Implementing AI at a nationwide scale, significantly in such crucial industries as healthcare, isn’t any simple feat.
Within the HIMSS24 APAC session, “Implementing AI-Powered Triage for a Nationwide Digital and Digital Entrance Door,” Dr Nirvana Luckraj, chief medical officer of Healthdirect, described how they selected, examined, and deployed an AI-powered medical resolution assist system to enhance its nationwide helpline companies.
Healthdirect affords a variety of free 24/7 helpline companies, together with nurse triage and GP telehealth. It has devoted strains for pregnant individuals, the aged, and most not too long ago, individuals coping with psychological well being issues. Moreover, Healthdirect supplies data on medicines and curated well being content material on their web site and options on-line reserving and referrals, which immediately combine with nationwide care pathways together with My Well being File.
THE PROBLEM
Buying a CDSS is a part of the actions Healthdirect took when it not too long ago migrated its know-how stack to its personal working platform.
It required the software to contemplate a number of signs on the outset. “We wanted a CDSS that would tolerate and analyse a number of signs. We additionally needed it to mirror actual session that thought of threat components reminiscent of predisposing components, continual historical past, and journey historical past.”
“We additionally needed one thing that was subsequent technology that would present a extra complete and correct triage,” Dr Luckraj added.
Beforehand, the service used a CDSS primarily based on a choice tree-type algorithm which required “in depth upkeep” and “may solely tolerate a single symptom enter.”
PROPOSAL
The organisation then went to the market to hunt a supplier of an AI-based CDSS. It initially shortlisted 5 world distributors whose choices have been subjected to medical testing.
To check the AI system’s applicability within the Australian public well being system, Healthdirect labored with AI specialists at Macquarie College’s Australian Institute of Well being Innovation. They adopted a take a look at methodology from a current examine that used case vignettes to test a CDSS’s accuracy.
“We ran these vignettes via the CDSS and located the efficiency was in line with the not too long ago printed examine. We additionally ran the identical vignette via our previous CDSS to check and located that the previous and new CDSS had related outcomes however that the brand new one was extra correct,” Dr Luckraj famous.
Finally, Healthdirect went with the Polish agency Infermedica’s AI CDSS, which runs on a probabilistic Bayesian inference engine that considers signs, threat components, and ailments, an up to date medical data base, and an API that connects to its CRM.
MEETING THE CHALLENGE
Instantly after launching the brand new CDSS on its helpline in March 2023, the implementing group encountered resistance from employees. “We had underestimated the change administration required when getting healthcare professionals to make use of new know-how to carry out previous duties,” Dr Luckraj admitted.
From inputting one symptom to the CDSS, their nurses now need to enter a number of signs of sufferers. “The nurses initially have been annoyed with the software as a result of it appeared to ask seemingly unrelated inquiries to the presentation of the affected person. Additionally they needed to decide their previous historical past to find out particular person threat components and the questions additionally appeared extra superior than the earlier.”
In coping with nurses’ preliminary frustration, the group took on their suggestions and assisted them in adapting to the brand new software. One of many key areas for enchancment right here, in line with Dr Luckraj, was working with their vendor on a suggestions loop mechanism the place nurses would not have to agree with each CDSS output.
“It is a assist system, not a diagnostic system. So the nurses can both improve or downgrade the triage consequence giving a motive for his or her change of disposition. We additionally checked out these flows the place the nurses disagree with the CDSS output to repeatedly enhance the software.”
RESULTS
A 12 months after enhancing the CDSS, the implementing group noticed that nurses are altering triage output much less and agreeing extra with the CDSS outcomes and that they’re extra happy with its new consumer interface. The software’s accuracy is continually enhancing, Dr Luckraj famous, as nurses additionally proceed to offer suggestions. On the patron facet, no critical medical incidents attributable to the CDSS have been reported; they’re now extra happy with the service, with satisfaction scores reaching the very best in three years.
In December final 12 months, the identical AI-powered CDSS was launched in Healthdirect’s consumer-facing on-line symptom checker, making it a “digital entrance door to quite a few different care choices, together with direct entry to pressing care companies and digital emergency departments.”
“Sooner or later, we’re additionally seeking to present customers with tailor-made data particular to their symptom enter to offer an excellent higher shopper expertise,” Dr Luckraj shared.
Since incorporating AI into their helpline, Healthdirect claims to divert half of emergency calls to much less acute companies. From July 2023 to June 2024, it related 44,000 calls to a digital emergency division. It additionally booked almost 5,500 individuals on-line for GP-led pressing care companies. In the meantime, nearly 350,000 individuals have been suggested on safely managing their signs at house. Total, Healthdirect nurses helped e book over 370,000 GP service appointments.