [Also: Next-up for EHRs: Vendors adding artificial intelligence into the workflow] What’s more, matching and enrolling patients in appropriate trials has proven to be a time-consuming, manual process. “Novel solutions are necessary to address this unmet clinical need, advance cancer research and treatments, and, in turn, improve the health outcomes of patients,” Tufia Haddad, MD, a Mayo Clinic oncologist, said in a statement. Watson for Clinical Trials Matching is programmed to accurately and consistently match patients to clinical trials for which they might be eligible, so that healthcare providers and patients can consider appropriate trials as part of a care plan. Mayo Clinic implemented the system in July 2016 in its ambulatory practice for patients with breast cancer. In the 11 months after implementation, there was about an 80 percent increase in enrollment to Mayo’s systemic therapy clinical trials for breast cancer. Also, the time to screen an individual patient for clinical trial matches was lower when compared with traditional manual methods. “This has enabled all patients to be screened for all available clinical trial opportunities,” Haddad noted. Based on the initial testing phase, Mayo and IBM agreed to continue developing the system to include trials for other types of cancer and aspects of cancer care beyond medical therapies, such as surgery, radiation and supportive care. Watson is programmed to support clinical trial matching for breast, lung and gastrointestinal cancers, and training on trials for additional cancer types is underway. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com

In his first State of the Clinic, Cleveland Clinic CEO Tom Mihaljevic, MD, called on the health system’s 57,000 employees around the world to focus on caring: “how we care for patients, care for each other, care for the organization, and care for our communities,” he urged. Mihaljevic succeeded Toby Cosgrove, MD, who held the top executive position for more than 12 years. Mihaljevic joined Cleveland Clinic in 2004 as a cardiothoracic surgeon, served as CEO of Cleveland Clinic Abu Dhabi since 2015 and took over the post here in the U.S. on January 1, 2018. In his speech, Mihaljevic called on staff to continue to improve healthcare by best using new technologies, notably artificial intelligence and the latest in data analytics as well as digital platforms. [Also: With patient experience, 'We need to dream bigger,' Cleveland Clinic leader says] Mihaljevic also revealed new initiatives for 2018, including efforts to improve patient safety and reduce caregiver and physician burnout. Cleveland Clinic reduced readmissions, improved care coordination, and increased hand-washing among caregivers in 2017. “We have a right to be proud of our work in patient experience,” he said. “It is inseparable from quality. But we need to go further.” He said Cleveland Clinic would continue to bolster its culture of safety, become an ultra-high reliability organization, and he promised to set bold goals, particularly regarding hospital-acquired infections and serious safety events. [Also: Cleveland Clinic's remote revenue cycle program saves money and makes employees more productive] A recent survey within the Cleveland Clinic, for instance, found that more than one in three physicians met the criteria for burnout. “We are here for patients first,” Mihaljevic said. “But we can’t succeed unless we take care of ourselves.” To that end, he announced that Cleveland Clinic has established the new Office of Caregiver Experience to address wellness, burnout and career development. Mihaljevic also praised Cosgrove’s achievements and his legacy. Today, Cosgrove has a new title: Executive Advisor and former CEO and President. He has been with the Cleveland Clinic for more than 40 years – as cardiac surgeon, department chair and ultimately CEO. Under Cosgrove’s leadership Cleveland Clinic saw increases in revenue, patient volume, research funding and community benefit. Mihaljevic delivered the State of the Clinic speech late last month. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com

New suite brings tools designed for doctors, clinicians and hospital managers, the company said.

Leading electronic health record vendors at HIMSS18 signaled intentions to incorporate AI and machine learning into EHRs and other tools currently being developed.

Last week, BJ-HC went to the Lancashire Care NHS Foundation Trust to find out more about the recent Electronic Patient Record (EPR) phased roll-out programme.

The post-EHR era is well and truly here, but EHR-centric challenges are still as thorny as ever.