Smart healthcare technology innovations to combat the COVID-19 coronavirus and improve people’s daily lives are at the centre of the UAE’s healthcare spending topping US$21 billion by 2021, according to the United States – UAE Business Council. The UAE government continues to increase its healthcare spend, especially in supporting healthcare technology innovations that can help to manage lifestyle diseases and coronavirus.

According to UAE-based IT infrastructure and information management consultancy and solutions provider Condo Protego, healthcare technology innovations are the foundation of the UAE’s record-high healthcare spend.

Related: Collaboration is key to the widespread adoption of AI for healthcare

Condo Protego highlights that healthcare providers should take a four-step process in their digital transformation: modernising IT infrastructure, maintaining 24/7 cloud access, launching mobile apps, and enhancing cybersecurity.

Speaking exclusively to Omnia Health Insights, Condo Protego’s deputy general manager Praj Calthorpe explains that by replacing time-consuming manual and paper-based processes with more efficient digital processes, Middle East healthcare providers can save time and money, and enhance patient experiences.

Related: Using artificial intelligence in COVID-19 research

“Cloud-based platforms are the foundation for hosting digital patient records,” he says. “These records can be updated in real-time by healthcare professionals, can allow patients to monitor their progress and input medical readings from their own self-care, and can enable instant communication and telehealth between patients and doctors.

“Amid social distancing, telehealth can help doctors treat more patients faster and with high-quality care,” Calthorpe adds.

In some cases, Artificial Intelligence-based applications can help doctors to make patient diagnoses more quickly based on the applications using big data analyses of potentially millions of prior x-rays and CT scans.

Integrating mobile apps and healthcare devices can also enhance patient care, Calthorpe explains. “For lifestyle diseases, such as diabetes, a digital blood glucose monitor could send results electronically into the patient’s digital patient records instead of a patient having to enter results in a written logbook. Linking in health insurance companies can also allow for more complete billing history and more convenient digital payments.”

What could the smart hospital of the future look like?

According to Calthorpe, smart hospitals that integrate the Internet of Things (IoT) can find real-time tracking of their assets – such as beds, IVs, and vital signs monitors – to help save time from nurses in tracking down supplies, and also money by accelerating or even predicting repairs. Pharmacies connected to hospitals can also have better insights on past order histories for real-time and predictive decision-making capabilities in ordering their medications.

“Having real-time insights on patient conditions could also help to stem outbreaks of infection in hospitals and CCTV surveillance could also better alert nurses to patients who may be leaving their rooms prematurely,” he says.

Calthorpe believes that, soon, we may see that doctors and nurses no longer need to take or transcribe handwritten notes, but instead can have them digitally transcribed. In turn, doctors and nurses can free up their vital time to focus on treating patients and providing better patient care.

“Amid the current era of coronavirus, mobile apps are already helping to stem the spread of coronavirus with contact tracing,” he concludes.

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine May 2020 as part of its COVID-19 Curbside Consults.

Acute kidney injury has been reported in as many as 29% of COVID-19 patients. Reported risk factors include elevated baseline serum creatinine, elevated blood urea nitrogen, acute kidney injury, proteinuria, and hematuria. Suspected causes include sepsis and acute tubular necrosis resulting from renal hypoperfusion, cytokine release syndrome, direct viral invasion, renal medullary hypoxia secondary to alveolar damage, rhabdomyolysis, and cardiorenal syndrome due to viral myocarditis.

Incidence of AKI

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Acute kidney injury (AKI) has been reported to occur in 3% to 29% of COVID-19 patients. The wide range of reported incidence is likely due to inconsistent use of AKI definitions and to variable incidence in people hospitalized with mild symptoms vs critically ill patients. Published reports indicate that kidney replacement therapy will be needed in about 3% to 17% of COVID-19 patients who develop AKI. Patients with AKI have a higher risk of mortality, and predictors for mortality in a study of 701 COVID-19 patients included elevated baseline creatinine, blood urea nitrogen, AKI, proteinuria, and hematuria.

