SiiM 2019 | Google in the Hot Seat | Robo-Glove

“ . . . not only is this the most significant health care data breach case in our nation’s history, but it is the most egregious given our allegations that the data was voluntarily handed over.”

Attorney, Jay Edelson, on his firm’s lawsuit against Google and the University of Chicago for sharing hundreds of thousands of patient records with un-anonymized date stamps.

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Google in the AI Hot Seat

Google’s found itself in a different kind of privacy violation hot seat last week, after the tech giant and the University of Chicago Medical Center were sued for allegedly sharing hundreds of thousands of patient records that still had identifiable information. The potential class-action lawsuit could have ramifications across healthcare AI, given the vital role of patient data and the personal information already available to emerging healthcare tech leaders like Google. Here are the key takeaways:

  • The Allegation – The lawsuit claims that although most of the shared EHR data was anonymized, patient check-in and check-out time stamps were unchanged. This could be seen as a HIPAA violation on its own, but Google’s access to personal location data (via Android, Google Maps, Waze, etc.) and the potential to combine time and location as a way to identify actual patients makes this a bigger deal.
  • Do No Evil – Both Google and the University of Chicago Medical Center asserted their focus on patient privacy and HIPAA compliance, while emphasizing the partnership’s lifesaving motivations.
  • Not Google’s First – Google’s was previously accused of violating patient privacy in 2016 following its DeepMind subsidiary’s partnership with the UK NHS. Google also has similar partnerships in place with Stanford and UCSF, so we’ll see if this is Google’s last.
  • Ramifications – Google’s access to personal data and its historical focus on using personal data for commercial purposes makes this much more than a standard anonymization story. The reality is, Google and other major tech companies who have an eye on healthcare will face increased scrutiny, especially while it remains unclear whether their medical aspirations might include monetizing healthcare data in addition to improving care.


Here’s a dream story for the medical futurists out there. UK physicians and telecommunication leaders demonstrated a new 5G-powered “Robo-Glove” that could help guide paramedics’ ultrasound diagnosis, allowing them to administer treatment faster and provide more patient details to emergency physicians before arrival. Here’s how it works:

  • Paramedics would wear the haptic Robo-Glove while performing ultrasound scans.
  • Ultrasound scanning data and live video captured within the ambulance is sent over a 5G network to hospital-based clinicians.
  • While viewing the data and video, clinicians use a joystick to send small vibrations to the paramedics’ gloved hand, directing them to where the ultrasound sensor should be moved.

Although some may point out challenges to this glove and joystick approach, this is arguably more of a 5G story than a healthcare story, as it was announced through UK telecom company BT and used as an example of the public benefits that 5G will bring. However, we’re certainly starting to see more 5G-enabled remote medicine developments (here’s another in China) and there’s no doubt that more innovations are on their way as 5G becomes a reality.

Radiology’s Evolving Role and Changing Needs

A new paper from Porter Research and Nuance Communications shared insights from radiologists across nine U.S. healthcare systems on radiologists’ evolving role and changing needs. The paper specifically focuses on how PowerScribe One addresses these needs, but the insights are relevant to everyone in the radiology space. Here they are:

  • Burnout and Job Satisfaction – It’s no surprise that burnout was a major issue among the interviewed radiologists, who noted that the ability to improve both clinical effectiveness and workflow efficiency is key to address radiologist burnout. The radiologists pointed to having access to AI tools that pre-populate report data, provide structured reporting formats, and automate routine tasks as valuable ways to improve their effectiveness and efficiency, thus potentially addressing burnout.
  • Care Team Collaboration – As one radiologists put it, “what we’re trying to become better at is being not just somebody sitting in the darkened room reading a case and spitting out a bunch of facts and handing it to the physician.” The respondents found that PowerScribe One can improve care team satisfaction and better connect radiologists to patient care by providing actionable reports (complete, consistent, timely, and accurate), allowing radiologists to leverage AI to add clinical guidance to radiology reports, and by supporting integration with downstream systems.
  • Improved Patient Outcomes – Patient outcomes of course remain a top priority, with the interviewed radiologists once again highlighting a need to provide complete and accurate reports with clear and actionable follow-up recommendations.
  • Next-Generation Radiology – Amid today’s growing workload and documentation demands and an ongoing shift towards data-oriented radiology, the radiologists revealed an understanding that their “tools must also change” with a focus on producing structured data that integrates clinical intelligence and AI-generated findings into workflow to automate and improve the reporting process.

The Wire

  • Radiology Partners expanded to the northeast U.S. with the addition of New Jersey’s Radiology Affiliates Imaging (RAI – 60 physicians, 11 hospitals, 5 health systems, and 5 imaging centers in NJ, PA, DE). The new practice partnership brings RP into its 21st state and gives the mega practice its first presence in the northeast U.S., after expanding throughout the south and southeast last year. Based on RP’s previous regional expansions (e.g. across Florida and Texas last year), it wouldn’t be surprising if its planning additional northeast U.S. partnerships through the end of 2019.
  • A team of Dutch researchers reviewed 18 studies on the benefits of supplemental training on radiologists’ breast screening performance, finding that 17 of the studies revealed improved performance including increases in sensitivity (100% of relevant studies), specificity (75%), and recall rates (83%). However, the researchers revealed that there’s still a need for better designed studies on this topic (due to small sample sizes and lack of control groups), suggesting that future studies should focus on performance in actual screening practice (not test sets) and should look for methods to isolate the training effect.
  • Ambra Health announced its integration with Box, making Ambra Health’s cloud-based PACS and image management platform available to facilities that use Box for DICOM image storage and sharing, expanding both Box’s workflow capabilities and Ambra Health’s addressable market.
  • Bracco Imaging announced its $450 million acquisition of molecular imaging company Blue Earth Diagnostics ($140m revenue, 100 employees). The acquisition significantly expands Bracco’s PET agent portfolio for prostate cancer diagnosis (Axumin F18-fluciclovine’s prostate cancer agent FDA/CE cleared, PSMA-targeted radiohybrid agent in pipeline) and has the potential to expand the company into other cancer imaging applications (e.g. neuro-oncology) in the future, while giving Blue Earth Diagnostics access to Bracco’s global footprint, marketing capabilities, and R&D infrastructure.
  • New research from the UK found that radiographers increasingly use digital side markers (DSMs) rather than less error-prone ASMs, and are generally open to cropping radiographs post-exposure to ensure they resemble “a textbook image,” rather than adjusting patient positioning using approved collimation settings. The researchers voiced radiation dosage concerns from these unintended consequences of the DR transition, suggesting that radiographers should prioritize best practices over image aesthetics.
  • Hyland Healthcare launched its ImageNext vendor-neutral imaging workflow optimizer, which combines intelligent imaging workflow orchestration with an integrated universal patient worklist, and connects with “virtually any” universal viewer, PACS, or VNA. ImageNext reportedly allows up to 20% productivity gains by routing, sorting, and distributing imaging studies based on preferences (e.g. physician location, schedule, subspecialty), eliminating the need for radiologists to access and monitor multiple worklists and dictation systems and by centralizing schedule management.
  • TeraRecon unveiled its new iNtuition AI Data Extractor, a tool intended to help convert archived and ongoing 3D post-processed studies into AI research-ready labeled training datasets. iNtuition AI Data Extractor runs locally or in the cloud as part of the EnvoyAI platform and is the first in a series of developer-focused EnvoyAI engines intended to support training, delivery, and application of new AI algorithms.

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