AI In Health (PDF)

 Book Testimonials “Practical, insightful and a page turning read. Tom makes short work of the much-hyped topic of artificial intelligence, drawing on decades of experience to find the pattern between a series of case studies. This no nonsense book is a must read primer for those working in the healthcare system seeking to understand the impact of AI for the sector, or those entrepreneurial thinkers looking for the business opportunities this revolution will create.” —Dr. Simon Kos CEO, Next Practices and former Chief Medical Officer, Microsoft Tom Lawry’s new book, AI in Health – A Leader’s Guide to Winning in the New Age of Intelligent Health Systems, will be landing on real and virtual bookshelves in hospitals and health systems at a most opportune time. After a long incubation period and much hand-wringing about poten- tial downsides of AI, the field is now ready for prime time in healthcare. Leaders in every aspect of the industry will find practical guidance in this concise and well-written book. That includes a clear and comprehensive breakdown of the many different technologies that comprise AI as well as a discussion of the myriad opportunities to leverage AI to improve not only clinical outcomes but workflows and processes in the many support functions that make a health-care system work. The book will definitely help them cut through the morass of incomplete and sometimes conflict- ing information on AI and position themselves to lead the Intelligent Health Systems of the future…systems that will be powered by AI. I highly recom- mend this book. —Dr. Patricia Salber CEO, The Doctor Weighs In  “There is perhaps nothing more profound than the impact AI will have on how healthcare is delivered in the future. In his new book, AI in Health – A Leader’s Guide to Winning in the New Age of Intelligent Health Systems, Tom shares wisdom that comes from a lifetime of experience as a business leader and technologist in the health industry. He has traveled the globe gathering insights from some of the world’s most gifted experts. He examines how AI is being used in healthcare today, as well as where this powerful tech will take us in the future. There are both challenges and opportunities for AI in healthcare and Tom carefully examines both sides of the equation.” —Dr. Bill Crounse CIO, CMIO, Senior Director, Worldwide Heath, Microsoft Corporation (retired). “Mr Lawry’s book is a sensitively written analysis of the opportunities to use AI in healthcare whilst avoiding the pitfalls and the hype. He takes the reader through the key concepts and applies them to healthcare as only an expert in the three fields of health, technology and analytics can. Many people will be familiar with the background to the AI in health story and will struggle to know where to start and end their work. If you want to get the benefits of AI, then this book is for you. It will tell you what good looks like and how to navigate ethics, build a workforce, create new operating models and apply disruptive thinking. I loved it.” —Paul Henderson Regional Director EMIS Health, (UK)  IN HEALTH A Leader’s Guide to Winning in the New Age of Intelligent Health Systems   IN HEALTH A Leader’s Guide to Winning in the New Age of Intelligent Health Systems Tom Lawry  CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2020 by Tom Lawry CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper International Standard Book Number-13: 978-0-367-33684-4 (Hardback) International Standard Book Number-13: 978-0-367-33371-3 (Paperback) This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http:// www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging‑in‑Publication Data Names: Lawry, Tom, author. Title: Artificial intelligence in healthcare: a leader’s guide to winning in the new age of intelligent health systems / Tom Lawry. Description: Boca Raton: Taylor & Francis, 2020. | Includes bibliographical references and index. Identifiers: LCCN 2019049404 (print) | LCCN 2019049405 (ebook) | ISBN 9780367333713 (paperback; alk. paper) | ISBN 9780367336844 (hardback; alk. paper) | ISBN 9780429321214 (ebook) Subjects: MESH: Artificial Intelligence | Delivery of Health Care—organization & administration Classification: LCC RA971.6 (print) | LCC RA971.6 (ebook) | NLM W 26.55.A7 | DDC 362.10285—dc23 LC record available at https://lccn.loc.gov/2019049404 LC ebook record available at https://lccn.loc.gov/2019049405 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com  To those who believe that health and medicine is a noble cause and strive to make it so.   vii Contents Preface and Acknowledgements xi ............................................................. Author xv ....................................................................................................... 1 The Future Is Not What It Used to Be 1 ......................................... I’m All for Change – You Go First 3 .............................................................. First Steps in an Ongoing Journey 4 ............................................................. Three Things Leaders Should Know ..........................................................6 Notes ..........................................................................................................10 2 The Rise of the Intelligent Health Consumer ............................11 The Rise of Intelligent Health Systems .....................................................13 Digital Transformation Is the On-Ramp for Intelligent Health ............15 There Are No Swim Lanes in the Blue Ocean .....................................16 The Consumerization of Health ...........................................................17 AI Is the New UI ...................................................................................17 Employee Experiences Will Be as Important as the Customer Experiences ...........................................................................................18 Intelligent Health Is a New Journey.........................................................19 Notes..........................................................................................................20 3 AI Is One Thing and Many Things ............................................23 AI Is One Thing and Many Things ..........................................................24 Defining AI – General ..............................................................................25 AI Building Blocks ....................................................................................25 Machine Learning (ML).........................................................................25 