Cleveland Clinic, Brigham, Stanford & others name healthcare's most promising tech

Technology continues to change the way healthcare is delivered. For instance, artificial intelligence is helping physicians examine medical records, while telemedicine is giving organizations opportunities to save money and improve access to healthcare.

Becker's Hospital Review asked healthcare professionals to share what healthcare technology they believe offers the most promise to transform care delivery at their hospital or health system. Read their responses below, presented alphabetically.

Note: The following responses were lightly edited for length and clarity.

Sameer Badlani, MD
CIO of Fairview Health Services (Minneapolis)

AI/machine learning-enabled workflows that are operationalized with maximum automation.

Marjorie Bessel, MD 
Chief clinical officer of Banner Health (Phoenix)

Predictive analytics offers the most promise to transform care delivery. If we can get better at predicting and preventing, it will be a game-changer.

Sricharan Chalikonda, MD
Chief of clinical operations and strategic initiatives for Allegheny Health Network (Pittsburgh)

The future EMR could help providers and patients by reducing the workflow related to documentation and reimbursement, often implicated as a contributor to provider burnout. In addition, a well-constructed EMR will help providers practice value-based medicine with the aim of delivering affordable, quality healthcare.

Albert Chan, MD
Chief of digital patient experience for Sutter Health (Sacramento, Calif.)

I'm certainly not the type who gets excited about technology for technology's sake, and I caution other clinicians not to fall into that trap either. In healthcare, I believe the best kind of technologies are those that reduce barriers and empower patients. Or sometimes they can simplify parts of the process — like scheduling appointments or refilling prescriptions. Together, these aspects enrich patient experiences and strengthen human connections that can lead to better health. 

That's why I've begun thinking of AI as a way to drive human connection in healthcare.

In healthcare, I believe AI will complement, not compete with, clinicians. Computers should make clinicians smarter, enhancing their ability to care for their patients. It has the potential to empower patients and make their time with a doctor or other clinicians more valuable.

Here's one example:

Any visitor to Sutter Health's website now has free access to the AI-powered symptom-assessment tool known as Ada. It's an online health platform — also available via our patient portal, My Health Online — that poses a series of questions tailored to the patient, assesses symptoms, determines what is most likely causing those symptoms, then recommends care options — whether that is through self-care, something that requires a visit to a nearby clinic, or something more acute requiring emergency care.

The benefits to the patient experience could be tremendous. Ada supports patients from the first onset of their symptoms. How many patients wait on the phone to talk to a nurse or send an email to their doctors asking if they need to come in for a health issue? With our busy schedules, who has the time to take time off work only to be told they did not need to be seen? When you do need care, Ada can to direct patients to the appropriate place — for example, a walk-in clinic around the corner from their house rather than a long wait at the emergency department across town.

Paul Fowler, MD
Radiation oncologist with MedStar Health Cancer Network (Baltimore)

New cancer cases continue to increase, and the ability to efficiently and precisely deliver radiation therapy is as important to us as physicians, as to our patients. 

Furthermore, improving patient experience and reducing toxicity have always been a primary goal. MedStar Good Samaritan Hospital in Baltimore has become the state's first user of the new Halcyon Linear Accelerator. The innovative technology is the latest system designed to do two important things: Deliver precise, safe radiation therapy, and provide the best possible patient experience.

Its unique way of delivering radiation therapy by imaging the tumor prior to each treatment, and in a fraction of the time required by a conventional accelerator, is truly revolutionary. It will allow us to treat more patients effectively, comfortably and in less time. This is increasingly important as the number of new cancer diagnoses are expected to increase in the coming years.

Jonathan Goldberg 
Senior vice president and CIO of Arkansas Children's (Little Rock)

Speech recognition technology, both in the ability to hear and respond, will have significant impact on healthcare in the coming years. Our ability to create efficiencies for our clinicians will ultimately translate to higher quality and safer care. They will be able to ask for recent test results, order medications, or even get summaries of care over multiple visits just by speaking. Our patient experience abilities will increase dramatically. Whether it be changing the temperature in their room, ordering food, or asking when their next test is scheduled for, all of these will make what is a difficult time just a little better. Patients and families will be able to schedule appointments, ask for prescription information, or maybe just ask to remind them what the physician said at their last visit. Speech technology partnered with machine learning has endless potential for transforming healthcare.

