The problem we solve: Only 54.9% of patients are getting the standard of care. One big reason is that knowledge explosion in medicine is getting harder to handle even for the smartest clinicians. Data-driven AIs such as IBM Watson Oncology is promising, but clinicians need to be able to make decisions based on both theory and consensus-driven knowledge, taking into account patient preferences, in addition to statistical predictions or pattern recognition. Interactive apps might be an answer, but clinical apps never reached the status of essential tools in clinical medicine. They suffer from sloppy UI/UX and inconsistent behavior and duplicated efforts between apps, reinventing the wheel every time. Due to the vast number of clinical disorders, the coverage of these apps are very spotty (e.g., an app for colon cancer screening, an app for fever in children), and the developers tend to be focusing on creating clinical calculators rather than dealing with comprehensive knowledge of disorders.
About our solution: We are going to make bundles of interactive, modular clinical guidelines, called "modules," with app-level interactivity for physicians. These modules aggregate relevant pieces of clinical knowledge together to personalize contents to specific clinical circumstances at the point of care. The UX/development side will be handled by developers, while the specific "modules" creation will be done by clinical experts using the ‘Playground,’ our author-facing tool. This approach will lead to better scalability, improved content quality, and reduced cost of building the contents, not reinventing the wheel every time we create clinical modules. The ecosystem of allowing clinician authors to create clinical modules also leads to an authorship system similar to academic journals or expert crowdsourcing.Progress to date:
We built an editing app (AvoMD Playground) for 'module authors,' who are clinicians without a technical skillset. We believe that the current version of AvoMD Playground should be easy enough to be used by provider authors without technological expertise. The founder created one test module on his own, and published to the App Store as a separate app ("SmartIntern ABG") for the market research, which was downloaded by 15.3K clinicians. (See the image below from the App Store analytics)
Five clinicians without technical skills tested the editing app to build drafts of test modules/apps for clinical problems. An internist created a fully-functional module within one week. We published the module to the App Store a ago for the test purpose as an independent app rather than a bundle of modules. (https://itunes.apple.com/US/app/id1435125519?mt=8).
We started recruiting authors to come up with MVP as a bundle of 10-12 clinical modules for inpatient generalists. We already have four clinicians who want to join the project without financial compensation.
Creator: Joongheum Park
Location: New York
Bio: Dr. Park is a practicing internal medicine clinician at NewYork Presbyterian-Columbia University Medical Center (CUMC). He is a clinical informatics fellow at CUMC, on the executive board of the National Association of Clinical Informatics Fellows (ACIF). He is also a professional developer, and has been mentoring computer science classes at GeorgiaTech for the development of healthcare software. He is leading multiple clinical artificial intelligence (AI) projects in collaboration with Columbia University, Albert Einstein College of Medicine, Rutgers University, and University of Pittsburgh. He have been making podium presentations regarding these AI projects as well as mobile health projects at AMIA (American Medical Informatics Association), American College of Rheumatology (ACR), Society of Hospital Medicine (SHM), American Psychiatric Association (APA), and HL7/FHIR meeting.
Hospital Affiliation: NewYork Presbyterian-Columbia University Medical Center
Title: Founder and Chairman of AvoMD, Inc, Clinical Informatics Fellow / Internist at Columbia University Medical Center
Advanced Degree(s): MD
CEO of AvoMD / Internal Medicine Resident, SUNY Downstate Medical Center , MD
Biography: Dr. Saperstein is an incoming Chief Resident for the internal medicine program, and an MPH candidate, at SUNY Downstate Medical Center. He is a member of Alpha Omega Alpha (AOA), and graduated from Albert Einstein College of Medicine with distinction in research in global health and from Yeshiva College as Valedictorian. He has a zest for life, for creating, building, learning and teaching. He chairs the Internal Medicine Wellness Committee, and co-founded two non-profit organizations, StartScience.org and Teach4Kids.org. He is acclaimed as a classical concert pianist and as a recreational ukelele jammer and has won numerous awards including The Jewish Week's "36 under 36" most influential Jewish Americans, semifinalist in the Dell Social Innovation Challenge, which “identifies and supports promising young social innovators who dedicate themselves to solving the world's most pressing problems with their transformative ideas," iGEM (International Genetically Engineered Machine Competition), Award for Best Human Practices Advance in the Americas and UIST (ACM [Association for Computing Machinery] Symposium on User Interface Software and Technology) 1st place team “Most Useful” software design in 2010. He co-founded AvoMD, Inc. to allow clinicians to teach each other while improving clinical practice on a broader scale.
