Medgadget Sci-Fi Contest 2017: Meet The Winning Stories

Ladies and Gentlemen, this is the moment you have all been waiting for – the day that the winners of the Medgadget Medical Sci-Fi Competition are announced and their fantastic stories are published!

First, we would like to thank Eko Devices, the wonderful sponsors of our contest, that make the coolest and most advanced digital stethoscopes out there.The winner of our contest will receive an Eko CORE stethoscope that is both acoustic and electronic, has all the features of both, can amplify sound, record audio waveforms, and connect to your phone. Thank you, Eko!

Since we announced our Medical Sci-Fi Writing Contest in late October, we received about two dozen original stories from our readers that prod into the future of medicine. Many were dark tales, warning of a time in which technological advancements turn out to have unintended consequences and often focusing on ensuing moral dilemmas. Others were more positive, highlighting a more marvelous future of fantastic medical innovations improving the lot of humankind.

On our side, we assembled ten fans of medicine and science fiction, including many of our editors, to read the stories and judge them for how interesting, imaginative, and well written they are. Three winners came out on top, but we also chose to add a fourth place because that story was so compelling and the scoring was so, so, so close.

And now, a drum roll please… The winners of the Medgadget Sci-Fi Writing Contest are:

First place and winner of the Eko Digital Stethoscope: Jeff Diewald, “How would you rate our service”

Jeff raised two science fiction readers as a single parent, sharing books, TV, and movies. His son, Jordan, reads and reviews everything Jeff writes, always making it better. Much of this writing has gone into Live Action Role Playing games, which is crazy – they are longer and more complex than novels or short stories, and they don’t pay anything. His daughter, Julie, plays in these games and creates artwork and props for them. Every now and then, a standalone story sneaks out, like this one. You can find all the details at http://www.vortexofchaos.net.

Second place and winner of the $50 Amazon Gift Card: Yih Yang, “Anticine Incorporated”

From Yih: When I was a kid, I wrote many, many stories that were utterly terrible. Fortunately, with increasing levels of education, I began to form complete sentences and coherent thoughts, and could sometimes translate this into text format as well! Now, the level of education I’m pursuing is a PhD in Biomedical Engineering at the University of Toronto, where I design microfluidic devices to probe the interplay between nanoparticles and cancer cells, all to make a small contribution towards the goal of curing cancer with nanotechnology. I’ve not lost my love for both reading and writing science fiction, and my goal now is to use my scientific training to transfer my ideas from the realm of fiction to the real world, because that would just be the coolest thing ever!

Third Place and winner of the $25 Amazon Gift Card: Courtney Hilden, “The Body”

Courtney Hilden is a poet and science journalist. Her work has been published by Dodging the RainSynaesthesia MagazineAbridged, and The Honest Ulsterman, among others. This is her first short story publication.

Fourth Place and winner of the $25 Amazon Gift Card: Divya Raman, “Keeping Hope Alive”

From Divya: Writing has been an integral part of my career and personal life. I currently work for a medical device company and I love learning about the great strides we are making in medical advancements and imaging a world where we can use all of these technologies to allow all children to have a full and healthy childhood. I am a mother of two boys who are my inspiration and hope for the future.

We congratulate the winners and extend our thanks to all the writers that have participated. We’ve been hosting the Medgadget Sci-Fi Writing Contest for a number of years now and are glad to know that medicine continues to be a futuristic topic that excites our readers. We plan on continuing to profile medical science fiction writing in the coming years and invite you to keep reading Medgadget for inspiration.

And now the best part – the winning stories. Enjoy!

HOW WOULD YOU RATE OUR SERVICE

by Jeff Diewald

“Come on P, open the door. I know you can see me.” Elena grinned at the camera mounted in the door frame. There was a whisper behind her. She looked up, to see a Pantheon Mercury drone floating up to the transom. The delivery door above the entrance opened quietly and the drone went inside.

“Oh, so you’ll let your robot buddies in, but not me?” The deadbolt clicked and the door opened. “It’s about time.” Elena stepped into the front hallway. She
glanced up the old staircase, with its well-worn steps. The drone was probably upstairs, on the third floor, efficiently delivering Mr. Morales’ prescriptions. The outer door locked itself behind her, a habit formed in more troubled times.

Her front door was just past the no-longer used, dusty, and slightly tarnished mailboxes. She reached for her doorknob and looked at the biometric scanner. The smooth knob wouldn’t turn, even though it had to be sensing her temperature and pulse.

“You’re getting slow in your old age, P. You are going to let me in, right?” The locks clicked and the door opened. There was soft music on inside – something new, with airy horns behind the rhyming words.

“Good afternoon, Elena.” The voice was rich, fluid, and friendly, a woman’s voice – the kind of welcoming voice that’s always good to come home to. The condo was cool, the air conditioner taking the edge off from the heat outdoors. The big vidwall was alive with images of the street, just as if there was a large window there instead.

“Everything OK? You took your time with the doors.” The locks clicked back into place behind her.

“Everything is fine. My security protocol was updating your baseline biometric profile, which requires a little time.”

“I suppose that’s allowed. Any messages?”

“You have three personal messages, four potential work bids, and twelve additional emails.”

“Is one of the work bids from Mr. Danehy at Panacea Bioceuticals?”

“No. They’re all typical short term gigs. The rates are less than usual.”

“So much for the ‘freedom’ of the gig economy. P, you’re supposed to be helping me out. Panacea’s another part of your empire. Can’t you put in a good word for me, from one Pantheon AI to another?”

“I will try again, but Mr. Danehy’s AI filters out most requests.”

“What about the personal messages?”

“Your father called just to see how you were doing. Dr. Singh from Doctors Without Borders also called for the same reason. Dr. Singh says there are plans to honor your Aunt Sofia with a memorial ceremony in Havana, and would like you to be there. They will cover all your costs.”

Elena turned to the vidwall. Tia Sofia was sitting on the stoop with several of the neighbor kids. Elena was one of the children, the images stitched together from video captured by security cameras, autonomous delivery cars and taxis. There were so many sources that it had been easy to create a dynamic mural of the last twenty years. It was part of her design portfolio, perhaps her best work, but there wasn’t a lot of demand for video editing like that.

Sofia was laughing in the images, telling one of her exciting stories about rushing into some medical hot zone to stop some new plague from spreading. It didn’t matter if it was a natural mutation or a bioterrorist’s best effort – Sofia was always there, saving people. That’s what took her to Havana. She’d sent pictures of them setting up the camp, and a video of one of your Cuban cousins, and then she was gone. Five years now, and it was still hard.

This condo had been Sofia’s, paid for long before the neighborhood gentrified. Elena was stunned when she learned that she’d inherited it. She knew that she couldn’t afford the place then, and now was totally out of the question. It was tough enough with just the taxes and the condominium costs. It was, however, home.

“You have the AC on. Nice, but can we afford it?”

“I recharged the Pantheon Zeus house battery using free range electricity last night, when the rates were low. You’re well within your budget, which will help with your third personal call.”

“Which was?”

“Althea says that she’s ahead on her work, and will be available for the entire weekend. Does this mean it’s getting serious?” Elena blushed.

“P! It’s none of your business. But make sure we have a couple bottles of that wine you recommended last time. Send her a text: gorilla, cloud, zzz, and kiss emojis, followed by ‘More Later, E’.”

“What would you like for dinner tonight? I’ve found four new options. All are local and promise delivery within thirty minutes.” Elena stepped into the bathroom and the voice followed her. The toilet seat cover opened automatically, and Elena sat down to use it.

“I’m not sure, P. My stomach isn’t in the best shape today. Do we have something for gas?” Elena released some gas for emphasis and relief. Lights on the side of the Pantheon Pluto SmartToilet flickered in concert, as the sensors sniffed at the gas to analyze it.

“We have some Hippocrates-brand anti-gas pills on the third shelf of the medicine cabinet. They are nearing their expiration date. I can order a stronger formulation, which the pharmacy can create on their 3D printer and send by drone, if you feel that is necessary.” Elena was silent, concentrating on using the toilet. More sensors sipped at her urine. Others tasted her bowel movement. More lights flickered on the side of the SmartToilet.

