This one is pretty interesting also... and from someone with real world experience.
66,'Rahul Patwari,'I am not a company, but a physician who works in an urban emergency department. Every day I see the costs of inefficient health care delivery. There is a monetary costs in unnecessary tests and the time delays they cause. There is a cost to patients in that the stretched resources end up inappropriately distributed. There is a cost to physicians who are burdened with an ever growing fund of knowledge which is impossible with which it\'s impossible to keep up. This eventually leads to medical malpractice lawsuits which are a drain to our legal and medical systems. ','A small but significant step in improving all of these problems is making it easy for physicians to practice with the latest standards-of-care. My solution is to use the iPhone as a platform to deliver diagnostic and treatment plans based on the current literature. For example, imagine a patient with a stroke. The physician, using his iPhone, can determine if he meets the criteria to receive blood-clot dissolving medication, or determine if that would pose too great a risk of fatal bleeds in the brain. X-rays can be ordered according to established guidelines instead of the gestalt/gut-feeling of the physician. These rules have been shown to be very sensitive in finding fractures, yet at the same time reducing the number of unnecessary x-rays. The applications are quite broad. ','There is no product like this available. The technology isn\'t difficult, just a bunch of algorithms organized properly: cardiovascular, neurological, orthopedics, etc. Right now the information is there in the medical literature and unwieldy text books. My idea is simply to bring them together into one easy-to-use program. The iPhone is a device many physicians already carry, and if not, are looking at buying. This would be a reason to do so. What makes this device unique is that these decisions/calculations can be done bedside (with the doctor holding the iPhone). When done, it can be easily slipped back into a pocket. ','There is no product like this available. There really won\'t be competition for this product as I intend to give this away for free. There is no reason that the patient in a poorer urban hospital shouldn\'t have access to the same care that a patient coming to a richer hospital would get. If everyone can practice the same degree of quality care, I sincerely believe we can improve our delivery of health care and possibly even to more people. It will be a long while before concrete changes in health care delivery will arrive, but this may help. ','Rahul Patwari, MD. Board Certified Emergency Physician, Chicago, IL. I received my BS in Engineering, Computer Science from the University of Illinois at Urbana-Champaign. Subsequently I did my medical training at the University of Illinois at Chicago and completed my residency in Emergency Medicine at Chicago\'s Cook County Hospital. ','','','New',0,20080306165443,20080306165443);
It is very hard to build software like this which is both accurate and easy to use. Especially for general use. There are a lot of expert systems for medical diagnosis, including some which were accessible on the web (hundreds were at Revolution Health), but they are really not useful: they take far too long to use and are not sufficiently accurate. In fact Revolution Health removed most of them. One of the main problems is the terrible bandwidth of answering questions posed by a wizard.
But, at least, if it's on the iPhone, the huge costs of building and dealing with hardware are dealt with. I wish them luck, though I expect they are ignorant of the challenges ahead.
Some time ago, my strategy was to focus on high priority automated diagnosis, using much higher bandwidth channels, like microphones and cameras and so on. I had some machine learning algorithms for detecting skin cancer that I thought would significantly improve on the best existing algorithms, reaching 80-90% accuracy on a single viewing (higher than physicians which get around 60%), and nearing 100% if the moles were tracked. There were two major, but surmountable problems: I needed to do a lot of preprocessing to remove the variability of different cameras and shots and conditions, and I needed to get a good dataset to train and test (those are hard to acquire.) Ultimately I shelved the project because my cofounder wanted to work on something else (which I shelved because now I'm working on compressed air powered vehicles.)
How difficult were the regulatory issues around your software? I've been lead to believe that the FDA is quite difficult to work with on this type of software.
Furthermore, wouldn't legal liability be quite high?
The regulatory issues were very difficult, and I wasn't able to figure them all out before suspending the project. There wasn't an obvious precedent. My suspicion would be that if you built it, you could find some way to make money with it, but it would take years before the world would open up enough for people to, say, use it online.
It is very hard to build software like this which is both accurate and easy to use.
I would expect that a doctor that is used to dealing with the diagnosis process directly would be the best candidate to design one of this things. Although I'm sure there are quite a few challenges ahead.
though I expect they are ignorant of the challenges ahead.
He has a BS in Engineering and CS from a pretty good University, in addition to the MD. He should have at least some idea about what he is talking about, but this might just be wishful thinking on my part.
"There is no product like this available. The technology isn't difficult, just a bunch of algorithms organized properly: cardiovascular, neurological, orthopedics, etc."
Actually, people with good qualifications and lots of funding have been working on those algorithms for more than two decades. Products have been on the market for more than two decades (e.g. http://www.lcs.mgh.harvard.edu/projects/dxplain.html, http://scienceline.org/2008/01/04/doctor’s-diagnosis-version...). Almost all of these are not ready for use. Additionally medical experience is usually quite broad: not so focused on a particular disease. Some of the biggest successes in diagnostic process come from people specializing in diagnostic processes doing computer analysis (For example, Brenden Reilly's work on heart attack diagnosis, as popularized by Malcolm Gladwell's book, Blink).
66,'Rahul Patwari,'I am not a company, but a physician who works in an urban emergency department. Every day I see the costs of inefficient health care delivery. There is a monetary costs in unnecessary tests and the time delays they cause. There is a cost to patients in that the stretched resources end up inappropriately distributed. There is a cost to physicians who are burdened with an ever growing fund of knowledge which is impossible with which it\'s impossible to keep up. This eventually leads to medical malpractice lawsuits which are a drain to our legal and medical systems. ','A small but significant step in improving all of these problems is making it easy for physicians to practice with the latest standards-of-care. My solution is to use the iPhone as a platform to deliver diagnostic and treatment plans based on the current literature. For example, imagine a patient with a stroke. The physician, using his iPhone, can determine if he meets the criteria to receive blood-clot dissolving medication, or determine if that would pose too great a risk of fatal bleeds in the brain. X-rays can be ordered according to established guidelines instead of the gestalt/gut-feeling of the physician. These rules have been shown to be very sensitive in finding fractures, yet at the same time reducing the number of unnecessary x-rays. The applications are quite broad. ','There is no product like this available. The technology isn\'t difficult, just a bunch of algorithms organized properly: cardiovascular, neurological, orthopedics, etc. Right now the information is there in the medical literature and unwieldy text books. My idea is simply to bring them together into one easy-to-use program. The iPhone is a device many physicians already carry, and if not, are looking at buying. This would be a reason to do so. What makes this device unique is that these decisions/calculations can be done bedside (with the doctor holding the iPhone). When done, it can be easily slipped back into a pocket. ','There is no product like this available. There really won\'t be competition for this product as I intend to give this away for free. There is no reason that the patient in a poorer urban hospital shouldn\'t have access to the same care that a patient coming to a richer hospital would get. If everyone can practice the same degree of quality care, I sincerely believe we can improve our delivery of health care and possibly even to more people. It will be a long while before concrete changes in health care delivery will arrive, but this may help. ','Rahul Patwari, MD. Board Certified Emergency Physician, Chicago, IL. I received my BS in Engineering, Computer Science from the University of Illinois at Urbana-Champaign. Subsequently I did my medical training at the University of Illinois at Chicago and completed my residency in Emergency Medicine at Chicago\'s Cook County Hospital. ','','','New',0,20080306165443,20080306165443);