The 10 Most Innovative Companies Bringing AI to Healthcare

www.insightscare.com December 2018

The

Most

Innovative Companies Bringing to

Healthcare

Wolf Shlagman Founder | CEO | Chief Angel

AI & Voice Powered Virtual Nurse Assistant Exponentially Scaling Healthcare Engagement

Editor-in-Chief Pooja M. Bansal Senior Editor Anish Miller Managing Editor Ashwini S. Deshpande Executive Editor Sayali Rane Contributing Editors Devasish, Sneha Visualiser David King Art & Design Head Amol Kamble Art & Design Assistants Poonam, Shweta Co-designer Paul Belin Art & Picture Editor Mayur Koli Business Development Manager Peter Collins Marketing Manager Marry D’Souza Business Development Executive Mark Williams Sales Executives John, Amy, Bill, Sarah Technical Head Jacob Smile Assistant Technical Head Swapnil Patil Technical Consultants David, Robert Digital Marketing Manager Alina Sege Assistant Digital Marketing Manager Prashant Chevale SME-SMO Executives Rahul, Gemson, Swati Research Analyst Eric Smith Circulation Manager Tanaji sales@insightscare.com

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Editor’s Column

AI Playing a Significant Role in the Reduction of Healthcare Cost

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ccording to recent estimations, 20% of healthcare costs are wasted, globally. The fact that this waste includes preventable and rectifiable system inefficiencies such as care delivery failures, over-treatment, and improper care delivery, is even more concerning. Such inefficiencies can be minimized by technologies like Artificial Intelligence (AI) very competently, ensuring significantly more cost-effective and stream-lined health ecosystems.

This technology has been in debate for a long time now. The potential applications of AI based systems are vast and spread over a plethora of industries, healthcare is no exception. Although the technology has not attained its full potential yet, there are strong evidences directing to a number of ways in, which AI can help domesticate healthcare costs.

Healthcare solution providers are moving towards a standard setup to record, analyze and store healthcare information securely and systematically. This will enable large sets of data to become available for analysis by AI-enabled systems. These systems will allow us to tract patterns following the treatment and also find optimum treatments centered on the patients’ profile. In doing so, AI ensures the right interventions and treatments while empowering clinical decision-making, creating a personalized line of attack to care. Repetitive, simple tasks such as the analysis of CT scans and certain tests can be done more precisely by AI-enabled systems, decreases physician error and aids early diagnosis.

Faster development of life-saving drugs and quicker analysis of patient data in clinical trials, are another potential application of AI, saving billions in costs. AI opens up the prospective to truly empower individuals to make improved decisions concerning one’s health. Massive numbers of people across the globe use wearable technology to gather daily data, from their heart rate to their sleep patterns. This data integrated with machine learning can notify people at threat of certain diseases, long before it develops into a critical ailment.

These instances characterize a very small part of what possibilities AI will allow us to unravel.

The possibilities can neither be underestimated nor overemphasized. Assistance amongst the public and private areas of the industry stakeholders is required if AI’s potential has to be leveraged to the fullest. ‘Perhaps it’s time to call in the machines!’

Sayali Rane, Editor

C O V E R S T O R Y

08

CXO

AI & Voice Powered Virtual Nurse Assistant Exponentially Scaling Healthcare Engagement

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48

Reshaping Healthcare

AI Changing Radiology

How Today’s Environment is Reshaping the Medical Device Industry

AI is Starting To Change Radiology, For Real

ARTICLES 26

34

Wearables

Tech-trends

Innovations that Let You Wear your Health

The Changing Face of the Global Medical Ecosystem

18

22

Conversa

CureAssist

Transforming the Provider – Patient Relationship with a Conversation

AI Assisted Smart Healthcare Revolution

24

38

Healthymize

Hindsait

AI-based Voice Monitoring for Voice Affecting Diseases

Aiding Healthcare Get Better with AI

40

46

iCarbonX

Niramai Health Analytix

Thinking Out of the Box & Making the Difference

Offering a Revolutionary Solution for Universal Cancer Screening

The

Most Innovative

Companies Bringing

AI to Healthcare

Exceptional Progress in the AI-based Healthcare Market

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significant amount of investment and resources are required to see a slightest development in the healthcare vertical. But technologies like Artificial Intelligence (AI) are ‘self-running engine for growth in healthcare.’

According to a report of Accenture, when combined with other resources, key clinical health AI applications can possibly generate $150 billion in yearly savings for the US healthcare economy by 2026. This technology has brought a paradigm shift in the healthcare industry, driven by the better availability of medical data and rapid development of analytics methods.

AI uses algorithms that promote it to ‘learn’ features from an enormous volume of healthcare data. It then uses this acquired acumen to assist clinical practice. This capability of AI can be further enriched by providing it with learning as well as self-correcting; so as to increase the accuracy of the feedback. A system built around AI can assist the physicians, by providing informed medical statistics from previous literature and clinical practices, to offer proper patient care. Diagnostic and therapeutic errors can be reduced to a great extent with the use of AI. All these gains and assistance is provided in real time, thus allowing the physicians to take fast and calculated decisions.

In this issue of “The 10 Most Innovative Companies Bringing AI to Healthcare”, we have highlighted some of the renowned organizations from all over the globe, which have attained the feat of integrating AI into their solutions successfully and are now ready to play the next big inning. These companies are transforming the way we care, with unique strategy implementation and patient satisfaction and engagement as their highest priority.

On the cover we bring you Care Angel, a company that offers a revolutionary solution to provide a seamless post treatment care to high risk populations, with its AI-powered Virtual Nurse Assistant, Angel.

Apart from this we have also included numerous companies from the healthcare sector namely, Conversa, delivers personalized, automated virtual care based on dynamic patient profiling in order to help healthcare organizations (health systems, pharma, and payers) to monitor, manage, and engage populations at scale; CureAssist, is an AI powered on-demand assessment & remote diagnostics platform solving for access to primary healthcare; Healthymize, provides AI-based voice analysis that turns smart devices into remote patient monitoring devices for voice-affecting diseases; Hindsait Inc., provides a SaaS platform applies artificial intelligence to large healthcare datasets, helping payors and providers improve patient health at a much lower cost; iCarbonX, combines genomics with other health factors such as metabolites, bacteria and lifestyle choices to create a digitalized form of life; Niramai Health Analytix, is a deep-tech startup addressing critical healthcare problems through automated solutions; CareCru, CureMetrix, and Infervision.

Also while flicking through the pages you will find interesting articles written by industry experts; Dr. Enhao Gong the Founder of Subtle Medical and Jeff Mongelli, the Founder & CEO of Acentec Inc. Our in house editorial team has also penned out some fascinating articles that might interest you.

So, flip through the pages of our magazine and treat yourself with the technological innovations trending in the Healthcare Industry!

COVER STORY Founder | CEO | Chief Angel

The

Most Innovative

Companies Bringing

AI to Healthcare

AI & Voice Powered Virtual Nurse Assistant Exponentially Scaling Healthcare Engagement

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undamentally, healthcare is broken. The phrase “we have a sick-care system, not a healthcare system” is heard quite often. And it’s true. Traditionally, healthcare has operated on a reactive health model instead of a proactive, preventative one. Most insurers and providers only proactively care for about 5 percent of the population, with a labor-intensive model, that is defined as high-risk, which is costly. In addition, traditional fee-for-service payment models have not provided any incentives to pay to manage the next 30-60 percent of the rising-risk populations. The clinical staff necessary to manage this population is at an all-time high, which is not scalable and just costs too much. This is where an AI-powered Virtual Nurse Assistant comes to the rescue.

According to Accenture, virtual nurse assistant applications can potentially create $150 billion in annual savings for the U.S. healthcare economy by 2026 and growth in the AI health market is expected to reach $6.6 billion by 2021.

Healthcare is at an inflection point. 85 percent of healthcare costs are spent on managing chronic conditions, mostly from seniors aging at home. Our society lives in a time when two-thirds of all people who have ever lived past the age of 65 are alive today. People are living longer than ever; with more conditions, costing much more and the results are having devastating ripple effects on families, employers, providers, payers, and society, as a whole. It has been called a Silver Tsunami and it can be society’s Achilles heel, unless we proactively do something about it. Care Angel is redefining how we care.

office or hospital into the home with high touch, low tech, and low-cost solutions.

With Care Angel, this is realized. Care Angel revolutionizes patient engagement and how one cares for the priciest, sickest, and most vulnerable populations by using an unlimited

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workforce of AI and Voice powered Virtual Nurse Assistants, meet Angel.

Care Angel seamlessly boosts the capacity and capability of existing human care teams by five-to-ten fold.

Angel, augments the effectiveness of her human clinician counterparts, thereby building a more intelligent and capable healthcare workforce of tomorrow.

Journey of Care Angel

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Aging at home with multiple chronic conditions, taking multiple medications requires daily commitment, health literacy, and highly keeping the patient engaged and disciplined about their own care. Research shows that up-to 75 percent of people just aren’t able to adhere to care plans and medication schedules without some kind of reminders and support. A home has traditionally been the black box for patient care, disconnected from providers and extended family members. Many of healthcare’s problems are exasperated by a lack of complete, accurate, and timely information. Continuous, proactive engagement at scale, to gather actionable data and keep patients adhering, is now an absolute necessity.

With value-based care and shared savings becoming the way most providers will get paid, payers, providers, and their care teams must be able to continuously engage with patients and provide care from the

Care Angel, established in 2015, is a pioneering company that has designed the world’s first AI-powered Virtual Nurse Assistant to meet the complex needs of people with chronic conditions. After two years in stealth development, the company launched its platform in late 2016 and hasn’t looked back since. Its main motive is addressing the desire and necessity for improved health engagement and wellbeing management at the enterprise

level to serve the evolving needs of payer and provider clients that manage the clinical and administrative needs of millions of lives in the US alone.

The company believes, technology can be used to exponentially scale the engagement, monitoring, and day-today care; to coordinate with the most vulnerable and at-risk populations (Medicaid, Medicare, and Dual Eligible). By personalizing intelligent engagement, making technology invisible, cost negligible, and complexity irrelevant, while meeting patients’ requirements, technologically, intellectually, culturally, and emotionally. “An engaged consumer is a healthier consumer. Engagement is the block-buster drug of the century,” says the CEO. According to VentureBeat, Care Angel is one of the three most Valuable Applications of AI in Healthcare, AI- powered Virtual Nurse Assistants; estimating the value of virtual nurse assistants to a whopping $20 billion.

never been proactively cared for due to lack of human labor resources, complexity, and costs.

