AI in Healthcare

INTRODUCTION

The development of Artificial Intelligence (AI) in healthcare has been a long road with many

significant obstacles that at the same time present opportunities for biomedical engineers and

medical physicists to assume leadership roles in the implementation of

AI in healthcare. Artificial Intelligence or AI- Refers to the simulation of human intelligence in

machines that are programmed to think like humans and mimic their actions.

Biomedical-Is the application of engineering principles and design concepts to medicine and

biology concepts for healthcare purposes.

Artificial Intelligence (AI) in biomedical-

Its usage of software and complex structure of algorithms to mirror human intelligence in the

analysis of composite medical data. Specifically, Artificial Intelligence is the capability for

computer algorithms to estimate results without direct human interaction.

Since the first introduction of the concept in 1955, artificial intelligence (AI) has been a

“Moving target” that always covered the most modern computing techniques aimed at achieving

things that were previously the exclusive task of humans. What distinguishes AI technology

from traditional technologies in health care is the ability to gain information, process it and give

a welldefined output to the end-user. All of these advances open questions about how such

capabilities can support, or even enhance, human decision making in health and healthcare.AI

does this through machine learning algorithms and deep learning.

The primary aim of health-related AI applications is to analyze relationships between prevention

or treatment techniques and patient outcomes. The system deals with medical data and

knowledge domain in diagnosing patients conditions as well as recommending suitable

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treatments for the particular patients. Major disease areas that use AI tools include cancer,

neurology and cardiology.

The system serves to improve the quality of medical decision making, increase patients'

compliance. AI in techniques in medical applications could reduce the cost, time, human

expertise and error. Due to the rapid development of AI software and hardware technologies, AI

has been applied in various technical fields mainly in biomedical. This progress provides new

opportunities and challenges as wells as directions for the future of AI in biomedical.

The purpose of Artificial Intelligence is to make computers more useful in solving problematic

healthcare challenges and by using computers we can interpret data which is obtained by

diagnosis of various chronic diseases like Alzheimer, Diabetes, Cardiovascular diseases, and

various types of cancers like breast cancer, colon cancer etc. It helps in early detection of various

chronic diseases which reduces economic burden and severity of disease. Even to review the

current state of AI in health, along with opportunities, challenges and practical implications.

Need of AI

● Computers are fundamentally well suited to performing mechanical computations using fixed

programmed rules.

● Artificial machines perform simple monotonous tasks efficiently and reliably, which humans are

ill-suited to.

● For more complex problems, things get more difficult. Unlike humans, computers have trouble

understanding specific situations, and adapting to new situations.

● Artificial Intelligence aims to improve machines' behaviour in tackling such complex tasks.

● Humans have an interesting approach to problem solving, based on abstract thought, high-level

deliberative reasoning and pattern recognition.

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● AI research is allowing us to understand our intelligent behaviour.

● Artificial Intelligence can help us understand this process by recreating it, then capability

enabling us to enhance it beyond our current capabilities.

Potential of AI

AI has been around for decades and its promise to revolutionize our lives has been frequently

raised, with many of the promises remaining unfulfilled. Fueled by the growth of capabilities in

computational hardware and associated algorithm development, as well as some degree of hype,

AI research programs have ebbed and flowed. The JASON 2017 report gives this history and

also comments on the current AI revolution stating: “Starting around 2010, the field of AI has

been jolted by the broad and unforeseen successes of a specific, decades-old technology: multi-

layer neural networks (NNs). This phasechange reenergizing of a particular area of AI is the

result of two evolutionary developments that together crossed a qualitative threshold: (i) fast

hardware Graphics Processor Units (GPUs) allowing the training of much larger—and especially

deeper (i.e., more layers)—networks, and (ii) large labeled data sets (images, web queries, social

networks, etc.) that could be used as training testbeds.

This combination has given rise to the “data-driven paradigm” of Deep Learning (DL) on deep

neural networks (DNNs), especially with an architecture termed Convolutional Neural

Networks (CNNs).” Is the current era just another hype cycle? Or are things different this time

that would make people receptive to embracing the promise of AI applications in health and

health care? AI is largely exciting to computational sciences researchers throughout academia

and industry. Perhaps previously the revolutionary advances in AI had no obvious way to touch

the lives of individuals.

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EVOLUTION OF AI IN HEALTHCARE

Among the many technology changes over the last decade we have seen the substantial growth of

data analytics for handling,processing,and gainfully using large amounts of data.However,since

data analytics can only work with historical data and give outcomes as predefined by humans,

specific rule based algorithms were developed to augment data analytics,thereby imparting the

self-learning capability to computer, which is now referred to as “Machine Learning”.Machine

Learning did not require the computers to be explicitly programmed,which is a definitive

advantage.Machine learning was then combined with data analytics to analyze data and develop

complex algorithms to predict models,which was named as predictive analytics.

The evolution of AIS and its application has a vast spectrum in healthcare. The most important

reason is that there is non-availability of trained manpower in both medical and para-medical

fields. While Doctors, Nurses, Physiotherapists, dieticians and Lab/Imaging Technicians are the

front-end clinical staff, back-end human resources like Medical records technicians, billing staff,

Administrative staff, maintenance staff, marketing staff, Finance/accounting staff, IT staff, etc.

How can all these be replaced by AIS?

