How a cross-sector collab seeks to bridge rural healthcare's AI divide

AI transforms stroke care for UK Healthcare's rural network

Health technologies, especially AI tools, can help rural facilities overcome persistent challenges, like eliminating the long distances rural Americans often have to travel for specialty care.

For instance, the University of Kentucky Healthcare is using Viz.ai's AI-powered stroke detection platform to determine patient transfers from rural facilities around the state.

According to Justin F. Fraser, M.D., director of cerebrovascular surgery and vice chair of the health system's neurological surgery department, UK Healthcare initially implemented the platform to identify large vessel occlusion stroke. Physicians can minimize the impact of LVO strokes using a procedure called mechanical thrombectomy.

"But the key is rapid identification and rapid triage to a center that does that kind of work," he explained. "Not every hospital is equipped to do it. So we needed a tool that would allow us to do that and would allow us to streamline that process."

Viz.ai's platform leverages the first FDA-approved algorithm for detecting strokes on CT scans. If a person comes into any of UK Healthcare's affiliated rural facilities in Kentucky with a suspected stroke, they receive a CT angiogram. The platform then analyses the images and flags those that look suspicious, sending them directly to UK neurologists' phones to determine whether the patient needs to be transferred to the UK's comprehensive stroke center, Fraser said.

The platform also provides a HIPAA-protected environment where neurologists can text or call the outside provider who's seeing that patient.

"It gives us an opportunity to interact, to talk about the clinical case, to discuss the clinical presentation, and to figure out if there is indeed an emergency situation," he said. "Essentially, it's a triage tool."

According to Andrew Ibrahim, M.D., chief clinical officer at Viz.ai, the platform can improve time-to-treatment by an hour in certain cases, a vital benefit when dealing with a time-sensitive condition like stroke, where early treatment can significantly improve outcomes.

UK Healthcare has expanded the tool to more than 50 rural health facilities. Not only has the platform enabled faster detection of LVO stroke, but it has also provided the health system with a trove of data, Fraser said. For example, the health system can track which areas patients are most often transferred from.

"When you're working with urban centers, the populations are so large that you can get really good statistics pretty quickly," he said. "But when you're spread out along a large region where each county might only have a few cases, it becomes very difficult to collect data and analyze it in a real-time fashion to allow you to make policy, protocol, workflow changes, to optimize care."

While the upfront costs of AI tools may be steep, the benefits they offer can help rural facilities use their limited resources more efficiently, he added.

Though efforts to address financial constraints and boost technology adoption are ongoing, what comes next can prove equally challenging for these facilities: implementation. Fraser shared that the rural hospitals they work with needed support when implementing the platform, including education, hands-on training and help measuring the impact on patient outcomes.

Slabach further noted that the sheer volume of AI technology options and the rapid pace of innovation can make it harder for under-resourced facilities to make decisions around selection, deployment and governance. And this is precisely the gap that the NRHA and Viz.ai aim to close.

Addressing rural AI adoption barriers

The goal of the collaboration launched in April is to help rural providers integrate AI deployment in their overarching strategic plans, according to Slabach.

"In other words, a take-home cheat, if you will, on what a rural provider needs to do in terms of their strategic planning and including AI as a part of that strategic planning process," he said.

Providing rural hospitals with the education and resources they need to select and deploy AI tools will be a critical aspect of the collaboration. Ibrahim noted that Viz.ai has spent 10 years working alongside rural hospitals to implement its AI platform, and it plans to use this experience to help facilities develop frameworks for selecting the right AI technology for their needs. This includes helping facilities understand how to vet tools and vendors as AI options proliferate.  

"We don't want a bunch of rural hospitals signing up for this expensive technology if they don't need it," he said. "And we also don't want the opposite of this, where a hospital could do so much more if they had the right tool."

The collaboration will help to connect those dots by providing various resources, including hosting educational webinars and creating a toolkit that includes a practical guide to AI deployment. Interviews and feedback from NRHA members will shape these materials, Ibrahim noted.

Not only that, but the collaboration will also work to connect rural care facilities with AI companies and advocate for responsible AI utilization in rural healthcare, Slabach said.

"The NRHA understands the power of artificial intelligence," he added. "We also are concerned about the abuses of it. And we are very conscious of the fact that we have a responsibility in this space to be thoughtful, to be curious, and implement programs and services that are available and implementable in a rural space."

Advancements in AI and its integration into healthcare show no signs of slowing down and unless rural care facilities gain a deeper understanding of how to select, implement and govern the technology, they will miss out on the myriad benefits it can provide.

"There's no question we are in a moment in healthcare where there is this new AI technology that could be fundamentally transformative," said Ibrahim. "And in many ways it has been. And we need to make sure that that gets harnessed appropriately."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers healthcare IT and innovation, including artificial intelligence, digital healthcare, EHRs and interoperability.