The company believes that in the not-too distant future, when one leaves a physician’s office or a hospital setting and goes home, an intelligent AI-powered Virtual Nurse Assistant, like Angel, will do all the automated follow up as an extension of the existing care teams to help one to be healthy and informed, and connected to care, while family members and clinical care managers are alerted when there is an issue or a need, catching small issues before they become hospitalizations. The exponential capacity is enormous.

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Transforming Healthcare Engagement

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The company believes access to quality healthcare is a right all should have. Care Angel’s mission is to empower millions to take better care.

The company was established after putting together a decade worth of experience in applying telehealth technologies; to make care more accessible, affordable, and available for basic episodic and chronic care.

“Post-acute episodic care accounts for only about 15 percent of healthcare costs, the remaining 85 percent of costs are attributed to chronic care,” asserts the CEO of Care Angel. Here lies Care Angel’s ultimate challenge −to apply the momentum and principles of remote care to ten times the populations that have traditionally

The Enthusiastic Promoter of Care Angel Wolf Shlagman is the CEO, Founder, and Chief Angel of Care Angel. He is a creative technologist, tinkerer, and visionary behind the success of the company. He has a long history of using technology to create solutions that make several aspects of life more

accessible, convenient, cost effective, efficient, and consumer friendly. As a serial entrepreneur, Wolf previously founded ‘Consult a Doctor’ in 2007, one of the earliest pioneers of B2B2C telemedicine platforms, which was acquired by Teladoc, Inc. (NYSE: TDOC), a Kleiner, Perkins portfolio company, in 2013 and the combined companies were taken public shortly thereafter.

As an innovator, Wolf has been shaping and transforming the telehealth space since the earliest days of digital health, nearly 20 years ago. He is a technological and business leader with executive level strategic, technical, and partnership development experience.

He is recognized as being a hands-on leader who is driven by passion in the pursuit of building impactful enterprise platforms and consumer solutions targeted to help alleviate the most pressing challenges affecting the entire healthcare ecosystem. Care Angel is especially meaningful, as it will help to care for millions who lack access, most notably our parents and grandparents.

A large amount of healthcare costs go towards managing chronic conditions, mostly in seniors. Along with this the high-risk, rising-risk, high cost, and vulnerable populations around the world, is affecting billions of lives.

Understanding this major demographic shift, Wolf set out to transform how his mom and people across the globe are taken care of. Foreseeing the major void in the market, Wolf was determined to help the industry and the people it serves, by applying technology to take better care of their conditions, from the comfort of their homes. But it goes much deeper than that, because the caregivers, providers and clinicians are also experiencing severe burnout due to the shortage of millions of physicians, care managers, and nurses around the world. We have

an aging society and a serious dilemma of not enough family or clinical caregivers.

Having a noble vision at heart, Wolf felt a responsibility to bring this vision to life. Wolf developed the SmartCare platform to be the most comprehensive end-to-end, enterprise solution for population health, risk stratification, quality care, and performance measure improvement. The platform features omni-channel engagement, continuous health monitoring and care coordination. The turn-key solution is flexible, configurable, and scalable to millions. “An innovative solution that is redefining how we care.” SmartCare comes to life through Angel, its AI-powered Virtual Nurse Assistant, who can unify disparate communication services to proactively engage, monitor, and manage entire populations. From care plan adherence, medication adherence, patient education, appointment scheduling, reminders, post-discharge, satisfaction surveys, and risk assessments to the continuous support of complex clinical care management programs, deploying

Angel ultimately leads to better outcomes and lower costs.

Angel & SmartCare: The Flagship Service Platform There is an unprecedented amount of value and demand for a comprehensive voice-first, omni-channel solution that can not only identify and address potential problems as they are happening, but to pass the collected information along to the clinical care manager and designated family members for rapid and appropriate intervention from prescription refills to transportation to medical supplies or a follow up appointment with their post-surgery specialist or primary care physician.

Angel is powered by Care Angel’s SmartCare platform, an award winning, patent-pending population risk stratification, omni-channel engagement, monitoring, and care management platform. Its revolutionary platform empowers its partners, such as payers, providers, health systems, MCOs, MSOs, ACOs,

and other large partnerships to stratify, engage, monitor, and manage high risk populations, such as Medicare, Medicare Advantage and Medicaid patients at scale, at the lowest cost and highest ROI. Angel can proactively engage 100 percent of the high risk population, which augments the care team’s capacity while freeing up 50 percent of clinician’s time from the repetitive, robot-like tasks of outbound telephonic engagement. It serves as an extension of the existing care team that was never possible before at such scale and personalization. It enables the existing care teams to be able to manage five to ten times of the patient populations and focus on the right patients at the right time.

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In a rapidly changing value-based care environment, where payments are tied to the quality of care and health outcomes for broad populations, Angel radically improves quality, patient engagement and adherence in the home, between visits, efficiently and effectively without adding clinical resources. It helps physicians address poor patient engagement, poor adherence, and data silos and helps patients overcome technology barriers with its ubiquitous voice-first, omni-channel engagement Care as a Service (CaaS) technology platform.

As a result, Angel enables the most effective, efficient, and scalable way to close gaps in care, reduce risk, admissions, readmissions, and significantly improve clinical, HEDIS, HCAHPS, STAR, and financial ROI outcomes by more than ten-fold.

ACOs, and APG organizations such as UM Health, Jackson Health, UnitedHealthcare, EliteHealth, and Orange Healthcare, ACO. Speaking of its happy and content clients, Wolf asserts, “Partners love Angel and her ability to scale care exponentially from the 5 percent of their patients to 50 percent plus, freeing up so much clinician time and exponentially impacting clinical and financial outcomes.”

Confronting Challenges with Resilience

Delivering Outstanding ROI

There is extreme pressure on the status-quo of hospitals, health systems, and carriers due to market disruption by external players like Amazon, Apple, JP Morgan Chase, Walmart, and Google.

Leading organizations that provide Care Angel to their members and patients include the largest provider and payers in the nation, academic hospitals, and health systems, MSOs,

Telemedicine, remote monitoring, and virtual care delivery is a reality.

Wolf says, “To a certain extent, initial iterations of telemedicine were very complex and costly, only

utilized by military, academic and teaching institutions in a hub and spoke model, utilizing video in order to meet payment guidelines. Utilization was non-existent. In the last 5-7 years, it only successfully penetrated the treatment of low acuity ‘cough and cold’ conditions, which account for about 15 percent of healthcare.”

The real gigantic challenge that Care Angel is solving for is how we engage, monitor, and manage vast high-risk and rising-risk populations, otherwise known as population health management (PHM), remote care, disease management, post-acute care, all of which add up to a large percent of healthcare costs, representing trillions of dollars. Chronic condition management, which occurs mostly in seniors who are aging independently at home, low income, and other vulnerable populations dealing with social determinants of healthcare, is the massive burden that the company is targeting to relieve, for its provider and payer clients from around the globe.

“We are carefully prioritizing our business approach to execute on

The company’s success is very evident from the love it receives in return for its exceptional services to patients and clinicians. Patients’ survey results speak for it:

99% 83%

Care Angel easy to use Helped improve my health As easy as speaking with a nurse Helps me stay on track with medications and care plan Helps me follow Dr. instructions between visits Feel more motivated to monitor my health

payers, providers, and partnerships in the United States first, while preparing an aggressive strategy to address the demand and extend our footprint globally,” said Shlagman.

Value-based Care is about improving quality and controlling costs, at Care Angel, we guarantee both,” says Wolf.

Exceptionality of Care Angel

The company estimates that the clinical cost savings, avoidable readmission reduction, and a minimum of 5:1 ROI is translated into savings of $3-4M per 10,000 patients.

The results are transformative. The SmartCare platform is able to handle every aspect of population management, from risk stratification, omni-channel engagement, and monitoring & care management to care coordination at scale. The company has set out to create the most comprehensive, most engaging, lowest cost, easiest to use, highest ROI platform in the market for managing populations at scale.

“It could be said that one of the most compelling highlights of our solution is the results we are seeing from our clients.

Walking into the Future Care Angel continues to magnify its capabilities; the company is excited about being able to expand into the home further. With solutions for Alexa and Google Assistant in addition to enhanced device and wearables integration, it will be more efficient to be able to gather data from anywhere. It is also engaging into numerous partnerships that will expand access to data for better predictive analytics of high-risk populations and provide additional services such as on-demand transportation and care coordination to vulnerable populations, so they receive the right care at the right time.

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“AI-powered Virtual Nurse Assistants is the new nervous system of healthcare and engagement at scale is the ultimate blockbuster drug of the century,” says Wolf.

Seamless Transition To Value-based Care

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Care Angel is revolutionizing how we engage and care for millions with a truly unique approach by building an innovative SmartCare platform to engage the costliest, sickest, and most vulnerable populations- regardless of technology. It’s set out to make technology invisible, by having Angel, its AI-powered Virtual Nurse Assistant, available starting with a simple phone call.

The

Most Innovative

Companies Bringing

AI to Healthcare Company Name

Management

Brief

Care Angel careangel.com

Wolf Shlagman Founder, CEO & Chief Angel

Care Angel offers a revolutionary solution to provide a seamless post treatment care to high risk populations, with its AI-powered Virtual Nurse Assistant, Angel.

CareCru carecru.com

Mark Joseph Founder & VP Marketing

CareCru is a powerful, automated growth and analytics platform for dentists.

Conversa conversahealth.com

West Shell III Co-founder & CEO

Conversa delivers personalized, automated virtual care based on dynamic patient profiling in order to help healthcare organizations (health systems, pharma, and payers) to monitor, manage, and engage populations at scale.

CureAssist cureassist.co

Saurabh Satija CEO

CureAssist is an AI powered on-demand assessment & remote diagnostics platform solving for access to primary healthcare.

CureMetrix curemetrix.com

Kevin Harris CEO

CureMetrix offers a next generation of medical image analysis for Mammography.