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Let's take the work of doctors and nurses. AIS can have algorithms for arriving at a differential

diagnosis based on symptoms and further also advise investigations based on another set of

algorithms to arrive at a probable diagnosis. It is not a pure science; hence two plus two will not

make four. Not all diseases can be diagnosed on AIS based algorithms and even treatments will

differ based on individual genetic makeup. Example- patients may have allergic reactions to

certain drugs and react differently to the same set of "factory based AIS output of treatments.

There is this famous saying, medicine is almost the same, the rest is in the mind!! The emotional

and human touch of compassion of a nurse or a doctor cannot be replaced ever by AIS based

treatment modalities. The care taken by a nurse cannot be replaced by AIS.

The idea behind AIS in medicine is not so much to replace the but to enhance the doctor’s

medical expertise. A.I. programs take the amassed knowledge that every good physician has

which is the product of everything she learned in medical school and in training as well as her

experience in treating patient after patient and scale it to unprecedented levels. Why should

patients have access to just one particular doctor’s expertise when it’s now possible to provide

them with the brainpower of hundreds of thousands? Why should patients in rural areas who live

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geographically far from the nation’s leading medical centers be deprived of all the up-todate

knowledge housed there? The way artificial intelligence starts to really impact what’s going on in

health care is to be able to start cloning all the expert knowledge, so now all of a sudden you get

access to all types of care, anywhere.

And with the amount of data available to physicians today—from information about disease

symptoms to new drugs, interactions between different drugs and how different people treated in

the same way can have very different outcomes—the ability to access and digest information is

fast becoming a required skill. And it’s one that machine learning is uniquely designed to master.

Doctors are realizing that if they want to make sense of massive amounts of data, machine

learning is a way of allowing them to learn from that data.

In cancer care the application of AIS is tremendous. For human doctors to digest all this

information on cancers would be nearly impossible, given the demands on physicians’ time to

see patients and keep up to date on the latest advances in their field. The potential benefit of

having an AIS “doctor” on call at every cancer hospital, no matter how small, can’t be

overstated. People with rarer cancers have more confidence, since they now have the institutional

knowledge of leading experts in their field at their disposal.

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KEY TECHNOLOGIES

MACHINE LEARNING:

The value of machine learning in healthcare is its ability to process huge data sets beyond the

scope of human capability, and then reliably convert analysis of that data into clinical insights

that aid physicians in planning and providing care, ultimately leading to better outcomes, lower

costs of care, and increased patient satisfaction.

Applied Machine Learning in Healthcare

Machine learning in medicine has recently made headlines. Google has developed a machine

learning algorithm to help identify cancerous tumors on mammograms. Stanford is using a deep

learning algorithm to identify skin cancer. A recent JAMA article reported the results of a deep

machine-learning algorithm that was able to diagnose diabetic retinopathy in retinal images. It’s

clear that machine learning puts another arrow in the quiver of clinical decision making.Still,

machine learning lends itself to some processes better than others.

Algorithms can provide immediate benefit to disciplines with processes that are reproducible or

standardized. Also, those with large image datasets, such as radiology, cardiology, and pathology,

are strong candidates. Machine learning can be trained to look at images, identify abnormalities,

and point to areas that need attention, thus improving the accuracy of all these processes. Long

term, machine learning will benefit the family practitioner or internist at the bedside. Machine

learning can offer an objective opinion to improve efficiency, reliability, and accuracy.

The Ethics of Using Algorithms in Healthcare

It’s been said before that the best machine learning tool in healthcare is the doctor’s brain. Could

there be a tendency for physicians to view machine learning as an unwanted second opinion? At

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one point, autoworkers feared that robotics would eliminate their jobs. Similarly, there may be

physicians who fear that machine learning is the beginning of a process that could render them

obsolete. But it’s the art of medicine that can never be replaced. Patients will always need the

human touch, and the caring and compassionate relationship with the people who deliver care.

Neither machine learning, nor any other future technologies in medicine, will eliminate this, but

will become tools that clinicians use to improve ongoing care.The focus should be on how to

use machine learning to augment patient care. For example, if I’m testing a patient for cancer,

then

I want the highest-quality biopsy results I can possibly get. A machine learning algorithm that can

review the pathology slides and assist the pathologist with a diagnosis, is valuable. If I can get

the results in a fraction of the time with an identical degree of accuracy, then, ultimately, this is

going to improve patient care and satisfaction.

DEEP LEARNING:

Deep learning (also known as deep structured learning) is part of a broader family of machine

learning methods based on artificial neural networks with representation learning. Learning can

be supervised, semi-supervised or unsupervised.

Deep learning is an artificial intelligence (AI) function that imitates the workings of the human

brain in processing data and creating patterns for use in decision making. Deep learning is a

subset of machine learning in artificial intelligence that has networks capable of learning

unsupervised from data that is unstructured or unlabeled. Also known as deep neural learning or

deep neural network.

Deep learning provides the healthcare industry with the ability to analyze data at exceptional

speeds without compromising on accuracy. It’s not machine learning, nor is it AI, it’s an elegant

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blend of both that uses a layered algorithmic architecture to sift through data at an astonishing

rate. The benefits of deep learning in healthcare are plentiful – fast, efficient, accurate – but they

don’t stop there. Even more benefits lie within the neural networks formed by multiple layers of

AI and ML and their ability to learn. Yes, the secret to deep learning’s success is in the name –

learning.

Deep learning uses mathematical models that are designed to operate a lot like the human brain.

The multiple layers of network and technology allow for computing capability that’s

unprecedented, and the ability to sift through vast quantities of data that would previously have

been lost, forgotten or missed. These deep learning networks can solve complex problems and

tease out strands of insight from reams of data that abound within the healthcare profession. It’s a

skillset that hasn’t gone unnoticed by the healthcare profession.