Harry Hawthorne, MD
Cenla Heart Specialists
Staff electrophysiologist at Christus St. Frances Cabrini Hospital (Alexandria, La.)

As a cardiovascular specialist, there are two technologies transforming how we treat heart disease.

There is balloon cryoablation pulmonary vein isolation for atrial fibrillation management, and for aortic valvular disease, there is transcatheter aortic valve replacement. People are living longer thanks to these advances in heart care.

The single most common arrhythmia we see is atrial fibrillation. This is a degenerative arrhythmia, so there are limitations as to how long medical management can be successful. That limited success and some significant complication rates for other procedures exposes some patients to less than ideal situations. However, in the last few years balloon cryoablation pulmonary vein isolation has shown better outcomes with shorter procedure and recovery times. The procedure freezes tissue and disables unwanted electrical signals that contribute to atrial fibrillation. 

Another procedure that has many heart specialists excited is transcatheter aortic valve replacement. Previously, the only strategy to relieve critical valve stenosis was surgical replacement of the valve. However, not all patients are surgical candidates. TAVR forgoes opening the chest to access the heart, an operation which can cause complications in some elderly patients or those with severe lung disease or congestive heart failure. The procedure is performed in an awake patient with a beating heart and does not require cardiopulmonary bypass.

Stephen K. Klasko, MD
President of Thomas Jefferson University and CEO of Jefferson Health (Philadelphia) 

One killer app will not move us from our current "Fred Flintstone" healthcare delivery system to a seamless "Star Trek" tricorder experience. But a platform that uses new and existing technologies to allow people to consume healthcare in the flexible manner in which they access every other consumer good will be a game changer and move us beyond "faux transparency." It's not about one technology, but rather a recognition and passion that healthcare is entering a digital ecosystem where most of health will happen at home. In this way, just as automobiles are evolving from manual control to GPS navigation to self-parking to autonomous vehicles, we will move from doctor and hospital to "self-healing humans."

Adam Landman, MD
CIO of Brigham Health (Boston)

Voice assistant technology has the potential to transform care delivery. At Brigham Health, we currently have widespread use of speech recognition to help improve the efficiency of electronic documentation. We are working toward a future where AI-powered voice assistants will ambiently monitor a patient interaction and produce documentation with minimal human review. If ambient voice recognition and note generation can be done with high accuracy and reliability, we will potentially see a dramatic reduction in the burden of EHR use. We are also exploring voice assistant technology to improve the patient experience, such as smart speakers in inpatient rooms and voice-enabled mobile apps for visit information and patient reported outcomes entry. The April 4 announcement that Amazon is offering an initial set of HIPAA-compliant Alexa skills is an exciting step forward to accelerate the use of voice assistant technology in healthcare.

Patrick McCarthy, MD
Cardiac surgeon, executive director of the Bluhm Cardiovascular Institute at Northwestern Medicine (Chicago)

We formed the Bluhm Cardiovascular Institute's new Center for AI in Cardiovascular Disease — [where Northwestern's cardiovascular clinical program collaborates with early innovators in AI, creates products and trains physicians] — last June with a generous philanthropic gift. The impetus was that several companies had approached us and presented AI solutions that were ready for clinical trials, and we are completing those trials at Northwestern Medicine now. Initial results look very promising. We also have a team partnered with Northwestern University's Computer Science Department to develop solutions, and to train physicians in AI as they obtain a Master of Science in AI.

For example, Eko is a company that focuses on digital stethoscopes. The breakthrough uses AI to interpret heart sounds. To detect the murmur of severe aortic stenosis — which has a very high mortality — clinicians need a very well-trained ear to detect and interpret the murmur. That may be hard, especially in a busy practice or a noisy environment like an emergency room. Some studies indicate accuracy as low as 50 percent. But the Northwestern study of Eko's AI enhanced platform — which we will present in June — demonstrated 96 percent accuracy. That's stunning.

