Applying AI in Healthcare for Iterative Efficiencies
Applying AI in Healthcare for Iterative Efficiencies
This week I am talking to Dr. Falgun Chokshi, MD (@FalgunChokshiMD), a Neuroradiologist and host of the podcast “Looking Around the Corner”. Falgun’s vision is to connect a healthcare innovation ecosystem that creates collaboration and focuses on a novel but importantly practical solutions. He has experience in bioinformatics (machine learning/AI) and advanced technology assessment (AI/Blockchain).
Hear what this neuroradiologist thinks about the impact of Artificial Intelligence will be on radiology, imaging, and medicine in general – its more about supporting radiologists getting to the “gestalt” of information and insights vs replacing them with technology.
His incremental step in improving healthcare
“Iterative Efficiencies”
Listen in to find out about his experience with Intermittent Fasting and the positive impact it had for him on will power and consistency of purpose.
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Applying AI in Healthcare for Iterative Efficiencies was originally published on Dr Nick – The Incrementalist
Stemming the Tide
The Opioid Epidemic
130 people die from an overdose of an opioid every day in the United States. Death from overdoses reached a staggering 47,600 people in the United States in 2017 – to put that into perspective that’s a 130 people per day, or 1 person every 11 mins, and now in the top 10 causes of death in the United States. The problem has been getting worse with an increase in preventable opioid deaths of 26% in 2016 which is only overshadowed by the 544% increase we have seen since 1999.
The background and causes to the problem are varied but in many cases, the start of addiction begins with medically prescribed medication and far too frequently end tragically with death from overdose. With the rising incidence, the epidemic is having a wide impact with barely anyone left untouched.
For some struck by tragedy, such as Ed Kopetsky, the CIO for Stanford Children’s Health, Lucile Salter Packard’s Children’s Hospital, they have turned devastation into a drive to action. Ed sadly lost his son, Jim, to an overdose following a history of exposure to opioids that dated back to high school. Take a look at the video of two of the stories from CHIME members here.
“If we can save just one more person from that addict path by speaking up and using our voices and using the power of CHIME and the power of the people all united to try to change, I think we will make a difference”
Together with his colleagues and friends from CHIME they formed the CHIME Opioid Task Force. Their mission is to harness the unique insights and assets of their healthcare leaders and institutions to make a real difference to address the crisis. They are united in their goal of combatting the increasing addiction and growing mortality of the Opioid Crisis by raising awareness, publicizing leading healthcare practices, providing data for medical research, policy advocacy and leveraging our leadership talent in unique and powerful ways.
NTT DATA Give Back
NTT DATA has a long history of giving back to worthy causes and this year at HIMSS19 as joined forces with The CHIME Opioid Task Force, DisposeRx (who offers a unique and safe method for disposal of unused or expired medications) and Luster Mosaics to create a mosaics picture from individual user-contributed pictures posted on Twitter and Instagram.
For every post using the hashtag #NTTDWhyICare NTT DATA is donating $5 (up to 15,000) to the CHIME Opioid Task Force and will use the pictures to create a unique mosaic image live on the show floor. To get involved, simply snap a shot, post it to Instagram or Twitter using #NTTDWhyICare with a statement about why you care.
You can click here to create a tweet with the correct hashtag
Or this link: Tweet #NTTWhyICarehttps://platform.twitter.com/widgets.js
Join in at HIMSS 2019
Stop by booth #3301 at HIMSS19 in Orlando to see the mosaic as it gets put together and see if you can find your picture. While you are there, pick up a DisposeRx packet and see how easy and effective it is to safely dispose of any medication in your home.
Come join us for a reception on Wednesday, February 13 at 5:00 pm EST at the NTT DATA HIMSS19 booth #3301 as NTT DATA and DisposeRx present a check and reveal the completed hashtag-driven social media mosaic art to the CHIME Opioid Task Force.
If you’d like to donate directly to the CHIME Opioid Task Force, you can do so here
Stemming the Tide was originally published on Dr Nick – The Incrementalist
Saving Healthcare Quality
Saving Healthcare Quality
This week I am talking to Fred Trotter (@fredtrotter), CTO CareSet Systems – the first commercial Medicare Data company. Fred has a long and fascinating background that unlike many healthcare Cybersecurity experts started in the security field and transitioned to healthcare and healthcare data. You can read his musings on Hacking Healthcare here.