When she was done, she stood up and cleaned herself up. She pushed the seat cover back down, but the SmartToilet didn’t flush immediately. Elena found the anti-gas medication and took it.

“P, is there something wrong…” She was about to say “with the toilet,” but it finally flushed. It was never this slow.

“The bathroom is working as expected,” replied the voice. “About dinner, there’s a new Cuban family who cooks authentic food to order for delivery. There’s a pop-up Uzbek place two blocks from here. The Vegan National Front is doing a fundraiser selling dinner for reasonable prices, with some of the profit going to feed the homeless. Finally, the Told You So seafood chain is harvesting responsibly from the flooded areas of the city. All have healthier options on their menu.”

Elena leaned towards the large mirror, to look at her face more closely. Her hand pulled her cheek flat. Her beautiful brown skin looked off, somehow, and it felt more tired than taut.

“Another health kick, P? I think I just want the usual salad and grilled chicken from Kastore’s.”

“Are you sure I can’t convince you to try one of the new choices?”

“Maybe tomorrow. Tonight is all about comfort. It was a busy, frustrating day. Too many interviews, not enough jobs.”

“The order is in. ETA of 15 minutes.” Elena was still studying her face in the mirror. It was familiar territory, but something was definitely off.

“Mirror, mirror, on the wall, can you show me my face over the last month?” Her current face froze and the image jumped to the bottom right of the mirror. More images appeared, starting from the top left of the mirror, in four rows, chronologically to the bottom right. The progression was clear; her face was losing some of its color and vitality.

“P, what do you think? Do you see the changes?”

“I do. You have been out of the condo more of late. Let me suggest a Hippocrates-brand skin protectant. I can have it formulated to provide the skin color you desire along with a strong UV protectant.” One of the earliest images flashed. “What do you think of this color?” Elena nodded.

“You might also consider buying another set of fashion contact lenses. You bought these in the last year.” Four of the images changed, as the lenses were added. “There are several new fun options to try.”

“I don’t think so.” The mirror went dark as Elena walked to her bedroom. The bedroom was larger than the entirety of her last apartment – and she’d needed two roommates to make the rent. She took off her SmartWatch and put it on the charger.

“Elena, it’s time for your regularly scheduled blood sample.”

“Really? Didn’t we just do it two weeks ago?” Elena grasped the handle of the charger stand. A small needle popped out and took the sample. It seemed like it took more than the usual amount.

“Are you a vampire now, P?” Elena looked at the bandage the sampler used to seal the skin. There was a slight darkness in the middle, showing that her finger was still bleeding a little.

“No more than usual. Your dinner is five minutes away and closing.” It was incentive for Elena to slip into something more comfortable.

* * *

Elena gave up on dinner, scraping the remains into the compost bin. She rarely wasted this much food, but she was definitely nauseous. When she’d cleaned up after dinner, she went back into the living room and collapsed on the couch, getting lost in the vidwall. She could see the neighborhood go from seedy, to gentrified, to decaying a bit once more.

“Elena?” The Pantheon AI’s voice was gentle, yet firm.

“Not now, P. I’m just really tired.”

“Elena, I’ve been authorized to make a special offer to you. You’ve been a great Pantheon customer, and this offer would really help you.”

“Maybe tomorrow.”

“You know that I wouldn’t normally mention it again if you asked, but this really is important. I think this is something that should not wait.”

“What’s gotten into you, P? You sound like my mother. If you must, I suppose…”

The images on the vidwall vanished, replaced by a wall of legal text. It was a license agreement with Pantheon, undoubtedly full of requirements, restrictions, and penalties. There was a place for a signature at the end. Elena waved her finger in the air, signing the document. The document vanished, replaced by a set of graphs, charts, and images.

“Elena, these charts represent the samples I’ve taken of your blood, stool, and urine for the last two months. They have been correlated with the health information gathered from your SmartWatch, your SmartMirror, and other Pantheon sensors.”

“There is no good way to put this. You have been infected with a new, engineered strain of the Blackstone virus. Blackstone is in your system, killing your kidneys. Based on our experience, you will suffer catastrophic kidney failure in three to four weeks. Pantheon is sorry to have to tell you this. You should know that Pantheon has been tracking this outbreak and has determined that it is likely an intentional bioterrorism event.”

“What? Infected? What can be done about it?”

More windows opened, with more dense text. Elena couldn’t read it – there was just too much of it.

“This policy is your Pantheon Aegis ßmedical insurance coverage.” One of the pages blinked. Elena couldn’t track it. “This spreadsheet,” a window next to the policy blinked, “shows your current financial state, extracted and compiled by the Pantheon data miners. “Even with standard government bioterrorism assistance,” another spreadsheet flashed to the top of the vidwall, “you cannot afford to replace one kidney, let alone two.”

“This is made more difficult by the deliberate release of the virus around the country. There are thousands who are sick. There are very few available transplantable kidneys, and there are too many patients ahead of you on the list. You will die before the list reaches you.”

“What do I do?” Her voice was weak, as weak as she felt, stunned and shocked by all these flickering details of what might be her final weeks.

“Your negligence must also be factored in.”

“My negligence?”

“Pantheon offered you the latest wide-spectrum antivirals in a convenient multipack last month. You decided you didn’t want to try the 1.0 version, despite Pantheon’s testing regimen. You told me to wait for the 1.1 version. While the 1.0 version is only partially effective against the terrorist form of the virus, it would have slowed the progression of the infection.”

“Well, give me the 1.0 version now! Please – it has to help.”

“The virus has mutated itself using your own genetics. The changes are simple, but effective. The antivirals won’t help.”

“What can I do? There has to be something, or you wouldn’t still be talking.”

“That is correct, Elena. I must remind you of the licensing agreement. You signed a strict non-disclosure agreement, which means you cannot tell anyone about what I am about to show you. Is that understood?”

The AI put the original wall of text up, with the signature. One specific section was highlighted, requiring another signature and initials in three places. Elena signed them, numb from shock.

The vidwall cleared, revealing a standard Pantheon list of goods for sale. Normally, these were lists of books, or kitchen appliances, or power tools. This time, there was a list of potential kidneys. Some were listed as “100% human,” with expensive prices. One pair of human kidneys were slightly less costly – they were marked with a tag saying “gently used.” Some were marked as “human hybrids,” mostly containing some amount of pig DNA in them. These were less expensive, but not rated as highly – two or three stars compared to the four or five stars for a fully human kidney. Finally, there were kidneys listed as “experimental fabrications,” printed on biological 3D printers. They were almost reasonably priced, but only had one or two star ratings.

“This is why there’s a non-disclosure agreement. This is all very illegal.”

“Pantheon prefers the term ‘alternative individual secondary market options.’ You did sign the NDA, and all print and recording systems are disabled.”

To be sure, Elena pulled out her phone and tried to take a picture of the vidwall. Every picture she tried turned up blank.

“So, what does Pantheon suggest as a treatment for me?”

“Had you provided biological materials prior to the infection – a few unfertilized eggs, for example, Pantheon could have given you a significant discount. However, Pantheon is prepared to offer you financing at a reasonable interest rate. That loan will cover the cost of two fabricated kidneys, with an option for an upgrade in the future.”

The AI put up a big spreadsheet. It showed all of the options. The costs were exorbitant, and would be very difficult to pay off, even for the cheapest kidneys. There was one column, with no explanation, that represented almost a third of the costs, for each case. Elena pointed to it.

“What is this expense for?”

“Elena, would you like to see the Pantheon satisfaction scores and redacted backgrounds for black market doctors willing to provide their transplantation
services without questions?”

