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Excitement Mixed with Realism at Top Of Mind 2018

Posted on December 18, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

The recent #TopOfMind2018 conference hosted by the Center of Connected Medicine was one of the best events of 2017. A stellar lineup of speakers was matched by an equally outstanding group of attendees. Together this combination created an atmosphere of realistic excitement – a unique mixture of exuberant enthusiasm for the latest healthcare technology (Artificial Intelligence, Machine Learning, Cybersecurity, Home Monitoring) tempered by sobering doses of reality (lack of patient access and poor usability).

One of the most engaging presentations was delivered by Jini Kim, Founder and CEO at Nuna. She opened by recounting her hilarious first-ever conversation with President Obama. Very early one morning (around 3am PT), Kim got a call on her cell phone from an unknown Washington number. When she answered the person on the other end introduced himself as President Obama. Kim reacted as I’m sure many of us would – with disbelief – and said as much to the caller. Obama laughed and said “I get that a lot, but seriously this is the President of the United States and I’m calling because your country needs you”. Kim compared that moment to feeling like a superhero being invited to join the Avengers.

Kim was one of six people handpicked by the President and his advisors to fix the failed Healthcare.gov website. For the incredible behind-the-scenes look at how this team was recruited and how they fixed the site, check out this amazing Time article.

In front of a slide that showed her company’s mantra, “Every row of data is a life whose story should be told with dignity”, Kim told story after story about how healthcare organizations would bring her in to help solve difficult healthcare problems. What Kim realized through that work was how badly health data is stored, protected and used.

In project after project, her team was tasked with bringing order to data chaos. One of the biggest challenges they encountered over and over again was bringing together massive amounts of data that was stored in different formats and used different terminologies.

Kim’s presentation was an effective counterbalance to the presenters just before her who had spoken excitedly about the future of Artificial Intelligence (AI). She cautioned the #TopOfMind2018 audience not to get too distracted by the shiny new AI object.

So much work needs to be done on the basics first before we can effectively apply AI. We need to get back to basics: data integrity and data cleansing. It’s not sexy, but if we don’t fix that then the more advanced technologies that layer on top will simply not work.

The session presented by Erin Moore, patient advocate and healthcare innovation consultant, made the biggest impact on the audience. For 45 minutes, she shared her deeply personal healthcare story, which started when her son Drew was diagnosed with cystic fibrosis seven years ago. Moore took the audience on an emotional roller coaster ride that mirrored her own family’s journey – from small wins (finding a doctor who would listen) to draining setbacks (medications changed without explanation) and from serendipitous windfalls (a researcher sent her an app that encouraged Drew to take his medication) to scratch-your-head moments (having to manually build Drew’s medical record by going to each provider and filling out forms in order for the information to be released).

There were two memorable takeaways from Moore’s presentation. First, was her story of how eye-opening it was for Susanna Fox, then Chief Technology Officer of the US Department of Health and Human Services, to spend the day shadowing Drew (virtually). Whenever Drew had to take his medication, Fox would pop a Tic-Tac. 500 Tic-Tacs and multiple hours waiting for appointments later, Fox had a new appreciation for how all-consuming it was to be the caregiver to someone who has cystic fibrosis. You can read more about Fox’s experience in her revealing blog post.

Second, was Moore’s double challenge to the audience:

  • To truly walk a mile in your end-users world when creating/designing the next generation products.
  • To make products truly interoperable.

The best unscripted moment of #TopOfMind2018 came from Amy Edgar, a #pinksocks #hcldr #TheWalkingGallery member. In one of the early Q&A sessions, she asked the speaker “How do we prevent digital health from becoming the next snake oil”. For a moment there was stunned silence as the room absorbed the full weight of Edgar’s comment.

For the rest of the day #TopOfMind2018 master of ceremonies Rasu Shrestha and other presenters made reference to snake oil. Edgar’s comment was even the inspiration for a recent HCLDR tweetchat that followed on the heels of the conference.

Overall #TopOfMind2018 was one of my most memorable conference experiences of 2018. The presentations were interesting. The venue was fantastic. Everything ran smoothly. Above all the people at the event were amazing.

Special Note: Thank you to Larry Gioia for organizing an amazing meetup during #TopOfMind2018 that was inclusive of #HITsm #HITMC #HCLDR #pinksocks and #TheWalkingGallery

Searching for Disruptive Healthcare Innovation in 2017

Posted on January 17, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Disruptive Innovation has been the brass ring for technology companies ever since Clayton Christensen popularized the term in his seminal book The Innovator’s Dilemma in 1997. According to Christensen, disruptive innovation is:

“A process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.”

Disruption is more likely to occur, therefore, when you have a well established market with slow-moving large incumbents who are focused on incremental improvements rather than truly innovative offerings. Using this definition, healthcare has been ripe for innovation for a number of years. But where is the AirBNB/Uber/Google of healthcare?

On a recent #hcldr tweetchat we asked what disruptive healthcare technologies might emerge in 2017. By far the most popular response was Artificial Intelligence (AI) and Machine Learning.