Deep learning in healthcare has already left its mark. Google has spent a significant amount of

time examining how deep learning models can be used to make predictions around hospitalized

patients, supporting clinicians in managing patient data and outcomes.

Deep learning in healthcare has already been seen in medical imaging solutions, chatbots that can

identify patterns in patient symptoms, deep learning algorithms that can identify specific types of

cancer, and imaging solutions that use deep learning to identify rare diseases or specific types of

pathology. Deep learning has been playing a fundamental role in providing medical professionals

with insights that allow them to identify issues early on, thereby delivering far more personalized

and relevant patient care.

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CURRENT USE CASES OF AI WITHIN BIOMEDICAL

● Medical Imaging-

Medical imaging refers to techniques and processes used to create images of various parts of the

human body for diagnostic and treatment purposes within digital health. Imaging seeks to reveal

internal structures hidden by skin and bones. Medical imaging equipment are manufactured using

technology from the semiconductor industry. They include CMOS integrated circuit chips and

power semiconductor devices.

Medical image analysis involves measurements in medical images, i.e., the extraction of relevant

quantitative information from the images. Manual measurements by human experts in large 3D

medical imaging datasets (in particular by radiologists in clinical practice) are not only tedious

and time-consuming and thus impractical in clinical routine, but also subject to significant intra-

and inter-observer variability, which undermines the significance of the clinical findings derived

from them. There is, therefore, great need for more efficient, reliable, and well-validated

automated or semiautomated methods for medical image analysis to enable computer-aided

image interpretation in routine clinical practice in a large number of applications. Which

information needs to be quantified from the images is of course highly application specific.

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While many applications in computer vision involve the detection or recognition of an object in

an image,whereby the precise geometry of the objects is often not relevant (e.g., image

classification, object recognition) or may be known a priori (e.g.machine vision), medical image

analysis often concerns the quantification of specific geometric features of the objects of interest

(e.g., their position, extent, size, volume, shape, symmetry, etc.),the assessment of anatomical

changes over time(e.g., organ motion, tissue deformation, growth,lesion evolution, atrophy,

aging, etc.), or the detection and characterization of morphological variation between subjects

(e.g., normal versus abnormal development, genotype related variability, pathology, etc.). The

analysis of 3D shape and shape variability of anatomical objects in images is thus a fundamental

problem in medical image analysis. Apart from morphometry, quantification of local or regional

contrast or contrast differences is of interest in many applications, in particular in functional

imaging, such as fMRI,PET, or MR diffusion and perfusion imaging. Within the wide variety of

medical imaging applications, most image analysis problems involve a combination of the

following basic tasks:

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1. Image Segmentation

Image segmentation involves the detection of the objects of interest in the image and defining

their boundaries, i.e., discriminating between the image voxels that belong to a particular object

and those that do not belong to the object. Image segmentation is a prerequisite for quantification

of the geometric properties of the object, in particular its volume or shape. Image segmentation

can be performed in different ways: boundary wise by delineating the contour or surface of the

object in one (2D) or multiple (3D) image slices; region-wise by grouping voxels that are likely

to belong to the same object into one or multiple regions; or voxel-wise by assigning each voxel

in the image as belonging to a particular object, tissue class, or background. Class labels assigned

to a voxel can be probabilistic, resulting in a soft or fuzzy segmentation of the image.Accurate

3D segmentation of complex shaped objects in medical images is usually complicated by the

limited resolution of the images (leading to loss of detail and contrast due to partial volume

artifacts) and by the fact that the resolution is often not isotropic (mostly multi-slice 2D instead

of truly 3D acquisitions). Hence, interpolation is usually needed to fill in the missing information

in the data. In clinical practice, precise 3D measurements (e.g., volumetry) may be too tedious

and timeconsuming, such that often a simplified, approximate 2D or 1D analysis is used instead

(e.g., for estimation of lesion size).

2. Image Registration

Image registration involves determining the spatial relationship between different images,

i.e.establishing spatial correspondences between images or image matching, in particular based

on the image content itself. Different images acquired at different time points (e.g., before and

after treatment), or with different modalities(e.g., CT, MRI, PET brain images), or even from

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different subjects (e.g., diseased versus healthy)often contain complementary information that

has to be fused and analyzed jointly, preferably at the voxel level to make use of the full

resolution of the images. Image registration is needed to compensate for a priori unknown

differences in patient positioning in the scanner, for organ or tissue deformations between

different time points, or for anatomical variation between subjects. After proper registration, the

images can be resampled onto a common geometric space and fused, i.e., spatially corresponding

voxels can be precisely overlaid, which drastically facilitates the joint analysis of the images. In

some cases,when deformations are ignorable, the registration solution can be represented as an

affine transformation matrix with a small number of parameters, but in general a more complex

transformation in the form of a locally flexible deformation field is needed to accommodate for

non-rigid distortions between the images.

3.Image Visualization

The information that is extracted from the imagesideally needs to be presented in the most

optimal way to support diagnosis and therapy planning,i.e., such that the correct interpretation by

the user of all relevant image data is maximally facilitated for a specific application. For 3D

medical images, 2D multi-planar visualization is not well suited to assess structural relationships

within and between objects in 3D, for which true 3D visualization approaches are to be preferred.

To this end, either surface rendering or volume rendering can be applied. Surface rendering

assumes that a 3D segmentation of the objects of interest is available and renders these within a

3D scene under specified lighting conditions by assigning material properties to each surface or

surface element that specify its specular and diffuse light reflection,transmission, scattering, etc.

