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How web search data might help diagnose serious illness earlier
Early diagnosis is key to gaining the upper hand against a wide range of diseases. Now Microsoft researchers are suggesting that records of the topics that people search for on the Internet could one day prove as useful as an X-ray or MRI in detecting some illnesses before it’s too late.
The potential of using engagement with search engines to predict an eventual diagnosis – and possibly buy critical time for a medical response — is demonstrated in a new study by Microsoft researchers Eric Horvitz and Ryen White, along with former Microsoft intern and Columbia University doctoral candidate John Paparrizos.
In a paper published Tuesday in the Journal of Oncology Practice, the trio detailed how they used anonymized Bing search logs to identify people whose queries provided strong evidence that they had recently been diagnosed with pancreatic cancer – a particularly deadly and fast-spreading cancer that is frequently caught too late to cure. Then they retroactively analyzed searches for symptoms of the disease over many months prior to identify patterns of queries most likely to signal an eventual diagnosis.
“We find that signals about patterns of queries in search logs can predict the future appearance of queries that are highly suggestive of a diagnosis of pancreatic adenocarcinoma,” – the medical term for pancreatic cancer, the authors wrote. “We show specifically that we can identify 5 to 15 percent of cases while preserving extremely low false positive rates” of as low as 1 in 100,000.
The researchers used large-scale anonymized data and complied with best practices in ethics and privacy for the study.
image: https://mscorpmedia.azureedge.net/mscorpmedia/2016/06/eric-horvitz_350.jpg
Eric Horvitz, a technical fellow and managing director of Microsoft’s Redmond, Washington, research lab (Photography by Scott Eklund/Red Box Pictures)
Horvitz, a technical fellow and managing director of Microsoft’s research lab in Redmond, Washington, said the method shows the feasibility of a new form of screening that could ultimately allow patients and their physicans to diagnose pancreatic cancer and begin treatment weeks or months earlier than they otherwise would have. That’s an important advantage in fighting a disease with a very low survival rate if it isn’t caught early.
Pancreatic cancer — the fourth leading cause of cancer death in the United States – was in many ways the ideal subject for the study because it typically produces a series of subtle symptoms, like itchy skin, weight loss, light-colored stools, patterns of back pain and a slight yellowing of the eyes and skin that often don’t prompt a patient to seek medical attention.
Horvitz, an artificial intelligence expert who holds both a Ph.D. and an MD from Stanford University, said the researchers found that queries entered to seek answers about that set of symptoms can serve as an early warning for the onset of illness.
But Horvitz said that he and White, chief technology officer for Microsoft Health and an information retrieval expert, believe that analysis of search queries could have broad applications.
“We are excited about applying this analytical pipeline to other devastating and hard-to-detect diseases,” Horvitz said.
Horvitz and White emphasize that the research was done as a proof of concept that such a “different kind of sensor network or monitoring system” is possible. The researchers said Microsoft has no plans to develop any products linked to the discovery.
Instead, the authors said, they hope the positive results from the feasibility study will excite the broader medical community and generate discussion about how such a screening methodology might be used. They suggest that it would likely involve analyzing anonymized data and having a method for people who opt in to receive some sort of notification about health risks, either directly or through their doctors, in the event algorithms detected a pattern of search queries that could signal a health concern.
But White said the search analysis would not be a medical opinion.
“The goal is not to perform the diagnosis,” he said. “The goal is to help those at highest risk to engage with medical professionals who can actually make the true diagnosis.”
White and Horvitz said they wanted to take the results of the pancreatic cancer study directly to those in a position to do something with the results, which is why they chose to first publish in a medical journal.
“I guess I’m at a point now in my career where I’m not interested in the potential for impact,” White said of the decision. “I actually want to have impact. I would like to see the medical community pick this up and take it as a technology, and work with us to enable this type of screening.”
