itnTV "Conversations": Creating an Interoperability Strategy
Paul Chang, M.D., professor of radiology, vice chair of radiology informatics and medical director for enterprise imaging, University of Chicago, explains some of the issues with artificial intelligence (AI) and how hospitals can better prepare for its eventual implementation across the field medicine. A key takeaway is that hospitals need an infrastructure and roadway for AI and deep-learning algorithms to operate. Chang said most health systems will not invest directly in AI, but will invest in analytics, which Chang said uses much of the same infrastructure required by AI.
Chang spoke on this topic at an AIMed breakfast briefing seminar in Chicago April 9, 2019. Listen to a webcast of this hour and 15 minute talk.
Khaldoun Tarakji, M.D., MPH, staff physician in the Section of Electrophysiology and Pacing in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute at the Cleveland Clinic, explains how wearable devices and smart phone apps can be used to aid electrophysiologists in patient care. He said the devices offer a constant remote monitoring of patient heart data, which can be helpful in diagnosing various types of arrhythmias and cardiac conditions. However, the main issue is how to sort through the large volumes of data and to figure out what the clinical value of some of this consumer data is through studies. He spoke at the American College of Cardiology (ACC) 2019 meeting.
Other Cardiac Wearable Content:
VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation — Interview with Robert Klempfner, M.D.
VIDEO: The Future of Wearables in Healthcare — Interview with Karl Poterack, M.D.
Karl Poterack, M.D., medical director, applied clinical informatics, Mayo Clinic, explains the role wearable devices will play in healthcare. He presented in several sessions at the 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.
Poterack said there is a brewing tsunami of data in wearable technologies that healthcare systems will have to figure out how to integrate in the coming years. He said the key issue with wearable data is that there needs to be outcomes data showing the value of how many steps a patient accumulates, changes in heart rate over time, or blood pressure changes in patients with specific aliments. Without this , he said there is limited value in the information.
Augmented reality (AR) and virtual reality (VR) are starting to be adopted for physician training, patient education about their planned procedures, treatment planning and it is expected to be used as a procedure guidance tool in the near future. This example of AR displayed at the Healthcare Information Management and Systems Society (HIMSS) 2019 meetingwas among the most innovative because it allows users to "feel" the 3-D hologram of the heart. Developed by the company SoftServe., the “Touch My Heart” work-in-progress technology allows anyone wearing an AR headset to see and interact with the heart and get a touch sensation when they reach into the virtual tissue. A pad below the image is composed of dozens of ultrasound transducers that emit sound waves in the shape of the heart so users feel touch sensations when interacting with the virtual tissue.
Anthony Chang, M.D., chief intelligence and innovation officer, Children's Hospital of Orange County (CHOC), and medical director of the Sharon Disney Lund Medical Intelligence and Innovation Institute. He is expert in artificial intelligence (AI). He spoke in several sessions at Healthcare Information and Management Systems Society (HIMSS) 2019 meeting on the integration of AI in healthcare.
He said AI will play a big roll in imaging assessments of adult congenital heart disease to help relieve the burden on the small number of congenital cardiologists.
Chang also explained there is a tsunami of data about to wash over healthcare as wearable devices begin to be integrated into patient care. AI will play a key role in sorting through all this data by monitoring the information to identify trends or disease markers and alert clinicians and the patient.
He was a keynote speaker at HIMSS19 with his session "Synergies Between Man and Machine — Future AI apps can be directed to help mitigate physician burnout by decreasing the EHR burden, improving medical education, and automating quality improvement."
Chang is head of the artificial intelligence organization AIMed, which hosts educational sessions and an annual meeting on AI applications in medicine.
Listen to Chang in the PODCAST: Fitting Artificial Intelligence Into Cardiology.
Read the article 6 Key Health Information Technology Trends at HIMSS 2019.
Robert Klempfner, M.D., director of the Cardiovascular Prevention Institute, Sheba Medical Center, Israel, discusses his center's use of wearable devices to manage a remote cardiac rehabilitation program. He spoke on the topic at 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.
Sheba Medical Center in Israel has adopted an app that interfaces with various wearables and Bluetooth-enabled patient monitoring devices to create remote cardiac rehabilitation and heart failure programs. It now remotely monitors hundreds of patients and does not require them to come to the hospital for sessions, which has helped increase patient satisfaction and aided in increasing physical activity compliance. The app is able to transfer device data to an EMR so progress and tasks assigned to patients can be monitored without the need for them to come into the hospital for sessions. Klempfner recently wrote a paper on this topic.
