Electronic Patient Records

NHS Providers urges government to prioritise digital investment to boost productivity

NHS Providers has called for urgent government investment in digital technology as a means to enhance productivity, following the release of a survey involving leaders of NHS trusts. This call comes amid growing concerns about financial pressures and operational challenges facing the health service.

The survey, whose results were published on 8 September 2024, painted a stark picture of the financial health of the NHS. Trust leaders indicated that their finances have been severely impacted by a number of factors, including ongoing industrial action, the effects of inflation, demands for increased efficiency, and the overall operational strain on the NHS. These challenges have exacerbated existing financial pressures, placing trust leaders in a difficult position as they attempt to manage their budgets for the upcoming year.

The survey found that a significant 51% of respondents were “extremely concerned” about their ability to meet operational priorities within their respective organisation’s financial budget for the 2024/25 fiscal year. This concern highlights the precarious financial state of many NHS trusts as they face increasing demand for services with limited resources.

Moreover, 92% of those surveyed expressed the view that the efficiency challenge for 2024/25 is more daunting than in the previous year, with the need to do more with less becoming ever more critical. This sentiment reflects the growing pressure on NHS leaders to find ways to increase efficiency in an already overstretched system.

When it comes to meeting recovery targets, trust leaders were notably divided in their confidence levels. While almost a third of respondents (32%) were optimistic that their system would achieve its targets to reduce waiting times for physical health services in 2024/25, only 8% felt confident that similar targets for mental health services would be met. This disparity underscores the particular difficulties the NHS faces in addressing long waits in mental health care, a sector that continues to experience significant challenges.

Respondents also shared their views on accident and emergency (A&E) services, with 46% of those providing these services indicating that their trust is likely to meet the new target of seeing 78% of A&E attendees within four hours by March 2025. This reflects the ongoing challenges in delivering timely emergency care, as the NHS grapples with rising demand and workforce shortages.

On the financial front, the outlook is similarly divided. A significant proportion of respondents (44%) forecasted a deficit for their trust’s financial position in 2024/25, while 45% predicted a breakeven position, and only 11% anticipated a surplus. These figures highlight the fragile financial footing on which many NHS trusts currently stand.

Sir Julian Hartley, Chief Executive of NHS Providers, praised the resilience and adaptability of trust leaders and their teams in the face of these considerable challenges. He stated: “It’s incredibly impressive how trust leaders and their teams are responding to the productivity challenge. You can see the benefits of collaboration, incentivising staff, and using digital tools to help them work more efficiently.” However, Sir Julian emphasised that these efforts, while commendable, can only achieve so much without substantial strategic investment.

He continued: “That’s all happening, but it can only go so far without significant strategic investment in infrastructure and digital technologies. We need to recognise the value of investment in the NHS – its impact as a catalyst for economic growth, employment, and research, and the importance of funding infrastructure, digital, and other technology to drive productivity.”

The timing of these survey findings is significant, coming just ahead of a much-anticipated review of the NHS by esteemed NHS surgeon and independent peer, Lord Ara Darzi. Commissioned by Health Secretary Wes Streeting, this review is expected to be published on 12 September 2024. Early indications suggest that the report will include sharp criticism of the NHS’s productivity levels, as well as concerns about the state of children’s health.

Prime Minister Sir Keir Starmer also weighed in on the state of the NHS during an interview broadcast by the BBC on 8 September 2024. In his remarks, the Prime Minister described the NHS as having been “broken” by successive Conservative governments. He referenced the upcoming review, underscoring the severity of the challenges facing the NHS.

Responding to the Prime Minister’s comments, Sir Hartley expressed that these concerns mirrored those frequently raised by NHS trust leaders. He said: “The Prime Minister’s comments today echo what trust leaders have been telling us. The shockwaves of the longest and deepest squeeze in NHS financial history, a growing mismatch between capacity and demand, major workforce challenges, and the after-effects of the Covid-19 pandemic are still being felt throughout the health service.”

Sir Hartley went on to highlight the need for sustained, long-term financial investment in the NHS, pointing out that the current approach to funding is unsustainable. He stated: “Time and again, trust leaders tell us they want to see long-term, multi-year investment in the health service which allows them to plan for the future instead of this stop-start approach to NHS funding which leaves them constantly worrying about budget cuts followed by quick-fix, short-term funding announcements.”

