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Written By

Jim VanderMey

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September 17, 2018

Healthcare and AI: Systems of Scalable Empathy

Eddie Guy - Scalable Empathy

Image Credit: WSJ & Eddie Guy

Last Thursday, I had the opportunity to participate in a panel discussion on advanced technologies (AI and Blockchain) at the Healthcare Executive Group (HCEG) event in Minneapolis.  Alan Abramson, SVP and CIO of HealthPartners was leading the panel.  As I was listening to the speakers in the morning and thinking through my remarks for the panel, a phrase came to mind that I believe captures the best hopes of AI in healthcare: Systems of Scalable Empathy.

We have learned from decades of system thinking that the value of software is in scalability.  We have learned from design thinking that we have to put people and their behaviors at the center for successful product development. By combining these human considerations and systems of insight we can create Systems of Scalable Empathy.

As I was thinking about systems that promote this concept, I read the Saturday Essay in the WSJ by Dr. Kai-Fu Lee titled The Human Promise of the AI Revolution:

While AI is great at optimizing for a highly narrow objective, it is unable to choose its own goals or to think creatively. And while AI is superhuman in the coldblooded world of numbers and data, it lacks social skills or empathy—the ability to make another person feel understood and cared for. Analogously, in the world of robotics, AI is able to handle many crude tasks like stocking goods or driving cars, but it lacks the delicate dexterity needed to care for an elderly person or infant.

It’s true. Empathy and AI are an odd juxtaposition.  The use of machines in the very human domain of healthcare would seem to be dehumanizing.  In Automating Inequality, Virginia Eubanks argues that the use of systems that incorporate mathematical models can be used to instantiate broad social biases.  Her book very powerfully articulates the harm that these systems are capable of, specifically when autonomy is removed from the individuals in the system (like a caseworker) or the system’s customer or client.  When these simple statistical regression models are then described as AI or ML (Machine Learning), the system takes on a higher level of perceived authority.

I believe that we can use well-designed AI/ML models to create unbiased systems that support human intuition.  By using models that support tailored responses to sensitive issues like discharge planning, chronic disease management, case management and inpatient adverse events, we can gain foresight into the near-term future for our patients and consumers. As a result, our capable and talented clinicians can leverage those responses or recommendations to provide care that intercepts the negative outcome before it happens. In this way, we elevate the individual and provide for more personalized care at greater scale.

The story of Ochsner Health decreasing inpatient ICU admissions with Epic and Microsoft is a great example of combining the best capability of machine learning and modeling with the bedside care of the clinical staff. Through Machine Learning, they were able to accurately predict patient deterioration hours before an adverse event. This early warning system was tightly integrated into Epic, enabling Ochsner’s Rapid Response team to intervene on patients proactively, rather than reactively. During their 90-day pilot at Ochsner Medical Center, the team successfully reduced codes outside of the ICU by 44%.

It is critical to maintain the autonomy of the person, otherwise they feel like they are simply a cog in dehumanizing machine. So how do we start creating Systems of Scalable Empathy? By giving smart people insights from the data we have at scale and coupling that with our creative imaginations, we create the space to make meaningful investments in people that make a difference. 

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About the Author

Jim VanderMey is the Chief Innovation Officer for OST. Jim has provided the technical leadership and product strategic planning for the organization since the very beginning. Jim is a technology visionary who sets the long and short-term direction for OST. He specializes in seeing the “big picture” of technology, the computer industry, and the business objectives supported by IT. As OST has gained an international reputation, Jim has taught and spoken at conferences in Europe, Japan, and throughout North America.

Jim attended the Grand Rapids School of Bible and Music as a pastoral ministries major, and went on to manage significant scale applications and infrastructures in the healthcare, manufacturing, and insurance industries. He has served as a consultant to many large organizations such as Herman Miller, Boeing, Priority Health, Magna-Donnelly Corporation, Hewlett Packard, Amway, Meijer, Komatsu, Mercedes, Navistar (International Truck), Flextronics, the US Navy and many hospital systems including Spectrum Health, Bronson Hospital, and HealthEast.

Jim has senior level data center skills in performance analysis and systems architecture, enterprise UNIX, reliability engineering, SAN design and implementation. He is a voracious learner and has held many technical certifications ranging from UNIX and Cisco administration through cloud architecture and design. As OST has grown and diversified, Jim has engaged with clients on product strategy, IT transformation, cloud enablement, CIO-level organizational change management, DevOps and IoT program leadership. Creating value by connecting the Data Center disciplines of the past to the Design-centric disciplines to help businesses leverage technology more effectively is a place of special focus for Jim in his recent engagements.

Jim has been heavily involved in OST’s healthcare initiatives where he has leveraged his decades of experience in healthcare, enterprise applications and systems architecture to design high performance infrastructures for the Epic EHR application and the client systems such as VDI for the access tier. He has also been directly engaged with the OST analytics team on assisting customers in the adoption of analytics to create substantial value and new revenue opportunities leveraging Big Data. In this space the combination of architecture, data visualization and design can be used to develop important new actionable insights.

Jim sits on the advisory board for the computer science/IS departments of Calvin College and Grand Valley State University Computer Science. He is an avid reader of all types of non-fiction and literature and most mornings can be found paddling a kayak, canoe or SUP before work. On the weekends, family and serving with his wife Ann at their church is a major focus.

Lastly, we must confess that some of OST’s peculiar culture is a direct derivation of Jim’s unorthodox style.