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Execs Say Silicon Valley Has The Jump On Healthcare Innovation

Posted on September 12, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Lately, it’s begun to look as though the leading lights of Silicon Valley might bring the next wave of transformation to healthcare. But can they work big changes in the industry on their own, or are they more likely to succeed by throwing their extremely considerable muscle behind existing healthcare players? That’s one of the many questions at issue as companies like Google, Amazon (Yes, I know they’re in Seattle), and Facebook shoulder their way into the business.

According to a new survey by Reaction Data, many healthcare execs think Amazon, in particular, has the potential to change the game.  When asked which outside entrants were most likely to disrupt the healthcare industry, two-thirds of respondents said the that the online retailing giant topped the list. “Amazon is ahead of the game in many ways compared to the other companies,” a chief nursing officer told Reaction Data.

There’s little doubt that there’s an opening for a company like Amazon to solve some pressing problems. As an industry outsider – unless you count its recent big-ticket acquisition of PillPack, which happened about a minute ago – Amazon may be able to bring fresh eyes to some of healthcare’s biggest problems. For example, what health exec wouldn’t kill to benefit from the e-retailer’s immense logistics capabilities? The mind boggles.

Facebook and Google aren’t making as many healthcare headlines, but they too are moving carefully into the business. For example, consider Google’s partnership with Stanford aimed at creating digital scribes. The digital scribe initiative may not seem like much, but I wouldn’t underestimate what Google can learn from the effort and how effectively it can operationalize this knowledge. It isn’t 2010 anymore, and I think the search giant has come a long way since its Google Health PHR effort collapsed.

Facebook, too, has made some tentative steps toward building a healthcare business, such as its recent agreement to collaborate with the NYU School of Medicine on speeding up MRI scanning using AI. The social networking giant hasn’t shown itself capable of much diversification to date, but I wouldn’t count it out, if for no other reasons than the massive profits to be made. Even for Facebook, we’re talking about serious money here.

If you’re wondering what these companies hope to accomplish, it’s not surprising. There are so many possibilities. One place to start is rethinking the EHR. Maybe I’m a starry-eyed dreamer, but I agree with observers like Dale Sanders, an executive with HealthCatalyst, who argues that Silicon Valley disrupters might be poised to bring something new to the table. “I keep hoping that the Googles, Facebooks and Amazons of the world will quietly build a new generation EMR,” Sanders writes in a recent column.

EMR transformation is just one of many potential targets of opportunity for the Silicon Valley gang, though. There’s obviously a raft of other goals healthcare leaders might like to see realized, The truth is, though, that it matters less what the Silicon Valley giants do than the competitive scramble they kick off within the industry. Even if these behemoths never succeed in leading the charge, they’re likely to spur others to do so.

Does NLP Deserve To Be The New Hotness In Healthcare?

Posted on August 30, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Lately, I’ve been seeing a lot more talk about the benefits of using natural language processing technology in healthcare. In fact, when I Googled the topic, I turned up a number of articles on the subject published over the last several weeks. Clearly, something is afoot here.

What’s driving the happy talk? One case in point is a new report from health IT industry analyst firm Chilmark Research laying out 12 possible use cases for NLP in healthcare.

According to Chilmark, some of the most compelling options include speech recognition, clinical documentation improvement, data mining research, computer-assisted coding and automated registry reporting. Its researchers also seem to be fans of clinical trial matching, prior authorization, clinical decision support and risk adjustment and hierarchical condition categories, approaches it labels “emerging.”

From what I can see, the highest profile application of NLP in healthcare is using it to dig through unstructured data and text. For example, a recent article describes how Intermountain Healthcare has begun identifying heart failure patients by reading data from 25 different free text documents stored in the EHR. Clearly, exercises like these can have an immediate impact on patient health.

However, stories like the above are actually pretty unusual. Yes, healthcare organizations have been working to use NLP to mine text for some time, and it seems like a very logical way to filter out critical information. But is there a reason that NLP use even for this purpose isn’t as widespread as one might think? According to one critic, the answer is yes.

