This presentation discuss the main applications of AI in healthcare, the progress made and the challenges remaining.

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October, 2019
AI IN HEALTHCARE
THE STATE OF ADOPTION
Alex Ermolaev, Director of AI,
Change Healthcare

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Intelligent Healthcare Network

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Why Apply AI to Healthcare?
Source: https://fortune.com/2019/02/21/us-health-care-costs-2/ , https://www.beckershospitalreview.com/finance/healthcare-poised-to-become-largest-r-d-spending-industry-by-2020-study-says.html ,
https://advocacy.consumerreports.org/research/engaging-consumers-on-health-care-cost-and-value-issues/ , https://www.cbinsights.com/research/report/ai-trends-healthcare/
Largest Industry
$3.65T
2018 US Healthcare spend
Lots of Waste
30%
of US Healthcare spend is wasted
Second in R&D
$170B
2018 US Healthcare R&D
Lots of Opportunities
>500
AI Healthcare startups funded

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AI in Healthcare
Early Diagnosis Health Monitoring Medical Imaging
Diagnostics
Precision Medicine Personalized Treatment Plans Clinical Trials
Personalized
Treatments
Smart Electronic
Health Records
Payment Accuracy
Patient Identification
and Retention
Optimized
Healthcare
System

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Diagnostics
Early Diagnosis Health Monitoring Devices Medical Imaging

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Sepsis Diagnostics
1.6M diagnoses/year (U.S.)
25%-30% mortality rate
#3 cause of death
#1 hospital cost in U.S.
Antibiotics increase survival rate
7.6% per hour
Source: Made for World Sepsis Day by lingruen-gmbh.com
0%
20%
40%
60%
80%
100%
120%
Sepsis is a medical emergency
0 1 2 3 4 5 6 9 12 24 36
Hours
Patients with effective antibiotic therapy
Patients survival
rate (%)

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Sepsis Diagnostics cont.
Source: https://www.researchgate.net/publication/326661039_Applying_Artificial_Intelligence_to_Identify_Physiomarkers_Predicting_Severe_Sepsis_in_the_PICU

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Source: http://news.mit.edu/2019/using-ai-predict-breast-cancer-and-personalize-care-0507
Using AI to Predict Breast Cancer and Personalize Care

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Predicting Alzheimer 6 Years Before Symptoms Appear
Source: https://www.ucsf.edu/news/2019/01/412946/artificial-intelligence-can-detect-alzheimers-disease-brain-scans-six-years

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Medical Devices

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Intelligent Workflow Driven by AI
Brain
Subarachnoid Hemorrhage
Subdural hemorrhage
Extradural hemorrhage
Intraventricular hemorrhage
Parenchymal hemorrhage
Hydrocephalus
Midline shift
Descending transtentorial herniation
Ascending transtentorial herniation
Abdomen
Perforation / Free air
Bowel obstruction
Spinal epidural hemorrhage
Vertebral fracture
Chest
Pneumothorax
Aortic dissection
PE
Spinal epidural hemorrhage
Vertebral fracture
Neck
Retropharyngeal abscess
Spinal epidural hemorrhage
Vertebral fracture
Vertebral artery dissection

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Personalized Treatments
Precision
Medicine
Personalized Treatment
Plans
Drug Discovery &
Clinical Trials

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Precision Medicine
Source: https://allofus.nih.gov/

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Personalized Treatment Plans
Source: https://www.media.mit.edu/publications/reinforcement-learning-for-designing-novel-clinical-trials-for-treating-cancer-patients/

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Clinical Trials
Oncology Trials
3.4%
of oncology clinical trials
are completed
Patients Enrolled
5%
of cancer patients are
enrolled in clinical trials
Sources: http://blogs.sciencemag.org/pipeline/archives/2018/02/02/a-new-look-at-clinical-success-rates
https://www.beckershospitalreview.com/quality/just-5-of-cancer-patients-participate-in-clinical-trials-5-things-to-know.html
"I don't think it's an unwillingness on the patients' part. I don't
even think it's an unwillingness on the physician's part. It’s really
a system error...” Scott Delacroix, MD, told PBS NewsHour.

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Optimized Healthcare System
Smart Electronic
Health Records
Payment Accuracy
and Streamlining
Patient Identification
and Retention

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About 1/3 of Healthcare Spending is Wasted
Sources: https://advocacy.consumerreports.org/research/engaging-consumers-on-health-care-cost-and-value-issues/
$10,000
$8,000
$6,000
$4,000
$2,000
$0
Average U.S. Healthcare
Spending per Person in 2014
$9,700
Total Wasted Spending per Person……… $2,910
Wasted
Spending
Necessary
Spending
Unnecessary Services
Example: Duplicate Tests $800
Inefficient Care Delivery
Example: Test Results Not Shared $495
Inflated Prices
Example: Excessive Profits $400
Fraud
Example: False Claims $285
Prevention Failures
Example: Missed Flu Shot $210
Excess Administrative Costs
Example: Billing Errors $720

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Medical Text
Understanding
Header ✓
Footer ✓
David A. Smith, M.D. ✓
Legalese ✓
Likely diagnoses ✓
Member info ✓

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Medical Claims
1. Source: https://www.businesswire.com/news/home/20170626005391/en/Change-Healthcare-Analysis-Estimated-262-Billion-Healthcare
2. Source: Change Healthcare Internal Statistics
US Medical Claims:
$3T per year1
Claims Denied:
$262B per
year (9%)1
Cost of Rework:
$118 per claim1
Total Loss:
> $100B2

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Patient Identification: Dual Enrollment
1 - CMS Fast Facts, January 2018: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMS-Fast-Facts/index.html
2- Kaiser Family Foundation: https://www.kff.org/medicare/state-indicator/medicare-beneficiaries-by-fpl/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
3- CMS, https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/DataStatisticalResources/Data-and-Statistical-Resources.html
Today
58.8M
Medicare beneficiaries
Live at or below
34%
of the federal poverty level
And only
10.6M
are dual-enrolled

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AI in Healthcare Summary
Early Diagnosis Health Monitoring Medical Imaging
Diagnostics
Precision Medicine Personalized Treatment Plans Clinical Trials
Personalized
Treatments
Smart Electronic
Health Records
Payment Accuracy
Patient Identification
and Retention
Optimized
Healthcare
System

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Healthcare
AI Startups
Source: https://www.cbinsights.com/research/artificial-intelligence-startups-healthcare/

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AI in Healthcare Challenges
Embrace
Variety
Respect
Data
Understand
Workflow

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Not All AI Projects are Viable Today
Source: An Empirical Model of Large-Batch Training, https://arxiv.org/pdf/1812.06162.pdf
Technically
Feasible
Economically
Feasible
Budget
Deadline

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Different AI Accuracy Requirements
EMS
Coding
Radiology
Coding
Risk & HEDIS
Coding
Revenue
Optimization
Audit
Payment
Integrity Audit
Full AI coding AI as a component
Dual
Eligibility
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA)

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Source: https://www.pwc.com/gx/en/issues/data-and-analytics/publications/artificial-intelligence-study.html
PwC’s Global Artificial Intelligence Study: Sizing the Prize
37%
Ready to go
Medical insurance and
smarter scheduling
(e.g., appointments
and operations)
23%
Medium-term potential
Data-driven diagnostics
and virtual-drug
development
40%
Longer-term potential
Robot doctors carrying
out diagnosis and
treatment

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“In order to understand trust in the relationship
between humans and automation, we have to
explore trust in two dimensions: trust in the technology
and trust in the innovating firm.”
Source: https://hbr.org/2017/04/to-get-consumers-to-trust-ai-show-them-its-benefits

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