The state of AI, cyber security and health data privacy in medicine with Larry Cohen, PhD

Hello and welcome to the AMA Update video and podcast series. Today we're talking about how we can address some of the biggest challenges facing healthcare through tech innovation.

I'm joined today by Dr. Larry Cohen, CEO of Health 2047 in Menlo Park, California. I'm Todd Unger, AMA's Chief Experience Officer in Chicago.

Welcome, Larry.

Thanks, Todd. This is an honor and it's a real pleasure.

Well, it's great to have you on our show today. Larry, before we dive in, some of our audience out there might not be exactly familiar with Health 2047 and its mission. Can you give us a brief overview and explain your connection with the AMA?

Sure, Health 2047 was formed, you know, in in around 2016 is when we really had our public coming out. It was obviously a few years in the making before that, and we are a wholly owned subsidiary of the AMA.

We like to think of ourselves as the commercial arm of the AMA, um, and and really, uh, I think the reason for Health 2047 to exist was the AMA's recognition that it could have a significant impact on the future of healthcare, but in order to do so, it needed to interact with a variety of commercial entities, with with access capital, and really to have a a publicly, you know, a public company, uh, located out here in Menlo Park, California was probably the best way to facilitate those types of interactions.

And for those of you out there that don't know, innovation is what we consider at the AMA one of our key accelerators. And Dr. Cohen, uh, uh, that seems to be needed because I guess traditionally tech innovation in healthcare has been historically slow compared to other industries. I'm curious if from your perspective, if that's the way you see it and if, uh, if it's changing.

I think it's very true, right? It it has been slower.

The adoption of technology and just all sorts of innovation have been slower in healthcare. I think there's a couple of reasons for that, um, perhaps, um, first and foremost is the extremely personal nature of healthcare. You've got to get this right, you're talking about people's livelihoods, you're talking about people's health, you're talking about their longevity, and so you really have to make sure that the sorts of things that you are instilling or inventing, um, are very carefully vetted before they get into that workplace. And the other thing is healthcare is an incredibly complex mix of various stakeholders.

There's physicians, there's patients, there's payers, there's provider healthcare systems, and so it is a really complicated environment to induce change.

Well, one of those stakeholders that you mentioned, the physician, has often been left out when we think about technological innovation, and the result of that, uh, has not been good in many cases. And so I know that a key part of your strategy involves having physicians collaborating. It may be obvious, but why is that so critical?

There's an old saying in in innovation, in fact, in a lot of change, which is there's no solving problems for me without me.

There's just no way that you can understand the complexity of of of, you know, the interaction between a physician and a patient, which is really where healthcare begins and where healthcare solutions have to begin as well.

Well, it must be interesting to kind of, uh, be that bridge between two camps because I'm going to imagine that tech innovators and physicians don't always speak the same language and that could probably be a big obstacle. How do you bridge that gap and get, uh, buy-in from both sides?

One of the things that surprised me in in in starting with this job was, in fact, how tech savvy a portion of physicians really are. If you think about some of the disciplines that they operate in, they are very technically involved operations, number one.

So, there actually is a relatively large subset of physicians that are very tech savvy, right?

And we rely on them to sort of help us bridge the gap, but importantly, I think that I think the point is, you need the physician at the table at the beginning of the conversation, and you need that rapport between the the tech technical person and the physician to develop from day one.

Now, let's talk about one of those particular innovations that is, uh, reached the level of lore, uh, in healthcare at this point, and that's the EHR, which we think, you know, is a pretty classic example of where physicians were not at the table and, uh, even though this is supposed to be a tech innovation that works, uh, for physicians, it's sometimes considered to be the other way around.

And we've seen a lot of the burden that's landed on physicians' laps as a result of this. Now, I know that things have since improved in some respects.

What's your take on that?

Is there a lot more opportunity there to really make physicians' lives easier?

There's an enormous amount of opportunity there. If you think, you know, the amount of data that's generated in healthcare, just broadly spoken, I don't have the number in front of me, but it is astounding at how how rapidly the database of what we know about diseases, about treatments, about whatever it is, magnifies on literally a daily basis.

And our ability to keep up with that data is not just where to store it, but how to access it, and once you've accessed it, how to turn that that that raw data into insights and then how to turn those insights into action. And so there is an enormous, you know, there when I first started this job six, seven years ago, there was enormous input on how can we accumulate all the data that we want.

That's that's sort of antiquated at this point because it's not all the data we want, it's all the data we need, and how do we how do we use that data again for insights and then ultimately actions.