Adding further weight to the conversation around NHS productivity, a report published by the Health Foundation in April 2024 examined clinicians’ views on the technologies that could offer the greatest opportunities to enhance productivity within the NHS. The report underscored the potential of digital tools to drive efficiencies, streamline operations, and improve patient outcomes, aligning closely with the calls from NHS Providers for greater investment in this area.

In conclusion, the message from NHS Providers is clear: while trust leaders and their teams are doing all they can to meet the challenges they face, there is a pressing need for the government to step up with significant investment in digital technologies and infrastructure. Such investment is critical not only for improving productivity but also for securing the long-term future of the NHS as it continues to navigate unprecedented operational and financial pressures.

AI tool simplifies cardiology reports making them ‘more understandable’ for patients

A pioneering study has revealed that an artificial intelligence (AI) tool can simplify heart test results into explanations that are accurate, relevant, and comprehensible to patients.

The focal point of the research was the echocardiogram—a diagnostic tool that employs sound waves to visualise the flow of blood through the heart’s chambers and valves. Traditional echocardiogram reports are replete with technical jargon and numerical data relating to heart function, dimensions, vessel pressure, and tissue thickness, all indicative of potential cardiac ailments. However, such reports are notoriously difficult for patients to decipher, often causing undue anxiety, according to the researchers.

To mitigate this issue, NYU Langone Health explored the potential of a specific AI technology capable of generating contextually appropriate language predictions. This AI, developed by OpenAI and known as GPT-4, was accessed in March 2023 when NYU Langone secured one of the earliest “private instances” of the tool, allowing them to safely experiment with real patient data under stringent privacy regulations.

The study, which was published online on July 31 in the Journal of the American College of Cardiology (JACC) Cardiovascular Imaging, evaluated 100 cardiologist-authored echocardiogram reports. GPT-4 was tasked with reformulating these into patient-friendly summaries. These AI-generated explanations were then assessed by five board-certified echocardiographers using a five-point scale to rate accuracy, relevance, and understandability. Impressively, 73 percent of these summaries were deemed accurate enough to be shared with patients without any modifications.

The evaluations showed that 84 percent of AI-generated summaries were completely accurate, and 76 percent included all critical information. The significance of these findings is underscored by none of the AI-generated explanations being rated as “potentially dangerous” due to missing information.

“Our study is the first of its kind to test GPT-4 for this purpose, and our findings suggest that generative AI can significantly aid clinicians in communicating complex echocardiogram results to patients,” explained Dr. Lior Jankelson, MD, PhD, the corresponding study author and an associate professor at NYU Grossman School of Medicine. He noted that such rapid, precise explanations could alleviate patient anxiety and reduce the overwhelming number of inquiries clinicians receive.

The need for such advancements is partially driven by the 21st Century Cures Act of 2016, which mandates the swift release of test results directly to patients, leading to a spike in patient inquiries due to misunderstandings about their health data.

Dr. Jacob Martin, MD, the study’s lead author, emphasised the ongoing need for AI tools to deliver results explanations promptly as they become available, thus potentially easing the burden on healthcare providers who must manually input vast amounts of data into electronic health records.

However, the study also revealed that 16 percent of AI explanations contained some inaccuracies. For instance, one AI summary incorrectly described the size of a pleural effusion—a mistake attributed to an ‘AI hallucination’, a known issue where AI tools generate erroneous or fabricated data. This underscores the essential role of human oversight in verifying and refining AI-generated drafts before they are finalised for patient review.

Additionally, the study involved a survey of non-medical participants to gauge the clarity of AI-generated explanations compared to traditional reports. A resounding 97 percent found the AI versions easier to understand, which often reduced their anxiety.

“This analysis confirms the potential of AI to enhance patient understanding and reduce anxiety,” said Dr. Martin. He revealed that the next steps would involve integrating these AI enhancements into regular clinical practice to improve patient care and reduce the workload on healthcare providers.

The research was a collaborative effort involving multiple specialists from NYU Langone’s Leon H. Charney Division of Cardiology and other departments, highlighting the interdisciplinary approach necessary for such innovative healthcare solutions.

Ireland’s new legislation to revolutionise digital health records

In a significant move to enhance healthcare management, Ireland’s Department of Health has introduced the Health Information Bill 2024, poised to revolutionise the management of digital health records across the nation. This pivotal legislation follows the approval of the Irish Government and is specifically crafted to create a comprehensive legal framework facilitating the efficient sharing of patient data necessary for care and treatment.

This legislative initiative aligns with Ireland’s obligations under the impending European Health Data Space (EHDS) Regulation, set for implementation within the year. The Health Information Bill 2024 aims to establish a robust national health information system, designed to significantly improve the quality of patient care as well as the planning and delivery of healthcare services.

