'If we knew then what we know now…': How to clinically, operationally approach AI

The fact that artificial intelligence is poised to not only change the way hospitals provide patient care, but also transform operations, is a foregone conclusion. 

The issue at hand, Mark Davis, MD, chief operating officer at Baptist Health South Florida's Miami Cancer Institute, told Becker's is whether or not hospital leaders are prepared to be proactive when it comes to making the most of the opportunities AI brings. Will hospital leaders decide to use AI to their advantage from the jump, or will they be bombarded by all the offerings and get buried in a sea of options?

Now is not the time to take a wait-and-see approach to AI, because it's here and poised to reinvent both clinical and business hospital operations.

"Today, in hospitals, we must take the time to think about how we're going to deploy AI. We are at an inflection point and we've seen this type of thing before over human history," Dr. Davis said. "But we must take the time upfront to think about how this new technology is going to impact us and how we can best utilize it clinically and operationally."

Consider the early days of electronic health record technology. "If we knew how EHRs would transform the way we do business, we might have approached it differently," he said. "Today, if we truly recognize what artificial intelligence is — the notion and reality that the computer is going to start acting a lot more like humans — we can see that it's up to us to determine how we are going to use this to our advantage."

Dr. Davis said the key is to take a tactical approach to AI implementation. There are so many technology solutions hitting the market at record speed, but it's important to look before you leap — in other words, don't grab at any and all AI-enabled programs. Instead, be thoughtful and strategic.

"We cannot choose solutions that sit in isolation and don't come together with other potential solutions," he said. "That won't help us address really important strategic problems in hospitals."

Privacy concerns with AI are paramount and data bias could be a significant concern. "AI could be making some big predictions about the future; we have to make sure the data it uses isn't biased," Dr. Davis said, adding "the potential is extraordinary, but the cautions we have to take are really important. We really do need to wrestle with it thoughtfully."

Dr. Davis shared his thoughts on how AI could be used to change hospital operations.

AI in research

AI will change the way scientists conduct research because it can go far beyond the typical hypothesis-test-analyze scientific method. "When you have datasets that are this enormous, millions of data points, you can find associations within the sets — is this cancer or is this not cancer? Does this drug work? Does it not work? We can look at so many factors that we couldn't do previously," Dr. Davis said. "This is why AI has really fundamental implications for healthcare. The question is: How do we go about research and discovery now?"

Diagnostics

When it comes to mammography, highly trained and experienced radiologists who only analyze breast scans day in and day out will be able to use AI as a backup. Beyond what even the most experienced eyes can spot, "there's so much more data in the thousands and thousands of images. AI can help find subtleties which humans have a hard time understanding," Dr. Davis said, noting that at the scale AI works, using the technology in diagnostics stands to have substantial effects on quality and safety. 

In fact, it's already doing just that at Baptist Health's Boca Raton (Fla.) Regional Hospital. Kathy Schilling, MD, medical director of the healthcare system's Christine E. Lynn Women's Health and Wellness Institute, told Becker's using AI has increased the breast cancer detection rate at the institute increased by 23 percent — finding Dr. Schilling called "huge."

Using AI to scan 3D exams in the study helped her team find "the tiniest of cancers possibly as early as two years sooner than they would have been diagnosed without AI," she said. "Every single day, perhaps multiple times a day, we're seeing things that refocus our attention — small things that could have easily been overlooked."

Alarm fatigue

Dr. Davis, an emergency physician, said clinicians work in an environment where alarms are "going off all the time all around you … and it creates information overload." 

An example is when a machine is set to sound an alarm if a patient's heart rate goes above 120 or below 70 beats per minute. AI technology might be able to refine these notifications to use other parameters, based on the individual patient, to determine if a clinician needs to respond immediately. 

"I'm not suggesting that we use AI now to make that final determination, because it's certainly not there yet," Dr. Davis said, adding the possibilities are within reach.

Patient scheduling

When hospitals make the most of their highest-cost assets, such as operating rooms, the bottom line benefits — as does patient experience and outcomes, he said.

AI can create "patient-centered scheduling" that benefits hospitals, as well. "This technology can help us learn when a patient has other conflicts, either in their schedule or because of their distance from the hospital," Dr. Davis explained. "Scheduling high cost assets is important" and not using these assets, such as operating rooms, efficiently, "costs hospitals a significant amount of money."

 

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