Tailoring Healthcare Analytics to a Value-Based Future | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Tailoring Healthcare Analytics to a Value-Based Future

November 14, 2016
by Rajiv Leventhal
| Reprints
An industry expert says that new approaches to analytics will be needed to survive and thrive in tomorrow’s healthcare

In January 2015, the U.S. Department of Health and Human Services (HHS) boldly announced a plan to tie 30 percent of traditional fee-for-service, Medicare payments to quality or value through alternative payment models such as accountable care organizations (ACOs) and bundled payments by 2016, and tying 50 percent of payments to these models by the end of 2018. HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through initiatives such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs.

But, earlier this year, a survey from Salt Lake City, Utah-based analytics vendor Health Catalyst revealed findings that many expected: most industry stakeholders seem to think the government was quite ambitious with these projected numbers. The survey, at the time of its publication, found that just 3 percent of health systems have already met the target set by HHS. Only 23 percent expect to meet it by 2019, just a year after the feds had hoped that half of all Medicare reimbursements would be value-based. What’s more, the majority of health systems—a full 62 percent—had either zero or less than 10 percent of their care tied to the type of risk-based contracts identified by HHS as “value-based,” including Medicare ACOs and bundled payments, the survey revealed.

The healthcare executives surveyed did say that they intend to steadily increase value-based care and at-risk contracts, and they said the most important organizational element needed for success with risk-based contracting is analytics. This is where Leonard D’Avolio, Ph.D., an assistant professor in the Brigham and Women’s division of general internal medicine and primary care, says change is needed. Dr. D’Avolio is also the CEO and co-founder of Cyft, a company based on years of his research optimizing machine learning and natural language processing to improve healthcare. He previously led informatics for the Department of Veterans Affairs’ (VA) precision medicine initiative (the Million Veteran Program) and the first clinical trial embedded within an electronic medical record (EMR) system.

D’Avolio fully understands that the success of value-based care is dependent on healthcare stakeholders understanding and predicting what will happen based on the information they have. Thus, he recommends a different approach to analytics from what has traditionally been practiced in healthcare. He says, “As value-based care organizations are now discovering, these multi-million dollar investments in traditional analytics are useful for understanding what happened—how many beds were filled, drugs prescribed, surgeries performed. However, they are incapable of answering the fundamental questions of value-based care: what should happen, to whom, when, and how, in order to prevent future events.”

As such, he says that most clinically relevant information is ignored by traditional analytics. To this end, as part of Healthcare Informatics’ Special Report on data analytics in this issue, D’Avolio recently spoke to Managing Editor Rajiv Leventhal about what needs to change in approaches to leveraging analytics in healthcare’s value-based future. Below are excerpts of that discussion.


Experience New Records for Speed & Scale: High Performance Genomics & Imaging

Through real use cases and live demo, Frank Lee, PhD, Global Industry Leader for Healthcare & Life Sciences, will illustrate the architecture and solution for high performance data and AI...

Can you tell me a little about your company, as it relates to the future of healthcare, and healthcare analytics?

Our company is focused on making technologies—such as machine learning and natural language processing—available to data analysts so they can harness the power of predictions in ways they haven’t been able to. We try to find organizations where the chief financial officer and the chief medical officer have the same incentive, meaning the organization is at financial risk for delivering high quality care. Frankly, relatively little of care provided at hospitals is at true financial risk today, though that number is increasing. Most companies are incentivized to still invest in technology to help them see folks more quickly. We are happy to see that changing though.

Sure you can talk about readmissions, but when you are at full financial risk, what you really care about is preventable utilization. Our customers will sometimes start the conversation asking about readmissions, but we ask them, what interventions do you have at your disposal? They might say that they hired a nurse to focus on COPD [chronic obstructive pulmonary disease]. So we say to them, what if we build a model to identify exactly who in your COPD population will end up in the ER in the near future? It’s a different approach from today’s risk scores, which is limited to claims data and is too one-sized-fits-all, with a focus on only a few problems. These approaches treat the geriatric patient with heart disease the same way as the high-risk pregnant patient. So we are trying to move away from one-sized-fits-all approaches.