Personally, I’m really excited about the potential of AI applied to diagnostics and decision support. There is just no way a single person can stay up to speed on all the latest clinical research while simultaneously remembering every symptom/diagnosis from the past. I believe that one day we will all be using AI assistance to guide our care – as common as we use a GPS today to help navigate unknown roads.

Some #hcldr participants, however, were skeptical of AI.

While I don’t think @IBMWatson is on the same trajectory as Theranos, there is merit to being wary of “over-hype” when it comes to new technologies. When a shining star like Theranos falls, it can set an entire industry back and stifle innovation in an area that may warrant investment. Can you imagine seeking funding for a technology that uses small amounts of blood to detect diseases right now? Too much hype can prematurely kill innovation.

Other potentially disruptive technologies that were raised during the chat included: #telehealth, #wearables, patient generated health data (#PDHD), combining #HealthIT with consumer services and #patientengagement.

The funniest and perhaps most thoughtful tweet came from @YinkaVidal, who warned us that innovations have a window of usefulness. What was once ground-breaking can be rendered junk by the next generation.

What do you believe will be the disruptive healthcare technology to emerge in 2017?

Mount Sinai Uses AI To Manage CHF Cases

Posted on October 31, 2016 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

New York-based Mount Sinai Hospital has begun a project which puts it in the vanguard of predictive analytics, working with a partner focused on artificial intelligence. Mount Sinai plans to use the Cloud Medx Clinical AI Platform to predict which patients might develop congestive heart failure and care better for those who’ve already done so.

As many readers will know, CHF is a dangerous chronic condition, but it can be managed with drugs, proper diet and exercise, plus measurement of blood pressure and respiratory function by remote monitoring devices. And of course, hospitals can mine their EMR for other clinical clues, as well as rifling through data from implantable medical devices or health tracking bands or smartwatches, to see if a patient’s condition is going south.

But using AI can give a hospital a more in-depth look at patterns that might not be visible to the unaided clinician. In fact, CloudMedx is already helping Sacramento-based Sutter Physician Services improve its patient care by digging out unseen patterns in patient data.

To perform its calculations, CloudMedx runs massive databases on public clouds such as Amazon Web Services and Microsoft Azure, then layers its specialized analytics and algorithms on top of the data, allowing physicians or researchers to query the database. The analytics tools use natural language processing and machine learning to track patients over time and derive real-time clinical insights.

In this case, the query tools let clinicians determine which patients are at risk of developing CHF or seeing their CHF status deteriorate. Factors the system evaluates include medical notes, a patient’s family history, demographics and past medical procedures, which are rolled up into a patient risk score.

In moving ahead with this strategy, Mount Sinai is rolling out what is likely to be a common strategy in the future. Going forward, expect to see other providers engage the growing number of AI-based healthcare analytics vendors, many of whom seem to have significant momentum.

For example, there’s Lumiata, a developer of AI-based productive health analytics whose Risk Matrix tool draws on more than 175 million patient-record years. Risk Matrix offers real-time predictions for 20 chronic conditions, including CHF, chronic kidney disease and diabetes.

Risk Matrix bases its predictions on its customers’ datasets, including labs, EHR data claims information and other types of data organized using FHIR. Once data is mapped out into FHIR, Risk Matrix generates output for more than 1 million records in less than three hours, the company reports. Users access Risk Matrix analyses using a FHIR-compatible API, which in turn allows for the results to be integrated into the output of the existing workflows.

But Lumiata is just the tip of the iceberg. CB Insights has identified more than 90 companies applying machine learning algorithms and predictive analytics to important problems in healthcare.

While many startups have flocked into the imaging and diagnostics space, expect to see AI-related activity in drug discovery, remote monitoring and oncology. Also, market watchers say companies founded to do AI work outside of healthcare see many opportunities there as well.

Now, at least at this stage, high-end AI tools are likely to be beyond the budget of mid-sized to small community hospitals. Nonetheless, they’re likely to be deployed far more often as value-based reimbursement hits the scene, so they might end up in use at your hospital after all.

E-Patient Update: Hospitals Need Virtual Clinicians

Posted on July 20, 2016 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Hospitals have a lot to lose if patients are readmitted not long after discharge. But in most cases, their follow-up care coordination efforts post-discharge are perfunctory at best.

My husband’s experience seems to be typical: a few weeks after his discharge, a nurse called and asked perhaps five or six very broad questions about his status. I doubt such as superficial intervention has ever done much prevent a patient from deteriorating. But this dynamic can be changed. As an active, involved e-patient, I think it’s time to bring artificial intelligence technology into the mix.

In recent times, AI platforms have emerged that may offer a big improvement on the, well, largely nothing hospitals do to prevent patients from deteriorating after they leave the facility. In fact, artificial intelligence technology has evolved to the point where it’s possible to provide a “virtual clinician” which serves as a resource for patients.

One example of this emerging technology comes from AI startup Sense.ly, which has developed a virtual nurse named Molly. According to the company, Molly is designed to offer customized patient monitoring and follow-up care, particularly for patients with chronic diseases. Its customers include the UK’s National Health Service, Kaiser Permanente, San Mateo Medical Center, University of California San Francisco, Microsoft and Allscripts.