And Horvitz, who said he lost his best childhood friend and, soon after, a close colleague in computer science to pancreatic cancer, said the stakes are too high to delay getting the word out.
“People are being diagnosed too late,” he said. “We believe that these results frame a new approach to pre-screening or screening, but there’s work to do to go from the feasibility study to real-world fielding.”
Horvitz and White have previously teamed up on other search-related medical studies – notably a 2008 analysis of “cyberchondria” – or “medical anxiety that is stimulated by symptom searches on the web,” as Horvitz puts it – and analyses of search logs that identify adverse effects of medications.
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While vaccines save millions of lives each year and are among the most cost-effective health interventions ever developed, about 1.5 million children die each year from vaccine-preventable diseases, according to the World Health Organization. Some factors that contribute to the availability of vaccines globally include unreliable transportation systems and intermittent storage facilities, which make it difficult to preserve high-quality vaccines that require refrigeration.
But with the use of smart technologies, including the Internet of Things (IoT), healthcare and medical device companies are improving ways to keep vaccines stored and protected throughout the supply chain. One great example is the Weka Smart Fridge, which enables clinicians in the field to better manage vaccine distribution, helping them save lives.
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“Clinicians in areas of Africa and other regions where power is unstable or inaccessible can use our Smart Fridge to store and dispense vaccines. And the Fridge is small enough that you can put it in a van. So if you can’t bring the people to the vaccine, you can bring the vaccine to the people,” says Alan Lowenstein, COO of Weka Health Solutions.
The Fridge automates vaccine storage and dose dispensing to save time and enhance patient care. It includes remote monitoring services to ensure vaccines are stored at the right temperature, while automatic inventory tracing saves staff time and ensures a reliable vaccine supply. The refrigerator houses each vaccine in its own cartridge, in keeping with required storage protocol by the Centers for Disease Control and Prevention. In addition, access is limited through a small drawer on the front of the Smart Fridge to protect vaccines from temperature change.
The Vaccine Smart Fridge uses an IoT platform that collects real-time data from numerous sensors on every unit to enable 24×7 monitoring and analysis. BlueMetal, the 2016 Microsoft Internet of Things Worldwide Partner of the Year, worked with Weka to develop the IoT-enabled device that keeps vaccines fresh, secured and accounted for. The real-time visualization of vaccine inventory throughout the network enables Weka to understand the vaccination rates at every location. And by using business intelligence capabilities such as those in Azure Machine Learning, organizations can be alerted to upcoming vaccine shortages at specific clinics or in certain areas. For example, if a clinic unexpectedly runs out of a vaccine, the system can let a healthcare worker know there’s a physician’s office a few miles away that has a surplus of that type of vaccine in stock.
Controlled refrigeration and monitoring also helps reduce financial losses. “Physicians generally have $40,000 to $60,000 worth of vaccines in their refrigerators,” says Lowenstein. “If the clinic suffers a power outage or the traditional fridge fails, they risk losing the entire inventory of vaccines.” By using automated processes to manage inventory through IoT sensors, the Fridge can deliver proactive alerts on inventory shortages or changes in temperature.
In addition, Weka estimates that a medical practice that dispenses approximately 400 vaccines per month could reduce human-resource costs by more than $1,000 a month with the Fridge’s monitoring system. This system helps ensure that the first vaccines in the refrigerator are the first that come out, so patients never receive an expired or recalled vaccine, and it reduces the manual task of vaccine management by clinicians.
The Smart Fridge is a great example of how companies can accelerate digital transformation with smart solutions to increase staff efficiency and quality control and automate inventory management. Weka’s Smart Fridge is currently scheduled to go to market at the beginning of 2017.
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The Next Wave of Transformative Digital Health
By Raj Ganguly, Eduardo Saverin as written on techcrunch.com
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Digital healthcare investing has gone through several waves: 2013 was the year of consumer wearables, 2014 of healthcare big data, 2015 of virtual care delivery and 2016, so far, has been about payer disruption. 2017 will be a return to the core practice of medicine: technology that enables providers and biopharma to extend their reach and take greater risk for outcomes.