Leonard D’Avolio, Ph.D.

How do you view the overall landscape in terms of analytics being leveraged by payers and providers as they move into risk-based contracting and reimbursing for value rather than volume?

The writing is on the wall; unless there is going to be a major political shift that comes with it a gutting of CMS [Centers for Medicare & Medicaid Services] policy, we are moving towards value-based care in various forms. CMS opened Pandora’s Box leading with ACOs, alternative payment models, and bundled payments, and the commercial plans have been waiting for this forever. When CMS fired that first shot with ACOs, many of the commercial plans turned to ACQs, or alternative quality contracts.

If you are having to do ACO models as part of your CMS reimbursement anyway, why not make it even more attractive and easier by giving more flexibility and creating alternative contracts so you can go at risk with us also? Most of the fee-for-service world is now keeping a close eye on MACRA [the Medicare Access and CHIP Reauthorization Act of 2015]. With MACRA, CMS and others drew a line in the sand saying that we will be more than 50 percent value-based by 2018.

One of the major challenges in value-based care is that we are in that quantum state in healthcare where there isn’t a value-based care policy; even the ACO program has many different reimbursement and quality measurement policies. There are a number of things with alternative payment models that need to be measured and reported on, too. It’s not getting talked about much, but healthcare is not transitioning to one new way of paying for care. In fact, depending on how you measure it, there are between five and 12 versions of this, many being implemented at the same time by provider organizations.

This leads to challenges around analytics for IT departments. With each new flavor of reimbursement usually comes a new layer of process measures that needs to be reported against, which usually means new bolt-ons to the EMR, which was never designed to improve the quality of care to begin with. So you are taking an EMR, which was designed 30 years ago for financial reimbursement, to communicate narratively between clinicians, and to ensure legal protection for the [provider], and you now bolt on dozens of new process measures. So you’re doing this quantum value-based care transition, and that creates challenges.

So what are the best analytics tools out there today?

In order to use analytics successfully, you want to take all information and turn it into actionable insight based on the organizations’ own highest priorities. Now, there is branching going on with analytics, driven by financial incentives. There are two branches that analytics are forced to operate within, and one of them is mandated reports based on each of your payer contracts. These are just reports, and they are mostly designed around the things that both sides agree on in advance and can probably be done based on using the EMRs we already have. The problem with mandating reporting is that we’re doing the opposite of what led to the digital transformation as experienced in other industries.

When other industries became digital, they had agreed upon outcomes, but then the competitive advantage came when they used all of their data to discover the best way to get to those outcomes. Amazon and Netflix, for example, did this by learning everything about the consumers they were serving. That’s the competitive advantage—taking all of the data and then becoming very personalized towards the recommendation and an agreed upon outcome. Healthcare has done the opposite in this branch of analytics—which is take all of the data we have, only look at a few points in time, create the standard patient and standard workflow, and somehow people think that will lead to the desired outcome.

The second branch of analytics is about organizations discovering the most efficient ways to do things. Because now, for the first time, you have to be able to make sense of all of the data, and you have to prioritize it for the care delivery folks. You can’t tell them that readmissions matter most to you. Instead, you have to say, “Here is the outcome—improve care—now you have to use your data to figure out the best pathways to get there.” In effect, you are becoming more like every other industry, in which digitization can reach its full potential. So I think if this happens, 95 percent of what passes as analytics today will either become obsolete or change dramatically.

Drilling down, regarding CMS’ readmissions reduction program, and the government’s mandatory bundled payment programs, how can I.T. leaders better use data analytics as they participate in these processes?