Healthymize healthymize.com

Shady Hassan MD & CEO

Healthymize provides AI-based voice analysis that turns smart devices into remote patient monitoring devices for voice-affecting diseases.

Hindsait Inc. hindsait.com

Pinaki Dasgupta CEO

Hindsait’s SaaS platform applies artificial intelligence to large healthcare datasets, helping payors and providers improve patient health at a much lower cost.

iCarbonX icarbonx.com

Jun Wang Founder & CEO

iCarbonX combines genomics with other health factors such as metabolites, bacteria and lifestyle choices to create a digitalized form of life.

Infervision infervision.com

Kuan Chen CEO

Infervision is an AI high-tech company that uses deep learning technology and computer vision to help diagnose cancers.

Niramai Health Analytix niramai.com

Geetha Manjunath CEO Nidhi Mathur COO

Niramai Health Analytix is a deep-tech startup addressing critical healthcare problems through automated solutions.

Conversa

Transforming the Provider – Patient Relationship with a Conversation

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onversations are the foundation of relationships. A healthy relationship is entirely based on a healthy dialogue between two individuals. And as far as healthcare is concerned, a strong dialogue is a necessity between the physician, patient, and the patient’s family. Today’s patients are active participants in their care. Patients expect timely access to vital health information for themselves and their loved ones, and communication helps them make better decisions. Conversa is a company that aims to bridge one of the largest gaps in care, i.e. the time between visits to the doctor.

The Conversa Conversation PlatformTM delivers scalable, flexible and fully-automated virtual care that helps monitor, manage, and engage patient populations at scale. It enables personalized care through the use of automated, digital conversations to make the healthcare experience more engaging, continuous, and collaborative for patients and their care teams.

As healthcare’s conversation platform, Conversa has an extensive library of over 500 clinically-intelligent conversation programs that include asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), diabetes,

18

DECEMBER 2018

The

Most Innovative

Companies Bringing

AI to Healthcare hypertension, joint replacement, and many more. Conversa is poised for growth and adoption, by provider customers, health IT partners, pharma, and payer groups.

Enthralling Journey of Conversa Established in 2013, Conversa Health (known as Conversa), and its pioneering technology delivers an advanced automated patient engagement platform to help clinicians manage their relationships with patients. The company’s cloud-based Conversa Conversation Platform augments care management and clinical understanding through deep integration with over 400 biometric devices as well as patients’ electronic health records (EHRs) and other clinical systems.

As a result, Conversa’s patient-profile driven technology can help care teams identify and focus on patients who will benefit from extra coaching and assistance. Clients can use the company’s flexible conversation platform for a variety of clinical applications, ranging from post-discharge and medication adherence to marketing. Healthcare providers can also use the solution for wellness, prevention, and lifestyle coaching to provide educational content and insights to foster understanding of disease processes and reduce patient anxiety.

In 2017, Conversa embarked on a strategic partnership with Allscripts using its technology to enhance Allscripts’ population health, care management, and patient engagement capabilities—providing Conversa access to Allscripts’ client base of over 2,500 hospitals and healthcare systems.

This year, Conversa received top accolades from several industry analysts, including Frost and Sullivan’s Top Patient Engagement Technology Leadership Award. From the industry report: “Each year, Frost & Sullivan presents this award to a company that has developed a pioneering technology that not only enhances current products but also enables the development of new products and applications.

The award recognizes the high market acceptance potential of Conversa’s technology. Overall, Conversa’s proven outcomes, ease-of-use, and visionary innovation have resulted in best-in-class patient engagement, remote inhome monitoring, and significant clinical and financial outcomes for its clients, catapulting the company into the market leadership position.”

DECEMBER 2018

An Experienced Leader West Shell III, the Co-founder, CEO and Chairman, is a 5-time serial entrepreneur. He is a creative, high-energy leader with a background in strategic marketing and a successful track record of building high growth, innovative companies with passionate employees and committed customers.

West co-founded Pacic Marketing Group (PMG), which over eleven years grew to be the largest independent marketing agency on the west coast. As an early Internet pioneer, he also grew Netcentives, an emarketing leader delivering CRM, loyalty, and email direct marketing solutions. After his success with the aforementioned companies, West then built Sapias, Healthline Networks, before moving on to, Conversa Health, which he co-founded.

Client Success Stories Conversa was recently recognized as a Top Patient Relationship Management Solution by Chilmark, and a Top Patient Engagement Solution by IDC Research. Use of Conversa shows“97% of the patients that engage in Conversa’s chat experience on behalf of a hospital partner find the chats helpful.”

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· Northwell Health (Northwell), New York’s largest healthcare provider, implemented Conversa-powered Northwell Health Chats to provide personalized, automated patient conversation experiences to discharged patients. Northwell reported that 70% of enrolled patients engage with the platform, with an 85% conversation completion rate, and 98% of the patients stated that Northwell Health Chats were helpful in managing their care. “Conversa is enabling Northwell to use innovative, scalable technology to improve care coordination, patient satisfaction, and ongoing patient relationship management resulting in the improved well-being of our customers while also reducing costs.”

—Joe Schulman, Northwell Health Solution · Centura Health – Penrose St. Francis Health Services (Penrose), a Colorado Springs-based acute care facility with 24,000 admissions per year, reported that 50% of patients using the Conversa platform experienced improvement.

With 70% of participants reporting that the conversations helped them become healthier.

A Matchlessness Platform to Ease Customer Service

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Conversa’s branching logic and structured data make an easy-to-use client interface. The company captures actionable data through AI-powered chats that are sophisticated, empathetic, and easy-to-use. The platform uniquely employs a proven motivational psychology methodology, i.e., self-determination theory, alongside superior PGHD integration to provide personalized conversational experiences that spur patient engagement. It helps physicians communicate and engage with their patients between visits through structured ‘digital checkups’ in order to improve health outcomes and patient satisfaction.

Better Conversation.

Better Care

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Conversa’s dual commitment to simplicity and flexibility leads to enhanced PHM and high engagement. Aside from data reported by its systems, userfriendly consumerization is becoming ubiquitous in all consumer-oriented markets. Conversa’s personalized, automated conversations provide a helpful, timely, and discreet method to deliver the right educational materials, and continue the doctor-patient relationship with less resource.

AI-revolutionizing the Healthcare Vertical

The adoption of AI and Machine Learning to augment clinical intelligence and scale will continue to push healthcare system towards the quadruple aim. Unprecedented patient access to timely and personal care information will lead to healthier patients, and at the same time make for a better provider experience in delivering the right care to the right patient, all at lower cost.

Specifically, automated solutions leverage continuous patient feedback to enhance healthcare accessibility, efficacy, and affordability through early intervention and risk reduction. Unlike traditional patient engagement approaches, such as surveys and educational seminars, automated digital solutions, improve treatment adherence through reminders and monitoring.

Healthcare will see massive adoption of technology like Conversa to maximize population health management, while reducing burden in the care management for clinical teams. Patient outcomes will improve, the cost of care will decrease for hospitals, and the experience for all will be smoother than ever before.

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CureAssist

AI Assisted Smart Healthcare Revolution

Saurabh Satija Co-founder & CEO

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emote diagnosis has previously been efficaciously applied in specific situations, such as long expeditions, conflict zones and lately in remote populations. These proficiencies have paved the way for varied use of remote diagnosis, especially in developing countries.

Increased efficacy is needed to meet the growing patient demand. Remote diagnosis collects and analyzes data, captivating in a larger range of data—considering both a person’s past medical history as well as associated data from the patients with similar illnesses than doctors typically have accessible to them.

Employing AI reinforced technologies; remote diagnosis can chaperon doctors to make informed choices faster and more accurately.

CureAssist is one such AI-powered on-demand assessment & remote

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diagnostics platform, which enables users, regardless of their location to get first level assessment of one’s health, diagnosis by a medical professional, access to preventive care services without having to leave their home or workplace.

The company works towards a single point vision to democratize healthcare and provide access to primary healthcare to everyone regardless of the geographical location they are in.

Empowering Journey of CureAssist Saurabh Satija, the Co-founder of CureAssist is a serial entrepreneur & hit upon the idea while working with his last startup – HealthSocho. This company solved availability for alternate medicines, where he kept getting requests from users to

recommend products for specific symptoms. “Since it was alternate medicine (Ayurveda, Nutraceuticals, etc.) people thought it was ok to selfmedicate on the basis of symptoms,” asserts Saurabh. He would consistently request HealthSocho users to visit doctors to understand what their symptom entails and why they should not self-medicate. While some patients would ignore the request, others would talk about geographical constraints and quality of doctors available in their locality.

These consumer responses led Saurabh to look at healthcare more closely and realize that there is a major supply restraint in terms of the number of doctors available in the country (800,000 for a population of 1.3 billion) and how skewed the concentration is - more that 70 percent of the doctors are in Metro and Tier 1 towns, which

DECEMBER 2018

The

Most Innovative

Companies Bringing

AI to Healthcare

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represents only one third of the population. “This skew made people fall for quacks and also self-medicate,” he says. This was the genesis of CureAssist. “Since I’ve always worked in the marketing domain, decided to bring in a doctor as a Co-founder, somebody who could bring in the domain expertise and also help in creating the right product.”

He joined hands with the other Co-founders- Pawan Shetty, Nischal D. and Dr. Ambana Gowda, and was able to build a great team. In terms of partnerships, this team is now working with 5 big hospitals, 175 doctors, one of India’s largest diagnostic chain, and healthcare at home service provider. CureAssist consistently goes back to its users, who provide the company with feedback based on, which it keeps refreshing its product offering.

Distinct Services and Products CureAssist is an app (Android & IOS) driven care ecosystem. It not only allows users to assess, but also get connected with doctors for further diagnosis. The platform enables users to choose from a host of services like diagnostic labs, healthcare at home, and on-call nutritionist amongst others.

AI Transforming Healthcare

Healthcare has never been this easy and hassle-free, reinforced with AI and Machine learning, CureAssist makes smart healthcare possible

geared to address key issues prevalent in healthcare, I still believe there is a lot to be done in terms of data ownership, data privacy and ownership in case of a miscue in diagnosis,” asserts Saurabh.