Etiology of AKI

The pathogenesis of AKI in COVID-19 is unclear due to the limited availability of kidney biopsy reports. It is intriguing that SARS-CoV-2 utilizes angiotensin converting enzyme 2 as the receptor for entry, which is highly expressed in the proximal tubules in the kidney. Suspected etiologies for AKI include sepsis and acute tubular necrosis resulting from renal hypoperfusion, cytokine release syndrome, direct viral invasion, renal medullary hypoxia secondary to alveolar dam age, rhabdomyolysis, and cardiorenal syndrome due to viral myocarditis. A postmortem analysis of 26 patients in China showed evidence of acute tubular necrosis and, less commonly, white blood cell casts and bacteria suggesting pyelonephritis. Viral particles were also identified within the podocytes and proximal tubular cells, supporting direct viral invasion as a possible mechanism for AKI. Additionally, patients with elevated serum creatinine phosphokinase had pigmented casts on autopsy, suggesting rhabdomyolysis as a possible cause. Interestingly, peritubular and glomerular capillary luminal obstruction by erythrocyte aggregation in some patients also suggests a possible role of hypercoagulability. Proteinuria and hematuria have been reported in some patients, although it is unclear whether this is due to underlying chronic kidney disease or to infection-mediated glomerulonephritis1: there is a report of collapsing glomerulopathy on kidney biopsy in an African American patient with nephrotic-range proteinuria and underlying high-risk APOL1 genetic variant.

Evaluation of AKI

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The evaluation of AKI in COVID-19 patients should follow the general approach to workup and diagnosis of AKI, utilizing the broad framework of prerenal, intrarenal, and postrenal causes. A careful history and physical examination, hemodynamic and volume assessment, and review of possible nephrotoxic medications should be undertaken. Urinalysis with sediment examination is helpful to differentiate the causes of AKI. A positive urine dipstick for hemoglobin with no erythrocytes on microscopy could signify rhabdomyolysis. Muddy brown casts and white blood cell casts on urine sediment examination would suggest acute tubular necrosis and acute interstitial nephritis or pyelonephritis, respectively. Measurement of urine sodium may help differentiate prerenal causes from acute tubular necrosis. Kidney ultrasonography can help identify underlying medical renal disease and rule out obstruction. Kidney biopsy should be considered in patients in whom the etiology of AKI is unclear, and if the benefits of identifying a cause outweigh the risks of performing the procedure.

Treatment of AKI

Supportive management includes optimizing hemodynamic and volume management and discontinuation of nephrotoxic medications. The indications and timing of dialysis initiation remains the same for COVID-19 patients as for other AKI patients. Additional therapies undergoing active investigation that are not limited to renal disease include antiviral and anti-inflammatory therapy, such as remdesivir, lopinavir-ritonavir, and tocilizumab. The efficacy and safety of these drugs have not been reported. Although there is no evidence to support acute nephrotixicty with these drugs, some renal adverse effects have been reported. Protease inhibitors should be used cautiously in kidney transplant recipients as they can increase the blood levels of immunosuppressive medications (including the calcineurin inhibitor tacrolimus), which can worsen AKI. Chloroquine and hydroxychloroquine have been rarely associated with renal podocytopathy mimicking Fabry disease. Adalimumab, a monoclonal antibody against tissue necrosis factor alpha, is associated with autoimmune glomerulonephritis. Bacterial superinfection necessitates initiation of antibacterial therapy, which may also have nephrotoxic effects.