If you are going to work in the bundled payment world, you need to be able to anticipate and not react after the fact. So you have to become much narrower in your predictions. It’s not just about readmissions, but for example, which of my patients is most likely to end up with a non-routine discharge so I can begin to prepare that patient in the most cost effective pathway possible? That’s a specific example of something we are doing now, and we are finding that you need to be able to consume far more than just claims data in order to make those kinds of predictions. Any tool that uses claims data alone has one arm tied behind its back. The claims data is dated, and also, ICD-9 codes can be up to 70 percent inaccurate depending on the disease. This will only get worse as we move to the 65,000 disease codes of ICD-10.

Another thing we are involved in now that you wouldn’t think about in a traditional value-based sense is patient satisfaction. We’re working with a managed care organization around which members of their population are most likely to disenroll after being in the program for one year. From a CMO and CFO incentive perspective, if you are going to invest in keeping folks healthy for a year, and take on acquisition and health maintenance costs, then knowing who will leave after a year is a big deal. So we are taking on 30 different file types and helping this managed care organization predict who is likely to leave in a year. It’s not curing cancer, but it’s critical for organizations to survive. People will have to get more granular using all their data rather than one-sized-fits-all risk scores for readmissions. 

What advice can you give to CIOs, CMIOs and CMOs as they continue to prepare for this new world?

First, analytics is not a tool; it’s a process. Clinicians understand where to focus, but you need to come up with the processes, tools, and support staff that will help and empower them to identify the highest priorities. Also, measure them on where it’s working and not working with ongoing feedback loops. It’s a problem to think of analytics as a product that you buy that will lead to behavior change, workflow change, and process change.

Second, be able to distinguish between what counts as analytics in the fee-for-service world with what will be required of analytics in a value-based world. You need to move beyond claims data and really use all of your data. It’s about understanding not just what happened, but what is most likely to happen and what you should be doing about it. This is very different than the traditional approach of what is considered analytics in healthcare.

Third, no CIO should settle for a vendor’s insistence about what’s good enough when it comes to predictions. If you are building models based on other peoples’ data and other peoples’ priorities and populations, you cannot presume that can be brought into your shop and will perform at the same level. CIOs need to own the evaluation with their own data on their own problems.

The Health IT Summits gather 250+ healthcare leaders in cities across the U.S. to present important new insights, collaborate on ideas, and to have a little fun - Find a Summit Near You!


Have CIOs’ Top Priorities for 2018 Become a Reality?

December 12, 2018
by Rajiv Leventhal, Managing Editor
| Reprints

In comparing healthcare CIOs’ priorities at the end of 2017 to this current moment, new analysis has found that core clinical IT goals have shifted from focusing on EHR (electronic health record) integration to data analytics.

In December 2017, hospitals CIOs said they planned to mostly focus on EHR integration and mobile adoption and physician buy-in, according to a survey then-conducted by Springfield, Va.-based Spok, a clinical communications solutions company, of College of Healthcare Information Management Executives (CHIME) member CIOs.

The survey from one year ago found that across hospitals, 40 percent of CIO respondents said deploying an enterprise analytics platform is a top priority in 2018. Seventy-one percent of respondents cited integrating with the EHR is a top priority, and 62 percent said physician adoption and buy-in for securing messaging was a top priority in the next 18 months. What’s more, 38 percent said optimizing EHR integration with other hospital systems with a key focus for 2018.

Spok researchers were curious whether their predictions became reality, so they analyzed several industry reports and asked a handful of CIOs to recap their experiences from 2018. The most up-to-date responses revealed that compared to last year when just 40 percent of CIOs said they were deploying an enterprise analytics platform in 2018, harnessing data analytics looks to be a huge priority in 2019: 100 percent of the CIOs reported this as top of mind.

Further comparisons on 2018 predictions to realities included:

  • 62 percent of CIOs predicted 2018 as the year of EHR integration; 75 percent reported they are now integrating patient monitoring data
  • 79 percent said they were selecting and deploying technology primarily for secure messaging; now, 90 percent of hospitals have adopted mobile technology and report that it’s helping improve patient safety and outcomes
  • 54 percent said the top secure messaging challenge was adoption/buy in; now, 51 percent said they now involve clinicians in mobile policy and adoption

What’s more, regarding future predictions, 87 percent of CIOs said they expect to increase spending on cybersecurity in 2019, and in three years from now, 60 percent of respondents expect data to be stored in a hybrid/private cloud.

