Speaker’s Disclaimer The speaker is an employee of Agfa HealthCare This presentation is not meant to offer medical, legal, regulatory compliance or advice, and is not intended to establish a standard of care The speaker is not promoting any service or product References have been cited for publicly available information, copyrighted material including figures, quotes etc. The content has been created for educational purposes, and many not be distributed without permission from the presenter

History and Future of Imaging Information Technology Franz Tiani

History of Medical Imaging Technology History and Future of Imaging Information Technology History of Medical Imaging Technology 1895 X-rays 1955 Ultrasound 1957 Endoscope 1967 Computer Tomography 1970s NMR cancer detection 1973 MRI images 1974 PET Camera 1980s MRI in hospitals 2010 Digital Pathology Educational Presentation

History of Medical Image Management History and Future of Imaging Information Technology History of Medical Image Management 1974 First PACS Precursor DIOGENE 1979 Theoretical PACS Groundwork 1982 First PACS Conference 1983 First PACS in a Health System 1992 DICOM Standards Committee founded 1998 VNA Concepts Presented 1998 IHE Founded 2016 Enterprise Imaging Educational Presentation

VISUALIZATION CHALLENGES History and Future of Imaging Information Technology VISUALIZATION CHALLENGES 1895 NOW Educational Presentation

VISUALIZATION CHALLENGES History and Future of Imaging Information Technology VISUALIZATION CHALLENGES Educational Presentation

Hospital District of Helsinki and Uusimaa Real World Example Hospital District of Helsinki and Uusimaa Educational Presentation

Hospital District of Helsinki and Uusimaa Real World Example Hospital District of Helsinki and Uusimaa Educational Presentation

Hospital District of Helsinki and Uusimaa Real World Example Hospital District of Helsinki and Uusimaa Educational Presentation

BIG DATA CHALLENGES Digital Universe Digital Health Digital Health History and Future of Imaging Information Technology BIG DATA CHALLENGES Digital Universe Consolidation Future proof platform 2020 By the year 2020, about 1.7 megabytes of new information will be created every second for every human being on the planet 04 03 Data Silos Stand alone systems Governance Where to begin Digital Health Digital Health 2020 2020 Avalanche of new research, clinical trials, scientific studies, and patient health information. Challenge for doctors and medical researchers to keep up 02 01 Technology Older IT Systems Ref: www.forbes.com Educational Presentation

HEALTHCARE EXPENDITURE vs. QUALITY History and Future of Imaging Information Technology HEALTHCARE EXPENDITURE vs. QUALITY Healthcare expenditures as % of GDP Health Expenditure per capita, 2014 (OECD stat) Health Care Access and Quality Index How well do countries’ healthcare systems treat preventable deaths? Private Public & Compulsory Health outcomes that matter to patients VALUE BASED CARE = Cost of delivering those outcomes Educational Presentation

HEALTHCARE IS UNDERGOING TRANSFORMATION History and Future of Imaging Information Technology HEALTHCARE IS UNDERGOING TRANSFORMATION Hospital-Centric Model FROM Population-Centric Model TOWARDS Drivers of Model Transformation Coordinated, collaborative care across the continuum Standardized care approaches to reduce care variation Optimized service distribution to ensure the right care at the right site New value-based models and other financial incentives Visionary frameworks: DHA 2021, HIMMS DIAM, AI, Machine Learning…. Integrated Care Hospital Services Prescription Services Physician and Clinical Services Home Health and Nursing Home Care All Other Educational Presentation

History and Future of Imaging Information Technology EVOLUTION OF EMR Pharmacy Medical Insurance Forms Clinical Reports Appointment Physician Documents Lab Results OB-Gyn Nurse Charts Medical Reports Referral Documents Scheduling Transition to some Digital Solutions improved specialty efficiencies, and helped reduce busy paper work Paper based medical records, difficult to understand, comprehension challenges, and error prone Educational Presentation

MEDICAL IMAGING IS EXPANDING Multispecialty Medical Imaging MEDICAL IMAGING IS EXPANDING Bifurcation Educational Presentation

Artificial Intelligence History and Future of Imaging Information Technology IMAGING HEALTH RECORD PACS Care-centric Workflow Clinical Imaging Diagnostic Imaging VNA Documents Universal Viewer Image Exchange Cloud Mobility Analytics Artificial Intelligence RIS Reporting Mobile & Web Consolidated Archive Educational Presentation

Integrated Care Specialist Nurse GP Psychiatrist Home nurse History and Future of Imaging Information Technology Integrated Care Specialist Nurse GP Psychiatrist Home nurse Nutritionist Specialist Educational Presentation

