Imagine this: a city homeless shelter serves breakfast and dinner, but not lunch. Hungry residents regularly go to the fire station next door, complain of chest pain, get taken by  ambulance to the hospital ER where they are evaluated, at high cost, given lunch, and then transported back to the homeless shelter in time for dinner.

Such was a scenario laid out recently at the MIT Sloan School as an example from an inefficient US social and health care system that cannot adequately keep track of patients, manage health of the poor, or control costs.

The scenario was described by Jason Helgerson, Medicaid Director for the New York State Health Department, at a day-long conference entitled “Health Systems Innovation.”  At the November 29 conference,  experts from industry, government, science, medicine and academe laid out some of US health care’s daunting problems, along with new visions and hoped-for solutions —many powered by digital innovation.

In introducing the sessions, which were organized by the MIT Sloan Initiative for Health Systems Innovation (HSI), moderator Jay Levine  pointed out that, today, there is more uncertainty regarding health care than at any time since the enactment of Medicare in 1965—a result of “overwhelming” political turbulence and concerns about health insurance and a tax plan that could upend the health industry and lead to huge, unsustainable losses in health delivery. Levine is retired principal of ECG Management Consultants, Inc.

 Retzef Levi,  an MIT/Sloan management professor whose department hosts HSI, outlined burgeoning health issues that accompany an aging US population. He emphasized the need to “sow seeds now”  for a “visionary, futuristic system”  to prevent disease  and know who is at risk in order to reduce future illness.

Such a system would  integrate local, state, and national systems, medical  and behavioral disciplines, primary,  specialty and community care, Retsef said.  Providers would be paid for performance rather than tasks undertaken. There would be a workforce sufficient to handle the nation’s long term care needs, personalize diagnosis and treatment. The system would make full use of  digital health innovations such as big data, analytics, sophisticated devices and mobile apps without losing the best aspects of human care.

After Levi’s remarks, Levine asked, “ in light of huge current losses in the system, where does the money come from to fix it?”

Panelists at the day long meeting never fully answered that question, but they did lay out a variety of promising digital approaches that could lead toward transformation, as well as roadblocks to change.

Analytics, machine learning and artificial intelligence
In a panel on “Machine Learning in surgery and cancer”, MIT PhD Candidates Jack Dunn and Daisy Zhou described analytic tools, based largely on longitudinal patient records,  that they are developing  to predict how long an individual surgical patient is likely to live, with what quality of life, if certain decisions are made.  Such tools, which evaluate “nuanced “ signals and  make use of “decision trees,” are aimed at helping doctors decide on treatment plans. Under current treatment guidelines, Zhou said, many doctors tend to “overestimate” prognoses, which can diminish patients’ quality of life and increase medical costs.

Dusty Mojumdar, PhD, IBM vice president and chief marketing officer for an IBM artificial intelligence (AI) system that reads, learns, understands and interacts with humans. Named “Watson,” after IBM’s first president, Thomas Watson, the system is now used, in health care, to: combat a major shortage of radiologists; predict whether nodules on individuals’ lungs will become malignant; develop new targets for ALS drugs, predict hypoglycemic events for diabetics; rank treatment plans and options for seven cancers, and match patients to clinical trials.

Artificial intelligence is also  being used to evaluate what one speaker termed an “explosion “of health data—which is reported in some 7000 new health care publications per day, and which doubles every 73 days, according to Mojumdar.  Several massive health systems are employing  artificial intelligence to co-ordinate electronic medical records—using “text analysis” and “pattern matching” to “catalog” patients with similar health conditions in order to evaluate  and predict outcomes of particular treatments.

In September, IBM made a 10-year, $240 million investment to create the MIT–IBM Watson AI Lab to  carry out fundamental AI research aimed at propelling scientific breakthroughs that unlock the potential of AI.

In Part II, I’ll share panelists’ information about a variety of digital devices and methods already in use to help streamline and personalize long-term care and health care delivery.