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“While the healthcare sector is growing at double digit numbers and is touted to reach $280 billion by 2020, predominantly at the back of rising income, greater health awareness & changing outlook towards preventive care, in spite of this there is still a huge accessibility gap when it comes to primary healthcare,” says Saurabh.

With the doctor to patient ratio of ~ 1:1700 and 70 percent of the doctor concentration in Tier 1 cities, there seems an urgent need to provide a technology solution at scale. While CureAssist’s initial solution is for the city dweller, the company is continuously striving to find an easy and effective solution to tap into the population beyond Tier 2 cities and reach out to the masses. Speaking of the future of the company, Saurabh says, “We are adding some very exciting features in the coming days!”

Artificial Intelligence has numerous applications and has been put to use in various cases in the healthcare sector; like diagnosis, prognosis, therapy, and to identify new therapies. Few of the examples being, primary care or triage, radiology, drug discovery, and risk identification. “While all of the initiatives are

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Healthymize AI-based Voice Monitoring for Voice Affecting Diseases

Shady Hassan MD & CEO

A

I is not here to replace the human contact between patients and caregivers, but it can give patients tools to maintain and improve their health, rather with the assistance of AI, numerous tools and devices can help caregivers gain access to new information. It allows the use of information to focus on the right health measures on the right people at the right time. The future of healthcare lies in embracing technology to keep patients healthy at home, exactly where a company called Healthymize is positioned.

Healthymize provides personalized, artificial intelligence (AI) based, voice monitoring that turns smart devices into remote patient monitoring devices for voice-affecting diseases such as Chronic obstructive pulmonary disease ( COPD ), heart failure, and pneumonia.

“Healthymize will become the worldwide leader in the monitoring

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voice-affecting diseases, starting with COPD, and then for other diseases as well, including asthma, mental health and more. Using voice biomarkers for monitoring and diagnosing diseases is a hot area today,” believes Shady Hassan, the MD and CEO of the company. “The setting is perfect, as voice interaction becomes the norm with smart devices like phones, tablets and home virtual assistants; it is easy to get voice samples from the users. The world is moving forward fast and voice monitoring for health and detection of early disease development signs will become a standard procedure.”

Notable Awards of Healthymize It is the winner of the Henry Ford Health System’s “Increasing Patient and Caregiver Engagement to Reduce Readmission” Challenge. It is the winner of the 2017 mHealth Startup Competition and the Israeli Ministry of Health’s 2017 Leading Healthcare Initiative Contest.

A Leadership with a Vision Its diverse team is composed of experienced individuals who work passionately to improve the lives of chronic patients. The Healthymize team is highly experienced in business, medicine, and engineering.

The CEO, Shady Hassan, has experience working as physician in internal medicine, and medical software implementation. He met the CTO (Chief Technology Officer), Daniel Aronovich, an expert in signal processing and machine learning algorithms, in an entrepreneurship program at the Technion Institute of Technology. They founded Healthymize and Rafi Gidron, a leading entrepreneur and investor in the Israeli high tech scene, joined as the pre-seed investor, COB (Chairman of Board) and Co-founder. The team met Maura Rosenfeld, its CBDO (Chief Business Development Officer) with years of experience in healthcare business development, and start up

DECEMBER 2018

The

Most Innovative

Companies Bringing

AI to Healthcare management, as a mentor in the Presentense entrepreneurship program.

A Solution that Stands Out Healthymize offers its voice analysis for integration into remote patient monitoring systems. Its goal is to provide a voice monitoring solution for home care, chronic care management, and readmission preventions. Healthymize prevents hospitalization and saves billions using personalized, AI- based, patented voice technology that turns smartphones, tablets, smart watches and home virtual assistants into continuous health monitoring devices.

It is developing personalized, AI-based voice analysis that turns smart devices into remote patient monitoring devices for voice-affecting diseases. Healthymize automates labor intensive phone monitoring typically in place to prevent readmissions and manage chronic patients, giving clinicians the ability to assess the voice of the patient at any time.

By utilizing advanced deep learning algorithms to analyze the human voice during regular calls or voice interaction with these devices, Healthymize provides remote patient monitoring for voice-affecting diseases such as asthma, COPD, heart failure and mental health disorders.

Healthymize aims to detect flare ups early and can be integrated into systems that remotely monitor patient vital signs.

Remote Monitoring: The company’s goal is to monitor the progression of these diseases wherever and whenever patients speak on their smartphones. Healthymize analyzes voice samples from the patient aiming to identify the onset of flare ups. When a flare up is detected, the Healthymize system can alert the medical teams to enable early treatment of patients at home, by keeping them where they feel most comfortable.

Consider a patient suffering with COPD. It is a progressive disease that restricts lung airflow. A COPD patient suffers from flare-ups that are characterized by shortness of breath, coughs, and sputum production.

Delayed diagnosis and treatment of these flare-ups often results in severe exacerbations requiring hospitalization.

The overall prevalence of COPD in the general population DECEMBER 2018

is more than 5 percent. Prevalence increases with age, reaching about 10 percent among adults between 75-84 years old. In 2010, the overall cost of COPD in the US was $36 billion and is We offer a personalized, estimated to reach AI-based, patented voice $49 billion by 2020. analysis designed to turn Costs due to COPDsmart devices and home related care are virtual assistants into driven primarily by continuous healthhospitalizations. This monitoring devices is where Healthymize

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can help with remote monitoring that will allow the care team to stay apprised of the patient’s condition while they are at home.

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Uniqueness of its Services For patients: · Prevent condition from worsening by predicting flare ups · Save time, anguish, and money by reducing hospital visits For Health Care Providers: · Detect flare ups earlier and to allow treatment to be delivered faster · Improves coordination and delivery of care · Save costs of hospitalization Bright Future of the Company Healthymize is building strong partnerships that will enable it to shape its product to market needs and gain credibility at the earliest stage possible. The company’s partnership with Henry Ford Health System is one such example and it is building other strong provider and industry partnerships.

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Innovatio that Let You

Wear your

Health

“Changes call for innovation, and Innovation leads to progress.”

– Li Keqiang

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I

nnovation is inevitable for an industry to flourish. In the Healthcare Industry, innovation is measured in terms design and development of devices, medicines, new and effective methods of treatment and breakthrough technologies that assist them. With the growing population comes the problem of new diseases, outbreaks, weak immune systems, drug-resistant strains of bacteria and viruses and much more complications. As such, the need for innovation in maintaining good health, monitoring health conditions, new yet cheap treatment methods cannot be disregarded. Moreover, these innovations need to give results that can be seen and interpreted in a jiffy.

DECEMBER 2018

ons

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Innovation for Good Health With advancements in science and technology, innovation in healthcare has received a great boost. Using technologies like AI, Robotics, Analytics and more, healthcare is finding solutions to its problems. The year 2018 saw some great feats, innovations, and development. Many wearable and even ingestible devices were made for better health. Here are a few noteworthy ones which are likely to be made perfect in the upcoming year(s).

Electronic Skin, popularly known as E-skin, is a flexible, stretchable, selfhealing, wearable skin-like device that can mimic human or animal skin functionalities. They combine information and communication technology with innovative hybrid material and micro-electronic sensors.

The successful combination of flexible and stretchable mechanical properties with sensors and the ability to self-heal is aimed at creating a natural look-and-feel skin for prosthetic limbs and robots or humanoids and health monitoring. The year saw semi-conductors being embedded in the patch which could catch and transmit the vital stats of the wearer via micro-LED lights on it.

Medicinal Contact Lenses are perfect for those who are unable to manage their eye-drop routine and in cases where simple eye-drop administration is not enough to treat the condition.

Researchers have come up with a new biodegradable polymer contact lens

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material that can ensure the proper amount of medicine to be delivered accurately for days and probably weeks. The breakthrough innovation suspends medicine in a layer made from PLGA (poly-lactic-co-glycolic acid), a biodegradable polymer. The amount of PLGA regulates the amount of medication that passes through it at any given time. The more the PLGA in relation to the medication, the slower it is released. Such lenses will be the perfect way to treat serious and chronic eye ailments like glaucoma, corneal scarring, corneal ulcers, chronic dry-eye, pediatric lenses and therapeutic or bandage lenses.

Needle-Free Injections are a boon to small kids and adults alike who can’t bear the sight of a needle. Over years the alternative to needles has been tried like patches with micro needles, nasal sprays, inhalers and more. But a needle shot is considered to be the most effective and sometimes the only way to deliver medicine to the body. But the issues are other too like sterilization, ensuring one-needle-one-patient, proper disposal after use, and proper training to those administering it.

Researchers have come up with a device that can deliver medicines akin to the syringe-shot minus the needle.

The device ejects a high-pressure stream of medicine which enters the bloodstream through the skin without piercing it the traditional way.

Tooth Sensors are wearable sensors or chip that can be mounted and attached to a patient’s tooth to monitor his diet and health in real-time. The sensor can

be tuned wirelessly with a mobile device and give information about the glucose, sugar, alcohol and salt intake.

The device has three layers with the inner core being the bio-responsive layer which absorbs the food. The outer layers are gold rings. Researchers hope to make these sensors do more than just the current tracking. They would like it to be able to detect nutrients and their amount in the food, also the changes in saliva which can serve as a warning of impending gum and oral diseases.

Ingestible Sensors or monitoring pills give a great view (scientifically speaking) of a patient’s gastrointestinal tract. These devices come in various forms with some loaded with cameras, some with sensors and some with even harmless bacteria. All of these are done to get a better insight into the working and current condition of the human digestive system. These devices can collect and send data pertaining to images and condition which can give the correct information predict the gut health, intestinal wounds, amount of gases and micronutrients, and even colon cancer.

Humans today live a longer life than they used to a century ago. Ensuring that this long life is healthy too lies in the hands of the healthcare industry.

Innovations are equipping it to fight with the changing form of diseases.

Together, individuals, industries and innovations can make life on earth, better and healthier than ever.

- Sneha Sinha DECEMBER 2018

Today’s How

Environment Is

Reshaping

Medical The

Device Industry

D

uring a recent trip to the doctor’s office, other than the nurse using two fingers on my wrist and a watch to take my pulse, everything else was completely different.

