Provider burnout has increased the need for AI solutions in healthcare. However, trust and intuition are key to adoption of medical AI due to concerns about technology overreach and the importance of clinical judgment. Bias and ensuring equity also present challenges but opportunities if diverse datasets are used to train models. Medical AI experts can help address these issues through consultation, focused training of annotators using specialized curricula, and leveraging networks of medical experts to support tasks like annotating surgical videos, pathology slides, and clinical documents.

1. ADADVA
Director of Medical AI
, M.D.

2. ADADVA
Need,Challenge,&
Opportunity
BRINGINGYOURMEDICALAIPROJECTSTOLIFE
ODSC | August 2020

3. ● Director of Medical AI, iMerit
● Plastic & Reconstructive Surgeon, Stanford
Hospital & Clinics
● 10 years in MedTech, 5 years in Medical AI
● Building Healthcare Datasets for Machine Learning
Use Cases at iMerit for >2 years
SINABARI,MD

4. Poll1

5. KEYTAKEAWAYS
● Provider Burnout lends urgency to the need for AI
solutions in healthcare
● Understanding Trustability and Intuition is the key to
adoption of Medical AI
● Concepts of Bias and Equity present both a challenge
and an opportunity for AI
Case Studies
Questions

6. WHOISiMERIT

7. • iMerit leverages human intelligence
to label and enrich data
• We enrich training data accurately,
securely, and with operational
efficiency
• We power algorithms in machine
learning and computer vision
• We effect positive social and
economic change by combining a
network of experts and an under-
utilized workforce
WeareiMerit
Strong
Social
Mission
On-Demand
Dynamic
Skilling
Technology
Powered
Enterprise
Grade
Client
Analytics
& Insights

8. ● iMerit Tools
● Client & 3rd Party Tools
● AWS Sagemaker Ground Truth
iMeritisToolAgnostic&PlatformInclusive

9. Medical Computer Vision Healthcare Informatics
● Physical Exam Imagery ● Virtual Nursing Assistants &
Chatbots
● Digital Radiology ● Medical Record Data
Enrichment & Extraction
● Digital Pathology ● Clinical Trial Data Enrichment
& Extraction
● Endoscopy & Robotic Surgery ● Medical Natural Language
Processing
iMerit’sDedicatedMedicalDivision

10. Poll2

11. PROVIDERBURNOUT

12. WhatisBurnout?
● Burnout is a combination of exhaustion,
cynicism, and perceived inefficacy resulting
from long-term job stress
● Burnout has increased over the last decade
● >50% of Physicians report experiencing
burnout (Jan 2020, MedScape)

13. WhataretheConsequencesofBurnout?
● Medical errors and diminished patient care
○ Higher Mortality
○ Increased Nosocomial Infections
● Domestic Violence and Harmed Personal Relationships
● Alcoholism & Substance Abuse
● Depression and Suicide

17. Radiology
Pathology
Anesthesia
Orthopedics
Primary Care
Urology
General Surgery
Nursing
“Loadtheboat”
Dermatology
Ophthalmology
Cardiology
Gastroenterology & Hepatology
Sports Medicine & Biomechanics
Dentistry
Neurology
Cardiology
Access to a medical community to build compliant solutions via
an industrialized process

18. Poll3

19. TRUST&INTUITION

20. HowdodoctorsfeelaboutAI?

22. Why?
● Doctors are luddites?
● Doctors are gatekeepers?
● Mis-steps can have disastrous
consequences
● Over eager adoption of
technology has a regrettable
history
● Intuition is a big part of
medicine

23. “Sickvs.NotSick”
Tversky & Kahneman
System 1: Fast, automatic,
frequent, emotional, stereotypic,
unconscious, resistant to change
System 2: Slow, effortful,
infrequent, logical, calculating,
conscious.

25. OPERATIONALUSECASES
CLINICALUSECASES
Screening
Triage
Measurement
Quantification
Autonomous Systems
Clinical Decision Support
Robotic Process Automation
Structuring Research Data
Patient Engagement
Iterative&NeedsDrivenAITechnology

26. BIAS&EQUITY

33. Whatisthesolution?
● Define and Measure
Fairness
● HiTL during training and
model validation
● Checking Counterfactual
Fairness
● Larger and More Diverse
Sets of Training Data

34. Inhouse & Consultative Network of Experts allows for tiered services
based on complexity
Tier 1 - Specialized Annotators with Expert created Guidelines &
Training
Tier 2 - Specialized Annotators with “Expert-in-the-loop” for
Production, QA, or QC
Tier 3 - Subject Matter Experts / Clinicians
“SolutiontoPollutionisDilution”

35. ● Narrow
specialization in
target domain
● Specialized
lexicon: domain,
metacognitive
● Distilled definitions
● Streamlined theory
& background
● Modularized curriculum
● Microlearning design
● Peer learning and consensus-
building
● Iterative practice
● Example-rich
● Exposure to edge cases
● Cumulative proficiency
development
Deep
Focused
Expert guided
Training
Specialists
APPROACHTOTRAINING

36. iMeritONE:LearningManagementSystem
Skill Configuration
Domains are broken into their
constituent foundational skill sets
Smart Resource
Allocation
Staff with the right skills are assigned
based on their Employee Skill Profiles
and the needs of the project
Virtual Classrooms
...and Supplemented with Online
Instructor led training
Project Skill Tagging
New Projects are tagged with the
relevant skills at the level of
workflow and role
Learning Management
System
Additional skills are built using our
modular online e-learning platform...
Practice &
Assessment Tools
Automated tools for evaluation
allow us to visualize status &
progres

37. iMERITPeoplePlatform(iMPP)
Skills List
3D Spatial, Cardiac, LIDAR, Polygon Segmentation,
Semantic Segmentation (II), Medical

38. MINICASESTUDIES

39. PROBLEM:
● Semantic Segmentation of
Robotic CABG Video
SOLUTION:
● TIER 1 Annotation Services
FEATURES:
● Expert Consultation & Guideline
Preparation
● Modular Curriculum focused on
Surgical Anatomy and Procedural
Steps
● iMerit PanOptic Tool
S CASE1:ROBOTICSURGERY

40. PROBLEM:
● Annotation of Whole Slide Images of
Ki-67 IHC Staining for IDC Breast Cancer
SOLUTION:
● TIER 2 Annotation Services
FEATURES:
● SME Consultation & Guideline Prep from
Primary Literature
● Modular Curriculum
● Multi-step Workflow
○ Step 1: Specialist Annotation Teams
○ Step 2: Pathologist Consensus &
Feedback
● Client Digital Pathology Tools
S CASE2:DIGITALPATHOLOGY

41. PROBLEM:
● Entity Recognition, Key-value
Pair Localization & Extraction
from Heterogenous
Documents
SOLUTION:
● TIER 3 Annotation Services
FEATURES:
● NLP Expert Consultation
● Team of Nurse Annotators
● iMerit NLP Annoation Tools
S CASE3:DISCHARGESUMMARIES

42. Summary

43. ● Disparate Care & Physician Burnout increase the urgency
for AI solutions in Healthcare
● Build needs-driven intuitive tools that integrate
thoughtfully with existing workflows
● “Load the boat” with a partner that can support data
operations, leveraging existing networks of medical
expertise
● Scale Data Operations to Industrialize and Commercialize
AI Solutions

44. Visit us @ imerit.net
Contact:
sina@imerit.net