Continuous kidney replacement therapy is the preferred modality of dialysis in patients with hypotension. Theoretically, convective forms of kidney replacement therapy (hemofiltration) have been suggested to improve the removal of cytokines, but they have not been proven to have better outcomes than diffusive forms (hemodialysis). There is an increased risk of clotting of hemodialysis filters due to cytokine-induced hypercoagulability, so clinicians should attempt to anticoagulate all patients that are on dialysis if there is no contraindication. Hemoperfusion filters, designed to remove bacteria and viruses from the blood, are being studied in trials in COVID-19 patients in Germany and Italy. Additionally, extracorporeal membrane oxygenation (ECMO) may help improve kidney oxygenation and reduce the risk of medullary hypoxia and both kidney replacement therapy and extracorporeal membrane oxygenation have been used in conjunction with one another.

Preserving resources

Due to the high rate of AKI requiring kidney replacement therapy in critically ill patients, a careful daily assessment of available resources is needed: a dialysis dashboard to track equipment, supplies, personnel, and patients should be implemented. Strategies to limit frequent patient contact include extension tubing that allows dialysis machines to be placed outside the patient rooms and the use of bedside video monitors. Due to disruptions in the supply chain, healthcare systems may experience difficulty with the availability of supplies including dialysis filters, tubing, and premade replacement fluid. Some institutions have switched from hemofiltration to hemodialysis and are producing dialysis solutions in-house.16 The Cleveland Clinic now has an online resource, which is a step-by-step tutorial for in-house dialysis fluid production. Others have suggested urgent-start peritoneal dialysis for patients with AKI when resources are limited.

Summary

Patients with COVID-19 have an increased risk of AKI and death. The etiologies of AKI are multifactorial, and data from larger case series are needed. Management of AKI is supportive, and extracorporeal therapies may be required in critically ill patients. Healthcare systems should closely track dialysis resources, and best-care practices should be shared to optimize care in settings of limited resources.

Read the full article.

In an effort to mitigate the ill effects of non-communicable chronic diseases, Burjeel Day Surgery Center, Al Reem Island, in Abu Dhabi has launched an Ayurvedic department to provide evidence-based treatments to multiple medical conditions. The centre, led by a team of extensively experienced doctors, follows a novel treatment approach, which blends modern medicine and traditional Ayurveda to achieve desirable outcomes.

The Ayurveda clinic called “Vaidyashala” was inaugurated by Sandeep Kumar Bayyapu, Deputy Chief of Mission, Indian Embassy. Vaidyashala aims to provide complementary treatment to chronic diseases such as arthritis, back pain, allergies, and asthma, migraine, skin diseases, and gynaecological problems. 

Related: Complementary and Alternative Medicine Gains Traction with UAE Population

The Indian Embassy in Abu Dhabi has been actively working to promote traditional Indian systems of medicine including Ayurveda in the UAE, said Bayyapu. “Traditional medicine has an important role in contemporary community healthcare due to its unique characteristics that promote health, prevent disease, and provide cure, rehabilitation, and rejuvenation.

Integrative approach

“COVID-19 pandemic has emphasized the need for the change in the lifestyle of the people particularly towards immunity-enhancing steps. Ayurveda highlights the positive role of traditional medicine and practices in enhancing immunity. India can play a major role in meeting the requirements of world markets through the promotion of Ayurveda and other traditional systems of medicine,” he added.

Related: Poor lifestyle choices contribute to weakened pelvic floor dysfunction in young adults in UAE

Burjeel Day Surgery Center has set up a full-fledged Ayurveda clinic to provide all curative therapies. This includes abhyangam (traditional Ayurvedic body massage), thala pothichil (head massage), tharpanam (treatment for eyes), ayurvedic facial, and many other packages for specific causes.

Dr. Shyam Vishwanathan, Head of Vaidyashala, said they would be providing complete care to patients at the centre for all major illnesses and medical conditions. “The science and practice of Ayurveda have been proven and recognized by the World Health Organization. The practice of Ayurveda would be hugely beneficial to the patients, particularly the elderly population, in providing necessary relief to them by reducing the effects of chronic diseases. At Burjeel Day Surgery Center, we will be following an integrative approach, where modern medicine and Ayurvedic practice would be a blend for ideal results,” he said.

