Clinical Collaboration in the Cloud

1. Network
Edge
Server
Network
Edge
Server
Network
Edge
Server
Network
Edge
Server
Network
Edge
Server
Network
Edge
Server
Clinical Collaboration in the Cloud:
Visual Neural Networking
& Mobile Medical Imaging
Disruptive Tools & Technologies
for Value Care­Giving Teams
Clinical Collaboration in the Cloud: Visual Neural Networking for Value Care-Giving Teams

2. Discovery Development
Delivery
Gather
Experimental
Evidence
Organize
Observational
Data
Develop
Explanatory
Theories
Formulate
Testable
Hypotheses
Outcomes
Measurement
& Monitoring
Clinical Signals
& Symptoms
Disease
Detection &
Diagnosis
Prognosis,Staging
& Treatment
Other Uses
or Benefits?
Is it Safe?
Does it Work?
Is it Better?
Life
Sciences
Drugs &
Devices
Value
Care
V
Clinical Collaboration in the Cloud with Visual Neural Networking
'Faster, Smarter, Better' Teams Collaborating with Clinical Cognitive Vismemes: 'Faster' Discovery in Life Sciences,
'Smarter' Development of Drugs and Devices, 'Better' Coordinated Delivery of Patient­Centric Value Care
Visual Neural Networking: Multi­sensory communications, collaboration, teamwork & training with 'clinical cognitive vismemes'; medical image­waveforms metadata­tagged
& encapsulated with annotation & instruction; integration of multi­modal, modal­scalar imaging & genomic data streams for signal detection, pattern recognition & precision medicine
Sophisticated
technology
that simplifies
Regulations &
standards
that facilitate
changeLow-cost
innovative
business models
Economically
coherent value
network
Disruptive Innovation Model
[The Innovator's Prescription]
1
2 3
Clinical Collaboration in the Cloud: Visual Neural Networking for Value Care-Giving Teams

3. Clinical Collaboration in the Cloud with Visual Neural Networking
Connecting Collaborating Teams with Clinical Cognitive Vismemes
in a Virtuous Circle of Visual Neural Networking
Clinical Collaborations with
Visual Neural Networking
Collaborate
Capture
Connect
Communicate
Technology Training
Communications
Collaboration
Teamwork
Teams
Imagination
Images
Ideas
Insight
Vismemes
‘Faster, Smarter, Better' Teams Collaborating with Clinical Cognitive Vismemes
"drives productivity by 5% to 10% each year"
[John Chambers, Cisco]
"cuts product innovation cycle times in half"
[Jeff Immelt, GE]
Networking
Visual Neural
Networked Visual Collaboration:
Visual Connectivity
∙ one­to­one [consultation]
∙ one­to­many [instruction]
∙ many­to­one [monitoring]
∙ on campus or offsite facility
∙ single office location or
∙ realtime or asynchronous
∙ augmented pattern
recognition [CADe]
Collaboration Relationship
∙ peer­to­peer [2nd opinions]
∙ mentor­student [training]
∙ multimodal image integration
∙ hospital, outpatient clinics
∙ multi­site clinical trials network
∙ clinician-patient eduction
∙ mind↔machine adaptive
learning systems
+ multi­paired combinations of visual connectivity &
collaborative communications relationships
Clinical Collaboration in the Cloud: Visual Neural Networking for Value Care-Giving Teams