Volume rendering instead renders the image voxels directly by specifying suitable transfer

functions that assign each voxel a color and opacity depending on their intensity. While in

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principle volume rendering does not require a prior segmentation of the objects of interest, in

practice a prior segmentation of the image is often applied such that the transfer functions can be

made spatially dependent and object specific, which allows to discriminate between voxels with

similar intensity belonging to different objects. In clinical applications such as image-based

surgery planning or image-guided intraoperative navigation, additional tools need to be provided

to manipulate the objects in the 3D scene to add virtual objects to the scene or to fuse the virtual

reality scene with real-world images. While such augmented reality techniques can improve the

integrated presentation of all available information during an intervention their introduction in

clinical practice is far from trivial.

Image segmentation, registration, and visualization should not be seen as separate subproblems

in medical image analysis that can be addressed independently, each using a specific set of

strategies. On the contrary, they are usually intertwined and an optimal solution for a particular

image analysis problem can only be achieved by considering segmentation,registration, and

visualization jointly.

Challenges-

Medical image analysis is complicated by differ ent factors, in particular the complexity of the

data, the complexity of the objects of interest, and the complex validation.

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1.Complexity of medical data-

Medical images are typically 3D tomographic images. The 3D nature of the images provides

additional information, but also an additional dimension of complexity. Instead of processing the

data in 2D slice by slice, 3D processing is usually more effective as it allows to take spatial

relationships in all three dimensions into account, provided that the resolution of the data inplane

and out-plane is comparable. Medical images are based on different physical principles and the

quantification of the images is complicated by the ambiguity that is induced by the intrinsic

limitations of the image acquisition process, in particular limited resolution, lack of contrast,

noise, and the presence of artifacts. Moreover, many applications involve the analysis of

complementary information provided by multiple images, for instance, to correlate anatomical

and functional information, to assess changes over time or differences between subjects. It is

clear that the variable, multi-X nature of the images to be analyzed poses specific challenges.

2. Complexity of the Objects of Interest

The objects of interest in medical images are typically anatomical structures (sometimes also

other structures, e.g., implants), either normal or pathological (e.g., lesions), that can be rigid

(e.g., bony structures) or flexible to some extent (e.g., soft tissue organs). Anatomical structures

may exhibit complex shapes, such as the cortical surface of the brain, the cerebral and coronary

vessels, or the bronchial tree in the lung. Such complex shapes cannot easily be described by a

mathematical model. Moreover, anatomical structures can show large intrasubject shape

variability, due to internal soft tissue deformations (e.g), as well as inter-subject variability, due

to normal biological variation and pathological changes. In general, the appearance of similar

structures in different images (of the same subject at different time points or from different

subjects) can show significant variability, both in shape and in intensity.

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Computational strategies for medical image analysis need to take this variability into account and

be sufficiently robust to perform well under a variety of conditions.

3. Complexity of the Validation

Medical image analysis involves the quantification of internal structures of interest in realworld

clinical images that are not readily accessible from the outside.Hence, assessment of absolute

accuracy is often impossible in most applications, due to lack of ground truth.As an alternative, a

known hardware phantom that mimics the relevant objects of interest could be imaged, but the

realism of such a phantom compared to the actual in vivo situation is often

questionable.Moreover,a hardware phantom usually constitutes a fairly rigid design that is not

well apt to be adapted to different variable anatomical instances. Instead, the use of a software

phantom in combination with a computational tool that generates simulated images based on a

model of the imaging process provides more flexibility, with respect to both the imaged scene

and the image acquisition setup itself. But again, such simulated images often fail to capture the

full complexity of real data.

Examples-

1. Detection of diabetic retinopathy in retinal fundus images - Many diseases of the eye can

be diagnosed through non-invasive imaging of the retina through the pupil. Early screening for

diabetic retinopathy is important as early treatment can prevent vision loss and blindness in the

rapidly growing population of patients with diabetes. Such screening also provides the

opportunity to identify other eye diseases, as well as providing indicators of cardiovascular

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disease. The increasing need for such screening, and the demands for expert analysis that it

creates, motivates the goal of low cost, quantitative retinal image analysis. Routine imaging for

screening uses the specially designed optics of a ‘fundus camera,’ with several images taken at

different orientations (fields, see Figure 2) and can be accomplished with (mydriatic) or without

(non-mydriatic) dilation of the pupil. Assessment of the image requires skilled readers, and may

be performed by remote specialists. With the advent of digital photography, digital recording of

retinal images can be carried out routinely through Picture Archiving and Communication

Systems (PACS).Figure 2:

Standard image formats for diabetic retinopathy (right eye). Source: taken from EYEPACS LLC

2017. As a point of reference, the standards for screening for diabetic retinopathy in the UK

require at least 80% sensitivity and 95% specificity to determine referral for further evaluation.

Screening using fundus photography, followed by manual image analysis, yields sensitivity and

specificity rates cited as 96%/89% when two fields (angles of view) are included, and 92%/97%

for three fields. (For a single field, cited rates are 78%/86%).

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Recently a transformational advance in automated retinal image analysis, using Deep Learning

algorithms, has been demonstrated. The algorithm was trained against a data set of over 100,000

images, which were recorded with one field (macula-centered). Each image in the training set

was evaluated by 3-7 ophthalmologists, thus allowing training with significantly reduced image

analysis variability. The results from tests on two validation sets, also involving only one image

per eye (fovea centered), are striking.