In 2016, the VC market has rewarded digital health startups that are disrupting traditional carriers. In the last 12 months, we’ve seen startups, like Bright Health (new carrier, $80 million raise in April), Clover Health (new Medicare Advantage plan, $165 million raise in May), Collective Health (TPA/ASO replacement, $80 million raise in late 2015), Hixme (migrating covered lives from large group to the individual market) and Oscar (new carrier, $400 million raise in February) raise tens to hundreds of millions of dollars in venture financing at substantial Series B and C valuations.
Why? Because payers have been an easy target.
Carriers were born in an era where fee-for-service reimbursement rewarded coverage, so they built large networks of contracted providers, leveraged economies of scale in volume and rented access to these networks to self-insured employers. That compact is fraying.
Providers are taking risk and competing upstream (with the help of companies like Evolent Health), employers are building their own narrow networks to steer volume to high-quality/low-cost centers of excellence (with the help of companies like Imagine Health) and medical loss ratios (which dictate the percentage of carrier premium revenues that need to be spent on clinical services) are squeezing carrier margins.
Large carriers have responded by consolidating, seeking even more scale. However, survival through size has its limits. The DOJ has drawn the line at Anthem’s $54 million bid for Cigna and Aetna’s $37 billion bid for Humana on antitrust grounds.
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The payer disruption story has played out
Our view is the business of insuring lives at scale is labor and capital-intensive. There is substantial operational complexity required to contract with 5,600 hospitals and 800,000 physicians in the U.S., issue membership cards, verify eligibility, process claims and engage consumers when they call. It’s hard to achieve venture level returns at Series B and C valuations approaching $1 billion.
Healthcare innovation is the solution to rising costs and limited access.
We’ve seen this story before: Investors putting tens of millions to work into Fitbit and Jawbone in 2013, chasing the consumer wearables story. Similarly, 2014 was the year of using healthcare big data in vertical applications like price transparency, which resulted in Castlight’s controversial IPO. 2015 was all about telehealth — Doctor on Demand raising $63 million, MDLive raising $50 million and Teladoc raising $157 million in their IPO, all announced during an eight-week window last summer. Later-stage investors in many of those instances have not been able to generate returns at exit.
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So what’s next? The funding market is returning to enabling the core practice of medicine
Our view is that in 2017, the market will reward innovative startups that are in the business of enabling providers and pharma companies to personalize care and participate in greater outcomes-based economics.
Several tailwinds are contributing to this. In the provider world, regulation with esoteric names like “Meaningful Use 1 and Meaningful Use 2” are largely behind us and providers will have more bandwidth to move on from EMR integration (plumbing) to the use of technology for expanding care (tools). Concurrently, advances in the fields of genomics and compound specialty pharmacy are enabling new ways for biopharma companies to personalize therapeutic delivery down to an individual patient, which is a building block for outcomes-based drug reimbursement.
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Prediction
VC investment into digital health will flow to startups in the business of provider and pharma enablement. It will start to happen in the back half of 2016.
Silicon Valley Bank predicts that $9-$9.5 billion will be invested in healthcare in 2016. MobiHealthNews recently reported that digital health companies raised $150 million in July 2016 alone. In the last month, Azalea Health raised a $10.5 million Series B to sell revenue cycle management software and mobile tools to providers. Akili Interactive raised a $11.9 million Series B to develop clinically validated video games for cognitive interventions. Caremerge, which markets a care coordination platform for assisted living facilities, raised a $14 million Series C. Docent Health raised a $17 million Series A to build patient engagement software for health systems.
