HEALTHCARE AI DEVELOPMENT CYCLE

Dr. Keith Dreyer Chief Science Officer, ACR Data Science Institute ACR Board of Chancellors, Chairman Informatics Commission Chief Data Science Officer, MGH, BWH, Partners Healthcare Associate Professor of Radiology, Harvard Medical School

BUILDING ARTIFICIAL INTELLIGENCE FOR HEALTHCARE PRODUCTS NEEDS HEALTHCARE AI DEVELOPMENT CYCLE ALGORITHMS IDEAS

MGH CLINICAL DATA SCIENCE CENTER CLINICAL CARE ENVIRONMENT HEALTHCARE AI DEVELOPMENT CYCLE CLINICAL AI APPLICATIONS

BUILDING AI PRODUCTS NEEDS HEALTHCARE AI DEVELOPMENT CYCLE ALGORITHMS IDEAS

AI IN CLINICAL DIAGNOSTICS 1,000 s OF AI USE CASES DETECT CLASSIFY

AI IN CLINICAL DIAGNOSTICS MAGNETIC RESONANCE COMPUTED TOMOGRAPHY POSITRON EMISSION RADIOGRAPHY ANGIOGRAPHY ULTRASOUND FLUOROSCOPY ABDOMINAL IMAGING BREAST IMAGING CARDIAC IMAGING EMERGENCY IMAGING THROACIC IMAGING NEURORADIOLOGY NUCLEAR MEDICINE PEDIATRIC IMAGING MUSCULOSKELETAL INTERVENTIONAL ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY

AI IN CLINICAL DIAGNOSTICS MAGENTIC RESONANCE COMPUTED TOMOGRAPHY POSITRON EMISSION RADIOGRAPHY ANGIOGRAPHY ULTRASOUND FLUOROSCOPY ABDOMINAL IMAGING BREAST IMAGING CARDIAC IMAGING EMERGENCY IMAGING THORACIC IMAGING PULMONARY NODULES NEURORADIOLOGY NUCLEAR MEDICINE PEDIATRIC IMAGING LUNG MUSCULOSKELETAL INTERVENTIONAL ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY

THE USE OF AI IN POPULATION HEALTH SCREENING Medical Management LUNG RADS ACR AI APPLICATIONS Disease Detection MEDICAL MANAGEMENT CAD that works! AI APPLICATIONS AI APPLICATIONS Screening Tech LDCT SCREENING AI APPLICATIONS Screening Population

AI-ASSISTED LDCT LUNG CANCER SCREENING Accuracy 100 98.2% RADIOLOGIST INTERPRETED LDCT CASES Untrained Neural Network Trained with 98.2% Accuracy 0 NEW LDCT TRAINED AI DETECTED LUNG-RADS SCORING RADIOLOGIST MEDICAL PATIENT SCREENING ALGORITHM AND QUANTIFICATION AND RECOMMENDATIONS INTERPRETATION MANAGEMENT

BUILDING AI PRODUCTS HEALTHCARE FACILITIES HEALTHCARE IT INDUSTRY NEEDS HEALTHCARE AI DEVELOPMENT CYCLE ALGORITHMS PROFESSIONAL ORGANIZATIONS HEALTHCARE DATA SOURCES IDEAS

Making imaging safe, effective and accessible to those who need it. 75+ years 36K members 12K digital facilities Core Purpose To serve patients and society by empowering members to advance the practice, science, and professions of radiological care.

ECONOMICS CPT CODING VALUATION OF PHYSICIAN SERVICES AND PRACTICE EXPENSE MACRA METRICS AND PAYMENT MODELS GOVERNMENT RELATIONS CONGRESS HHS QUALITY AND SAFETY REGISTRIES AND ACCREDITATION APPROPRIATENESS CRITERIA TECHNICAL STANDARDS AND PRACTICE PARAMETERS INFORMATICS TECHNOLOGY STANDARDS - DICOM CLINICAL DECISION SUPPORT COMPUTER ASSISTED REPORTING MODALITY ACCREDITED FACILITIES* MAMMOGRAPHY 8252 MRI 7099 CT 6991 ULTRASOUND 4970 Nuclear Medicine 3558 Breast Ultrasound 2222 PET 1542 Stereotactic Breast Biopsy 1473 *as of April 5, 2016 Breast MRI 1612 Radiation Oncology 678 Total 38,397

ECONOMICS CPT CODING VALUATION OF PHYSICIAN SERVICES AND PRACTICE EXPENSE MACRA METRICS AND PAYMENT MODELS GOVERNMENT RELATIONS CONGRESS HHS QUALITY AND SAFETY REGISTRIES AND ACCREDITATION APPROPRIATENESS CRITERIA TECHNICAL STANDARDS AND PRACTICE PARAMETERS 12000 10000 8000 6000 4000 2000 TRIAD (TRANSFER OF IMAGES AND DATA) Registries Accreditation Clinical Trials INFORMATICS TECHNOLOGY STANDARDS - DICOM 0 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q4 2014 Q1 2014 Q2 2014 Q3 2014 Q4 2015 Q1 2015 Q2 2015 Q3 2015 Q4 2016 Q1 2016 Q2 2016 Q3 CLINICAL DECISION SUPPORT COMPUTER ASSISTED REPORTING

ACR Data Science Institute: Participation http://www.acrdsi.org/ Physicians Technologists Industry Data Scientists Informaticists Health Care Execs Patients 2017 DATA SCIENCE INSTITUTE : AMERICAN COLLEGE OF RADIOLOGY ALL RIGHTS RESERVED.