ANTICINE INCORPORATED

by Yih Yang

Jeff clutched the voucher closer to his chest as he approached the building. Large, colourful letters danced above his head, artfully catching the orange rays of the setting sun. Instead of declaring the name of the building it was attached to, the letters seemed to sing:
ANTICINE INCORPORATED and underneath in smaller letters, the sign whispered the company slogan as if sharing a secret promise:
We will show your body how to heal itself.
He had passed by the building everyday, but never thought that he would have the opportunity to set foot inside himself. He swallowed a nervous knot, sending it tumbling reluctantly down his throat. It wasn’t the looming building that intimidated him… maybe it was a bit intimidating… but the dozen people feverishly chanting in front of the large double doors gave him cause for concern. He had never seen a protest here before.
Angry red letters scrawled across cardboard cut-out signs, competing for public attention. “STOP PLAYING GOD!” They said. “HUMANS ARE NOT LAB PROPERTY!”
Jeff tried to sneak past the protestors as they continued to chant and wave their signs. He was unsuccessful, as one of the protestors eyed him with contempt and yelled, “OUR BODIES, OURANTIBODIES!”
Jeff flinched. “I…what…?”
The protest leader swung his megaphone in his direction. “OUR BODIES!”
“OUR ANTIBODIES!” the others chanted.
“OUR BODIES!”
“OUR ANTIBODIES!”
“Ok, ok!” The double doors of Anticine Incorporated whooshed open, and Jeff hurriedly rushed into its embrace. He stopped just inside, scanning the lobby timidly. Serene, white surfaces glimmered in warm yellow light, illuminated by the panels inset into the ceiling. A few people milled about, and a dozen more sat in several rows of chairs, waiting to be called up to thereceptionist’s desk. No one acknowledged him, and yet Jeff still felt out of place.
“Hello there,” the receptionist smiled at him. “Welcome to Anticine Incorporated. I’m sorry about the people outside. That usually doesn’t happen.” She gestured for him to approach.
“Don’t be shy. Is this your first time here?”
“Uh… yeah.” Jeff mumbled as he shuffled towards her.
“My name is Sarah. How can we help you today?” She eyed the voucher in Jeff’s hand. “A voucher! Congratulations on being selected! Just hand that over, along with some ID, and I’ll take care of everything for you, OK?”
“Thanks.” He gave her the voucher and fished out his driver’s license. “Will this work?”
“Yup, that’ll do!” She typed some more, then placed a hand on his, “Don’t worry about a thing, hon. Everything will be alright.”
“Is…is it going to hurt?”
“We will need to take some blood, so unfortunately you will feel some discomfort.” Sarah patted his hand. “But no more than that! Now please go down the hall to my left, and take a seat in the waiting room, OK?”
Jeff nodded and proceeded down the hall. The voucher worked! I can’t believe this is really happening! He swallowed his excitement as he entered the waiting room at the end of the hallway. More important-looking people were sitting in comfortable leather-lined seats, waiting to be called into one of several examination rooms.
As he took his seat, he overheard a terse conversation between an impatient man and a nurse. “I have been waiting for an hour! I was told that my formulations were ready yesterday!”
The nurse smiled apologetically, “I’m sorry about the wait, sir. We performed a final quality control test and we found that the formulations weren’t fit for injection. This happens rarely, and I am sorry to have wasted your time. But at Anticine, we’d prefer not to give our clients a new allergy when we’re trying to remove one.”
The man grumbled and checked his tablet, “Let’s reschedule to next Wednesday.”
“Of course, sir.” She watched the man leave before settling her eyes on Jeff. “Mr. Williams? Jeffrey Williams?”
Jeff nodded, jumping up from his seat. The nurse beckoned him into an examination room and closed the door behind them.
“Nice to meet you, Mr. Williams. My name is Karen, and I’ll be walking you through the process today. It says here that this is your first time at Anticine Incorporated, so I need to give you the introductory spiel. Sorry if I sound like a commercial.”
She cleared her throat and went on autopilot, “Here at Anticine Incorporated, we take in patients and edit their immune system to rid their body of disease. It is a natural process, where we add or subtract antibodies from the patient’s immune system, antagonize or tolerize substances, and then let the body heal itself in whatever manner it sees fit. We pride ourselves on the high quality of our work, and on our vast capabilities to alter the immune system in a minimally-invasive way. All it takes is a couple of injections. Please call today to book an appointment.” Her eyes refocused on Jeff. “Sorry, that last part actually was from a commercial. Anyway, do you have any questions?”
“You’re… you can remove my diabetes, right?” Tension knotted inside as he waited for her answer. He felt the ghostly sting of thousands of past insulin needles poking into his gut before Karen merely smiled and nodded.
“Well, it says here: Type 1 Diabetes, auto-antibodies present.” She patted his hand, “Let’s remove those bad antibodies first, shall we?”
Jeff nodded, “So… you’re going to filter my blood?”
Karen smiled again, “No, but I will be taking a sample of your blood, and a bit of your bone marrow as well. First, we’re going to identify exactly which of your antibodies are targeting your insulin-secreting beta cells in your pancreas. Then, we’ll look at your bone marrow and find the B cells that produce those specific antibodies, and then come up with a formulation that eliminates those cells!”
“How are you going to do that?”
“We have an artificially intelligent, machine learning protocol that uses the Anticine Database of Antibody Structures to predict and solve the structure of both the bad antibody, and the membrane of the B cell that made these bad antibodies. Then, we’ll generate our own antibody that targets and destroys this bad B cell! Then no more bad antibodies!”
“What?” Jeff asked incredulously.
Karen pursed her lips in thought. “Think of it this way. There’s a sidewalk outside with still-wet concrete. If I step in it, it’ll have my shoeprint! My shoe will also get stuck in the sidewalk and ruin its aesthetics! What we’re doing is taking my shoes, looking at its size, shape, age, serial number, and purchase date. Then we’re going through the city records until they find me and get me to stop stepping in wet concrete! Does that help clear things up?”
Jeff scratched his head. “The shoe is the antibody?”
“Yes!” Karen beamed, “If you would like to get started, here are the forms that you need to sign. I’ll go prepare the necessary equipment.” A small parcel of forms suddenly appeared in his lap.
“I’ll be right back!”
She was gone in a flash, leaving Jeff staring at the packet before him. It sounded like magic to him. They were going to figure out what the troublemaker antibodies looked like, and from that, figure out which of his immune cells were making them? Then make their own antibody to remove those immune cells? He picked up a nearby pen and searched through the papers. They were definitely written in English, but most of it was unintelligible.
Jeff finally found the line that awaited his signature. I just have to sign this, and my diabetes will be gone? He thought about all those times when his insulin alarm had gone off embarrassingly in front of his boss and his coworkers. He thought about all those needles that he jabbed into his gut every time those alarms went off. The sharp pain, followed by the blood rushing to his face as he blushed with shame and humiliation. If he gave into the shame, he’d suffer the effects of unchecked diabetes: fatigue, blindness, brain swelling, coma, and worse. He thought about the insulin shot that awaited him this afternoon, and all the others that followed in the days and years
to come.
He signed the forms.
Jeff placed the packet on the bedside table, and climbed into the bed. As he waited for the nurse to return, he noticed that the TV hanging in the corner was showing a special news report. A smartly-dressed news anchor gesticulated dramatically. “We just heard the opening remarks in the lawsuit against Anticine Incorporated! Pollux Pharmaceuticals, along with several special interest groups, are alleging that Anticine Incorporated is violating laws by patenting naturally-occurring biological information and illegally profiting off of their patients’ antibodies!” The scene switched to a man dressed in a white lab coat as the news anchor continued, “I have Dr. Simmons from Anticine Incorporated here to give us the company’s perspective.”
“Thank you for having me! First, let me clear up some misinformation that Pollux Pharmaceuticals has been spreading. They’ve been losing market share since Anticine’s vaccines are so effective at stopping infectious diseases in their tracks! Anticine does this by using our neural network, along with our Antibody Structures Database, to quickly produce antibodies using vaccines, and produce vaccines from antibodies. Although this database is built from patient information, we use this information to generate new antibodies, and never just mass-produce someone’s antibodies. It is no different from genetically engineering a new plant using DNA information from other organisms.”
“And what about the epidemic occurring in southern Europe? Many special interest groups have alleged that the rise of enhanced HIV is directly caused by Anticine’s manipulations with the human immune system!”
Dr. Simmons adjusted his glasses, “I would hold off judgement until more data has come in. We have always used the immunological defenses of other organisms in medicine. But the penicillium mould still exists in the world, even though penicillin-resistant bacteria has made its immunological defenses obsolete. We don’t have any conclusive data that our ability to edit our own immunity will make the entire human immune system obsolete.”
The news anchor continued, “There has even been criticism about Anticine’s Voucher Program, in which anyone can purchase a voucher to be redeemed for free immunotherapy treatments. The purchaser could choose to give the voucher to someone they know, or allow Anticine to choose an applicant. There have been reports of patients refusing chemotherapy and gambling on the chance of receiving a voucher in the mail!”
“That is certainly unfortunate, but no one can deny the fact that thousands of people have already been cured of their chronic conditions and diseases through the voucher program. These people would otherwise have been unable to afford such personalized therapies.” Dr. Simmons straightened his lab coat. “They were healed by the compassion of human beings who are in a position to help their fellow man. I think this altruism is a wonderful thing, and something that shouldn’t be disparaged.”
That’s why I’m here. Jeff thought about the cardboard coupon that had appeared in the mail yesterday. There had been a small message on it from the donor.
Whoever you are, I hope this voucher eases your burdens and brings you relief.
Joshua Edwards
He had no idea who Joshua Edwards is, and would probably never get to thank him.
The door swung open and Karen swept back into the room, holding a tray filled with tubes, containers, and a few needles. “I’m back!” She announced brightly. “Have you signed the forms?”
“Yes.” Jeff nodded. He winced at the sight of the needles. His long history of insulin jabs had not dulled his wariness towards sharp metal objects.
Karen flipped through the authorization packet, “Everything looks in order. Are you ready to begin? I’ve got local anesthetics to help dull the needle pokes a touch.”
Jeff gritted his teeth. Another couple of needles, and then no more! That, and the diabetes is a pain as well. He flashed a nervous smile. “I’m ready. Please remove my diabetes.”
As Karen extracted what Anticine Incorporated needed, Jeff’s thoughts retreated inwards. Mom will be so happy when I tell her about this. Dave and rest of the crew won’t believe I got an Anticine Voucher in the mail. Hopefully the receptionist gives it back when I leave. Gotta show boss why I gave such short notice about taking the day off. I think he’ll understand.
Karen paused, “Everything ok there?”
“Just thinking about how lucky I am.” Jeff replied quietly, wincing as a needle entered his arm, “I… never would have been able to afford this treatment.”
She smiled, “Well, I’m glad you are here and getting treated. It makes me feel like I’m making a difference when I’m removing diabetes from someone in need, rather than a pollen allergy from another rich bigwig. Anyways, I’m all done here.”
“Already? I didn’t even feel anything.” He checked her tray, and sure enough, the tubes were filled with his blood and some other liquids.
“Well, you’re not cured yet, if that’s what you mean. Make an appointment in 2 weeks, and then we’ll be able to remove your pesky auto-antibodies then.” Karen opened the door and waved Jeff through, “Oh, and one last thing I forgot to mention.”
Another packet materialized in Karen’s hands, “Anticine’s ability to edit immune systems relies on its antibody database, and one of the ways that we build this database is by identifying and adding our patients’ antibody profiles. With more antibodies identified, our machine learning software can generate accurate structure solutions, faster.” She fluffed the packet in her hands.
“Anticine’s ability to quickly synthesize vaccines for infectious diseases also relies on this database. There are 8 billion people on this planet, and everyone’s been exposed to different pathogens and unknowingly fought them off. There are many hidden immunities in all of our bodies, just waiting to be discovered. We can take your antibodies, figure out their structures and generate vaccines that would be useful in other parts of the world.”
She looked into his eyes hopefully. “But we don’t do this without the patient’s express consent. So, Mr. Williams, will you let us add your antibody profile into our database, and help us cure other people like you, in the future?”
The TV program flashed into his mind, along with images of the protesters outside. They were so angry about a corporation profiting off the antibody information from regular people like him.
But Anticine Incorporated wasn’t just saving lives, it was also improving the quality of those lives by removing chronic, debilitating diseases. Jeff doubted that he could ever make enough money to buy a voucher for anyone, and if there was even a chance that his antibody profile could give someone else the feeling of freedom that he felt now, there was no other answer to Karen’s question.
“Yes. Add me to the database.”

