00:04:51:25 - 00:05:13:01
Alex Chebl, M.D.
But, just as importantly, it's also helped us with our door-to-needle
time. So that balloon scan mentioned that you can also give the clot
busting medication. That has to be given within 4.5 hours(Way too slow! Unless you have the protocols that stop the neuronal cascade of death saving hundreds of million to billions of neurons! Since you don't, your plans are a failure!). And so we've
now are consistently able to treat patients instead of roughly within an
hour presentation. We're now being able to treat almost all patients
with 45 minutes.
00:05:13:01 - 00:05:19:16
Alex Chebl, M.D.
And we're approaching 30 minutes from door-to-needle. And every minute is essential in that effort.
00:05:19:18 - 00:05:22:27
Tom Haederle
That's really impressive. What's been the impact on patient outcomes?
00:05:23:04 - 00:05:44:13
Alex Chebl, M.D.
Tremendous patient outcomes. If you look nationally, but also at our
sites, you look at the number of patients, proportion of patients who
recover to normal or nearly normal has increased. If you look at the
number of patients who are discharged to home rather than to rehab, a
good measure of whether patients have disability, that has also
increased.
00:05:44:15 - 00:05:58:13
Alex Chebl, M.D.
And nationally, the data clearly support, this overwhelmingly so, so
that the American Heart Association, for example, keeps shortening the
time metric, because the sooner we do it, we're getting better outcomes.
00:05:58:15 - 00:06:17:21
Tom Haederle
Really good news for patients. I'm wondering, given the size of Henry
Ford, a big, big system you have. And I imagine that rolling out any new
technology or software or changing how things are done, particularly
across a scale like that, has got its challenges. Did you run into any
kind of bureaucratic obstacles or resistance? We don't know what this
thing is . . .
00:06:17:21 - 00:06:21:23
Tom Haederle
Prove it to us. Was it hard to sell, or not really?
00:06:21:26 - 00:06:45:08
Aaron Lewandowski, M.D.
What? Dr. Chebl first brought the idea to us at the West Bloomfield
emergency Department, it was certainly interest in, you know, ways that
we can improve our stroke care. I would say overall, we didn't really
experience any significant barriers to implementing Rapid AI here at
Henry Ford. I would say the hurdles that we faced were the standard
hurdles you faced with integrating any new piece of software or
technology into your preexisting hospital system.
00:06:45:10 - 00:07:23:24
Alex Chebl, M.D.
Yeah, I would second that. You know, there was some trepidation amongst
some team members. You know, our implementation of Rapid AI, there's
many different ways that you could implement such a program. One could
be it just notifies the radiologist, "hey, there's a potential stroke.
Take a look." We have gone to the exact or most extreme or the deepest
implementation, meaning all members of the team are notified when we
have a stroke, and this has minimized the number of phone calls we have
to make to get the patient ready, to get the OR team ready, etc. and
when you have that many people learning something new there can be some
trepidation.
00:07:23:24 - 00:07:44:12
Alex Chebl, M.D.
And the biggest fear really was, why do I have to have another app? And
this is just going to increase my workload, right? I'm going to be
bothered all the time with these unnecessary things. And in fact, it's
the exact opposite. Most people got used to it. They could not believe
that they were living without it. It's made their lives better.
00:07:44:12 - 00:07:49:11
Alex Chebl, M.D.
Not just the patients lives better. It made all of our lives better because it's simplified the communication.
00:07:49:14 - 00:08:21:26
Aaron Lewandowski, M.D.
And I would certainly second that. From an emergency medicine
perspective, a lot of our job on a day to day basis is discussing phone
calls with consultants and trying to communicate with other team
members. So being able to have that initial phone call with the stroke
neurologist to discuss the initial plan of care, but then everything
else being in the, HIPAA secure chat with rapid AI has certainly allowed
for our communication to be much more effective and much more quicker
so that everyone can see in real time what's going on, what's the plan?
00:08:21:26 - 00:08:23:14
Aaron Lewandowski, M.D.
What are we doing for the patient?
