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IBM Unveils Watson-Powered Imaging Solutions at RSNA

December 1, 2016
by Heather Landi
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Merge Healthcare and Watson Health, both IBM companies, unveiled at the Radiological Society of North America Annual Meeting (RSNA 2016) new imaging solutions utilizing machine learning and artificial intelligence (AI) technologies.

The solutions are designed to help healthcare providers pursue personalized approaches to patient diagnosis, treatment, and monitoring.

IBM researchers estimate that medical images, as the largest and fastest-growing data source in the healthcare industry, account for at least 90 percent of all medical data,

Tools to help clinicians extract insights from medical images remain limited, requiring most analysis to be done manually. This has created an opportunity to analyze and cross-reference medical images against a deep trove of lab results, electronic health records, genomic tests, clinical studies and other health-related data sources to enable providers to compare new medical images with a patient’s image history as well as populations of similar patients to detect changes and anomalies.

According to a press release, Watson Health showcased a number of new advancements during RSNA, including a cognitive peer review tool intended to help healthcare professionals reconcile differences between a patient’s clinical evidence, and data in that patient’s electronic health record (EHR) and a cognitive data summarization tool intended to provide radiologists, cardiologists, and other physicians with patient-specific clinical information to use when interpreting imaging studies, or when diagnosing and treating patients.

Additionally, Watson Health demonstrated the MedyMatch “Brain Bleed” App, a cognitive image review tool intended to help emergency room physicians diagnose a stroke or brain bleed in a trauma patient by identifying relevant evidence in a patient record.      

During RSNA, Merge also showcased new technologies, such as Marktation, a new process for interpreting medical images intended to help physicians improve image reading speed and accuracy, with an initial application in mammography and the Watson Clinical Integration Module, a cloud application for radiologists that aims to help increase reader efficiency and counteract common causes of errors in medical imaging, such as base rate neglect, anchoring, bias, framing bias, and premature closure.

“Watson cognitive computing is ideally suited to support radiologists on their journey ‘Beyond Imaging’ to practices that address the needs of patient populations, deliver improved patient outcomes, and demonstrate real-world value,” Nancy Koenig, general manager of Merge Healthcare, said in a statement.

 

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Survey: Digital, AI Top Priorities in 2019, but EHRs Will Dominate IT Spend

January 22, 2019
by Heather Landi, Associate Editor
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Digital, advanced analytics, and artificial intelligence (AI) are top spending priorities for healthcare executives in 2019, but electronic health record (EHR) systems will dominate technology spending budgets, according to a recent technology-focused healthcare survey.

Damo Consulting, a Chicago-based healthcare growth and digital transformation advisory firm, surveyed technology and service provider executives and healthcare enterprise executives about how the demand environment for healthcare IT is changing and will impact the industry in the coming year. Damo Consulting’s third annual Healthcare IT Demand Survey also analyzes the challenges for healthcare organizations and the perceived impact of macro-level changes.

The report indicates technology vendors will continue to struggle with long sales cycles as they aggressively market digital and AI. For the second year in a row, the rise of non-traditional players such as Amazon and Google will have a strong impact on the competitive environment among technology vendors while EHR vendors grow in dominance.

Among the key findings from the survey, IT budgets are expected to grow by 20 percent or more, with healthcare executives indicating they are more upbeat about IT spend growth than vendors. All the healthcare executives who participated in the survey said digital transformation initiatives are gaining momentum in their enterprises.

However, the majority (75 percent) agree that rapid change in the healthcare IT landscape makes technology decisions harder and only 58 percent believe there are plenty of viable and ready-to-deploy solutions available today in emerging technologies such as AI and digital health solutions. Seventy-one percent agree that federal government policies have provided a boost to healthcare IT spend this past year.

Top IT priorities for healthcare enterprise executives in 2019 are digital, advanced analytics and AI. Of the survey respondents, 79 percent said accelerating digital health initiatives was a top priority and 58 percent cited investing in advanced analytics and AI capabilities as top priorities. However, modernizing IT infrastructure (25 percent) and optimizing EHRs (21 percent) are also significant priorities.

