The "Saving Limbs, Saving Lives" campaign aims to give healthcare providers access to a digital health platform that offers care management resources and a virtual connection to specialists.

A new national campaign aims to reduce the number of leg amputations in the US by giving healthcare providers access to digital health tools aimed at improving care management.

The "Saving Limbs, Saving Lives" (SL2) project, unveiled at the recent New Cardiovascular Horizons (NCVH) annual conference, targets the estimated 150,000 annual lower extremity amputations, according to the National Institutes of Health. The effort to give members of the American Podiatric Medical Association access to a digital health platform developed by CarePICS that includes wound care management guidelines and best practices and virtual access to specialists.

With studies estimated that as much as 60% of lower extremity amputations could have been prevented, the project takes aim at four critical care gaps in the wound treatment process: imprecise assessment and measurement using manual tools; inadequate and inconsistent documentation; inefficient follow-up care and communication; and fragmented care coordination between initial care providers and vascular specialists.

"When we look broadly at the medical histories of patients who have undergone lower extremity amputations, the evidence reveals that only about half have ever had a vascular evaluation or were referred to a vascular specialist," Timothy Yates, MD, of Florida-based Palm Vascular Centers, said in a press release issued by CarePICS. "Their condition simply progressed to a stage where the limb could not be salvaged. This is exactly the scenario SL2 is helping avoid. Using the CarePICS app, podiatrists can quickly and easily request an electronic consult with a vascular specialist, then convert it to an electronic referral when it's indicated that the patient needs a vascular evaluation."

The campaign is part of a three-phased approach, and will run through June 2024. Organizers will evaluate the results and then determine whether to make it permanent.

Amol Vyas says the federal government has to push forward with efforts that promote interoperability, addressing current barriers like trust, security, and scale

The National Committee for Quality Assurance (NCQA) recently appointed Amol Vyas as its first vice president of interoperability, giving the non-profit organization a point man as the government and healthcare industry make progress toward nationwide health information exchange.

Vyas has more than two decades of experience in information technology, most recently with Cambia Health Solutions. He also was part of the MedicaLogic team that helped to develop one of the first electronic medical record systems, and he led development of the Common Payer Consumer Data Set and the CARIN FHIR Implementation Guide for Blue Button.

He recently sat down for a virtual Q&A with HealthLeaders on his new role.

Q. Why is the NCQA creating a VP of Interoperability now?

Vyas: We are at an important juncture in the healthcare industry’s interoperability journey. The federal government (particularly the Centers for Medicare & Medicaid Services and the Health and Human Services Department's Office of the National Coordinator for Health IT) have doubled down on standards-based health data interoperability. Both payers and providers are now mandated to share health data using interoperable APIs. In creating the VP of Interoperability role, I believe NCQA has committed to focusing on harnessing these exciting developments in the transition to full digital quality measurement.

Q. What are your priorities and goals in the year(s) ahead?

Vyas: One of my top priorities is to create an enterprise strategy that is aligned with not only the key business focus areas but also the healthcare industry's current state of maturity in interoperability. The goal is to position NCQA's products and services to leverage regulated interoperability APIs that are currently in use.

Q. What are the challenges or barriers affecting nationwide healthcare interoperability?

Vyas: The payer and provider interoperability APIs have arrived and are here to stay. However, to reach the next level of maturity, we need to address major hurdles like scale, security, and trust.

Q. Do healthcare organizations understand the value of interoperability?

Vyas: Over the last five years, healthcare organizations have come a long way in terms of understanding the value of interoperability. The 'carrots-and-sticks' approach adopted by the industry and federal government has played an important part in organizations realizing the potential of interoperability.

Q. How can new digital health tools play a part in promoting or achieving interoperability?

Vyas: Newer digital health tools are increasingly riding on the success of interoperable exchange of data. The liquidity, portability, and higher quality of data that such tools expose or ingest can fuel innovative business use cases and patient journeys.

Q. What more can or should be done to promote or achieve interoperability?

Vyas: We need to find solutions to emergent issues as part of our increasing adoption of interoperability. Scale, security, and trust are the next challenges that need to be addressed in time to maintain our momentum. The ONC’s Trusted Exchange Framework and Common Agreement (TEFCA) and CMS’ National Directory of Health Care Providers and Services are some of the evolving solutions to watch for.

Q. Should the government be incentivizing interoperability or penalizing those who aren't moving toward that goal?

Vyas: The 'carrots-and-sticks' approach adopted by the industry and federal government has played an important part in how organizations have adopted interoperability.

Q. What has surprised you, good or bad, about the path to interoperability?

Vyas: The healthcare industry's slow pace (or absolute lack) of adoption of evolving interoperability standards in the absence of incentives or penalties continues to surprise me.