How wearable devices will play a role in healthcare was a big topic at the Healthcare Information Management and Systems Society (HIMSS) 2019 meeting. The biggest question is how to attached the data from consumer devices into a usable format for clinicians that interfaces with the electronic medical record (EMR). A good example of how wearables are being integrated in clinical care was demonstrated by the company Datos. It offers software that can integrate data from a wide variety of wearable devices from several makers into a mobile app, It can transfer the information to an EMR. The app also offers two way communication between the patient and the doctor’s office. It can prompt patients with a list of things they need to do each day to reach physician specified goals and displays analytics on a patient’s health data, including charts and graphs.
The system is used by Sheba Medical Center in Israel for a remote cardiac rehabilitation program. It now remotely monitors hundreds of patients and does not require them to come to the hospital for sessions, which has helped increase patient satisfaction and aided in increasing physical activity compliance. Watch the VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation — an interview with Robert Klempfner, M.D., director of the Cardiovascular Prevention Institute, Sheba Medical Center.
This is a virtual heart with the same electrophysiology characteristics as the real patient being developed to help optimize cardiac resynchronization therapy (CRT) lead placement. CRT currently has a 30 percent nonresponder rate, which is mainly due to the placement of leads. This model allows virtual placement of the leads In various locations to test response prior to the implantation procedure. The green dot shows the location of the virtual lead. It was unveiled at the Healthcare Information Management and Systems Society (HIMSS) 2019 annual meeting in February by Siemens. This "digital twin" technology is in development and will be able to create virtual, digital organs from a patient’s ECG, MRI scan and other clinical data. Siemens said the technology also might have applications for testing virtual ablations strategies to save procedure time when the patient is in the EP lab.
Steve Holloway, principal analyst and company director for the healthcare market research firm Signify Research, explains the key trends he is seeing in enterprise imaging systems. He spoke to ITN at the 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.
This is an example of an arterial venous malformation (AVM) in the brain imaged on a Canon Alphenix Alpha angiography system. It shjows a contrast injection highlighting the vessels, which have been color coded to show the position of the veins and arteries involved in this vascular defect.
This is the newest cardiac cath lab at the University of Colorado Hospital in Aurora, Colorado. Construction was completed in June 2018. It is centered around a Philips Azurion Clarity IQ angiography system, which was chosen because its low X-ray dose imaging and guidance technologies that enable more complex, longer procedures. The room is use for the most involved complex percutaneous coronary interventions (PCI), including chronic total occlusions (CTOs) and complex high-risk indicated procedures (CHIP) patients. It is also used for transcatheter aortic valve replacement (TAVR), septal occluder procedures, transcatheter LAA closures and alcohol ablations.
The room is equipped for radial access procedures, which is used in a little more than 50 percent of cases at the hospital. It is also equipped with an Impella hemodynamic support system, wires and microcatheters for CTOs, and a SonoSite point of care ultrasound console for vascular access needle guidance.
The FDA cleared the MaxQ AI Accipio Ix intracranial hemorrhage (ICH) detection software in November 2018. Here it is displayed at the Radiological Society of North America (RSNA) 2018 meeting.
This is a quick video tour of the Machine Learning Showcase at the Radiological Society Of North America (RSNA) 2018 meeting today. More than 150 vendors showed software for radiology incorporating artificial intelligence (AI) or deep learning.
Read more in the article “How Artificial Intelligence Will Change Medical Imaging.”
This is an example of the FDA-cleared OpenSight augmented reality (AR) system for surgical planning from NovaRad at the Radiological Society Of North America (RSNA) 2018 meeting. It uses a HoloLens headset to register an overlay of the patient’s MR or CT scan in the patient. The operator can use hand movements to slice through and manipulate the images.
The vendor gained an FDA indication for AR to be used in surgical planning in 2018. NovaRad is working with the FDA for a second indication for use of the AR in the operating room during procedures.
This video is jerky, slightly misaligned and the hand movements did not always respond because itwas shot with an iPhone inside the visor. The image quality and hand movements are much better when actually wearing it on your head and aligned for the specific user.
This is an example of how artificial intelligence (AI) can help improve patient care by pulling together patient data from numerous sources n the elect if medical records that are specific to a patient’s diagnosis and treatment for a specific disease state. This is Siemens’ AI-Pathway Companion introduced at the Radiological Society Of North America (RSNA) 2018 meeting this week. In this examples. A prostate cancer patient has all their data on a single time line that can be accessed by single clicks on the points to open reports, images, procedures or labs.
At the end of the time line it integrates AI driven clinical decision support that recommends the next course of action based on clinical guidelines. The guidelines cited can also be opened for review by the clinician.
DAIC Editor Dave Fornell takes a tour of some of the most innovative new cardiovascular technologies on display on the expo floor at the American Heart Association (AHA) 2018 meeting.