Title: CEO of AvoMD / Internal Medicine Resident, SUNY Downstate Medical Center
Advanced Degree(s): MD
A NEJM report showed that only 54.9% of patients are getting the standard of care. One big reason is that knowledge explosion in medicine is getting harder to handle even for the smartest clinicians. (Harvard Business Review: https://hbr.org/2016/12/how-physicians-can-keep-up-with-the-knowledge-explosion-in-medicine.) There was a hope that AI tools such as IBM Watson Oncology, would help physicians make decisions more efficiently, but the Watson’s failure showed that clinicians need to be able to make decisions based on both theory and consensus-driven knowledge, taking into account patient preferences, in addition to statistical predictions or pattern recognition. (https://www.statnews.com/2017/09/05/watson-ibm-cancer/)
There have been approaches to make clinical knowledge more accessible to clinicians such as UpToDate. Despite its success, the service is technically an extensive collection of static HTML documents without interactivity and should be considered a web version of a medical textbook on steroids.
Instead, we are trying to personalize clinical knowledge at the point of care, because only a small subset of the document is relevant for a specific clinical situation when a clinician is seeing a patient. Instead of hypertext-based articles, our clinician user searches interactive clinical modules of their interest (e.g., a module of anemia diagnosis.), which aggregate relevant pieces of knowledge together to personalize contents to specific clinical circumstances at the point of care. The UX/development side will be handled by developers, while the specific "modules" creation will be done by clinicians using the ‘Playground,’ our author-facing tool. This approach will lead to better scalability and reduced cost of building the contents, not reinventing the wheel every time we create clinical modules. The ecosystem of allowing clinician authors to create clinical modules also leads to an authorship system similar to academic journals.
We can guarantee that your providers can access the interactive clinical knowledge at the point of care. The will improve the compliance of your providers to the standard of care. The effects could be even more prominent with your trainees and NPs. As our author facing tool ('Playground') can be used by clinicians without no technical expertise, the hospital systems can even create your own modules for any purposes (e.g., an interactive antibiotic stewardship module specific to your institution).
Affiliation(s)Dr. Joongheum Park is presently a clinical/informatics fellow at Columbia University Medical Center. Dr. Saperstein is a internal medicine resident a SUNY Downstate Medical Center.
Key Milestones Achieved and PlannedWe already have our test module ('Stage 0 MVP') in the App Store. We plan to build our first bundle of 10-12 modules within 4-6 months and start contacting hospital systems for the letter of intent and contracts. Another inflection point is the completion of one of our major modules including ABG analysis module and preoperative evaluation module, which will be on the App Store by Q1 2019 as separate apps (unbundled) for free for the promotion of the company.
Our Competitive AdvantagesWe believe that our approach is novel concerning the following aspects: (1) Providing personalized medical knowledge at the point of care, rather than offering static documents. (2) Provide summarized, comprehensive knowledge on the top of medication calculations. (3) Can adapt to rapidly changing clinical consensus and new results of trials with expert crowdsourcing.
Barriers to EntryWe thoroughly explained the unique characteristics of our service, which I do not think other companies realize. I want to note that companies I listed as potential competitors (UpToDate, EHR companies and AI decision support initiatives) are often considered unrelated. For instance, UpToDate is a medical education company, and EHR companies are building software for hospitals. As we are personalizing clinical knowledge at the point of care, AvoMD tries to connect the distinct sectors. We believe that we are the only company who figured out how we can reduce the cognitive burden to the clinician offering optimized medical knowledge at the point of care, also addressing the scalability of the contents.
Funding, Partners and Alliances To DateWe recently incoporated in Sep 2019 and received no funding at this moment.
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