How one health system developed AI to tackle patient safety

Photo: Courtesy Sheba Medical Center

Sheba Medical Center is focused on using artificial intelligence to turn around statistics on patient safety.

"In terms of patient safety, we've made no progress over the past 30 years," said Prof. Dr. Eyal Zimlichman, chief transformation and innovation officer at Sheba Medical Center, which is located on the outskirts of Tel Aviv. 

After seeing a report on these findings, Zimlichman said he and his team realized two things: It was a huge challenge; and they had "no clue how to handle" it. Zimlichman, who has also served as the health system's CMO since 2017, turned to digital health technology to tackle patient safety.

Zimlichman leads the Accelerate Redesign Collaborate (ARC) Innovation Center at Sheba, which, with close to 2,000 beds, is among the largest health systems in the Middle East. ARC is focused on precision medicine, big data, artificial intelligence, predictive analytics, telemedicine and mobile health.

In 2016, ARC launched Aidoc to help physicians read CT scans. It has been implemented in 1,000 hospitals, with 800 of those located in the United States, according to Zimlichman. Aidoc is being used, for example, to more accurately predict stroke. Physicians have to read a few hundred CT scans in one night, which can lead to delays in interpretation and treatment of such conditions, he said. 

"By introducing an AI solution to read those scans, if there is a suspected stroke in the CT scan, (it can) more accurately and read much faster than the traditional way," Zimlichman said. "Something like this also reduces mortality. You're able to initiate therapy."

Aidoc can also predict a pulmonary embolism in the lungs and other life-threatening conditions, Zimlichman said.

Beyond the benefit of quality of care, there are cost savings and efficiencies in being able to interpret more scans. It also helps ease the workforce shortage of radiologists. Treating conditions earlier also leads to reducing the length of stay and the cost of rehabilitation and post-acute care, he said.

Zimlichman believes that the bigger picture for innovation is the transformation from sickness to wellness. "We're looking to transform from a house for the sick to a city of health," he said. "That's the future for hospitals." 

Zimlichman is a graduate of the Harvard School of Public Health Care Management Master of Science program and previously worked for Mass General Brigham, where he found a big emphasis on quality and patient safety.

"One of the biggest challenges is the ability to deliver higher quality of care," he said. "A quarter of people who come into the hospital are hurt. This is why we have to turn to innovation."

WHY THIS MATTERS

Transformation is not just about trying harder, but in redesigning the system, he said. First, problems must be tackled from the physician side, Zimlichman said.

To do this, there must be a culture for innovation.

"We talk a lot about organic innovation," he said. "To thrive there needs to be a system and processes in place to provide the needed support to bring those ideas forward. We have innovation champions, doctors who go through training, start with a problem, and then facilitate what would be the solution, and then take that forward as far as a prototype."

The money spent often comes back to the hospital in savings.

Another benefit is easing burnout. "We have found innovation is a great way to tackle burnout," Zimlichman said. "Clinicians love to innovate.

"At the end of the day, it's more than seeing another patient, another patient, another patient. They need to find an outlet."

THE LARGER TREND

The next Aidoc challenge is a whole bedside solution to perform echocardiography by a primary care provider or a nurse, rather than sending the patient to a cardiologist. This also allows for a faster read, treatment and quality improvement. 

"This is a recent development that we will bring to the United States over the next few months," Zimlichman said.

Moving the needle is always a struggle, he said. Innovation requires the right leadership to make this a focus for their organizations.

It's also not just for large health systems, he said, because a lot of transformation is not a huge expense. It may not even involve technology.

Hospitals need to find the right partnerships, such as aligning with healthy food supermarkets or working with Lyft, Uber or other ride shares to transport patients.

"There is something," he said, "called an innovation culture."

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org