An AI enhanced stethoscope can be used across the whole system — primary care offices, emergency rooms, paramedics — and eventually using telemedicine, it can be used in schools and other community locations. Technology enhanced tools will be disruptive in the next decade.

Murry Mercier
CIO of ProMedica (Toledo, Ohio)

The ProMedica health system has grown into an integrated health and well-being organization that includes acute care, skilled nursing, home care and hospice delivery locations across 28 states. Technology that allows us to treat patients in the lowest cost setting and promotes smooth transition of care will be a priority. Telemedicine applications that support the extension of clinical centers of excellence into skilled nursing facilities to improve quality of care and avoid unnecessary re-hospitalizations along with tight integration between care settings will continue to be a priority.

Amy Merlino, MD
Enterprise chief medical information officer and maternal fetal medicine staff physician at Cleveland Clinic

The time is right for augmented intelligence to transform care delivery. We now have robust data not only from our clinical interactions with patients in a classic healthcare setting. We additionally have patient-generated data (questionnaires, home medical devices, wearables and more) as well as data from various social determinants of health sources. Using these data we can now do amazing things to get to truly patient-centered care. 

While these can be used in standard healthcare environments, for example with early warning tools in an inpatient setting, the real transformation in care delivery comes for developing interactions with patients outside the walls of the healthcare facility to help them manage their health and wellness. In addition to the available data and technology, patients expect this personalized experience for their healthcare as they have for other aspects of their lives. 

The caveat to this transformation is the understanding that there is no "easy button" for this, we must respect there is art to medicine. It will require the input of the clinical specialist and care teams to develop the solutions for specific diseases or situations. The vision is ongoing interactions with our patients for both wellness and chronic disease management where we partner with the patient to monitor their health, identify risks and recommend modifications in therapy or interactions with the care team appropriate for their specific situation. These escalations of care could be directed to the appropriate care team member and the appropriate venue of care — virtual, office or emergency.  These interactions to support our patients' healthy behaviors and proactive disease management should help people remain healthy at home or to identify issues as they arise for healthcare intervention in a timely fashion. Using all of the data we have to help keep patients healthy or to intervene early can transform care delivery and help bring back some of the joy in medicine.

BJ Moore
Executive vice president and CIO of Providence St. Joseph Health (Renton, Wash.)

The technology I feel like has the biggest opportunity for transformation in care delivery is big data — in conjunction with AI and machine learning. As we take a patient record and enhance with internet of things data (smart watch, smart scale, etc.), BioMed devices (electrocardiogram, continuous positive airway pressure, etc.), DNA, medical imaging, and other information to build big data stores for patients, we can then use AI and machine learning to identify precursors for diseases. In advance of today's diagnostic tools, we can lower cost of care while significantly improving care delivery and outcomes.

Mitch Parker
Executive director of information security and compliance at Indiana University Health (Indianapolis
)

The application of AI, machine learning and deep learning in the healthcare environment holds great promise for patient care. Organizations are dealing with significantly more data points on patients than they were just several years ago. Current systems do not allow us to effectively manage all the data to make it useful to support clinical decision-making. The evolution of medicine to involve precision medicine, genomics, information sharing, population health and wearables increases the analytical complexity and onus on care providers to manage and interpret this information, develop plans for patients and populations and measure ongoing compliance and opportunities for improvement. The effective and ethical implementation of these technologies has the potential to give care providers the tools they need to significantly improve care delivery.

David Rich, MD
Chief 
medical information officer for WVU Medicine (Morgantown, W. Va.)

As I think about how can we make things a little easier in healthcare from day to day, I see patients as being part of the solution. One of the things that has the greatest potential to transform the way we deliver healthcare is enabling patient data entry — patient data entry from the waiting room, hospital bed, home or elsewhere. There is a great opportunity to leverage our patients and lay caregivers to capture key information directly into the record. We are doing some of this with e-visits and pre-visit questionnaires, but I think there is a great amount of untapped potential out there.