ACR DSI Mission Leverage the value of radiology professionals as AI evolves through the development of appropriate use cases and workflow integration Establish industry relationships by providing credible use cases, help with FDA and other government agencies, and pathways for clinical integration Protect patients through leadership roles in the regulatory process with government agencies and verification of algorithms Educate radiology professionals, other physicians and all stakeholders about AI and the ACR s role in data science for the good of our patients 2017 DATA SCIENCE INSTITUTE : AMERICAN COLLEGE OF RADIOLOGY ALL RIGHTS RESERVED.

AI APPLICATIONS IN THE RADIOLOGICAL SCIENCES Image interpretation Quantification of findings Quantified comparison between multiple studies Multiparametric analysis across multiple modalities Volumetric analysis Textural analysis Automation of Region Of Interest targeting and measuring Patient care and safety Detection of potentially critical/stat exams Radiation dose optimization Pre-test probability assessment of patient risk of positive findings and contrast reactions Cancer and mammography screening Automatic protocoling of studies from EMR data Radiologist and practice optimization for productivity and quality Automated transcription of audio narration Automated population of structured reports Optimization for case assignment across teams Smarter PACS hanging protocols and synchronization protocols Communication and tracking of primary and incidental findings Decreased patient waiting times Quality improvement in scanning Prediction and prevention of missed patient appointments

AI IN CLINICAL DIAGNOSTICS MAGNETIC RESONANCE COMPUTED TOMOGRAPHY POSITRON EMISSION RADIOGRAPHY ANGIOGRAPHY ULTRASOUND FLUOROSCOPY ABDOMINAL IMAGING BREAST IMAGING CARDIAC IMAGING EMERGENCY IMAGING THORACIC IMAGING PULMONARY NODULES NEURORADIOLOGY NUCLEAR MEDICINE PEDIATRIC IMAGING MUSCULOSKELETAL LUNG INTERVENTIONAL ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY ANATOMY

DSI ACR USE CASE DEVELOPMENT USE CASES ACR DSI Use Case Creation Process AI HIGHEST CLINICAL VALUE USE CASE PRIORITIZATION SOLVABLE USING AI

DSI ACR USE CASE DEVELOPMENT ACR DSI Use Case Creation Process Breast Imaging Neuroimaging Abdominal Imaging Thoracic Imaging Interventional Radiology Pediatric Imaging AI USE CASE PANEL AI USE CASE PANEL AI USE CASE PANEL AI USE CASE PANEL AI USE CASE PANEL AI USE CASE PANEL USE CASE PANELS Cardiac Imaging AI USE CASE PANEL Musculoskeletal Imaging AI USE CASE PANEL PATIE NT Quality, Safety AI USE CASE PANEL Oncology RO And Cancer AI USE CASE PANEL TOUCH-AI (Technically Oriented Use Cases for Healthcare-AI)

BUILDING HEALTHCARE AI HEALTHCARE FACILITIES PRODUCTS HEALTHCARE IT INDUSTRY NEEDS HEALTHCARE AI DEVELOPMENT CYCLE ALGORITHMS PROFESSIONAL ORGANIZATIONS IDEAS HEALTHCARE DATA SOURCES

BUILDING HEALTHCARE AI CMS & FDA HEALTHCARE FACILITIES PRODUCTS HEALTHCARE IT INDUSTRY FDA REGISTRIES CLINICALLY IMPLEMENTED PRODUCTIZE REGULATORY PROCESS NEEDS PERFORMANCE ASSESSMENT ASSESS CONCEPT CLINICAL USE CASES ACR Assess-AI HEALTHCARE AI DEVELOPMENT CYCLE ACR DSI SERVICE DECENTRALIZED VALIDATION Certify-AI VALIDATION PRODUCE CREATE AI TRAINING & TESTING ALGORITHMS EXPERT PANELS TOUCH-AI USE CASES ANNOTATED DATASETS AI ALGORITHMS MEDICAL SOCIETIES PROFESSIONAL ORGANIZATIONS IDEAS HEALTHCARE DATA SOURCES AI INDUSTRY

REAL WORLD MONITORING OF HEALTHCARE AI HEALTHCARE AI MANUFACTURERS REGULATORY AGENCIES ACR COORDINATED REGISTRY NETWORK Assess-AI DSI AI USE CASE PANELS REAL WORLD DATA NEW PATIENT LDCT SCREENING TRAINED AI ALGORITHM DETECTED AND QUANTIFICATION LUNG-RADS SCORING AND RECOMMENDATIONS INTERPRETATION ACR ASSIST / TRIAD RADIOLOGIST MEDICAL MANAGEMENT