Selecting for high specificity (low false negatives), yielded sensitivities/specificities of

90.3%/98.1% and 87.0%/98.5%). Selecting for high sensitivity yielded values of 97.5%/93.4%

and 96.1%/93.9%). These results compare favorably with manual assessments even where those

are based on images from multiple fields as noted above. They also are a significant advance

over previous automated assessments, which consistently suffered from significantly lower

sensitivities. The Deep Learning algorithm shows great promise to provide increased quality of

outcomes with increased accessibility.

2. Dermatological classification of skin cancer- Skin cancer represents a challenging diagnostic

problem because only a small fraction (3–5% of about ~1.5 million annual US skin cancer cases)

are the most serious type, melanoma, which accounts for 75% of the skin cancer deaths.

Identifying melanomas early is a critical health issue, and because diagnosis can be performed on

photographic images, there are already services that allow individuals to send their smart-phone

photos in for analysis by a dermatologist. However, the detection of melanomas in screening

exams is limited – sensitivity 40.2% and specificity 86.1% for primary care physicians and

49.0%/ 97.6% for dermatologists.A recent demonstration of automated skin cancer evaluation

using a convolutional neural network (CNN) algorithm yielded striking results.The authors drew

on a training set of over 125,000 dermatologists labeled images, from 18 different online

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repositories. Two thousand of the images were also labeled based on biopsies. The algorithm was

trained on all the dermatologist labeled images, using 757 disease classes and over 2000

diseases.

1. A further classification test was performed drawing only on images that were biopsyproven to be

in a specific disease class. The algorithm then was run to answer only the question of whether the

lesion in the image was benign or malignant. The results for analysis of 130 images of

melanocytic lesions are shown in Figure 3b, compared with results from assessments by 22

different dermatologists. As with the broader classification tests, the algorithm performs similarly

or slightly better than individual dermatologists. The performance for both algorithms and

dermatologists is much better for this specific task than for the classification, noted above, of

images from a set representing all the different diseases. As with the retinopathy example, these

results indicate that AI algorithms can perform at levels matching their training sets. The poor

level of results for the broad screening tests is consistent with the training set, which is based on

dermatological characterization.

More use cases are-

1.Virtual health assistants:

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Using augmented reality, cognitive computing, speech and body recognition software, a virtual

persona is created for patients to engage with. These virtual health assistants are able to provide a

personalized experience in which patients can ask questions and learn how to better manage their

health.

2.Health Monitoring:

Wearable health trackers – like those from FitBit, Apple, Garmin and others – monitors heart rate

and activity levels. They can send alerts to the user to get more exercise and can share this

information to doctors (and AI systems) for additional data points on the needs and habits of

patients.

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3. Managing Medical Records and Other Data:

Robots collect, store, re-format, and trace data to provide faster, more consistent access.E.g.

Nuance is a production service provider that uses AI and machine learning in order to predict a

particular user's intent and by implementing nuance in an organisation workflow you can develop

a personalized user experience that allows the company to make better decisions and better

action.

Nuance provides AI powered solutions to help doctors cut documentation time and improve

reporting quality.nuance basically helps in storing,collecting and reformatting data in order to

provide faster and more consistent access to all the data so that any further analysis or any

diagnosis.

4. AI for Diagnostics:

Determining a patient’s diagnosis is a vital aspect of healthcare. Care providers and medical

researchers alike can see the useful potential of using AI to augment or replace the human ability

to identify illness and disease.

5. Mental and Physical Health Screening

Another aspect of healthcare that is primed for assistive AI—in some cases, already seeing the

use of AI—is the diagnostic screening process. This is typically performed by a patient speaking

with a doctor or other healthcare professional and answering a series of questions about their

medical history and describing symptoms, which the health care provider uses to make a

diagnosis or recommend a course of action for the patient.

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6. Industry

The use of AI in the healthcare industry section could be another article altogether, such vast and

detailed are the applications. The main focus of AI in the health sector is in the clinical decision

support systems, several industrial Giants are widely in use of these systems.

1. Microsoft’s Hanover project, in partnership with Oregon Health and Science University’s Knight

Cancer Institute, analyzed medical research to predict the most effective cancer drug treatment

options for patients.

2. Google’s DeepMind is being used by the UK National Health Service to detect certain health

risks through data collected with the use of a mobile app.

3. Apple Iphone’s health app keeps track of users’ activities and he can check and analyze his

lifestyle, monitoring heart rate Pulse, and steps taken in a day.

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CURRENT RESEARCH

Various fields of medicine have inculcated AI into their procedures and achieved improvement.

● Radiology- This field has grasped the most popular so far, having acquired the adeptness to

interpret imaging results and detecting minute changes which could otherwise be easily missed

by the human eye. Algorithms with higher resolution have been implemented to detect diseases

like pneumonia with better accuracy.

● Pain management: This is still an emergent focus area in healthcare. As it turns out, by

leveraging virtual reality combined with artificial intelligence, we can create simulated realities

that can distract patients from the current source of their pain and even help with the opioid

crisis.

● MelaFind: This technology uses infrared light to evaluate pigmented lesions.

Using algorithms, dermatologists can analyze irregular moles and diagnose serious skin cancers

such as melanoma. Although this technology should not replace a biopsy, it helps with giving an

early identification, Dr. Weber said.

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IMPACT OF AI IN BIOMEDICAL

Technology has already improved diagnostic accuracy, drug delivery, and patients’ medical

records, and AI will only add to those breakthroughs. AI can mine medical records, design

personalized treatment plans, handle administrative tasks to free up medical providers’ time for

more meaningful tasks, and assist with medication management.

