Category: Innovation

What if AI helped students learn, not just do (harvard.edu)

This is the beginning of the beginning. Teachers are starting to create generative AI that helps students learn, and NOT do the actual assignment. Imagine a chatbot where a student can ask questions outside of the classroom to understand concepts or ask it to critique initial writing. I like this very much. There is something here for medical residents and medical students, and indeed even practicing physicians. Tweaking the relationship between the AI assistant and the human is our hard work to come.

What if AI could help students learn, not just do assignments for them?

UCHealth Parkview reduces sepsis deaths (Beckers)

The story continues. Our EHR, partnered with Epic predictive AI model among other predictive tools have reduced sepsis mortality by 1000 fewer deaths per year compared to our baseline, as we find and treat sepsis earlier with reconfigured teamwork in addition to improved detection tools. Another tale of the Psycho-80: 80% of a project’s success is about the psycho-socio-political skills of the people and 20% of the success is due to technology. Grateful for smart colleagues and partners. (image, our fearless informatics leaders, analysts and trainers having a well-deserved meal after another EHR implementation day)

https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/how-uchealth-uses-its-ehr-to-reduce-sepsis-deaths/

Passwords are so last year. Passkeys! (Wired.com)

I have joined the passkey (quiet) revolution. Far superior even to long passwords, and better and faster than 2 factor and multifactor authentication. I’m all for faster and easier security for my accounts.

https://www.wired.com/story/what-is-a-passkey-and-how-to-use-them/

UCHealth Biobank breaks new ground in personalized genomic medicine (news)

Our smart colleagues at UCHealth Biobank delivered the 1 millionth pharmacogenomic result into our Epic EHR. In separate news, the Biobank also delivered our 1000th pathogenic variant (like BRCA).

Congratulations to the UCHealth Biobank team including Drs. Christine Aquilante and David Kao. See the linked articles:

Your drugs and your genes may not play nicely together. A UCHealth project aims to find out in advance.

https://www.uchealth.org/newsroom/biobank-at-the-colorado-center-for-personalized-medicine-uncovers-1-million-genetic-insights-to-improve-patient-care/

https://www.sciencedirect.com/science/article/pii/S2949774424009981

Our Biobank, in parallel work streams have

  1. Delivered their 1 millionth pharmacogenomic result based on Biobank testing of patients blood or saliva to detect drug-gene interactions to warn prescribers in our system to avoid drugs that may not play well with individual patient’s genetics. We believe we are now have the largest genome bank delivering these results for clinical care.
  2. Delivered over 1000 pathogenic variants (genomic risks like BRCA mutations for breast cancer and the like) so that patients can be aware and take preventive or screening actions.

The investments in this infrastructure began in 2014. Even though it seems like an “overnight success” this was more than 11 years in the making, yet another reason that long term, basic-science approaches should be part of our strategic scientific funding. These transformative technologies come out of years of blood, sweat and tears (pun intended) on behalf of our researchers and technologists and with the contribution of dozens of thousands of patients.

Congratulations to our hardworking, groundbreaking colleagues.

UCHealth joins the Epic COSMOS family. Datathon! Ukulele Parody!

This past week, we hosted our Epic Wisconsin colleagues for an immersion trip on Slicer Dicer and COSMOS, as our researchers, data scientists and faculty dove deeply into Slicer Dicer and the finer points of exploring the deidentified Cosmos database of over 300 million patients. We can’t wait to join the growing list of scientists drawing new lessons from a global repository of clinical care experience.

Scenes from our Cosmos Datathon

In a few short hours after learning the tools, our researchers were asking innovative questions and cranking out quick-win first draft answers that can easily expand into full fledged investigations.

So cool.

I am grateful to smart collaborators:

  • Brian Montague, system physician informaticist at UCHealth for planning and hosting this Cosmos Datathon, where over 60 faculty and scientists came to learn about and explore the Cosmos database and tools.
  • Our Epic Wisconsin colleagues who came for an immersion visit to round with our Transplant and other clinical teams
  • Our UCHealth Epic IT and operational teams for working to install the hooks necessary to contribute to and draw knowledge from Cosmos.
  • Our scientist colleagues who came to learn, practice and grow skills at exploring this data
  • Epic Systems for dreaming up and constructing a de-identified repository where we can safely and securely ask big questions, test our theories, and push forward the boundaries of knowledge of human illness and wellness.

And I am grateful to the Beatles for the original Helter Skelter. A boy band out of Liverpool, who blew apart convention to invent the heavy metal genre.

I like to think this blog is a heavy metal breakthrough as well! (jk)

When Fires Rage, Millions Turn to Watch Duty (wired.com). I think it is the next wikipedia-like crowd-sourced success

Crowd-sourcing when those in charge of disasters do not build the infrastructure to inform the public. The creator of Watch Duty describes how he came to build it.

https://www.wired.com/story/watch-duty-john-mills/

I love a good data story.

Like many of you, I downloaded Watch Duty during the LA fires, as my folks were near the Eaton Fire as it flamed this past month. It was so helpful to LA residents near the fire, and to all of us who care for those residents.

The power of internet computing and the existence of those with skill from any industry, distributed globally, means that anyone (or any team) with the right skill set, the right interest, the ability to build relationships, can create a world-changing tool that becomes instantly useful.

Now Watch Duty is used in 22 states and growing, and the creator is considering adding other natural disasters to the free app. Incredible.

Read the WIRED story and be transfixed. Heroes still exist in our world.