The medical facility has launched the Ayurveda department ‘Vaidyashala’ on the occasion of celebrating its third anniversary.  The Ayurveda centre is also offering programs for weight loss, post-natal care, detox therapies, and lifestyle modification.

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine June 2020 as part of its COVID-19 Curbside Consults.

Current Centers for Disease Control and Prevention guidelines state that patients with moderate to severe asthma may be at greater risk for more severe disease if infected with SARS-CoV-2; however, no published data support this suggestion. During this pandemic, it is recommended that patients with asthma continue taking all controller inhalers and other asthma medication as prescribed to prevent exacerbations and limit outpatient clinic and emergency room exposure. Symptoms that may differentiate COVID-19 from asthma exacerbations caused by another trigger may include fever, fatigue, anorexia, or myalgias. Patients with suspected or confirmed COVID-19 should avoid nebulizer treatments due to the risk of aerosolization.

Asthma and COVID-19

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Current Centers for Disease Control and Prevention guidelines state that patients with moderate to severe asthma could be at greater risk for more severe disease if infected with SARS-CoV-2. However, no published data support this suggestion. Early epidemiologic data from Wuhan, China, of 140 hospitalized patients with confirmed COVID-19 suggest that asthma and COPD are underrepresented as co-morbidities in this population. Additional epidemiologic studies support this finding with low rates of pre-existing respiratory disease in patients with COVID-19.

Prior novel coronaviruses, SARS-CoV and MERS-CoV, did not appear to increase the risk of asthma exacerbations unlike seasonal coronaviruses, which have been linked to an increased risk.

Related: Impact of COVID-19 on radiology services

There has been concern about the use of oral corticosteroids to treat an asthma exacerbation during the pandemic. Studies looking at the use of oral corticosteroids with influenza infections and other coronavirus infections have found an association with increased mortality. One early observational study from Wuhan, China, suggested that patients with adult respiratory distress syndrome who received methylprednisolone had a reduced risk of death, but the results were not adjusted for confounders due to the small sample size. Corticosteroids are known to increase viral shedding with viral pneumonia, but the clinical implications of this are not clear.

The most important recommendation for patients during this pandemic is to continue taking all controller inhalers and other asthma medication as prescribed. This can prevent exacerbations and potentially be lifesaving. Maintaining good asthma control will also help limit outpatient clinic and emergency room exposure during the pandemic. The Global Initiative for Asthma has issued frequently asked questions about asthma management in the context of COVID-19.

There are some key symptom differences that caregivers can use to differentiate COVID-19 infection from asthma exacerbations caused by another trigger. The most common symptoms associated with COVID-19 include fever, fatigue, dry cough, anorexia, myalgia, and dyspnea. Most asthma exacerbations would not be expected to cause fever, fatigue, anorexia, or myalgias. Patients with typical asthma exacerbation symptoms and without other symptoms suggestive of COVID-19 should be treated with standard care. Oral steroids should be limited to the lowest possible dose for the shortest length of time. Asthma patients with COVID-19 infection should remain on their current asthma regimen. Oral corticosteroids can be used if COVID-19 is thought to be the cause of an asthma exacerbation, again limiting dose and length of treatment as much as possible.

For patients with suspected or confirmed COVID-19, nebulizer treatments should be avoided. Nebulization is an aerosol-generating procedure that can increase the risk of transmission. Metered-dose inhalers should be used instead whenever possible. If nebulizer treatments are necessary, healthcare workers who provide the treatment should use airborne precautions and wear personal protective equipment. Patients who need to administer a nebulizer treatment at home should do so in a location that limits exposure to other household members. Ideally, this should be a location where the air is not recirculated into the home and where surfaces can be cleaned more easily, such as a patio, porch, or garage.

Read the full article.

