Author Archives: Brett Nicolle

Physician receives advice from algorithms

Artificial intelligence Two hospitals formally give algorithms an advisory role in medical decisions.

Liza van Lonkhuyzen, January 28, 2020

https://www.nrc.nl/nieuws/2020/01/28/arts-krijgt-advies-van-algoritmen-a3988515

Photo: Flip Franssen

In the Reshape center, the innovation department of the UMCRadboud, employees monitor patients remotely.

The computer will advise doctors: can a patient be safely ‘discharged’ from intensive care?

The Amsterdam UMC, location VUmc, is putting this into practice now that the medical device regulator has given researchers the green light. Artificial intelligence is used to calculate the likelihood that a patient will end up in intensive care again after a transfer or die. Doctors can be advised in this way before they choose who is healthy enough to be accommodated in other departments.

The algorithm looks at two hundred factors. This includes, for example, laboratory results and notes from nursing staff. Doctors can choose to read out the most important factors in the advice so that they can understand what the computer is based on.

Protocol

Along with the approval for the VUmc, another hospital also took an important step with an ambitious data project. In the Radboudumc in Nijmegen, computer scores that say something about the health of patients become part of the protocol. The hospital wants to see problems coming before the patients feel sick.

The Nijmegen hospital has set up a former laboratory room as a kind of control room. There, on monitors, a lot of information is kept from the patients of two nursing departments: whether they are sitting upright in bed, lying down, how their heart rate is, their temperature, breathing, and so on.

With this data stream – which comes from small boxes on the wrist of patients and stickers on the body – an algorithm searches for connections. For example, if the heart rate rises and the respiratory rate increases, a respiratory tract infection could play a role. The computer searches for signals of blood poisoning, among other things.

Now that research from the hospital shows that continuous monitoring in itself already results in one third fewer transfers to intensive care, the way is clear to investigate whether even more can be gained with the ‘predictive’ computer scores. Doctors and nurses are required by the new protocol to examine the computer’s alarm signals.

Artificial intelligence

In the healthcare sector, much attention is being paid to the possibilities of artificial intelligence. Many hospitals and care institutions do experiments. The Leiden University Medical Center, for example, is working on a system that automatically recognizes patient complaints based on speech recognition and artificial intelligence in the doctor’s office and eventually even records them in the electronic patient file. The Pacmed data company, which also worked on the intensive care algorithm, developed software that should help estimate which men are more likely to have tumors after prostate cancer treatment.

There are many questions to be asked about this trend. For example, the predictions of the computer depend on the underlying data. If data is not entered correctly in the computer, it may come to the wrong conclusion. In addition, an algorithm only looks at what is measurable. What a doctor sees himself, in the doctor’s office or at the bedside, must be just as important, experts say.

St. Joseph Mercy Oakland Hospital has won the 2015 Most Wired Innovator award from the American Hospital Association

St. Joseph Mercy Oakland Hospital has won the 2015 Most Wired Innovator award from the American Hospital Association. The hospital’s development and implementation of the Intelligent Care System, a fully integrated suite of technologies that provide patient care and safety, contributed to the win.

The American Hospital Association also named St. Joseph Mercy Oakland a “Most Wired” hospital for the third consecutive year. The hospital’s development and implementation of the Intelligent Care System, a fully integrated suite of technologies that provide patient care and safety, contributed to the win.

Fabian Fregoli, vice president of clinical quality and patient safety and chief medical informatics officer at St. Joseph Mercy Oakland, said new technology has been met with positive results.

“St. Joseph Mercy Oakland has deployed technologies that are enabling our doctors and nurses to provide an unrivaled quality of care in southeast Michigan,” Fregoli said.

The system includes the following technologies:

• The Voalte Communication platform, in which smartphone-based devices send alarms and monitoring cues and allow nurses to communicate with patients and staff.

• ViSi Mobile by Sotera, part of a safety system worn on patients’ wrist that wirelessly and remotely monitors blood pressure, heart rate, pulse oximetry, respiratory rate and skin temperature.

• Visensia Early Detection Monitoring System, which interprets vital sign data from electronic health records and helps earlier identify signs of change in a patient’s condition.

• Centrak, a real-time location system used to detect specific staff performances related to hand hygiene and infection prevention practices.

Other technologies include a nurse call system which monitors staff location and patient bed data and includes patient safety features; a smart bed that improves patient comfort and safety and communicates with health reports and caregivers; an interactive entertainment and patient education system; and an integration hub allowing all technologies to communicate with the electronic health reports.

“St. Joseph Mercy Oakland has served as the pilot program for many of our health system’s technology innovations. Our health system is actively working to deploy many of these award-winning technologies across each of our five hospitals in the metro Detroit region,” said Rob Casalou, president and CEO of Saint Joseph Mercy Health System.

St. Joseph Mercy Oakland President and CEO Jack Weiner stated,“By finding innovative technology solutions to clinical problem areas, our hospital has vastly improved safety and quality of care for patients.”

“With these awards, our hospital has proven itself to be a regional and national leader in the area of health care innovation. Our patients have benefited from these efforts and are seeing positive results firsthand.”