Light-Based Chips Could Slake AI’s Thirst (Wired.com)

Light based chips use photons instead of electrons to transmit zero’s and one’s. This is faster and uses much less power. However, our tools for switching and processing are decades more advanced when based on electrons. Do photons have a chance?

https://www.wired.com/story/ai-needs-enormous-computing-power-could-light-based-chips-help/

Wired writes about innovative tech to move from electronic chips (like market-leader’s Nvidia chips that power AI computing) to light-based chips. With a 10-year runway of development, there is a potential for 1000x increased computing efficiency and reduced power demands using light to transmit data instead of electrons.

This feels a lot like the potential transformation that might come from quantum computing. The people and companies innovating in this space need huge amounts of investment, people, resources to figure out the dead-ends and solutions to as-yet impossible problems.

At the beginning of all these ideas, they all look promising.

Good luck! Of course, 10 years from now, hind-sight will be 20:20. “Oh, of course, these particular projects were successful and the others were just stupid ideas.”

 

Go Slow to Go Fast, or Human Autonomy vs Bot Autonomy

University of Colorado’s General Internal Medicine leaders have decided to block one appointment per half day clinic for all physicians and APP’s. Find out what happened!

Illustration via Microsoft Bing – Copilot

Thanks to Drs. Robert Doolan and Mark Earnest for developing and studying this idea.

THE CRISIS: Physicians and APP’s in general internal medicine primary care clinics are overburdened and leaving medical practice. How might we make a creative leap to reduce burnout with minimal impact to finances?

THE IDEA: Give the clinicians back some autonomy. Protect one appointment slot per half-day (or 2 slots in a full day) of clinic. That time slot is 100% controlled by the clinician. It could be used for:

  • Working on inbasket messages (incoming patient advice requests from the patient portal; replying to telephone messages recorded by triage nurses; reviewing and/or delivering test results to patients; handling prescription requests; responding to messages from other colleagues)
  • Scheduling patients at their own discretion, for example urgent requests from patients; patients being discharged from hospital
  • Catching up on work (prescriptions, orders, notes) from earlier in the day
  • Doing a team huddle to distribute patient care duties for each half-day

What would happen? Would the clinic lose clinical income by reducing appointment slots? Would patients be unhappy?

Our clinic leaders gave it a shot.

How did it go? Reviewing the appointment data for completed visits and for RVU’s (relative value units: a measure of clinic productivity of seeing patients) and for clinician satisfaction:

The results: pretty incredible.

An 81% reduction in burnout symptoms, and a 53% reduction in “intent to leave or cut back clinical time.” At the same time, minimal change in clinical productivity and minimal incremental cost per clinician AND totally worth reducing the $750,000 cost to replace one primary care provider.

Some clinicians used this time to tackle the large volume of inbox messages.  Others used the time to complete forms for patients. I often used it to squeeze patients in after a hospital discharge, since in my full practice it may take several weeks to see me otherwise. The feeling of being able to flex my own time was surprisingly empowering.

Human autonomy, it turns out, is a big deal in our burnout equation. Instead of pushing for more AI Bots to take over human actions (yes, this is coming), increasing human autonomy can be surprisingly beneficial.

References by Drs. Doolan and Earnest:

Doolan R, Drake L, Fraumeni B, Schilling L, Earnest M. Right Sizing the Primary Care Template to Meet Modern Demands. Oral presentation at the Society for General Internal Medicine Annual Meeting; May 15-18, 2024; Boston, MA.

Fraumeni B, Drake L, Doolan R, Earnest M, Weir G, Schilling L. Humanity in primary care: provider perspectives on dedicated asynchronous work time. Poster presented at the Society for General Internal Medicine Annual Meeting; May 15-18, 2024; Boston, MA.

Making Comprehensive Primary Care Sustainable for the Digital Age
Poster – American Conference on Physician Health. 2023

CMIO’s take: Who else is doing this? As a participant in this study, and a beneficiary of the scheduling and cultural shift in our clinics, I totally love it. Thanks to Drs. Doolan and Earnest for this visionary adaptation.

Most Wired Level 10: Thought Leader Round Table at CHIME Fall Forum

A Thought Leader Round Table at CHIME by Most Wired Level 10 leaders, on AI and many other topics in informatics and healthcare IT.

Picture credit: CHIME CENTRAL

Thank you to my smart colleagues at CHIME and at other Most Wired Level 10 healthcare organizations for peering into the crystal ball to see where the next year’s breakthroughs are going. Our Round Table had some luminaries discussing their priorities and peering into the future. See the link for the transcript.

https://chimecentral.org/content/tlrt-digging-deeper-reaching-farther-with-healthcare-technology#gsc.tab=0

 

The Genius Behind @OKWildlifeDept’s Most Viral Tweets Is Signing Off (wired.com)

There are ways of making science and government cool. “Southerland announced that she’d made her final post. It was about not feeding doughnuts to wildlife. ‘For the past four years, it’s been my job—nay, my PLEASURE—to be the tweeter behind the @OKWildlifeDept account,’ she wrote. ‘It’s been my absolute honor to roast and ratio some of you into the ground in the name of science.'” I had to look up “ratio” on urbandictionary. 🙁

I love this person. Brilliant.

https://www.wired.com/story/oklahoma-department-wildlife-conservation-social-media-legacy

During the pandemic, a new voice on twitter and later on tiktok took up the standard Oklahoma Wildlife twitter account and made it cool. Here’s the backstory on the person behind the account.

We could use such a person in medical informatics. Just sayin’.