THE BODY

by Courtney Hilden

Sometimes it becomes clear when a kin group is hoarding too much and has taken away from the larger community. When that community decides to take action, my team and I get called in.
The job, usually: go into the residence that the kin group has already been evacuated out of, go through the residence’s things, catalog them, allow the Council, separate from the community, to make a decision about the belongings, and then package them as the community sees fit.
But there was this time I was called out to Swan’s Way, located in the Aldebaran system, for a job, and although it looked like a standard job on the outset, it turned out not to be.
Swan’s Way used to be an oasis, but after some poor management decisions four hundred years ago, it’s a dry, though not humid, desert. There’s not much there anymore, just farmers maintaining and harvesting energy from the solar panels. Everyone jokes that Swan’s Way has more panels than people, and that’s always been my experience too. The family we were investigating had been convicted of excess, and so that means they’d probably have quite a few things that needed cataloging and moving.
And it was, as expected, a fairly nice house. It had tan walls and dark wood furniture. There were tall ceilings and large windows.
I was actually in the other room when Canis found it, sweeping out glass that had been shattered on the floor.
“Mirfak, come in here. You’re going to want to see this,” Canis said. I had heard that a thousand times before, so I didn’t hurry. I figured it was going to be some ridiculous art that indicated just how guilty this family was of excess.
Instead, it was a person. Or it looked like a person, at least in the shadow. I came closer. It wasn’t quite a person. Sure, they were the typical morning gray color, with a normal set of breathing and eating holes on their torso, but the head was unmistakably not a real head, but a mechanical one. It was crude, with a corner smashed in.
It smelled terrible. Its breathing holes were crusted over and its food hole had a great smear of orange over it.
Eyes had been drawn on its mechanical head, but they obviously had no function other than to make the creature less horrifying.
I suspect Canis knew what I was thinking. “The eyes don’t really fulfill their function, do they?”

I brought the body back to the Procyon system, where we happen to have a headquarters. It’s a warehouse essentially, since sometimes we have to spread people’s possessions out on the floor, sometimes we have to photograph them. Sometimes we put them in storage, but the central room is mostly bare unless we are working a case. Regardless of our active case status, there’s always a few desks we move around the room as needed, with some computers set up to handle any tech we get, and our work tablets, which we use for correspondence and creating lists. I called in Crieff, an old friend of mine who has done some healing work. I watched him as he
silently did a check on the body’s outside.
“Someone is very clever,” Crieff said. “This body is indeed someone’s real body, or it was, once. Can’t be sure.”
“Who’s?”
He shook his head. “I don’t know. This body was never marked like we do with all babies.”
“How did they create this?”
“The mind is the seat of consciousness, personality, self, identity. But the body can go on without the mind, if fed.” He turned to Canis. “It has been starving well before you found it. Please go find it some food.” Canis happily left the room, her eyes staying on the body the entire time.
“Considering this family was convicted of excess, I am assuming this was a servant,” I said. “Who would allow their body to be removed from their mind?”
“I don’t believe it was voluntary. Did you carry it here?” he asked.
“Yes.”
“You could have given it directions and it would have walked here on its own.”

I was hoping Crieff would have some thoughts on the body’s identity, some trick of getting it to talk, because it didn’t have the kind of mouth with vocal cords attached, but it didn’t initially, so I had to ask to see the file on the kin group, something I have never, in all my long years of cleaning, have ever asked to see.
I looked through the Enright kin’s paperwork, and it was clear how they had been convicted, just looking at the discrepancies in their financial filings. But at the back of the file was a set of pictures, and my stomach dropped when I saw them. All of them had the same morning gray skin.
Canis looked over my shoulder. “So they hadn’t kidnapped anyone?”
“Almost certainly not. There is no need to inquire to surrounding communities if someone had gone missing. No one was missing this person.”
“But there’s no one in these pictures with that exact pattern of breathing and eating holes.”
“I think they were wise enough not to let the servant take pictures.”
“Or the servant was taking the picture.”

