Health Datapalooza IV: June 3rd-4th, 2013 The State of the Art: Enterprise Data Use at the Point of Care Moderator: Janet Marchibroda, Director, Health Innovation Initiative, Bipartisan Policy Center The new delivery models have made it clear- they need health information technology (IT) and data in order to succeed in providing high value health care. Many decision-makers and clinical staff are overwhelmed by or are looking for the evidence to support using the increasing amount and divergent types of data that can be leveraged at the enterprise level and point of care. Patient-generated data, open data streams, cost and quality information – how will it fit into the clinical workflow, and does it make a difference in operations and clinical outcomes? Join us for demos and a discussion of the state of the art. Panel A (3:30-4:15pm): Enterprise-Level Data Analytics Speakers: Jack Challis, Chief Executive Officer & Co-Founder, CliniCast Allen Kamer, Vice President Corporate Development and Marketing, Humedica Jonathan Porter, Vice President Product Strategy, athenahealth Eric Page, Chief Executive Officer, Amplify Health Graham Gardner, Chief Executive Officer, Kyru.us Panel B (4:15-5:00 pm): Data at the Point of Care Speakers: Jason Bhan, Executive Vice President & Co-founder, Medivo Madhu Nutakki, Vice President of Digital Presence Technologies, Kaiser Permanente Noah Craft, Chief Medical Officer, VisualDx Michael Long, Chief Executive Officer, Lumeris Omri Gottesman, CLIPMERGE, Mount Sinai School of Medicine These sessions are eligible for continuing education credit.

1. Health Datapalooza IV—Data at the Point of Care
Created by: Noah Craft, MD  Version: 6/2011
VisualDx
Diagnostic decision
support:
-- helping doctors think
-- engaging patients
Noah Craft, MD, PhD, DTMH
Chief Medical Officer, Logical Images
Clinical Associate Professor of Medicine
UCLA-Olive View Medical Center

2. A 27 year old women develops a fever and red skin lesions and
feels quite sick. She is taken to the emergency room.

3. The clinician’s problem:
What could this be? What does she have? What
should I do?

4. With their unaided mind, can a
doctor ….
Know all of the medical and scientific literature?
Know every detail about every patient?
Sort through it all?
Make an accurate diagnosis in 15 minutes?

5. How big is the problem?
• 10-30% of all diagnoses are in error
• 80,000-160,000 deaths per year
• Doctors are overconfident and don’t have enough time
• Most parts of the system are not incentivized for
accuracy
• Both patients and clinicians have limited access to
structured data or knowledge for diagnosis.
How can we improve things?

6. Tools to help the clinician extend
-- the hands, ears, and eyes…..

7. What about extending this?

8. Diagnostic Clinical Decision Support
100 Years Ago

9. Search for scabies….

10. Remedies for scabies….onions???

11. And what happens when you search for Anthrax?

12. Case 1
35 year old South Korean professor.
Weight loss over 3 weeks, night sweats
Coughing up blood, febrile
Exam:
Ill appearing.
Temp 38.3 (101) other vitals normal
Enlarged anterior cervical nodes
Dullness and rales in right upper lung
Pustules and nodules on arm and neck as in photos
Pathology shown
Oh, and he also traveled through Thailand,
Mexico, and Southern California recently.

13. Why is VisualDx successful?
How can we help people recognize thousands of medical
conditions, each with multiple symptoms and visual
clues?
•Own the world’s best medical images
•Develop a standards based medical terminology
•Build a comprehensive structured medical knowledge database
•Hire a team of experts and distill their experience
•Merge images, terminology, database
•Design a visually-based intuitive search process and UI
•Deliver meaningful answers in seconds to the point of care….
•Do all of this, but make the doctor’s life easier and save time.
…AND use this structured knowledge database to
transform medicine moving forward…

14. Premise of Clinical Decision
Support

15. VisualDx Stats – market success
•Licensed by more than half of all medical schools
-- Includes Harvard, Yale, Cornell, UPenn, UCLA, UW,
others…
-- Top 5 favorite app by Harvard (2008, 2011) and UPenn
(2013)
•Licensed by more than 20% of EDs nationally
•Licensed by the entire VA nationwide, and 6 entire states
•Partnered and integrated with UpToDate
•KLAS Best in Class 2011, 2012
•Integrates with most EMRs
•98% renewal rate

16. VisualDx Stats – under the hood
•Image collection built from more than 2 million images
•100,000+ images with metadata in database
•~27,000 images in the active VisualDx product
•~1300 Dx and growing
•~40,000 Dx to finding relationships
•~5,000 Rx to Dx relationships
•~125 editors internationally and 30 employees
•~ 50% of traffic is through mobile
•Expanding to cover all diagnoses and findings in medicine, all
things visual in medicine, and all drug reactions.
•As the structured knowledge database grows, inclusion of
genomics risk factors, feedback loops, patient input, etc.

17. VisualDx in Action

18. Problem Oriented Search

19. Not an algorithm -- multiaxial search

20. Enter a lesion type

21. Visually based Differential Dx

22. Refine your search -- patterns

23. Refined Differential Dx

24. Add a medical history risk factor

25. Patient-contextualized DDx in
seconds

26. Search by disease

27. Choose Disease: Psoriasis

28. Change Patient Context: Dark
Skin

29. Change Affected Area: nails

30. Search by problems in the eye

31. Search by x-ray findings

32. View variations in presentation

33. Search by mucosal problems

34. VisualDx – suspected drug
reaction

35. VisualDx – suspected drug
reaction

36. VisualDx – Dual Use for CBRN
suspicion

37. Case 2 – sick kid, worried mom

38. VisualDx – in your pocket

39. VisualDx – complex decision
support

40. VisualDx – improved diagnostic accuracy

41. VisualDx - data at the point of care

42. VisualDx – patient engagement

43. VisualDx – saves time

44. VisualDx – builds patient trust

45. Thank you
Contact:
Noah Craft, MD, PhD
ncraft@logicalimages.com
www.visualdx.com