From booking my appointment online, to completing much of the usual paperwork from home, things have changed. For the first time, I was able to provide an actual medical history, since I was home where that information is. When I arrived at the office, I checked in on a tablet and was told the wait would be less than 5 minutes. Once the doctor entered the exam room, she had already reviewed a thorough and accurate medical history and began firing off questions about the sorts of things that happen during an active lifestyle. Although my first encounter with this provider, she seemed to know me like she'd been treating me for years. During the encounter, I was able to share with her the heart rate alerts I had received on my Apple Watch while essentially doing nothing. This type of information has been made available by the Internet of Things, or internet connected devices, both wearable and otherwise. That’s the positive side of technology’s impact on healthcare.

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DECEMBER 2018

Jeff Mongelli Founder & CEO

DECEMBER 2018

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About the Author Jeff Mongelli built and sold his nance company 17 years ago to GE Capital to enter the healthcare industry. As the Founder and CEO, Jeff built Acentec, Inc. into a national leader in improving the clinical and nancial performance of healthcare organizations. He understands that achieving the promise of improved healthcare through aggregated data requires dedicated commitment to the protection and privacy of that information. Jeff is considered an industry expert in IT Technology & Security, HIPAA compliance, and is actively involved in the eld of articial intelligence. He is frequently quoted in the industry's publications and is a featured speaker at national trade shows and Medical Association meetings.

He's a member of the FBI's Infragard program and a collaborator in their Healthcare CyberSecurity Workgroup and also a member of Homeland Security's Information Network.

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It’s not just our physician encounters that have changed.

Medical devices have also seen great change. Not only do our elderly have access to home health monitoring equipment, but virtually every medical device being manufactured is now either connected directly to an internal network or onto the World Wide Web. These technological advancements have allowed for the flow of data into software systems that analyze, alert, and share that information with providers throughout the care chain. The result is leading to better health outcomes and improved quality of life for many of us.

Sadly, it’s not all good news. The connectivity of all these devices has created a treasure trove of opportunities for cyber criminals. The possibility of extorting someone for bitcoins or they’ll shut your pacemaker off is not an unrealistic concern. In fact, a 2017 Ponemon Institute study found that 39% of medical device manufacturers reported attackers have taken control of their devices. Additionally, 38% of care delivery organizations said inappropriate therapy/treatment had been delivered to patients because of an insecure medical device. Imagine a hacker in Romania manipulating the medicine pump connected to your arm when you’re in the hospital – this is today’s reality.

What’s being done about it?

Truthfully, not enough. Rather than pile on the device manufacturers themselves, let’s consider 3 stakeholders and where each carries a share of the burden. First, it’s the device manufacturers who’s brands are on the line, so one would think they’re doing all they can to strengthen their final products. That may not be the case. The Ponemon study goes on to state most device manufacturers have yet to adopt more stringent software and device security protocols, resulting in production devices with vulnerable code. The urge to get to market as quickly as possible often supersedes adhering to the proper process of security and vulnerability testing.

Second, one must consider the security of the facilities who house these devices, namely hospitals, other care facilities, and even our own homes. From a hackers perspective, medical devices are simply another node on a network, much like a computer or a printer. That means they’re as vulnerable as any other networked device. If medical devices are not being routinely patched and updated, whether manually or automatically, then they’re vulnerable to new threats and exploits.

DECEMBER 2018

Finally, the third culprit in our trio is the facilities who refuse to update their devices. Believe it or not, there are still medical devices in use today that are running Microsoft XP as their operating system. This OS became unsupported in April of 2014, which means for the past 4 plus years, any new Microsoft based attacks would find an open door to those devices. Again, to be fair, a significant reason these devices haven’t been upgraded is because the cost to small and rural facilities is prohibitive. Many of these smaller organizations, like solo providers, are struggling to stay above water in our new healthcare environment. The thought of spending $200,000 or more on a new X-Ray machine, for example, is beyond their reach and reason.

This particular issue doesn’t have a simple fix.

software development team to add the soft layer on top of a device is no longer valid. Gone are the days when an offshore software team can be hired, given a functional specification, and then be released once the project is completed. Now, medical device manufacturers need to bring software development in house and incorporate it into the design cycle as early as possible. Likewise, the firmware team needs to stay intact post development and work closely with the software team to coordinate patches and updates on an ongoing basis. Needless to say, these teams aren’t cheap, nor is this talent easy to come by. As a result, it’s going to take some time for medical device manufacturers to get the right teams in place and to adjust their business models to account for the increased overhead they present.

What was left off the list?

Many industry insiders grew accustomed to blaming the bureaucratic morass as their reason for not developing and pushing out updates to their devices. However, as far back as 2005 the FDA began making allowances for security related patches and updates and this year again issued an update to this policy with the intent to streamline the process. Frankly, we can’t accuse the FDA of standing in the way on this issue.

We also omitted the fact that few IoT devices communicate their data over encrypted channels. This includes medical devices. Citing the Ponemon study, only a third of device makers built encryption into their devices and few healthcare facilities were deploying it on their own IoT devices. While the percentages have likely improved since the study was published, those devices, and the thousands produced before them, are still in use and will be in use for years to come. Lack of encryption of data in transit and data at rest violates a HIPAA recommendation and can be a source of fines from the Office for Civil Rights (OCR), so it should be implemented wherever possible.

Like all things cybersecurity related, the manufacturers can do everything right, but a secure environment is as much dependent on the training of the workforce as the hardware itself. Even today, despite the security holes that exist in the bulk of the currently deployed medical devices, the greatest source of breaches originate at the user level.

Ultimately, the costs of this shift will be borne by the consumers through increased costs of care. We can hope that more vigilant cybersecurity efforts will leverage down the risks involved, but unfortunately this new business model is here to stay.

What needs to change?

Due to these increased vulnerabilities, a paradigm shift is required and it’s as significant as the technological advancements that led to them. The traditional way of contracting with a

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THE

CHANGING

FACE GLOBAL MEDICAL OF THE

ECOSYSTEM O

ver the last few decades, the global healthcare industry is on a high by the unique confluence of innovative technologies and investments trends. Continuous technical breakthroughs, comprehensive medical research’s, new business models, along with the emerging players are changing the dynamics and are also shattering the traditional approaches at the same time. While escalating cost, fierce competition, increasing count of patients, new diseases are posing difficult questions, the same factors are the driving factors for today’s growth as well.

Out of the innumerable components, clinical trials, pharmaceutical innovations, and medical research stand to be the pillars for drafting the success story of the healthcare industry in today’s modern era. These life-saving vaccines, medicines and innovative solutions are the end-result of countless clinical trials, research work done by the physicians, and medical professionals. Insights provided and shared by these professionals have led to minimize or at least lessen the impact of life-threatening diseases at the global level. As scientists continue to explore the molecular world, the healthcare industry witnesses constant improvisations that help to fight and eradicate traditional diseases from the planet!

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DECEMBER 2018

Human Head Transplant

Virotherapy One such breakthrough that has attracted the eyeballs of the medical fraternity is the on-going research work on ‘Virotherapy’. Termed as a major development to fight cancer, this is an evolving branch of medicine that could be a lethal/powerful weapon in fighting cancer. The foundation of Virotherapy was laid by a surgeon – Dr. William Coley, around a century ago. However, his ‘failed’ experiments were the preliminary steps that are on record and today’s progressive phase do carry the imprints of this previous works.

Through the advancements done in the field of genetic engineering, Virotherapy has seen the light of the day. In easy terms, this process involves a mutated virus that destroys the cancer cells without harming the healthy cells within the body.

Artificial Pancreas

DECEMBER 2018

A decade earlier, talking about a face transplant would have been nothing short of a scene from a science fiction movie, however, today it’s a reality.

Taking extensive inputs and stepping up the ladder, an Italian neurosurgeon – Sergio Canavero has claimed a 90% success rate that a patient can be treated and would be able to walk after a few months of post-surgery. However, even if it’s a success, the process would be too expensive and would be for the handful of the ‘richest’ people in the world!

As research work continues, Professor Canavero announced a successful experiment to reattach the head of a corpse to the body in November 2017. His next step will be to perform the experiment on a live, but a brain-dead person who has donated his body, only after which the first operation on a living person will be done. Interestingly, a 30- year old Russian suffering from a degenerative muscle condition – Valery Spiridonov has volunteered himself as the first living person on whom this experiment can be performed.

For a patient suffering from diabetes, this invention is nothing less than a God’s gift. As the pancreas of a patient suffering from diabetes produces lower quantities of insulin than usual, Medtronic’s MiniMed 670G is an innovative device that monitors blood glucose level and the insulin pump. This is approved by the US FDA (Food & Drug Administration). This device is immensely useful for the treatment of type 1 diabetes for the patients aged above fourteen years. Counted as the world’s first ‘hybrid closed-loop system’ it was released in March 2017 for commercial purposes.

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Wireless Pulse Oximeter For decades now, we all are quite habituated with the pulse Oximeter that is one of the most widely used devices for monitoring patients. This function measures the level of oxygen saturation in a blood that is very critical while performing operations and complex medical procedures. However, the advent of wireless personal pulse oximetry devices in 2016 has driven the sales volume to new heights. Originated in France, ‘MyOxy’ monitor is a Bluetooth-enabled device that integrates oxygen saturation along with other parameters like temperature, blood pressure into a smartphone or a tablet. The other one – ‘MightySat’ was invented in the US and is also a Bluetooth-based device that can be connected to an Apple or Android application. This home-use device tracks the vital information while they are in motion.

Daurismo Blood Cancer Drug One of the premier pharmaceutical companies – Pfizer is planning to launch a drug in the US that treats a form of blood cancer in newly-diagnosed patients under a ‘combination therapy’. The FDA recently approved the drug to be used for adults suffering from ‘acute myeloid leukemia’ (AML) for patients aged 75 or more. This treatment is also restricted to the patients who have certain health conditions prior to receiving the diagnosis and secondly on whom intensive chemotherapy is not a feasible option.

Recent research on AMD Age-related macular degeneration blurs the part of the eye called ‘macula’ that allows a person to perform ‘straight-head’ activities like driving, reading, to name a few. Although it doesn’t convert to complete blindness, with time the eyes develop blank spots in the central vision that hugely impacts the eye-sight.

