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.

Want  to  lunch one-on-one with a senior exec from a major pharma company and help people in the developing world at the same time?

UK/US Life science consulting firm Alacrita,  based in the Cambridge Innovation Center, has launched a benefit auction in which you can bid for a two-hour, one-to-one lunch with senior executives from the pharmaceutical industry who have donated their time to the appeal.

According to Alacrita Partner Rob Johnson,   the appeal aims to raise money for WaterAid, an international non-profit organization that  transforms the lives of people in the world’s poorest countries by improving access to safe water and sanitation.

Bidding opened Monday 3^rd December and closes on Thursday 13^th December on 5pm EST/10pm GMT.

In order to bid,  click on a name, below. You will be redirected to eBay for bidding.

• Heather Bell, Head of Corporate Strategy and Shaun Grady, Head of Business Development at AstraZeneca (one lunch)
• Moncef Slaoui, Chairman, Research & Development at GlaxoSmithKline
• Douglas Giordano, Senior Vice President, Worldwide Business Development at Pfizer
• Susan Silbermann, President and General Manager, Vaccines, Specialty Care Business Unit and Polly Murphy Vice President, Specialty Care Business Unit Business Development at Pfizer (one lunch)
• Graham Brazier, Vice President, Business Development, Strategic Transactions Group at Bristol-Myers Squibb
• Pamela Demain, Executive Director, Corporate Licensing at Merck
• Susan Jane Herbert, Executive Vice President and Head of Global Business Development and Strategy and Annalisa Jenkins, Executive Vice President and Head of Global Drug Development & Medical and Belen Garijo, Executive Vice President and Chief Operating Officer at Merck Serono (one lunch)

Bidding  will be open until 13^th December, 5pm EST/10pm GMT.

Johnson said: “We are thrilled to launch this year’s seasonal appeal to raise funds for WaterAid. 783 million people, or one in ten of the world’s population, live without access to safe water and last year WaterAid reached 1.6 million people with water and 1.9 million people with sanitation in 27 countries. ”

David Winder, CEO of WaterAid, America added: “We are delighted that Alacrita has chosen to  donate the proceeds of their charity auction to  WaterAid.  Every day, 2,000 children die from water-related diseases that could easily be prevented.  The funds raised will help us reach more of the world’s poorest people with safe, clean water and sanitation.  These vital basic services are essential for saving  lives, improving health and reducing poverty in the world’s poorest countries.”

–Anita M. Harris
New Cambridge Observer is a publication of the Harris Communications Group,  an award-winning PR/content marketing and social media firm specializing in health, science, technology and energy.

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

Earlier this month, in Kendall Square, two entrepreneurs described new medical devices designed to provide low-cost “point-of-care” tests-far from laboratories or medical centers in the developing world.

Speaking at a meeting of  Health Care and Life Science Special Interest Group of the MIT Enterprise Forum at the British Consulate  former Mass Biotechnology Council  President Una Ryan described the paper-based  medical testing technology that her new nonprofit enterprise,  Diagnostics for All (DFA), has licensed from the George Whitesides Laboratory at Harvard.

The technology allows bodily fluid to accumulate in patterns on postage-stamp sized pieces of paper–to be used for  multiple  tests simultaneously. DFA’s first project, funded in part by the Bill and Melinda Gates Foundation, is a liver function test to monitor the effects of drugs for HIV/AIDS and tuberculosis, and  to help manage viral hepatitis.  The test kits will first be sold in convenience stores in Africa at a cost of approximately ten cents each, Ryan said.

Bill Rodriguez, CEO of Daktari Diagnostics, showed a handheld, point of care, battery-operated diagnostics device the size of a small lunch box or portable radio that will first be used to test for AIDS in Africa–at a cost of $1.50 per test–starting next year. He pointed out that while drugs are available to treat the  33 million people worldwide who have  HIV– “ten million of them don’t know it.”

Scientia Advisors Partner Arshad Ahmed, who  served as moderator, (and is my client) pointed out in a recent blog that emerging markets may have the opportunity to adopt the latest point-of-care products, leapfrogging developed countries, in some instances–and that “emerging markets are where we will see the first application of low cost and inovative disruptive technologies at work.” Launching in the developing world allows companies to test out and market technologies before going through the rigorous approval process required in the developed world.

I was blown away by the prospects for  devices like these. I asked when and how they will affect the  costs and structure of, say, US healthcare–and whether those who make and market our costly technologies will try to keep these new testing devices from our marketplace. Ryan, whose nonprofit, DFA, will have a commercial wing, responded that she does not expect opposition from stakeholders in our current system. And a marketer for the device and pharma industries was adamant that  developments like these will not impact her customers–for many years,  at least.  Given the vicissitudes of the US regulatory system and financeers needs for ROI, that may well be true.

But, clearly,  technologies like these have tremendous potential to transform health care–and I’m excited at their prospects– for the long-neglected developing world.

—Anita M. Harris

Anita M. Harris is President of the Harris Communications Group, a marketing and public relations firm specializing in health, science and technology industries, worldwide.