As a part of my interview series with leaders in healthcare, I had the pleasure to interview Dr. Michelle Archuleta. Dr. Archuleta is an entrepreneur and inventor in artificial intelligence. As the Founder of AIpiphany, an AI NLP startup, she develops foundational AI technology into products that improve patient’s lives. AIpiphany Notes is a product that transforms electronic health records into patient friendly language, so that patients can understand their most personal and relevant information. Michelle is very passionate about making a positive impact in patient’s lives through the use of technology.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
My career has always been influenced by my grandmother from completing my doctoral degree in cancer biology and applied mathematics, to working on bringing oncology drugs to the clinic, she has always been my inspiration. My journey today with my startup AIpiphany was inspired by my grandmother’s poor experience with healthcare.
Growing up in rural Colorado, healthcare and educational opportunities were very limited. Despite this I learned an incredible resilience and work ethic from my parents and the people of my community. I also had an extreme curiosity and love for mathematics and medicine. So much so, that in high school I read twenty or more neuroscience textbooks as well as physics, chemistry, and mathematics.
In college and throughout my career I have always had one foot in medicine and the other in mathematics. At the time there was no such degree as data science, computational biology, or artificial intelligence but I knew that is what I wanted to do. I wanted to leverage mathematics to make a positive impact in medicine. My graduate dissertation was a blend of mathematics and computer science applied to cancer biology.
Along the way I was very much influenced by my grandmother. She was always one of my biggest advocates. She was my champion for my education and she always encouraged me to reach beyond the stars. When I was a junior in college, my grandmother was diagnosed with colon cancer. She was 70 years old and the local doctor had never recommended a colonoscopy. Around this time I began working for a professor who would become my graduate advisor and my dissertation would be focused on applying algorithms to understand the mechanisms of cancer signaling.
Shortly after I graduated with my undergraduate degree my grandmother passed away. I continued my journey in cancer research focusing my skills on computational biology and artificial intelligence. I moved to Boston and worked at a very prestigious biomedical research institute.
During the time of travelling between Boston and rural Colorado, two completely different worlds an idea came to me. Patient’s were unable to advocate for their own health because their experience of healthcare, medical language was always like a foreign language. I thought about my research projects that could lead to publications. However, those publications would never be accessible because they were written in a technical jargon language. I thought of my grandmother and her experience if only she had been able to advocate for her health.
This is what led me to start AIpiphany, an artificial intelligence company with the product AIpiphany Notes that can transform complex medical jargon found in electronic health records into patient friendly language. A health record in plain understandable language can empower patients to be active participants in their health, build trust and partnership with their doctors, identify medication errors and ultimately save lives.
Can you share the most interesting story that happened to you since you began leading your company?
An artifical intelligence product is very different than other types of products in that it is often times the chicken and egg scenario. Massive datasets are needed to train algorithms, the algorithms are needed to create the product, and the product is required to generate traction and funding for more datasets.
Sometimes what we don’t have can help us the most. Being data poor creates new constraints and induces the right environment for evolution and adaptation. We have been able to leverage AI in unique ways to make innovative advancements in natural language processing.
What makes your company stand out? Can you share a story?
There exists a dichotomy in healthcare such that personalized information (e.g. electronic health records, genetics, insurance) arguably the most important information is completely inaccessible to the majority of patients while generic information arguably the least relevant is the most understandable. AIpiphany’s solution is the first product that allows personal information to be understandable and accessible; empowering to all patients.
Most AI startups face real ethical dilemmas that tear at the fabric of society (e.g. mass job elimination). AIpiphany, an AI for good company, provides a solution that enhances human connectivity and increases trust and transparency between specialists and the people they serve.
We see AI as an opportunity to bring people closer together; an opportunity to build and improve relationships.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
The Centers for Medicare & Medicaid Services (CMS) mandated that healthcare providers adopt and demonstrate “meaningful use” of electronic health records (EHR). The vision of CMS was a future of ‘collaborative care’ between patients and their providers.
The only problem, electronic health records are written in a foreign jargon medical language that almost nobody can understand.