AI has already made headway in medicine, helping to do everything from processing x-ray

images and detecting cancer to assisting doctors in diagnosing and treating patients. In fact, the

global AI healthcare market is expected to reach $22,790 million by 2023.And the general public

is on board. According to a recent survey, 47% of people were comfortable with AI assisting

doctors in the operating room. More than half of respondents over age 40 were willing to go

under the knife with the help of technology, compared with only 40% under age 40. Additionally,

six in ten participants

(61%) were comfortable with their doctor using data from wearable devices, such as an Apple

Watch or Fitbit, to assess their lifestyle and make recommendations based on that data.

So what healthcare areas will AI have an impact on in the next five to ten years?

● Mining medical records

In our current age of big data, patient data is valuable. Oftentimes, patients’ files are unorganized

and mining their records to extract necessary medical insights can be a great challenge.E.g.David

Lindsay, founder of Philadelphia-based start-up, Oncora Medical, realized this struggle in

radiation therapy. He and his team built a data analytics platform that helps doctors design sound

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radiation treatment plans for patients, personalizing each one based on their specific

characteristics and medical history.

● Drug development

Clinical trials can take more than a decade and cost millions of dollars. AI can play a part in

speeding up the process of drug development, along with making it more cost effective.GSK, a

company that researches, develops, and manufactures innovative pharmaceutical medicines,

vaccines, and consumer healthcare products, is actively applying AI to its drug discovery arm.

In fact, it created an in-house AI unit called “Medicines Discovered Using Artificial

Intelligence.” In 2017, the company announced a partnership with Insilico, to identify novel

biological targets and pathways.

● On jobs of Healthcare sector

Emergence of AI in healthcare has instigated a fear among people about losing jobs,eventually

slowing down the adoption of AI among healthcare workers.most federal governments and

policy makers have a misconception that with increasing adoption of AI,jons would become

redundant thus adversely affecting the economic goal of job creation. on the contrary,it is being

analysed that with adoption of AI,the employment opportunities are going to increase and new

age skills would be in great demand.Many jobs like caregiving and rehabilitation require human

emotions and utmost care which AI cannot currently replicate.AI is integrated in healthcare

organisations to assist with care provisions,not replace it.moreover,as AI continues to evolve in

healthcare,there would be more job created for new skills sets.Ai in healthcare would have

advantages of increased efficiency and decreased costs of treatment,leading to higher profit and

employment opportunities.Thus,it is a misconceptions that AI would replace a healthcare

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workers in reality it can lead to an increase in demand of a qualified workforce and improve

efficiency in services like diagnostics,patients,engagement and precision medicine.

AI IN THE GLOBAL HEALTHCARE MARKET

Similar to other industries,healthcare is witnessing a shift to consumerization,pushing payers and

providers to focus on value based care and improve the health outcomes.Across various

geographics advanced tools like ai are being implemented to address varied stakeholders

challenges and augmented care provision,in most economics,irrespective of the stages of

development,the cost and demand for care is rising,there by increasing the need for digital

technologies,it becomes imperative to provide seamless and integrated care by leveraging the

benefits of the connected ecosystem where patients providers,payers and other stakeholders are

increasingly adopting technology to simplify the processes.

Advanced and developed economies like US,Germany,canada and UK spend a huge proportion

of gdp on healthcare however the adoption of proven technologies like AI is yet to gain

importance in their health system.Through US is the highest spender on healthcare globally as a

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percentage of its GDP,it faces challenges like rising cost of healthcare provision,storage of

primary care professions,poor quality outcome and lack of coverage fora high percentage of the

population.US spends two and a half times higher than the average of organisation for economic

co-operation and development(OECD)countries on healthcare,with significant proportion being

out of pocket or voluntary coverage.it also has the highest rates of medication errors compared to

other OECD countries.The average insurance subscription in US is about USD400 a month and

significant amount of healthcare service contributions are co-payments.

Germany AI in Healthcare Market Size, Share & Trends Analysis Report by Offering (Hardware

and Software & Services), By End-User Industry (Hospitals & Healthcare Facilities, Personal

Care, Biotechnology & Pharmaceutical Companies), By Application (Diagnosis, Biomarker,

Virtual Nursing Assistance, Remote Monitoring of Patients, Drug Discovery, and AI-Enabled

Hospital Care), and Forecast 2019-2025.

Germany AI in the healthcare market is estimated to grow significantly at a CAGR of 51.6%

during the forecast period. The presence of well-established and start-up companies is one of the

major factors driving the growth of the AI in the healthcare market in the country. The market is

segmented on the basis of offering, end-user industry, and application. Based on offering, the

market is divided into software & services and hardware. Based on the end-user industry, the

market is segmented into hospitals & healthcare facilities, personal care, and biotechnology &

pharmaceutical companies. Further, on the basis of application, the market is segmented into

diagnosis, biomarker, virtual nursing assistants, remote monitoring of patients, drug discovery,

and ai-enabled hospital care.

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BENEFITS

1.Job stability: According to the United States Bureau of Labor Statistics, the healthcare

industry is projected to grow 18 percent from now until 2026, much faster than the average for

all occupations. This projected growth is mainly due to an aging population and a greater

demand for healthcare services. Plus, it doesn’t matter where you are in the world, there will

always be people in need of help. In a shaky economy and world of uncertainty, having this

much job security is a huge advantage.