A cornerstone of this initiative, as outlined by the Department of Health, is the bill’s crucial role in the successful implementation of the ‘Digital for Care: A Digital Health Framework for Ireland 2024 – 2030’. This framework, launched in June, 2024, outlines a strategy for integrating digital technology into healthcare systems over the next several years.

Upon enactment, the bill will empower the Health Service Executive (HSE) to amalgamate health information across diverse care settings—encompassing private, public, and voluntary sectors. This comprehensive consolidation is intended to facilitate the development and deployment of digital health records accessible to all patients across Ireland.

Moreover, the bill proposes enhanced accessibility of health information for both patients and healthcare providers, which is anticipated to lead to improved health outcomes. It also focuses on augmenting patient safety by refining patient identification processes, incorporating tools like Eircode and the Personal Public Service Number (PPSN) to seamlessly integrate patient data with Ireland’s national digital strategy.

Ireland’s Health Minister, Stephen Donnelly, emphasised the importance of integrated care, as envisioned in the Sláintecare reform. He stated, “Integrated care as envisioned in Sláintecare, needs the right information, in the right place, at the right time. The Health Information Bill gives patients greater access to their own information so they can make informed decisions about their health and care options. It also enables health professionals to have a more complete, holistic view of the patients they are treating.”

Minister Donnelly also noted that the bill is slated to progress through the Houses of the Oireachtas during the upcoming autumn legislative session. Furthermore, additional legislative measures are planned for the forthcoming months and years to fully realise the policy intent of the approved General Scheme of the Bill and to ensure compliance with the EHDS implementation deadlines set for 2026 to 2030. This series of legislative updates underscores Ireland’s commitment to a fully integrated and digitally enhanced healthcare system.

AI-generated alerts proven to reduce death risk in hospital patients

Recent research highlights the transformative role of artificial intelligence (AI) in improving patient outcomes in hospitals. AI-generated alerts, designed to notify hospital staff of any significant changes in a patient’s condition, have been found to dramatically reduce the risk of mortality.

The innovative system increases the likelihood of timely medical intervention, with patients 43% more likely to have their care escalated, markedly boosting survival rates. According to Matthew Levin, Professor of Anesthesiology, Perioperative and Pain Medicine at The Mount Sinai Hospital, this approach leverages AI and machine learning technologies to proactively address potential declines in patient health. “We wanted to see if quick alerts made by AI and machine learning, trained on many different types of patient data, could help reduce both how often patients need intensive care and their chances of dying in the hospital,” Levin explained.

Traditionally, tools like the Modified Early Warning Score (MEWS) have been used to assess the risk of clinical deterioration. However, Levin points out that the automated machine learning algorithms used in this study surpass these older methods in both accuracy and timeliness, facilitating earlier and potentially life-saving interventions.

The study evaluated the effectiveness of these AI alerts across four surgical units at The Mount Sinai Hospital in New York, encompassing a total of 2,740 patients. These individuals were divided into two groups: the first group received real-time alerts about health deterioration directly to their doctors or rapid response teams, while the second group had alerts generated but not immediately transmitted to their healthcare providers.

David Reich, President of The Mount Sinai Hospital and Mount Sinai Queens and a leading figure in both Anesthesiology and Artificial Intelligence and Human Health at Icahn Mount Sinai, highlighted the substantial impact of real-time, AI-driven alerts on patient care. “Our research shows that real-time alerts using machine learning can substantially improve patient outcomes,” Reich stated. He described these tools as “augmented intelligence” that enhance clinical decisions, ensuring that timely and appropriate interventions are made to improve patient safety and outcomes, aligning with the goals of a learning health system.

Further benefits of the AI alert system include a higher likelihood of patients receiving necessary medications for heart and circulation issues, alongside a decreased mortality rate within 30 days of care. The system is under continual development, with a dedicated team of intensive care doctors assessing high-risk patients daily, providing targeted recommendations to the treating physicians. This ongoing refinement of the algorithm, driven by an increasing amount of patient data, is enhancing its accuracy and reliability.

This study not only reaffirms the critical role of AI in modern healthcare but also points towards a future where technology and human expertise converge to deliver superior patient care.

The rising tide of cyberattacks on healthcare systems

The cybersecurity landscape within the healthcare sector is facing an unprecedented level of threat, with attacks growing both in frequency and severity. Notably, Rick Pollack, President and CEO of the American Hospital Association (AHA), described the Change Healthcare cyberattack as “the most significant and consequential incident of its kind against the US healthcare system in history.” This incident starkly illustrates the escalating challenges that cyber threats pose to healthcare operations and patient safety.