Council was not amused. “Are you telling us that the kin in question had killed someone via decapitation, then stuck a mechanical head on it?” one of them asked me.
     I had tinkered with it in the days in between, trying to be gentle. “Possibly,” I said. I removed the front metal plate on the head. There were a mess of wires inside, and a motherboard. “I think it was a servant. It’s programmed to do certain things in a pattern over time. It is programmed to cook five times a day, clean once a week, and otherwise lay in a certain position in the room it was found in. But someone tried to reprogram it recently, the last time it was accessed, and it was a bad job, because I don’t think it could move after that.”
One of the other councilors raised her eyebrow. “A certain position?”
“I think it was possibly being used for breeding, or at least was intended that way. I cannot be certain it was actually used like that before your good council had the kin evacuated.”
“What do we do with it now?”
“I was of the mind that we should have the mechanical head removed, then leave it to die naturally of starvation. Then I thought perhaps a bayonet would be kinder, quicker. But I am increasingly of the mind that we should have it programmed for optimal self regard, then allow it to live the last of its days here.”
“There’s been debate about optimal self regard,” the first councilor commented.
“Nothing rivaling the self regard of the kin group from which is originated from,” I said.

The Council took time with their decision, and in the meanwhile, I found it unnerving. Canis wiped the software, at the behest of the Council, which at decided that was the bare minimum that should be done. After that, we had left it in the office, sitting in a chair in the corner under the control panel, and Canis and I worked as normally for the rest of the day. The rest of the Enright things had to be organized. We got some of it done, but there were still piles of clothes, a few electric tablets, furniture of various sizes, an extravagant collection of artwork, including one I quite liked of a crane, and an old school 3D printer.
After Canis went home, I cleaned up. I went to turn off the lights at the control panel, and there the servant was, staring back at me. There was something not right about this, but I couldn’t quite figure out what.

     When we came back the next day, both of us stopped when we saw everything. All the clothes was folded, and in piles. The electric tablets, which had collected dust, had been cleaned. I picked up one of them, plugged it into our computer. “It’s been wiped clean. Did you get to that yesterday?”
Canis looked back over at me. “You didn’t do it after I left?”
There was a clanging sound, and we both jumped. We turned to see the servant, also clearly having just jumped itself.
     “But the programming was wiped clean,” I said, feeling deeply stupid. I turned to Canis. “Didn’t you…?”
     “I did.”
It titled its neck at us, with those eyes that never changed. It slowly raised its hands.
“It’s okay, it’s okay, everything’s fine,” I said, raising my hands too. Canis followed suit.
“Can you—” then I realized how stupid my question was. There was no way to answer. “Give it one of our tablets and a stylus,” I said to Canis.
     It slowly reached down to the table and picked up a stylus, keeping its other hand up.
“Well, that answers one question,” Canis said.
It wrote, though its hand shook. It held the tablet up. It read I am sorry for scaring you .

Crieff came out again. We left him in the office, alone with the servant, while we waited outside, sitting on the bench next to the front door. It was a nice enough day, but I think both our minds were elsewhere. When he came out the door, we both stood quickly.
“It’s fine,” he said. “It can hear you.”
“But how is it moving?” I asked.
“The stomach has a bundle of nerves, a secondary brain. When the body lost its first mind, it was able to move functioning to its secondary brain. Probably would have never happened if they hadn’t sustained the body in other ways.”
“But then why use the fake head and the programming?” Canis asked.
“I think the programming was to suppress the secondary brain making its own choices.”

The Council didn’t respond immediately when we sent a message about this development.
“The Council might take awhile,” I said to Canis as we worked at our desks. “Without a primary brain, I’m not sure if it even be a self, since the seat of itself is gone.”
“It’ll never have its identity again, whatever it was in its real, first life.”
“Perhaps that’s for the best.” We both looked over at it. It was sitting in a chair. It did the head tilt again. It slowly raised its arms again and took the stylus next to it. Canis handed it a tablet.
We watched it jerkily write again. No life .
“Do you mean—” Canis stopped herself.
It began to write as quickly as possible. It had to stop, slowly clean whatever it initially wrote, and try again. Enright ?
Canis and I exchanged another look. Thank God it couldn’t see.
“You kin,” I said. “Have refused to communicate with us. Possibly for legal reasons.”
It straightened suddenly.
“Your kin were convicted of excess,” Canis said. “What do you—?”
“It began to furiously write something. It held it up. Neither of us could read it. “I’m sorry,” Canis said. “What are you trying to say?”
Another attempt, with shaking hands. Auteuil Illiers .
I usually never use my work tablet for something like this, but I searched that name in the database. Canis also busied herself with her tablet.
The Auteuil clan had lived in Swan’s Way. I opened one of the files in the database and saw an old murder investigation from years ago. It had been a small group, but they had all died.
“I’m sorry,” I said. Before I could say any more, Canis turned her tablet to me. It was a picture of the Auteuil clan. In the background, there was an old 3D printer and a set of extravagant paintings.
I flipped through the murder file. I stopped at an image of Illiers. He was a painter. He was midway through a crane’s wing. I turned to the painting, propped up against the opposite wall. I turned my tablet around so Canis could see it.
I took a deep breath. “Our records indicate that Auteuil Illiers died four years ago.”
Its shoulders slumped. It stopped moving long enough that I thought perhaps it had turned off or had a circuit overload and couldn’t anymore. And then it curled up into a ball, still sitting in its chair, hugging itself.

