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How NYC hospitals are using artificial intelligence to save lives
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HOW NYC HOSPITALS ARE USING ARTIFICIAL INTELLIGENCE TO SAVE LIVES



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By
Jaclyn Jeffrey-Wilensky

Published Jun 27, 2023 at 10:00 a.m.

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Courtesy of Mount Sinai Health System

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By
Jaclyn Jeffrey-Wilensky

Published Jun 27, 2023 at 10:00 a.m.

1 comment

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Artificial intelligence is changing the way we learn and work. But New Yorkers
may not realize that similar algorithms are already aiding lifesaving decisions
at hospitals every day.

Staff at three New York City hospital systems say that in mere seconds,
artificial intelligence tools can gauge a patient’s odds of malnutrition,
delirium, ICU admission and even death — well before a doctor even enters the
hospital room.

Some AI programs take on administrative tasks, such as helping patients book
appointments or request refills without the hassle of playing phone tag. Other
systems can give tailored pregnancy advice or even identify signs of diseases
like breast cancer.

They can’t perform physical exams – yet. But staff at three New York City
hospital systems say these AI systems are helping prioritize specialists’ time,
guide medical decision-making and even identify signs of breast cancer.
Clinicians discussed these applications at a summit held in late May by the New
York Academy of Sciences.

> We’re able to identify patients who otherwise wouldn’t be spotted.

Sara Wilson, senior director of clinical nutrition services, Mount Sinai Health
System


“We’re able to identify patients who otherwise wouldn’t be spotted,” Sara
Wilson, senior director of clinical nutrition services at Mount Sinai Health
System, said of one tool that flags patients at risk of malnutrition. “Your
brain just can’t move as fast as this machine can and touch all the metrics that
a machine can.”

This malnutrition tool is what’s known as a predictive model, and it doesn't
work all that differently from an experienced clinician. This type of AI scans
through patients’ charts, paying special attention to factors that may
predispose each individual to under-nourishment, like weight and bloodwork. If a
patient’s risk factors pass a certain threshold, they get flagged for a
follow-up visit with a registered dietitian.

The key advantage of AI tools, hospital staff explained, is speed. They can sift
through records in the fraction of time it would take a human to do so. That
frees up doctors and nurses to spend more time actually interacting with
patients, Wilson said.



Some AI tools can help health care workers interpret medical scans.

Courtesy of Mount Sinai Health System

That speed also means that doctors can more quickly identify and start treating
the patients who need it most. For conditions like delirium — a state of
confusion that can signal health problems in older patients — that efficiency is
essential, explained Mount Sinai’s Dr. Joseph Friedman. Before they started
using their AI model, he said, “we weren’t able to engage in the kind of
aggressive and decisive treatment of patients to bring them out of this delirium
because of all the time we were spending assessing them.”

Now, they’re able to target more at-risk patients with fewer screenings and get
them on the road to recovery that much faster. Before the tool was up and
running, he said, clinicians would have to screen up to 100 people per day to
identify even two delirious patients. Now, the AI program can identify as many
as 10 patients for every 25 screened per day.



Other AI tools can even identify patients in need of life-saving time-sensitive
procedures. New York City Health + Hospitals uses an algorithm to canvass brain
scans of stroke patients. The system quickly flags patients who are good
candidates for surgery to remove the clot.

> A care planning tool, deployed by NYU Langone, estimates a patient’s chances
> of dying within the next two months.

“Those are the people you’d want to identify quickly,” said Dr. Michael Bouton,
chief medical information officer for the public hospital system.

Some hospitals are also experimenting with chatbots for patients to interact
with — both for everyday tasks like scheduling and actual medical care. Mount
Sinai has a chatbot that guides anxious patients who are trying to decide
between making a regular doctor’s appointment, visiting a local urgent care or
heading to an emergency room, said Robbie Freeman, chief nursing informatics
officer for the health system. Separately, Northwell Health launched an
AI-enhanced pregnancy chat app earlier this year to screen for common symptoms
and give users personalized advice. The app can also connect users to a human
health care worker or even prompt them to call 911 if their responses call for
it — for example, if they’re describing symptoms of preeclampsia or thoughts of
self-harm.

Hospital staff interviewed by Gothamist say they’re excited about the potential
of large language models like ChatGPT that can generate text in response to
carefully crafted prompts. The systems could help health care providers with
writing tasks, including talking to patients.

But AI isn’t immune to errors. One tool, designed to predict the deadly
infection response known as sepsis, had to be extensively redesigned after
researchers and journalists flagged flaws in its detection system. Depending on
how the computer programs are trained, AI can also replicate biases inherent to
their human makers. NYC Health + Hospitals’ Bouton explained that the hospital
system decided not to use a tool for predicting which patients were most likely
to miss their scheduled appointments, citing bias concerns.




Three major hospitals said their AI tools are approved by an ethics board and
thoroughly tested before use with patients.

Courtesy of Mount Sinai Health System

Health + Hospitals and the other health providers interviewed for this story all
said that their AI tools must be approved by an ethics committee and thoroughly
tested before they’re deployed.

That’s especially important for tools that predict patients’ decline or death. A
care planning tool that estimates patients’ odds of dying within the next two
months required especially rigorous discussion, Nader Mherabi, chief information
officer at NYU Langone, said in an email. The tool prompts doctors to talk to
high-risk patients about their end-of-life wishes and treatment preferences,
which can then be documented in a living will or other instructions.

Representatives for New York City Health + Hospitals, Mount Sinai Health System
and NYU Langone Health all stressed that the AI tools are simply informing
medical professionals’ decision-making, not supplanting it.

“Humans are always in the loop,” Mehrabi said. The models are just one factor in
“a sea of data points,” considered by each health care provider, he added.

For all the hype and doomsday labor predictions, doctors and other clinicians
aren’t worried about AI coming for their careers anytime soon — particularly
when the job requires physical interaction.



“The AI serves us. We don’t serve it,”said Friedman. “It’s not like a Star Trek
holographic doctor who’s making decisions. We’re simply not there."

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Tagged

Health and Science
health care
new york city

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Jaclyn Jeffrey-Wilensky


Jaclyn writes data-driven health and science stories for WNYC/Gothamist. She
also runs Gothamist's COVID data dashboards. She is an alumna of the Newmark
Graduate School of Journalism. Her work has appeared in NBC News, Spectrum, the
Daily Beast, and other outlets. Got a tip? Email
jjeffrey-wilensky@nypublicradio.org or Signal 516-366-4382.

Read more

Gothamist is funded by sponsors and member donations

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Gothamist is funded by sponsors and member donations

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