AI critical care software revolutionizes emergency response
Artificial intelligence (AI) is revolutionizing how critical care teams are responding to stroke, pulmonary embolism, aortic artery aneurism (AAA) and other acute conditions by offering immediate access to imaging, patient information and communication with team members. Several vendors now have FDA-cleared AI that can independently monitor images coming from CT scanners, identify these conditions and alert all the care team members on the smartphones. The alerts notify the physicians about a suspected emergent case with links to the patient information and immediate access to the CT scan images. This happens before the images reach the PACS or a radiologist, which is designed to speed the care team activation process.
Though these AI algorithms were originally aimed at helping better identify critical cases and alerting radiologists they need to do an immediate STAT read, the AI has seen a much biggest reception from critical care teams for stroke and pulmonary embolism (PE).
"This technology was initially integrated for stroke detection within our health system and has now been expanded to include pulmonary embolism. Its implementation has been revolutionary, allowing us to make timely decisions and avoid missing critical cases," explained Peter Monteleone, MD, an interventional cardiologist, director of the interventional cardiology fellowship program at Ascension Texas Cardiovascular, national director of cardiovascular research at Ascension Health, assistant professor, UT Austin Dell School of Medicine, and a member of the Pulmonary Embolism Response Team (PERT) at his hospital.
He said the instant communication ensures that team members are informed and can coordinate their response without delay, many times before the emergency department officially alerts them.
Monteleone detailed the efficiency gains as follows: "We can now discuss potential high-risk PE cases among the PERT team before the primary care providers are even aware. This proactive approach allows us to intervene sooner, which is crucial given the busy nature of emergency rooms today."
The technology also plays a pivotal role in clinical trials, enhancing Ascension Health's research capabilities. "Our research coordinators can screen every incoming PE case for eligibility in clinical trials, significantly improving our ability to study and advance treatment options," Monteleone said.
The criteria for determining emergent treatment have also been refined. High-risk cases are quickly identified based on physiological and hemodynamic changes, such as low blood pressure or tachycardia, which may necessitate immediate interventions like systemic IV thrombolytic medications or mechanical thrombectomy. The AI system also assists by an automated evaluation of right ventricular strain through imaging and presenting the measurements and imaging showing how the measurements were made. Monteleone said this information can quickly impact the direction of care they provide, with significant strain indicating the need for more aggressive interventional therapy.
Critical care teams are embracing the technology because it combines 24/7 automated surveillance, a first pass radiology read to triage patients for the teams and for radiology reading lists, sends alerts, links all the relevant patient data and imaging, and also provides a messaging platform for care teams. This all boosts efficiency and helps reduce the time to treatment.
This technology is offered through vendors such as Viz.AI, Aidoc and RapidAI. Monteleone said they adopted RapidAI for their PERT because it was already in use at the hospital for stroke and the neuro interventionalists said it was extremely helpful.
"RapidAI's diagnostic capabilities embedded in our CT scanners allow for real-time assessment and decision-making across multiple hospitals in our system. This connectivity and the ability to provide expert input remotely have been game-changing," Monteleone added.
The Ascension PERT uses a hub and spoke system where PERT members at larger hospitals can help smaller hospitals with less resources address a series PE case they are alerted about. This may include sending an ECMO team to that hospital to support the patient, or transferring the patient to a center where they can receive more urgent catheter based therapies.
The success of this AI integration underscores the potential for widespread adoption and the standardization of advanced care practices. He said PE care is moving to a PERT team approach at most health systems to enable faster response and better outcomes for patients. Monteleone emphasized the importance of enthusiasm and leadership in implementing such programs.
"We no longer need an extensive network of subspecialties to provide top-tier care. With champions of the program and the right technology, we can elevate care standards universally," Monteleone explained. "There's going to be this elevation of care where it's no longer an ivory tower that cares for PE, it's the base expectation that these tools are available everywhere."
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com