Health Tech
Personalizing Digitization in Healthcare
Gregory Makoul, Founder & CEO, PatientWisdom
Personalizing Digitization in Healthcare
It’s well known that being a good listener makes a person more successful in any profession. In healthcare, it plays a particularly important role as hearing out patients helps clinicians better understand how to provide truly patient-centered care.
Dr. Gregory Makoul strongly believes in the power of listening and aptly tagged ‘We hear you’ for his concept PatientWisdom – a solution that makes it easy for patients to share what matters to them and runs analytics to turn patient perspectives into actionable insights at the N=1 and population levels.
The Founder and CEO of PatientWisdom, Inc. sees the practical combination of digital and personal communication as the key for turning transactions into relationships in the age of consumerism and value-based health care.
The Journey
The idea to start PatientWisdom roots back almost 30 years when Greg completed his Ph.D. in Communication at Northwestern University and joined the faculty at Northwestern University Feinberg School of Medicine. “It quickly became clear that most physicians-in-training and physicians-in-practice had very little understanding of how patients experienced health and illness. I started giving patients video cameras and asked them to share what their lives were like. These patient narrative videos were incredibly powerful,” recalled Greg. They have been used across the US and in many countries to help providers focus on the patient perspective.
Greg added, “Patient, provider, and community member perspectives are valuable, yet mostly unheard.” Recognizing the value of listening, Greg and his team worked with health system partners to develop a suite of three digital solutions – PatientWisdom®, ProviderWisdom®, and CommunityWisdom® – all of which use the same logic and underlying software platform, called Wisdomics®.
“In each case, we capture real-world perspectives via our mobile-responsive digital solutions and distill the information into meaningful, actionable insights to help health organizations become more responsive and successful. We are convinced that we can help health organizations literally transform the experience and delivery of care by listening to the people involved – individually and at scale. This combination of digital plus personal is the key to winning in the age of consumerism, personalization, and value-based care.”
The Current Market
Reflecting on the current healthcare market, Greg noted that the marketplace is tremendously fragmented, and that many health organizations are struggling with the promise of strategy and the reality of culture as there is often a gap in organizational readiness. Greg suggested, “The way to win in a crowded, fragmented marketplace is to offer a compelling platform that drives value for stakeholders. While there are lots of great ideas and point solutions out there, they can feel like another rock in the backpack if not well integrated and coordinated. Our Wisdomics platform does this for health organizations who have prioritized the voice of patients, providers, and community members.”
The Promise of AI
When queried about the impact technology has been making on the healthcare system, Greg said, “There is no question that AI and machine learning have made great strides in areas such as pattern recognition and imaging interpretation. They are also gaining traction in terms of automating some basic elements of communication and decision support. I’m particularly excited about advances in data science and analytics: Healthcare is awash with data – the key is to turn it into useful information that can empower stakeholders.”
The Success Story
Asked about success stories so far, Gregory said, “I will never forget what we heard the very first time we asked a patient for feedback on PatientWisdom. She said, ‘By using PatientWisdom, I’m giving a gift to my doctor and to myself. My doctor has an easy way to learn what’s important to me, so I get better care.’ And that’s the point. We’re making it easy for patients to share what matters to them, and making it easy for clinicians to do better without taking longer – it takes only 15 seconds to review the inSIGHT summary that we create and display in the electronic health record so every member of the care team has an at-a-glance view of clinically relevant, non-clinical data.”
Greg advises start-ups and entrepreneurs to always start with identifying the problem to be solved, not only when shaping a company or product/service, but as a touchstone in every decision. “Believe in your vision, but don’t be afraid to test it by seeing through your stakeholders’ eyes. And recognize that when people tell you it’s a rollercoaster, they don’t simply mean that there are highs and lows – they mean that you’ll likely feel both high and low points every single day. Make sure you’re ready for that.”
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.