The February cyberattack on Change Healthcare, the largest US billing and payment system, severely disrupted the processing of millions of patients’ prescriptions and other services, delaying access to crucial medications and care. Even two months post-attack, an AHA survey indicated that numerous medical practices were on the brink of closure due to the financial impact of unpaid claims, thereby endangering patient access to medical services.

This is not an isolated event; the healthcare sector has witnessed several crippling cyberattacks over recent years. For instance, in May 2017, the global WannaCry ransomware attack disrupted a third of hospital trusts across NHS England, resulting in the cancellation of nearly 7,000 appointments and rendering medical staff unable to access vital patient data. Moreover, in May 2021, a ransomware attack on Ireland’s Department of Health and Health Service Executive affected over 80% of their IT infrastructure, compromised the personal data of almost 100,000 individuals, and led to widespread service cancellations.

The financial aftermath of these cyberattacks can be staggering. The Change Healthcare hack alone is estimated to potentially cost up to $1.6 billion. According to the European Repository of Cyber Incidents, there has been a significant global increase in cyberattacks on healthcare, with reported incidents rising from 32 in 2022 to 121 in 2023.

The increasing reliance on interconnected digital technologies such as electronic health records, medical devices, and AI-supported diagnostic tools, especially accelerated during the COVID-19 pandemic, has heightened vulnerabilities. Many healthcare providers continue to utilise outdated technologies, increasing susceptibility to attacks. The complex digital interconnectivity within the sector provides cybercriminals with numerous potential entry points to exploit, posing a formidable challenge to system security.

Despite the critical need for robust cybersecurity measures, investment in this area remains insufficient. A recent survey by the Healthcare Information and Management Systems Society revealed that US healthcare organisations allocate only an average of 7% of their spending to cybersecurity, significantly lower than the 11-12% average across other sectors. This underinvestment is even more pronounced in low and middle-income countries, where the lack of infrastructure and regulatory frameworks exacerbates the risks.

The healthcare sector must prioritise the advancement of cybersecurity to align with or surpass the protections afforded in other critical infrastructure sectors. Enhanced research into the specific risks and vulnerabilities faced by healthcare systems is essential, along with strategic planning to mitigate these risks effectively. Furthermore, simple yet critical security practices, such as implementing two-factor authentication and educating about phishing scams, are vital steps in safeguarding against potential cyber threats. As the landscape of cybersecurity evolves, the focus must remain firm on protecting the integrity of healthcare systems and the safety of patients, affirming that cybersecurity is not merely an IT concern but a fundamental healthcare imperative.

AI enhances physician-patient communication, study reveals

UC San Diego Health, as one of the initial health institutions in the United States to integrate generative artificial intelligence (GenAI) into the Epic Systems electronic health record system, is at the forefront of digital health innovation. This integration facilitates the drafting of replies to patient inquiries, marking a significant step forward in medical communication.

The findings from a recent study conducted by the University of California San Diego School of Medicine, published in the Journal of the American Medical Association’s Network Open on April 15, 2024, reveal that while AI-generated drafts did not shorten the time physicians took to respond, they significantly reduced the mental effort required by doctors by providing an initial empathetic draft. This allows physicians to refine the message rather than composing one from scratch.

This pioneering study represents the first randomised prospective evaluation focused on AI-drafted messages within physician-patient communication, highlighting its potential to alleviate some of the cognitive demands on healthcare providers.

Christopher Longhurst, MD, the senior author of the study and a leading figure at UC San Diego Health, emphasised the utility of AI in addressing challenges within health systems, notably the surge in patient communications contributing to physician burnout. He pointed out that the lengthier AI-drafted messages suggest enhanced quality and that physicians have expressed appreciation for the assistance, which lessens their cognitive load.

The research underscores the role of GenAI in improving the quality, efficiency, and engagement of digital healthcare interactions. By reducing the workload on physicians, AI allows them to concentrate on the more intricate aspects of patient care, thereby aiming to mitigate burnout.

Ming Tai-Seale, PhD, MPH, the lead author and a professor at UC San Diego School of Medicine, described generative AI as a collaborative tool that assists physicians, who may receive around 200 messages per week, in overcoming writer’s block by providing a foundation for crafting empathetic responses to patients.