Recently, a team at the University of Pennsylvania has categorized a new animal model that impersonates the aspects of AMD. This model will assist the researchers to explore and probe the environmental risk factors that stimulate this disease and that can eventually help them to design a successful treatment accordingly.

- Devasish Kanojiya

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DECEMBER 2018

Hindsait Aiding Healthcare Get Better with AI

Pinaki Dasgupta Founder & CEO

T

here is a ‘perfect storm’ brewing in the US Healthcare Industry, which is crying out loud for innovative solutions to bend the cost curve and improve the quality of care. There are three distinct elements in the ‘perfect storm’ metaphor in US healthcare; rising cost of healthcare -$3.2 Trillion in 2017 or 16.9% of GDP, the changing business model from Fee for Service (FFS) to Capitated payment model or Value based Care, and Digitalization of US Healthcare- as initiated by Hitech Act in 2009.

Founding members of team Hindsait Inc. saw this ‘Perfect Storm’ scenario both as a huge challenge yet an once-in-a-lifetime opportunity to innovate and transform healthcare to make a huge societal impact, which was the guiding motivation for team-Hindsait to come together and transform US Healthcare system for good.

Hindsait is a Delaware incorporated C-Corp. The company’s Artificial Intelligence platform enables payers

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and benefit managers to improve quality of care and reduce unnecessary health services, human errors, biases, wastages, and frauds.

Hindsait’s brilliance starts with its ability to ingest and translate physicians’ “unstructured free text” in patient charts within a context of clinical guidelines and regulatory requirements. These inputs drive machine learning and predictive analytics in Hindsait’s SaaS Platform that evaluate, score, and flag patient charts for specific actions like ‘Medical Necessity Determinations’ during pre-service as well post service reviews and audits.

The company has pioneered the application of an AI enabled utilization management solution that has been tested and proven with ~5 years of experience covering 20+ Million commercial, exchange, Medicare and Medicaid health-plan lives across USA. Its achievement is wide spread and speaks profoundly of the company’s success.

The Visionary Guardian of Hindsait Hindsait was established under a visionary entrepreneur, Pinaki Dasgupta, who currently serves as the

CEO. His is a passionate advocate, with a vision to transform healthcare, by the way of Artificial Intelligence (AI) technology. A former Accenture Partner, Pinaki had founded Hindsait in 2013 to prevent unnecessary health services, errors, frauds, wastages, and abuses in US Healthcare systems.

Since 2013, under Pinaki’s leadership, the company’s AI technology has been adopted by leading Fortune 500 healthcare organizations and has drawn strategic investments from GuideWell Innovation/Florida Blue Cross and Blue Shields and the firm has also received multiple accolades and recognitions from the leading analysts, including prestigious Gartner’s “Cool vendor in AI in Healthcare 2017” and “Top 10 Artificial Intelligence Solution Provider 2018” by Healthcare Tech Outlook, among others.

“We are on a mission to transform US Healthcare system by eliminating unnecessary health services, errors, frauds, wastages, and abuses, by harnessing the power of Artificial Intelligence (AI) technology,” asserts Dasgupta.

The team at Hindsait is a group of highly talented multi-disciplinary personnel consisting of Data Scientists, Physicians, Clinicians, Business

DECEMBER 2018

The

Most Innovative

Companies Bringing

AI to Healthcare operators, Technologists that came together to transform Healthcare. This team collectively works towards the company’s vision which is to be the leading AI platform/clinical decision support system that can prevent unnecessary health services, over-utilizations, frauds, errors, abuses, and wastages.

Distinct Services and Products Hindsait’s AI maximizes the effectiveness of clinical management, payment integrity, fraud and abuse. Listed below are the company’s applications, which are available to its clients as subscription services (SaaS) with the seamless integration of the clients’ existing systems and workflows: Prior-Authorizations, Payment Integrity Audit, Quality Focused Analytics (HEDIS/STAR), and Clinical Natural Language Processing (CNLP) as a service.

Here is a list of modular AI technology that has been consistently rated highly by industry acclaimed 3rd party analysts, media, and its clients alike: Robotized Process Automation (RPA) toolsets, which offers the user with Automated Image Enhancement and De-skewing (AIED) algorithms that automatically detect and re-orient/correct de-skewing of images/faxed records and offer image enhancement techniques to addresses issues such as character erosions, dithering, ghosting, etc.

Additionally, it allows them to process any input file formats. Further, its Optical Character Recognition (OCR) lets its customers convert images into text, along with the ability to detect regions with the hand-written-notes and scoring algorithms to measure the quality of output produced by the OCR reader.

Clinical Natural Language Processing (CNLP) Toolsets are top-tier and have been field proven. Its capabilities include uniquely parsing medical records to extract clinical concepts, qualitative or quantitative metrics, lab values, medications (Rx), provider’s names, facilities names, ICD 9/10 codes, CPT procedure codes, and so forth. Other proficiencies include temporal detection can tag the extracted concepts, ICD 9/10 codes, CPT codes with the associated dates of services. Additionally, its CNLP tool can robustly detect negations to make extraction context-sensitive.

Machine Learning and Predictive Analytics are the core strengths of Hindsait. These tools help it to address end-to-end business use cases with high ROI solutions to claims processing and care management solutions. The

DECEMBER 2018

company’s machine-learning and predictive analytics modules have proven to augment human decision-making to adjudicate clinical and administrative decisions more efficiently, demonstrating millions Our technology and of dollars in additional cost-of-care savings innovative approach and reductions in has paved a way to average case use and manage processing time, enabling enhanced healthcare data consistency and resourcefully reliability in decision making.

“

Its API web services have the ability to tightly integrate with the most workflow solutions for a seamless integration with the processes and workflow.

”

AI- The Revolutionary Technology “In such a world, we believe AI will enable Physicians, Clinicians, and other decision-makers in healthcare including Patients to make more informed, consistent, reliable decisions which are grounded on evidence,” asserts Dasgupta. Hindsait’s team believes AI technology is to augment human decision-making and more importantly will enable us to make more consistent and reliable decisions going forward.

Promising Future of Hindsait Since the very beginning of the company’s journey, Hindsait viewed US healthcare landscape as a major challenge for any startups to make headways, yet with its resilience and zeal Hindsait has always believed that, “This is once-in-a-lifetime opportunity to transform healthcare and leave behind your mark in the process!”

“Hence we wake up every day with the same sense of awe and excitement to make a difference,” quotes Dasgupta. The company is currently working on a couple of very exciting game-changing opportunities and distinct product launches in stealth mode. The company will make announcements in due course.

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iCarbonX

Thinking Out of the Box & Making the Difference

Jun Wang Founder & CEO

T

he carbon element is the chief component in any life form.

Carbon is the central element, without which life as we know it would not exist. Any compound that consists of carbon atoms is generally termed as an organic compound; these make up the cells and other structures of organisms and carryout the metabolic processes. It is an essential part of our DNA, lipids, and cells. It’s only fitting then that a company, which focuses on digitizing, analyzing, and understanding life, reflects life’s essential component through its name, iCarbonX. The company is led by an individual who has done more to scale the application of genetics around the world: Jun Wang. He is the Founder and CEO of iCarbonX. He is a top Chinese researcher and former Head of Beijing Genome Institute. Wang was trained in artificial intelligence before he co-founded Beijing Genomics Institute (BGI) in 1999. As CEO he built BGI into a premier global genome sequencing center. He is also credited with sequencing the genome of the first

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Asian person, the rice plant, SARS, the giant panda, silkworms, pigs, chickens, goats and the human gut microbiome. And he is a significant contributor to the Human Genome Project and to the rice genome sequencing initiative.

As one of the world’s leading scientists, Wang could have stayed in genomics, and remained at the top of a science he helped to commercialize and consumerize. But in 2015, he founded iCarbonX to create a future in which people can drive their own health and defeat disease with advanced data and AI. Now, he has assembled the best set of partners to operationalize his vision.

habits systematically. But by digitizing data, people will be able to get better treatments in the future,” asserts Wang. iCarbonX is a technology company, combining advances in artificial intelligence, disease management, multiomics, and immuneomic profile technology to fundamentally change how people understand their present, to manage their futures. It has built a platform of deep biological digitization to analyze and deliver precision solutions, services, and applications for any moment in life’s journey; from wellness, skincare, fitness, and nutrition to prevention, heath care, condition management and outcome achievement.

Going Beyond Genetics

He believes that digitization of health information is crucial for the choice of medicine, health, and treatments. “It’s essential that the population digitizes their health data because it provides individuals with greater knowledge of their own health, and the data provides doctors with better insight into their patients. Today, very few people know their own genetics or have insight into their digital health data. They do not know their gut bacteria or heart function and do not record dietary

“What If?” A question that iCarbonX wishes to answer by going beyond genetics. To answer the million dollar questions of life, so that one doesn’t just choose the road less traveled, but the road that should be traveled; is the vision the company works towards.

“All our individual paths will create a global map of health; parallel, intersecting and divergent,” says Wang. “This far-reaching and expansive atlas will forge an endlessly

DECEMBER 2018

The

Most Innovative

Companies Bringing

AI to Healthcare connected, cross-cultural community where everyone contributes to, learns about, and perpetually optimizes this experiment called life.”

The Journey of the Organization iCarbonX was instituted in Shenzhen, China, in the year 2015. iCarbonX finished its Series A financing led by Tencent in the following year. The post investment value of iCarbonX reached $1 billion. Later that year, iCarbonX announced its acquisition of Imagu Vision Technologies and the establishment of iCarbonX-Israel R&D center. iCarbonX Research Shenzhen, announced a collaboration with the Boston University School of Public Health (BUSPH), in 2017. Meum™ which is the digital health management platform built up by iCarbonX, was officially released to the public, and its digital life ecosystem partners later that year.

Simultaneously the company announced its alliance with seven companies and that iCarbonX ecosystem has invested a total of nearly $400 million in the seven companies that form the alliance: SomaLogic, HealthTell, PatientsLikeMe, AOBiome, GALT, Imagu and Robustnique. This year, German Chancellor Angela Merkel visited iCarbonX, and it partnered with OP Financial and DaChan Food to Deploy Precision Nutrition Industry.

