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Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Electronic Health Records Vendors Now Adding Generative AI to Their Products

One goal of these new functions is to streamline physician workflows. However, these new EHRs may interface differently with clinical laboratory information systems

Artificial intelligence (AI) developers are making great contributions in clinical laboratory, pathology, radiology, and other areas of healthcare. Now, Electronic Health Record (EHR) developers are looking into ways to incorporate a new type of AI—called “Generative AI”—into their EHR products to assist physicians with time-consuming and repetitive administrative tasks and help them focus on patient-centered care. 

Generative AI uses complex algorithms and statistical models to learn patterns from collected data. It then generates new content, including text, images, and audio/video information.

According to the federal Government Accountability Office (GAO), generative AI “has potential applications across a wide range of fields, including education, government, medicine, and law” and that “a research hospital is piloting a generative AI program to create responses to patient questions and reduce the administrative workload of healthcare providers.”

Reducing the workload on doctors and other medical personnel is a key goal of the EHR developers.

Generative AI uses deep learning neural networks modeled after the human brain comprised of layers of connected nodes that process data. It employs two neural networks: a generator [generative network] which creates new content, and a discriminator [discriminative network] which evaluates the quality of that content.

The collected information is entered into the network where each individual node processes the data and passes it on to the next layer. The last layer in the process produces the final output. 

Many EHR companies are working toward adding generative AI into their platforms, including:

As our sister publication The Dark Report points out in its December 26 “Top 10 Biggest Lab Stories for 2023,” almost every product or service presented to a clinical laboratory or pathology group will soon include an AI-powered solution.

Girish Navani

“We believe that generative AI has the potential of being a personal assistant for every doctor, and that’s what we’re working on,” Girish Navani (above), co-founder and CEO of eClinicalWorks, told EHRIntelligence. “It could save hours. You capture the essence of the entire conversation without touching a keyboard. It is transformational in how it works and how well it presents the information back to the provider.” Clinical laboratory information systems may also benefit from connecting with generative AI-based EHRs. (Photo copyright: eClinicalWorks.)

Generative AI Can Help with Physician Burnout

One of the beneficial features of generative AI is that it has the ability to “listen” to a doctor’s conversation with a patient while recording it and then produce clinical notes. The physician can then review, edit, and approve those notes to enter into the patient’s EHR record, thus streamlining administrative workflows.

“The clinician or support team essentially has to take all of the data points that they’ve got in their head and turn that into a narrative human response,” Phil Lindemann, Vice President of Data and Analytics at Epic, told EHRIntelligence. “Generative AI can draft a response that the clinician can then review, make changes as necessary, and then send to the patient.”

By streamlining and reducing workloads, EHRs that incorporate generative AI may help reduce physician burnout, which has been increasing since the COVID-19 pandemic.

A recent study published in the Journal of the American Informatics Association (JAMIA) titled, “Association of Physician Burnout with Perceived EHR Work Stress and Potentially Actionable Factors,” examined physician burnout associated with EHR workload factors at UC San Diego Health System. The researchers found that nearly half of surveyed doctors reported “burnout symptoms” and an increase in stress levels due to EHR processes. 

“Language models have a huge potential in impacting almost every workflow,” Girish Navani, co-founder and CEO of eClinicalWorks, told EHRIntelligence. “Whether it’s reading information and summarizing it or creating the right type of contextual response, language models can help reduce cognitive load.”

Generative AI can also translate information into many different languages. 

“Health systems spend a lot of time trying to make patient education and different things available in certain languages, but they’ll never have every language possible,” Lindemann said. “This technology can take human language, translate it at any reading level in any language, and have it understandable.”

MEDITECH is working on a generative AI project to simplify clinical documentation with an emphasis on hospital discharge summaries that can be very laborious and time-consuming for clinicians.

“Providers are asked to go in and review previous notes and results and try to bring that all together,” Helen Waters, Executive Vice President and COO of MEDITECH, told EHRIntelligence. “Generative AI can help auto-populate the discharge note by bringing in the discrete information that would be most relevant to substantiate that narrative and enable time savings for those clinicians.”

Many Applications for Generative AI in Healthcare

According to technology consulting and solutions firm XenonStack, generative AI has many potential applications in healthcare including:

  • Medical simulation
  • Drug discovery
  • Medical chatbots
  • Medical imaging
  • Medical research
  • Patient care
  • Disease diagnosis
  • Personalized treatment plans

The technology is currently in its early stages and does present challenges, such as lack of interpretability, the need for large datasets and more transparency, and ethical concerns, all of which will need to be addressed. 

“We see it as a translation tool,” Lindemann told EHRIntelligence. “It’s not a panacea, but there’s going to be really valuable use cases, and the sooner the community can agree on that, the more useful the technology’s going to be.”

Since generative AI can be used to automate manual work processes, clinical laboratories and anatomic pathology groups should be alert to opportunities to interface their LISs with referring physicians’ EHRs. Such interfaces may enable the use of the generative AI functions to automate manual processes in both the doctors’ offices and the labs.