The enduring high demand for digital communication between patients and physicians, amplified by the COVID-19 pandemic, has led to the widespread use of patient portals like MyUCSDChart. These systems facilitate direct emails to doctors but also increase the pressure for timely responses, a demand that many physicians struggle to meet efficiently.

In response, UC San Diego Health initiated a pilot program with Epic Systems in April 2023 to employ GenAI for drafting responses to non-urgent patient queries. The AI-generated drafts include a disclaimer to inform patients of the AI’s involvement before the messages are reviewed and personalised by the responding physician.

Despite not reducing response times, the AI helps compose more detailed and compassionate replies, which are valued by patients. According to Marlene Millen, MD, another co-author and chief medical information officer for ambulatory care at UC San Diego Health, the AI’s ability to maintain consistent performance, regardless of the time of day, provides significant support in drafting empathetic messages that integrate relevant patient information.

While the study did not find time savings in message drafting, the qualitative benefits suggest a potential shift in healthcare communication practices. Further research is needed to evaluate patient perceptions of the enhanced empathy and detail in AI-assisted replies.

Since May 2023, UC San Diego Health and the Jacobs Center for Health Innovation have been rigorously testing GenAI models, exploring their safe and innovative applications in healthcare settings, thereby paving the way for future advancements in the field.

Pioneering AI tool developed by NHS teams to transform patient care

A ground-breaking artificial intelligence (AI) tool, designed to forecast patient health trajectories, has been developed by a collaboration of healthcare researchers within the NHS. Dubbed “Foresight,” this innovative tool is poised to revolutionise clinical decision-making processes, enhance monitoring in healthcare environments, and bolster clinical trials.

The development team is composed of specialists from two NHS foundation trusts in London—King’s College Hospital and Guy’s and St Thomas’—as well as academic experts from King’s College and University College London. Utilising the Cogstack platform, which is renowned for its capability in information retrieval and extraction, Foresight leverages natural language processing to efficiently mine data from NHS electronic health records. This allows the tool to be trained on vast amounts of healthcare data, employing a deep learning methodology to identify intricate patterns within both structured and unstructured data sources.

A critical evaluation published in The Lancet Digital Health illustrates Foresight’s effectiveness: the tool successfully predicted the next ten possible health disorders in a patient’s timeline with impressive accuracy rates—68% at King’s College Hospital, 76% at Maudsley NHS Foundation Trust, and an outstanding 88% with the US-based MIMIC-III dataset.

The tool’s utility was further underscored through a practical test where five clinicians created 34 hypothetical patient timelines based on simulated scenarios. An impressive 93% of the predictions made by Foresight were deemed clinically relevant, affirming their practical applicability in real-world settings.

According to a report from the NIHR Maudsley Biomedical Research Centre, Foresight’s capabilities are not limited to forecasting; it can also emulate clinical trials, facilitate longitudinal research, generate synthetic datasets, and simulate interventions to study disease progression. Professor Richard Dobson, a leading figure in medical informatics at King’s College London and the senior author of the study, expressed enthusiasm about the multitude of applications for Foresight. He highlighted its potential in creating digital health twins and advancing medical education, among other uses.

Professor Dobson emphasised the importance of employing high-quality data to refine AI models and expressed a vision for expanded collaboration. His aim is to involve more hospitals in the development of “Foresight 2,” an iteration that promises even greater accuracy through enhanced language models.

This initiative has garnered substantial support, receiving funding from the NHS AI Lab, the National Institute for Health and Care Research, and Health Data Research UK (HDRUK). Professor Andrew Morris, director of HDRUK, noted that the success of such innovations hinges on the quality and representativeness of the data used. He advocated for continued investment in the UK’s data infrastructure to ensure these advancements can be realised in a manner that is both secure and respectful of patient privacy.

World Health Organisation unveils new Global Digital Health Initiative to transform healthcare

In a significant step towards advancing global health care through technology, the World Health Organisation (WHO) unveiled its Global Initiative on Digital Health (GIDH) on Tuesday (20th of February, 2024). This initiative represents a coordinated network managed by WHO, aimed at bolstering and harmonising resources to support the digital transformation of health care led by countries around the world.

The GIDH is set to fortify collaboration and knowledge sharing, serving as a critical mechanism for the execution of the Global Strategy on Digital Health for the period 2020-2025. Its objectives include evaluating and addressing the digital health requirements of member countries to ensure sustainable transformation, enhancing capacity building, and unifying efforts to promote the local development, maintenance, and adaptation of digital health technologies in response to evolving health care needs.

