Health Tech
Making Medical Imaging Affordable To All
Cristin Dickerson, CEO & Founder, Green Imaging
Making Medical Imaging Affordable To All
Medical imaging is a key diagnostic tool in the health care industry. Over the years the associated technology has witnessed tremendous growth, making it more affordable and efficient. An acclaimed business leader in the health care industry Cristin A. Dickerson, who is also an MD and the CEO and founder of Green Imaging, has participated in that growth, having spent 28 years in the industry. Her company’s primary aim is to help patients make the most informed decisions about MRIs, CT scans and other imaging procedures. Based out of Houston, Texas, Green Imaging is a full service virtual medical imaging network, offering cash-pay price to all its patients and direct contracting to innovative health plans ensuring they are charged a fair all-inclusive price for imaging procedures (the prices include the radiologist interpretation and any contrast or supply charges).
The Journey
The journey of Green Imaging began in 2012 when Cristin realized that there was a dearth of high quality, affordable medical imaging centers in Houston. “We had a 21% uninsured population in Houston in 2012. We had very few options for high quality, affordable medical imaging for those folks. I explored opening a cash pay imaging center but was looking at $3-4 million in debt,” she said. Cristin added that the centers her group served as radiologists were at 50% capacity at best, hence she decided to use a Travelocity-like model and bought the unused time on their scanners at a discount. “I and the other radiologists in my practice read the exams to assure quality across the network. That model grew throughout Texas. Then, last year we began contracting with independent imaging centers nationally and our network now consists of about 950 centers across the country.”
Technology to the rescue
Technology, for Cristin, was the key enabler in improving access to affordable imaging for the masses. Cloud based technology allows referral management for tens of thousands of exams from varying referral sources. It also enables images from across the country to be interpreted centrally and efficiently in a PACS (picture archiving and communications)/RIS (radiology information system).
The Challenges
The current healthcare industry is crippled with challenges including HIPAA (The Health Insurance Portability and Accountability Act) compliance. Cristin said the healthcare industry is held to standards that stifle and drive up the cost of innovation. “Why is your healthcare data more precious than your legal and financial data and personal/interpersonal communications?” she asked further citing dependency on decade-old medical claim forms and coding systems trademarked by the AMA as another challenge. “60-70% of physicians being employed by hospital systems are relying on the hospitals to find innovation rather than exploring it for their own independent practices,” she added.
The Success mantra
As a strategic leader, Cristin has relentlessly carried the tirade against the healthcare experts who did not want to break away from the existing tyranny in the system. “One can overcome failure only through powering through it. Power through it, you will sometimes fail, but it can make you stronger and smarter,” she noted.
But now, Cristin is on cloud nine. Green Imaging is finalizing a contract with a company with 40,000 employees. “We are also developing a custom network for 100,000 employees in California and are presenting to a school district in Florida very soon. We can save employers and health plans 10% on their overall health care spend.”
A word of advice for start-ups
According to Cristin, start-ups and booming entrepreneurs should rely on self-funding, especially if they were looking to establish their business in the emerging cost contained healthcare system. “The real need of the hour is to get rid of bloated middlemen who have bled the system dry. I was a self-funded employer when I was president of a 50- doctor multi-specialty group and always saw the potential of Green Imaging becoming a preferred cost containment network for employer health care plans and that has come to fruition these last 3 years.”
Top 50 Healthcare Technology CEOs Of 2020
Health Tech
Viruses: Biological versus Computer
By Mark Webb-Johnson, Chief Technology Officer of Network Box
During this time of the COVID-19 pandemic, those of us working with computer viruses continue to be amazed at the similarities between the techniques used by the medical community to fight SARS-CoV-2 (the virus that causes the COVID-19 disease) and the processes involved in our electronic anti-virus systems. Let’s look at some of these similarities, and see how computer anti-virus researchers help protect.
By Mark Webb-Johnson, Chief Technology Officer of Network Box
What is the Virus?
SARS-CoV-2 is an RNA virus. Essentially, a strand of information wrapped up in a protective shell and a mechanism to infect cells – information, envelope, infection mechanism.
By comparison, a computer virus consists of the payload, a carrier, and an exploit mechanism. For example, the payload would be the malicious code, the carrier an email message, and the exploit mechanism something to take advantage of a vulnerability in a particular mail client. Another example would be script downloaded from a web page, taking advantage of a web browser exploit.