Find other new cardiovascular innovations in these videos from other conferences over the past year:
James Januzzi, M.D., Hutter Family Professor at Harvard Medical School and a cardiologist at Mass General Hospital, Boston, spoke at the 2018 American Heart Association (AHA) meeting about his use of artificial intelligence to data-mine patient records. He spoke at AHA on the use of an AI-driven model to predict acute kidney injury (AKI) in patients undergoing coronary angiography, and on the results from a catheter sampled blood archive in a cardiovascular disease study.
Akshay Khandelwal, M.D., director of medical operations at the Henry Ford Heart and Vascular Institute, Detroit, and associate professor of cardiology at Wayne State University, explains how his center has reduced X-ray radiation dose in the cardiac catheterization labs.
Watch the related VIDEO: Reducing Cath Lab Radiation Dose at Henry Ford Hospital — Discussion with Nicolas Bevins, Ph.D., vice chair, physics and research, and Jessica Harrington, RCIS, Henry Ford Hospital.
For more on how to reduce dose in the cath lan, read these related articles:
Example of GE Healthcare’s FetalHQ software for the ultrasound imaging of fetal hearts. The new tool runs on GE Healthcare’s Voluson ultrasound systems and is the first tool to simultaneously examine the size, shape and function of the fetal heart echocardiography for congenital heart evaluations.
Rami Doukky, M.D., professor of medicine, preventative medicine and radiology, and chief of the Division of Cardiology at Cook County Health and Hospitals System, discusses how artificial intelligence (AI) will impact all medical imaging modalities at the 2018 American Society of Nuclear Cardiology (ASNC) annual meeting in San Francisco.
Related AI in Cardiac Imaging Content:
VIDEO: Artificial Intelligence in Cardiac Ultrasound — Interview with Partho Sengupta, M.D.
A discussion with Nicolas Bevins, Ph.D., vice chair, physics and research, and Jessica Harrington, RCIS. They explain the use of shields, technique and use of newer angiography technologies to reduce X-ray radiation dose in the cardiac cath labs at Henry Ford Hospital, Detroit.
Watch the VIDEO: Technologies and Techniques to Reduce Radiation Dose in the Cardiac Cath Lab — Interview with Akshay Khandelwal, M.D., director of medical operations at the Henry Ford Heart and Vascular Institute
For more on how to reduce dose in the cath lan, read these related articles:
Kavitha Chinnaiyan, M.D., FACC, FSCCT, associate professor, Oakland University, William Beaumont School of Medicine, Royal Oak, Mich. She presented at the Society of Cardiovascular Computed Tomography (SCCT) 2018 meeting.
Related FFR-CT Content:
VIDEO: Implementation and the Science Behind FFR-CT — interview with James Min, M.D.
VIDEO: Early U.S. Experience With FFR-CT in Evaluating ED Chest Pain Presentation — interview with Simon Dixon, M.D.
VIDEO: Status of FFR-CT Adoption in the United States — interview with Campbell Rogers, M.D.
Suhny Abbara, M.D., FSCCT, chief of cardiothoracic imaging and chair of the CT operations committee, University of Texas Southwestern Medical Center, Dallas, incoming president of the Society of Cardiovascular Computed Tomography (SCCT), and editor of the new RSNA journal Radiology: Cardiothoracic Imaging. He spoke to DAIC at SCCT 2018 meeting.
A discussion with Gianluca Pontone, M.D., Ph.D., FSCCT, director of cardiovascular MRI, Centro Cardiologico Manzino, Milan, Italy, at the Society of Cardiovascular Computed Tomography (SCCT) 2018 meeting. He said CT can be comparable to the gold-standards of nuclear and MRI perfusion depending on the scanner used to acquire the images.
Jonathon Leipsic, M.D., FSCCT, professor of radiology and cardiology at the University of British Columbia, Vancouver, Canada, and an expert in transcatheter valve imaging. He spoke about his experiences with TAVR and TMVR trials and devices planning at the the Society of Cardiovascular Computed Tomography (SCCT) 2018 meeting.
Read the related article "The Essentials of Structural Heart Imaging."
DAIC Editor Dave Fornell highlights some of the most innovative new technology on the show floor of the American Society of Echocardiography (ASE) 2018 meeting. The segments include virtual reality workstations, advanced 3-D cardiac ultrasound quantification and visualization, improved echo-fluoro image fusion technology, and imaging aided by artificial intelligence.
Partho Sengupta, M.D., DM, FACC, FASE, chief division of cardiology, director of cardiac imaging, West Virginia University Heart and Vascular Institute, explains how artificial intelligence is being integrated into echocardiography and used to mine big data to better assess patients at the American Society of Echocardiography (ASE) 2018 meeting.
Watch the VIDEO: Ultrasound's Integration of Artificial Intelligence and Robotic Echo, with Senguta at the ASE 2017 meeting
Organizations who are embarking on an enterprise imaging journey share many of the same questions and concerns regarding how to best optimize workflow across providers, departments and facilities; which technologies will provide the best fit for achieving the future vision; and how to maximize value and accelerate return on investment by driving adoption and improving satisfaction among providers and healthcare consumers (patients).
