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February 6, 2020
 
Buoy Coronavirus Pathway
 
 

It’s hard to flip on the TV and not see some mention of the novel coronavirus. The number of cases reported has continued to rise daily, as the World Health Organization reports that the virus has sperad to 25,000 individuals across 25 countries. 

However, a biproduct of the disease has been fear, according to Buoy Health Founder and CEO Dr. Andrew Le. 

Increasingly startups and innovators are turning to tech as a way to educate the public on the virus and collect data for researchers and public health officials. 

“I think the biggest problem with epidemics in general is there is this massive supply and demand mismatch. On the demand side [there’s] panic and fear. People are saying ‘oh I know someone who went to China maybe I have it.’ … That’s just totally inappropriate fear for what is actually going on. So, in this epidemic you have demand that is artificially high," Le told MobiHealthNews. "On the supply side you have healthcare providers — there is not enough of them. In today’s healthcare when you do go see somebody you immediately put other people at risk if you are indeed sick. If you aren’t sick, you are putting yourself more at risk now that you are putting yourself around people who could be sick.”

Le’s company, Buoy Health is a health-focused chatbot that helps people interpret their symptoms and suggests what level of care they should seek. He said this panic got his team thinking about ways to combat that fear and send people who might have the condition to the right place. 

“The way we thought about it is the average user who uses Buoy has been sick for less than 12 hours,” he said. “The average person hasn’t gone to the doctor until they have been sick for about 72 hours. So we are actually seeing people before they ever go in. So if we can reach someone really early on and we can bring information to them that is relevant to their symptoms, and what they are worried about and basically quell fear when people are inappropriately scared — so dampen inappropriate demand but if people do need to go get them to appropriately call in.”

To work on the new tool Buoy joined forces with researchers from Health Map, a digital epidemiology tool developed by a team at Boston Children’s Hospital, led by John Brownstein, in 2006. 

Health Maps has been working on tracking the novel coronavirus from the onset, and has experience tracking the spread of diseases. 

“Health Maps has been tracking disease outbreaks for 15 years now. [It's] this idea that there is all this information online and we can capture events ahead [of time using] what might be reported through these networks, social media, chatrooms … our work is focused initially on early signs of a disease,” Brownstein told MobiHealthNews. “That is what we did with the coronavirus and found some signs on local news, chatrooms. ... We’ve been working with an international team to do some crowdsourcing of identification of key words and metadata.”

As part of this collaboration Health Maps can give Buoy an idea of what is happening on the broader coronavirus disease landscape. 

“Basically, what we did was we called the CDC with [Brownstein]’s help. The CDC put us on the same phone calls they do with a bunch of other infectious disease doctors,” Le said. “What they said was here are the latest CDC infectious disease guidelines. Our team basically took those CDC guidelines, which get updated on a regular basis, and adjusted them into our AI, which actually was a very difficult thing for us because [while] our AI is very nimble and it is mathematically based, to then layer in CDC rules was a difficult challenge.”

As of yesterday morning, the coronavirus feature is live on Buoy. Patients can get information about the condition. It may also be listed as a possible condition for certain patients — based on travel history and other factors. 

“Because we have a good sense of underlying risk we can push that information to Buoy, and that can help them fine tune their algorithm and fine tune their decision support tools,” Brownstein said. “But the reverse is also true — they are collecting symptom data from consumers that can point to signals for disease contamination.”

Both Brownstein and Le said that their tools are aiming to provide researchers and health organizations with better insight into emerging disease trends. 

“The goal is to go back to the public health officials like the CDC, like the WHO, and say 'this is what Health Map is seeing in the hospital and this is what we are seeing in the community,' and helping them change the response in real-time," Le said. "What if the symptoms aren’t the same over time? What if the transition isn’t droplets as people expected? There are all these different variables that we don’t really know yet about the virus, and what you need is data. If you think about why we are working together, Health Map has fantastic data in the hospital and we have fantastic data in the home.”

WHY IT MATTERS 

As of yesterday, the new strain of coronavirus (2019-nCoV) has spread to 24,554 cases globally, as of the latest numbers from WHOThe condition has led to just under 500 fatalities. According to WHO, older people and individuals with preexisting conditions "appear to be more vulnerable" to the virus. 

The number of infections has been growing since the first case was reported December 31 in Wuhan, China. So far, the bulk of the cases reported have been in China. However, new patients are emerging around the globe. 