At WVU Medicine, we are beginning to experiment with tablets for patient data entry in the waiting rooms. We have e-visits and use some electronic questionnaires through our patient portal, but I think we are just scratching the surface. There is still a lot more potential to use these and other related tools to advance healthcare and improve efficiency.

Rich Roth
Chief strategic innovation officer of Dignity Health (San Francisco) 

One of the great opportunities that a health system has is blending the medical-based world — physicians, clinics, medical care — and the community services world, which. That food insecurities or housing insecurities or other types of issues that prevent healthy communities. I think the most exciting technologies are ones that blend and connect these two worlds and facilitate the ability for patients to co-travel between these worlds, so that truly the best care can be given to the patient, whether it's from the medical world or the community world. The most exciting technologies — and many can be built over time — are ones that are going to connect the community-based world and the medical world and offer that as one experience for patients.

Kathy Sanford, RN, CNO of CommonSpirit Health (Chicago)

I think the one thing that is going to transform healthcare the most with technology is telehealth and the ability to use telehealth across this country, especially in rural areas where people can't get to offices, physicians and specialists. Also, it'll spread the ability of people from all over the country to be able to get to specialists and people who really know about their illness, because telehealth is going to connect everybody to everybody.

Like others, we're already doing virtual behavioral health, in palliative care and on-demand primary care and a variety of places. It's already happening across many health systems — and the future expansion and enhancement is exciting.

Christopher Sharp, MD
Chief medical information officer at Stanford (Calif.) Health Care

At Stanford Medicine, as an academic organization, we see a lot of the newest opportunities that are being driven through innovations, research, partnerships with industry and forward-thinking opportunities that come to our faculty. There are many core capabilities that are paramount, like interoperability, increasing patient engagement and enhancements in usability of our infrastructure and our primary service engines: our EHRs. Under many of those, we're recognizing that the creation of advanced capabilities with AI and application of machine learning to fundamental capabilities is going to be tremendously important. We have leaders in machine learning and AI at Stanford. We have partnerships with Google and Amazon and others where we're exploring novel capabilities that really start to lay the foundation for how we'll be able to do the things we want to do.

I would put these in a couple of buckets that are really critical. When we think about usability of systems and what the experience is both from the provider and patient standpoint, there are huge gaps today that lead to clinician burnout and patient dissatisfaction.  This happens because our software and services are not at the level that our users expect and need. Whether you're looking at voice enablement, clinical decision-support assistance or getting to the patients over paperwork thinking as [CMS Administrator] Seema Verma espouses. All of those are going to need to have some new underlying capabilities and technologies that we don't have today. We definitely see that AI is a critical component as we're advancing in that direction.

Another area that we think is immensely important — and one of the first applicable opportunities —is AI for imaging. The ability to assess images and to enhance and enable imaging interpretation is something we see as very near-term application of AI. We have an AI in medical imaging center at Stanford where we're looking at both upstream and downstream AI in imaging. Upstream includes functions that happen at the device level. So, this team has a proof of concept model to administer 10 percent of the contrast dye that we put into people's veins in order to enhance images. It may be possible to put just 10 percent of that chemical and have AI enhance the image as if 100 percent was administered so the same diagnostic utility comes from the image to the radiologist. And on a downstream level, if AI is able to identify abnormalities on a chest X-ray close to the level of a radiologist then the two can be compared and enhanced.  For example, the radiologist make[s] their decision and has the AI cross-check to make sure nothing was missed by either party. We think that this is a tremendous opportunity. We're working actively at our center to understand the opportunities of these technologies and their limits and applications to advance the field and its impact.

Lisa Stump, MS, RPh
Senior vice president and CIO of Yale New Haven Health and Yale School of Medicine (New Haven, Conn.)