4. Bending the Cost Curve with Collaborative Connected Team Care
Illustrative Clinical Use Cases for Potentially Significant Cost Savings with Connected Team Collaboration & Clinical Cognitive Vismemes
• Collaborative sharing of annotation­enriched image­waveforms by clinicians and specialists that reduces redundant testing,
avoids unnecessary exposures to harmful radiation and improves detection, diagnostic evaluation and treatment
• Rapid evaluation and emergent treatment of acute ischemic stroke [“Time is Brain”] with neurological expertise and remote
telestroke support for neuroprotective rescue therapies within the “golden hour” that limit permanent damage and disability
• Virtual tumor board networks with multi-specialist team collaborations that boost recruitment and retention of patients for
adaptive clinical trials, and improve treatment and care for remote, rural and under-served populations
• Surgical “road mapping”, simulation and training, including pre-operative team “warm-ups” with actual patient images, prior to
interventional radiology, cardiac catheterization and endovascular procedures
• Teleretinal screening for diabetic retinopathy (DR) with computer-assisted diagnostics (CADe) and pattern recognition tools for
early detection of pre-diabetes before the onset of type 2 mellitus with vision impairment
• Team care ‘checklists’ with clinical cognitive vismemes that help secure and sustain gains in quality team care, patient safety
and clinical outcomes in the OR, and avoid potentially deadly miscommunications during patient hand­offs
Connecting Silos from Bench to Bedside – and Back Again
Collaborative image sharing with multi­sensory clinical instruction empowers care-giving teams to deliver communications-enhanced
team ‘value care’ in the 21st century – ‘faster, smarter, better’ patient-centric care – with higher quality, lower costs and healthier
outcomes. Disruptive technologies such as visual neural neuworking with mobile medical imaging enrich and enhance team skills in
a ‘virtuous circle’ of communications, collaboration, cooperation and coordination.
Teamwork and training boost productivity and performance. Team care ‘checklists’ help secure and sustain gains in quality, safet
and outcomes (especially in the OR), and avoid potentially deadly miscommunications during patient hand-offs. “Anywhere, Anytime”
medical imaging “revitalizes” aging technology infrastructures with ubiquitous connectivity, bidirectional ‘pixel liquidity’, and ad hoc
collaborations that extend the range, reach and effectiveness of medical devices and equipment.
Mobile medical imaging transforms workflows for teams empowered with mHealth connectivity. Smart, agile teams, working in
concert from off-campus locations, consume fewer and less costly RVU resources to orchestrate the delivery of team value care.
With fewer medical errors, less redundant care and more skilled labor delivering better care in less costly venues, cost
savings begin to accrue, compound and multiply. Working together, collaborative care-giving teams can start bending the cost curve.
‘Disruptive’ tools and technologies on the near horizon ­ such as augmented pattern recognition with computer­assisted detection
[CADe] and Spatially Invariant Vector Quantization [SIVQ] for rapid adaptive machine learning with NLP semantic search, interactive
data visualization for integrative visual bioinformatics ­ may help us with earlier detection of disease, more precise and predictive
diagnoses, and better treatment options ­ so that we can begin to deliver on the promise of personalized precision medicine.
Clinical Collaboration in the Cloud: Visual Neural Networking for Value Care-Giving Teams

5. Visual Neural Networking with Mobile Medical Imaging:
Disruptive Tools & Technologies for Value Care­Giving Teams
“In the 21st century the delivery of healthcare will be a team sport”
Jim Smurro discusses the promise and potential of Clinical Collaboration in the Cloud, with Visual Neural Networking [VNN] and Mobile
Medical Imaging [MMI]. These potentially ‘disruptive’ technologies provide ubiquitous visual connectivity for care-giving teams,
enabling collaborative image sharing and delivery of communications-enhanced value care with smart phones, netbooks and tablets.
Visual Neural Networking
Visual communications, collaboration, teamwork and training with medical images and video, including multi-modal image integration
at the point of cognition with multi-sensory instruction for rapid team learning in collaborative innovation networks. Imaging-enriched
collaborations encompass a variety of combinations of visual connectivity and collaborative communications relationships, including:
one-to-one [peer-to-peer consultation], one-to-many [student-mentor training], many-to-one [remote patient monitoring] in real time,
or asynchronously. VNN connects Imaging, Teams and Technology in a ‘virtuous circle’ of collaborative clinical cognition.
VNN technologies enable multi-modal, multi-scalar image integration for more precise and predictive disease detection and diagnoses in
the era of personalized medicine. Visual systems integration at the point of cognition facilitates analysis and correlation of anatomic,
cellular and molecular imaging with metabolomic, genomic and proteomic information for integrative systems biology by teams of domain
knowledge experts with computer­assisted detection tools [CADe] for augmented pattern recognition.
Mobile Medical Imaging
Savvy technology forecasters anticipate an explosion of traffic, devices and infrastructure capabilities in the mHealth space:
• by 2013 there will be over 100 million tablets in use [Forrester]
• by 2014 more than two-thirds of carrier wireless networks will be 4G/LTE
• by 2015 mobile data traffic will increase 26 times [2,600%] over 2010 volumes
• two-thirds of that traffic increase will be mobile video [John Chambers, Cisco]
• by 2021 smart phones will be 100 times faster than today’s models [Eric Schmidt, Google]
[Moore’s Law – technology performance doubles every 18 months]
Mobile Medical Imaging provides ubiquitous visual connectivity with Commercial-Off-The-Shelf [COTS] technology components available today.
Clinical Collaboration in the Cloud for Personalized Precision Medicine
VNN technologies provide a platform for collaborative discovery in life sciences, drugs and devices development and value­care delivery.
High speed, high performance mobile medical imaging enable care-giving teams to Capture­Connect­Communicate­Collaborate and
train together - anywhere, anytime - with medical image­waveforms and video.
Annotated medical images, telestrated cine clips and encapsulated audio files help care-givers document and share episodes of care.
Clinical encounters and specialist consultations are captured at the point of care in standards-compliant clinical notes. Secure, encrypted
imaging portals with digital identity verification enable multi-disciplinary teams to better communicate, collaborate and coordinate
delivery of value care ­ ‘faster, smarter, better’ personalized precision medicine with patient­centric value care.
Clinical Collaboration in the Cloud: Visual Neural Networking for Value Care-Giving Teams