Symptoms include respiratory issues, fever, cough and shortness of breath. WHO said that more severe cases can include pneumonia, severe acute respiratory syndrome and kidney failure. 

THE LARGER TREND 

Chatbots have been employed to help address patient’s concerns during epidemics before. Notably, in 2018, the CDC reported that influenza rates were at the highest rate in a decade

In terms of health mapping, Kinsa, a smart thermometer that takes your temperature, crowdsources its data to track flu trends. 

ON THE RECORD 

“I think generally what we are seeing is a thorough collaboration happening between academic centers, commercial entities, government agencies,” Brownstein said. “So what is exciting is we have a government agency identifying issues and meeting in response, scientific communities helping build models and improving access to data, and then those companies leverage that information to work directly with consumers and help them make better choices. We have this amazing amount of flow and cooperation that ultimately can lead to an impact on the emergence of an infectious disease.”

 
employee at a desk
 
 

A new survey polling thousands of international office workers suggests that two in five will opt to search their symptoms online and self-medicate rather than visit a doctor, with the same amount admitting that doing so makes them more nervous about seeking care from a professional.

On the flip side, a similar portion of respondents (43%) said they would investigate their condition online and then see a practitioner. And while 40% said they hadn’t seen a doctor in the past year despite long-term health worries, 35% and 33% noted that they would be more likely to visit a professional if they could book their service or view their personal health data through an app or online tool.

These numbers come from a report published recently by Aetna International, which polled more than 4,000 office workers at mid-to-large businesses in the UK (1,012 respondents), US (1,007 respondents), UAE (1,001 respondents) and Singapore (1,006 respondents). In addition to the digital-centric findings, the survey also quizzed workers on their health engagement and the role their employers could play in promoting regular care.

On these topics, 24% said they were worried about their health but are afraid of having a health check, and many said that they weren’t aware of their current blood pressure (37%), BMI (41%), cholesterol level (67%) or blood type (35%).

Meanwhile, a third of the respondents said that they didn’t have the time to be ill at work, with 21% noting that they are unable to take time off of work to attend a checkup. Forty-six percent said that they ability to easily take time off work to attend an appointment would encourage them to see a doctor, as 27% said that motivation from their boss would encourage them to take a greater interest in their health.

WHY IT MATTERS

Even if it’s not quite the majority of workers, these data suggest that online search tools and the information most readily available are influencing many employee’s health-seeking behaviors.

“There’s no getting away from Dr. Google,” Dr. Sneh Khemka, SVP of population health solutions and vHealth at Aetna International, said in a statement. “We need to recognize that people are going to use the internet/Google more and more over time. So the onus is really on big tech giants such as Google — to make sure they’re curating results that come from validated, reliable sources of information.”

The other findings highlight an opportunity for employers and management to drive greater healthcare engagement. Of note, employee’s interest in digital health tools coupled with time management concerns outline a particular opportunity for apps and other offerings that are focused on convenience.

“As digital tech allows you to have a consult there and then, you get a much quicker, more immediate, personalized response and get triaged to the right level — from there you’re either going to be advised to go and rest, or to go and see a specialist and have further tests, for example,” Khemka said.

THE LARGER TREND

These survey results come in alongside another poll from Mercer Marsh Benefits, Mercer and Oliver Wyman, which suggested that employees and employers alike are interested in the potential of digital health offerings (although prior data suggests that the types of services these two groups are eying may differ).

Consumer-friendly devices like Apple Watches and Fitbits are becoming an increasing staple of some employers’ wellness plans, while digital health management and coaching services like Livongo have touted the ROI they can offer. And just this week Hinge Health CEO and cofounder Daniel Perez stressed to MobiHealthNews the strength of the employer health market as a factor in his company’s recent success and investor confidence.

 
 
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By HIMSS Insights
 
Connected Care is about patients moving smoothly from their home through the continuum of care and back, depending on their medical needs and facilitated by data that is immediately available wherever it's needed. Making data available is about interoperability, but in a broad sense. IT tools have to be able to communicate, and so do the people involved. Healthcare made some progress recently with technical standards, but are we improving human-to-human interoperability too?

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ASSESSING EMERGING TECHNOLOGIES
 
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Today, industry players are zeroing in on the best ways to assess these new technologies coming into the market. But each stakeholder has a different priority — which means a different way of evaluating these tools. This month MobiHealthNews will be taking a closer look at how digital tools are validated and assessed by health systems, payers and investors.
 
 
 
 
 
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