PACS remains an indispensable tool for viewing and interpreting imaging results, but leading health care providers are now beginning to move beyond PACS. The new paradigm brings data from multiple medical specialties together into a single platform, with a single user interface that strives to provide a holistic understanding of the patient and facilitate clinical reporting. By connecting data from multiple specialties and enabling secure and efficient access to relevant patient data, advanced information technology platforms can enhance patient care, simplify workflows for clinicians, and reduce costs for health care organizations. This organizes data around patients, rather than clinical departments.
Meeting patient expectations
Health care providers generate an enormous volume of data. Today, nearly one-third of the world’s data volume is generated by the health care industry. The growth in health care data outpaces media and entertainment, whose data is expanding at a 25% compound annual growth rate ,compared to the 36% rate for health care data. This makes the need for a comprehensive health care data management systems increasingly urgent.
The volume of health care industry data is only part of the challenge. Different data types stored in different formats create an additional hurdle to the efficient storage, retrieval, and sharing of clinically important patient data.
PACS was designed to view and store data in the Digital Imaging and Communications in Medicine (DICOM) standard, and a process known as “DICOM-wrapping” is used for PACS to provide access to patient information stored in PDF, MP4, and other file formats. In addition to adding additional steps that impede efficient workflow, DICOM-wrapping makes it difficult for clinicians to work with a file in its native format. PACS users are given what is essentially a screen shot of an Excel file, which makes it impossible to use the data analysis features in the Excel software.
With an open image and data management (IDM) system coupled with an intuitive reading and reporting workspace, patient data can be consolidated in one location instead of in multiple data silos, providing clinicians with the information they need to provide the highest level of patient-centered care. In a 2017 survey by health insurance company Humana, its patients said they aren’t interested in the details of health care IT, but are nearly unanimous when it comes to their expectations, with 97% of patients saying that their health care providers should have access to their complete medical history.
Adapting to clinical needs
To meet patient expectations and needs, health care IT seeks to meet the needs of health care providers and systems by offering flexibility—both in its initial setup and in its capacity to scale to meet evolving organizational demands.
A modular architecture enables health care providers and systems to tailor their system to their specific needs. Depending on clinical needs, health care providers can integrate specialist applications for reading and reporting, AI-powered functionalities, advanced visualization, and third-party tools. The best systems are scalable, so that they can grow as an organization grows, with the ability to flexibly scale hardware by expanding the number of servers and storage capacity.
A simple, unified UI enables a quick learning curve across the organization, while the adoption of a single enterprise system helps reduce IT costs by enabling the consolidation and integration of previously distinct systems. Through password-protected data transfers, these systems can also facilitate communication with patients.
A new training model, dubbed “KnowNo,” aims to address this problem by teaching robots to ask for our help when orders are unclear. At the same time, it ensures they seek clarification only when necessary, minimizing needless back-and-forth. The result is a smart assistant that tries to make sure it understands what you want without bothering you too much.
Andy Zeng, a research scientist at Google DeepMind who helped develop the new technique, says that while robots can be powerful in many specific scenarios, they are often bad at generalized tasks that require common sense.
For example, when asked to bring you a Coke, the robot needs to first understand that it needs to go into the kitchen, look for the refrigerator, and open the fridge door. Conventionally, these smaller substeps had to be manually programmed, because otherwise the robot would not know that people usually keep their drinks in the kitchen.
That’s something large language models (LLMs) could help to fix, because they have a lot of common-sense knowledge baked in, says Zeng.
Now when the robot is asked to bring a Coke, an LLM, which has a generalized understanding of the world, can generate a step-by-step guide for the robot to follow.
The problem with LLMs, though, is that there’s no way to guarantee that their instructions are possible for the robot to execute. Maybe the person doesn’t have a refrigerator in the kitchen, or the fridge door handle is broken. In these situations, robots need to ask humans for help.
KnowNo makes that possible by combining large language models with statistical tools that quantify confidence levels.
When given an ambiguous instruction like “Put the bowl in the microwave,” KnowNo first generates multiple possible next actions using the language model. Then it creates a confidence score predicting the likelihood that each potential choice is the best one.
The news: A new robot training model, dubbed “KnowNo,” aims to teach robots to ask for our help when orders are unclear. At the same time, it ensures they seek clarification only when necessary, minimizing needless back-and-forth. The result is a smart assistant that tries to make sure it understands what you want without bothering you too much.
Why it matters: While robots can be powerful in many specific scenarios, they are often bad at generalized tasks that require common sense. That’s something large language models could help to fix, because they have a lot of common-sense knowledge baked in. Read the full story.
—June Kim
Medical microrobots that travel inside the body are (still) on their way
The human body is a labyrinth of vessels and tubing, full of barriers that are difficult to break through. That poses a serious hurdle for doctors. Illness is often caused by problems that are hard to visualize and difficult to access. But imagine if we could deploy armies of tiny robots into the body to do the job for us. They could break up hard-to-reach clots, deliver drugs to even the most inaccessible tumors, and even help guide embryos toward implantation.
We’ve been hearing about the use of tiny robots in medicine for years, maybe even decades. And they’re still not here. But experts are adamant that medical microbots are finally coming, and that they could be a game changer for a number of serious diseases. Read the full story.
We haven’t always been right (RIP, Baxter), but we’ve often been early to spot important areas of progress (we put natural-language processing on our very first list in 2001; today this technology underpins large language models and generative AI tools like ChatGPT).
Every year, our reporters and editors nominate technologies that they think deserve a spot, and we spend weeks debating which ones should make the cut. Here are some of the technologies we didn’t pick this time—and why we’ve left them off, for now.
New drugs for Alzheimer’s disease
Alzmeiher’s patients have long lacked treatment options. Several new drugs have now been proved to slow cognitive decline, albeit modestly, by clearing out harmful plaques in the brain. In July, the FDA approved Leqembi by Eisai and Biogen, and Eli Lilly’s donanemab could soon be next. But the drugs come with serious side effects, including brain swelling and bleeding, which can be fatal in some cases. Plus, they’re hard to administer—patients receive doses via an IV and must receive regular MRIs to check for brain swelling. These drawbacks gave us pause.
Sustainable aviation fuel
Alternative jet fuels made from cooking oil, leftover animal fats, or agricultural waste could reduce emissions from flying. They have been in development for years, and scientists are making steady progress, with several recent demonstration flights. But production and use will need to ramp up significantly for these fuels to make a meaningful climate impact. While they do look promising, there wasn’t a key moment or “breakthrough” that merited a spot for sustainable aviation fuels on this year’s list.
Solar geoengineering
One way to counteract global warming could be to release particles into the stratosphere that reflect the sun’s energy and cool the planet. That idea is highly controversial within the scientific community, but a few researchers and companies have begun exploring whether it’s possible by launching a series of small-scale high-flying tests. One such launch prompted Mexico to ban solar geoengineering experiments earlier this year. It’s not really clear where geoengineering will go from here or whether these early efforts will stall out. Amid that uncertainty, we decided to hold off for now.
