Artificial Intelligence to be the game changer for patient outcomes

The use and benefits of new technologies by the healthcare sector has recently been in the news, with British Prime Minister Theresa May announcing plans to use artificial intelligence (AI) and data in the diagnosis of chronic diseases.

“The United Kingdom will use data, artificial intelligence and innovation to transform the prevention, early diagnosis and treatment of diseases like cancer, diabetes, heart disease and dementia by 2030,” Mrs May said in a speech in late May. The announcement created headlines in the UK and around the world.

The excitement of the announcement is shared by Dr Martin Than, Emergency Medicine Specialist at the Canterbury District Health Board, New Zealand, who will explore AI and what it means for emergency medicine when he presents as a keynote speaker the 35th Annual Scientific Meeting (ASM) in Perth later this year.

Register now

Early Bird Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.

Check out the program and further details on the ASM website.

On the Edge of AI in emergency medicine

Dr Than is the Director of Research at Christchurch Hospital’s Emergency Department and has a specific interest in evidence-based healthcare and the safe rapid translation of research findings into clinical practice.

With his deep interest in new technologies and AI he will discuss what technology, machine learning and artificial intelligence will impact emergency medicine.

“Medicine will start to change dramatically in the next five years,” Dr Than says. “And I think we all accept that change is happening but I don’t think people quite understand just the extent and speed of change.”

Caution and skepticism regarding new technology is natural and appropriate and in part, that reaction is following the ‘hype cycle’, according to Dr Than. The hype cycle is a tool that provides a graphic representation of the maturity and adoption of technologies and applications. Basically, technology goes through various stages on the rocky road to mass adoption.

For Dr Than, the benefits of AI in emergency medicine are starting to crystallize and become more widely understood.

“Soon we will have the data, the machine enhanced techniques to use the data and analyse it, and have the processing power to do it in real time at the patient bed side,” he said. “So those three things together fundamentally change what can happen in patient care. For any patients in front of you at any one time, you should be able to make quite precise and individualised predictive diagnoses.

“Research as we know it will continue but much research will actually become real time patient care. Each new patient that you treat will become one more patient in your database that leads to the treatment of the next patient immediately afterwards.”

Dr Than says despite the advances in technology, data and use of computers, there would always be a role for emergency physicians. In fact, it is the hope that doctors and nurses will be freed up to spend more time communicating with patients.

“I see this (new technology) as being a bit like an angel on your shoulder,” Dr Than says. “You don’t have to listen to it, but it will be prompting you and giving you advice when you ask for it.

“I believe that it’s definitely going to happen, it’s going to come quicker than we expect.”

Dr Than is aware that, like in the UK, sceptics and opposition to AI exists, but says the issue has moved on from “publishing some interesting observational findings in a journal”.

“This is actually about taking data and applying it to the next patient you are going to see,” Dr Than says. “So that to me is doing something very meaningful and something that drives me to continue this work.”

Reflecting on emergency medicine

For Associate Professor Anna Holdgate, a lot has changed in emergency medicine over the last 30 years.

A Sydney-based emergency physician with a distinguished record in Australasian emergency medicine as a researcher, teacher and mentor, it will be these changes that she will reflect on as a keynote speaker the 35th Annual Scientific Meeting (ASM) in Perth later this year.

Register now
Early Bird Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.
Check out the program and further details on the ASM website.

Constant change

“I will reflect on what is new and what is not, what has changed and what has not, and what has changed back to where it was when I started my career,” Associate Professor Holdgate says.
“I will be looking at changes in clinical practice, changes in culture and behaviour in emergency medicine, and the changes in educational techniques and strategies.
“And evidence to support those changes, or whether there is in fact any evidence to support some of those changes. It is sometimes fashion as much as evidence that shapes what we do.”
Associate Professor Holdgate, who is a Senior Staff Specialist at Liverpool and Sutherland Hospitals, added changes she had witnessed and experienced in emergency medicine have not necessarily always been for the better.
“Some [changes] are [for the better] and some aren’t,” she said. “And some probably really don’t make much difference.
“It is very important when there is change to think if it’s of proven benefit and a useful thing to do, or whether it is just change for the sake of change but doesn’t actually make much difference.
“One of the important messages I want people to think about is that just because something has changed doesn’t necessarily make it better, and we need to keep critical thinking continuing even as things change.”

And what are some of the specific changes she will comment on?
Associate Professor Holdgate teasingly says that you will have to be at the ASM to find out.

Bringing everyone together
“Sharing information is one of the key dynamics behind emergency medicine,” Associate Professor Holdgate says when asked why events like the ASM are important.
“Of all the specialities it is probably the one that requires team work at the highest level and that the experience of people from a whole lot of different places both geographically and demographically makes a huge difference to your own practice.”
Associate Professor Holdgate, who was awarded the ACEM Teaching Excellence award in 2013 and a recipient of the John Gilroy Potts award for research in 2014, says she loved the “variety of practice” in emergency medicine.
“It’s an opportunity to see people from all walks of life and also an opportunity to interact with junior doctors and help shape their careers into the future, their clinical thinking, and hopefully develop their critical thinking skills to have a long-lasting influence on their future clinical practice,” she said.

