By Thomas Davis, CRNA, MAE DNAP candidate

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“It’s likely that machines will be smarter than us before the end of the century—not just at chess or trivia questions but at just about everything, from mathematics and engineering to science and medicine.”

~ Gary Marcus, Professor/scientist, New York University

 

“Son, be smart and plan for the future. Get job security and land yourself a job as a conductor on a train, a great career job that will never go away.” The year 1899 was an exciting time for people who needed fast, reliable transportation and rail service appeared well up to the task of carrying its passengers into the 21^st century.

Fast forward to 1999 and the same conversation suggested the child enter the field of healthcare.  After all, as long as there are people, there will be a need for healthcare caregivers.  Today, nearly two decades into the 22^nd Century, though the need for caregiving remains high, the healthcare train circa 1999 has long left the station and a new train has pulled in powered by an engine called Technology.

Just as train travelers in 1899 could not imagine the 1903 debut of the flying machine, those of us in healthcare today, especially those on the frontline delivering hands-on patient care, view our future workflow through the lens of today’s practice and can’t imaging things that have not yet been invented.  Although new hardware, software and devices are continually being developed, the awesome advance in technology that will have a monumental effect on healthcare will be artificial intelligence (AI).

Take an Exciting Glimpse Into the Future…

Artificial intelligence is defined as, “…machines that respond to stimulation consistent with traditional responses from humans, given the human capacity for contemplation, judgment, and intention,” says Darrell West, Director of the Center for Technology Innovation.  Stated another way, artificial intelligence involves data bases and algorithms that think, respond as humans would, and do it faster and with more accuracy. Here are some current uses of AI in healthcare.

 

Sepsis

• Duke University actively uses an AI based sepsis watch protocol in the emergency department. The program feeds vital signs, lab tests and patient histories into a database and opens it to digital scrutiny for analysis.  Emergency room workers are alerted when the computer detects patterns suggestive of the early onset of sepsis.
• The Johns Hopkins has its own life-saving sepsis alert program called TREWS. The miraculous protocol is being used in the many ICUs on the Baltimore campus simultaneously tracks 27 factors related to sepsis.  Like the Duke protocol, when signs of sepsis emerge, ICU workers are alerted an intervention is initiated.
• University of Tennessee Children’s hospital is equally committed to eradicating infection and has implemented AI in the ICU with a program like those utilized by Hopkins and Duke.  Using digital insight to analyze multiple real-time factors identifies children in the earliest stages of distress and allows healthcare providers to initiate treatment early in the process.

 

Disease prediction

• Mount Sinai Hospital has explored uses of AI going back to the deep dive project of 2018. Rather than looking for a specific condition such as sepsis, the project uploaded over 700,000 medical records into a database and gave the green light for the computer to “learn as you go.”  Deep dive gave latitude for AI to assess the information in a “learn as you go” manner and report the findings.  The program was able to accurately identify individuals who were most likely to develop hypertension, diabetes or other common diseases.  An unexpected finding was the ability to predict those who would develop schizophrenia.
• Case Western Reserve University has programmed a robot to use AI to detect emotions in people. The robot quickly detects the mood of the person at the moment as well as changes in mood and personality over time.  Currently, the robot is being taught to respond with music, video or conversation to elevate the person’s mood when depression is detected.

 

Diagnostics

• Ophthalmology The British Journal of Medicine reports that AI will continue to have a vital and expanding role in the future of ophthalmology. Digital analysis is particularly useful in diagnosing diabetic retinopathy, age-related macular degeneration and glaucoma.
• Radiology The use of AI in radiology is predicted to be so successful that it will threaten the existence of the profession. The blog diagnostic imaging forecasts that AI will be able to read radiology images faster and more accurately than a radiologist.  A digital radiologist has the additional advantage of being available 24/7 to a worldwide population.
• Pathology Similar to radiology, AI is revolutionizing the field of pathology.  Sophisticated programs are being taught to correctly identify the existing disease and will also be able to predict which cells will progress to a serious disease.

 

Anesthesia

• Pharmacogenetics Webster defines genome as the complete set of genetic material found in every cell of a person. Pharmacogenetics is the relationship of an individual’s genome to their response to pharmacologic agents.  After genetic mapping, a person’s genetic composition can be reviewed by AI to forecast their exact response to drugs.  The anesthetic of the future will be based on the ability of AI to assess the genome and then provide a detailed prescription of the best combination of medications, the exact doses, and the re-dosing interval customized to the person’s genetic profile.
• Ventilation Ventilators are being developed which allow AI to guide mechanical ventilation. Smart ventilators will analyze physiologic data and self-adjust to provide optimal exchange of respiratory gases.  When used in an ICU setting, AI ventilators will also prescribe appropriate sedation to complement the ventilation.

 

Encouraging adolescents to enter the healthcare field is still solid advice, however preparation for a career on the frontline of patient care delivery will go beyond science and chemistry and will include preparation in basic digital technology.  Moving healthcare into the future will require the C-word – collaboration between physicians, nurses, technicians and artificial intelligence experts.  Designing a career path that establishes job security into the future does not involve punching tickets on a train.  It requires boarding Starship Enterprise and “going where no [human] has gone before.”

 

Tom is a respected author, speaker leader, and clinical anesthetist.

Contact tom@procrna.com to book a speaking engagement.