Molly, an avatar-based system which was designed to mimic the bedside manner patients crave, can access data to assist with real-time care decisions. It also monitors vital signs – though I imagine this works better with a remote connected device — and tracks patient compliance with meds. Molly even creates custom questionnaires on the fly to assess patients, analyzes those responses for risk, and connects patients directly to real- life clinicians if need be.

While this is admittedly a groundbreaking approach, some independent research already exists to suggest that it works. Back in 2011, Northeastern University researchers found that patients who interacted with virtual nurse Elizabeth were more likely to know their diagnoses and make follow-up appointments with their doctor, ZDNet reports.

And if you’re afraid that using such a tool exposes your facility to big legal risks, well, that’s not necessarily the case, according to veteran healthcare attorney David Harlow.

“The issue is always in the terms of use, and if you frame that properly – and build the logic properly – you should be OK,” Harlow told me. He concedes that if hospitals can be sued for patient care problems generated by EMR failures — which happens now and then — a cause of action could arise from use of virtual clinician. But my sense from talking with him was that there’s nothing inherently more dangerous about deploying an AI nurse than using any other technology as part of care.

Speaking for myself, I can’t wait until hospitals and medical practices deploy a tool like Molly, particularly if the alternative is no support at all. Like those who tested Elizabeth at Northeastern University, I’d find it much easier to exchange information with an infinitely patient, focused and nonjudgmental software entity than a rushed nurse with dozens or hundreds of other patients on their mind.

I realize that I’m probably ahead of the market in my comfort with AI technology. (My mother would have a stroke if you asked her to interact with a virtual human.) But I’d argue that patients like me are in the vanguard, and you want to keep us happy. Besides, you might be pleasantly surprised by the clinical impact such interventions can have. Seems like a win-win.

The Amazon Echo – Bringing Sci Fi Reality to Healthcare

Posted on February 16, 2016 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children's hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children's hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David's latest CXO Scene posts here and follow me at Twitter Facebook.

My initial impression of the Amazon Echo was that this is simply a Bluetooth speaker that looks like a portable humidifier with a little bit of artificial intelligence. The next thing I discovered is that the Echo always needs to be plugged in for it to work. But then, after playing around with it, I realized that the Amazon Echo is actually quite impressive.

The Echo introduces the handy Alexa function. The initial conversations with Alexa are very simple. You can ask about the weather, the time, sports results, or the latest news. But with time, I learned that Alexa could even read an audio book; tell me about the local businesses; and where to go for a Thai dinner.

The other benefit of Echo its accessibility and quality. It comes with a remote control or you may control it via your mobile device after downloading the Amazon echo app. The bottom part of the Echo has a 360-degree speaker that surprisingly fills the entire room with sound. Even at a distance of 9-10 feet Alexa can pick up commands.

Because of the sophisticated voice activated system, the Echo has great potential for use by patients in a healthcare setting. The main use case that I see is in the hospital’s patient room. Let’s think of a scenario where we have a 50-year-old patient in the hospital that had just gone through a surgery procedure and is expected to be in the hospital for two days. Echo can be a great device to allow personalization such as: integration to the patient’s Spotify music, control of the room temperature and blinds, the ability to order an Uber for the patient’s family, as well as many other features of a smart home. The goal will be to bring the technology of a smart home into a patient’s room to enhance the patient’s experience away from home.

From a clinical perspective, the Echo can assist the medical provider by reciting the medical education transcribed by the doctor to the patient, such as: the side effects of a prescription drug that the patient should expect for the next month after surgery. If we go back to the example of the patient who is recovering from surgery and has been prescribed drugs, the Echo can either be a replacement or an integrated device for the nurse call system where the patient can ask for pain medication through Echo. In addition, patients can also order their meals through the device if it is integrated with the dietary system in the hospital. As such, the voice-activated system would clearly be a great two-way communication tool for the patient who may not be able to move from their bed with ease.

As healthcare is moving towards the goal of creating the best patient experience possible, we have to start integrating consumer products with the strategy of providing a hotel-like experience in an inpatient room. The integration of smart room technology and voice activation communication has become an invaluable part of luxury hotels, and likewise, we must attempt to replicate that same kind of technology and convenience in hospitals.   I have personally witnessed a lot of success by international hospitals incorporating the hotel experience into their culture to improve patient experience. Similarly, I believe that hospitals in the US must start to adjust our strategy in order to meet the expectation of today’s consumer-patients.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

The Impact of AI and Robots on Healthcare

Posted on December 30, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As we end 2014, it seemed appropriate to post a little bit of mental floss for those of us who are trying to consider where all of this technology in healthcare is headed. Luckily, Twitter provides a lot of mental floss and these two tweets will give you a lot to consider when it comes to artificial intelligence (AI), robots, and the mixture of related technologies. We can’t see it now, but 10 years from now we’ll be just as disrupted as we were 6 years ago when the iPhone was introduced.

Here are two tweets that will hopefully help you to reframe your thinking:

What do you think all of this means for the future of healthcare?