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Health See other Health Articles Title: Report How Google Plans To Use AI To Reinvent The $3 Trillion US Healthcare Industry Google is betting that the future of healthcare is going to be structured data and AI. The company is applying AI to disease detection, new data infrastructure, and potentially insurance. In this report we explore Google's many healthcare initiatives and areas of potential future expansion. Get the FULL REPORt Using AI to tackle disease, from monitoring, to detection, to lifestyle management Google’s strategy involves an end-to-end approach to healthcare, including: Data generation — This includes digitizing and ingesting data produced by wearables, imaging, and MRIs among other methods. This data stream is critical to AI-driven anomaly detection. Disease detection — Using AI to detect anomalies in a given dataset that might signal the presence of some disease. Disease/lifestyle management — These tools help people who have been diagnosed with a disease or are at risk of developing one go about their day-to-day lives and/or make positive lifestyle modifications. While most of these projects fall under Verily’s purview, DeepMind is involved in several parts of disease detection and Google itself holds several patents under the parent company. These are currently the main diseases Google is tackling with this approach. As shown below, work on these disease spans organizations under the Alphabet structure. We’ll dive deeper into each area. EYE DISEASE Verily is working on detecting diabetic retinopathy (a condition when high sugar levels cause damage to blood vessel in the eye) via a partnership with Nikon’s subsidiary Optos, which makes the machines for retinal imaging tests and eye disease detection. In earlier research, Google proved its algorithms were equally as good as trained ophthalmologists in detecting the condition. The DeepMind division is also working with the Moorfields Eye Hospital in the UK to improve on this prior eye disease research and assist eye doctors in assessing the risk of a patient’s eye problem and directing them to medical care based on the urgency of the condition. In the current system, all anomalies are treated as urgent, even though there is a spectrum of severity. Verily isn’t only focused on detecting eye diseases, but also on potentially fixing certain diseases as well. Analyzing the frequency of words in Verily’s granted patents reveals it has consistently filed patents related to contacts and eye implants. Several of Verily’s patents highlight ways to combat presbyopia (age-related eyesight degeneration) by using contact lenses to help focus vision. This is a project Verily is working on in conjunction with Alcon, a subsidiary of Novartis, though the project appears to have delayed its trials and its current status is unclear. DIABETES Diabetes detection and management is a major healthcare focus for Google, which has already had some success rolling out products. Given the prevalence of diabetes — the condition affects 30 million people in the US alone — it makes sense that this would be an area of attention. Detection In addition to combating presbyopia, the Alcon contact was also meant to monitor glucose through tears, and was one of Verily’s first “moonshots” to be publicly announced. However, other experts have suggested that tears are not a reliable source for monitoring glucose. Google’s smaller continuous glucose monitor (CGM), which Verily created with medical device company Dexcom, is already farther into the commercialization pipeline. The Dexcom G6 monitoring system, which has been submitted to the FDA for approval, monitors levels of interstitial glucose right under your skin. The long-term goal is to create an even smaller disposable sensor that can be worn for 14 days like a bandage and requires no finger stick calibrations (as opposed to the current G6, which requires a finger stick calibration once a day). This was mentioned in the Dexcom investor presentation as seen on the left. The collaboration with Verily has also seen an increasing number of mentions in Dexcom’s earnings calls over the last couple of years. While diabetes management is relatively well understood, there’s a gap in diabetes detection today. Because your pancreas is connected to your autonomic nervous system, small changes in heart rhythm could potentially help detect development of the disease. Cardiogram, a startup that uses heart rate to monitor and predict disease, recently released a study that used existing wearables, including the Android Wear, to detect diabetes with 85% accuracy using AI and heart rate. This kind of detection could be a potential area of expansion for Verily if it looks to improve its early detection of diabetes. Management Verily is also leveraging multiple partnerships in the diabetes space by including the Dexcom monitors in the starter kit for Onduo, its virtual diabetes management program that recently began its commercial launch. Onduo is a joint venture between Sanofi and Verily, which have together invested $500M into the solution. Using sensors and coaching, the company’s goal is to help type 2 diabetics manage their condition. Onduo is similar to other virtual diabetes programs like Omada Health, which combine hardware (glucose monitors, smart scales, etc.), software, and coaching to help people with diabetes manage their condition. AI is useful here to detect at-risk patients and streamline the coaching process. Google CEO Sundar Pichai mentioned in the Q1’18 earnings call that Onduo began a commercial launch of its diabetes program earlier in the year, likely targeting insurance carriers (based on its website, below) and employers (based on this study working with supermarket employees in the Netherlands). Verily also recently patented a smart syringe to help diabetics monitor their injections. The syringe will likely be part of