AI Revolutionizing Healthcare “AI system could learn to understand human health and human life better than we do.” says Wang. “The AI will try to draw a iCarbonX is leading formula for life. Life is the way into the digital, like a computer program — post-genomic era if you want to by creating the understand the results platform for digitizing, of the programming, how the genes lead to analyzing, and phenotypes; it is understanding life sufficiently complicated for you to need an AI system to figure out the rules.”

“

”

iCarbonX is collecting every kind of data around an individual’s life. That includes genomics, proteomics, metabolomics, antibiotics, and microbiomes. It also includes smart devices checking everything around one’s lifestyle, diets, the environment data, and even your emotions and modes. “So we’re collecting everything around you,” quotes Wang.

Future of Healthcare Industry and iCarbonX

Meum: A Personal Health Guide for Individuals Meum is a digital health management platform that helps people to easily create a digital profile of their lives, so they can understand and monitor their present health status, predict the trends, and improve their future through customized solutions around their health, aging, and disease.

Each user has a dedicated digital life account on the Meum platform. With it, they can record and display more than ten types of data from their comprehensive health exams — genes, metabolism, intestinal microbes, and phenotype data collected from iCarbonX’s one-stop smart devices.

The Smart Health Coach within the Meum App can then manage that comprehensive health data. One only needs to record one’s dietary and life habits through audio or photos; the Smart Health Coach will automatically analyze nutrition intake, measure balance level, alert are available for any kind of abnormality, and provide customized solutions.

DECEMBER 2018

Applying digital technology in healthcare opens a lot of possibilities. In the future a lot of the digital technologies should be or has to be applied in healthcare, believes Wang.

Because the doctor will know the patient better and the patient will know themselves better using these kinds of technologies.

If one wants to use a skincare product, one should know your skin first. “If you use a medicine for yourself, you should know your disease first,” says Wang. So one needs to digitalize where and what one wants. This will allow and help people, start to manage your digital life, not just manage ones’ life from pure instinct feelings, but actually from data. iCarbonX is just doing that. It will be more intelligent and easy to use for every individual.

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Training Programmes

ALTIUS HOSPITAL HIGHTECH & LAPAROSCOPY GYNAECOLOGY HOSPITAL

About The Trainer Dr. B. Ramesh is one amongst the leading Gynaec. Laparoscopic surgeon in India & Abroad conducts live surgical workshops in these forums. Currently, he is the Director and Chief Endoscopic surgeon for Altius Hospital, a referral center dealing with complicated Laparoscopic and Hysteroscopic procedures.

• Very keen on training young gynecologists in Gynaec Endoscopy. Altius Hospital is a recognized center by the Federation of Gynecological Societies of India (FOGSI) for advanced training in Gynaec laparoscopy and ICOG. • The Fellowship Program in Gynaec Endoscopy is recognized by Rajiv Gandhi University of Health and Science and also recognized by the Health Ministry.

• Has successfully trained more than1000 gynecologists from all over India and from countries like Malaysia, Singapore, United Kingdom, Srilanka, Bangladesh etc.

• Providing hands on training for rural gynecologistst deputed by govt. of Karnataka.

• Assisted in setting up nascent laparoscopic units to promote use

of laparoscopic technology on wider scale across the country.

• Has successfully conducted 8 International Workshops and Conferences named ‘RAGE’ (Recent Advances in Gynecology, Gynaec Endoscopy and Urogynaecology) at Altius Hospital, Bangalore with several world renowned International Faculties from Europe, USA, Singapore attending the same.

AUTHOR OF 3 BOOKS 1. Text Book & Atlas of Laparoscopic Hysterectomy.

2. Single Port Laparoscopic Surgery in Gynecology.

3. Text Book on Everything about Fibroids.

TRAINING PROGRAM

“AFFILIAT IONS TO PROFESSIONAL SOCIETIES/ASSOCIATIONS”

At Altius Hospital gynecologists get an opportunity to learn and do under supervision all practical laparoscopic surgeries within the ultramodern laparoscopic HD setup and assist in 3D cases.

• Life member of Federation of Obstetrics and Gynecological Societies of India (FOGSI).

• Life member of American Association of Gynecologic laparoscopists (AAGL).

• Life member of European Society for Gynecological Endoscopy (ESGE).

• Life member of the International Society for Gynecologic Endoscopy (ISGE).

• President of Bangalore Gynaec Society-2011-2012.

• Executive committee member of IAGE, 2010-2011.

The Laparoscopic surgery training course is created and designed at this institute in a manner that after this training program, gynecologists will be able to do all basic and advanced laparoscopic surgeries on their own patients as well as diagnostic and advanced Hysteroscopic procedures.

ONE MONTH CERTIFICATE COURSE (FOGSI recognized) This course is adequate to perform diagnostic laparoscopy, laparoscopic sterilization, biopsies, ovarian drilling, management of ectopic pregnancy, minor endometriosis and other similar procedures like LAvH, Diagnostic & Operative Hysteroscopy & Ovarian Cystectomies.

CURRICULUM: Trainees will be attending all operation theatres at various places and will be allowed to perform minor surgeries and assist major surgeries. In addition, they will be taught pelvi trainer exercises which will enhance their laparoscopic skills. On an academic frontseminars, theory & practical classes will be conducted.

HIGHLIGHTS OF TRAINING v v v v v v v v v v

Basic to Advanced Endoscopy Covering all aspects on Laparoscopy and Hysteroscopy Special Emphasis on Pelvic Anatomy Pelvi trainer Sessions Lectures and Seminars Laparoscopic Suturing on Dummys Hystero trainer Session Electrosurgery Hands on Training under Supervision Authenticated Training Certicates (FOGSI recognized) Proctor and Mentoring after Training

SIX MONTH CERTIFICATE COURSE (Institution Fellowship) This course aims at imparting basic as well as advanced theoretical and practical knowledge in minimal access surgery to the young and experienced surgeons in a structured manner.

Emphasis is on day to day practical problems that a Laparoscopic Surgeon faces. Admissions are as per Institution regulations.

FELLOWSHIP IN MINIMAL INVASIVE SURGERY (18 MONTHS RECOGNIZED BY RGUHS)

ADDRESS Altius Hospital #6/63, 59th Cross, 4th Block, Rajajinagar, (opp) to MEI Polytechnic, Near Ram Mandir, Bangalore–560 010.

080–23151873, 9900031842 endoram2006@yahoo.in

Eligible Candidate MD / MS (OBG) DGO / DNB. Laparoscopic Training courses for Gynaecologist are totally candidate centered and its aim at imparting basic in addition to advanced theoretical and practical experience in Minimal Access Surgery in a structured manner. We emphasize on daily difculties encountered in laparoscopic surgeries.

www.laparoscopicsurgeries.com www.altiushospital.com

HIV

STILL AN IMPENDING THREAT TO MANKIND

H

IV research has come a long way since the disease was discovered in the 1980's. Antiretroviral therapy was a major milestone that has changed the lives of millions, but the goal now is to nd an HIV cure before 2020. Over the past several decades, researchers have learned a lot about the human immunodeciency virus (HIV) and the disease it causes, acquired immunodeciency syndrome (AIDS).

WHEN WILL WE HAVE AN HIV CURE? Although there are several approaches that could eventually bring a functional HIV cure, there are still some challenges ahead. One of the biggest concerns around any HIV treatments is the virus’ ability to quickly mutate and develop resistance, and for many of these new approaches there is still no data on whether the virus will be able to become resistant.

So far, none of these functional cures have reached late-stage clinical testing, meaning it doesn’t seem likely that we will meet the goal of having an HIV cure by 2020.

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DECEMBER 2018

SHOCK AND KILL STOPPING THE REPLICATION OF HIV Last year in a clinical trial scientists showed that this approach has the potential to become a functional cure for HIV. The key to its potential is that it can target the reservoir of HIV viruses that “hide” inactive within our cells. Current therapies suppress the virus in circulation by inhibiting the formation of new viruses, but they don't touch the reservoir. Once you stop, the virus comes back in 10-14 days. ABX464 is the rst drug candidate ever shown to reduce the HIV reservoir. The drug, called ABX464, binds to a specic sequence in the RNA of the virus, inhibiting its replication.

Another approach that is becoming popular in the ght against HIV also goes after the hidden HIV reservoir. The “shock and kill” or “kick and kill” approach uses latencyreversing agents (LRAs) that activate or “kick” the latent HIV reservoir, making it possible for standard antiretroviral therapy to “kill” these viruses. In 2016, a group of UK universities reported promising results from one patient treated with this approach. A similar strategy using vaccine is currently being tested. One stimulates the production of antibodies that block the replication of HIV, while the other attacks the reservoir.

03 01 04 02 IMMUNOTHERAPY

GENE THERAPY

What makes HIV so dangerous is that it attacks the immune system, leaving people unprotected against infections. But what if we could supercharge immune cells to ght back? That's the reasoning behind immunotherapies. Researchers reported last year that thanks to an immunotherapy that primes the immune system against the virus, 7 out of 15 patients were cured. Their approach combines a drug to activate the hidden HIV reservoir with a vaccine that can induce an immune response thousands of times stronger than usual.

It is estimated that about 1% of the people in the world are naturally immune to HIV. The reason is a genetic mutation on the gene that encodes CCR5, a protein on the surface of immune cells that the HIV virus uses to enter and infect them. People with this mutation are missing part of the CCR5 protein, making it impossible for HIV to bind to it. Using gene therapy, it would, in theory, be possible to edit our DNA and introduce this mutation to stop HIV. In the future, gene therapy for HIV could be done with CRISPR, a gene editing tool that is much easier and faster to make. Its potential in HIV has already been shown in vitro, and soon HIV could become of the rst diseases to be cured with CRISPR.

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Niramai Health Analytix Dr. Geetha Manjunath

Ms. Nidhi Mathur

CEO & CTO

COO & CFO

A

s an innovative technology, Artificial Intelligence is proving its ground as a potential tool to tackle various challenges in today’s healthcare vertical. The core mathematics used by AI algorithms has now matured and the accuracy levels of automated decision making has reached the threshold of acceptance, and in some cases even has surpassed or countered the human decision making. This has unleashed a

Offering a Revolutionary Solution for Universal Cancer Screening

new era of innovation creating real-life impact. This is leading to AI making real impact in various areas, with healthcare being the most important and impactful space.