Artificial intelligence (AI) vendors are partnering with healthcare providers to identify practical challenges and consider AI technology as a potential solution. This type of collaboration is crucial to successful AI adoption because the technology is designed to tackle real-world healthcare problems. A myriad of examples was displayed at the 2020 Radiological Society of North America (RSNA) annual meeting.

The next 5 to 10 years will be pivotal for the expansion of the healthcare AI software market. Omdia forecasts that the healthcare AI software market will grow from about $800 million in 2019 to nearly $11 billion in 2025, representing a 54% CAGR.

Related: Using artificial intelligence in COVID-19 research

Figure 1: Global AI software revenue for healthcare; Source: Omdia

Related: A Healthcare C-Suite Powered by Artificial Intelligence

In recent years, healthcare practices have dramatically increased AI spending. The latest annual (2020) Information and Communications Technology Enterprise Insights in the Healthcare Industry (ICTEI) survey found that this trend will likely continue. Nearly 60% of respondents reported plans to increase AI spending in the next 18 months. The Omdia Artificial Intelligence for Ultrasound Survey (AIUS) 2020 and ICTEI 2020 survey identified many factors driving the increase in AI spending, including improved diagnostics, time savings, and government initiatives.  The unforeseen health crisis caused by the coronavirus disease (COVID-19) may be the greatest market accelerator in the near-term.

Despite several tailwinds, currently, healthcare AI is used primarily in advanced hospitals, universities, and research facilities in mature markets, like the US and Western Europe. Meanwhile, much of the medical world has limited exposure to AI, with lingering doubts that technology is a good use of budget. It is incumbent upon AI vendors and equipment manufacturers working with each other and healthcare providers to design AI products that realistically meet clinicians’ needs and share some of the financial and logistical burden associated with purchasing and implementing AI.

A confluence of factors is promoting rapid AI adoption

The Omdia AIUS 2020 explored the internal factors driving the adoption of AI. Over 80% and 60% of respondents identified “improved diagnostics” and “time savings” as top drivers for AI adoption, respectively. These results are consistent with the survey’s findings related to the current impact of AI and industry expectation of AI’s ability to improve the accuracy and efficiency of medical imaging. Vendors at RSNA 2020 were promoting the diagnostic and time-saving capabilities of AI products. For example, CureMetrix showcased the results of a study that found that its AI software improved radiologists’ diagnostic accuracy and specificity by 25% and 34% respectively, and reduced the time required to read normal exams when interpreting mammograms (Source: CureMetrix).

Omdia’s ICTEI 2020 survey identified that external factors, including “federal healthcare industry-wide initiatives”, are crucial in driving AI adoption. In 2019, the UK government announced a £250 million budget to establish a new national AI laboratory dedicated to developing solutions to address the nation’s severely strained healthcare system. Similar initiatives have been implemented in other Western European countries, as well as the US, China, Japan, and South Korea.

One of the most significant external drivers of AI adoption in the healthcare industry in the short- and long-term will be the COVID-19 pandemic. Efficient and effective COVID-19 diagnoses is of upmost importance during the pandemic, which has accelerated the development of AI software in the healthcare sector.  Further government investment in AI-based drug and vaccine research, medical imaging, and machine learning tools for patient screening, triage, and monitoring is also expected. While the impact of the pandemic will be temporary, COVID-19 will serve as a litmus test for AI technology. At RSNA 2020, RADLogics showcased its latest iteration of AI solutions designed to detect symptoms of COVID-19 from CT and X-ray images (Source: RADLogics).

Figure 2: COVID-19 forecast effect on AI software industries; Source: Omdia

Stakeholders must collaborate to overcome barriers

To reach its full potential in the healthcare market, AI vendors must overcome daunting barriers to adoption. The AIUS 2020 and ICTEI 2020 survey identified that information technology (IT) and workflow integration and education and training were top barriers from the healthcare provider perspective. To overcome these challenges, healthcare equipment and AI vendors should increase ongoing support with clients’ IT departments, to ensure that AI technology can be integrated effectively. AI vendors should also improve and increase engagement with healthcare providers to support education and training, which has shown to significantly increase the likelihood of future AI adoption.