00:08:23:16 - 00:08:44:22
Tom Haederle
Yeah. You hear that so often about applications of AI and in almost any
capacity, ambient listening or anything else. People are delighted. It's
a time saver and a work saver. And you've seen that with the with the
implementation of, Rapid AI at Henry Ford. Any thoughts you would share
about another system or hospital that is considering going around and
maybe integrating it for the first time?
00:08:44:25 - 00:08:50:24
Tom Haederle
What would you say in terms of it's utility, in terms of its ease of use, that kind of thing?
00:08:50:26 - 00:09:17:29
Alex Chebl, M.D.
Well, I mean, I think there's two aspects. One is you've got to lay the
groundwork for this. You need a stroke champion, champions. Certainly
someone from emergency department is critical. You need someone on the
neurology side. And they need to then sell this to everyone. Once you've
laid the groundwork and you've got buy-in from everyone
00:09:18:01 - 00:09:41:20
Alex Chebl, M.D.
the actual implementation isn't that difficult. Securing IT, and the
firewalls, etc.. The company helped set up. They also have individuals
who can come and help train users. How to use it, how to adjust the
settings, etc.. So we found that it was pretty straightforward to
initiate the Rapid AI in our system.
00:09:41:26 - 00:10:00:29
Alex Chebl, M.D.
And one way to do it, I guess, would be my suggestion would be don't
start too big. You know, maybe start if you have a large system like we
have, you know, start locally, 1 or 2 smaller hospitals. Don't include
every single team member. Get the bugs worked out of the system and then
expand.
00:10:01:01 - 00:10:21:13
Aaron Lewandowski, M.D.
And definitely when you're trying to, you know, sell the idea to
administration or other departments, certainly focusing on the benefits
to patient care, like quicker diagnosis and also the benefits to the
team members, such as more effective communication. I think is a really
good way to show the positive benefits that can come from this.
00:10:21:16 - 00:10:47:18
Alex Chebl, M.D.
You know, obviously we do everything focused on the patient. We want the
best patient outcomes, but we can't deliver good health care without
paying for everything that's required to do so. So the money does play a
role. And I think this is where it's important for an administrator to
understand is that the better the patient does, the shorter length of
stay, the less money is spent on that patient.
00:10:47:22 - 00:11:02:22
Alex Chebl, M.D.
And therefore a health system can keep more of that money for the other
services that they need. And I think that's very important. I mean,
after all, this is why we were able to convince CMS to pay for these
very complex treatments is because overall it ends up saving money.
00:11:02:24 - 00:11:09:23
Tom Haederle
It's a great point, thank you. As we wrap up, any final thoughts?
Anything we haven't talked about that you'd like to say about Rapid AI?
00:11:09:26 - 00:11:35:20
Alex Chebl, M.D.
You know, these systems now? Although they're mostly started in stroke,
there are many competitors, Rapid AI as well, but they have other
modules. And so these systems can be used for other disease states,
pulmonary embolism, the identification of intracranial hemorrhage,
cerebral aneurysms. And so there are many opportunities for multiple
different departments to collaborate. And that can also help with the
financial aspects of this.
00:11:35:21 - 00:11:46:14
Alex Chebl, M.D.
You know, the more users you have on board, it tends to be, you know,
cheaper than just having each individual division having their own
systems working independently.
00:11:46:16 - 00:11:51:12
Tom Haederle
That's a great point, thank you. Thank you for bringing that up. Dr, Lewandowski, any final thoughts?
00:11:51:15 - 00:12:09:23
Aaron Lewandowski, M.D.
I've certainly enjoyed the implementation of Rapid AI. It makes my job
simpler. It provides better patient care. You know, I don't think that
AI will ever replace physician assessment and judgment, but it's very
impressive what a powerful tool it can be when used appropriately, to
improve the care that we provide to our patients.
:12:09:26 - 00:12:21:22
Tom Haederle
Absolutely. Thank you both so much for your time today and this great
discussion. And I hope it reaches a lot of ears and get some people
thinking about just how powerful this tool is. So again, appreciate your
time. Thank you for being on Advancing Health.
00:12:21:25 - 00:12:22:15
Aaron Lewandowski, M.D.
Thank you very much.
00:12:22:20 - 00:12:25:05
Alex Chebl, M.D.
Thank you. Have a wonderful day.
00:12:25:07 - 00:12:33:18
Tom Haederle
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