Healthcare innovation is the solution to rising costs and limited access. We think of healthcare as a global economy, not just an industry — it is a $3 trillion market approaching 20 percent of GDP in the U.S. alone. Access to affordable, effective care is a universal challenge felt in both developed and developing markets. To the entrepreneurs out there — we look forward to funding the next wave of transformative digital health companies that enable greater access to quality, outcomes-based care.
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Skype for Business Extends the Healthcare Experience
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Improve population health with virtual care
Improve care team productivity and expertise, reduce medical errors, and increase real-time care team communications with Skype for Business. Promote provider education to stay current with advancements in medicine and meet continuing medical education requirements. Microsoft has developed solutions to eliminate communication silos to accelerate decision-making.
Manage healthcare provider shortages
For more information call 858-429-3000
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Skype for Business from Managed Solution
Microsoft's Skype for Business can improve team communication and performance by extending access and reach of services to more patients across all demographics and geographies. With Skype for Business, Healthcare Facilities can improve population health by virtually caring for and engaging patients in the context of their digital lifestyles and work styles, reduce travel time and distance between affiliated organizations, manage aging population and complex case-mix patients plus much more.
Benefits of using Skype for Business
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Enterprise-Class meeting recording. Scalable to meet your growing organization’s capacity needs while being highly redundant, secure and economical.
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Scheduled or on demand. Recording can be initiated both as part of the meeting scheduling process or on demand with simple controls easily accessible within the Skype for Business, Lync or other virtual meeting vendors’ interfaces.
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Managed content. Users have access to manage their recordings, allowing them to trim, edit thumbnails, and share them easily right from within the communications tool.
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Integrated with your corporate security framework. This minimizes administration and provides the flexibility to meet your multi-level access control needs.
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Automatic metadata capture. Highly customizable metadata capture for enhanced search/retrieval as well as audit/compliance of meeting recordings.
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Automated workflows. Can be created for specific types of meeting recordings with automated disclaimers, mandatory approvals, and security.
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Easily share meeting content. Can be shared via collaboration platforms, email, websites and social tools while maintaining security.
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Aiming to Deliver New Drugs Faster at Less Cost in the Cloud
Researchers from Molplex, a small drug discovery company; Newcastle University; and Microsoft Research Connections are working together to help scientists around the world deliver new medicines more quickly and at lower cost. This partnership has helped Molplex develop Clouds Against Disease, an offering of high-quality drug discovery services based on a new molecular discovery platform that draws its power from cloud computing with Windows Azure.
Rethinking Drug Discovery
David Leahy, co-founder and chief executive officer of Molplex, envisions a way to help pharmaceutical researchers anywhere in the world form effective drug discovery teams without large investments in technology or fixed running costs. "It takes massive computing resources to search through chemical and biological databases looking for new drug candidates. Our Clouds Against Disease solution dramatically reduces the time and cost of doing that by providing computation and chemical analysis services on demand," Leahy says.
Molplex regards drug discovery as a big data and search optimization problem. Clouds Against Disease uses its computational molecular discovery platform to automate decision making that is traditionally the scientists’ task.
"Instead of having teams of scientists scanning chemical information, our software searches for structures that have multiple properties matching the search criteria," explains Leahy. "When we integrate that with highly automated chemical synthesis and screening, it becomes a much more efficient and productive way of doing drug discovery."
Data Manipulation on a Larger Scale
In a recent pre-clinical study, the company applied its computational platform to more than 10,000 chemical structure and biological activity data sets. This action generated 750,000 predictive relationships between chemical structure and biological effect. After generating numerous possible outcomes, Molplex then used the same validation criteria that scientists would use to narrow down the 750,000 relationships to just 23,000 models covering 1,000 biological and physico-chemical properties, a relatively small data set that humans could then manage. "It would have taken hundreds of scientists several years to do this the conventional way," Leahy
Windows Azure was critical to the success of Clouds Against Disease. Molplex can access 100 or more Windows Azure nodes—in effect, virtual servers—to process data rapidly. The physical-world alternative would be to source, purchase, provision, and then manage 100 physical servers, which represents a significant investment in up-front costs. Before they could begin drug research, scientists taking this traditional approach would have to raise millions of dollars, but Windows Azure helps eliminate start-up costs by allowing new companies to pay for only what they use in computing resources.