the Onduo solution. While Onduo is currently focused on type 2 diabetes, it has mentioned moving into type 1 diabetes management in the future as well. Startups making AI-powered medical devices that help manage type 1 diabetes automatically like Bigfoot Biomedical are developing this kind of closed-loop system for type 1 diabetes. Bigfoot Biomedical creates an automated insulin dispensing solution by combining a continuous glucose monitor, an insulin infusion pump, and software to optimize insulin delivery automatically. This area could be one Verily chooses to move or acquire into. HEART DISEASE Currently Google is approaching data generation and heart condition monitoring in two ways. The first is via the Study Watch, produced by Verily and used by researchers to monitor different biomarkers of study participants. This includes both an electrocardiogram (ECG) and heart rate monitor, which researchers can use to help detect anomalies earlier and to better understand what other factors might lead to or be precursors to heart episodes. This could help in identifying better predictors of heart disease earlier in the development of the condition. The second is highlighted in a patent for a passive heart monitor using optical sensors and machine vision that seems more catered towards the everyday person. The patent talks about taking images of key blood flow areas to provide a continuous monitoring of heart health in order to promote more healthy behaviors. The patent also has a disease detection component, detecting blood flow issues in areas like the brain for stroke detection or detecting cardiac abnormalities like an arrhythmia, which could indicate cardiovascular issues. Google is also looking to help providers detect cardiovascular issues via retinal images. The company published a paper on how its machine learning algorithms were able to detect risk for cardiovascular issues by analyzing the blood vessels in the eye. Below are fundus images of the eye, with the green lines being the areas that the neural network used to make its predictions. To help patients who are at higher risk of developing cardiovascular disease or who already have heart conditions, Verily has participated in a $75M grant to One Brave Idea, a project from Dr. Calum MacRae, chief of cardiovascular medicine at Brigham and Women’s Hospital. The project aims to better understand the factors that contribute to different types of heart disease, as well as methods of preventing heart disease and potentially reversing it. The grant was given in conjunction with AstraZeneca and the American Heart Association. While details on the project are still vague, it’s possible that Verily will eventually move to create a lifestyle management system similar to Onduo for people at risk for heart disease. PARKINSON’S DISEASE Parkinson’s disease is a debilitating neurological disorder that is poorly understood. Now, Verily is trying to figure out the underlying causes of the disease by capturing and analyzing data to produce earlier disease identification, personalized treatments, and improved management. Verily launched the Personalized Parkinson’s Project with Radboud University in the Netherlands to combine clinical data with patient data collected by the Study Watch, including heart functionality, electrodermal activity, and inertial movements. One hope is that with 24-hour monitoring researchers will be able to identify indicators of disease onset, such as changes in heart rhythm or sleeping patterns. Another hope is that Verily can use data from the project to build algorithms that can segment Parkinson’s patients and hopefully personalize the treatments. Through the Personalized Parkinson’s study, Verily developed an encrypted database of deidentified data for researchers to use. It’s building a similar database for the NIH called the Knowledge Portal as well, allowing researchers to share and visualize datasets related to Parkinson’s research. Through this work, Verily and researchers hope to find earlier indications of the onset of the disease, understand how it progresses, and potentially find new ways to create therapies for people with the disease. In the meantime, Verily is also looking at ways to help Parkinson’s patients manage their day-to-day lives. This began with the acquisition of Lift Labs, creator of the Liftware spoon that helps Parkinson’s patients stabilize their food while eating. The spoon and related attachmentsa are sold for $195 and up. According to patents it’s filed, Verily is exploring other ways to use the Liftware tool to help people with neurological disorders. For example, this patent suggests the spoon can be used to detect the mass of food and number of bites taken per meal to ensure that patients are getting adequate nutrition. This is useful information for caregivers and providers that are helping manage patients with neurological disorders. MULTIPLE SCLEROSIS Multiple sclerosis is also a disease without a known cause or cure. MS is the result of the immune system attacking the myelin sheath in the brain, causing deterioration of muscle control, memory loss, and more. Verily is working with biotech company Biogen and Brigham and Women’s Hospital to set up a longitudinal study to understand how the disease develops. This combines data from participants wearing the Study Watch with clinical data fed into Verily’s machine learning algorithms to improve detection and understand what causes the disease to progress and flare up. Verily hasn’t explicitly talked about management of the disease. However, there’s been exploratory research into using electroceuticals to combat MS, which could inform a project Verily is pursuing with GlaxoSmithKline called Galvani Bioelectronics. The project uses miniature electronics to control how electrical signals flow throughout the body. Electroceuticals are very small electronic implants that help modulate the flow of electrical signals