An executive summary released alongside the GIDH’s launch highlighted that over 120 WHO Member States have formulated national digital health policies or strategies. However, many of these strategies lack detailed financial planning or comprehensive architectural designs. Moreover, the rapid progression of digital health transformation faces hurdles such as fragmented resource allocation, inconsistent definitions, and varying quality levels of digital solutions.

A pivotal concern among countries is the transition from product-centric digital health initiatives to the establishment of a national digital health infrastructure. This transition necessitates reliable, high-quality technical support to meet national digital health priorities effectively, with governments leading the charge.

To combat challenges like effort duplication and product-focused digital health transformation, the GIDH is structured around four foundational pillars. These pillars are designed to ensure that digital health investments align with national priorities through a country needs tracker, identify both conventional and innovative funding opportunities via a country resource portal, enhance country capacity and autonomy through a transformation toolbox, and promote robust collaboration and knowledge sharing across digital health networks globally, regionally, and nationally.

A particular focus of the GIDH is on data sharing and enhancing patient access to digital health tools. Mathias Cormann, secretary general of the Organisation for Economic Cooperation and Development, emphasised during a webinar that the initiative could significantly contribute to improving data sharing and patient access to digital tools. He pointed out the underutilisation of health-related data, which, despite constituting 30% of the world’s data, sees less than 1% used in healthcare decision-making. Cormann also highlighted the introduction of public application programming interfaces (APIs) for health data by at least 14 OECD countries, which could serve as valuable models for similar efforts worldwide.

Improving patient access remains a priority, with 23 out of 27 OECD countries reporting that patients can view their electronic health records. Nevertheless, the accessibility of this data to all patients and health providers is limited, and functionality issues persist.

Dr Tedros Adhanom Ghebreyesus, WHO’s director-general, warmly welcomed the GIDH, underscoring WHO’s longstanding commitment to leveraging technology to enhance health. He mentioned the establishment of the Department of Digital Health and Innovation at WHO and the creation of a global digital health certification network. This network facilitates the bilateral verification of digital records and health certificates across over 75 countries. Additionally, WHO recently introduced guidelines for member states on regulatory considerations for artificial intelligence, marking another stride towards assisting countries in achieving their digital transformation ambitions.

Dr Tedros highlighted the challenges of fragmentation and overlap in the digital health sphere, exacerbated by the proliferation of new digital tools lacking common standards. He advocated for a digital health future characterised by interoperable systems, reducing the workload on health care providers and improving service delivery to the public. The emphasis is on governments having access to quality-assured digital tools and resources necessary for the local production and ownership of digital health solutions.

This initiative builds on WHO’s recent policy brief on digital health data, including new guidelines on “person-centred” HIV strategic information, reinforcing its dedication to shaping a future where digital health tools are integral to global health care enhancement.

U.S. healthcare industry powers toward digital future

In an era marked by rapid technological evolution, the healthcare industry in the United States is making significant strides towards a digitally-enhanced future. A recent study conducted by Information Services Group (ISG), a prominent global technology research and advisory institution, sheds light on this transformative journey. The findings, encapsulated in the 2023 ISG Provider Lens™ Healthcare Digital Services report, underscore a concerted move by healthcare providers and insurers towards embracing digital health tools, aiming to bolster the efficiency, accessibility, and quality of healthcare services.

At the heart of this digital shift are integrated electronic health records (EHRs) and patient-centric applications. These innovations are enabling healthcare organisations to monitor patients with greater precision, facilitate seamless data exchange among healthcare professionals, and offer tailored wellness advice directly to patients. The implications of such advancements are profound, enhancing patient care and operational efficiencies across the board.

Bob Krohn, a healthcare partner at ISG, highlights the transformative impact of this trend. He points out that as the industry gains a deeper understanding of the social determinants of health, there is a growing emphasis on utilising technology to promote health equity and outcome-focused care. This modernisation wave is not only about adopting new technologies but also about rethinking approaches to healthcare to ensure it is more inclusive and outcome-oriented.

A critical aspect of this transformation is the collaboration between providers and insurance companies. This partnership is pivotal in identifying and supporting the most vulnerable segments of the population. By integrating technology with a deep understanding of the social factors influencing health, the sector aims to foster behavioural changes that could lead to significant improvements in public health. Technologies such as EHRs, machine learning, and predictive analytics are at the forefront of these efforts, enabling a more personalised, holistic approach to healthcare.

The report also highlights a shift towards more cost-effective healthcare services, particularly under Medicare, through partnerships between providers and insurance companies. This move towards value-based care, which prioritises quality over quantity, is not just improving patient outcomes but is also presenting providers with new growth and competitive opportunities.