Cost is also a major barrier to healthcare AI adoption. Over 50% of AIUS 2020 survey respondents identified that the cost of AI was too high. AI solutions may need to be simplified, eliminating less important features, to bring down the cost to meet customer expectations. Conversely, with proper education and training, vendors may be able to maintain or increase prices by justifying the value of AI. During the early stages of AI adoption, it might be necessary for vendors to share some of the capital burden associated with adoption by utilizing nontraditional business models. The 2020 AIUS and ICTEI survey results identified a discrepancy between the business models currently used for AI and end-user preference. More than 90% of ICTEI respondents identified a preference for an operating expenses (OPEX) type AI business model; however, the AIUS results showed that over 60% of respondents adopted AI through one-time purchases. Subscription-based business models reduce healthcare providers’ financial risk and provide new opportunities for AI software to demonstrate value and justify the long-term investment.

Collaboration between AI vendors, healthcare equipment manufacturers and healthcare providers is essential to further AI development and adoption. At RSNA, NVIDIA announced the launch of its Inception Alliance program which will facilitate partnerships between medical imaging AI startups, GE Healthcare and Nuance (Source: NVIDIA). The program will help to fast-track the development of AI for healthcare and link software development with the medical imaging community. Collaborations like Inception Alliance will help healthcare AI take the next step in its expansion as advanced technological developments will be guided by real-world healthcare challenges.

Read part one of the article here

According to the International Osteoporosis Foundation, one in three women and one in five men over 50 will suffer a fracture due to osteoporosis, and many of the risk factors for the disease are prevalent in the UAE.

These risk factors include diabetes, vitamin D deficiency, low mobility levels, premature menopause, long-term steroid use, smoking, being underweight, bone diseases, malabsorption of nutrients and other dietary issues such as calcium deficiency, and a family history of fractures.

Related: Orthotics: Is it Science or a Sham?

According to Dr Sara Suliman, who is a consultant endocrinologist and diabetologist at Mubadala Healthcare’s Imperial College London Diabetes Centre (ICLDC), people with diabetes, particularly type 1 diabetes, often have poorer bone quality and an increased risk of fractures.

“Those with long-standing diabetes (>5yrs) and poor blood sugar control, and those who take insulin have the highest fracture risk,” she tells Omnia Health Insights. “It is suggested that they have altered bone quality due to the binding of glucose to collagen in bone causing weakness in the bone structure.”

Related: Diabetes management in the times of COVID-19

She also highlights that type 1 diabetes is also associated with other autoimmune disorders that may cause osteoporosis such as coeliac disease, premature ovarian insufficiency or thyrotoxicosis.

“Some treatments for diabetes, such as pioglitazone may also cause osteoporosis, and people with diabetes can have complications such as blindness, neuropathy and hypoglycaemia that increase the chance of fractures if they get osteoporosis,” she adds.

Because advancing age and chronic conditions such as diabetes make people more vulnerable to the effects of COVID-19, many osteoporosis patients were previously encouraged not to leave the house for non-emergency care during the height of the pandemic. However, recently, ICLDC encouraged those patients with osteoporosis who are treated with denosumab to return to their normal injection schedules to ensure optimal bone health and avoid the risk of bone fractures.

Treatment

While osteoporosis causes bones to weaken and become more susceptible to fractures, treatment with denosumab prevents bone loss by blocking a specific receptor in the body to decrease bone breakdown. However, the treatment is intended to be lifelong and if it is stopped or delayed, bone health decreases rapidly, potentially increasing the risk of fractures significantly after a delay of just two months.

“It is important that these patients receive the injections every six months, or their bone mineral density – meaning the quality and quantity of bone – will deteriorate even more quickly than before treatment, falling to pre-treatment levels within just 12 months,” Dr Suliman says.