Breast cancer has become the talk of the town due to the rising mortality and incidence rate, especially amongst the young female population. There are quite a few challenges in the diagnosis of breast cancer in young women.

Special consideration must be given to the woman’s safety from radiation and body image issues.

In light of this situation, Niramai Health Analytix has come up with a novel AI based solution to detect early stage breast cancer in a completely safe

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and privacy aware manner. It is a health technology startup offering cancer diagnosis solution to Hospitals and Diagnostic centers, as well as a low cost cancer screening solution to improve rural healthcare solutions through Government and Non- Profit Organizations.

With a vision to incorporate its test as a standard preventive screening tool into the clinical practice across the country, Niramai has introduced a new technique called Thermalytix™. It is a novel computer-aided diagnosis solution to identify cancer and pre-cancerous patients in an affordable, accessible, and effective way. The company’s solution is a non-contact, non-invasive, low cost, portable solution for detecting breast cancer for women of all ages. The tool does not require expert skills to operate the system and can enable large scale rural screening; making breast cancer detection accessible to every woman.

The core of Niramai’s software consists of novel computer algorithms

DECEMBER 2018

The

Most Innovative

Companies Bringing

AI to Healthcare based on Artificial Intelligence and machine learning over thermal images.

Competent Women with a Vision Established in July 2016 by two women Co-founders, Dr. Geetha Manjunath and Ms. Nidhi Mathur with diverse expertise, Niramai has achieved a lot in a very short span.

Geetha, who is the CEO and CTO at Niramai, holds a PhD in Artificial Intelligence from IISc and has led large teams to deliver innovative solutions in Hewlett Packard Labs and Xerox Research. She has over 25 years of research expertise in the IT industry and has several patents, publications, national, and international recognitions to her credit.

Nidhi on the other hand plays the role of COO and CFO at Niramai. She is an MBA from IIMB with specialization in strategy and marketing, and has expertise in commercializing new-to-the-world innovations. This remarkable duo have helped in developing Niramai to a position of strength and achieved excellence for the company.

of mammography, it makes the solution more affordable and accessible.

• Accurate: Niramai test We provide has shown good accuracy of detecting complete breast abnormality hardware-software in women of all age solution for breast groups.

“

cancer screening

“AI/Deep Learning that is safe, non-touch, Technologies are cost-effective, definitely useful in a a portable solution country like India for large-scale where there is a shortage of skilled screenings medical professionals and increasing pressure of healthcare delivery system,” asserts Geetha. “Niramai makes cancer diagnosis objective, simpler and effective for Radiologists by helping them make more reliable clinical decisions with the help of technology.”

”

Future Plans of Niramai Distinctive Features Since its inception, for the past two years Niramai has focused on protecting IP, launching the product, establishing clinical validity, and establishing centers across three states. The key and one-of-its-kind benefits of these solutions are: • Unique screening experience: Its breast screening test that is radiation free, non-contact, painless and is completely privacy-aware. During the test, no one touches, compresses, or even sees the women being screened.

• Age-agnostic: Breast cancer incidences among young women are on a rise and traditional methods remain ill-suited for preventive screening for young women.

Niramai test works on women of all age group, not just above 45 years of age. The lesser known fact is that breast cancer can also happen to men, and its test is also suitable for screening men.

• Safe: This test is completely safe and can be taken as often as needed without any side effects.

• Affordable: This test used off-the-shelf thermal sensors.

Since the capex for that equipment is less than one tenth

DECEMBER 2018

Niramai is working towards increasing the awareness about its solution among women population as well as practitioners. It is partnering with leading medical specialists to create additional proofs of the efficacy of the solution and establish the complete workflow to recommend how this solution can be an integral part of health services delivery.

Niramai is also looking at extending the application of the innovation to areas other than breast cancer screening. With efforts like that, we will gradually move the solution towards being the standard modality accepted by a wider section of medical community.

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Dr. Enhao Gong, Founder

ABOUT THE AUTHOR Dr. Enhao Gong is the Founder of Subtle Medical.

Dr. Gong graduated with a Ph.D. in Electrical Engineering from Stanford University in 2018, with research focus on applying Deep Learning to improve medical imaging reconstruction, analysis, and quantiďŹ cation. He has been awarded Forbes China 30under-30 in 2018, and serves in the committee of Machine Learning Workshop of ISMRM. Subtle Medical Inc., is an AI+Radiology startup founded

by Dr. Enhao Gong and Professor Greg Zaharchuk from Stanford University, it is the Winner of 2018 NVIDIA Inception Award and Minnie Semi-ďŹ nalist of Best Radiology Vendor.

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DECEMBER 2018

AI

T

he AI transformation is remarkable for its speed. For example in conference such as RSNA (Radiology Society in North America) and ISMRM (International Society of Magnetic Resonance in Medicine), AI applications was still a niche area before 2016, but is the top-1 hottest topic right now. We have passed beyond the point that people doubted the applicability and potentials of AI in radiology. Machine Learning and Deep Learning algorithms have demonstrated good performance that can supplement and verify the imaging tasks for radiologists. Although still in early stage, variable AI algorithms have already started to be test in clinical environment. This year 2018 is also a landmark year for AI in radiology, since several AI+radiology products have received FDA’s nodding that they can practice in clinics for segmenting heart from MRI, make classification from CT, evaluate lung nodules, etc.

Beyond Classification - AI Improves Entire Radiology Workflow Particularly, when talking about AI for radiology, most people think of an AI algorithm that can eventually “replace” radiologists and conduct diagnosis. When people talk about the possibility of “replacing” radiologist, it is important to recognize the complexity of radiology. Radiologists are imaging experts with more than 10+ years of medical training, who render diagnosis and clinical decision suggestion from interpreting medical images and correlating their findings from images with other exams and tests. Currently, most AI algorithms are often designed for simplified ImageNet-ish image classification tasks, to separate images from different categories such as with or without abnormality. It is clear that there are still huge gaps between predicting a classification label, which is well studied and achieved by AI algorithms, and rendering final diagnosis, which is much more complicated and requires both images and non-image information.

Beyond image classification, however, AI actually has great potentials to improve entire imaging/radiology workflow. AI algorithms and products can supplement existing radiology solutions, with more efficient and accurate imaging acquisition, reconstruction,

DECEMBER 2018

49

analysis, detection, diagnosis, and prognosis, which goes way beyond predicting labels of normal and abnormal tissues.

Several research works, including the works we have done at Stanford; recently demonstrate that Deep Learning can replace conventional iterative algorithms for more accurate medical imaging reconstruction from 10x faster MRI scan or even 200x lower-dose PET scans. In addition, a lot clinical research works in neuroradiology; showed AI algorithms can not only categorize current disease, but also predict how the disease will progress in the future. From faster exams to accurate prognosis prediction, the entire radiology workflow can be improved using AI. Different from other AI+radiology companies and startups focus on automating radiology diagnosis using AI, we at Subtle Medical chose a different route to integrate AI into clinical radiology. We provide hospitals and imaging centers software infrastructure for AI-empowered imaging workflow enabling at least 4x faster and safer MRI and PET exams. We believe these AI tools will help hospitals and imaging centers to improve their productivity, quality of the service and patient satisfaction.

No Workflow Disruption from Disruptive AI Technology It is no doubt that AI is a disruptive technology that will reform the radiology practice and workflow. However, the innovation in radiology practice, as well as in healthcare in general, should never disrupt clinicians’ operation. There is a saying that if the change of workflow requires radiologists to move from their chairs, it is not going to works. AI is supposed to free clinicians from repetitive tasks, not to add more tasks to them. Therefore it is fundamental for an AI product to seamlessly integrate into the entire workflow.

For example, at Subtle Medical, all the products are designed in a way to (semi-) automatically function between scanners and PACS, staying almost silent and invisible to technicians and radiologists.

In general, we believe the best radiology tool should simplify, accelerate, and prioritize tasks for radiologists, making exams more accurate, efficient and personalized, and improve the productivity and satisfaction for both patients and clinicians. AI products have potentials to achieve all of these requirements.

Super-human Capability of AI

such as Deep Learning, have great potentials in tasks human professionals are not good at as well. For example, in identifying diagnosis disease subtypes, similar to finegrained image classification of identifying two similar dog breeds in ImageNet challenge, AI algorithms can do better than human and resolve inter-reader variability. In addition, for all the repetitive and quantitative measurements in radiology, such as contouring, segmentations, measuring brain thickness, and recording tumor size changes, AI algorithm can not only free clinician from these timeconsuming mundane tasks but also get more accurate results. In addition, quantitative biomarkers and quantitative parameter mapping is a new trend in medical imaging as it offers better objective criteria for clinical decision, where Deep Learning is shown to improve for MRI. Last but not least, new algorithms lead ways to correlate radiology with large scale genetic datasets, which is too complicated that human can never be good at but AI. All of these new advances from AI can contribute to personalized and precision medicine in future radiology.

Still a Long Way to Go Although AI in radiology has achieved a lot progresses, there are still a long way to go until it is routinely used in clinics. In 2016, Dr. Geoffrey Hilton mentioned “it is quite obvious that we should stop training radiologists.” Later, several AI papers published on achieving “expert-level performance” in diagnosis add-up the concerns that radiologists should be worried about losing jobs. However nowadays we know there are definitely some hypes in “replacing” radiologists. As the developers of radiology AI, we also understand and appreciate more that radiologists are doing much more than image categorizing. Most AI/Computer-Assisted-Diagnosis products are still in their early stage for a closed-set of a few disease categories.

AI, for a foreseeable future, will not be generalized. No human is better than a small calculator for accurate arithmetic, but that is all that the calculator can do. Given the long-tail effects and the lack of datasets for rare disease, it is unlikely AI can do everything for radiologists. But, as put by Dr. Langlotz from Stanford, “radiologists who use AI will replace radiologists who don’t.” AI in radiology, probably similar to AI in other popular areas such as manufacturing and autonomous driving, will keep improve its capability to change the entire industry. As quoted in a recent Forbes article on robotics: AI will replace tasks, not jobs.

Several research works show state-of-the-art AI algorithms,

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DECEMBER 2018