Furthermore, Generative AI (GenAI) is identified as a burgeoning technological wave poised to redefine the healthcare industry. With many organisations planning substantial investments in GenAI solutions over the next five years, there is anticipation of significant impacts on healthcare technology and economics. ISG predicts that GenAI will prompt a reevaluation of current projects, with technology service providers ready to guide enterprises through these transitions.

The exploration of healthcare technology trends extends to integrated health platforms and the increasing need for electronic medical record migration services. Moreover, the report delves into challenges such as talent shortages and the integration of new technologies with existing systems, offering insights and recommendations for addressing these issues.

The 2023 ISG Provider Lens™ Healthcare Digital Services report evaluates 39 providers across three categories: Payer Digital Transformation Services, Provider Digital Transformation Services, and Healthcare Platform Implementation Services. It recognises leaders in the field, including Accenture, Cognizant, and HCLTech, among others, for their outstanding contributions across various segments. Additionally, companies like CitiusTech and Persistent Systems are acknowledged as Rising Stars, indicating their promising potential in the healthcare digital services landscape.
This comprehensive report, available for subscribers or through a one-time purchase, offers an invaluable resource for understanding the dynamic changes underway in the U.S. healthcare sector and the digital innovations driving these changes forward.

UCSD Health study reveals AI’s potential in reducing sepsis mortality

Sepsis, a critical and often fatal response to infection that causes widespread inflammation and organ damage, is a major health concern, claiming the lives of approximately 350,000 Americans annually. Timely detection is crucial for effective treatment, involving prompt administration of antibiotics and intravenous fluids to stabilise the patient.

Researchers at UC San Diego Health have been exploring the potential of artificial intelligence (AI) to enhance early sepsis diagnosis. Their internally developed AI system, named COMPOSER, utilises machine learning and is trained on over 100,000 digital patient records from previous sepsis cases. A recent study published in the journal npj Digital Medicine has demonstrated the potential of COMPOSER in reducing mortality rates.

COMPOSER operates by analysing electronic health records of emergency patients at UCSD every hour. It evaluates various parameters, including medication histories and recent vital statistics, to identify individuals who may be in the initial stages of sepsis. This approach is particularly beneficial in ambiguous cases, where symptoms do not distinctly indicate sepsis.

Dr. Gabriel Wardi, a co-author of the study and a specialist in emergency medicine and sepsis, highlights the algorithm’s significance in situations where diagnostic clarity is lacking. The system acts as an additional tool for medical professionals, suggesting further examination of patients at risk of developing sepsis, thereby facilitating timely intervention.

The study involved 6,217 emergency patients at UCSD’s Hillcrest and La Jolla emergency departments. Comparing the outcomes of 5,000 patients treated before the implementation of COMPOSER with 1,152 patients during its active phase, researchers observed a reduction in sepsis mortality from 11.39% to 9.5%. While these results are promising, they represent correlations rather than direct cause-and-effect, due to the non-randomised nature of the trial.

Karin Molander, director of the Sepsis Alliance, acknowledges the potential benefits of AI in healthcare, particularly in continuous monitoring without human limitations. However, she emphasises the importance of verifying AI-generated recommendations.

The implementation of COMPOSER required careful calibration to minimise false alerts, ensuring that it aids rather than burdens healthcare providers. The system, while capable of predicting sepsis, cannot replace medical professionals, who are responsible for all patient care decisions.

Shamim Nemati, a co-author and UCSD associate professor, notes the challenges in training the algorithm to differentiate between sepsis and similar conditions. The ongoing development of COMPOSER includes enhancements to request additional diagnostic tests when necessary.

UCSD is expanding the use of COMPOSER to include patients admitted to the hospital, and its application is expected to extend to the new East Campus. The integration of advanced wearable sensors and large-language models like ChatGPT into the system is also underway, aiming to improve data accuracy and reduce false alarms.

UC San Diego Health is actively incorporating AI into various aspects of patient care, having appointed its first chief AI officer and collaborating with Microsoft Inc. to utilise AI technologies like ChatGPT in routine patient communications. This initiative is part of a broader strategy to centralise data integration and maximise the benefits of AI in healthcare.

Mayo Clinic teams up with Cerebras Systems to advance healthcare AI

The Mayo Clinic, a renowned non-profit medical institution based in Rochester, Minnesota, announced a strategic partnership with the Silicon Valley-based startup Cerebras Systems on Monday (15th of January, 2024). This collaboration aims to harness the power of artificial intelligence (AI) in enhancing healthcare services.