Bacteriophages, or phages, may play a significant role in treating complex bacterial infections in prosthetic joints, according to new Mayo Clinic research. The findings suggest phage therapy could provide a potential treatment for managing such infections, including those involving antibiotic-resistant microbes.

"The treatment for chronic prosthetic joint infection has been surgery plus antibiotics, with surgery being the backbone of therapy. When these efforts fail, there can be significant suffering, loss of limb, even death," says author Gina Suh, M.D., Mayo Clinic infectious diseases specialist. "Phage therapy has the potential to be paradigm-shifting in how we treat infections in this era of increasing medical device use and antibiotic resistance."

Related: Orthotics: Is it Science or a Sham?

Phages are naturally occurring viruses found throughout the earth that target and kill specific bacterial cells, including those that have grown resistant to multiple antibiotics. The microscopic organisms, numbering in the billions, destroy bacteria by injecting their DNA or RNA into the bacteria to replicate and burst the cells open.

Although phage therapy is new to Mayo Clinic, the bacterial predators were discovered more than a century ago, predating antibiotics. Today, much of the basic science of phages remains to be discovered.

Related: The Use of Stem Cells in Orthopaedics

Dr. Suh oversaw the first phage treatment at Mayo Clinic in June 2019, when a 62-year-old man was facing potential amputation after multiple failed courses of antibiotics and surgery. The intravenous use of phage therapy was approved by the U.S. Food and Drug Administration on a compassionate-use basis.

"We started phage therapy as kind of a last-ditch effort to save his limb, and the patient responded beautifully," Dr. Suh says. "He has remained asymptomatic after completing treatment and he experienced no adverse effects."

The patient's infection involved a biofilm that formed on his knee-joint replacement device — a common complication among the millions of people worldwide who undergo life-enhancing joint replacements every year.

Study co-author Robin Patel, M.D., says biofilms are communities of bacteria held together in a slimelike substance and that growth in biofilms enables bacteria to evade the effects of many antibiotics.

"When bacteria grow as biofilms on surfaces, such as joint replacement devices, bacteria are difficult to eradicate because being in biofilm state makes them resistant to many of the antibiotics that would otherwise work against them," says Dr. Patel, director of Mayo Clinic's Infectious Diseases Research Laboratory.

Dr. Patel uses proteomic analysis to identify a patient's bacterium to begin the process of matching it with a phage.

"We then test a collection of phage against that particular patient's species of bacteria to determine which might work best," Dr. Patel says. "We're looking for the ability of phage to either kill or keep these bacteria from growing as a measure of activity."

She says as the world faces a growing public health threat from drug-resistant bacterial infections and that it is possible that phage therapy could save lives, but more study is needed.

"There have been several patients who have been treated with phage with promising outcomes, but as a scientist, a single case like ours, or even a collection of single cases, is not enough to prove that a therapy is active," Dr. Patel says.

The next step in the study is to expand the clinical use of phage therapy on prosthetic-joint infections of the hip and knee. Mayo Clinic is launching a two-year clinical trial later this year to continue to evaluate phage therapy in the treatment of infectious diseases.

Omdia considers the healthcare artificial intelligence (AI) market to be nascent because of its relatively small size compared to the total addressable market. Omdia estimated that in 2019, the global market for healthcare AI software was $823 million, making it the sixth-largest industry for AI revenue, but only a small fraction of the $16 billion total AI software market. Omdia forecasts that the healthcare AI software market will grow to over $10 billion in 2025. This drastic growth will be driven by the large size of the healthcare equipment market, which totalled $214 billion in 2019, and the great amount of investment available to the healthcare industry. Despite the great potential provided by the healthcare industry, the healthcare AI market remains mostly untapped as the technology is still in early stages of development and faces barriers, such as regulation, and many healthcare providers are unsure of the value of AI.