CIOs also expressed concern regarding big tech companies such as Apple, Amazon and Google disrupting the healthcare market; 70 percent said they were somewhat concerned.

More From Healthcare Informatics


How One Community Hospital is Leveraging AI to Bolster Its Care Pathways Process

December 6, 2018
by Heather Landi, Associate Editor
| Reprints
Click To View Gallery

Managing clinical variation continues to be a significant challenge facing most hospitals and health systems today as unwarranted clinical variation often results in higher costs without improvements to patient experience or outcomes.

Like many other hospitals and health systems, Flagler Hospital, a 335-bed community hospital in St. Augustine, Florida, had a board-level mandate to address its unwarranted clinical variation with the goal of improving outcomes and lowering costs, says Michael Sanders, M.D., Flagler Hospital’s chief medical information officer (CMIO).

“Every hospital has been struggling with this for decades, managing clinical variation,” he says, noting that traditional methods of addressing clinical variation management have been inefficient, as developing care pathways, which involves identifying best practices for high-cost procedures, often takes up to six months or even years to develop and implement. “By the time you finish, it’s out of date,” Sanders says. “There wasn’t a good way of doing this, other than picking your spots periodically, doing analysis and trying to make sense of the data.”

What’s more, available analytics software is incapable of correlating all the variables within the clinical, billing, analytics and electronic health record (EHR) databases, he notes.

Another limitation is that care pathways are vulnerable to the biases of the clinicians involved, Sanders says. “In medicine, what we typically do is we’ll have an idea of what we want to study, design a protocol, and then run the trial and collect the data that we think is important and then we try to disprove or prove our hypothesis,” he says.


Experience New Records for Speed & Scale: High Performance Genomics & Imaging

Through real use cases and live demo, Frank Lee, PhD, Global Industry Leader for Healthcare & Life Sciences, will illustrate the architecture and solution for high performance data and AI...

Sanders says he was intrigued by advances in machine learning tools and artificial intelligence (AI) platforms capable of applying advanced analytics to identify hidden patterns in data.

Working with Palo Alto, Calif.-based machine intelligence software company Ayasdi, Flagler Hospital initiated a pilot project to use Ayasdi’s clinical variation management application to develop care pathways for both acute and non-acute conditions and then measure adherence to those pathways.

Michael Sanders, M.D.

Flagler targeted their treatment protocols for pneumonia as an initial care process model. “We kicked around the idea of doing sepsis first, because it’s a huge problem throughout the country. We decided to use pneumonia first to get our feet wet and figure out how to use the tool correctly,” he says.

The AI tools from Ayasdi revealed new, improved care pathways for pneumonia after analyzing thousands of patient records from the hospital and identifying the commonalities between those with the best outcomes. The application uses unsupervised machine learning and supervised prediction to optimally align the sequence and timing of care with the goal of optimizing for patient outcomes, cost, readmissions, mortality rate, provider adherence, and other variables.

The hospital quickly implemented the new pneumonia pathway by changing the order set in its Allscripts EHR system. As a result, for the pneumonia care path, Flagler Hospital saved $1,350 per patient and reduced the length of stay (LOS) for these patients by two days, on average. What’s more, the hospital reduced readmission by 7 times—the readmission rate dropped from 2.9 percent to 0.4 percent, hospital officials report. The initial work saved nearly $850,000 in unnecessary costs—the costs were trimmed by eliminating labs, X-rays and other processes that did not add value or resulted in a reduction in the lengths of stay or readmissions.

“Those results are pretty amazing,” Sanders says. “It’s taking our data and showing us what we need to pursue. That’s powerful.”

