Artificial intelligence is likely to transform the public sector by automating many government tasks—including making combat decisions. But, according to experts at a recent symposium held  at Harvard University, this “over-the-horizon” technology can only guide and inform government leaders. There will always be a need for human decision making—and for clear ethical standards to prevent harmful intentions.

At the September 20 conference, “AI-Government and AI Arms Races and Norms,” organized by the Michael Dukakis Institute (MDI), Professor Marc Rotenberg underscored the growing gap between informed government decision-making and the reality of our technology-driven world. “Governments may ultimately lose control of these systems if they don’t take action,” he told some 60 attendees.

Rosenberg, who teaches at Georgetown University Law School, is President of the Electronic Privacy Information Center (EPIC), and a member of the AI World Society Standards and Practice Committee,

Prof. Matthias Scheutz, Director of the Human-Robot Interaction Laboratory at Tufts University, said the greatest risk caused by AI and robotics technologies is when unconstrained machine learning is out of control. This can happen when AI systems acquire knowledge and start to pursue goals that were not intended by their human designers, he said. For example, “If an AI program operating the power grid decides to cut off energy in certain areas for better power utilization overall, it will leave millions of people without electricity, which consequently turns out to be an AI accidental failure.”

Scheutz also said that common preventive solutions inside and outside the system are largely insufficient to safeguard AI and robotics technologies. Even with “emergency buttons,” the system itself might finally set its own goal to prevent a shutdown previously set up by humans.

The best way to safeguard AI systems is to build ethical provisions directly into the learning, reasoning, recognition and other algorithms. In his presentation, he demonstrated “ethical testing” to catch and handle ethical violations.

Here’s a link to video of Scheutz’s talk. https://youtu.be/66EeYzkTxwA

Prof. Joseph Nye, emeritus of Harvard University, who created the concept of “Soft Power” diplomacy, focused on the expansion of Chinese firms in the US market and their ambition to surpass the US in AI. Nye said the notion of an AI arms race and geopolitical competition in AI can have profound effects on our society. However, he added, predictions that China will overtake the US in AI by 2030 are “uncertain” and “indeterminate” because China’s only advantage is having more data and little concern about privacy.

Nye also point out that as people unleash AI, which is leading to warfare and autonomous offensives, we should have treaties in place to control the technology, managed perhaps by international institutions that will monitor AI programs in various countries.

During the symposium, Tuan Nguyen and Michael Dukakis, cofounders of the Michael Dukakis Institute (MDI), announced MDI’s cooperation with AI World–the industry’s largest conference and expo covering the business and technology of enterprise AI, to be held in Boston December 3-5, 2018.

Nguyen said, “Our cooperation marks the determination between two organizations toward achieving the goal of developing, measuring, and tracking the progress of ethical AI policy-making and solution adoption by governments and corporations.” Nguyen also introduced Eliot Weinman – Chairman of AI World Conference and Expo as a new member of AIWS Standards and Practice Committee.

Conference details are published in the current issue of AIWS Weekly.
–Dick Pirozzolo

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

Dick Pirozzolo is a member of the Group; the Michael Dukakis Institute, formed by Boston Global Forum, is his client. 

I recently interviewed Bob Langer–MIT biotech guru extraordinaire–on behalf of the EBD Group, which holds international partnering conferences for the life sciences six times a year.  Here’s the opening…and a link to the rest, on the EBD Site. The piece will also  appear in xconomy shortly. Full disclosure…Bob is a personal friend, former classmate, and a member of the Harris Communications Group advisory board…so this should be considered a sponsored post.

–Anita M. Harris

When Bob Langer joined the MIT faculty in 1977 he had a rocky start. Trained as a chemical engineer and working on drug delivery systems, many of his ideas went against conventional wisdom. “I had people write the most insulting things about my knowledge of biology and medicine. Many thought my ideas were crazy. A number of professors wanted me to leave and my first nine grant proposals were turned down.”

Eventually, after numerous academic scientists and companies repeated and used his work Langer was able to get grant funding from the NIH. He also turned to companies for research funding—in return for licensing his patents—which, at that time, also went against the conventional grain.