In a recent piece, Dale Sanders, president of technology at HealthCatalyst, goes after the use of comparative data, predictive analytics and NLP in healthcare, arguing that their benefits to healthcare organizations have been oversold.

Sanders, who says he came to healthcare with a deep understanding of NLP and predictive analytics, contends that NLP has had ”essentially no impact” on healthcare. ”We’ve made incremental progress, but there are fundamental gaps in our industry’s data ecosystem– missing pieces of the data puzzle– that inherently limit what we can achieve with NLP,” Sanders argues.

He doesn’t seem to see this changing in the near future either. Given how much money has already been sunk in the existing generation of EMRs, vendors have no incentive to improve their capacity for indexing information, Sanders says.

“In today’s EMRs, we have little more than expensive word processors,” he writes. “I keep hoping that the Googles, Facebooks and Amazons of the world will quietly build a new generation EMR.” He’s not the only one, though that’s a topic for another article.

I wish I could say that I side with researchers like Chilmark that see a bright near-term future for NLP in healthcare. After all, part of why I love doing what I do is exploring and getting excited about emerging technologies with high potential for improving healthcare, and I’d be happy to wave the NLP flag too.

Unfortunately, my guess is that Sanders is right about the obstacles that stand in the way of widespread NLP use in our industry. Until we have a more robust way of categorizing healthcare data and text, searching through it for value can only go so far. In other words, it may be a little too soon to pitch NLP’s benefits to providers.

Report Says EHR Usability Tests Should Focus On Common Safety Threats

Posted on August 29, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The American Medical Association and health system operator MedStar Health have published a report laying out a set of proposals designed to improve EHR safety. The report, which is also backed by The Pew Charitable Trusts, looks at ways that use of EHR usability can fail to prevent or even lead to patient harm.

As readers will know, to meet certification criteria EHRs currently need to conform with EHR usability requirements established in 2015. Developers need to document how they meet clinician needs and conduct formal usability testing addressing clinicians’ efficiency, effectiveness and satisfaction in using the system.

Unfortunately, the current generation of certification standards don’t focus specifically on high-prevalence safety hazards, which may mean that the process doesn’t address how usable some important EHR features are, the report says. Plus, even the earlier versions didn’t do much in regards to usability.

Over time, of course, both EHR developers and providers have begun to take these issues more seriously, and as the paper points out, are moving beyond the minimum required to meet certification standards.

For example, developers have agreed to review safety incidents with patient safety officers and product users, along with sharing such information across healthcare facilities. Also, providers have taken their own steps in this direction, such as protecting EHR safety surveys or establishing safety teams tasked with identifying EHR-related problems. As we all know, however, there’s a lot more to be done.

To make more progress, the groups suggest, EHR developers need to design more rigorous, safety-focused test cases. While they already need to run such real-world-oriented test cases, which are required for certification, but these studies might not be looking for the right things, the report says.

To be truly useful, these test cases should represent the expected uses of the technology; should represent a clinically-oriented goal with clear measures of success and failure; test known areas of risk and efficiency; and address a defined audience.

The paper also includes a list of criteria developers and providers can use to boost EHR usability and safety across the system’s entire lifecycle. For providers, this includes establishing a culture of safety which will support EHR-based safety efforts; seeing that user needs and product capabilities are aligned; customizing and configuring the system to meet those needs; implementing and maintaining the EHR carefully; and training clinicians to use the product safely and effectively.

Not surprisingly, research on these topics is ongoing, but some providers are more engaged than others. I was interested to see that MedStar Health’s National Center for Human Factors  in Healthcare continues to work with the AMA on these issues. For example, about two years ago the partners released a joint framework designed to rank EHR usability. (The partners also use the framework to rank the usability of several widely-implemented systems, including that Allscripts and McKesson were doing the best job at the time. That was fun.)

I hope to see more work on the links between EHR usability and safety in the future, as well, of course, as feedback on how to address both. We simply don’t spend enough time on this subject.

Can Providers Survive If They Don’t Get Population Health Management Right?

Posted on August 27, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Most providers know that they won’t succeed with population health management unless they get some traction in a few important areas — and that if not, they could face disaster as their volume of value-based payment share grows. The thing is, getting PHM right is proving to be a mindboggling problem for many.