LINKS TO:
Part I Overview, Watson, analytics
Part II digital devices, long term care.
Part III Apps, devices, roadblocks

Videotapes and photos of the conference, held November 29, 2017,  are available at http://mitsloan.mit.edu/alumni/events/2017-cambridge-health-conference/

–Anita M. Harris
Anita Harris is a writer and communications consultant specializing in health, science and technology.

New Cambridge Observer is a publication of the Harris Communications Group, a content, PR and digital marketing firm based in Cambridge, MA.

Earlier this week,  I had the privilege of attending the tenth annual “BIO-IT World Conference and Expo,” at which some 2500  information technology professionals participated in a 12-track program featuring more than 200 presentations on scientific and technologic developments.

From  keynote speakers Jill Mesirov, PhD, and Martin Leach, PhD,  respectively the Associate Director and Chief Information Officer  of the Harvard-MIT Broad Institute,  I learned that exponential increases  in computing power promise to bring personalized medicine –allowing highly individualized diagnosis and treatment –to doctors offices within ten years. I also learned how hard it is to keep track of the petabytes  ( a PBs is a unit of information equal to one quadrillion  bytes, or 1024 terabytes )  used to keep it all going.

Mesirov announced the upcoming launch of “Genome Space“–a new Web-based technology to help scientists make sense of and collaborate in using such data.

And in a talk entitled “BIG,”  Leach described the difficulty of defining “big data,” because the amount of available information is growing so rapidly.   He described an event held recently at the Broad to celebrate the Institute’s ability to store and analyze ten pedabytes of data –his glee soon tempered by  his recollection that in 1993, NIH’s Institute of Medicine was thrilled with its ability store 16 gigabytes–which anyone can now do on a cell phone.

Today,  Leach said, we are  seeing “increasing big data with a decreasing footprint.” [that is, smaller systems needed for gathering and retrieval].

Mentioning that he has an autistic son and would like to be able to figure out what causes the disorder, Leach  asked, “Why is there no Google search for data, no way to access thousands of data repositories?

“We need a new application ecosystem and a breed of data scientist who knows how and where to push this data, ” he said.  He predicted that there will soon be 50 thousand jobs in the  “big data” arena.

In the exhibit hall,  I was pleased to see that  see that Wingu, headquartered in the Cambridge Innovation Center, where I work, had been nominated for a best of show award for its pharmaceutical, contract research and academic collaboration software.

The winners, announced last night, were Recentris, Opscode, Clear Trial, and Cambridge Semantics. [More info at http://www.bio-itworld.com/2012/04/26/2012-best-of-show-winners.html]. Best Practice Grand Prizes went to big Pharma: Merck, Pfizer, and Merck KGaA (Germany)  went to and two genomics organizations, BGI Shenzhen and the University of Utah/Omicia. http://www.bio-itworld.com/2012/04/25/bio-it-world-announces-winners-2012-best-practices-awards.html.

BIO-IT World is sponsored by  Insight Pharma Reports, Samsung, and the Portland Group. It runs through April 27, 2012.

—Anita M. Harris

I’m pleased to announce that Scientia Advisors has launched ScientiaNET,  a “knowledge network” for  health care and the life sciences. ( True,  they are my client, but I AM pleased).

The network now has 10 thousand member/experts and is seeking additional ones.  Members are leading scientists, physicians, practitioners, academics and industry professionals who are  paid their hourly rates to provide Scientia and its clients with analyses, opinions, surveys and consultation on life science tools and technologies, medical devices, diagnostics, biotechnology, pharmaceuticals, functional foods, and regulatory issues.

The member/experts typically consult with business leaders and decision-makers on industry trends and developments, operational problems/solutions, or specific products/services.

If you’d like to become a ScientiaNET member or engage one (or many)   please visit www.scientiaadv.com. 

AMH

Scientia Advisors, based in Cambridge, MA and Palo Alto, CA, is a global management consulting firm specializing in strategic growth and operational strategies  for major and emerging companies in health care and the life sciences.

New Cambridge Observer is a publication of the Harris Communications Group of Cambridge, MA.