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During the spring of 2020, hospitals across the U.S. were gearing up for a surge of COVID-19 patients. They paused elective procedures, and many patients appeared to be forgoing care for serious problems like strokes or heart attacks. 

That one-two punch dramatically lowered the number of people seeking health care, a major financial blow for providers and a potentially dangerous situation for patients.  

In response, health care providers turned to telemedicine, treating patients from a distance via video or phone calls. Federal and state regulators loosened rules governing telehealth at the start of the pandemic, and in the blink of an eye the technology was everywhere. 

In many cases, patients have appreciated the convenience of telemedicine, and many health care leaders expect the technology to stick around. That could be a step towards the acceptance of more technology in health care generally.

In the wake of the coronavirus pandemic, a group of companies from Middle Tennessee sees an opportunity to use artificial intelligence to make health care more efficient and more convenient. They say telehelath especially could benefit tremendously from AI, and in some ways it’s paving the way for the technology.

“It'll mostly be accelerating what folks have already been thinking about. And it'll push folks to do things faster with AI,” Digital Reasoning VP of health care solutions Chris Cashwell said. “The data alone that will be created from the pandemic will push people to say, we have so much more information we need to stay on top of, we can't handle it unless we have an artificial intelligence solution.”

Artificial intelligence involves programming a computer to perform tasks that would normally require a human — like predicting TV shows you might enjoy on Netflix or products you might want to buy on Amazon — usually using humongous amounts of data. 

Health care providers are already using AI to prioritize patients with the most urgent needs and avoid costly billing errors, but the technology is more common in areas like finance, manufacturing and entertainment. 

The Franklin health care analytics company AdhereHealth uses AI to identify people who might misuse their medication or stop taking it altogether, which can cause serious health problems. 

CEO Jason Rose said that the recent shift towards telehealth has made people much more comfortable using technology in a health care setting, and that gives momentum to newer tech like AI.

“I would look at (telehealth) as foundational for AI,” he said. "People are more accepting of using tech for their care, and it could be anywhere from a (smart) watch to Bluetooth enabled devices in their homes ... all that is foundational in accepting technology.”

Heather Bassett, the Chief Medical Officer for the Nashville health care analytics company Xsolis, sees a similar trend. She said the adoption of telemedicine moves more health care onto cell phones, a place where we already accept the use of AI for route planning on Google Maps or ride hailing with Uber.

“There's AI in everything you do these days, whether you know it or not,” Bassett said. “The fact that people very quickly were able to see that it does work on a cell phone using these tools. That's getting it over the hump, and it's going to be an acceleration after that.” 

At the same time, the explosion of telehealth also creates an opportunity. Both Bassett and Rose said AI could help doctors quickly search through droves of health care data about a particular patient and pull up the most relevant information during a telehealth visit. 

“I see, for the next generation of telehealth, where the telehealth doctor has access to more information about the patient's background and the issues that are maybe beyond the reason for the phone call,” Rose said. 

Rose said human doctors simply can’t process all of the data about any one patient. Artificial intelligence can guide doctors to the information they need and filter out the rest. 

However, they cautioned that acceptance of artificial intelligence will likely be slow. Rose described the transition to telehealth as “the flip of a switch,” something that almost never happens in health care. The pandemic’s effect on the integration of AI will likely be much more modest. 

“Basically, the reason for that is that there's a big difference between knowing where you're going for lunch and, do I have a serious health issue?” Charles Apigian, co-director of MTSU’s Data Science Institute said. 

He said the increase in telemedicine does make it more likely that patients will accept other forms of technology, but they will probably be less comfortable if it’s involved directly in health care decisions. 

"I'm OK with an algorithm telling me I have a cold. But if it's going to tell me that I have cancer I think I would want a doctor in front of me for that,” he said. 

Instead, the next steps for AI are probably in a support role.  

Damian Mingle is a data scientist based in Williamson County and the founder of LogicPlum, which helps companies use artificial intelligence. In the health care industry, his company usually uses AI to provide administrative support, such as predicting which patients won’t show up for an MRI appointment. 

After the pandemic subsides, he expects health care providers will want more of that type of support, rather than turning to AI for clinical decisions. 

"It's not so much about trying to predict if someone has cancer, it's more along the administrative aspect of health care,” he said. “Trying to figure out how am I going to manage who should come in first, who should be seen? Figuring out who needs surgery, who needs a check up? How do you prioritize those individuals?”

Still, using AI to make administrative tasks more efficient would still be a big win for hospitals that lost millions of dollars because of the pause in elective procedures. It also means that patients could get better care. 

But Mingle also points to several barriers that could prevent hospitals from adopting AI. They may not have the IT capacity to feed data into an artificial intelligence system.  

In addition, large numbers of patients delayed elective surgeries earlier this year. In the fall, they’re likely to come back in droves, which means hospitals may not have the time to set up the technology.

Franklin-based Digital Reasoning is currently trying to convince health care providers that artificial intelligence is actually the best way to manage the wave of patients now scheduling delayed appointments. 

In addition to delayed elective procedures, Digital Reasoning is predicting an increase in cancer diagnoses. A report published in May by the electronic medical records vendor Epic found that cancer screenings dropped dramatically in the spring. 

That means health systems could soon see a surge of cancer diagnoses, the company argued in a press release this summer. Now, the company is providing an AI tool for reading pathology and radiology reports to hospitals at cost. 

The software reads pathology reports written by doctors and identifies the patients that need immediate follow up. Normally, a human would have to read the reports one by one, rather than prioritizing the most important patients. 

"We're taking things that a human had to process through and we're compressing that down," Digital Reasoning VP of health care solutions Chris Cashwell said. "That needle in a haystack that you had to look an hour for, you get to look for a few seconds and find the needle, so you move on to the next thing."  

Cashwell said he’s hopeful hospitals using the AI platform will see its value and become a customer in the future. 

After a tumultuous first half of the year, many health care providers are exhausted. Some have spent months trying to treat a deadly new disease while others have been furloughed because of the disease’s economic impact. Mingle said he’s hopeful that hospital administrators will be motivated to use AI to take some of the pressure off those health care workers.  

"On the business side of health care, all they're hearing about is that the providers are exhausted. And they are. The pressure we're seeing is, how can I be innovative for my team?" he said. "I've got to push some of these technologies forward that can assist and support what they're trying to do."

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