2.Great pay and benefits: As of May 2017, the median annual wage for healthcare practitioners

and technical occupations (such as registered nurses, physicians and surgeons, and dental

hygienists) was $64,770 – almost double the median annual wage for all occupations. Typically,

the more training you have, the better the wages will be.

For example, the average base pay for a neurosurgeon is $489,839 per year.

3.Fast-paced workday: It’s likely that your career in healthcare will be highly stimulating with a

constantly changing atmosphere (bye, bye 9-5 desk job). What your workday looks like depends

on your specialty but be prepared to work face-to-face with patients and be on your feet most of

the day. The medical field is full of excitement, and you’ll never live the same day twice.

4.Opportunities for growth: You don’t need years of medical training to make a difference in

someone’s life. Some specialties only require a certificate, which could be achieved in a year or

two. Plus, medical facilities are looking for people to work in all areas of care, like reception and

administration. If you’re looking to work your way up, many companies also offer continued

learning programs and tuition reimbursement.

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5.The chance to help people: Those who work in the healthcare industry typically have a

desire to make a difference. Whether you’re the surgeon who removes debilitating tumors or the

receptionist who offers a friendly smile to a patient who just received a difficult diagnosis, you’re

there for patients and families when they need it most.

6.AI helps in early diagnosis: By implementing AI, healthcare professionals can reap the benefit

of early detection by pinpointing any risks highlighted by the AI algorithm. The AI database

gathered over a period of time compiles a lot of symptoms and diagnosis to accurately predict

potential health risks in a patient.

7.AI cuts down time needed in diagnosis: AI based healthcare apps have a strong advantage in

coming up with accurate disease diagnosis in a swift time frame. This is possible because of the

amount of data and millions of symptoms/diagnosis these AI apps have. This makes AI more

time efficient and cost efficient in coming up with the disease diagnosis.

CHALLENGES AND RISKS

1.Injuries and errors—The most obvious risk is that AI systems will sometimes be wrong, and

that patient injury or other health-care problems may result. If an AI system recommends the

wrong drug for a patient, fails to notice a tumor on a radiological scan, or allocates a hospital bed

to one patient over another because it predicted wrongly which patient would benefit more, the

patient could be injured. Of course, many injuries occur due to medical error in the health-care

system today, even without the involvement of AI. AI errors are potentially different for at least

two reasons. First, patients and providers may react differently to injuries resulting from software

than from human error. Second, if AI systems become widespread, an underlying problem in one

AI system might result in injuries to thousands of patients—rather than the limited number of

patients injured by any single provider’s error.

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2.Data availability—Training AI systems requires large amounts of data from sources such as

electronic health records, pharmacy records, insurance claims records, or consumergenerated

information like fitness trackers or purchasing history. But health data are often problematic.

Data is typically fragmented across many different systems. Even aside from the variety just

mentioned, patients typically see different providers and switch insurance companies, leading to

data split in multiple systems and multiple formats. This fragmentation increases the risk of error,

decreases the comprehensiveness of datasets, and increases the expense of gathering data—which

also limits the types of entities that can develop effective health-care AI.

3.Privacy concerns—Another set of risks arise around privacy.The requirement of large datasets

creates incentives for developers to collect such data from many patients. Some patients may be

concerned that this collection may violate their privacy, and lawsuits have been filed based on

data-sharing between large health systems and AI developers. AI could implicate privacy in

another way: AI can predict private information about patients even though the algorithm never

received that information. For instance, , even if the person had never revealed that information

to anyone else. Patients might consider this a violation of their privacy, especially if the AI

system’s inference were available to third parties, such as banks or life insurance companies.

4.Reinforcement of outmoded practice — AI can’t adapt when developments or changes in

medical policy are implemented, as these systems are trained using historical data.

5.Self-fulfilling prediction — An AI machine trained to detect a certain illness may lean toward

the outcome it is designed to detect.

6.Negative side effects — AI systems may suggest a treatment but fail to consider any potential

unintended consequences.

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7.Unsafe exploration — In order to learn new strategies or get the outcome it is searching for,

an AI system may start to test boundaries in an unsafe way.

8.Unscalable oversight — Because AI systems are capable of carrying out countless jobs and

activities, including multitasking, monitoring such a machine can be near impossible.

POSSIBLE SOLUTIONS

There are several ways we can deal with possible risks of health-care AI:

Data generation and availability-Several risks arise from the difficulty of assembling

highquality data in a manner consistent with protecting patient privacy. One set of potential

solutions turns on government provision of infrastructural resources for data, ranging from

setting standards for electronic health records to directly providing technical support for

highquality data-gathering efforts in health systems that otherwise lack those resources. A

parallel option is direct investment in the creation of highquality datasets.

Quality oversight- Oversight of AI-system quality will help address the risk of patient injury.

The Food and Drug Administration (FDA) oversees some health-care AI products that are

commercially marketed. The agency has already cleared several products for market entry, and it

is thinking creatively about how best to oversee AI systems in health. However, many AI systems

in health care will not fall under FDA’s purview, either because they do not perform medical

functions or because they are developed and deployed in-house at health systems themselve a

category of products the FDA typically does not oversee. These health-care AI systems fall into

something of an oversight gap. Increased oversight efforts by health systems and hospitals,

professional organizations like the American College of Radiology and the American Medical

Association, or insurers may be necessary to ensure quality of systems that fall outside the FDA’s

exercise of regulatory authority.