through the nervous system. It’s possible that Galvani’s bioelectronics could be used to help manage MS as it progresses. Notably, Verily has a job posting for neuromodulation, suggesting it will explore the area. In addition, Google could eventually help people manage the disease by creating external solutions that help people with impaired motor functions. Exoskeleton companies like ReWalk Robotics help people with impaired motor function stay mobile by combining software, sensors, and electronics. DISEASE AREAS Other areas Google may explore next include Chronic Obstructive Pulmonary Disease (COPD), cancer, mental/behavioral health, and aging. COPD Chronic lower respiratory disease, primarily COPD, which is caused by inflamed airways, is the third leading cause of death in the US. However, like diabetes and cardiovascular disease, which Verily is already tackling, COPD can be managed with a combination of lifestyle adjustments and therapies. The Study Watch already captures environmental data, which can often be a trigger for lung inflammation — so it’s not hard to envision the Study Watch alerting wearers to environmental conditions that potentially trigger COPD. In addition, Senosis Health, which Google acquired in 2017, could potentially be used to develop diagnostic tools and treatments for COPD. Senosis claims to be able to use an existing smartphone microphone as a spirometer to measure lung function, and additionally use smartphone cameras to measure hemoglobin levels, which is useful for detecting anemia. Anemia is seen as a potential comorbidity with COPD, and so these two datasets could augment each other in better understanding and treating COPD. Google has yet to incorporate Senosis technology into its products but could in the future. Another possibility is using the bioelectronics from Galvani, Verily’s project with GlaxoSmithKline that focuses on controlling how electrical signals flow throughout the body. GSK has suggested that Galvani could be used to treat asthma, another pulmonary disease, though specific details have not been mentioned. Different cancer types Google has been researching different ways to identify and create treatment plans for cancer through its DeepMind division. In 2017 the company released research regarding tumor identification, in which algorithms were trained on an existing set of images of breast cancer that had metastasized to adjacent lymph nodes. Algorithms could then detect tumors with 92% accuracy, allowing for some false positives (such as macrophages that might look like tumors). Since 2017, the company has partnered with the NHS and Cancer Research UK Centre at Imperial College London to further this research and improve early detection of breast cancer. DeepMind is also working on other cancers like head and neck cancer. DeepMind’s work in this area is more related to treatment design, with the company trying to apply AI to speed up the mapping process for determining where radiotherapy should be applied. The current mapping process takes approximately four hours — DeepMind believes it can shorten it to one. Notably, Google has no means of generating this data itself, and instead partners with hospitals that then submit cancer data. Verily’s investment in Freenome could be a stepping stone in this direction as well. Freenome aims to detect cancer at earlier stages by detecting trace amounts of DNA that tumors shed into the blood stream (circulating tumor DNA). Verily could also continue its partnership approach with a company like Siemens Healthineers or Phillips to gain access to MRI/CT images firsthand, and then use the data to build algorithms to improve detection and treatment planning. Another possible area Google could explore is coaching and lifestyle management for cancer patients. In 2005 — 2006 Google was involved in a study related to connecting new cancer patients with cancer survivors as a form of peer guidance and navigation, though it appears no results came from that. Mental and behavioral health Google could enter the behavioral health space by detecting patterns of mental health issues via searches. The company is already partnering with the National Alliance on Mental Illness (NAMI) to develop a questionnaire for users who search for depression systems. Google Ventures has also invested in Quartet Health, a company that helps primary care physicians detect untreated mental health illnesses and guides patients to appropriate care. Quartet Health could use its expertise and data to help Google detect behavioral health issues earlier. Notably, Verily has an open job posting for a behavioral health program manager, which suggests that it’s looking into this area. Aging Google spinout Calico is trying to understand the mechanisms that cause us to age. The company is looking at how different lifestyle changes, cellular processes, genetics, etc. impact the course of aging. Through this process, Calico seeks to better understand disease detection and lifestyle management, and depending on what the division learns, it will probably also be involved in the data generation layer as well. The company recently released research about the aging pattern of naked mole-rats and has announced partnerships to create aging-related drugs. Post Comment Private Reply Ignore Thread Top • Page Up • Full Thread • Page Down • Bottom/Latest Begin Trace Mode for Comment # 3.
#1. To: Tatarewicz (#0)
Interesting. Since Google is evil I spose the intent is to use a lot of this to help the govt and medical industry help themselves to more of our rights etc. Thanks, Tata.
Only by association with the Tribe. If G can do for health research what they've done for communications, more power to them.
Yes, if these new ideas are used benignly it's sensational. But Google is evil. It's liberal as hell and using its colossal fortunes to jew the world. Both Brin and Page are kikers.
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