MAMMO SCREEING CHALLENGE What have we learned so far Educational Presentation

BREAST CANCER CHALLENGE History and Future of Imaging Information Technology BREAST CANCER CHALLENGE Educational Presentation

BREAST CANCER CHALLENGE History and Future of Imaging Information Technology BREAST CANCER CHALLENGE In 2010, nearly 1.5 million people were told “you have breast cancer” Dramatically, one-third of these cancer deaths could be decreased if detected and treated early. In a worldwide context, this means nearly 400,000 lives could be saved every year.* http://seer.cancer.gov/ (2013-2014 figures) http://www.cancer.org Educational Presentation http://www.worldwidebreastcancer.com/breast-cancer-statistics-worldwide/

Educational Presentation Breast Cancer in UAE More than 20 per cent of all female deaths in the UAE are caused by breast cancer The deadly disease is attributed to almost 40 per cent of all cancer cases Girls as young as 17 are at risk ‘UAE’s median age of breast cancer diagnosis 10-15 years younger than in West’ Breast cancer deaths rates have declined from 8.7 per 100,000 women in 2009 to five per 100,000 women in 2014, with late detection of the disease going down from 64 per cent in 2009 to 16 per cent in 2013. https://www.khaleejtimes.com/news/uae-health/make-use-of-free-screenings-for-early-detection-of-breast-cancer-in-uae https://www.haad.ae/simplycheck/tabid/140/default.aspx Educational Presentation http://gulfnews.com/xpress/news/uae-s-median-age-of-breast-cancer-diagnosis-10-15-years-younger-than-in-west-1.2100559

BREAST CANCER CHALLENGE IN UAE History and Future of Imaging Information Technology BREAST CANCER CHALLENGE IN UAE More than 20 per cent of all female deaths in the UAE are caused by breast cancer The deadly disease is attributed to almost 40 per cent of all cancer cases Girls as young as 17 are at risk ‘UAE’s median age of breast cancer diagnosis 10-15 years younger than in West’ Breast cancer deaths rates have declined from 8.7 per 100,000 women in 2009 to five per 100,000 women in 2014, with late detection of the disease going down from 64 per cent in 2009 to 16 per cent in 2013. https://www.khaleejtimes.com/news/uae-health/make-use-of-free-screenings-for-early-detection-of-breast-cancer-in-uae Educational Presentation https://www.haad.ae/simplycheck/tabid/140/default.aspx http://gulfnews.com/xpress/news/uae-s-median-age-of-breast-cancer-diagnosis-10-15-years-younger-than-in-west-1.2100559

HOW CAN ARTIFICIAL INTELLIGENCE HELP Machine Learning – Cognitive Computing – Artificial Intelligence Educational Presentation

AI ENABLED CLINICAL INTELLIGENCE Analytics: The Next Frontier AI ENABLED CLINICAL INTELLIGENCE Cancer Diagnostics, Chronic Diseases Population Health Analytics performed prior to review for immediate classification of studies Clinical Triage Clinical intelligence delivered in real-time to the clinician at the time of exam review Point of Care Analysis Educational Presentation

Educational Presentation Clinical Challenges in Mammography High volume of cases assigned to each radiologist Unable to intelligently sort and prioritize worklists Inter-observer variability among radiologists High cost to recall patients High cost of unnecessary biopsies Educational Presentation

Educational Presentation Workflow Triage Task-based Rules Optimization: It is the coupling of artificial intelligence – the AI’s quantification of a lesion - and real intelligence – the doctor’s interpretation of a lesion – and creating of automated rules to achieve the highest standard of patient care with workflow automation. Work List Prioritization Clinical Protocol Optimization Resource Utilization Real-time Notifications Educational Presentation

TB (TUBERCULOSIS) CHALLENGE Roughly one-third of the world's population has been infected with M. tuberculosis Global figures released last year by the WHO showed that in 2015, some 1.8 million people died from TB. Educational Presentation

TB (Tuberculosis) detection – First World Challenge Educational Presentation

Educational Presentation TB (Tuberculosis) detection – First World Challenge https://beta.theglobeandmail.com/opinion/when-tuberculosis-strikes-complacency-is-the-big-killer/article34435132/?ref=http://www.theglobeandmail.com& Educational Presentation

Dubai Health Authority – Region’s First AI Project Work in Progress

VALUE-BASED VALIDATION OF AI – Excellent Results Work in Progress

What’s Next? Intersection of machine learning and advanced applications, where clinical knowledge and medical data converge. Realize benefits using AI in context of workflows and systems that healthcare practitioners operate & interact with. Amplify human intelligence. Work in Progress

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