Important Update
Check the main digital transformation trends in healthcare:
Today one of the main drivers of digital transformation in healthcare is artificial intelligence (AI). This AI is a sophisticated programming code that processes large volumes of data and is used by multiple industries. AI is particularly attractive for developers in healthcare as most AI products are approved by the FDA for use in hospitals via the 510(k) process, which in the majority of cases does not require clinical trials.
Given that clinical trials can take over a decade to complete it is easy to see why AI and medical devices (also eligible for 510(k)) are a fast route to market. More than 40 AI products were authorized by the FDA in the last five years. [Szabo] This compares with 220 market approvals for traditional drugs. [CDER]
This article highlights digital transformation driven by AI in medical imaging, telemedicine, and patient medical records.
Images or digital representations are a key component of medical diagnostics and everyday hospital procedures, including magnetic resonance imaging (MRI), positron emission tomography (PET), x-rays, and ultrasound to name a few. A key strength of AI is its ability to recognize, enhance, and even generate images which makes it ideal for medical imaging.
Subtle Medical’s SubtlePET ™ and SubtleMR ™ are the first and only AI solutions to receive FDA 510(k) clearance for medical imaging enhancement.
They integrate with any PET or MRI scanner to enhance images during acquisition without any alteration in the existing workflow resulting in up to 4x faster scan times. PET relies on small doses of radioactive tracer being administered to the patient. The actual tracer used depends on what is being imaged, cancer, the heart, or brain for example. AI can help reduce the doses of toxic tracers, benefiting patient health, and cutting hospital costs.
A brain scan for Alzheimer’s using the approved tracer Florbetapir costs approximately $3000 each. Subtle Medical’s AI can reduce the dose of tracer needed by 100x while maintaining image quality. [Xu] This has the potential dual benefit for the patient of reducing the level of potentially harmful radiation they are exposed to and reducing the actual cost of the scan.
Florbetapir is currently not available through Medicare coverage as it is not considered “reasonable and necessary”, largely due to the cost. Additional tracers are coming through the pipeline such as those that target Tau protein. AI could be instrumental in making these new tracers more affordable. Furthermore, medical imaging AI is not limited to MRI and PET.
Breast cancer screening has already been transformed by AI guided digital imaging. Hologic’s FDA approved Genius 3D mammography exam reconstructs high-resolution 3D data to produces 6 mm “SmartSlices.” According to the company, AI technology reduces the number of images that the physician needs to review by two-thirds, saving an average of one hour per eight hours of daily image interpretation time. To date, there are nearly 7,000 Hologic 3D Mammography systems in use in the USA. Further transformations can be expected as AI is applicable to all imaging applications.
Telemedicine through wearables and AI is another area where digital transformation is revolutionizing healthcare. A Hospital’s ability to treat patients is limited by the number of beds they have available, which can sometimes lead to longer than optimal waiting times, or some patients needing to be transferred to other hospitals experiencing less workload. Telemedicine can help free up beds for those most in need, reducing the aforementioned problems.
Oftentimes patients occupying hospital beds are simply being monitored so that swift interventions can be made if needed. Remote monitoring or telemedicine offers the solution of monitoring patients from the comfort of their own home, however, safety is key.
It is fundamentally important for such technology to detect any deterioration in inpatient health as early as possible to allow appropriate intervention. Such an intervention could be as simple as a medical consult by video call or it might require hospitalization.
Wearables with integrated data analysis through AI are part of the telemedicine solution. For example, Current Health’s AI wearable monitoring device received FDA-clearance for patients to use at home in 2019. It measures pulse, respiration, oxygen saturation, temperature, and mobility and relays the information wirelessly.
Other devices such as Fitbit are complementary to healthcare but are not specifically tailored to unwell patients. Healthcare as a whole, however, is moving towards a preventative model. Telemedicine, wearables, and AI are encouraged by the policy.
Hospitals are incentivized to reduce readmissions for conditions such as heart failure and COPD through the Hospital Readmissions Reduction Program (HRRP), which is a Medicare value-based purchasing program that reduces payments to hospitals with excess readmissions. This makes telemedicine tools such as wireless wearable patient monitors attractive to healthcare providers who want to keep patients healthy at home.
Digital transformation through AI generates a lot of medical data, some of which can be directly appended to patient medical records. Contrasting the information flow into health records until recently patient access to medical records has been only on a need to know basis.
The patient could request the information, but this wasn’t common unless needed for a specific reason. Modern cloud technology such as utilized by smartphones is making it possible for patients to access and monitor their medical records instantly.
Actively maintaining an accurate personal health record can lead to big savings for the individual both monetarily and in the prevention of health deterioration. These records help doctors make crucial treatment decisions. The reasons for developing a personal medical record App are clear.
Although companies such as Alphabet (Google’s parent company) have dabbled in medical record Apps, only the Apple “Health” App is currently fully integrated with the medical records of over 425 healthcare institutions. In addition to other features, the App allows viewing of consolidated timeline records including lab results, immunizations, and medications.
The App can also integrate records held by multiple institutions if they have agreements with Apple. This feature, in particular, can greatly simplify the personal management of health records. In an emergency the ability to share health records instantly with just a smartphone is invaluable.
AI-driven digital transformation of healthcare has led to improved medical imaging, patient management, and data access. This is enabled by AI, wearables, smartphones, and cloud technology (Internet of Things).
The transformation discussed here is mainly related to improved efficiency, however digital transformation such as prescription digital therapeutics, and predicting disease is also beginning to change the way patients are treated. These latter developments are still undergoing intensive R&D before their potential can be fully realized in the clinic. AIs coup d’état of healthcare is not yet complete.
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