Now, your focus at Health 2047 mirrors a lot of the AMA's strategic priorities. You've also talked about how relevance or doing something relevant has always been a driving force for you personally. Tell us a little bit more about those priorities and why they're particularly relevant in today's environment.

So we we we took the three, um, you know, strategic arcs of the AMA, chronic disease, personal development, taking the friction out of out of medicine, and we translated those into what we call our pillars. So this is roughly where we concentrate our efforts, where we look for problems and solutions, and that is data, it's in chronic disease, it's in productivity, and by productivity, we mean increasing and enhancing the interaction between a physician and a patient, and then ultimately value and equity.

Right? So if those are our pillars, um, it's it it's obvious that with the amount of data out there, that if we focus on improving, getting the right data to the physician at the right period of time, um, it is going to be critical.

Chronic disease is something like 90% of the spend in healthcare in this country now.

Our system was developed over the years to deal with acute disease, and now chronic disease is is the overwhelming factor. So we need to change the paradigm to to that degree. If you think about physician productivity, again, we have this enormous amount of data. Can we use machine learning, AI, new technologies to present the physician with the most relevant data at the best time so that he can turn that into action?

And obviously, value and equity, you know, is sort of speak for themselves.

Everything we do needs to increase value, and everything we do has the lens of how do we make sure it's being equitably applied to the populations that need it the most.

Now, Larry, you've used the word data a lot, and a huge issue that we've seen cropping up in regard to that, of course, is around security. Have you seen any startups or innovations that will, uh, not only help us connect the dots on the data, uh, and improve access across many different channels, but also really address the concerns we've got building about privacy and security?

We actually have a startup which we've just launched, I believe in 2021, so during the pandemic, um, but it's called Heal Security, and it is focused specifically on healthcare, uh, cybersecurity. It's an enormous problem, and again, I don't have the statistics in front of me, but the the the number of breaches, the the the cost of those breaches, and the potential harm from those breaches of the most personal data is really devastating. What Heal does or attempts to do differently than what others have done, first of all, it's focused on healthcare, but secondly, it's focused on not just providing a wave or a mass of information to the the the CTO, the CIO, who's ever getting that information, but again, actually collating, you know, curating that information and providing them with actionable insights that they can do. It's an enormous problem with healthcare, the more our healthcare system is distributed, the more data is being held in different places, the greater the chance of of of there being security breaches.

And on that that particular topic that you just mentioned, which is about the insights into the data, and you kind of thematically hit that before, which is not just more data, it's, uh, putting it to use, having it be actionable. Um, we've had a lot of conversations recently about AI and its role in healthcare. Where do you see machine learning adding value, and are there any innovations that have piqued your interest in this particular area?

You know, I think I think the way we think about it, and obviously this is this is synonymous with the way the the AMA thinks about it, is artificial intelligence is really augmented intelligence. It has meant to supply the physician with information or background that they can use for their judgment. It is not meant to take the place of that judgment, but rather to assist the physician in making that judgment.

And so you can imagine that there are ways that you can provide the physician with data, which is going to help him diagnostically or perhaps even choose therapeutic. So it's decision support, but it's decision support across the entire spectrum.

We have a small company that's working on that as well, um, you know, called RecoverX, which is again, is trying to be essentially the physician's augmented intelligence assistant.

Now, you kind of have a bird's eye view of a lot of the tech innovation that's happening out, uh, uh, from Silicon Valley's point of view. When you look at the landscape of what's going on, what what do you find is the most exciting thing about the future of healthcare?

What's what's on your, uh, what's on your list?

I think it's really, you know, I I think it's really focused on that physician-patient interaction. It is taking the friction out of that interaction. It is it's interestingly because it's using technology to make the interaction more personal, right? It's using technology that allows the physician and the patient to focus on what's in front of them in the room.

You know, the old technology you brought up the EHR, that that made the interaction significantly less personal, right? Today, the way people are thinking about the use of technology in improving healthcare is really interestingly, almost paradoxically, it is directed towards making that physician-patient interaction a much more personal and productive interaction.

Well, I know that, uh, physicians will look forward to that. So, uh, more to come there.

Larry, for folks who want to learn more about Health 2047, where should they look?

So we have a website, which is health2047.com. Um, it it is a very interactive website.

It allows people to contact the company.

So please, uh, check that out.

We're always interested in entrepreneurs, we're always interested in physician input, and we're always interested in problems to solve.

Well, thanks so much for being here today.

Learned a lot.

That's it for us today's episode.

We'll be back soon with another.

In the meantime.

You can find all our videos and podcasts at AMA-assn.org/podcasts.

Thanks for joining us today.

Please take care.

Thank you, Todd.