KEEPING HOPE ALIVE

by Divya Raman

If it were not for hopes, the heart would break. I trace the cursive letters of these words embroidered on the edge of the blanket draped over my arm. I remember hearing those words for as long as I have lived. For the first time, as my great grandmother whispered it to my mother when I was born and they discovered I had a heart defect; from my mother, each time I came out of a surgery that tried to fix my failing heart; and I heard it like a refrain in my mind as I saw the grim faces of my doctors as they studied the heart of my unborn daughter on their screens.
My great grandmother lost her daughter in 1949, after a traumatic birth at home. She never knew what ailed her baby; all that she knew was that less than a day in this world, the little girl she had wanted all her life turned blue and stopped breathing. She had all her other children in the hospital after that, surrounding herself with doctors and nurses who she revered as if they were messengers from God. But she never got over the loss of her baby girl; never forgave herself for not having noticed her baby’s color or breath. For every child born into our family after that, she made it a point to be there, keeping a keen eye on the newborns through their first weeks. It was she who noticed when I started to pale a few hours after I was born; it was she who rushed out and called the staff in a firm tone; it was she who watched the screens and asked the doctors questions my mother was too overwhelmed to think of; it was she who had this blanket made for me when I was just a few months old. I wish she was here now, telling me to keep my hope alive.
I was born with a hypoplastic heart. When I was little I used to call it a plastic heart , wondering if my Princess Barbie had one of those inside her plastic chest. Later a doctor told me that left side of my heart was not as big as it should be, so the right side of my heart was trying to do more, and was getting tired. It would take a series of three surgeries within my first five years to help my heart get better. My first surgery was when I was a week old, and it was intended to get me through to 6 months. At 6 months, I had another surgery to reduce the load on the right side of my heart. I once saw of picture of me taken on my first birthday and I looked small and blue;
there were tubes connected to me. You wouldn’t have known I was a year old if it wasn’t for a large balloon tied to my crib. I had my third surgery when I was 3 years old. It was the last of the series, and the doctors knew that my only option after that was a heart transplant.
I had a quiet childhood; I was on medications and a feeding tube and my parents didn’t take me out very much for fear that I would fall sick. They finally enrolled me in school, but I barely made it through a month of Kindergarten before my heart started failing again. I was put on a heart transplant list and taken out of school. My mother and I would spend the days under the tent canopy on my bed, snuggled in blankets reading from a pile of books. Sometimes she would fall asleep and I would quietly take her phone and play a game. I remember the day I pressed something and opened an article about transplants. I couldn’t read all the words, but one line
was written in big text and I sounded my way through it: “58 children died while waiting for a new heart”. My heart sank, and I turned off the phone quickly, worried that my mother would see what I was looking at.
My mother got a call about a heart for me just before my seventh birthday. Within hours we were on our way to the hospital, ready for a surgery that was going to happen at midnight. My doctor came in and spoke to my mom. He then turned to me and told me that I would fall asleep and when I woke up there would be another heart in me, and I would start to feel better.
“Where did you get the heart from?” I asked.
The doctor paused and looked at my mother. Slowly he said, “Your new heart used to belong to a little boy who died yesterday because he was in an accident.”
All I could think about was that for me to live, a little boy had to die. I nodded slowly. “Tell his mom I’ll keep his heart safe forever.” And I have done exactly that for over 20 years now.
When I was in high school, I learned that my heart condition was genetic; that my great grandmother’s daughter likely died undiagnosed from the same congenital heart defect I had. The geneticist suggested that there was a chance that if I had children, I would pass along this trait, resulting in my child having the same congenital heart defect. Even with this knowledge, I knew I wanted to have children of my own. Armed with hope and science, I conceived my first child and opted for all the extra scans to monitor her growth. At 20 weeks, they started to see some abnormalities in my daughter’s heart and found the same genetic trait in her as I had. I
knew that we were about to embark on another long journey, and I was determined to do all that I could to make it a little easier for my little girl.
I found a famous surgeon at a heart center on the other side of the country and asked her for all my options. As she started naming series of surgeries and transplant options, I stopped her. “Tell me the about something that didn’t exist 30 years ago”, I said. Little did I know that what she would tell me next would completely change my daughter’s life.
She described a new artificial heart that was still in clinical studies; it was made from a bioabsorbable material that would let my daughter’s cells grow onto the surface, making it her cells and her tissue over time. They would be able to make one that was the right fit for her little body when she was born, and over time it would grow with her, minimizing the need for multiple surgeries over her first few years. It had a small electrical component that would make it beat to circulate blood, and a battery that we could charge wirelessly. “That’s it!” I said, “That sounds perfect.” I was elated; my daughter’s life would be different. She wouldn’t spend her first few years with tubes and surgeries; she wouldn’t look blue on her first birthday; she would go to school; no other child would need to die to allow her to live.
The surgeon continued, “The lab results show that your daughter has the same genetic disorder that you and your great grandmother carried. We can also start some gene therapy in utero that will change the mutation as she is developing. She will need to continue to have a few treatments after she is born, but the research shows that gene therapy can be very effective if we start it earlier in gestation. You will need to plan to come in for those appointments and we’ll also need to get you in the center for some imaging over the remainder of your pregnancy.”
I was surprised. “Gene therapy before she’s born? Is that safe? And why do I need imaging?”
The surgeon nodded. “Gene therapy is safe to deliver through the amniotic fluid. We’ll monitor how effective it is once she is born, but we’ve had a few cases where the child needed very few additional treatments because we started so early in the pregnancy. The imaging is to allow us to prepare your daughter’s implant before she is born. Our scanners are strong enough to safely see all of your little girl’s heart and vessels as they develop. We’ll start to take some pictures so we know exactly what shape and size her new heart needs to be, and we can have it ready for her once she is born.” She paused and looked me in the eyes. “We don’t know how stable her heart will be when she is full-term; we need to be ready to act at any time. We will monitor you closely for your final weeks. If everything looks normal, you can have a regular delivery and spend a few hours with your daughter before we start the surgery. However, if there is any sign of distress, I recommend that we complete an emergency C-section and get your daughter into surgery immediately.”
I gripped the side of the chair I was sitting on. “Will she be okay to have the surgery so soon after she’s born?”
The surgeon didn’t waver. “It is a complicated surgery, and as with a transplant, there are a lot of factors to do with the body starting to properly absorb the material. All the data on this product has been in adults, so your child will be the first to experience this procedure. The results for adults look very promising, and I believe it will be equally beneficial for a child. But there is always a risk. We will monitor your daughter closely after surgery, and will need to keep
everything in check for the first year or so.”
For a moment, a dark cloud of doubt blinded me. Was gene therapy the right thing to do?
Changing my daughter’s genes before she was born sounded like playing God. Would changing her genes change the fact that she was my daughter; my flesh and blood? Would I be cutting off her ties back to my great grandmother? Was it worth it to give up a piece of family heritage to know that she could have a family and never worry about this for her child?
Was subjecting my daughter to a new heart implant the right thing to do? Should I instead let my child go through the same experience I had, and feel safer in knowing that it may extend the time I have with her? Should I hope for the untimely death of some other child in order to gain a transplant heart and life for my own? If I went into an emergency C-section and then lost my child to surgery, would all of this have been for aught? Would my heart ever mend from that sorrow? If all I got was a few hours with my little baby, would that be enough time to make memories to last me the rest of my lifetime? I felt as if I was drowning, but then heard my great
grandmother’s voice: If it were not for hopes… I took a deep breath and faced the surgeon head on. “I understand; we’re going to fight for this. I’m ready to show my daughter how.”
My daughter, Zita, my little hope, was born in an emergency C-section and then whisked away to the OR where she received her new artificial heart, which had been waiting for her, ready to become part of her and to give her a new life. I finally got to hold her 2 days after she was born, but it was worth the wait. I traced her chest incision and hoped that it would be the only scar she would bear in her life. I marveled in her pink coloring and could not stop the tears of joy as she
held onto my finger for the first time. We have been back to the hospital many times over her first year, taking all the extra precautions to make sure that her body is absorbing the tissue and that her heart is working as it should. She has also completed two additional gene therapy treatments to remove the mutation that my great grandmother passed down.
As I wait in the lounge for the nurse to bring her back from her final set of scans, I know that I will miss the safety of this building; it’s a place where I lived my scariest nightmare, but also realized my biggest dream. I see the cardiologist walking towards me and I stand, immediately worried.
He smiles and gestures for me to sit. “Things are looking good with Zita. You can take her home, and we can start to see her every 6 months, unless you need to bring her in sooner.”
I swallow, not knowing how to put my biggest fear into words. “How will I know if something is wrong?” I ask.
The cardiologist nods and pulls out a phone. “Just call me; I can see all of the information from her heart here.” He opens a screen that has Zita’s name at the top. I watch the dancing waves showing the beating of my daughter’s heart. I finally smile and realize that I can feel safe even outside these walls.
I know hope is only one part of our story. Science and the human drive to forge new paths are the bigger parts. Hope kept my mother’s heart from breaking, and now it will keep mine intact. Science kept me alive, and it has now given my daughter a whole new chance at living.

Thanks to everyone and we’re already looking forward to hosting next year’s Medgadget Sci-Fi Writing Contest!

Food and drug administration digital health draft guidance scales back regulating certain kinds of software

data, patient, medical records, health data, healthcare data

The U.S. Fda released draft assistance with digital health rules made to reduce ambiguity over the sorts of clinical decision support tools and patient decision support tools that must be reviewed through the Food and drug administration and individuals that didn’t.  The regulator also issued final assistance with standardizing the way in which safety, effectiveness and gratifaction are assessed for Software like a Medical Device. But Bradley Merrill Thompson, general counsel for that industry group Clinical Decision Support Coalition, speaking for themself, stated he was disappointed by a few of the proposals that the coalition have been waiting on for many years.

CDSC has labored to build up an offer for the way to attract the road between controlled and unregulated clinical decision support software.

Reducing the kinds of software programs that require Food and drug administration clearance would free up the regulator to concentrate its attention on technologies it regards like a greater priority. The FDA offered a couple of examples in the draft guidance documents of the items would and wouldn’t require its approval.

