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

. 12 MIN READ

AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.

AMA Update

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

Apr 17, 2023

CEO of Health2047, Larry Cohen, PhD, joins from Menlo Park, California, to discuss how the latest technological advancements impact medicine and the future of health care delivery. From the importance of physician input on new tech innovations, to the flow of health data and cybersecurity—plus how artificial intelligence and generative AI could reduce friction and improve electronic health records (EHR). American Medical Association CXO Todd Unger hosts.

Health2047 helps find, fund and scale early-stage startups working to transform health care. More than a Silicon Valley innovation firm, they help connect physicians with health care entrepreneurs and industry leaders working on new technologies to improve medical care. Learn more.

Speaker

  • Larry Cohen, PhD, CEO, Health2047

AMA Recovery Plan for America’s Physicians

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Unger: 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 health care through tech innovation. I'm joined today by Dr. Larry Cohen, CEO of Health2047 in Menlo Park, California. I'm Todd Unger, AMA's chief experience officer in Chicago. Welcome, Larry.

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

Unger: 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 Health2047 and its mission. Can you give us a brief overview and explain your connection with the AMA?

Dr. Cohen: Sure, Health2047 was formed—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.

And really, I think the reason for Health2047 to exist was the AMA's recognition that it could have a significant impact on the future of health care. But in order to do so, it needed to interact with a variety of commercial entities, access capital. And really, to have a public company located out here in Menlo Park, California was probably the best way to facilitate those types of interactions.

Unger: 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, that seems to be needed because like I say, traditionally, tech innovation in health care 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 it's changing.

I think it's very true. It has been slower. The adoption of technology and just all sorts of innovation have been slower in health care. I think there's a couple of reasons for that.

Perhaps first and foremost is the extremely personal nature of health care. 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 are very carefully vetted before they get into that workplace.

And the other thing is health care is an incredibly complex mix of various stakeholders. There's physicians. There's patients.

There's payers. There's provider health care systems. And so it is a really complicated environment to induce change.

Unger: 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 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?

Dr. Cohen: There's an old saying 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 the interaction between a physician and a patient, which is really where health care begins and where health care solutions have to begin as well.

And so if you just think about the kinds of innovations that have been made in other industries versus the kinds of innovations that have been attempted in health care, for too long, there has been a lack of recognition that that primary interaction takes place with the doctor—with the physician and the patient. And that's really where the AMA's insights and experience obviously excels.

Unger: Well, it must be interesting to kind of 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 can probably be a big obstacle. How do you bridge that gap and get buy-in from both sides?

Dr. Cohen: One of the things that surprised me 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 and we rely on them to help us bridge the gap. But importantly, 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 technical person and the physician to develop from day one.

Unger: Now, let's talk about one of those particular innovations that has reached the level of lore in health care at this point. And that's the EHR, which we think is a pretty classic example of where physicians were not at the table. And even though this is supposed to be a tech innovation that works 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?

Dr. Cohen: There is an enormous amount of opportunity there. The amount of data that's generated in health care, just broadly spoken—I don't have the number in front of me, but it is astounding at 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 raw data into insights, and then how to turn those insights into action.

And so there is an enormous—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 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 use that data, again, for insights and then ultimately actions?

Unger: Now, your focus at Health2047 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.

Dr. Cohen: So we took the three strategic arcs of the AMA—chronic disease, personal development, taking the friction 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 the patient. And then ultimately, value and equity—so if those are our pillars, 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, it is going to be critical.

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Chronic disease is something like 90% of the spend in health care in this country now. Our system was developed over the years to deal with acute disease and now chronic disease is the overwhelming factor. So we need to change the paradigm 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 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?

Unger: 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 not only help us connect the dots on the data and improve access across many different channels, but also really address the concerns we've got building about privacy and security?

Dr. Cohen: We actually have a startup which we've just launched, I believe in 2021—so during the pandemic. But it's called HEAL Security. And it is focused specifically on health care cybersecurity. It's an enormous problem.

And again, I don't have the statistics in front of me. But the number of breaches, 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 health care.

But secondly, it's focused on not just providing a wave or a mass of information to the CTO, the CIO—who's ever getting that information—but again, actually curating that information and providing them with actionable insights that they can do. It's an enormous problem with health care. The more our health care system is distributed, the more data is being held in different places, the greater the chance of there being security breaches.

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

Dr. Cohen: I think the way we think about it—and obviously, this is synonymous with the way 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 them 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 called RecoverX, which again, is trying to be essentially the physician's augmented intelligence assistant.

Unger: Now, you have a bird's eye view of a lot of the technology innovation that's happening out from Silicon Valley's point of view. When you look at the landscape of what's going on, what do you find is the most exciting thing about the future of health care? What's on your list?

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

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

Unger: Well, I know that physicians will look forward to that, so more to come there. Larry, for folks who want to learn more about Health2047, where should they look?

Dr. Cohen: So we have a website, which is Health2047.com. It is a very interactive website. It allows people to contact the company. So please, 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.

Unger: Well, thanks so much for being here today. I learned a lot. That's it for 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.

Dr. Cohen: Thank you, Todd.


Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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