Let’s start with some numbers which give us at least one perspective on the situation.

According to a survey by Health Leaders Media, 87% of respondents said that improving their population health management chops was very important. Though the article summarizing the study doesn’t say this explicitly, we all know that they have to get smart about PHM if they want to have a prayer of prospering under value-based reimbursement.

However, it seems that the respondents aren’t making nearly as much PHM progress as they’d like. For example, just 38% of respondents told Health Leaders that they attributed 25% or more of their organization’s net revenue to risk-based pop health management activities, a share which has fallen two percent from last year’s results.

More than half (51%) said that their top barrier to successfully deploying or expanding pop health programs was up-front funding for care management, IT and infrastructure. They also said that engaging patients in their own care (45%) and getting meaningful data into providers’ hands (33%) weren’t proving to be easy tasks.

At this point it’s time for some discussion.

Obviously, providers grapple with competing priorities every time they try something new, but the internal conflicts are especially clear in this case.

On the one hand, it takes smart care management to make value-based contracts feasible. That could call for a time-consuming and expensive redesign of workflow and processes, patient education and outreach, hiring case managers and more.

Meanwhile, no PHM effort will blossom without the right IT support, and that could mean making some substantial investments, including custom-developed or third-party PHM software, integrating systems into a central data repository, sophisticated data analytics and a whole lot more.

Putting all of this in place is a huge challenge. Usually, providers lay the groundwork for a next-gen strategy in advance, then put infrastructure, people and processes into place over time. But that’s a little tough in this case. We’re talking about a huge problem here!

I get it that vendors began offering off-the-shelf PHM systems or add-on modules years ago, that one can hire consultants to change up workflow and that new staff should be on-board and trained by now. And obviously, no one can say that the advent of value-based care snuck up on them completely unannounced. (In fact, it’s gotten more attention than virtually any other healthcare issue I’ve tracked.) Shouldn’t that have done the trick?

Well, yes and no. Yes, in that in many cases, any decently-run organization will adapt if they see a trend coming at them years in advance. No, in that the shift to value-based payment is such a big shift that it could be decades before everyone can play effectively.

When you think about it, there are few things more disruptive to an organization than changing not just how much it’s paid but when and how along with what they have to do in return. Yes, I too am sick of hearing tech startups beat that term to death, but I think it applies in a fairly material sense this time around.

As readers will probably agree, health IT can certainly do something to ease the transition to value-based care. But HIT leaders won’t get the chance if their organization underestimates the scope of the overall problem.

Being Honest About Your Reasons For Cybersecurity Decisions

Posted on August 16, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

This week, a team of McAfee researchers released a paper outlining a terrifying exploit. The paper describes, in great technical detail, how a malicious attacker could flip a cardiac rhythm display from 80 beats per minute to zero within less than five seconds.

This might not lead to severe harm or death, but it’s possible that other very negative outcomes could occur, notes Shaun Nordeck, MD, who’s quoted in the report. “Fictitious cardiac rhythms, even intermittent, could lead to extended hospitalization, additional testing, and side effects from medications prescribed to control heart rhythm and/or prevent clots,” he notes.

The paper does point out that if the bedside monitor is working normally, nurses have access to other accurate data, which could diminish the impact of such disruptions to some extent. However, the potential for adverse events is clearly higher than normal if someone scrambles a patient’s vitals.

Unfortunately, this is far from the only attack which wasn’t possible before connected devices became the norm. At various points, we’ve seen that pacemakers, insulin pumps and even MRIs can be hacked externally, particularly if their operating systems aren’t patched as required or haven’t put even basic security protections in place. (Think using “password” as a password.)

But while these vulnerabilities are largely known at this point, some healthcare organizations haven’t begun to tackle them. Solving these problems takes work, and costs money, The best-intentioned CIO might not get the budget to fix these problems if their CEO doesn’t see them as urgent.

Or let’s say the budget is available to begin the counterattack. Even if everyone agrees to tackle connected device vulnerabilities, where do we begin the counterattack? Which of these new connected health vulnerabilities are the most critical?  On the one hand, hacking individual pacemakers doesn’t seem profitable enough to attract many cybercriminals. On the other, if I were a crook I might see the threat of meddling with a hospitals’ worth of patient monitors to be a great source of ransom money.