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 AI in Healthcare

CHANGES NEED TO ENCOURAGE THE INTRODUCTION

AND SCALING OF AI IN HEALTHCARE

The strides made in the field of AI in healthcare have been momentous. Moving to a world in

which AI can deliver significant, consistent, and global improvements in care will be more

challenging.

Of course, AI is not a panacea for healthcare systems, and it comes with strings attached. The

analyses in this report and the latest views from stakeholders and frontline staff reveal a set of

themes that all players in the healthcare ecosystem will need to address:

What needs to change to encourage the introduction and scaling of AI in healthcare?

The strides made in the field of AI in healthcare have been momentous. Moving to a world in

which AI can deliver significant, consistent, and global improvements in care will be more

challenging.

Of course, AI is not a panacea for healthcare systems, and it comes with strings attached. The

analyses in this report and the latest views from stakeholders and frontline staff reveal a set of

themes that all players in the healthcare ecosystem will need to address:

1. Working together to deliver quality AI in healthcare. Quality came up in our interviews time and

again, especially issues around the poor choice of use cases, AI design and ease of use, the

quality and performance of algorithms, and the robustness and completeness of underlying data.

The lack of multidisciplinary development and early involvement of healthcare staff, and limited

iteration by joint AI and healthcare teams were cited as major barriers to addressing quality

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issues early on and adopting solutions at scale. The survey revealed this is driven by both sides:

only 14 percent of startup executives felt that the input of healthcare professionals was critical in

the

early design phase; while the healthcare professionals saw the private sector’s role in areas such

as aggregating or analysing data, providing a secure space for data lakes, or helping upskill

healthcare staff as minimal or nonexistent.

One problem AI solutions face is building the clinical evidence of quality and effectiveness.

While startups are interested in scaling solutions fast, healthcare practitioners must have proof

that any new idea will “do no harm” before it comes anywhere near a patient. Practitioners also

want to understand how it works, where the underlying data come from and what biases might

be embedded in the algorithms, so are interested in going past the concept of AI as a “black box”

to understand what underpins it. Transparency and collaboration between innovators and

practitioners will be key in scaling AI in European healthcare.

User-centric design is another essential component of a quality product. Design should have the

end user at its heart. This means AI should fit seamlessly with the workflow of decision makers

and by being used, it will be improved. Many interviewees agreed that if AI design delivers value

to end users, those users are more likely to pay attention to the quality of data they contribute,

thereby improving the AI and creating a virtuous circle. Finally, AI research needs to heavily

emphasize explainable, causal, and ethical AI, which could be a key driver of adoption.

2. Rethinking education and skills. We have already touched on the importance of digital skills—

these are not part of most practitioners’ arsenal today. AI in healthcare will require leaders

wellversed in both biomedical and data science. There have been recent moves to train students

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in the science where medicine, biology, and informatics meet through joint degrees, though this

is less prevalent in Europe. More broadly, skills such as basic digital literacy, the fundamentals of

genomics, AI, and machine learning need to become mainstream for all practitioners,

supplemented by critical-thinking skills and the development of a continuous-learning mind-set.

Alongside upgrading clinical training, healthcare systems need to think about the existing

workforce and provide ongoing learning, while practitioners need the time and incentive to

continue learning.

3. Strengthening data quality, governance, security and interoperability. Both interviewees and

survey respondents emphasized that data access, quality, and availability were potential

roadblocks. The data challenge breaks down into digitizing health to generate the data, collecting

the data, and setting up the governance around data management. MGI analyses show that

healthcare is among the least digitized sectors in Europe, lagging behind in digital business

processes, digital spend per worker, digital capital deepening, and the digitization of work and

processes. It is critical to get the basic digitization of systems and data in place before embarking

on AI deployments—not least because the frustrations staff have with basic digitization could

spill over to the wider introduction of AI.

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FUTURE OF AI IN BIOMEDICAL

Artificial Intelligence will dominate the healthcare industry in the future that can sense or predict

a disease outbreak(pandemic) from stopping it’s early outspread. In the early decades, there was

a time where people lacked medical services and technology on a disease outbreak.

The deaths were innumerable and diseases were unknown. Today’s scenario is devastating as the

world has witnessed a pandemic like any day before, besides highly equipped technology and

medical services.

This isn’t enough! The world requires more! Something that can change the whole situation

upside down. We have to shift to the advanced stage of healthcare where AI comes into the

rescue.

Artificial Intelligence is about conquering human intelligence with its utmost systemized

configurations that can boost the healthcare industry to serve better and more at the same time.

Today, many world-famous AI healthcare companies use this technology for the development of

cutting-edge solutions. And the major market players are still very familiar: IBM, Microsoft, and

Google. Here is just a overview of what they are working on:

● IBM applies AI to create solutions for cancer and chronic diseases treatment as well as for the

development of new medications;

● Microsoft conducts in-depth research on how AI can help predict cancer treatment reactions and

develops programmable cells;

● Google creates a platform that detects health risks for patients based on the mobile software

collected data

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CONCLUSION

As we take stock of how far AI has come, and how it has driven advances in digital health

technology, it’s easy to be excited by the future. Many questions still remain— how to preserve

the security and privacy of medical data, for example, or the unexpected hazards of constant

biomedical surveillance.

But with the prevalence of smartphones, wearable devices, AI assistants, and autonomous robots,

all of them brimming with medical applications, the future of digital health looks bright. AI

integrations have the potential to detect diseases earlier, track epidemics more effectively,

lasertarget treatment options, and connect patients to their doctors in ways that a presmartphone

generation never thought possible.

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Third BSc cs