Cognitive Services .................................................................................29 Applying AI Building Blocks....................................................................34 Notes ..........................................................................................................38  viii ◾ Contents 4 From Gods to Geeks – A Brief History of AI .............................41 Notes ..........................................................................................................49 5 Do Submarines Swim? ...............................................................51 Managing Different Types of Knowledge ................................................52 Notes ..........................................................................................................55 6 Creating Value Today with AI....................................................57 Today’s High Value Use Cases ..................................................................58 Clinical Opportunities ...........................................................................59 Bolstering Patient Engagement and Satisfaction ..................................64 Operational and Financial Opportunities ............................................67 Opportunities for Intelligent Health Payers..........................................71 Opportunities for Intelligent Pharma and Drug Discovery.................72 Matching AI to Clinical and Business Needs ...........................................72 Barriers to Adoption .................................................................................73 Notes ..........................................................................................................75 7 The Leadership Imperative ........................................................79 Are You a Change Master or Transformation Leader? .............................82 Reimagining Processes and Workflows ................................................83 Workforce Transformation ....................................................................84 Data as a Strategic Asset.......................................................................84 The New Face of AI Leaders....................................................................85 Notes ..........................................................................................................90 8 When AI Meets HR ....................................................................91 AI to the Rescue ........................................................................................93 Choose One: Divide or Empower Your Workforce .................................95 Adopt and Communicate a People-First Approach .................................95 Understand How and Where AI Will Impact Jobs and Careers ..............96 Create a Learning and Development Plan That Supports Transformation ..........................................................................................98 Align Recruiting and Retention Plans to the New Intelligent Work Environment ..............................................................................................99 Create a Data-Driven Culture .................................................................100 Notes ........................................................................................................103 9 Engaging Your Clinicians ........................................................105 The Opportunities and Challenges of Clinician Engagement...............106 Engaging Clinicians to Shape the Future before It Arrives ...................108  Contents ◾ ix Steps for Meaningful Clinician Engagement ..........................................108 If You Don’t Engage Your Clinicians Their Patients Will...................... 111 Notes ........................................................................................................ 114 10 Making Radiologists More Rad ............................................... 115 Radiology Is Dead. Long Live Radiology ............................................... 116 It Takes a Village – Or at Least a Forward-Looking Medical Association .............................................................................................. 117 The Future Role of Radiologists .............................................................120 Notes ........................................................................................................120 11 Understanding and Managing the Ethics of AI .......................123 Principles.................................................................................................127 Fairness – AI Systems Should Treat All People Fairly ........................127 Reliability – AI Systems Should Perform Reliably and Safely ............128 Privacy and Security – AI Systems Should Be Secure and Respect Privacy .................................................................................................130 Inclusiveness – AI Systems Should Empower Everyone and Engage People .....................................................................................132 Transparency and Accountability .......................................................133 Notes ........................................................................................................134 12 The Role of the Cloud in AI.....................................................137 A Bright Cloudy Future ...........................................................................138 The Benefits of AI in the Cloud.............................................................139 Cloud Computing Delivery Models ........................................................141 Notes ........................................................................................................146 13 Manage Your Data Estate Like Your Finances .........................147 Creating and Managing Your Data Estate ..............................................149 Data Governance .................................................................................... 153 Creating a Data Culture ..........................................................................154 Notes ........................................................................................................ 