—JP Schlingman

Related Information:

How Four EHR Vendors Are Leveraging Generative AI in Clinical Workflows

NextGen Healthcare Unveils NextGen Ambient Assist, an AI Solution Designed to Boost Provider Efficiency

Science and Tech Spotlight: Generative Ai

What is Generative AI? Everything You Need to Know

Generative AI Could Revolutionize Health Care—But Not if Control is Ceded to Big Tech

Generative AI in Healthcare and Its Uses—Complete Guide

Association of Physician Burnout with Perceived EHR Work Stress and Potentially Actionable Factors

New Study Shows Protective Immunity Against COVID-19 Is ‘Robust’ and May Last Up to Eight Months or Longer Following Infection

Researchers find declining antibody levels in SARS-CoV-2 patients are offset by T cells and B cells that remain behind to fight off reinfection

Questions remain regarding how long antibodies produced by a COVID-19 vaccine or natural infection will provide ongoing protection against SARS-CoV-2. However, a new study showing COVID-19 immunity may be “robust” and “long lasting” may signal important news for clinical laboratories and in vitro diagnostics companies developing serological tests for the coronavirus disease.

The study, titled, “Immunological Memory to SARS-CoV-2 Assessed for up to 8 Months after Infection,” was published in the journal Science. The data suggest nearly all COVID-19 survivors have the immune cells necessary to fight re-infection for five to eight months or more.

“There was a lot of concern originally that this virus might not induce much memory. Instead, the immune memory looks quite good,” Shane Crotty, PhD, Professor at the Center for Infectious Disease and Vaccine Research at the La Jolla Institute (LJI) for Immunology in California and coauthor of the study, told MIT Review. LJI has an official affiliation agreement with UC San Diego Health System and the UC San Diego School of Medicine.

Retaining Protection from SARS-CoV-2 Reinfection

The LJI research team analyzed blood samples from 188 COVID-19 patients, 7% of whom had been hospitalized. They measured not only virus-specific antibodies in the blood stream, but also memory B cell infections, T helper cells, and cytotoxic (killer) T cells.

While antibodies eventually disappear from the blood stream, T cells and B cells appear to remain to fight future reinfection.

“As far as we know, this is the largest study ever for any acute infection that has measured all four of those components of immune memory,” Crotty said in a La Jolla Institute news release.

The LJI researchers found that virus-specific antibodies remained in the blood stream months after infection while spike-specific memory B cells—which could trigger an accelerated and robust antibody-mediated immune response in the event of reinfection—actually increased in the body after six months. In addition, COVID-19 survivors had an army of T cells ready to halt reinfection.

“Our data show immune memory in at least three immunological compartments was measurable in ~95% of subjects five to eight months post symptom onset, indicating that durable immunity against secondary COVID-19 disease is a possibility in most individuals,” the study concludes. The small percentage of the population found not to have long-lasting immunity following COVID-19 infection could be vaccinated in an effort to stop reinfection from occurring on the way to achieving herd immunity, the LJI researchers maintained.

Do COVID-19 Vaccines Create Equal Immunity Against Reinfection?

Whether COVID-19 vaccinations will provide the same immune response as an active infection has yet to be determined, but indications are protection may be equally strong.

“It is possible that immune memory will be similarly long lasting similar following vaccination, but we will have to wait until the data come in to be able to tell for sure,”

LJI Research Professor Daniela Weiskopf, PhD, said in the LJI statement. “Several months ago, our studies showed that natural infection induced a strong response, and this study now shows that the response lasts. The vaccine studies are at the initial stages, and so far, have been associated with strong protection. We are hopeful that a similar pattern of responses lasting over time will also emerge for the vaccine-induced responses.”

The study’s authors cautioned that people previously diagnosed with COVID-19 should not assume they have protective immunity from reinfection, the Washington Post noted. In fact, according to the LJI news release, researchers saw a “100-fold range in the magnitude of immune memory.”

Alessandro Sette, Doctor of Biological Sciences an Italian immunologist in a blue sweater
Alessandro Sette, Doctor of Biological Sciences (above), an Italian immunologist, Professor at the Center for Autoimmunity and Inflammation/Center for Infectious Disease and Vaccine Research at La Jolla Institute for Immunology, and co-author of the study, told the Washington Post that people should act responsibly. “If I had COVID, I would still not throw away my masks, I would not go to rave parties … It’s like driving a car where you know you have 90% probability that the brakes work.” (Photo copyright: La Jolla Institute for Immunology.)

Previous Studies Found Little Natural Immunity Against SARS-CoV-2 Reinfection

The Scientist reported that several widely publicized previous studies raised concerns that immunity from natural infection was fleeting, perhaps dwindling in weeks or months. And a United Kingdom study published in Nature Microbiology found that COVID-19 generated “only a transient neutralizing antibody response that rapidly wanes” in patients who exhibited milder infection.

Daniel M. Davis, PhD, Professor of Immunology at the University of Manchester, says more research is needed before scientists can know for certain how long COVID-19 immunity lasts after natural infection.

“Overall, these results are interesting and provocative, but more research is needed, following large numbers of people over time. Only then, will we clearly know how many people produce antibodies when infected with coronavirus, and for how long,” Davis told Newsweek.

While additional peer-reviewed studies on the body’s immune response to COVID-19 will be needed, this latest study from the La Jolla Institute for Immunity may help guide clinical laboratories and in vitro diagnostic companies that are developing serological antibody tests for COVID-19 and lead to more definitive answers as to how long antibodies confer protective immunity.

—Andrea Downing Peck

Related Information:

Immunological Memory to SARS-CoV-2 Assessed for up to 8 Months After Infection

Protective Immunity Against SARS-Cov-2 Could Last Eight Months or More

Covid-19 Immunity Likely Lasts for Years

Longitudinal Observation and Decline of Neutralizing Antibody Responses in the Three Months Following SARS-CoV-2 Infection in Humans

Studies Report Rapid Loss of COVID-19 Antibodies

10 Percent of Wuhan Study Patients Lose Coronavirus Antibodies Within Weeks