Today, Langer is one of 13 Institute Professors (being an Institute Professor is MIT’s highest honor) at Massachusetts Institute of Technology. With more than 1,400 articles to his credit, he is the ninth most cited individual in history, according to Google scholar. (Sigmund Freud is first). His 1,300 patents, licensed or sublicensed to more than 350 companies in pharmaceutical, chemical, biotechnology and medical device fields, have led to more than 100 products currently in use or in clinical trials. He has received more than 220 major professional awards including the Queen Elizabeth Prize for Engineering, Priestly Medal, National Medal of Science, National Medal of Technology and Innovation, the Charles Stark Draper Prize (considered the equivalent of the Nobel Prize for engineers), and the Lemelson-MIT prize for being “one of history’s most prolific inventors in medicine.” In June 2018, he was named a US international envoy for science by the US State Department.

Despite his success, Langer remains well aware of his early setbacks, and, as a scientific advisor to some 200 companies over the past 40 years, is highly cognizant of what can go wrong.

“You can have bad animal results, failed trials, or patent problems. I’ve seen partners pull out, companies take bad loans, and the FDA create delays. Stumbling blocks can arise anywhere along the way,” he says.

One of the most difficult problems can occur early on “when a researcher has good findings but is not far enough along for investors or companies to want to spend a lot of money.” In that situation, known as “the valley of death,” Langer says, “the question is how to get enough data so that will change.”

More: 

Anita M. Harris is a writer and communications consultant based in Cambridge, MA.

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

Spent an interesting Wednesday afternoon, last week,  visiting exhibitors at the Bio-IT World Conference & Expo –several of whom won “Best of Show” Awards later that day.

The judges, listed below,  named winners in six categories: Data Integration & Management; Analysis & Data Computing; Genomic Data Services; Data Visualization & Exploration; Storage Infrastructure & Hardware; and the Judges’ Prize.  Attendees also voted on the People’s Choice Award, selecting products that they believed measurably improve workflow or capacity, enabling better research.

One of my favorites was Nanome, which won best in show for Data Visualization and Exploration.
Nanome uses virtual reality to improve the drug discovery process, according to its award application. The company offers applications for experimentation, collaborattion, and learning at the nano-scale– leveraging  VR hardware such as the Oculus Rift and HTC Vive to create immersive virtual workspaces allowing users to visualize, design, and simulate molecules, proteins, and more.

At  Nanom’se i BIO–IT World booth, Marketing Director Jarrell James handed me a pair of VR goggles and two joysticks (?) with which  I could explore within a molecule–by seeming to make components larger, smaller or revolve.

A more sophisticated user might be able to:

• -Import molecular structures from a local machine or an online database such as RCSB or DrugBank.
• – Manipulate molecular structures by literally grabbing, rotating, or enlarging the area of interest with their hands.
• – Apply different representations to their selection of Atoms, Residues, Chains, or Proteins such as Stick, Wire, Ball & Stick, or Van der Waals.
• – Measure distances and angles between atoms.
• – Mutate amino acids and cycle through rotamer libraries.
• – Design small molecules by building with any element from the periodic table.
• – Minimize manipulated molecules to prevent clashes and provide a local energy minimum conformation.
• – Duplicate or Split any selected area of your structure to modify or export independently.
• – Export your molecular structures to PDB.
• – Join a virtual reality session as a guest with or without virtual reality hardware.

• – Present and collaborate in the same virtual environment with colleagues to demonstrate proposals or compare before and after results.

Nanome plans next to enter the education space. The company’s VR technology wil help high school and college students , likely already proficient in gaming technology,  better understqand biologic processes, James said.

The Hyve 

I also spent some time with the folks at Hyve…whose fake robot ( that is, a “robot inhabited” by a human) did make me  curious about Hyve’s work.

RADAR-base
radar-cns.org

As described in the company’s award submission,  the company’s RADAR-base, developed in the framework of the IMI RADAR-CNS project, is an open source platform designed to securely collect, store and share readings from wearable devices and smartphone sensors to enable remote monitoring. The RADAR-base platform consists of three major categories of components:

• Data ingestion: Recognizing and registering data-sources (including smartphones and wearable devices), collecting the data via a direct Bluetooth connection or through a 3rd party API and streaming in near real time to the server (green box in the figure). Using Apache Kafka, the collected data is streamed to dedicated topics in real-time where the data is optimally schematized using Apache Avro;
• Data storage and management: Consists of two centralized storage systems behind an authorized security layer. A cold-storage based on HDFS that is scalable and fault-tolerant focusing on storing large volumes of high frequency raw-data, and a hot-storage based on MongoDB storing aggregated data to provide a near real-time overview of the raw-data. (blue box in the figure);
• Data sharing: Visualizing aggregated data in a live dashboard and exporting raw data for further analyses in various formats including AVRO, JSON and CSV (yellow box in the figure).