With the success of the pneumonia care pathway, Flagler Hospital leaders also deployed a new sepsis pathway. The hospital has expanded its plans for using Ayasdi to develop new care pathways, from the original plan of tackling 12 conditions over three years, to now tackling one condition per month. Future plans are to tackle heart failure, total hip replacement, chronic obstructive pulmonary disease (COPD), coronary artery bypass grafting (CABG), hysterectomy and diabetes, among other conditions. Flagler Hospital expects to save at least $20 million from this program in the next three years, according to officials.

Finding the “Goldilocks” group

Strong collaboration between IT and physician teams has been a critical factor in deploying the AI tool and to continue to successfully implement new care pathways, Sanders notes.

The effort to create the first pathway began with the IT staff writing structured query language (SQL) code to extract the necessary data from the hospital’s Allscripts EHR, enterprise data warehouse, surgical, financial and corporate performance systems. This data was brought into the clinical variation management application using the FHIR (Fast Healthcare Interoperability Resources) standard.

“That was a major effort, but some of us had been data scientists before we were physicians, and so we parameterized all these calls. The first pneumonia care path was completed in about nine weeks. We’ve turned around and did a second care path, for sepsis, which is much harder, and we’ve done that in two weeks. We’ve finished sepsis and have moved on to total hip and total knee replacements. We have about 18 or 19 care paths that we’re going to be doing over the next 18 months,” he says.

After being fed data of past pneumonia treatments, the software automatically created cohorts of patients who had similar outcomes accompanied by the treatments they received at particular times and in what sequence. The program also calculated the direct variable costs, average lengths of stay, readmission and mortality rates for each of those cohorts, along with the statistical significance of its conclusions. Each group had different comorbidities, such as diabetes, COPD and heart failure, which was factored into the application's calculations. At the push of a button, the application created a care path based on the treatment given to the patients in each cohort.

The findings were then reviewed with the physician IT group, or what Sanders calls the PIT crew, to select what they refer to as the “Goldilocks” cohort. “This is a group of patients that had the combination of low cost, short length of stay, low readmissions and almost zero mortality rate. We then can publish the care path and then monitor adherence to that care path across our physicians,” Sanders says.

The AI application uncovered relationships and patterns that physicians either would not have identified or would have taken much longer to identify, Sanders says. For instance, the analysis revealed that for patients with pneumonia and COPD, beginning nebulizer treatments early in their hospital stays improved outcomes tremendously, hospital leaders report.

The optimal events, sequence, and timing of care were presented to the physician team using an intuitive interface that allowed them to understand exactly why each step, and the timing of the action, was recommended. Upon approval, the team operationalized the new care path by revising the emergency-department and inpatient order sets in the hospital EHR.

Sanders says having the data generated by the AI software is critical to getting physicians on board with the project. “When we deployed the tool for the pneumonia care pathway, our physicians were saying, ‘Oh no, not another tool’,” Sanders says. “I brought in a PIT Crew (physician IT crew) and we went through our data with them. I had physicians in the group going through the analysis and they saw that the data was real. We went into the EMR to make sure the data was in fact valid, and after they realized that, then they began to look at the outcomes, the length of stay, the drop in readmissions and how the costs dropped, and they were on board right away.”

The majority of Flagler physicians are adhering to the new care path, according to reports generated by the AI software's adherence application. The care paths effectively sourced the best practices from the hospital’s best doctors using the hospital’s own patient groups, and that is key, Sanders notes.

“When we had conversations with physicians about the data, some would say, ‘My patient is sicker than yours,’ or ‘I have a different patient population.’ However, we can drill down to the physician’s patients and show the physician where things are. It’s not based on an ivory tower analysis, it’s based on our own data. And, yes, our patients, and our community, are unique—a little older than most, and we have a lot of Europeans here visiting. We have some challenges, but this tool is taking our data and showing us what we need to pursue. That’s pretty powerful.”

He adds, “It’s been amazing to see physicians rally around this. We just never had the tool before that could do this.”