I want to pause and reemphasize this point. Our most personal information is incomprehensible to the majority of patients.
Think about the ramifications, what if a mistake was made that a patient or family member could have discovered.
Think about a patient who is reluctant to take their medication because they fail to understand the full implications of their condition.
How many patients do you know of, maybe a mother, uncle, or grandmother who went to the hospital and left without a full understanding of what procedures were performed?
How many times were you sent from one specialist to the next only to discover they were talking past each other and not seeing the holistic prospective that only you could provide?
We are able to transform jargon ridden electronic health records into patient friendly language that can make our most personalized information accessible.
We are disrupting that ‘status quo’ that patients should only do what the doctor has ordered. We are providing patients and family members a seat at the table to collaborate and be engaged with their healthcare.
The benefits of collaborative care will have a ripple effect across healthcare providing savings and benefits to payers, providers, and patients.
A good bench mark we have for this is a study that was published in 2015 that showed patients that received their original doctor’s notes were 5% more likely to comply with their medication regimen.
Imagine instead if those patients were able to understand their health records.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
1) Routinely challenge your assumptions. Look at your assumptions and see how it impacts the big picture.
2) Surround yourself with people that can challenge you.
3) Always trust your gut. We have intuition for a reason; always trust and listen to that voice when something does not feel right.
4) Don’t sweat the small stuff.
5) Always practice gratitude. It just makes life sweet.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
The US healthcare system suffers from a lack of identity being neither a consumer driven industry nor a social single payer system. There are enormous inefficiencies and waste caused by this lack of identity. On one side a multi-payer system with limited government influence, such as the US healthcare system suffers from extraordinary high administrative costs and drug costs. On the other side the lack of consumerism due to health inequality, limited transparency, and low health literacy prevents competition that would otherwise drive improved healthcare services.
The five reasons that contribute to the US ranking so poorly are the following: 1) ZIP code health inequality, 2) lack of transparency, 3) low health literacy, 4) high administrative costs, and 5) high drug costs.
1) ZIP Code Health Inequality: There is an extreme dichotomy in the quality and accessibility to healthcare services. In fact, statistical analysis has shown that your ZIP code can carry more weight on your health outcomes than your genetic code. Growing up in rural Colorado I witnessed the disparity in healthcare first hand.
Patients living in rural communities have very little access or no access at all. I remember having to drive 35 miles to our 8-bed community hospital or 90 miles to a larger hospital.
At the other extreme patients living in urban areas over-utilize specialists through the process of referral decision-making. Instead of a primary care doctor treating a patient, the patient is referred on to a specialist that treats the same condition at a much higher rate.
These extremes can both exacerbate costs. Underserved patients have limited access to preventive care and when they become sick their illness is oftentimes much more advanced. This results in healthcare cost rising exponentially. While patients in urban communities have a higher specialist referral cost than is necessary.
2) Transparency: Healthcare is one of the last frontiers for consumerism because it has always remained a pool of murky water. Take for example a family wishing to purchase a car they do extensive price comparisons and research before making their final purchasing decision.
In healthcare, comparison-shopping has been almost non-existent. It was seen as a nuisance if a patient requested an estimate of the cost of the procedure from healthcare administrators and/or providers. To make matters worse the estimate could be completely inaccurate due to lack of transparency between service providers and insurance companies.
Beyond cost transparency patients often leave the hospital without a clear understanding of their condition and/or procedures or operations that took place. When patients leave the hospital in this state they are less likely to comply with their medication and follow-up appointments and more likely to be readmitted within 30 days of discharge. The US has higher readmission rates than other countries.
3) Health Literacy: A study of health literacy in Europe reported that at least 1 in 10 Europeans have inadequate health literacy while in the US the estimate is 1 in 3 Americans have inadequate health literacy.
Health literacy empowers patients to advocate for their own health and is essential for navigating through the complex web of healthcare. Starting with access and utilization of healthcare, to interacting with health service providers, caring for one’s own health and the health of others, and participating in health care decision-making, health literacy is an essential skill.
Patients with poor health literacy experience communication difficulties that affect their health outcomes. Studies have shown worse health outcomes and increased hospitalization rates occur most frequently in health illiterate patients.