We talked about Fred’s coordination of the Save the Agency for Healthcare Research and Quality (AHRQ) data project that took off online using twitter and other social channels as an unofficial mechanism. The AHRQ and the National Guideline Clearinghouse (NGC) was expected to be taken offline earlier this year as part of budget cuts and there was a significant concern that the 1,500+ clinical guideline summaries currently available would disappear forever. Some of us might think its a simple thing to copy content thus preserving the material but as Fred explains it was not that simple
In fact he contributes to the Internet Archive project (aka the Way back Machine) on a regular basis as one fo the important community projects that is workmen to preserve the digital history fo the web. Listen in to find out why the internet archive copy that was stored on this site was not enough and how Fred and the others used the insights and data from the Archive site to improve their data capture and storage. You can access the data on Guidelines here and the Quality Measures here – all sourced from this GitHub Project
We also talk about his history and involvement in the Health Care Industry Cybersecurity Task Force that was convened under President Obama’s administration by the DHS in March 2016. They issued their report to congress June 2017: Report on Improving Cybersecurity in the Health Care Industry. Listen in to hear about the experience of bringing this diverse group together as they attempted to predict future attacks (Hint – many of the things they predicted came true that same year!)
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Saving Healthcare Quality was originally published on Dr Nick – The Incrementalist
Summit
Keys to Successful Conferences
How do you describe the CNS Summit and what it offers – the word impossible springs to mind. Even the name can be a little misleading especially for medical folks who might look at that and think “Central Nervous System” but actually its stands for Collaborating for Novel Solutions
This coming year will be the 10th year of the event and it continues to get better – testing new ideas and concepts for conferences to make the event valuable on multiple levels. The history and experience reminds me a lot of friendships and how they develop – the first interaction can be awkward and uncertain but intuitively you get a sense that the person you are talking to is someone who will be a friend pretty quickly (science suggests it is not minutes or seconds but a 1/10th of a second). Over time the relationship deepens and you learn more, and understand more, and how much you enjoy working with, learning from, sharing and sometimes just hanging out. So it is with the CNS Summit or more frequently know as “Summit”.
Where else can you come to a conference and get clever new ideas and techniques on how to use your mobile phone camera in interesting and creative ways from the incredibly talented and inspiration photographer Asa Mathat (recommend instagram @AsaMathat to get a sense of his incredible lens on the world and people). He is a renowned Photographer to the stars, creator of the big pink ribbon and at Summit – photographer for attendees as well!).
(Hint – Don’t think in traditional planes of movement and use your volume buttons as triggers and when you reach the end of your panorama, just reverse direction to switch it off).
Areas Covered
It hard to categorize the conference into a bucket – it benefits from being not too big so as not to overwhelm but large enough to attract an impressive diversity of participants and speakers. The mix includes leaders from the Pharmaceutical Industry, digital health, medical and device companies and technology companies.
Insights continued from cancer survivors who parlayed their personal experiences to focus on taming the data mountain in healthcare and science, the pharmaceutical executive who nearly died from a side effect of a drug that had a life changing effect on the personal trajectory that allowed for a rethinking the model of industrial production of pharmaceuticals.
Of course for this Whisky Librarian, there is even a special highlight put on by Woody Woodaman – the whisky tasting that raises money for a fund set up in his wife’s name Betty Jean Memorial Scholarship Fund to support nurse training. The conference floor is always offers new concepts and technologies – everything from taste experiences to the highly popular hugging booth set up by friend and colleague Andrew Chacko.
Each year is an eye opening experience full of surprises that Amir Kalali the conference Chief Curator keeps close to his chest like a proud parent who know’s he’s picked the best birthday gift for their child and can’t wait to reveal it.
This year there were many mind blowing presentations – for me “Breaking the Logjam in Medical Imaging” by Mary Lou Jepsen from Openwater that pushed the boundaries of wearables by offering a path to an MRI wearable. Sounds far fetched – not if you approach the problem with a different lens and understand that our photo sensor chips have reached a sensitivity of a micron – the wavelength of infrared. Combine this with the fact that our bodies are translucent to red and near infrared light – but red light scatters but this is not random, it is deterministic and reversible if you can record a hologram of it. So with some clever use of relatively old technology that allowed us to move from overhead foils
to LCD projectors we are all accustomed to. This now allows the generation of ultrasound waves from small devices and using the change in phase of the light as it passes through the red light (you all know the doppler shift experiment you learnt in physics at school) they are now able to find vasculature at higher resolution than MRI and fMRI and even have additional capabilities to differentiate between oxygenated and non-oxygenated blood as achieved with the fMRI
But the resolution is now down to a few microns which is at the size of neurons, meaning they have the ability to see into our bodies at the detail of our nervous system… real time!
Combined with the early science that shows we can reconstruct what we are thinking and seeing based on analysis of our brain activity (Reconstructing visual experiences from brain activity evoked by natural movies, Nature – pdf). Most exciting the project is driven by a challenge to deliver a low cost, better imaging solution, to everyone, given that 2/3 of humanity lacks access to imaging.
Final Conference Day
The highlight for me was the last day – which according to my research and discussions with others, is just like every other conference poorly attended with many people missing the best elements.