Big data analytics and AI will transform care delivery profoundly in the coming years. The ability to understand an individual patient's genetic make-up coupled with a broad understanding of their environment, medical conditions and social surroundings creates a profoundly powerful data set.  Analyzing those data, the combination of genotypic and phenotypic data, will enable us to design truly individual and wholistic care models and plans. From the ability to more precisely select therapy plans that minimize side effects and more quickly reach therapeutic goals to finding the individual genetic basis for disease, precision medicine is transforming the care we deliver. 

At the same time, aggregating such data across broad populations can generate insights that further inform treatment and care. Complementing the ability of our clinicians and researchers with AI and machine learning will both enrich and accelerate these efforts beyond what humans could accomplish alone.  And the ability to disseminate these findings in the context of an individual's care, through the EHR, brings the right information to the right people, at the right time to create the right outcome. 

This is an incredibly exciting time in healthcare and in healthcare IT as we create these data assets and platforms and translate them into direct care decisions that positively impact health.  

Angela Yochem
Executive vice president and chief digital and technology officer at Novant Health (Winston-Salem, N.C.)

Broadly speaking, there are three transformational advances in technology that will affect care delivery. The first is an unprecedented abundance of data. This includes not only a tremendous amount of health and wellness data, but also behavior data from social media and other sources. With this data, we can achieve remarkable personalization in how we engage our patients, both in and out of a clinical setting. This extraordinary availability of data would be less interesting without the second transformational advance: the rapid evolution of computing power. It's this ubiquitous compute capability that creates an opportunity for very sophisticated solutions we see emerging in the delivery space to leverage on all this data we now have. This where you see the AI-based tools and the like coming into play.

Finally, we can't talk about transformational technology without mentioning the advent of 5G. As virtual care channels are used for increasingly sophisticated patient engagements, the future proliferation of 5G will be a game-changer for care delivery in rural areas. Taken together, data abundance, advanced computing power and nearly unlimited network access to even the most rural areas we serve will radically transform our care delivery over time.

Richard Zane, MD
Chief innovation officer of UCHealth (Aurora, Colo.)

First, when anyone asks a question about technology, most will automatically assume some type of device, new machine or "ricorder"— when technology could simply be a new way of thinking or using what we have or already know.

Next, timing is always part of the question: Transformation takes time, and time is contextual —tomorrow, next week, next month, this coming decade, etc. I always think of Amara's law, which states, “We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run.” This is most assuredly true for healthcare which, to date, remains the last bastion of industry where deploying technology makes it more expensive and more complicated instead of less. With those caveats, probably the single most important technological advancement that has the greatest impact to transform healthcare is data.

We are now entering an era where we have the ability to perform remote surveillance and ingest, normalize, store and mine data from myriad sources — clinical data, outcomes and claims data, genomics data and non-traditional data, which until recently should not have been considered medically important, like deviation from usual patterns, what one searches for on the internet, how and where you drive, what you buy, who you live with, etc. Being able to integrate these data and then develop individually applicable intelligence — medical decisions — to a provider or patient based on these enormous data sets will fundamentally change the way we care for patients and how patients interact with what is now considered traditional healthcare. Some will refer to this as augmented or AI or personalized or precision medicine, but it really is simply medicine.  

In the traditional sense, a patient has a set of conditions, known or unknown; past medical history, and either symptoms or lack of symptoms, takes medications or not, gets certain tests and then along with their provider “ingest” these facts, assimilate them, and the provider makes a judgement about the health or illness of the patient and the best course of action. Sometimes the patient will have more than one provider, and multiple providers may manage parts of a patient's condition or come together and have a jointly influenced opinion or decision about the best thing to do. This prescriptive or augmented intelligence is this similar process times a million or 100 million —not too dissimilar when comparing the computational ability that allowed us to go to the moon with how we can now produce autonomous satellites. Simply, information sets too large for any human, or group of humans, to comprehend, along with the tools to analyze and make sense of them, then informing the next best course of action.  

So, the short answer is “intelligence” informed by data is the most important technological advancement with the biggest potential to transform healthcare.

 

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