The platform is highly secured by a centralized management system of users and their authorities, participants, allowed devices and their specifications. RADAR-Base platform is distributed as Docker containers with associated scripts and configuration files to enable easy installation.

 In addition, I  visited Sinequa, which took the prize in the Analysis & Data Computing category. 

Sinequa ES v10
sinequa.com

The Sinequa Cognitive Search and Analytics platform handles all structured and unstructured data sources and uses Natural Language Processing (NLP), statistical analysis and Machine Learning (ML) in order to create an enriched “Logical Data Warehouse” (LDW). This LDW is optimized for performance in delivering rapid responses to users’ information needs. Users can ask questions in their native language or ask that relevant information be “pushed” to them in a timely fashion when it emerges.

More than 180 connectors ready for use “out of the box” make the process of connecting multiple data sources fast and seamless. Company and industry-specific dictionaries and ontologies can be easily integrated, putting specific knowledge “under the hood” of the Sinequa platform, making it an intelligent partner for anyone in search of relevant subject information.

Other awards, as descrbed in company literature: :

Genomic Data Services

Diploid
Moon 1.0
diploid.com/moon

Moon is the first software to autonomously diagnose rare diseases from WES/WGS data. By applying AI to the domain of rare disease diagnostics, Moon brings speed and scalability to the genome interpretation process.

The software only requires the patient’s gender, age of onset and his/her symptoms – in addition to the genetic data. Moon then goes from whole genome variant data (VCF) to pinpointing the causal variant in less than 5 minutes.

The software highlights one or a few variants that could explain the patient’s phenotype. For every variant, Moon displays an extensive list of annotations that it mined from the literature, allowing geneticists to easily verify decisions from the AI algorithms. Moon’s speed does not only save a lot of time and money, it also saves lives: Moon has already proven its utility in the NICU at Rady Children’s Hospital (San Diego): https://goo.gl/7TDrQD.

Unfortunately, about 50% of rare disease patients remain undiagnosed, even after whole genome sequencing and expert interpretation. Most hospitals don’t have the resources to keep analyzing negative cases even though new correlations between genes and disorders are published every day. Moon changes all this: as the software autonomously mines the literature and analyses samples, it can reanalyze older, negative cases in the background. Only when new information that might lead to a diagnosis becomes available, the assigned geneticist is notified. That way, hospitals can frequently reanalyze thousands of cases with minimal labor, providing a perspective to undiagnosed patients.

Storage Infrastructure & Hardware

PetaGene
PetaSuite Cloud Edition – Version 1.2
petagene.com

Launching at Bio-IT World 2018, PetaSuite Cloud Edition (CE) combines two innovations: (i) the ability for a user’s software tools and pipelines to seamlessly integrate with a wide variety of cloud platforms without modification, and (ii) significantly improved, high-performance, scalable PetaSuite genomic compression technology. 

For example, users can now directly run, without modification, their custom BWA-mem, GATK, Python, Java, shell scripts, and other POSIX-based software/pipelines streaming directly to/from AWS, Google Cloud, Azure, and private cloud storage, as though they were local filestores. PetaSuite CE supports each platform’s object encryption during transfer and at rest. User applications can connect to multiple cloud platforms, buckets and regions as desired, transparently, and on demand, in user-mode, without needing to modify their pipelines, setup mounts, or have administrator privileges.

Whether running on bare-metal, in VMs, or within Docker containers, for public, private or hybrid cloud, PetaSuite CE enables organizations to unlock the power of distributed object storage seamlessly from their POSIX-compliant tools and pipelines.

PetaSuite CE is built from the ground-up for the extremely high performance streaming and random-access workloads demanded by genomics applications. The integrated, transparent PetaGene compression has been significantly improved to deliver even faster compression and greater reductions of up to 6x of both BAM and FASTQ.GZ files, enabling large costs savings in cloud storage and data transfer times. Moreover, PetaGene compression can also preserve the MD5 checksum of the original BAM or FASTQ.GZ file and not just the internal raw SAM/FASTQ data.

The Judges’ Prize went to 

 Linguamatics and its iScite 2.0 (iscite.com) provide a Software-as-a-Service search application that puts the power of text analytics directly into scientists’ hands, according to the company writeup.