155 14 The Importance of Intelligent HIT Vendors ............................157 Notes ........................................................................................................168 15 From Aspiration to Execution ..................................................169 Complete an AI Reality Check ...............................................................170 Lay a Solid AI Foundation: People + Data ............................................171 Nix Moonshots in Favor of Well-Curated Use Cases.............................172 Understand and Manage Workforce Impact .......................................... 174  x ◾ Contents Focus on Delivering Secure and Responsible AI ................................... 174 Become Your Organization’s AI CEO (Chief Evangelist Officer) ...........175 Measuring Success .................................................................................. 176 AI Leaders and Laggards ........................................................................177 The Choice Is Yours ................................................................................178 Notes ........................................................................................................178 16 The Road Ahead for AI ............................................................179 Precision Medicine..................................................................................180 A Quantum Leap for Health...................................................................182 Emotional AI ...........................................................................................183 Intelligent Testing....................................................................................184 Biohacking...............................................................................................184 The Advent of Data Whisperers.............................................................185 Unifying Mind and Machine with Brain–Computer Interfaces .............186 Creating an Intelligent Data Collaboration Graph of Medicine .............187 Augmented Reality..................................................................................187 Conversational AI....................................................................................188 Making Global Health Smarter ...............................................................188 AI in Health Will Amplify Society ..........................................................192 Notes ........................................................................................................193 Index ..............................................................................................195  xi Preface and Acknowledgements Give me a place to stand, a lever long enough and I can move the Earth. —Archimedes Ours has been called the information age. There is probably no place where this rings truer than healthcare. In the 1950s, a newly minted physician would go their entire career before seeing medical information and knowledge double. Those graduating today can expect this to happen in a year or less. Such is the challenge and opportunity for those in health and medicine today. Artificial Intelligence (AI) gives us the ability to harness the power of healthcare’s data tsunami to make us better at virtually everything we strive to be better at. In this regard, AI will augment much of what we do but will not replace us… Everything about AI in health starts with humans using it to do good. Like most of you reading this book, I’ve spent my entire career in and around healthcare. Whether you’re running a rural clinic in the United States or you’re a researcher at one of the top centers in Stockholm or London, what binds us together is this: We believe that healthcare is a noble cause worthy of our time and energy, that we can make a difference, and that there are many things about the system that challenge us to do better. Enter the new possibilities of AI. In the hands of competent and caring clinicians, health executives, and others, our charge is straightforward—to use it to make a bigger difference than we are making today. As the national director for AI for Health and Life Sciences at Microsoft (and as the former director of Worldwide Health), I’ve given keynotes and talks on AI around the world including some heady places like the Nobel  xii ◾ Preface and Acknowledgements Forum. I’ve had the privilege of working with clinical and health leaders who are pioneering new ways of using data to push back the boundaries of health and medicine. When it comes to my knowledge of AI, I’m reminded of what an early mentor taught me—“none of us is as smart as all of us.” Whatever wisdom and knowledge I possess comes as part of an emerging “knowledge collec- tive” on what AI is and how we apply it to keep people healthy and care for them when they are not. With this in mind, there are countless people I could list as contribu- tors to this book. Some of the most notable that come to mind include the following: Kris Mednansky, Senior Editor at CRC Press/Taylor & Francis Group. While my name is listed as the author, Kris is really the one responsible for this book. It’s a result of a chance meeting we had as I was racing to catch a flight. Her interest and persistence for a book specifically focused on AI for health leaders was the impetus for what you are reading now. She provided great guidance along the way. John Doyle, Director Cloud and AI, Microsoft. John is one of the smart- est people I know when it comes to real-world knowledge about the cloud and how clinical and business leaders can harness its power. His impatience with old-style data management is a driving force helping others transform systems and processes with cloud-based data and AI solutions. While many talk of their aspirations for the cloud and AI, John has a knack for making things real. Harry Pappas, Founder and CEO of the Intelligent Health Association (IHA). When it comes to what intelligent health is (or is becoming), Harry’s knowledge is broad and his enthusiasm infectious. Under his leadership, IHA demonstrates the power of people coming together around new or emerging technologies to share ideas and collaborate on how we understand and apply new and emerging technologies to improve the quality and effec- tiveness of health and medical services globally. Ankur Teredesai, Ph.D., Professor of Computer Science and Executive Director of the Center for Data Science at the University of Washington, Co-founder and CTO of KenSci. Ankur has a unique perspective on the application of AI in health as he splits his time between academia and working with health organizations around the world in the use of AI to solve significant problems. His guidance was especially useful in ensuring that my attempts to explain AI and its uses in health in lay terms did not reduce the integrity of the information provided.