While Flagler Hospital is a small community hospital with fewer resources than academic medical centers or larger health systems—for example, the hospital doesn’t have a dedicated data scientist but rather uses its in-house informatics staff for this project—the hospital is progressive in its use of advanced analytics, according to Sanders.

“We’ve been able to do a lot of querying ourselves, and we have some sepsis predictive models that we’ve created and put into place. We do a lot of real-time monitoring for sepsis and central line-associated bloodstream infections,” he says. “Central line-associated bloodstream infections are a bane for all hospitals. In the past year and a half, since we’ve put in our predictive model, we’ve had zero bloodstream infections, and that’s just unheard of.”

Sanders and his team plan to continue to use the AI tool to analyze new data and adjust the care paths according to new discoveries. As the algorithms find more effective and efficient ways to deliver care that result in better outcomes, Flagler will continue to improve its care paths and measure the adherence of its providers.

There continues to be growing interest, and also some hype, around AI tools, but Sanders notes that AI and machine learning are simply another tool. “Historically, what we’ve done is that we had an idea of what we wanted to do, conducted a clinical trial and then proved or disproved the hypothesis, based on the data that we collected. We have a tool with AI which can basically show us relationships that we didn’t know even existed and answer questions that we didn’t know to ask. I think it’s going to open up a tremendous pathway in medicine for us to both reduce cost, improve care and really take better care of our patients,” he says, adding, “When you can say that to physicians, they are on board. They respond to the data.”


Related Insights For: Analytics


At RSNA 2018, An Intense Focus on Artificial Intelligence

November 29, 2018
by Mark Hagland, Editor-in-Chief
| Reprints
Artificial intelligence solutions—and discussions—were everywhere at RSNA 2018 this week

Artificial intelligence solutions—and certainly, the promotion of such solutions—were everywhere this year at the RSNA Conference, held this week at Chicago’s vast McCormick Place, where nearly 49,000 attendees attended clinical education sessions, viewed nearly 700 vendor exhibits. And AI and machine learning promotions, and discussions were everywhere.

Scanning the exhibit floor on Monday, Glenn Galloway, CIO of the Center for Diagnostic Imaging, an ambulatory imaging center in the Minneapolis suburb of St. Louis Park, Minn., noted that “There’s a lot of focus on AI this year. We’re still trying to figure out exactly what it is; I think a lot of people are doing the same, with AI.” In terms of whether what’s being pitched is authentic solutions, vaporware, or something in between, Galloway said, “I think it’s all that. I think there will be some solutions that live and survive. There are some interesting concepts of how to deliver it. We’ve been talking to a few folks. But the successful solutions are going to be very focused; not just AI for a lung, but for a lung and some very specific diagnoses, for example.” And what will be most useful? According to Galloway, “Two things: AI for the workflow and the quality. And there’ll be some interesting things for what it will do for the quality and the workflow.”

“Certainly, this is another year where machine learning is absolutely dominating the conversation,” said James Whitfill, M.D., CMO at Innovation Care Partners in Scottsdale, Ariz., on Monday. “In radiology, we continue to be aware of how the hype of machine learning is giving way to the reality; that it’s not a wholesale replacement of physicians. There have already been tremendous advances in, for example, interpreting chest x-rays; some of the work that Stanford’s done. They’ve got algorithms that can diagnose 15 different pathological findings. So there is true material advancement taking place.”

Meanwhile, Dr. Whitfill said, “At the same time, people are realizing that coming up with the algorithm is one piece, but that there are surprising complications. So you develop an algorithm on Siemens equipment, but when you to Fuji, the algorithm fails—it no longer reliably identifies pathology, because it turns out you have to train the algorithm not just on examples form just one manufacturer, but form lots of manufacturers. We continue to find that these algorithms are not as consistent as identifying yourself on Facebook, for example. It’s turning out that radiology is way more complex. We take images on lots of different machines. So huge strides are being made,” he said. “But it’s very clear that human and machine learning together will create the breakthroughs. We talk about physician burnout, and even physicians leaving. I think that machine learning offers a good chance of removing a lot of the drudgery in healthcare. If we can automate some processes, then it will free up our time for quality judgment, and also to spend time talking to patients, not just staring at the screen.”