Vladimir J. Sykora, co-founder and chief operating officer for Molplex, explains that the Molplex computational platform runs algorithms his company developed to calculate the numerical properties of molecules rapidly. Consequently, Molplex has been able to produce drug discovery results on a much larger scale than what was previously feasible. "We would not have been able to predict so many compounds without the cloud computing resources enabled by Windows Azure," asserts Sykora. "The speed and high level of detail provided by Windows Azure allow us to explore far beyond what would have been possible with traditional hardware resources."
Fighting Tropical Diseases
Molplex is embarking on a new collaboration with the Malaysian government to search for drugs that fight tropical diseases. This search has always been a lower priority for drug companies because the market is smaller, making it a less desirable commercial prospect. The traditional drug discovery program is geared to $1 billion a year blockbuster drugs; however, there are fewer opportunities today for drugs with that level of commercial potential.
Increasingly, scientists are researching tropical diseases that affect smaller populations; radically reducing the cost of drug discovery makes it feasible for scientists to tackle them. "Unlocking drug discovery technology from a physical location with the cloud has tremendous potential to help researchers work on curing these diseases faster and at less cost," asserts Leahy, "wherever they are in the world."
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Healthcare compliance, security, and trusted health technology
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Integrate and simplify your healthcare compliance
Security and healthcare compliance offerings from Microsoft help protect your ICT infrastructure. Protection, access , and management features help you manage risk and achieve your strategic goals. The cloud is a far more powerful, far less expensive way to innovate than health solutions built the traditional way. But health organizations need to trust that sensitive information will stay secure and comply with regulations when they adopt cloud platforms. We are committed to ensuring that your data stays secure, private, and under your control, and that with the Microsoft Cloud, you will stay compliant, even as regulations and standards evolve.
Deliver security-enhanced access from virtually anywhere
For more information call 858-429-3000
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Healthcare Mobility Solutions from Managed Solution
The Microsoft family of devices, services, and solutions can help transform the way care teams communicate and access and use information throughout the course of their day. Windows-based, clinical-grade devices help to enable virtually anywhere access to actionable intelligence, resources, and personalized experiences that improve user productivity. With these enterprise-grade solutions that help keep patient information secure and compliant, users can leverage any single clinical-grade device to tap into comprehensive information systems while enjoying the ease of use associated with advanced technology. By providing efficient access to patient health information to both care teams and patients, all involved parties have the information they need to make informed decisions and to follow through on the prescribed care regimen.
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Integrate and extend security features across your organization
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Built-in security features work across multiple platforms and environments, and integration across the layers helps you get more value from your existing investments
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Manage healthcare compliance, simplify the security experience
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Help simplify the deployment and delivery of security features aligned to the needs of health professionals and patients so health professionals and patients can quickly and easily access security-enhanced applications and information
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Accelerate the planning and delivery of health solutions
The Microsoft Connected Health Platform (CHP) provides a collection of best practices and guidelines to help build e-health solutions that are efficient, security-enhanced, flexible, and scalable. All of these features build a platform that helps improve patient engagement.
Based on the extensible and agile principles of the Connected Health Framework (CHF), Microsoft CHP provides offerings for optimizing health information and communication technology, including prescriptive architecture, design, and deployment guidance; tools; and solution accelerators. Microsoft CHP is built primarily on a foundation of application platform technologies and services, as well as generic Microsoft infrastructure optimization models and tools, tailored for the health environment, enabling the delivery and management of on-premises, cloud, or hybrid solutions.
