1. Diagnostic Decision Support And AI
Autonomous Medicine| 8:30-9:30
Diagnostic Decision Support
And AI
Art Papier MD
CEO VisualDx
Associate Professor of Dermatology
University of Rochester

2. LEARNING OBJECTIVES Define diagnostic decision support
Describe the interplay of decision support and machine learning of skin lesions and rashes

3. What Large Problem Are We Trying To Solve?

4. Primary Care, Emergency Medicine, OB/GYN, Infectious Disease, Dermatology . . . Anything!!
Chest pain
New medication
Diabetes management
Eye irritation
Asthma worsening
Back pain
Depression
Injury to ankle
Cough
Weight Loss
Uncontrolled Hypertension
New and changing skin lesion

5. Primary Care, Emergency Medicine, OB/GYN, Infectious Disease, Dermatology . . . Anything!!
Chest pain
New medication
Diabetes management
Eye irritation
Asthma worsening
Back pain
Depression
Injury to ankle
Cough
Weight Loss
Uncontrolled Hypertension
New and changing skin lesion

6. + > Decision Support: Machine Learning Artificial Intelligence
Machine Leaning
Rule Based Systems
Machine
Learning
Artificial
Intelligence
Rule Based Systems

7. Medical Cockpit for Professionals and Patients

8. + > Medical Cockpit Design:
Medical images of all forms and variations
Comprehensive medical knowledge database
Visual search process and interface
Merge terminology, images, database, machine learning and interface

9. Reduce Cognitive Burden: Visualization of Complexity
2 matching findings: Arthralgia (Joint Pain, Articular Pain), Fever (Febrile)
Searchable by condition, medication or unique patient factors delivering point- of-care differential diagnosis, testing and therapy.
Medicon
Reduce Cognitive Burden:
Visualization of Complexity
Transforming the “diagnostic list”
by allowing for comparison of disease features

10. Supports the recognition of the variation of disease presentation
Findings entered: facial palsy, arthralgia
Findings entered: blanching patch, targetoid
Differential shown
in Sympticons
Differential shown
in photo view
Supports the recognition of the variation of disease presentation
Example: Phases of Lyme Disease

11. VisualDx Multiple Workflows
Uses SMART on FHIR
Native iOS and Android apps
Interoperable in:
EHR
UpToDate
Telemedicine
VisualDx iOS and Android Apps
VisualDx within UpToDate
VisualDx is in Cerner
VisualDx on modern browsers

12. Machine Learning and decision support

13. International network of dedicated contributors has participated in building good data.
Images and case data are submitted by experts from around the world. Diseases of regional and geographic importance are captured, uploaded and labeled

14. The Basis For Machine Learning and AI: Good Data
Human Phenome
From genome to transcriptome to proteome to microbiome, the importance of these efforts ultimately hinges on connecting the genetic and molecular data to the clinical manifestations of disease.
Machine Learning
The goal of our research is to merge image recognition with knowledge databases to improve diagnosis.

15. Machine Learning:
Training on Skin Examination Description

16. Recent Case Study Presents to ED on April 10, 2018
Female, 66 years old
Two-week history of enlarging lesion on finger. Patient removed lesion herself. Lesion recurred larger.
Brian Browne, MD

17. Machine Learning Process Review diagnostic possibilities.
Snap a picture.
Confirm lesion type.
Add other symptoms.
Put in screen shots
Process

18. Apple’s
Core ML:
Speed and on Device

19. 59 VisualDx is Widely Used Point of Care Tool MILLION+
Images viewed
in 2017
MILLION+
2,695,470 Clinical Inquiries

20. What about AI for
Non-Physicians?

21. Aysa
Aysa gives people personalized guidance about what to do for a set of 200 common skin conditions.
Aysa is focused on skin conditions because this is an area of real need and a place where we have the expertise to help.
Take a photo.
Answer questions.
Review information.
See results.

23. Art Papier MD apapier@visualdx.com QUESTIONS? THANK YOU