Technology vendors also see AI, advanced analytics and digital transformation as top areas of focus for next year, as those areas were cited by 75 percent and 70 percent of technology and service provider executives, respectively. Thirty-three percent of those respondents cited EHR optimization and 25 percent cited cybersecurity and ransomware. Thirteen percent cited M&A integration as a top area of focus in 2019.

However, EHR systems will dominate technology spending budgets, even as the focus turns to digital analytics, the survey found. Technology and service provider executives who participated in the survey identified EHR system optimization and cybersecurity as significant drivers of technology spend in 2019. Sixty percent of respondents said enterprise digital transformation and advanced analytics and AI would drive technology spend this year, but 38 percent also cited EHR optimization and cybersecurity/ransomware. One executive survey respondent said, “For best of breed solutions, (the challenge is) attracting enough mindshare and budget vs. EHR spends.”

When asked what digital transformation means, close to half of healthcare executives cited reimaging patient and caregiver experiences, while one quarter cited analytics and AI and 17 percent cited automation. As one executive said, “The biggest challenge for healthcare in 2019 will be navigating tightening margins and limited incentives to invest in care design.”

Healthcare executives are divided on whether digital is primarily an IT-led initiative, and are also divided on whether technology-led innovation is dependent on the startup ecosystem.

The CIO remains the most important buyer for technology vendors, however IT budgets are now sitting with multiple stakeholders, the survey found, as respondents also cited the CFO, the CTO, the CMIO and the chief digital officer.

“Digital and AI are emerging as critical areas for technology spend among healthcare enterprises in 2019. However, healthcare executives are realistic around their technology needs vs. their need to improve care delivery. They find the currently available digital health solutions in the market are not very mature,” Paddy Padmanabhan, CEO of Damo Consulting, said in a statement. “However, they are also more upbeat about the overall IT spend growth than their technology vendors.”

Looking at the technology market, healthcare executives perceive a lack of maturity in technology solution choices for digital initiatives, as well as a lack of internal capabilities for managing digital transformation. In the survey report, one executive said, “HIT architecture needs to substantially change from large monolithic code sets to an API-driven environment with multiple competing apps.”

A majority of healthcare enterprise executives view data silos and lack of interoperability as the biggest challenges to digital transformation. And, 63 percent believe the fee-for-service reimbursement model will remain the dominant payment model for the foreseeable future.

In addition, cybersecurity issues will continue to be a challenge for the healthcare sector in 2019, but not the biggest driver of technology spending or the top area of focus for health systems in the coming year, according to the survey.

Healthcare executives continue to be confused by the buzz around AI and digital and struggle to make sense of the changing landscape of who is playing what role and the blurred lines of capabilities and competition, according to the survey report. When asked who their primary choice is when looking for potential partners to help with digital transformation, 46 percent of healthcare executives cited their own internal IT and innovation teams, 17 percent cited their EHR vendor and 8 percent cited boutique consulting firms. A quarter of respondents cited “other.”

For technology vendors, the biggest challenge is long cycles, along with product/service differentiation and brand visibility.

The rise of non-traditional players, such as Amazon, Apple, and Google, will have a strong impact on the competitive healthcare technology environment, the survey responses indicated. At the same time, deeply entrenched EHR vendors such as Epic and Cerner will grow in dominance.

 

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AMIA Charts Course to Learning Health System

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Initiative seeks to create virtuous cycle where clinical practice is not distinct from research

In September 2015, at AcademyHealth’s Concordium 2015 meeting in Washington, D.C., I saw a great presentation by Peter Embi, M.D., who was then an associate professor and vice chair of biomedical informatics as well as associate dean for research informatics and the chief research information officer at the Wexner Medical Center at Ohio State University. 

That day Dr. Embi outlined some of the limitations of the traditional approach to evidence-based medicine —  that it is a research/practice paradigm where the information flow is unidirectional, and clinical practice and research are distinct activities, with the research design as an afterthought. “We want to leverage information at the point of care and in engagements with patients so we can systematically learn. That is what the learning health system is all about,” Embi said.

But in the current model, he noted, there is little consideration of research during planning of health systems. That limits the ability to invest in and leverage clinical resources to advance research. Also, there are no financial incentives for non-researchers to engage in research. Research as an afterthought also leads to regulatory problems and wasted investments.