Using Linguamatics’ Award-winning Natural Language Processing
Researchers can extract and analyze relevant data to rapidly answer business-critical questions. iScite utilizes Linguamatics’ award-winning Natural Language  L(NLP) based blend of analytical methods. By understanding the semantics and structure of text, iScite handles the variety of ways people express the same information, ensuring searches are comprehensive and accurate.

Easy to use on any device
iScite’s intuitive HTML interface includes a simple search box and auto-complete suggestions. The innovative answer-routing engine lets users answer simple or complex questions using puzzle-piece building blocks – simplifying access to powerful queries that extract concepts, relationships, numerical data such as drug dosages, mutations and more.

Get answers to questions, not just documents
Data sources include Linguamatics’ cloud-hosted content. MEDLINE, Clinical Trials.gov, FDA Drug Labels, PubMed Central, and Patent Abstracts are annotated with curated terminologies for diseases, drugs, genes and organizations. Scientists can answer questions such as:

• What genes are involved in breast cancer?
• What protocol designs have been used for immuno-oncology trials?
• What are the adverse events for kinase inhibitors?

Actionable results
Results are presented in structured form, with bar chart facets for dynamic, visual results-filtering, a document viewer that highlights key terms and relationships, and relevant link-outs. Users can curate, save, and export their results.

iScite allows users across drug discovery and development to cut through the vast information landscape and discover the most valuable insights.

The People’s Choice award went to 

OnRamp BioInformatics, Inc. and itsROSALIND™ platform:  the first-ever genomics analysis platform specifically designed for life science researchers to  analyze and interpret datasets, while freeing up more time for bioinformaticians.

Named in honor of pioneering researcher Rosalind Franklin, who made a major contribution to the discovery of the double-helix structure of DNA with her famous photograph 51, OnRamp’s ROSALIND platform aims to simplify the practice of genomic data interpretation. According to the company’s writeup,  ROSALIND puts the researcher into the driver’s seat of data analysis and democratizes bioinformatics by broadly expanding access to genomic and proteomic technologies for cancer research, precision medicine and sustainable agriculture.

While many open-source tools remain the lifeline of genomic analysis, a simplified and innovative user experience for the biologist can empower them to run their own analyses, while utilizing these tools without the need for typing any command-line instructions.

ROSALIND is powered in partnership with Google Cloud and features scalable compute power and economical cloud-based storage. ROSALIND is a swarming docker-based genomic analysis solution incorporating the industry’s most trusted open-source tools and algorithms, with an angular front-end and secure RESTful API. ROSALIND is also deployable on-premise.

On Ramp technololgists believe that empowering biologists with “an intuitive and comprehensive platform” to explore their data and collaborate with colleagues and bioinformaticians, they  can help accelerate their industry and the widespread adoption of genomic technologies by dramatically lowering costs, reducing  complexity and, ultimately, focus more on what what to do with results, rather than on how to get to them.

In the words of Allison Profitt, BIO-IT World’s editor,” The awards program recognizes the best of the innovative product solutions for the life sciences industry on display at the conference,

“It’s always a treat to explore what’s new in our industry.

” The innovation on display by Bio-IT World exhibitors never disappoints, and we are excited to shine a spotlight on the best life sciences has to offer.”

Judges
“The Best of Show program relies on a panel of expert judges from academia and industry who screen eligible new products and hear presentations from a list of finalists on site. This year our judges considered 46 new products and viewed presentations on site from 18 finalists.”

The 2018 judging panel included Joe Cerro, BostonCIO; Chris Dwan, Bridgeplate; Richard Holland, New Forest Ventures; Eleanor Howe, Diamond Age Data Science; Phillips Kuhl, Cambridge Healthtech Institute; Steve Marshall, Marshall Data Solutions; Michael Miller, Genentech; Art Morales, Analgesic Solutions; Nanguneri Nirmala, Tufts University School of Medicine; Alexander Sherman, Massachusetts General Hospital; Subi Subramanian, Vertex Pharmaceuticals; Bill Van Etten, BioTeam; and Proffitt.

–Anita M. Harris
Anita Harris is a science writer based in Cambridge, MA. 
New Cambridge Observer is a publication of the Harris Commmunications Group, also in Cambridge, ma.  