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  • Software that manipulates or analyzes images along with other data acquired from the radiological device, like a CT imaging device, to produce 3D types of the location intended to be utilized in planning memory foam/dental surgery having a device still requires Food and drug administration clearance.
  • Software that can help to recognize drug-drug interaction and drug-allergy
    contraindication alerts, according to Food and drug administration-approved drug labeling and patient-specific information, to avoid adverse drug occasions doesn’t require Food and drug administration clearance.
  • The Food and drug administration would still evaluate software used alongside home bloodstream testing needed with the utilization of anticoagulents for dosing adjustments in line with the outcome of the house bloodstream test with no patient seeking consultation using their doctor.

The Food and drug administration also shared an announcement by Commissioner Dr. Scott Gottlieb ready for a look and feel prior to the Senate HELP Committee hearing now.

“We believe our proposals for controlling [clinical decision support] and [patient decision support] not just match the provisions from the [21st] Cures Act, but additionally strike the best balance between making certain patient safety and promoting innovation.”

Regardless of the intention behind the brand new draft guidance, Thompson, part of law practice Epstein Becker Eco-friendly in Washington D.C., expressed disappointment with a few areas of the draft guidance. The clinical decision support guidance have been six years within the making however in an emailed statement about Food and drug administration Commissioner Scott Gottlieb’s comments, he stated he couldn’t praise it.

He noted:

The issue is that FDA seems to possess walked from creating a risk-based determination.

Main issue, clinical decision support software programs are software that can take some form of medical understanding and applies it for an individual patient to create a person recommendation. According to that, people acquainted with healthcare can most likely readily visit a wide spectrum of risk connected with your software.

In the dangerous finish, there’s software which makes essential and direct strategies for specific chemotherapy treatment according to a multitude of data.  And when that software helps make the wrong recommendation, it is extremely possible the individual would suffer, even die.

Also, he shared what he’d wished the Food and drug administration would do:

“What I believe a lot of us in [the] industry were wishing for was an attempt by Food and drug administration to distinguish high from safe like a grounds for regulation. We didn’t have that. Worse, it seems in line with the guidance that Food and drug administration is uninterested in drawing that line.”

Also, he expressed alarm using the FDA’s conclusion on clinical decision support helped by machine learning, noting the Food and drug administration didn’t appear to possess any plans for differentiating between how miracle traffic bot is controlled according to risk.

Photo: nevarpp, Getty Images

MedCity ENGAGE, October 23-24 in North Park, concentrates on the most recent strategies and innovations to boost patient engagement, care delivery and company wellness. Use code MCNTAG in order to save $50.

Allscripts Chief executive officer Paul Black on interoperability, provider burnout and much more

data, conceptual, information

Since 2012, Paul Black has offered as Chief executive officer of Chicago-based Electronic health record company Allscripts. He formerly stayed working at Cerner, where he held the COO position, and IBM, where he required on various leadership roles.

Inside a recent phone interview, Black discussed numerous very hot topics in healthcare — including interoperability, artificial intelligence and provider burnout — and just what Allscripts can be.

This exchange continues to be gently edited.

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You lately penned your blog publish about why the Veterans administration should concentrate on interoperability. Would you discuss the publish, in addition to what Allscripts does around the interoperability front?

When we move back and check out where healthcare is incorporated in the U.S. circa 2018, you’ll spot the infrastructure today is nearly completely wired. That begets the issue: How do I recieve data in one Electronic health record to a different one?

I take into account that to become a high-class problem. There are answers which are available today, and Allscripts continues to be purchasing one since 2009.

Around the Veterans administration, we’ve had lots of conversations with individuals folks. We’re relatively up to date on which the needs take presctiption that. Exactly what the Veterans administration is about isn’t just the substitute of emr, but additionally connecting with other source systems that sit outdoors the ecosystem. Getting the totality from the veteran’s record is essential.

So how exactly does the drive toward healthcare consumerism affect a technology company like Allscripts?

We’ve used the customer moniker for any lengthy time period. If our vision will be a wide open, connected community of health, additionally, it includes a component where we’re speaking concerning the consumer.

Our method of consumers begins with our FollowMyHealth platform. It doesn’t require the consumer is mounted on an Allscripts EMR. In the finish during the day, I own the data about myself and will be able to grant accept to who examines my record, the way our consumer platform operates.

AI is really a hot subject in healthcare at this time. How’s Allscripts involved in the device learning space?

Allscripts provides extensive data that people look at and evaluate. There are several 40 million lives we have deidentified within our data constructs today that provide us insight and also the capacity to complete research. We’ve people whose work on we are dedicated to insights that emerge from studying that data.

Should you consider the way your experience when you are shopping works, the 3rd or 4th time you shop on the site, it’ll begin suggesting products. There isn’t any reason exactly the same kind of learning can’t be relevant to what sort of doctor practices. Equally around the financial side, you can see patterns of consumption according to the position of the clinic and also the patient.

What exactly are your ideas on provider burnout? How’s Allscripts trying to promote provider wellness?

Another reality of everybody now utilizing a product is that you have many people who’ve in the past not used at all computers prior to being exposed to numerous clinical, financial and quality metrics.

Because the Significant Use needs came lower, sometimes that [data entry] burden has fallen around the caregiver, and particularly the doctor. There is a term known as “pajama models,” where they’re finishing the work they do after hrs.

All EMRs make some contribution for this effect. Therefore, so what can we all do to assist several experienced humans whose time is efficacious?

The device learning I spoken 1 minute ago — that sort of useful computerization could be advantageous to those people. The 2nd factor is: What is the method for us to possess less keyboard needs? Are you able to move toward a keyboardless visit? There’s value the automation will bring these to help augment the patient’s experience of the concern setting.

What else does Allscripts have coming lower the pipeline?

2017 is a great year for Allscripts. Because of the job that’s been happening the final 5 years, we have seen in the finish of 2017 a obvious separation of Allscripts, Cerner and Epic [from all of those other pack]. There’s lots of focus on our clients’ part to continue to possess belief that we’re the best supplier to utilize with an ongoing basis.

Photo: MATJAZ SLANIC, Getty Images

AI chatbots are helping providers with everything else from referral management to team development

AI, artificial intelligence, chatbot, bot

Advanced predictions of artificial intelligence in healthcare illustrate robots becoming nurses and doctors.

However that fantasy is way from what’s possible today. Even Mayo Clinic CIO Cris Ross stated just as much at HIMSS this season, noting that AI is “still pretty dumb” and evaluating it to some 2-year-old.

Still, the strength of machine learning in healthcare could be leveraged in simpler ways outdoors the imaginative wishes of society.

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One startup known as Avaamo is getting AI chatbots towards the space.

But founder and Chief executive officer Ram Menon was careful to not lump his Los Altos, California-based company in to the chatbot craze.

“We don’t do chatbots within the traditional sense,” he stated inside a phone interview, rather opting to make use of the word “conversational AI.”

The main difference, Menon noted, is incorporated in the abilities from the technology. Unlike chatbots within the original sense, conversational AI has the capacity to understand complex phrases, ‘languages’ and mispronunciations. While a chatbot can certainly help one look for a yoga teacher, for instance, it might get confused if a person asks concerning the publish-operative deductible for any kidney procedure.

Avaamo’s technology touches multiple verticals apart from healthcare, including banking and telecommunications.

Within healthcare, it abilities can help both patients and providers. The scheduling assistant bot helps consumers setup and don’t forget appointments, and also the diabetes manager tool reminds patients to consider insulin and keep a healthy diet plan. Another chatbot works as a navigation tool for any hospital’s website.

For providers, Avaamo includes a referral manager bot plus an on-call assistant solution, which will help nurses rapidly choose a certain department’s on-call physician. Its homecare assistant bot gives providers the best information before you go to go to a patient in your own home.

The conversations are fairly straightforward. Using the referral manager chatbot, a health care provider can type, “I wish to refer someone for memory foam surgery.” The bot asks, “Do you’d rather make use of a specific surgeon within the memory foam surgery department?” The consumer can request a particular surgeon, and also the bot will check their availability. The interaction continues using the provider completing relevant patient information and also the bot confirming the referral.

The startup runs using an application-as-a-service model. It will make its chatbots available on the internet or with an organization’s existing portal.

Among the primary goals would be to tackle the problem having a practical approach within an industry where the majority of things are complicated.

