Some of the most exciting (and scary) aspects of machine learning that you may not know about

The decibel of chatter around artificial intelligence is rising to the point where many are inclined to dismiss it as hype. It’s unfair because while certain aspects of the technology are a long way away from becoming mainstream tech, like self-driving cars, it’s a fascinating topic. After listening to a talk recently by Dr. Eric Horvitz, Microsoft Research managing director, I can appreciate that the number of applications being conceived around the technology is only matched by the ethical dilemmas surrounding it. But in both cases, they are much more varied than what typically dominates the conversation about AI.

For fans of the ethical roads less traveled in AI, Horvitz offered a fair few items for his audience to consider at the SXSW conference last week that alternated between hope for the human condition and fear for it. Although I previously highlighted some of the healthcare applications he discussed, there are plenty of issues he raised that one day could be just as relevant to healthcare. I have included a few of them here.

Interpreting facial expressions

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The idea of machine learning being applied to make people more connected to each other improve in subtle ways our communication skills is fascinating to me. One example used was a blind man conducting a meeting and receiving auditory cues on the facial expressions of his audience. The idea is to provide more insight on the people around him so he can have a better sense of how the points he raised are perceived beyond what the people in the meeting actually say. In a practical way, it gives him an additional layer of knowledge he wouldn’t have otherwise and makes him feel more connected to others.

The ethical decisions of self-driving cars

As exciting as the prospect of self-driving cars is, Horvitz called attention to some of the still unresolved, important questions of how they would perform in an accident or when trying to avoid an accident. What decisions would the computer make when, say a collision with a pedestrian is likely and the car has to make a split-second choice? Does it preserve the life of the driver or the pedestrian, if it comes to that?  What responsibility does the manufacturer have?  What values will be embedded in the system? How should manufacturers disclose this information?

Horvitz slide

A slide that was part of Dr. Eric Horvitz’s talk at SXSW this year.

Adversarial machine learning

One fascinating topic addressed in the talk was how machine learning could be used with negative intent —referred to as adversarial machine learning. It involves feeding a computer information that changes how it interprets images, words, and how it processes information. In one study, a computer that was fed images of a stop sign could be retained to interpret those images as a yield sign. That has important implications for self-driving cars and automated tasks in other sectors.

Another facet of adversarial machine learning is the use of information tracking individuals’ Web searches, likes and dislikes shared in social networks and the kinds of content they tend to click on and using that information to manipulate these people. That could cover a wide swathe of misdeeds from manipulation through fake Tweets designed by neural networks in the personality of the account holder to particularly nasty phishing attacks. Horvitz noted that these AI attacks on human minds will be an important issue in our lifetime.

“We’re talking about technologies that will touch us in much more intimate ways because they are the technologies of intellect,” Horvitz said.

Appling AI to judicial sentencing software

Although machine learning for clinical decision support tools is an area of interest in healthcare to help identify patients at risk of readmission or to analyze medical images for patterns and anomalies, it’s also entering the realm of judicial sentencing. The concern is that these software tools that some states permit judges to use in determining sentencing include the bias of their human creators and further erode confidence in the legal system. ProPublica drew attention to the issue last year.

Wrestling with ethical issues and challenges of AI

Although he likened the stage of AI development to the first airplane flight by the Wright Brothers at Kittyhawk, North Carolina which was 20 feet off the ground and lasted all of 12 seconds. But the risk and challenge of many technologies is that a certain point it can progress far faster than anyone can anticipate. This is why there’s been a push to wrestle with the ethical issues of AI rather than address them after the fact in a reactive way, such as Partnership on AI. Eight years ago, Stanford University set up AI100, an initiative to study AI for the next 100 years. The idea is that the group will study and anticipate how the effects of artificial intelligence will impact every aspect of how people work and live.

Photo: Andrzej Wojcicki, Getty Images

Digital Pharmacist acquires rival app to accelerate pharmacy services product development

A digital health business formed from the merger of RxWiki and TeleManager Technologies in January has made its first acquisition, according to a news release. Digital Pharmacist acquired PocketRx —an app that’s designed to help community pharmacists enable their customers to better engage with pharmacists. The deal will help Digital Pharmacists speed up product development and consolidate their products and services into one app.