Links to
Part I Overview, Watson, analytics
Part II digital devices, long term care.
Part III Apps, devices, roadblocks

Behavioral and Population Health; Roadblocks to change

Can mobile apps really improve mental health? Cut the costs of health care? Help professionals track and care for patients? At a day-long conference sponsored  on health systems innovation organized the MIT/Sloan MIT  Initiative for Health Systems Innovation (HSI), experts from a variety of fields attempted to answer those and other questions aimed at furthering a transformation of  the US healthcare system.  Part III of a series about the conference describes apps and devices for behavioral health, personalized and long-distance care. It also discusses new state models to integrate community, health and social systems aimed at tracking and caring for patients and points out that no matter how sophisticated the technology, it is still up to human beings to make it work.

Behavioral Health

Don Mordecai, Kaiser Permanente

Dan Mordecai, MD, National Leader, Mental Health and Wellness at the managed care consortium Kaiser Permanente described:

• Promising mobile apps aimed at helping people prevent or overcome eating disorders, addiction, or suicide; remain on diets or exercise plans; or connect them with treating providers or coaches.
• Wearables that can measure how much people move or perform text and voice analysis to help professionals understand who needs care, months or years before it is needed.
• Predictive analytics to help prevent self-harm

While many of the above technologies have yet to be proven effective, Mordecai said, telehealth technology has been shown to be helpful in supporting and promoting long-distance health care for areas with shortages of medical personnel.  Telehealth may be carried out through videoconferencing, store-and-forward imaging, streaming media, and terrestrial and wireless communication.  

Mordecai also pointed out that with digital advances, “we are moving from individual doctor patient relationships” to a “personalized’” system, which relies increasingly on data, but that “there is a long way to go.”    Mordecai plans to use what he termed “crowd sourcing” to analyze the effectiveness of apps and other new health technologies, based on the electronic health records of Kaiser Permanente’s   nearly 12 million patients.

State models and population health
Analysis like that used at Kaiser Permanente is crucial for assessing treatment and cutting costs, but it is more challenging to perform outside of managed care programs, which have access to a vast array of patient records, according to Michael Wilkening, the California Undersecretary for Health and Human Services.  Analysis to records for care funded by government or private insurance is hampered by fragmented  social, health provider and  insurance systems and by legal and technical challenges of sharing patient data among those systems,

The New York State Medicaid director, Jason Helgerson, pointed out that for state Medicaid systems,  which serve mainly low-income populations,  it can be difficult to simply keep track of patients,  much less co-ordinate and evaluate their care or reduce their treatment costs.  As an example, he described a city homeless shelter that serves breakfast and dinner, but not lunch. Hungry residents regularly go to the fire station next door and complain of chest pain; they are taken by ambulance to a hospital emergency room, where they are evaluated, at high cost, given lunch, and then transported back to the homeless shelter in time for dinner.

Medicaid systems in at least several states are working on projects to prevent such situations by better integrating social services with medical and behavioral health care. Some are starting to employ analytics to recommend, monitor and measure the success of treatments, and to pay for performance rather than service.  As a result, Helgerson said, “Medicaid may be in the best position to drive change” in health delivery systems.

Roadblocks to change
Still, as a variety of speakers pointed out, despite the promise of digital innovation, there are many roadblocks to change.   Such roadblocks include: reluctance to replace or augment human decision-making with digital solutions;  complex reimbursement systems  and the need for insurer “buy-in” to pay for new technologies;  disparate stakeholders with different goals;  issues of privacy and security;   the  tendency of legislators and other policymakers to view health problems as individual rather than societal;   failure to address the lack of food and shelter that leads to poor health and expensive repeat hospital visits;  and, last but not least, cost.

In the words of Vocera’s Elizabeth Boehm, regarding systemic change, “it takes more than technology to get it done.“

And, as Restef Levi, of the Sloan School, put it: “Technology is important but…at the end of the day, health is about humans.”

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 and digital marketing firm based in Cambridge, MA.

Wearables, robots, monitors, and IT systems for long-term care and  delivery systems. 

Part I Overview, Watson, Analytics
Part II digital devices, long term care.
Part III Apps, devices, roadblocks

At a recent health systems innovation organized the MIT/Sloan MIT  Initiative for Health Systems Innovation (HSI), experts from a variety of fields described current and envisioned methods for streamlining, personalizing and cutting the costs of health care in the US.  Among them were : wearables; robots; sophisticated monitors;  and digital methods to better coordinate communication and care.