AI vendors have developed advanced AI algorithms that can be applied to healthcare devices, especially for medical imaging. Many major healthcare equipment manufacturers have partnered with these vendors to incorporate AI tools into product lines or have developed AI software tools in-house. Collaborations between healthcare providers, equipment manufacturers, and AI vendors will be crucial to ensuring that healthcare challenges are addressed. AI has the potential to help combat the growing problem of strained healthcare provision by helping healthcare practices deliver better patient outcomes with limited resources. These challenges have been exacerbated by the pandemic caused by coronavirus disease 2019 (COVID-19), making healthcare AI of the utmost importance.

Healthcare AI, especially for ultrasound, is developed in collaboration with end-users to solve real-world problems

Related: Artificial Intelligence in healthcare delivery

According to the Omdia Artificial Intelligence for Ultrasound Survey (AIUS) 2020, many healthcare practices rely on AI to address top-cited areas of improvement, including image quality and standardization, workflow efficiency, and diagnostic support. For example, algorithms assist in prioritizing and screening patients. Next, AI walks the ultrasound user through a scan and enhances the image, ensuring the acquisition of high quality and consistent scans that can be easily interpreted. Finally, AI identifies anatomy and anomalies on scans and makes measurements to help the reader interpret the scan. AI serves as a safeguard, ensuring that the radiologist does not miss any areas of concern on a scan, and as a second opinion, improving the radiologist’s confidence in their diagnosis.

Figure 1: AIUS results – Most important AI feature, Source: Omdia

Related: Using artificial intelligence in COVID-19 research

According to the AIUS, AI for ultrasound is versatile, with 60% of respondents’ practices using AI in multiple clinical applications. AI utilization in general imaging was the most frequently reported clinical application, but Omdia expects AI utilization in point-of-care (POC), cardiology, and nontraditional applications to increase during the next few years as image libraries grow enabling the development of more specialized algorithms. The development of AI at the edge and in POC settings will drive integrated and cloud-based AI deployment in addition to the use of AI with portable medical imaging equipment.

AI enables more efficient and effective diagnostics, which are crucial during the COVID-19 pandemic

As the virus continues to ravage healthcare systems around the world, healthcare providers are employing AI as an important tool to combat COVID-19. AI is being used to quickly screen and triage COVID-19 patients and identify symptoms on scans. This can help healthcare practices to limit the spread of the virus and quickly treat more patients. While many healthcare providers are utilizing preexisting AI, many AI vendors and equipment manufacturers have developed and continue to develop AI software, to aid in the identification and diagnosis of pulmonary and cardiovascular symptoms associated with COVID-19. The benefit and growing understanding of AI for COVID-19 is made clear by the accelerated development of software, increased funding, and easing of regulations.

To become commonplace, the value of healthcare AI must transcend to a broader audience

While in many cases the advantage of using a new technology is anecdotal, the benefit of AI is supported by several metrics tracked by healthcare administrators. According to the AIUS, 85% of respondents reported that AI saved their practice time, 69% reported that the use of AI saved their practice money, 82% cited improved diagnostics as a top driver for AI adoption, 74% of respondents reported that AI increased their practices’ utilization of ultrasound, and 49% reported that AI reduced the amount of training required for a technician to operate an ultrasound. These results are significant because they demonstrate that an overwhelming majority of respondents see measurable improvements following implementation.

Healthcare providers that have employed AI clearly understand the value of AI and this is reflected by usage rates. The AIUS identifies that 73% of respondents’ practices use an AI feature at least once a day, with 40% of respondents reporting hourly usage. This type of buy-in from the medical community is crucial to the widespread implementation of healthcare AI. AI vendors should continue to partner with equipment manufacturers, healthcare providers, and medical schools to identify key AI applications and to facilitate adoption.

Part II of the article focuses on why collaboration is key to the widespread adoption of AI for healthcare