Experience New Records for Speed & Scale: High Performance Genomics & Imaging

Through real use cases and live demo, Frank Lee, PhD, Global Industry Leader for Healthcare & Life Sciences, will illustrate the architecture and solution for high performance data and AI...

Looking at the hype cycle around AI

Of course, inevitably, there was talk around the talk of the hype cycle involving artificial intelligence. One of those engaging in that discussion was Paul Chang, M.D.., a practicing radiologist and medical director of enterprise imaging at the University of Chicago. Dr. Chang gave a presentation on Tuesday about AI. According a report by Michael Walter in Radiology Business, Dr. Chang said, “AI is not new or spooky. It’s been around for decades. So why the hype?” He described computer-aided detection (CAD) as a form of artificial intelligence, one that radiologists have been making use of for years.

Meanwhile, with regard to the new form of AI, and the inevitable hype cycle around emerging technologies, Dr. Chang said during his presentation that “When you’re going up the ride, you get excited. But then right at the top, before you are about to go down, you have that moment of clarity—‘What am I getting myself into?’—and that’s where we are now. We are upon that crest of magical hype and we are about to get the trench of disillusionment.” Still, he told his audience, “It is worth the rollercoaster of hype. But I’m here to tell you that it’s going to take longer than you think.”

So, which artificial intelligence-based solutions will end up going the distance? On a certain level, the answer to that question is simple, said Joe Marion, a principal in the Waukesha, Wis.-based Healthcare Integration Strategies LLC, and one of the imaging informatics industry’s most respected observers. “I think it’s going to be the value of the product,” said Marion, who has participated in 42 RSNA conferences; “and also the extent to which the vendors will make their products flexible in terms of being interfaced with others, so there’s this integration aspect, folding into vendor A, vendor B, vendor C, etc. So for a third party, the more they reach out and create relationships, the more successful they’ll be. A lot of it will come down to clinical value, though. Watson has had problems in that people have said, it’s great, but where’s the clinical value? So the ones that succeed will be the ones that find the most clinical value.”

Still, Marion noted, even the concept of AI, as applied to imaging informatics, remains an area with some areas lacking in clarity. “The reality, he said, “is that I think it means different things to different people. The difference between last year and this year is that some things are coming to fruition; it’s more real. And so some vendors are offering viable solutions. The message I’m hearing from vendors this year is, I have this platform, and if a third party wants to develop an application or I develop an application, or even an academic institution develops a solution, I can run it on my platform. They’re trying to become as vendor-agnostic as possible.”

Marion expressed surprise at the seemingly all-encompassing focus on artificial intelligence this year, given the steady march towards value-based healthcare-driven mandates. “Outside of one vendor, I’m not really seeing a whole lot of emphasis this year on value-based care; that’s disappointing,” Marion said. “I don’t know whether people don’t get it or not about value-based care, but the vendors are clearly more focused on AI right now.”

Might next year prove to be different? Yes, absolutely, especially given the coming mandates coming out of the Protecting Access to Medicare Act (PAMA), which will require referring providers to consult appropriate use criteria (AUC) prior to ordering advanced diagnostic imaging services—CT, MR, nuclear medicine and PET—for Medicare patients. The federal Centers for Medicare and Medicaid Services (CMS) will progress with a phased rollout of the CDS mandate, as the American College of Radiology (ACR) explains on its website, with voluntary reporting of the use of AUC taking place until December 2019, and mandatory reporting beginning in January 2020.

But for now, this certainly was the year of the artificial intelligence focus at the RSNA Conference. Only time will tell how that focus plays out in the imaging and imaging informatics vendor space within the coming 12 months, before RSNA 2019 kicks off one year from now, at the conference’s perennial location, McCormick Place.



See more on Analytics

betebet sohbet hattı betebet bahis siteleringsbahis