PALO ALTO, Calif聽 –When Dr. Sarah Russell sees patients at the Veterans Administration hospital here, she sometimes turns to a trusted adviser:聽 the supercharged software on her desktop.
Whether a patient needs a blood transfusion, a different medication or a more refined diagnosis, the artificially intelligent program can give her options in seconds.
Say a patient is anemic. With input from the patient鈥檚 electronic medical record and a vast store of information from what has worked for other patients, the computer can determine quickly whether a transfusion is likely to be worthwhile.
The program also warns her whether patients might react poorly to a given medication and flags patients who may have a greater risk of getting re-admitted to the hospital after being sent home.
鈥淚鈥’m not asking [the program] to say, 鈥楾his is where a patient is headed鈥,鈥 says Russell, the VA’s chief medical informatics officer for the Palo Alto health system.聽 Instead, for similar patients, 鈥渏ust tell me what’s happened in the past, and I’ll make the call.鈥
The system is one of a growing number of similar tools around the country allowing doctors to tap into聽 databanks of patient records and research to improve and streamline care.
Supercomputers and homegrown systems can help identify patients who might be at risk for kidney failure, cardiac disease or postoperative infections and to prevent hospital readmissions. In addition, patients鈥 individual health data鈥攊ncluding genetic information鈥攃an be combined with the wealth of material available in public databases, textbooks and journals to help come up with more personalized treatments.
Driving the increased reliance on artificial intelligence is health reform law, which seeks to leverage technology to improve outcomes and reduce costs, and the availability of cheaper and more powerful computers. In addition, doctors are embracing 鈥減opulation management鈥 —聽 the practice of using large reservoirs of information about聽 patients with similar medical histories to help draw inferences about individual cases.
To be sure, computers can鈥檛 replace doctors at the bedside, but they can be a tool to take full advantage of electronic medical records, transforming them from mere e-filing cabinets into full-fledged doctors鈥 aides that can deliver clinically relevant, high-quality data in real time.
So far, computers have gotten really good at parsing so-called structured data鈥攊nformation that can easily fit in buckets, or categories. In health care, this data is often stored as billing codes or lab test values.
But this data doesn’t capture patients鈥 full-range of symptoms or even their treatments.聽 Images, radiology reports and the notes doctors write about each patient can be more useful. That鈥檚 unstructured data, and computers are less savvy at handling it because it requires making inferences and a certain understanding of context and intent.
That鈥檚 the stuff humans are really good at doing — and it鈥檚 what scientists are trying to teach machines to do better.
In recent years, universities, tech companies and venture capital firms have invested millions into making computers better at analyzing images and words. Companies are popping up to capitalize on findings in studies suggesting that artificial intelligence can be used to improve care.
But many challenges remain, experts say. Among them is the tremendous expense and difficulty of gaining access to high-quality data and of developing smart models and training them to pick up patterns.
Most electronic medical record-keeping systems aren鈥檛 compatible with each other. The data is often stored in servers at individual clinics or hospitals, making it difficult to build a comprehensive reservoir of medical information.
Moreover, the systems often aren鈥檛 hooked up to the Internet and therefore can鈥檛 be widely distributed or accessed like other information in the cloud. So, unlike the vast amount of data on Google and Facebook, the information can鈥檛 be mined from anywhere by those interested in analyzing it.
From the perspective of privacy advocates, this makes some good sense: A researcher鈥檚 treasure trove is a hacker鈥檚 playground.
鈥淚t鈥檚 not the greatest time to talk about鈥 health records on the web, given security scandals such as the Edward Snowden leaks and the Heartbleed bug, said Dr. Russ Altman, the director of Stanford University鈥檚 biomedical informatics training program.
Also standing in the way are concerns about how far computers should encroach on doctors鈥 turf. As artificial intelligence systems get smarter, experts say, the line between making recommendations and making decisions could become more murky.
At the moment, the technology isn鈥檛 good enough to tell doctors with 100 percent certainty what the best treatment for a patient may be.
Despite these limitations,聽 some physicians and researchers find the possibilities of artificial intelligence聽 to be tantalizing.
鈥淓lectronic health records [are] like large quarries where there鈥檚 lots of gold, and we鈥檙e just beginning to mine them,鈥 said Dr. Eric Horvitz, the managing director of Microsoft Research.