And this brings us to some tough ethical questions. Should we evaluate these threats by how many patients would be affected, or how many of the sickest patients?  How do we calculate the clinical impact of vital signs hacking vs. generating inaccurate MRI results? To what extent should the administrative impact of these attacks be a factor in deciding how to defeat these challenges, if at all?

I know you’re going to tell me that this isn’t an all or nothing proposition, and that to some extent standard network intrusion detection techniques and tools will work. I’m not disputing this. However, I think we need to admit out loud that these kinds of attacks threaten individual lives in a way that traditional cyberattacks do not. For that reason, we need to get honest about who we need to protect — and why.

More Than 3 Million Patient Records Breached During Q2 2018

Posted on August 15, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study by data security vendor Protenus has concluded that more than 3 million patient records were breached during the second quarter of 2018, in a sharp swing upward from the previous quarter with no obvious explanation.

The Protenus Breach Barometer study, which drew on both reports to HHS and media disclosures, found that there were 143 data breach incidents between April and June 2018, affecting 3,143,642 million patient records. The number of affected records has almost tripled from Q1 of this year, when 1.13 million records were breached.

During this quarter, roughly 30% of privacy violations were by healthcare organizations that had previously reported a data breach. The report suggests that it is because they might not have identified existing threats or improved security training for employees either. (It could also be because cyberattackers smell blood in the water.)

Protenus concluded that among hospital teams, an investigator monitors around 4,000 EHR users, and that each was responsible for an average of 2.5 hospitals and 25 cases each. The average case took about 11 days to resolve, which sounds reasonable until you consider how much can happen while systems remain exposed.

With investigators being stretched so thin, not only external attackers but also internal threats become harder to manage. The research found that on average, 9.21 per 1,000 healthcare employees breached patient privacy during the second quarter of this year. This is up from 5.08 employee threats found during Q1 of this year, which the study attributes to better detection methods rather than an increase in events.

All told, Protenus said, insiders were responsible for 31% of the total number of reported breaches for this period. Among incidents where details were disclosed, 422,180 records were breached, or 13.4% of total breached patient records during Q2 2018. The top cause of data breaches was hacking, which accounted for 36.62% of disclosed incidents. A total of 16.2% of incidents involved loss or theft of data, with another 16.2% due to unknown causes.

In tackling insider events, the study sorted such incidents into two groups, “insider error” or “insider wrongdoing.” Its definition for insider error included incidents which had no malicious intent or could otherwise be qualified as human error, while it described the theft of information, snooping in patient files and other cases where employees knowingly violated the law as insider wrongdoing.

Protenus found 25 publicly-disclosed incidents of insider error between April and June 2018. The 14 of which for which details were disclosed affected 343,036 patient records.

Meanwhile, the researchers found 18 incidents involving insider wrongdoing, with 13 events for which data was disclosed. The number of patient records breached as a result of insider wrongdoing climbed substantially over the past two quarters, from 4,597 during Q1 to 70,562 during Q2 of 2018.

As in the first quarter, the largest category of insider-related breaches (71.4%) between April and June 2018 was healthcare employees taking a look at family members’ health records. Other insider wrongdoing incidents including phishing attacks, insider credential sharing, downloading records for sale and identity theft.

Healthcare CIOs Focused On Patient Experience And Innovation

Posted on August 2, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Not long ago, 22 healthcare CIOs had a sit-down to discuss their CEOs’ top IT-related priorities. At the meeting, which took place during the 2018 Scottsdale Institute Annual Conference, the participants found that they were largely on the same page, according to researchers that followed the conversation.

Impact Advisors, which co-sponsored the research, found that improving patient experiences was priority number one. More than 80% of CIOs said patient engagement and better patient experiences were critical, and that deploying digital health strategies could get the job done.

The technologies they cited included patient-facing options like wearables, mobile apps and self-service tools. They also said they were looking at a number of provider-facing solutions which could streamline transitions of care and improve patient flow, including care coordination apps and tools and next-generation decision support technologies such as predictive analytics.

