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.

Much enjoyed last week’s opening of the Koch Institute’s 2017 Image Awards Exhibition. The exhibit, dubbed “with/in/sight”  includes 10 scientific images chosen as best-in-class from among some 120 entries from MIT life scientists and their collaborators across the country–and one from Ireland.

The display, in the public galleries at the Koch Institute for Integrative Cancer Research, is the Koch’s seventh in as many years. Its goal is to celebrate “the diversity of biomedical research at MIT and offers insight into the important role that science and engineering play in our complex and ever-changing world,” according to a Koch brochure.

The images are printed on t-shirt material stretched across frames back lit with LEDs. They are striking artwork in themselves– and showcase some of the most exciting work under way in the cancer research arena.

“Making Waves: Delivery for Ageless Skin.” Koch Institute, Harvard University, Mass General Hospital.

“Making Waves” conveys research on non-invasive sound waves that carry genetic material through protective layers of skin, transferring genes to cells whose genetic clocks have been turned back by the nucleic acids they have received– in order to reverse skin-aging. Credits go to Carl Schoellhammer, Denitsa Milanova, Hamberto Trevino, Cody Cleveland, Jeffrey Wyckoff, Anna Mandinova, Giovanni Traverso, Robert Langer, and George Church.

Whithead Institute: Snap Chat: A Flatworm Creates a New Profile

At the Whitehead Institute, Samuel LoCascio, Kutay Deniz Atabay and Peter Reddien are studying planarian flatworms to learn more about how they regerate. Each color in their image represents a different layer of neurons in the flatworm’s head.

Downstream Dreams: Investigating Melanoma in a Zebrafish: Koch Institute, MIT

Dahlia Perez and Jacqueline A. Lees are studying zebrafish to provide insight into melanoma. This image shows the organization of zebrafish cells in their normal state. Next, biologists will mutate a single gene known to initiate a certain melanoma in order to determine its “downstream” effects.

Center: “Minding the Gap: Studying the Tumor Extracellular Matrix,” Koch Institute

Tumor Penetrating Nanoparticles Infiltrate Cancer Cells, Koch Institute

Steffen RIckelt and Richard Hynes of the Koch Institute are studying not the clusters of brownish colon cancer metasteses shown in the image, screen, but, rather, the “seeming neutral” tissue matrix around them. The goal is determine how the matrix impacts the progression of tumor cells navigating a complex network of cells and proteins.

Langliang Hao, Srivatsan Raghavan, Emilia Pulver, Jeffrey Wyckoff and Sangeeta Bhatia of the Koch Institute are using  biocompatible nanoparticles (yellow) to target and penetrate clusters of cancer cells (pink) with the goal of delivering treatment.

Body of Knowledge: Self-Organized Brain Cells, MIT Department of Biological Engineering and Koch Institute at MIT.

Colin Edington, Iris Lee and Linda Griffith of MIT are involved in the Griffith lab’s “Human on a Chip,” project, in which many different”mini organs”, developed from stem cells in matrix, are linked together in a bioreactor platform. The researchers are studying interactions of multiple organs and the cross between them in order to develop new disease treatments. Shown here are neurons (green) and astrocytes (red).

Microfluidics for the Masses, Measuring Cell Growth Rates, Koch Institute

Selim Olcum, Nathan Cermak and Scott Manalis are using microfluidics to measure the response of cell masses to drugs. Their image shows fluid filled channels (bottom) connected to tiny mass sensors shaped like hollow diving boards (top); the sensors’ whose  vibrations precisely reveal the mass of individual cells passing through them. As treated cells flow across the array of sensors, each cell is weighed multiple times, thereby revealing how quickly the mass of individual cells is changing. Researchers are beginning to use this method to predict optimal treatment strategies for individual patients.

Hashtag No Filter,: Visualizing Breast Cancer Conversations. Royal COllege of Surgeons in Ireland and Wellcome Images.

My favorite image does not show cells, nor was it submitted by an MIT lab. Rather, it visualizes twitter conversations about breast cancer carried out by a network of connected cancer patients and their loved ones, patient advocates, health care professionals, and researchers. The image, by Erie Clarke, Richard Arnett and Jane Burns of the Royal College of Surgeons in Ireland,  represents 92, 915 tweets posted over an eight-week period. It is from the Wellcome Images collection.