Alan Stickler, Digital Pharmacist Chief Technology Officer, shared some information about the deal in a phone interview.

The financial terms of the deal were not disclosed.

Stickler said the deal would support Digital Pharmacist’s efforts to provide a more personalized service to pharmacists and their own customer base. Customers use the app to track their own medications and refills. But for community pharmacists, the services are designed to give them access to resources that most pharmacists lack compared with the likes of CVS and Walgreens. Pharmacies use the app to improve their marketing reach and give them better insights on the needs of their customer base.

As part of the acquisition deal, Digital Pharmacist is acquiring the app from software developer Praeses. Robert Terrell, product manager for PocketRx, has joined Digital Pharmacist as product development director. Praeses will also give software development and support for Digital Pharmacist.

Stickler estimated that a fully consolidated app would be ready by the end of the second quarter or the beginning of the third quarter.

The acquisition of PocketRx follows a string of digital health acquisitions last week and the consolidation that has been happening across healthcare, particularly in the pharmacy sector.

Photo: Nicols Meroo, Getty Images

Miss the SXSW festival? Here were the healthcare highlights from Biden to health innovation hubs

Disruption has been the theme for healthcare at South by Southwest with everyone looking to disrupt the status quo. Other than the cold and rain, the Health track may have been the real disruptor of SXSW 2017, which was exciting for those passionate about the healthcare disruption movement.  The health track sessions moved from the JW Marriott to the Austin Convention Center, and saw significant wait times at sessions.

It was great to be reunited with the supportive and collaborative SXSW community not viewing innovation as a transactional, zero-sum game, but inspired by a group of people working on the same problems and supporting the success of each other.  Shawna Butler of Singularity University, an Austinite,  referenced the city in a way I loved saying, “Austin is full of pathologically helpful people”.  I could not agree more about Austin or the SXSW community.

The SXSW health track attendees covered the ecosystem of patient care, provider support, policymakers, entrepreneurs and investors seeking to improve healthcare globally.

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Rise of the health innovation hubs

TMCx, athenahealth, StartUp Health and J&J Innovation had a nice presence at SXSW.  These accelerators attract and reward top startups with capital and nurturing to rapidly commercialize concepts within healthcare ecosystems.  Look for the next wave of successful digital health companies from these channels that nurture leading concepts and top talent they select when they believe they can accelerate them.

GE Vice Chair Beth Comstock and Steve Case, chairman and CEO of investment firm Revolution LLC, discussed his “Rise of the Rest” concept on a panel.  They discussed how tech innovation first evolved regionally from within corporations. Innovation then consolidated to venture capital markets in New York City, San Francisco and Boston. Case’s boomerang theory represents today’s third wave from venture arms in corporations that fund and partner with external startups to tap into the entrepreneurial spirit and harvest innovation. Case used the healthcare hubs as an example. He also referenced GM for leading Lyft’s recent round.

Baylor Scott & White Hospitals put together a talk on Embrace Digital Disruption to Reinvent Healthcare with a panel of exciting digital health startup CEOs they’re partnering with.  Baylor realizes, like many hospital systems, they are ill-equipped to innovate and develop digital tools and seeks outside partnerships to assist their desired change towards consumerism, greater access, and improved population health outcomes. PediaQ CEO, Jon O’Sullivan, discussed their partnership and how their Q.care mobile app provides triage video access to answer questions and navigate a patient to the best point of care or old fashioned house calls on demand.

The Impact Pediatric Health competition was hosted by eight top hospitals to showcase pediatric healthcare innovations they can accelerate and commercialize.  Keriton was the digital health winner for improving breast milk for NICU babies and Luminopia won in Medtech using VR for visual and neurological care.

Runner-up CareDox created a technology hub connecting schools, families and providers to coordinate care. CareDox CEO and founder, Hesky Kutscher, framed the opportunity and importance to improve pediatric care in a new way for me, “with 50 million children enrolled in U.S. public schools, it is a patient population larger than Medicare. School nurses, teachers and coaches need to be tremendous partners with hospitals in improving children’s health outcomes and prevention.” Connecting the overall community to improve our care system, rather than talking about HIPAA, is the exciting disruption we need.

Connecting the overall community to improve our care system, rather than talking about HIPAA, is the exciting disruption we need.