Another issue near the top of the list was controlling IT costs and/or increasing IT value, which was cited by more than 60% of CIOs at the meeting. They noted that in the past, their organizations had invested large amounts of money to purchase, implement and upgrade enterprise EHRs, in an effort to capture Meaningful Use incentive payments, but that things were different now.

Specifically, as their organizations are still recovering from such investments, CIOs said they now need to stretch their IT budgets, They also said that they were being asked to prove that their organization’s existing infrastructure investments, especially their enterprise EHR, continue to demonstrate value. Many said that they are under pressure to prove that IT spending keeps offering a defined return on investment.

Yet another important item on their to-do list was to foster innovation, which was cited by almost 60% of CIOs present. To address this need, some CIOs are launching pilots focused on machine learning and AI, while others are forming partnerships with large employers and influential tech firms. Others are looking into establishing dedicated innovation centers within their organization. Regardless of their approach, the CIOs said, innovation efforts will only work if innovation efforts are structured and governed in a way that helps them meet their organization’s broad strategic goals.

In addition, almost 60% said that they were expected to support their organization’s growth. The CIOs noted that given the constant changes in the industry, they needed to support initiatives such as expansion of service lines or building out new ones, as well as strategic partnerships and acquisitions.

Last, but by no means least, more than half of the CIOs said cybersecurity was important. On the one hand, the participants at the roundtable said, it’s important to be proactive in defending their organization. At the same time, they emphasized that defending their organization involves having the right policies, processes, governance structure and culture.

Healthcare Leaders See AI Tech In Their Future

Posted on July 30, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

You’ve probably noticed that the movement of healthcare AI from visionary to commonplace has already begun. There are endless examples I could cite to demonstrate this, but here’s a taste:

  • A UK hospital is delegating some tasks usually performed by doctors and nurses to AI technology
  • The AMA is working to set standards for physician use of AI
  • Competition between AI-based disease management players is increasing
  • New AI software can detect signs of diabetic retinopathy without involving a physician

Of course, anytime a technology seems poised to take over the world, there’s a voice in our head saying “Are you sure?” And we all know there are many flashes in the technology pan.

When it comes to AI, however, we may be on the brink of such widespread adoption that no one could argue that it hasn’t arrived. According to a recent Intel survey of U.S. healthcare leaders, AI will be in use across the healthcare spectrum by 2023.

The research, which was conducted in partnership with Convergys Analytics, surveyed 200 US healthcare decision-makers in April 2018 on their attitudes about AI. The survey also asked subjects what barriers still existed to industry-wide AI adoption.

First, a significant number of respondents (54%) said that they expected AI to be in wide use in the industry within the next five years. Also, a substantial minority (37%) said they already used AI, though most reported that such use was limited.

Among those organizations that use AI, clinical use accounted for 77%, followed by operational use (41%) and financial use (26%). Meanwhile, respondents whose organizations hadn’t adopted AI still seem very enthusiastic about its possibilities, with 91% expecting that it will offer predictive analytics tools for early intervention, 88% saying it will improve care and 83% saying it will improve the accuracy of medical diagnoses.

Despite their enthusiasm, however, many of those surveyed were sure they could trust AI just yet. More than one-third of respondents said that patients wouldn’t trust AI enough to play an active role in their care (and they are probably right, at least for now). Meanwhile, 30% assume that clinicians wouldn’t trust AI either, predicting that concerns over fatal errors would kill their interest. Again, that’s probably a good guess.

In addition, there’s the issue of the AI “black box” to bear in mind. Though Intel didn’t go into detail on this, both clinicians and healthcare executives are concerned about the way AI gets its job done. My informal research suggests that until doctors and nurses understand how AI tools have made their decisions — and what data influenced these decisions — it will be hard to get them comfortable with it.

Company Supports Patient Data Sharing Via Blockchain

Posted on July 23, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

After a year in development, a tech startup has released a platform using blockchain to help patients share personal health records. The company, which was founded by former IMS Health exec Robert Chu, plans to sell their information to pharmaceutical companies without involving a third-party data broker.

