Baystate Health, the premier integrated health system serving more than 800,000 patients in western New England, announced a partnership with Life Image, the largest medical evidence network providing access to points of care and curated clinical and imaging data, to develop novel artificial intelligence tools that would help advance technical innovations in radiology, neurology and oncology.
Specifically, TechSpring, the innovation arm for Baystate, will work with Life Image to evaluate a number of AI solutions including those that promise to improve speed and accuracy in diagnosing blood clots in stroke patients; improve clinical pathways for physicians treating or diagnosing a patient by finding and comparing clinical criteria against a group of de-identified patients with similar clinical characteristics; and identify potential patient matches to oncology clinical trials in order to advance cancer research, as well as give western New England residents better access to potentially life-saving treatments.
Baystate and Life Image began working together 10 years ago when the health system became one of the company’s first customers. Life Image created the image exchange category when it developed solutions more than a decade ago to help solve the many technical and structural barriers that prevented the seamless exchange of medical images.
With its beginnings in image exchange, Life Image is now a global medical evidence network that offers ‘living’ datasets of novel imaging data that’s linkable to other clinical information and provides network access to points-of-care to enable improved care delivery, novel research and innovation.
By Janak Joshi, senior vice president, chief technology officer and head of strategy, Life Image.
In December 2018, the FDA announced its new framework for the real world evidence (RWE) program, which would require including imaging data alongside claims, electronic health records (EHRs) and other datasets in clinical research. In issuing this new framework, regulators underlined the continued importance of using contextualized, quality datasets to make drug development faster, safer, more efficient and less expensive.
Because of this move to include authentic patient data in the drug development process, imaging data has become an essential part of RWE as it can accelerate the development cycle and improve the confidence in the final clinical arguments in support of drugs going to market.
Imaging data plays such a leading role in clinical decision-making because it is the most advanced diagnostic evidence for several diseases, and it can clearly show disease progression and drug impact across a variety of therapeutic areas, among other reasons. While EHRs and medical claims are the predominate sources of data, because they were initially designed for billing and payment purposes they do not have the depth and breadth needed to accurately capture the nuances of a patient’s full clinical history – nor do they contain imaging information.
Clinical researchers looking to achieve a holistic view of each patient’s healthcare journey by incorporating medical imaging into their RWE programs should avoid these three things.
Institutional bias stems from using data from a single health system, which tends to follow a uniform set of treatment protocols, leading to homogenous evidence data. A diverse dataset includes variation, for instance in geography, which can influence socioeconomic and environmental factors, level of education, healthcare access, payer mix and demographics.
The most effective RWE incorporates medical data, including imaging, from varied populations that include both research and non-research settings, AMCs and community hospitals, publicly and privately funded institutions, and a mix of highly insured and uninsured patients. The ultimate goal of RWE is to be representative of any and all patients across the globe.
A limited, siloed data pool
Small datasets do not accurately reflect the “real world,” therefore RWE requires very large databases with various datasets in order to ensure data integrity and credibly match patients to appropriate clinical trials. This poses a challenge since much of today’s data is siloed. To make RWE representative of outcomes and context, clinical researchers must break down siloes to achieve a large, interoperable pool of quality data from a breadth of sources, which they can normalize and match across sets for optimal results.
Take, for example, a new drug trial that needs to involve 500 individuals meeting specific real-world data standards. For each participant, researchers may require four years of prescription details, four years of imaging data, five years of blood test results, as well as genomics and other relevant data. However, consider that over the years many of these patients likely went to various pharmacies, switched health plans and/or providers, and had imaging and blood tests performed at various facilities or out-of-network sites. As a result, each patient’s information may be spread out over multiple EHR systems and may even be in non-digital, fax or CD formats.
Life Image and swyMed announce a new strategic partnership to enhance telestroke capabilities. This engagement will improve the ability for physicians to collaborate and coordinate care while using swyMed’s offering by seamlessly integrating relevant clinical and imaging data into the telemedicine encounter. The agreement also deepens swyMed’s ability to connect to neurologists and primary stroke centers, which are already part of the Life Image network. Life Image is currently supporting more than 140 stroke centers within its U.S. network.
This new partnership will advance swyMed’s telestroke solution by combining the exceptional bandwidth management capabilities in its videoconferencing platforms, which are highly beneficial for rural area hospitals, with access to all relevant medical records, diagnostic imaging, and other critical clinical data.
This data is made available through the Life Image clinical image exchange, which is integrated into the workflows of 80 percent of all large health systems and academic medical centers in the U.S. The engagement will also provide Life Image hospital customers with a value-added telestroke solution as part of the Life Image Interoperability Suite, to extend neurology departments’ reach beyond the walls of the organization and deliver timely, high-quality care for patients affected by stroke.
“Despite widespread knowledge that every moment counts when it comes to treating acute ischemic stroke, a majority of stroke patients do not receive adequate treatment in time due to lack of access to primary stroke centers and appropriate specialists,” said Evie Jennes, CCO, swyMed. “We have dedicated extensive efforts to innovating solutions to overcome these challenges and optimize outcomes among stoke patients. By engaging with Life Image, we can now provide immediate access to imaging and clinical data to speed up diagnosis and treatment, as well as connect swyMed users to premier neurology centers and leading research facilities through Life Image’s extensive provider network.”
There are several access-related challenges associated with acute stroke treatment, which are further compounded by the fact that diagnosis and treatment are incredibly time-sensitive and require a specialist. Unfortunately, research shows a severe lack of stroke specialists in the U.S.: only 55 percent of Americans reside within 60 miles of a primary stroke center, and there are only an estimated 1,100 neurologists specializing in stroke nationwide.
This new strategic partnership between swyMed and Life Image will address these data access and specialist shortage issues by offering immediate connectivity, even in the most bandwidth-challenged areas, to stroke specialists across the U.S., and integrating all relevant medical data into the telemedicine encounter to allow diagnosis and treatment to begin before the patient arrives at the hospital.
“Providers have long struggled with interoperability and data-integration issues across systems and locations, and these issues come to a head when caring for a stroke patient. Paramedics and emergency room doctors especially need to immediately reach stroke specialists and provide them with the patient’s neurological exam and other imaging and clinical data in order to achieve the best-possible outcome for the patient,” said Matthew A. Michela, president and CEO, Life Image.
“We see this partnership with swyMed as an important opportunity to advance the clinical practice of telestroke. Whether it’s a rural hospital with poor bandwidth or a hospital without stroke specialists, this new engagement will benefit all providers dealing with stroke management by uniting swyMed’s cutting-edge telemedicine platform with our powerful global network of data and integration into thousands of provider workflows nationwide.”
Life Image’s interoperable solution, which integrates into existing workflows, orchestrates the flow of more than 10 million clinical encounters per month. The network connects 1,500 U.S. facilities, 8,000 affiliated sites, 150,000 U.S. providers and 58,000 global clinics with a broader ecosystem of patients, life sciences, medical device companies and telemedicine companies.