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Computer-assisted AI diagnosis aims to reduce colorectal cancer at Hoag


Hoag a nonprofit, regional health system based in Orange County, California, that treats more than 30,000 inpatients and 460,000 outpatients annually. Hoag consists of two acute care hospitals – Hoag Hospital Newport Beach and Hoag Hospital Irvine – in addition to 10 health centers and 14 emergency care centers.

THE PROBLEM

Colorectal cancer represents the third most common cancer in the United States. It is also the third most common cause of cancer -related death in the United States.

There are many factors involved in trying to address the issue of reducing the incidence and complications of colorectal cancer. These factors can be broad categories of community or population health and system health. The latter can be further subcategorized where there is always a quality issue. And tthe quality of health care continues to improve.

“One of the tools to improve healthcare in general is technology,” said Dr. Paul Lee, chief of services for the GI lab at Hoag. “We know that a colonoscopy is an important procedure to help prevent colorectal cancer. Colonoscopies can help prevent colon cancer by identifying precancerous polyps and removing them during the procedure.

“It has been reported that these precancerous polyps are sometimes missed by the doctor,” he continues. “We call it the miss rate. There are a lot of reasons involved in why these polyps don’t exist – some patient -centered, doctor -centered and technology -centered.”

PROPOSAL

Health technology vendor GI Genius suggested Hoag upgrade later.

“From a different perspective, a surrogate marker for the quality of the doctor performing the colonoscopy is the adenoma detection rate (ADR),” Lee explains. “One of the performance targets set for screening colonoscopies, that is, colonoscopies in otherwise asymptomatic patients, is a 25% ADR in a mixed gender population or 20% ADR for women or 30% for men.

“The role of computer-assisted diagnosis is a future technology that will only improve.”

Paul Lee, Hoag

“The technological aspect of colonoscopy has undergone many advances,” he added. “These advances focus on the instrument itself. It comes from a strict scope, to the use of fiber optics, to high-definition resolution, to narrow-band imaging, and so on.”

GI Genius incorporates artificial intelligence to help the doctor identify lesions using millions of different pre-programmed algorithms. In addition, it uses pattern recognition to release lesions that the computer considers suspicious.

It is still up to the doctor to determine if what is known is a matter of concern.

“By using this technology, it should reduce the miss rate or increase ADR,” Lee said. “In some reports, ADR increased by 14%. By increasing ADR 1%, it is estimated that this translates into a reduction in colorectal cancer by 3%.

REACHING THE CHALLENGE

Hoag brought the technology to the GI lab. It will work for any gastroenterologist who can use their colonoscopies, regardless of the indication.

Hospital outpatient colonoscopies are usually reserved for patients who have a higher periprocedural risk or have more comorbidities that may be allowed in an outpatient surgery center. In the hospital context, staff care for the inpatient and outpatient.

“Obviously, patients are admitted for specific reasons and colonoscopies for these instances are not the screening procedures for which the technology was originally intended,” Lee explains. “However, I have found in these instances, GI Genius is useful in identifying pre-cancerous polyps and helping the physician accomplish objectives outside of the screening colonoscopy indication.”

RESULTS

Hoag recently implemented AI technology and no data has yet to be reported. However, anecdotally, Lee said the technology has been adopted and used by many doctors who go to the hospital’s GI lab.

ADVICE FOR OTHERS

“The role of computer-assisted diagnosis is an up-and-coming technology that is only getting better,” Lee said. “The question is not how it will help, but how and when it can be used. One of the big barriers is how to value the available technology and how it translates into quality and cost.

“To the best of my knowledge, the fee for increasing the quality of a colonoscopy does not increase the fee for such a procedure,” he concluded. “This unequal consequence is unsustainable and must be addressed by all parties involved.”

Twitter: @SiwickiHealthIT
Email the author: bsiwicki@himss.org
Healthcare IT News is a publication of HIMSS Media.





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