The conference, taking place this week in San Diego, has drawn healthcare leaders, researchers, and entrepreneurs to discuss how healthcare should map out an AI strategy.

AI is having its moment. And healthcare leaders are fully invested, excited about the potential for the technology but wary of the dangers.

The technology that's on everyone's lips and in everyone's pilot programs could be used to address healthcare's key pain points, be it a shrinking workforce, surging stress and burnout rates, or care coordination and management inefficiencies. Advocates point out that AI can handle burdensome and tedious tasks that take providers away from providing care, while also gathering and analyzing data far more quickly and efficiently than the human mind.

"It's what we hear all day, every day now," said Karen Seagraves, PhD, MPH, NEA-BC, a senior healthcare consultant and former vice president of Atrium Health's Neuroscience Institute.

But while some are calling it an unguided missile, capable of causing great harm, others see it as a transformative technology poised to reinvigorate healthcare, if only healthcare would listen.

"We wouldn't have used the iPhone," points out Chip Steiner, a product manager for healthcare at Kore.ai, a digital health company focused on language-based AI technology. "We didn't know we needed it until now we do."

The good and the bad are on display at the AIMed (Artificial Intelligence in Medicine) Global Summit, taking place this week in San Diego. The brainchild of Anthony Chang, MD, MPH, MS, MBA, a pediatric cardiologist at Children's Hospital of California (CHOC) and Freddy White, a UK-based events organizer and author of Intelligence Based Medicine, the five-year-old conference boasts a registered attendance of some 1,500 healthcare executives, clinicians, researchers, and vendors.

With a high-level and international speaker list and an intimate exhibit hall ringed by track-level stages similar to the HLTH and ViVE conferences, AIMed is poised to capture the conversation. That includes heeding the concerns of those who argue for tapping the brakes on the hype.

Just remember what happened with the EHR.

"There is enthusiasm about this disruptive technology," said Jesse Ehrenfeld, MD, MPH, a senior associate dean, tenured professor of anesthesiology and director of the “Advancing a Healthier Wisconsin Endowment” at the Medical College of Wisconsin, and president-elect of the American Medical Association, while also bringing up the "horror stories" of EHR adoption caused by a provider population that clearly wasn't ready or willing to embrace the new technology. "The existing regulatory framework is clearly not equipped to handle [AI governance]."

Ehrenfeld said the healthcare community needs to make sure that AI adoption doesn't follow the same path as EHR adoption, and that healthcare executives and clinicians play an active role in shepherding the technology forward.

"They've got to include clinician voices at the front end, not as an afterthought," he said.

During a panel composed primarily of healthcare executives, the general consensus was that AI—defined as augmented intelligence rather than artificial intelligence—would help healthcare make some early gains in reducing administrative tasks and improving workflows. That's an important selling point for an industry dealing with stress, burnout, and shortages up and down the roster, from clinicians and nurses down to tech support.

'We're always asked to do more with less," said Lynn Jeffers, MD, MBA, FACS, chief medical officer at Dignity Health.

"Efficiency is at the crux of how we solve this," added Stephanie Lahr, MD, CHCIO, the former CHIME board member and CIO and CMIO at Monument Health who's now president of digital health company Artisight.

The panel even featured one of the first and few healthcare executives whose role is specifically focused on AI: Ashley Beecy, MD, FACC, an assistant professor at Weill Cornell Medical College and medical director of AI operations at New York Presbyterian Hospital. Beecy noted her role was created to bring clinical leadership to the table when discussing AI strategy, so that clinicians can be part of the process in developing, testing, and scaling AI projects.

And that's where AI should start. While Chris DiRienzo, MD, MPP, senior vice president and chief physician executive for the American Hospital Association and an adjunct professor at the Duke University School of Medicine, pointed out that AI not only can help clinicians do their work better but also do work that clinicians can't do, the inclination is to reach immediately for the stars and use the technology to, say, find a cure for cancer. Instead, he and others said, start with the low-hanging fruit and build up the small successes.

"We have to cultivate the culture," said Eric Eskioglu, MD, MBA, chief medical and scientific officer at Novant Health.

That's going to take some time. When asked to predict the future for AI acceptance in healthcare, some foresaw 10 failures for every success and a gradual annoyance of the ChatGPT craze. But mixed with that was an understanding that healthcare leaders would move slowly to embrace more AI applications in healthcare, primarily because consumers and clinicians will be learning how to use the technology and will be pushing for more opportunities to use it.

Chang sees the landscape remaining unsettled for another one or two years, then a gradual understanding of what can and can't be done in three to five years.

"I do think there is more hope than ever before," he said.