Embleema, which built its software on the Ethereum smart-contract platform, is focused on delivering what it calls “real world evidence” to drug researchers.

Its blockchain-based app, which is known as PatientTruth, allows patients to pull provider CCDs and Fitbit data together in a single location. The idea here is that blockchain will permit patients to manage data sharing permissions far more securely and effectively than with other approaches.

When patients agree to share their data, they get crypto-tokens. Embleema, for its part, generates income by selling an anonymized version of that data to clinical researchers.

The company contends that its data offers significant advantages over traditional data sources include that it offers in individual rather than aggregate data. Having access to individual data allows drugmakers to monitor a given patient over time, which helps to improve research and drug development, it says.

On the whole, Embleema seems to have a smart business model and seems to address some well-defined needs. Bringing together health data users and sellers directly probably offers some advantages. And it will probably be very profitable to give drugmakers access to real-time patient data structured as individual records.

That being said, I’m not sure how the company will get, much less maintain, patients’ interest. Other than people in this industry, few of my acquaintances or family members have the slightest idea of how to upload their health records. In fact, some of them would be quite intimidated by the prospect.

Also, it’s is a little weird that patients who share their data with Embleema are paid in tokens rather than actual publicly-negotiable money. I know I’d find cash incentives to be a lot more motivating than tokens. My guess is that either way, patients aren’t going to get much of the income generated by their data, and I have little doubt that competitors will point this out.

Of course, clinical researchers always face some form of obstacle in getting the data they need. No matter what approach they take, the data they choose seems to have some significant limitations.

I can’t tell whether Embleema has solved this problem completely, and if so, whether its solution is scalable and if it’s really any better than companies like IMS Health, but it does seem to be focused on a sector with deep pockets and a bottomless need for patient data. In fact, I’m sure its competitors will show up soon.

Healthcare Execs Investing In Intelligent Technologies Face Roadbumps

Posted on July 16, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A recent report from Accenture concludes that healthcare executives are enthusiastic about “intelligence technologies” such as AI and IoT. It also suggests, however, that health organizations will need to add new capabilities to be sure they can manage these technologies responsibly.

The report, based on a survey of 100 health executives, found that 77% of respondents expect to invest in IoT and smart sensors and that 53% expect to invest in AI systems.  Presumably, they expect these technologies to offer benefits more quickly.

Why the gap in adoption? The truth is that healthcare leaders haven’t yet gotten their arms around AI just yet. While IoT and smart sensor technology can boost the flexibility and “judgment” of enterprise systems, AI arguably has the potential to be far more flexible and wide-reaching — and ultimately less than predictable.

This unpredictability makes AI investment a bit trickier to implement than other emerging technologies. Just over four-fifths of health leaders said they were not prepared to explain AI-based conclusions to their internal stakeholders nor outsiders.

To address this deficit, 73% said they plan to develop internal ethical standards for AI to make sure these systems can act responsibly. Before that, they’ll need to determine what “acting responsibly” actually means — and as far as I know there are no accepted guidelines for developing such standards. (They might want to start off by reviewing Google’s ethical principles for AI use here.)

Adding AI to the enterprise IT mix could also wreak havoc. I for one was surprised to read that almost one-fourth of respondents said that they had been the target of adversarial AI behaviors, including falsified location data or bot fraud. (This stat blew my mind. Why haven’t we heard more about these “adversarial behaviors” and what are they?)

This certainly adds another element of uncertainty for CIOs interested in AI investments. While AI technologies can’t “think” in the traditional sense, they can create a range of problems previous-gen technology couldn’t.

This is part of a larger picture in which health organizations aren’t sure if their data has been corrupted. In fact, 86% of health execs said they hadn’t yet invested in technologies which could verify their data sources. Adding AI to the mix could potentially compound these problems, as it might create a cascade in which the AI then draws false inferences and takes inappropriate actions.

Meanwhile, respondents were excited about blockchain and smart contracts technology, with 91% reporting that they believed it would be a critical tool for supporting frictionless businesses over the next three years. All told, expect to see IoT and blockchain investments right away, with AI lagging until health IT leaders can teach it to play nicely.