Replication
The virus’s primary purpose is to replicate – to make copies of itself. SARS-CoV-2 does this by infecting cells (in the lungs, stomach, and other areas of the human body), then using the cell’s own mechanisms to make copies of its RNA and make new virus particles.
Computer viruses have the same primary purpose of replication. They want to infect as many hosts as possible. Once in a computer system, they make multiple copies of themselves and transmit out to new hosts. It is this self-replication capability that defines this as a virus.
Identification and Testing
The gold standard for identifying viruses is the whole genome sequence. This maps the full sequence of the chemical components of the RNA (made up adenine, uracil, guanine, and cytosine; abbreviated as A, U, G, and C), and results in a very long string of these four letters. That is excellent for precise identification, but not so good for testing. Due to mutations, what we know of as SARS-CoV-2 is actually a collection of hundreds of different strains of the same fundamental virus, each with their own slightly different sequences (more on this later).
To test for the virus, researchers instead concentrate on relatively small portions of the full sequence. This way, they can extract samples from a potentially infected human, amplify the RNA in the sample to obtain enough to test with, and then compare that against the portion of the full sequence. That is the RT-PCR test.
Computer virus researchers work similarly. The payload of the virus itself is a sequence of computer code that can be expressed in binary, or more commonly in hexadecimal notation. Computer viruses are often intentionally self-encrypted and randomized (we call these polymorphic viruses) to avoid whole sequence detection. Nowadays, these are by far the most common form of computer virus seen.
Researchers extract portions of the sequence that don’t change and use pattern matching techniques to detect those partial sequences in suspicious samples. We call these ‘signatures,’ and they can be effectively used to detect known viruses in suspicious samples.
Immune Response and Vaccination
The human immune system has a component known as the ‘adaptive’ immune system. The system works by identifying portions of viruses already in the body, and creating antigen-specific cells designed to identify, remember, and attack that specific antigen. These cells protect against future infections of the same virus and can survive in the body for some time (months, or years, typically). This is why after you’ve had the measles once, for example, you usually don’t get it again. Vaccinations work by purposely injecting the body with antigens that will generate such an adaptive immune response, to protect you from future specific infections.
Computer anti-virus systems store databases of signatures of known viruses. When your computer receives a new file, it can scan it, look for a match against those signatures, and take action if a match is found (quarantine, etc.). Such signature-based systems are the computer equivalent to the body’s adaptive immune system.
Innate Immune Response
Another component in the human immune system is known as ‘innate.’ This system can detect what is not ‘you’ (what is ‘foreign’) and attack the invader. It relies on the antigen’s chemical properties and doesn’t need to have previously seen that specific antigen.
For computer anti-virus, this is extremely hard to achieve well. The capability to detect and block previously unknown viruses is what differentiates good anti-virus systems from the poor. Various techniques are used, but mostly revolve around a) decoding the virus code to the rawest form, b) detecting suspicious encoding or exploit behavior, and c) using emulation or sandboxing techniques to see what the virus does when executed. Looking at behavior, rather than code sequences.
Mutations and the Future
RNA viruses such as SARS-CoV-2 are very poor at accurate replication, and sometimes the copies made are not perfect. Base pairs get flipped. Portions of the sequence are lost. Parts of other viruses are incorporated. Before long, you are dealing with bad copies of bad copies of a bad copy. It is like the story of a million monkeys with a million typewriters, eventually producing the works of William Shakespeare. Sometimes these viral mutations are beneficial to the virus, but most often not. Whatever the outcome, these mutations are the way the virus adapts to further its goal of replication.
Thankfully, we do not see the same with computer viruses. A computer virus can and does make perfect copies of itself, 100% of the time. Sure, we have self-encrypting polymorphic computer viruses, and randomizing fragments are often introduced, but the core code of the virus is not changed, and certainly not randomly. Perhaps in time, we will see this, but with today’s non-forgiving computer CPU architectures, it is unlikely to be a successful approach.
Of course, given enough monkeys and enough typewriters, anything is possible. Perhaps they can even improve on Shakespeare. Before that day comes, however, make sure you are prepared. Subscribe to a Managed Security Services Provider (MSSP) that can adapt, and protect you from cyber threats.