We, Paragon Consulting Partners LLC (PCP Imaging), are a team of passionate healthcare professionals that bring over 100 years of collective clinical, technical and business leadership experience within the healthcare IT and imaging informatics industries. In this video we address the key challenges and considerations faced by organizations undertaking an Enterprise Imaging journey, and how a trusted partner can contribute valuable expertise and guidance that enable healthcare organizations and vendors of any size to successfully tackle even their most challenging enterprise imaging initiatives. For more information, visit pcpimaging.com.
DAIC Editor Dave Fornell previews the launch of augmented reality (AR) technology in the March/April 2018 issue of DAIC. Augmented reality brings new depth to print content through your smartphone by connecting to related videos and other resources.
Take a video tour of some of the medical devices designed to improve patient care, improve patient engagement and increase physiologic monitoring highlighted at the 2018 Consumer Electronics Show (CES). One of the most interesting technologies is a flexible electronics ECG monitor that can bend and twist with the skin and interfaces with a smartphone app. The exhibition includes more than 3,000 vendors and more than 170,000 attendees. For more examples of future healthcare technologies, watch the VIDEO “Editor's Choice of Future Healthcare Technologies at HIMSS.”
Emanuel Kanal, M.D., director of MRI services and professor of radiology and neuroradiology at the University of Pittsburgh Medical Center, explains the new mobile application he developed, which lets users visually model the forces at work during an MRI exam on patients with implanted medical devices, at the 2017 Radiological Society of North America (RSNA) meeting.
Read the related article “The Changing Relationship Between MRIs and Pacemakers.”
Dianna Bardo M.D., director of body MR and co-director of the 3-D Innovation Lab at Phoenix Children's Hospital, discusses how 3-D printing and other advanced imaging modalities can help improve outcomes in complex cases. Read the article “The Use of 3-D Printing in Cardiology.” Watch the WEBINAR “Innovation and Success in 3D-inspired Development of the Business and Clinical Practice,” presented by Bardo.
Dee Dee Wang, M.D., director, structural heart imaging at Henry Ford Hospital, Detroit, explains how her center uses 3-D printing and computer aided design (CAD) software to improve patient outcomes. She spoke to DAIC at the 2017 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. Read the articles “The Use of 3-D Printing in Cardiology” and “Henry Ford Hospital Study Shows 3-D Imaging Improves Fixing Broken Hearts.”
Prem Soman, M.D., director of nuclear cardiology at the Heart and Vascular Institute, University of Pittsburgh, and president-elect of the American Society of Nuclear Cardiology (ASNC), explained advances in PET and SPECT imaging and the learning curve involved in reading scans from the new CZT SPECT cameras. Watch the VIDEO: Trends in Nuclear Cardiology Imaging, an iknterview with David Wolinsky, M.D., director of nuclear cardiology at Cleveland Clinic Florida. Read the related article "Advances in Cardiac Nuclear Imaging."
Randy Thompson, M.D., attending cardiologist, St. Luke’s Mid-America Heart Institute, Kansas City, explains protocols and what to consider when working with the newer generation CZT-SPECT camera systems for nuclear cardiology. He spoke during the 2017 American Society of Nuclear Cardiology (ASNC) Today technology update meeting. Watch the related VIDEO "PET vs. SPECT in Nuclear Cardiology and Recent Advances in Technology." Read the related articles "Managing Dose in PET and SPECT Myocardial Perfusion Imaging," and "Advances in Cardiac Nuclear Imaging."
Rami Doukky, M.D., system chair, Division of Cardiology, professor of medicine, Cook County Health and Hospitals System, Chicago, discusses the new CMS requirements for clinical decision support (CDS) appropriate use criteria (AUC) documentation in cardiac imaging starting on Jan. 1, 2018. He spoke at the 2017 American Society of Nuclear Cardiology (ASNC) meeting. Read the article "CMS to Require Appropriate Use Criteria Documentation for Medical Imaging Orders."
Partho Sengupta, M.D., professor of medicine, director of cardiovascular imaging and chair of cardiac innovations at the West Virginia University Heart and Vascular Institute, discusses futuristic technologies that are entering cardiac ultrasound at the 2017 American Society of Echocardiography (ASE) annual meeting. Watch the related ASE 2017 VIDEO "Ultrasound Technology Trends and Technology to Watch."
The shift to value-based payment models requires focused attention on quality and cost. Lumedx’s Cardiovascular Performance Program offers a new approach to managing this transition so hospitals can improve outcomes — and dramatically reduce costs. See how complications reduction, cost-per-case variations and other key metrics delivered in real-time can drive radical change. For more information, visit www.lumedx.com.