With significant presences across three major campuses in the United States and additional facilities in the United Kingdom and the United Arab Emirates, the Mayo Clinic is set to utilise cutting-edge computing chips and systems supplied by Cerebras. The collaboration will delve into the Mayo Clinic’s extensive archive of anonymised medical records and data, laying the groundwork for the development of bespoke AI models.

According to Matthew Callstrom, Mayo’s Medical Director for Strategy and Chair of the Radiology Department, these AI models are poised to revolutionise various aspects of medical record management and diagnostics. Some models are being designed to interpret and summarise extensive medical records for new patients, streamlining the patient onboarding process. Additionally, other models will focus on identifying intricate patterns in medical imagery and genome data, patterns that might elude even the most experienced medical professionals. However, Callstrom emphasised that these systems are intended to augment medical decision-making, not replace it. The human expertise of doctors remains paramount in the clinical decision-making process.

“The integration of AI is about enhancing the decision-making process for each patient, considering the multitude of factors and drawing upon extensive experience,” Callstrom explained.

The Mayo Clinic’s collaboration with Cerebras is anticipated to yield results that will be accessible via the Mayo Clinic Platform. This platform is a comprehensive data network already utilised by various healthcare systems such as Mercy in the U.S., the University Health Network in Canada, and other systems in Brazil and Israel.

While the pricing model for the AI technology developed through this partnership has not been finalised, Callstrom indicated that the Mayo Clinic intends to disclose further details about this venture during a presentation at JPMorgan Chase’s healthcare conference in San Francisco.

Andrew Feldman, CEO of Cerebras, described the deal as a multi-million-dollar agreement spanning several years, though he refrained from disclosing specific financial details. Cerebras, aspiring to compete with industry leaders like Nvidia, will provide both the necessary hardware and software development expertise as part of the agreement. This collaboration marks a significant step in integrating advanced AI capabilities into the healthcare sector, aiming to enhance patient care through technological innovation.

Vietnam and Australia join forces to accelerate digital health transformation

A pivotal conference in Hanoi, sponsored by the government, has recently brought together health authorities and experts from Vietnam and Australia. This gathering focused on exploring collaborative opportunities to enhance Vietnam’s digital healthcare infrastructure and capabilities.

The conference saw participation from the Vietnam Military–Civil Medicine Association, the Health Strategy and Policy Institute under the Vietnamese Ministry of Health, and the Iverson Health Innovation Research Institute at Swinburne University of Technology in Australia.

The significance of this event lies in addressing the urgent need for Vietnam’s health sector to secure resources for its digital transformation. Deputy Minister of Health, Dr Tran Van Thuan, emphasised the importance of such advancements in improving patient access to medical services. He highlighted the potential role of international cooperation and assistance in achieving these goals.

Vietnam currently faces several challenges in its journey towards healthcare digitalisation, notably its underdeveloped IT infrastructure, which hampers the support for Electronic Medical Records (EMR). Additionally, there is a notable scarcity of funding to integrate new health technologies in medical facilities across the country.

Dr Tran Quy Tuong, chairman of the Vietnam Health Informatics Association, pointed out further obstacles, such as the shortage of IT skills and manpower and the lack of standardised protocols and guidelines for integrating data across various medical information systems.

The Iverson Health Innovation Research Institute from Swinburne University of Technology, which participated in the conference, is actively engaging in collaborations with governments and industry stakeholders. Their focus includes the management of patient health records among other digital health areas. However, there has been no formal announcement regarding a partnership between the research institution and the Vietnamese government.

In the broader context, Vietnam is aiming to establish smart healthcare by 2025 as part of its National Digital Transformation Programme. This initiative encompasses three key areas: smart disease prevention, smart medical examination and treatment, and smart health administration.

Vietnam commenced its healthcare digitalisation foundation in 2019 with the nationwide implementation of Electronic Health Records (EHRs). While all public hospitals have adopted Health Information Systems (HIS), there is still progress to be made in integrating PACS, RIS, and LIS systems.

International collaborations have been crucial in introducing advanced technologies in Vietnamese healthcare. Earlier this year, IT giant Microsoft entered its first technology partnership in Vietnam, teaming up with VinBrain, a local AI healthcare company supported by Vietnam’s leading conglomerate Vingroup. Their collaboration focuses on three primary AI healthcare areas: data sharing, cross-product validation, and research and development.