Advancing emergency medicine internationally

A group of international doctors from developing countries has spoken about the inspiration they gained following a visit to Australia.

The group were awarded the International Scholarship from the ACEM Foundation and attended and presented at #ACEM17 in Sydney.

The scholarship aims to increase awareness and support for emergency medicine in developing countries. By nomination of a FACEM or trainee, the scholarship is designed to help increase recipients’ skills and understanding of emergency medicine systems and standards throughout Australia and New Zealand.

The scholarship may include visiting emergency departments within Australia and New Zealand to help increase the scholarship recipients’ skills and understanding of emergency medicine systems and standards throughout Australasia.

The 2017 recipients were:

  • Dr Aung Myo Naing (Myanmar)
  • Professor Maw Maw Oo (Myanmar)
  • Dr Chamida Aruna Suraweera (Sri Lanka)
  • Dr Patrick Toito’ona (Solomon Islands)
  • Dr Sonai Chaudhuri (Nepal)

Immediate Past President Professor Tony Lawler, Dr Patrick Toito’ona, Professor Maw Maw Oo, Dr Sonai Chaudhuri, Dr Suraweera and Dr Naing

Dr Toito’ona said learning about emergency department layout and design and the country’s triage system, and meeting “the hard working” doctors and nurses was “very inspiring indeed”.

“Just to come to Sydney and meet wonderful people, and most importantly being able to see what emergency medicine was like in Australia, the experience was unforgettable,” Dr Toito’ona said.

Dr Toito’ona said he hoped as a result of the trip and contacts he made, “we can be more heavily involved in research collaborations, which in turn will help boost emergency medicine in the Solomon Islands”.

Read Dr Toito’ona’s report on his trip.

Dr Suraweera said the trip was a “once in lifetime opportunity”. “It was a great and broad experience to participate and present at this [the ASM] event, as the first Sri Lankan recipient of this International Scholarship of ACEM Foundation,” Dr Suraweera said.

Read Dr Suraweera’s report on his trip.

Professor Maw Maw Oo said the visit to Sydney’s hospitals allowed him to observe patient care “in real time”. “We have FACEMs who work in Myanmar and tell us stories, but this trip was an opportunity to see it first hand and learn about staffing models and patient care pathways,” he said.

Dr Naing described the ASM in Sydney as “fantastic”. “We now have many new relationships with doctors from other developing countries,” he said.

FACEMs Dr Georgina Phillips and Dr Gerard O’Reilly said: “It was a privilege to host these wonderful and talented doctors, and we look forward to receiving nominations for this year’s ASM in Perth.”

2018 International Scholarship

Nominations for this year’s scholarship, which supports the attendance and presentation of doctors and other health professionals from developing countries at the ACEM ASM, are open and will close on 29 April.

Further details, including eligibility, and selection criteria and process, are on the ACEM website.

Holy smokes BatDoc! Ken Milne to speak, entertain at #acem18

By day he is the Chief of Staff at South Huron Hospital Association in Exeter, Ontario, Canada. By night he turns into BatDoc, starring in light-hearted videos promoting medical conferences, thought leaders, ideas and events advancing emergency medicine.

Welcome to the world of Dr Ken Milne.

Dr Milne, who has been doing research for over 30 years publishing on a variety of topics, is one of the keynote speakers for the 35th Annual Scientific Meeting (ASM) in Perth later this year.

“Medicine and science – I love them – but you have got to have fun too, you have got to enjoy it, and the videos are part of that fun,” Dr Milne says of his popular YouTube videos.

Dr Milne is also active on social media, including twitter, and is the founder of The Skeptics’ Guide to Emergency Medicine project. This social media initiative uses a weekly blog and podcast to disseminate high-quality, clinically-relevant, evidenced-based and patient-centred emergency medicine information around the world for free.

Registrations are now open

Early Bird Registration is now open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.

Check out the program and further details on the ASM website.

Looking after emergency physicians’ wellbeing

Dr Milne is currently completing a research project on mindfulness and using this technique to prevent burnout among emergency physicians, and hopes to present this at the ASM.

“I want to talk about, as an emergency physician, we are on the edge of life and death, but we are also on the edge of being healthy and well. Our work can take a personal toll, so we need to look after ourselves so we can always be on the top of our game when it comes to looking after our patients,” he says.

Dr Milne is also passionate about scepticism and critical thinking. “We shouldn’t being doing stuff unless we’ve darn good reason to believe that it works,” he says. “And so the burden of proof is on those making the claims. So that’s where the healthy scepticism comes from.