The latest on health tech investing

Whether listening to investment panels, or meeting investors at the Capitol Factory Founders party, there is clearly a lot of money seeking the next disruptive startup. We have seen fewer total deals recently with more late-stage deals completed, however, there is still a lot of interest and money looking at early stage deals.  With the lower costs for bringing minimally viable products (MVP) to market today, we are seeing VCs willing to make smaller bets on earlier stage companies than their primary investment thesis, when they like the team, concept and see follow-on investment opportunities.

Troy Bannister, director of scouting and onboarding from the StartUp Health army of Health Transformers, led a panel on Real Success Stories of Hackathons.  This panel adapted the MIT Hacking Medicine concept teaching healthcare entrepreneurship to solve global healthcare problems. The group discussed what entrepreneurs need to do next to build an MVP and then a successful company. Bannister discussed the entrepreneurial mindset required to create and communicate a vision that can attract both ‘A players’ and capital as used in StartUp Health to assist their companies achieve this.

Disrupting healthcare requires strong leadership, a strong team and a vision but also the ability to remain nimble in a rapidly evolving system.  Positioning the company for where the puck might be in a few years is a foundation VCs seek more than a great product or business model.

Telemedicine Magazine publisher, Logan Plaster, and I walked the convention floor together discussing innovative presenters.  Two that stood out to us were PokitDok and Tellus as the infrastructure players that will be at the heart of the new digital systems.  PokitDok calls itself the infrastructure for digital health with an API allowing two-way interoperability between devices, apps, hospitals and payers.  Tellus has patented the technology allowing hospitals to add apps to their system.

One other consistent point I heard was that the health systems are seeking partners, products and services that lower cost or increase access.  Hospitals and systems expect to serve more underinsured patients and take on more bad debt.  These leaders seek to improve care, but all have a top-down mandate to seek solutions that lower costs.  Follow the money as investors look for cost saving platforms.

Joe Biden discusses his Cure Cancer Moonshot

The passionate former Vice President Joe Biden headlined the Connect to End Cancer sessions. Technology is playing a greater role in research to accelerate finding cancer cures but also to improve care in innovative ways. Biden spoke intimately about losing his son to the disease and the need for scientists to share data and research rather than everyone working in silos.

After Biden’s talk, an attendee spoke to him and shared how his wife was battling Leukemia.  Biden asked how she was and looked relieved to learn she was in remission. Then he demanded to get her on the phone.  Joe left her a long message telling her how much her husband cared for her and how much he admired her courage for fighting her battle. Everyone attending this session was inspired and strengthened that Biden is making Cure Cancer his personal moonshot.

Social fabric of Austin

Guerilla marketing was as popular as ever, even with the weather. Supa was one group I enjoyed running into.  Many panels discussed sports, AI, biometrics, and cognitive tracking, and the Supa Heroes infiltrated events and parties in their onesies and sweaters to promote their sports, fashion and biometrics products.

It’s shameful to not take advantage of the social fabric of Austin, as that’s part of the SXSW experience — seeking out the best parties and staying out later than planned. The rain altered the SXSW ethos around party hopping and relaxing with a drink and live music in the sun. Still, we were able to work in some of the local culinary favorites — a margarita and some tacos al pastor at Guero’s Taco Bar,  breakfast tacos at Tacodeli, and Texas brisket at Stubb’s.

One thing will never change about SXSW.  It was a great week to see old friends, make new connections, and get inspired by new technology and entrepreneurs.  Thank you, Austin, and your community of pathologically helpful people.

At a pediatric innovation challenge, startups illustrate growing maturity of healthcare entrepreneurs

CEO Vidur Bhatnagar’s company Keriton won the digital health track of the Impact Pediatric Health pitch at SXSW.

The two companies that walked away with awards in their hands and $15,000 checks in their pockets from the Impact Pediatric Health pitch event at SXSW offered practical solutions to common problems.

Luminopia used virtual reality to tackle and treat a common problem —lazy eye, which affects 2 percent to 3 percent of the population. Keriton, which MedCity News profiled earlier this month, developed a system to bring more organization to the task of making sure a mother’s breast milk gets to the right baby in the neonatal ICU and tracking how much mothers are producing.