It included two amazing presentations by the compassionate and gentle Daniel Friedland (Leading Well from Within), the wonderful, funny and insightful Chris Hadnagy (Social Hacker and previous guest on my radio show) and Stephanie Paul’s fun and eye opening Improv experience and included Asa Mathat participating and recording the activities with his unique eye. This picture captures the fun and learning we had as we learnt and connected
So my Incremental step for you is set aside Oct 31 – Nov 3, 2019 for Summit 2109 (It is the 10th anniversary so I’m imagining Amir and the guiding council is thinking hard about making this event super special) and you to will have the learning opportunity and fun as you find a new friend in CNS Summit
And one more Incremental step – if you are taking the time to go to a conference, don’t head out before it finishes but rather plan to enjoy the last sessions where organizers often try to save the best till last.
Summit was originally published on Dr Nick – The Incrementalist
Consumer Rights Driven Data Access
The Bluebutton Innovator
This week I am talking to Mark Scrimshire (@eKiveMark) a fellow Walking Gallery member and Entrepreneur in Residence at NewWave and on assignment as Medicare Blue Button 2.0 Innovator at CMS where he is designing and implementing the new API to enable 53 million Medicare Beneficiaries to share their claims information with the applications, services and research programs they choose to trust.
His work extends back to 2010 when the initial concept of the Blue Button was conceptualized but it took several years before this started to really take off with the concept of View, Download and Transmit. One of the key Incremental Steps to get this interoperability rolled out centered on changing the positioning of HIPAA from a barrier to sharing and portability to an enabler. Ironic when you consider that it stands for “Health Insurance Portability and Accountability Act”! Listen in to find out the details behind the change and a key incremental step to progress – changing the messaging
Part of this changed messaging centers on the Office of Civil Rights (OCR) and the clear guidance to direct consumers to have the right to access their data in electronic format. As promised in the broadcast here is the Rights to Access Memo they issued in September 2015 and something I carry with me to all my medical appointments.
He shares his view on how to move toward interoperability and his incremental step connected with the Fast Healthcare Interoperability Resources (FHIR, pronounced “Fire”) set of Resources and removing complexity and simplifying the approach the is a recurring theme for Incremental Improvements.
Don’t let perfection stand in the way of progress
You can read more about the project in the FHIR Wiki he mentioned here. Listen in to hear Mark talk about the new project and how he is turning the oxymoron of Explanation of Benefits (EOB) which fails to provide insights to the people it is directed at and how the DaVinci project. The move from the old model of Fee for Service (FFS) to paying for outcomes is also driving a whole shift in data accessibility and utility and willingness to share which is exciting for our the consumer rights driven access movement.
Their Incremental steps to improvement include the huddle but listen in to hear what other incremental steps you may be missing that has added significantly to their team-based approach, coordination and success
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Consumer Rights Driven Data Access was originally published on Dr Nick – The Incrementalist
Digging in to Your Social Media Feed
It was with interest I read a recent Viewpoint article in the Journal of American Medical Associations (JAMA) titled: Social Determinants of Health (SDoH) in the Digital Age, Determining the Source Code for Nurture authored by Dr. Freddy Abnousi, the head of healthcare research at Facebook, along with a couple of other authors, Dr. John Rumsfeld, Chief Innovation Officer at the American College of Cardiology (@DrJRums) and Dr. Harlan Krumholz, Professor of Medicine at Yale (@hmkyale)
They rightly point out the major contribution of social determinants of health – a fact highlighted as far back as to 1946 and the World Health Organization (WHO), but the research has been hampered by the inability to capture accurate granular data which is mostly self-reported (with the associated unreliability). We do need better approaches and the social networks offer a tantalizing look into data of this nature with a peek into online behavior, data that is posted by the millions of users who engage daily online.
They offer an intriguing potential to pre-identify suicidal ideation, “with enough advance warning and accuracy to stage a peer-driven intervention“. The opportunity to identify high risk for opioid addiction or finding those at highest risk of cardiovascular mortality and engaging with the users corresponding social network who would be “tasked with responsibilities”.
There is much to applaud in the concept but it raises some serious and challenging issues in my mind
1) Informed Consent is a major challenge and history and recent revelations do not engender any confidence that this data or insights would not be used against the patients or their families
2) De-Identification of data is already problematic – when you consider Intensity Analytics ability to identify individuals and behavior simply from their interaction with a keyboard
3) Trust is broken across so many areas and the current system is working as designed – a business. It is highly unlikely that users would ever *knowingly* give their consent
4) Healthcare consumers in the United States are struggling while the business of healthcare continues its march towards profit. Intuitively any insights from an SDoH program would have to focus on the best economic solutions which are mostly non-healthcare solutions (food, housing, income, education)
We need insights and data to provide the data to support and effect change and this idea has merit – but without some real changes to the business of healthcare, it will struggle to take off or deliver value to our population. I’d suggest a better incremental step would be to look at this data to show the underlying struggles of the users and creating a catalyst for change
Digging in to Your Social Media Feed was originally published on Dr Nick – The Incrementalist
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