“But I am always trying to stay away from the edge of being a cynic or being nihilistic. I will be on the edge of skepticism and the border of nihilism.”

Dr Milne will also stress that everyone can make a difference. “From a statistical point of view – because I am a nerd – in the emergency department we are one of the few specialties that can have a Number Needed to Treat (NNT) of one. So we can help every single person we come into contact with because we are on the edge of the healthcare system.”

Worldwide system issues

Dr Milne notes emergency physicians in Canada confront the same issues in Australia, namely a workforce battling increased demand, access block and overcrowding, coupled with fewer resources and funding.

“As Chief of Staff I am constantly looking at changes that we can do to improve the system because what we do matters,” he says. “Making sure people get the care they need in a timely fashion is really, really important.”

Call for Plenaries and Interactives

Following a successful #ACEM17, planning is well underway for the 35th Annual Scientific Meeting in Perth later this year.

And in a marked change to previous years, the organising committee is inviting submissions for presentation at the ASM, a move designed to attract and hear from as many FACEMs and trainees as possible when the event gets underway in November.

“At every ASM we see high quality presentations from well-known researchers and educators. You know who those people are, and so do we, and we hope to ask many of them to present in Perth,” explains FACEM Professor Ian Rogers, Scientific Convenor for the meeting.

“We also know that with about 2500 FACEMs and as many trainees there must be many more potential presenters out there that are unknown or only known locally but who are really well suited to presenting at the ASM.

“They will have special interest or expertise in an area that aligns with the themes we plan for the meeting. We want to give them the opportunity to speak but to do so they need to let us know who they are.”

Expressions of interest to present Plenaries and Interactives at the ASM are now open. Submit your expression of interest for Plenaries and Interactives here. This will close 26 March.

Prompt decisions will be made on these submissions before a further Scientific Abstracts call that will be open from April to July. Depending on the subject matter it may be possible to submit as a scientific abstract a plenary proposal that was not successful. Every submission will be judged on its merits.

You can discover more about the submission process including the difference between a Plenary and Interactives, and Scientific Abstracts guidelines on the ASM 2018 website.

“These calls – both stages – are open to anyone but will be competitive. We want the best science to fill every part of every stream in the meeting,” Professor Rogers said.

“My role as the Chair of the meeting Scientific Committee is to put on a program with the best science, and in in the most engaging format possible.

“Our keynote speakers have already been announced and they will each bring their special interests and style to the meeting, with one of them opening each of the four days with a plenary presentation to the whole conference.

“One of the features of the meeting is that we plan to run less parallel streams than in the past to ensure that no presentation occurs in front of a small audience or an under-filled auditorium. Having only four streams will also make it much easier for delegates to move from room to room to get to the presentations they most want to see.”

Themes of the meeting that have already been identified include knowledge translation and decision making, resuscitation science and resuscitation technology.

Professor Rogers added: “Our whole organising committee is excited about showcasing our city and state. It isn’t often that the ASM crosses the Nullarbor and I know that for many attendees this will be their first west coast ASM and perhaps even their first trip to Western Australia.

“We look forward to seeing everyone in Perth.”

For further inquiries, please email the organising committee at acem2018@encanta.com.au

On the Edge of Artificial Intelligence in Emergency Medicine

What is the difference between machine learning and artificial intelligence?

Machine learning is an application of artificial intelligence that provides systems the ability to improve and automatically learn from experience without being programmed. Computer programs accessing data and learning for themselves (think Terminator).

Artificial intelligence is machines being able to carry out tasks in a way that we would consider “smart”.

What does this mean for emergency medicine? Dr Martin Than, Emergency Medicine Specialist at the Canterbury District Health Board, New Zealand, will explore these issues at the 2018 Australasian College of Emergency Medicine’s Annual Scientific Meeting. The ASM will be held in Perth on 18 – 22 November and will include Dr Than’s keynote address “On the Edge of Artificial Intelligence”.

Dr Than is the Director of Research at Christchurch Hospital’s Emergency Department and has a specific interest in evidence-based healthcare and the safe rapid translation of research findings into clinical practice. His work focuses on cardiac biomarkers and acute coronary syndrome with approximately 110 papers in this field since 2011.

Dr Martin Than has now led two randomised controlled trials on the benefits of using accelerated decision making pathways for patients being assessed for possible ACS, and led the implementation of rapid chest pain assessment pathways into every hospital throughout New Zealand. With his deep interest in new technologies and artificial intelligence he will discuss what technology, machine learning and artificial intelligence will impact Emergency Medicine.

The ASM will have a number of high profile keynotes discussing a variety of topics on the theme “On the Edge” and is a perfect opportunity for emergency medicine physicians, trainees, nursers, paramedics and anyone in this field to update their knowledge and skills at the largest Australian and New Zealand Emergency medicine scientific meeting.