Not only are many digital health and medtech entrepreneurs making better choices of which pain points to go after, they are increasingly showing a grasp of marketing that makes their pitch more persuasive.

Team Luminopia cofounders Scott Xiao (left) and Dean Travers

Team Luminopia won in the medtech category.

The medtech winner,  Luminopia,  was formed by a group of Harvard freshman who developed a way to use virtual reality goggles to correct amblyopia or lazy eye. Long term, the company’s technology holds the potential to provide a way to detect this condition, which can frequently go undiagnosed. The current practice for treating lazy eye is an eye patch but that comes with a social stigma that is likely to mean children are inclined not to wear it.

Dean Travers is the CEO and one of three cofounders at Luminopia. His presentation noted that one nice aspect of its approach is that primary care physicians can prescribe the virtual reality device to children and they can do the necessary exercises with it from home.

“We don’t need to disrupt the workflow,” Travers said.

The Impact Pediatric Health pitch event at SXSW offers a glimpse not only at how entrepreneurs are trying to solve the healthcare challenges of an often overlooked market. It also offers a perspective on how children’s hospitals are evaluating startups’ technology.

Certa Dose was founded by a physician who developed a color-coordinated syringe showing the appropriate amount by weight as a way to reduce the risk of overdosing young children. The company targets high-risk drugs. The device is aimed at hospitals and parents. Dr. Caleb Hernandez, the Chief Medical Officer and cofounder, noted that the company’s device eliminated the need to make complex mathematical calculations to determine dosage by weight. It also envisions paramedics using its device for conditions like anaphylactic shock, signaling it plans to compete with EpiPen.

Neuroelectrics developed a connected cap to monitor and stimulate targeted brain areas for children with epilepsy. Ana Maiques, the CEO, who modeled the company’s head gear, showed that to make the device less intimidating to children, it provides a cover with mouse ears to make the device more appealing. Asked by judges how the company knows it’s the best for the market it is targeting, Maiques gave an unusual but gutsy answer.

“I don’t know if it will meet the endpoints in the [upcoming]clinical trial, but if we fail we fail.”

Photo: Daniel Kraft of Singularity University, who served as a judge and emcee for the event,  Impact Pediatric Health

At the intersection of cancer treatment and technology, it’s more evolution than revolution

For the first time at SXSW, a series of panel discussions in the health track zoomed in on cancer — Connect to End Cancer. The themes that dominated tended to be the role of technology such as telemedicine and data from connected devices, the role of 5G technology and technology’s shortcomings. But concerns over what Trump’s FDA nominee will do with the FDA cast a long shadow over parts of the discussion.

Here were some of the more interesting conversation points across a couple of the panel discussions I attended.

 Telemedicine, telehealth and the impact of 5G

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Most people don’t think of cancer treatment and telemedicine intersecting but as Rebecca Kaul, Houston-based MD Anderson Chief Innovation Officer noted, cancer center patients tend to have a varied geographical base. “We think telemedicine is highly important — two-thirds of our patients come from outside of Texas.”

John Donovan, AT&T Chief Strategy Officer and group president for AT&T Technology and Operations, noted that 5G had the potential to improve the quality of virtual interactions between patients and physicians.

5G will improve the quality of technology execution from telemedicine from near real time to real time, he noted. Donovan pointed out that healthcare is one of several industries hindered by slow technology. This advancement could help not only healthcare but other industries as well such as fintech.

Coping with technology shortcomings

Another interesting part was when the discussion tackled some of the shortcomings of technology, particularly when our expectations can’t be matched by the reality on the ground. Greg Simon, director of the Biden Cancer Initiative at the Biden Foundation, defended platforms like IBM Watson by noting that even the Hubble space telescope when initially launched had blurry vision. It took a team of scientists to correct that.  The computer platform is not a panacea because one of the challenges of new technology is that it takes time before it rises to its potential.

“It’s not that surprising that Watson isn’t perfect,” Simon noted. “It is still a student. It reads everything but it doesn’t know everything.”

Aman Bhandari, Merck executive director of data, sciences and partnerships, observed that there is dissonance between what we have the ability to do and what is actually happening in the healthcare delivery system.

“So much great innovation is happening, yet our current health delivery system isn’t working to make those innovations available to everyone,” Bhandari said.