Embi argued for moving from “evidence-based medicine” to an “evidence-generating medicine” approach, which he defined as the systematic incorporation of research and quality improvement into the organization. Rather than findings flowing only from research done looking back at historical data, this approach creates a virtuous cycle where clinical practice is not distinct from research.

Flash forward to 2019 and Dr. Embi is now president & CEO of Regenstrief Institute Inc., vice president for learning health systems at IU Health, and chairman of the Board of Directors of the American Medical Informatics Association (AMIA). And he is still advocating for a shift to evidence-generating medicine. He and AMIA colleagues recently published a paper in JAMIA offering more than a dozen recommendations for public policy to facilitate the generation of evidence across physician offices and hospitals now that the adoption of EHRs is widespread.

The paper cites several examples of current high-visibility research initiatives that depend on the EGM approach: the All of Us Research Program and Cancer Moonshot initiative, the Health Care Systems Research Collaboratory, and the development of a national system of real-world evidence generation system as pursued by such groups as the US Food & Drug Administration (FDA), Patient-Centered Outcomes Research Institute (PCORI), National Institutes of Health (NIH), and other federal agencies.

The paper makes several recommendations for policy changes, including that the Trump administration should faithfully implement 2018 Revisions to the Common Rule as well as establish the 21st Century Cures-mandated Research Policy Board. The administration must implement this provision to better calibrate and harmonize our sprawling and incoherent federal research regulations.

Another recommendation is that the HHS Office of Civil Rights (OCR) should refine the definition of a HIPAA Designated Record Set (DRS) and ONC should explore ways to allow patients to have a full digital export of their structured and unstructured data within a Covered Entity’s DRS in order to share their data for research. In addtion, regulators should work with stakeholders to develop granular data specifications, including metadata, and standards to support research for use in the federal health IT certification program.

The AMIA authors also suggest that CMS leverage its Quality Payment Program to reward clinical practice Improvement Activities that involve research components. This would encourage office-based physicians to invest time and resources needed to realize EGM, they say.

Based on the paper’s findings, AMIA is launching a new initiative focused on advancing informatics-enabled improvements for the U.S. healthcare system. The organization says that a multidisciplinary group of AMIA members will develop a national informatics strategy, policy recommendations, and research agenda to improve:

• how evidence is generated through clinical practice;

• how that evidence is delivered back into the care continuum; and

• how our national workforce and organizational structures are best positioned to facilitate informatics-driven transformation in care delivery, clinical research, and population health.

A report detailing this strategy will be unveiled at a December 2019 conference in Washington, D.C.

 

 

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Definitive Healthcare Acquires HIMSS Analytics’ Data Services

January 16, 2019
by Rajiv Leventhal, Managing Editor
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Definitive Healthcare, a data analytics and business intelligence company, has acquired the data services business and assets of HIMSS Analytics, the organizations announced today.

The purchase includes the Logic, Predict, Analyze and custom research products from HIMSS Analytics, which is commonly known as the data and research arm of the Healthcare Information and Management Systems Society.

According to Definitive officials, the acquisition builds on the company’s “articulated growth strategy to deliver the most reliable and consistent view of healthcare data and analytics available in the market.”

Definitive Healthcare will immediately begin integrating the datasets and platform functionality into a single source of truth, their executives attest. The new offering will aim to include improved coverage of IT purchasing intelligence with access to years of proposals and executed contracts, enabling transparency and efficiency in the development of commercial strategies.

Broadly, Definitive Healthcare is a provider of data and intelligence on hospitals, physicians, and other healthcare providers. Its product suite its product suite provides comprehensive data on 8,800 hospitals, 150,000 physician groups, 1 million physicians, 10,000 ambulatory surgery centers, 14,000 imaging centers, 86,000 long-term care facilities, and 1,400 ACOs and HIEs, according to officials.

Together, Definitive Healthcare and HIMSS Analytics have more than 20 years of experience in data collection through exclusive methodologies.

“HIMSS Analytics has developed an extraordinarily powerful dataset including technology install data and purchasing contracts among other leading intelligence that, when combined with Definitive Healthcare’s proprietary healthcare provider data, will create a truly best-in-class solution for our client base,” Jason Krantz, founder and CEO of Definitive Healthcare, said in a statement.

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