Long Term care
On a panel covering digital innovation and long-term care, Thomas Grape, founder, chairman and CEO of Benchmark Senior Living,  described a variety of digital devices and methods used in his more than 60 facilities and elsewhere to improve care,  streamline operations and  cut costs amid a projected shortage of elder care workers.

Among digital innovations for patient care are:

• “Real time” monitoring and location systems to keep track of patients in dementia wards
• Wearables (such as vests or bracelets) with sensors that monitor movement to prevent falls
• Virtual and augmented reality devices such as “Wayback,” designed to enhance the experiences of individuals in early stages of mental decline—for example, by allowing them to “visit” faraway places or feel that they are attending historic events.
• Robots, such as”Jibo,” to keep patients company and entertain them. The robot, Jibo is “powered” by face and voice recognition. According to the Jibo Web site, the robot “remembers” people and builds “relationships” with everyone “he” meets.  Engineered by “character designers,” the robot has a “3-axis motor system” and “the moves” to match the personality of the human it is interacting with.
• Monitors that respond catastrophic events and proceed along“critical paths”: for example, by calling an ambulance and transferring a nursing home resident’s file even before a nursing home knows a patient has fallen and needs to go to the hospital.

Digital innovations for facilities and operations aimed, largely, at reducing staffing costs include:

• Monitors to measure light levels in hallways
• Exoskeletons,  worn by staff to cut the number of aides needed to lift and assist patients
• Robotic machines to help people in and out of chairs and toilets
• Automation of repetitive” back-office” business tasks.

Healthcare Delivery and Health Management

IT-Based Startups
On a panel showcasing three young companies, entrepreneurs described new methods for streamlining and coordinating healthcare delivery and management.

• Elliot Cohen, founder and chief technology officer of Pillpack, described his company’s “behind the scenes” effort to make managing and taking medication a “delightful” experience for patients. “Pillpack” uses information technology to coordinate physicians’ prescriptions and insurance companies in order to prepackage and send medication to patients exactly as it will be taken.
• Liz Boehm, research director of the Vocera Communications Experience Innovation Network explained that her company is focused on “unified clinical communications.” Vocera employs digital technology to align and manage workflow by connecting  patients, clinicians, and clinical systems.
• Health Reveal offers “a cloud-based digital health solution” to detect, monitor, and recommend prevention options for patients at risk for developing full-blown chronic disease, according to Christine Tsien Silvers, MD, the company’s chief medical officer. The system, paid for by insurers, includes not only purchasers, payers, providers and accountable care organizations but also patients, (who receive financial incentives for adherence to recommendations), pharmaceutical companies and device manufacturers, Silvers said.

In Part 3, I’ll describe promising mobile apps for behavioral health; personalized care and long-distance care as well as new state models to integrate community, health and social systems so as to better track and care for patients. I’ll also report on roadblocks to change.

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 focusing on health, science and technology.
New Cambridge Observer is a publication of the Harris Communications Group, a content and digital marketing firm based in Cambridge, MA.

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.

Fresh Pond Rules of the Road, posted after we contacted Ranger Jeanne

Two weeks ago, I stopped to thank Ranger Jean Rogers for the information she sent after I emailed her about almost being run off the path at Fresh Pond, in Cambridge–and to mention it that I’d posted it on New Cambridge Observer (September 11).

She told me that several people had similar complaints, and that her office would soon be posting signs suggesting proper “etiquette.” (She also suggested that I call the police if anyone ran roughshod like that, again).

On my run this morning, I was pleased to see that signs outlining etiquette have been posted.

They apply to runners, walkers, bikers and dog people. (Well, to everyone)

• Keep to the right
• Pass on the left and make your presence known.
• Slow down when passing
• Keep your dog on a leash
• Be aware of your surroundings . When running with ear buds. check behind you before passing.
• Kindly move off the path to stop and talk.
• Slower-moving people stay to the right
• Use lights when it’s dark.
• See Fresh Pond Reservation Rules and Regulations for off-leash use.

Fresh Pond, Sept 24, 2017

.I want to apologize for occasionally running on the dirt path to the left of the blacktop–but only because, in some areas, the dirt path is very narrow and overrun with bushes or, worse, yet, poison ivy.

I also want to thank Ranger Jean for her help with this.

Anita Harris

Anita M. Harris is a writer, photographer and wunner (she walks and runs?)  in Cambridge, MA.

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