Even immunotherapy, which is a hot area of investment for venture capital and is regarded as a promising new technology, has its own set of shortcomings. The problem with immunotherapy is that it can attack healthy tissue as well as unhealthy tissue.

Big data and interoperability often rise to the surface as obstacles in healthcare and these sessions were no exception. In a lightning round for a panel moderated by Halle Tecco, who founded Rock Health and now teaches a class at Columbia Business School, she asked panelists what’s the biggest challenge they currently face. Bhandari noted data liquidity and Tecco’s husband Jeff Hammerbacher, the cofounder of Cloudera, called attention to the “Tower of Babel” around data.

Every regulation at the FDA has been written in blood

With speculation that President Donald Trump’s nomination to head up the U.S. Food and Drug Administration will champion deregulation, several of the panelists in one session feared what the consequences might be. Simon and Bhandari touched on the evolution of the FDA.

“Every regulation at the FDA has been written in blood,” said Simon solemnly. “You will not hear from the cancer community that the FDA is slow and burdensome.”

Bhandari added, “Every major regulation has happened because of a public health concern.”

Simon expressed the hope that the administration would steer clear of cancer initiatives that have already been launched.

Another panelist expressed the hope that providing better education support to patients about particular clinical trials would help with poor recruitment efforts.

Simon was also frustrated by the way data from clinical trials is not released until one year after the clinical study was finished and hoped that would change.

Advice for startups

Tecco also asked her panel to offer some advice for startups. At some point in the conversation, Bhandari expressed some frustration with startups that make AI and machine learning claims without providing a more nuanced approach to how they are using these tools or even noting the slight differences between the two. Machine learning is one aspect of AI, which is a much broader term.

Simon advised entrepreneurs to “immerse yourself in patients” and focus on their interests and priorities rather than investors, adding:

“Don’t think about investors or the markets — if you immerse yourself in patients, you will figure something out.”

Photo: xrisca30, Getty Images,

5 startups from the SXSW Accelerator that you should meet

Sound Scouts, an Australian-based business that developed a DIY hearing test app that parents can download and run for their children, emerged as the winner of the SXSW Accelerator pitch competition in the digital health and wearables track, according to an emailed announcement from the organizers. The test is cleverly disguised as a game designed to create a more interactive experience for kids but alert parents to any hearing problems that warrant attention from healthcare professionals.

It wasn’t immediately clear what Sound Scouts’ plans for the U.S. market are, but Founder Carolyn Mee said during her initial presentation that she wants to make the product available to adults and children around the world.

Although there was only one dedicated health track, the technology behind a few of the other startup winners have direct or indirect applications for healthcare as well.

Enterprise and Smart Data

Deep 6 AI developed technology to make it easier to match patients with appropriate clinical trials through natural language processing and artificial intelligence. The clinical trial recruitment process is one of the most time consuming and costly aspects of drug development and Deep 6 AI is one of several companies to take up the gauntlet of creating a more streamlined process. Wout Brusselaers is the founder and CEO.

Security and Privacy

UnifyID uses data collected by sensors from an individual’s mobile devices such as GPS, accelerometer, gyroscope, magnetometer, barometer, ambient light, and WiFi and Bluetooth signal telemetries to figure out what makes the owner unique, according to the San Francisco company’s website. The data is kept on the local device, is encrypted and anonymized. UnifyID’s approach can also be applied to desktop and laptop computers. Given the cybersecurity concerns in healthcare over the theft of personal health data it seems like UnifyID’s approach could have useful applications in this sector.

Innovative World

Thimble.io in Buffalo, New York wants customers to discover their inner engineer, their inner maker. A monthly subscription gives users an electronics kit each month that teaches them how to code, hack and construct electronic devices. By playing the long game, stimulating young and older minds to use these kits as stepping stones towards realizing their creative interests, they could help create a new generation of software developers and biomedical engineers wherever they might be.

Augmented and Virtual Reality

Lampix shuns the goggles and other head gear that tends to be associated with augmented and virtual reality. Instead, it takes a more subtle approach. The company’s product lets users adopt flat surfaces like a table to project a computer screen and interact with the screen projection as if it’s a touchscreen. As for healthcare applications, Lampix’s platform could be used as another approach to gaming technology for cognitive assessment to expanding health literacy delivery tools.