4) Administrative costs: Due to the complexity of the multi-payer US healthcare system administrative costs are five times more than the average of other wealthy countries. The US spends over $800 per person on administrative costs, which is significantly more than what is spent on preventative care.
5) Drug costs: The Federal government in the US does not negotiate for lower drug prices like in other countries. As a result drug costs are much higher in the US. The US spends $1,000 per capita, which is nearly doubled compared with France and the UK.
You are a “healthcare insider”. Can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
I believe we need to empower patients to be healthcare consumers. Healthcare consumerism is a trending topic today with the proposed healthcare price transparency rule whereby hospitals are required to tell a patient, prior to treatment, how much their insurance plan would pay and how much they would owe out of pocket.
In addition, I think there should be full transparency across healthcare with providing tools to help patients understand their health and options. We want patients to understand their condition, the procedures or tests, medications, and prognosis. This is what is needed for true comparison-shopping. What procedure do I need and why do I need it?
At AIpiphany, we are doing this by transforming electronic health records into patient friendly language that patients can understand.
This is very different than past solutions in that it tells a very personal story while transforming jargon into terms that are familiar and provide insights to patients.
Typically after a hospitalization, a patient would receive a pamphlet or a brochure about a particular condition. However, this is very generic and does not relate to what the patient experienced while they were hospitalized.
Instead having a very personal story that a patient understands with respect to their past medical history can help improve his or her overall health literacy and ultimately health outcomes. It can help them to better communicate with providers and seek out the best treatment options.
In addition, patients will be a second set of eyes on a patient friendly version of their healthcare records and can help detect medical errors.
The drive towards patient consumerism can also reduce administrative and drug cost. One example of this is branding where healthcare systems can charge as much as they want based on their brand. This will change with patients paying more out-of-pocket expenses and higher premiums. Patients will shop for the best value for their money. The same is true for patients selecting generic brands over higher cost name brands.
I also believe significant policy decision need to be made to reduce administrative and drug cost.
Telehealth is very exciting technology for tackling ZIP code healthcare inequality in the US by providing underserved patients with healthcare access and better services. There are still technology challenges such as lack of high speed Internet and patients who cannot afford data plans. Despite these challenges I really hope to see Telehealth bring better options to rural and underserved communities.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
As individuals, we must advocate for transparency in healthcare. We must see our role as a patient not as a victim to healthcare but rather as a consumer with options. We must be empowered to advocate for our health and seek out the best options. We are the centerpieces in the complex web of healthcare and we should have full transparency with our most personal information.
The steps for individuals to become healthcare consumers are to request for cost transparency and request access to your health records. Do the necessary research. Ask questions and use whatever tools are available to stay better informed about your health. Stay connected with us on Twitter #AIpiphany and www.aipiphany.tech.
Corporations and healthcare organization can be facilitator’s of transparency by giving patients access to the resources and tools that they need. We invite corporations to partner with us by connecting and following us on Twitter #AIpiphany and www.aipiphany.techwith the mutual goal to empower patients with health records they can understand.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
‘The Patient Will See You Now’ and by Eric Topol is a fantastic read about the dramatic change in the patient doctor relationship that will evolve with technology. Another excellent book by Eric Topol is ‘Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again.’ This book is brilliant in that it shows how artificial intelligences can free up doctors time to allow them to be more human again.
‘What Patients Say, What Doctors Here’ by Danielle Ofri is a fantastic book. I really enjoyed this book because it focuses on the patient doctor relationship and the role of communication in medicine. It is an excellent read with a lot of insight and gives a great prospective from a patient’s lens.
The Podcast that I have been tuning into lately is Mike Biselli’s Passionate Pioneers, which features the incredible journeys of entrepreneurs as they tackle healthcare.
How can our readers follow you on social media?
Readers can follow us on social media Twitter #Aipiphany or linkedin (https://www.linkedin.com/in/michelle-archuleta-phd-9027ba26/). Readers can also stay tuned into our progress on AIpiphany Notes on our website www.AIpiphany.tech
Thank you so much for these insights! This was so inspiring!