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AI has mountains of data to study

The ideas and innovators shaping health care
Jan 26, 2024 View in browser
 
Future Pulse

By Daniel Payne, Ruth Reader and Erin Schumaker

INNOVATORS

A person watches lines of code on a computer | AP Photo

Making sense of it all is the challenge. | Michel Spingler/AP Photo

The U.S. health system has the data.

AI could be the key to actually using it.

That’s the future Dr. Atul Butte, chief data scientist at the University of California Health System, imagined in a recent interview with JAMA.

How’s that? AI has the potential to make good on many promises that came with electronic health records, he said, putting the data collected to better use in research and, ultimately, patient care.

“To me, it’s a tragedy now if we don’t use all that data to improve the practice of medicine,” Butte said.

AI doesn’t provide answers the way that researchers’ gold standard, the randomized controlled trial, does. But there are benefits in having both, Butte said.

What’s next? Hospitals have plenty of data to feed AI systems.

At the University of California Health System, more than 9 million patients are in the dataset. Every test, diagnosis, vital-sign reading and prescription could be included in algorithms to make sense of how to best treat a patient.

The possibility that AI could, better than current tools, interpret the mountains of health records is appealing to providers looking to invest in the technology — though they’re already asking a key question: How will AI offer a return on investment?

 

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EXAM ROOM

This photograph taken on Dec. 12, 2023, shows a view of a care room at the instrumental abortion experimentation centre at Pitie Salpetriere hospital in Paris.

Sepsis is a leading cause of death in hospitals. | Emmanuel Dunand/AFP via Getty Images

Artificial intelligence relying on so-called deep learning, in which a computer processes and reprocesses data, is identifying patients at risk of sepsis, a sometimes fatal reaction to an infection. The condition is a leading cause of death in hospitals.

A review of the technology, built by researchers at the University of California, San Diego, and backed by the National Institutes of Health, showed that AI was associated with a 17 percent reduction in mortality from sepsis among hospital patients. The study was published in npj Digital Medicine.

Why it matters: In 2021, a study found that a sepsis algorithm developed by Epic, an electronic health records company, generated too many false alarms and failed to detect some sepsis risks. Subsequent studies have shown mixed results.

Last year, researchers at Johns Hopkins University achieved similar results to those of the San Diego study with a machine-learning algorithm — a different type of AI.

It’s a positive sign that sepsis detection is moving in the right direction.

What’s next? Shamim Nemati, principal investigator on the San Diego study, is working on refining his detection platform by incorporating active sensing technology into the data set. By collecting data from wearable technology, such as smartwatches, the AI can gain additional insight into patient health.

 

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WORKFORCE

The Phoenix VA Health Care Center building

The VA may have issues, but the private sector's are worse, a new study says. | Ross D. Franklin/AP Photo

The private sector could learn something from the VA about running an efficient hospital system.

That’s the bold claim made by VA researchers, along with colleagues at Hunter College of the City University of New York, Harvard Medical School and the University of Washington, in a new report.

They found that administrative staffing makes up 30 percent of the private-sector health care workforce compared with 23 percent at the VA.

Still, their finding is bold because of the VA’s record of poor care. Stories of veterans dying while they waited months for appointments prompted Congress to intervene a decade ago and the VA to let more vets seek care in the private sector on its dime.

Even so: It’s unclear whether private-sector care is superior to what the VA offers. A systematic review the VA released last year found that, compared with the private sector, VA care was of equal or better quality.

If the private sector operated more like the VA, it could cut roughly 900,000 administrative roles, the new report, published in JAMA Network Open, found.

The researchers analyzed data from 2019 — the same year the VA began allowing veterans to seek private care — of 122,315 health care workers, including private-sector and VA hospital worker surveys from the Census Bureau, health insurance employee data from the Bureau of Labor Statistics and VA hospital personnel records.

Why it matters: “We’re throwing away dollars,” Dr. David Himmelstein, study co-author and professor in the School of Urban Public Health at Hunter College, told Erin.

In Himmelstein’s estimation, the private sector’s larger administrative bureaucracy is due to tasks beyond caring for patients, such as reviewing prior authorizations required by insurance companies, responding to mandatory prompts from electronic medical records systems and checking each patient’s insurance coverage.

Reality check: The VA is no nirvana. The effort to update its electronic records system is now projected to cost more than $40 billion more than initially anticipated and, according to the department, the system’s failings have contributed to the deaths of four veterans.

 

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