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Designing secure health solutions with Azure
Receive guidance and considerations you need to make regarding the secure use and implementation of Azure cloud technology
Since its launch in 2010, Microsoft Azure has gained rapid adoption from organizations of all sizes around the world, spanning many industries. The users of Azure benefit from agility, reduced costs and complexity, limitless scale, and innovation made possible by cloud computing.
For organizations in regulated industries, such as healthcare, where laws regulate protected health information (PHI), the need to understand how cloud adoption affects their privacy, security, and regulatory compliance posture is paramount. These organizations should seek deeper understanding and guidance in solution design and cloud deployment operations.
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FaST-LMM and Windows Azure Accelerate Genetics Research
Today, researchers can collect, store, and analyze tremendous volumes of data; however, technological and storage limitations can severely impede the speed at which they can analyze these data. A new algorithm that was developed by Microsoft Research, called FaST-LMM (Factored Spectrally Transformed Linear Mixed Models), runs on Windows Azure in the cloud and expedites analysis time—reducing processing periods from years to just days or hours. An early application of FaST-LMM and Windows Azure helps researchers analyze data for the genetic causes of common diseases.
Searching for DNA Clues to Disease
The Wellcome Trust in Cambridge, England, is researching the genetic causes of seven diseases—including hypertension, rheumatoid arthritis, and diabetes. The project involves searching for combinations of genomic information to gain insight into an individual’s likelihood to develop one of these diseases. With a database containing genetic information from 2,000 people and a shared set of approximately 13,000 controls for each of the seven diseases, they needed both massive storage and powerful computation capacity.
They are storing their vast database of genetic information in the Windows Azure cloud, instead of traditional hardware storage, which represents a profound shift in how big data are stored. ”We are taking on the challenge of taking what would be traditional high-performance computing, one of the hardest workloads to move to the cloud, and moving to the cloud,” observes Jeff Baxter, development lead in the Windows HPC team at Microsoft. “There’s a variety of both technical and business challenges, which makes it exciting and interesting.”
Exploring the Power of the Cloud
Resource management is one of the primary issues associated with big data: not only determining how many resources are required for the project, but also identifying the right type of resources—within the available budget. For example, running a large project on fewer machines might save on hardware costs but result in substantial project delays. Researchers must find a balance that will keep their project on track while working with available resources.
The FaST-LMM algorithm can analyze enormous datasets in less time than existing alternatives. Microsoft Research also has the infrastructure that is required to perform the computations, explains David Heckerman, distinguished scientist at Microsoft Research. With more CPUs dedicated to a job, computations that would ordinarily take years to finish can be completed in just hours.
For the Wellcome Trust project, the team’s available resources included a combination of Windows HPC Server, Windows Azure, and the FaST-LMM algorithm. The team knew that they had a powerful set of technologies. The question was, could it achieve the results required in the desired timeline?
“For this project, we would need to do about 125 compute years of work. We wanted to get that work done in about three days,” explains Baxter. By running FaST-LMM on Windows Azure, the team had access to tens of thousands of computer cores and an improved algorithm that was able to expedite the work. “You’re still doing hundreds of compute years of work,” he explains, “but with these resources, we can actually do hundreds of compute years in a couple of days.”
While the results were impressive, there was something that had an even bigger impact. “The most impressive thing was how quickly we could take this project from inception to actually completing it and generating new science,” Baxter notes. “This is stuff that, without both the improvements in the algorithms that the Microsoft Research guys had come up with and the ability for us to provide the tens to hundreds of thousands of cores, would have been infeasible.”
The Future for Big Data Research
The Wellcome Trust project is just the beginning of what could be a major shift in how research databases are stored and analyzed. “With this new, huge amount of data that’s coming online, we’re now able to find connections between our DNA and who we are that we could never find before,” Heckerman says. The ability to analyze that data more quickly, and with greater depth, could help scientists make faster breakthroughs in genetic research—and breakthroughs in critical genetic research. The FaST-LMM algorithm running on Windows Azure is helping to accelerate just such breakthroughs.