Other images not included here display pathways taken by metatastic lung cancer cells over time and  ovarian cancer cells as they break through the abdominal wall.

I’m the first to admit that these photos do not do justice to the real images–nor do they adequately convey the amazing convergent technologies –including imaging–used to carry out the research.

The gallery,  at street level in the Koch Institute, 500 Main Street, in Cambridge, is open to the public at no charge from 8-6 Monday-Thursday, and until 4 pm on Friday. The images are also visible from the sidewalk, outside.

Through March 2018.

Anita Harris is a writer, photographer and communications consultant based in Cambridge, MA.
New Cambridge Observer is a publication of the Harris Communications Group, an award-winning PR and market development firm located in Kendall Square, Cambridge.

MIT, Convergence Idea Challenge

For the  last few months, I’ve had the opportunity to work on an amazing national report about the Convergence of technologies in the life sciences. The goal of the report–which will be launched this coming Friday at the National Academy of Sciences, in Washington, DC– is to encourage  increased  funding for engineers, mathematicians, physicists, chemists, and information technologists for work in health and life science fields.  More on the report and Convergence later this week.

For now, I want to let you know that Nobel Prize winning scientist Phil Sharp of the MIT Koch Institute  has offered a $3000 award for the best Convergence idea submitted by students across the US–and that the public is invited to help choose  a second, $1000 “community” winner—-by “liking”  ideas submitted via on Facebook.  The goal is to challenge  emerging researchers to combine the life/physical sciences, information technology, social sciences, and engineering to improve human health.The voting deadline is 6 pm on Thursday, June 23, 2016.

Here’s a list of the submissions–which come from researchers across the US.  More info on each idea–and “like” options– are available at https://www.facebook.com/ConvergenceIdeas/

• Hex House; a rapidly deployable, dignified home
• A Multi-disciplinary Approach to Tackling Childhood Poverty
• Biomarkers and Neural Circuits Underlying Resilience to Stress
• Neuroprosthetics in Nerve Reanimation: Implantation of Intraneural Building
• Beyond Biology Breast milk – mine of potential therapies
• Getting VacSeen-ated Mobile Screening and Diagnostics
• Engineering Pro-Regenerative Immunotherapies
• Empowering HIV-positive Youth in Swaziland, Africa: A Novel Digital Mentorship Experience
• Development of minimally invasive assessment of placenta across gestation
• An Epidemiological Cellular Automata Model of Gun Violence
• Transforming Clinical Data Into Field-Deployable Medical Apps
• Engineering a Flexible Organic Photovoltaic Cell as an Artificial Retina to Restore Sight: A Promising Vision in Bio-nanoelectronics
• Accelerating translation from bio-discovery to engineered applications by single cell niche sequencing
• Using Nature’s Fundamental Choice Against it
• Drinking Water Health – Intermittent Water Supply in Developing Countries
• “Brain train” – optogenetic cognitive-conditioning for neuropsychiatric disorders
• Sparsh- Sleeping Bag
• Quantified ethology decreases time to diagnosis of infection
• Interlocking culture system for resolvable three-dimensional cell arrangements
• A New Treatment for Depression through Modification of Semantic Networks in the Brain Using a Computer Game

–Anita M. Harris
New Cambridge Observer is a publication of the Harris Communications Group, a marketing and communications firm based in Kendall Square, Cambridge, MA.

The Cambridge Innovation Center and quite a few companies will be holding open houses this Thursday in Kendall Square, Cambridge–as part of the nine-day Cambridge Science Festival.

Billed on its Web site as “the first of its kind in the nation,”  the annual Festival opened on Saturday, April 24, to showcase  Cambridge as an internationally recognized leader in science, technology, engineering and math.  A multifaceted, multicultural event held every spring, the Cambridge Science Festival makes science accessible, interactive and fun.

A myriad of events–ranging from talks and panel discussions to demonstrations, luncheons, museum exhibits, elementary school science fairs  and company open houses–are listed at the  Festival’s Schedule of Events.

I expect to be at the Cambridge Innovotion Center open house at 1 Broadway  on Thursday evening–as will my client, InVivo Therapeutics, and   Vitality, Seeding Labs, Acorn Product Development,   HubSpot and other companies.   The Venture Cafe, on the 11th floor,  will be open to the public  from 6-9 pm.