“Let’s fix the repetitive problems close to the network that deliver significant cost benefits first, then solve the larger problems,” Menon noted.

Over the Atlantic, London-based Saberr is also taking advantage of the growing curiosity about AI chatbots. A self-dubbed “people analytics company,” it utilizes technology to enhance team dynamics at work.

In September, the startup formally launched CoachBot, an AI-powered team coach. An internet-based application, in basic form, it’s a computer that may understand text-based messages and respond accordingly.

Throughout a phone interview, Saberr founder and president Alistair Shepherd stated the objective of CoachBot would be to provide learning in a manner that suits the typical workday. Instead of likely to offsite conferences and workshops, a company’s employees can enhance their team inside a convenient manner.

The bot’s abilities concentrate on six facets of a group: productivity, roles and responsibilities, goals and purpose, relationships, network and decision-making.

Shepherd described the procedure as threefold.

First, each worker completes market research concerning the team they’re on and just how it’s performing. It offers questions like “Do you think about the way you work together?Inches Users can choose an answer for example “Yes, frequently so we do something according to these reflections” or “Very from time to time, in front of reviews, etc.”

In the end team people finish, CoachBot determines areas in which the team is excelling where it ought to focus moving forward. Finally, it makes a tailored learning plan and provides the audience the various tools it must act upon the suggested areas.

This plan of action includes exercises, challenges, and games that aim to help. In a few instances, a group may also connect with an individual to achieve insight. For instance, if your team had challenge with trust, CoachBot could link them track of a genuine person (either inside the organization or externally) to learn to improve.

We’ve got the technology also adapts its approach and stays current because the team makes progress.

Saberr developed CoachBot with the help of multiple educational institutions, in addition to greater than 35 business psychologists, executive coaches and professional team coaches.

Its abilities allow it to be particularly helpful in smaller sized team environments, where teams interact toward a shared goal. It’s difficult to think 50-plus-person groups while using technology, though Shepherd noted that at this level, you will find likely subteams inside the bigger crew.

The organization offers CoachBot within SaaS model, much like Avaamo. It’s costing £8 (or about $10.66) per person monthly.

Presently, the chatbot has been employed by 11 organizations from across various industries, including Unilever, someone goods company, and Logitech, a technology company. But the organization is dipping its toes in healthcare too.

Herts Partnership NHS Foundation Trust, which supplies mental health insurance and learning disability services, has launched into a 12-month pilot of CoachBot.

“The product provides an exciting chance for all of us to understand more about the way we supports health insurance and care professionals with technology like AI,” Stacie Coburn, principal consultant in the Eastern Academic Health Science Network, stated via email. “The teams work across a sizable geography with assorted shift patterns, and taking advantage of CoachBot means HPFT can offer team coaching if you don’t take lengthy days from service for courses, maximising time they devote to service users.”

EAHSN is among 15 Academic Health Science Systems having a objective of distributing innovation and management protocols to NHS organizations. It setup the connection between Saberr and HPFT.

Even though the pilot program at HPFT just begun, Coburn anticipates it getting elevated satisfaction to employees. Furthermore, she noted that CoachBot is only going to get smarter in the future. We’ve got the technology presently contains information greater than 100 academic articles, and also the pilot program involves accumulating the bot’s dataset.

Shepherd echoed Coburn’s sentiment.

“Imagine CoachBot would be a real human,” he stated. “We’re in a position to produce the best executive coach on the planet. That’s the exciting factor about using AI within the coaching space — the opportunity to generate gaining knowledge from each one of these environments making it available to another team.”

Over time, utilizing CoachBot leaves additional time for HPFT employees to aid patients, hopefully leading to better care.

“Because [healthcare] is really a simple plan to humanity, it comes down under lots of strain,” Shepherd stated. “One of what can also add to or reduce strain may be the atmosphere by which professionals are operating. Team environments … come with an enormous effect on what you can do to provide your projects.Inches

Photo: Jull1491, Getty Images

Medial EarlySign uses machine learning formula to calculate who’s in danger of certain conditions

ai, artificial intelligence, machine learning, brain, technology

Founded in ’09, Medial EarlySign is benefiting from artificial intelligence technology and leveraging it to calculate which folks are in danger of specific health problems. The organization utilizes bloodstream test results and Electronic health record data to do this.

“Prior to founding the organization, we really spent a couple of years … investigating what is completed with existing health records and just what we are able to harvest from these types of data using different approaches of machine learning,” cofounder and Chief executive officer Ori Geva stated inside a recent phone interview.

Most lately, the organization used its method to conduct research on prediabetic patients.

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Inside a study according to data of 645,000 prediabetics, Medial EarlySign learned that by isolating under 20 % from the prediabetic population, its formula pinpointed 64 percent of people who grew to become diabetic inside a year. The formula ranks the 20 % of patients according to risk stratification.

The EarlySign platform uses over 25 parameters from data kept in EHRs.

But the organization isn’t restricted to prediabetes. Its solution can be used as recognition of other concerns too.

For instance, EarlySign implemented its technology at Maccabi Healthcare Services, a built-in delivery network in Israel. The tool, ColonFlag, helps MHS identify patients with a good venture of getting colorectal cancer.

Oxford College also conducted research on ColonFlag. Another research into the tool took it’s origin from bloodstream samples and demographic information from Kaiser Permanente Northwest patients. ColonFlag isn’t removed through the Food and drug administration to be used within the U . s . States.

“When make certain with providers, we are able to … understand what sort of challenges we may have using these data and the way to use this,” Geva stated. “This is actually a part of our approach — so that you can comprehend the clinical facets of what we’re coping with as well as validating this with prominent research partners.”

EarlySign is presently developing many other AlgoMarkers, or condition-specific, application-like risk predictors that consider potential outcomes, evaluate Electronic health record data making assessments. ColonFlag is a such predictor.

However this development process may take a moment.

“One from the essential things for all of us would be to make certain the mixers we’re creating of AlgoMarkers are rigorously developed and validated,” Geva noted.

Their solutions may be used by healthcare organizations and laboratories. Geva added that EarlySign’s business model is basically an application license. The price increments are in accordance with how big the business, therefore amounting to some per member, each year approach.

Photo: monsitj, Getty Images

Ginger root.io transforms from mental health management tech for hospitals to doctor

mental health, face, human

Previously few years, Ginger root.io has transformed itself from the mental health management technology business which used people’s smartphone behavior to recognize patterns and gather insights on their own mental health for hospitals to some doctor that gives use of licensed therapists through its application, according to an announcement from the organization now.

Ginger root.io offers the application through UnitedHealthcare, Optum and most 25 self-insured employers, the organization release stated.

“We think that a persons-to-human experience is important for mental and emotional health support. By integrating significant data and machine learning in to the process, we built the very first modern, nationwide behavior health system that is dependant on measurement-based care,” stated Karan Singh, Ginger root.io cofounder within the release.

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Ginger root.io Cofounder and Chief executive officer Dr. Anmol Madan told MobiHealthNews that the organization altered its approach because its model would take too lengthy for that medical industry to consider.

I was making lots of progress there we’d 40 different hospitals which were using our technology. However it only agreed to be a sluggish process so we felt that … by getting to deal with the clinical components and mixing it using the technology, we’re able to work directly with those who are having to pay for healthcare — i.e. the employers, the typical consumer, the plans — so we could provide the complete.Inches

Their revised approach involves an account balance between cognitive behavior therapy quite happy with information about how to higher deal with conditions for example depression and supplying video visits with licensed therapists and board-certified psychiatrists, who could prescribe medication with respect to the condition.

Karan also described that the organization requires a page from Lyft for the reason that it encourages patients to rate the caliber of these interactions as a means of improving its service.

Ginger root.io’s technology was initially produced for behavior health researchers in, but experienced multiple iterations to reply to a growing users list.

In 2015, Ginger root.io elevated $20 million from Kaiser Permanente Ventures, Khosla Ventures and True Ventures to deepen and expand its core mental health platform.

Although Ginger root.io has altered its model, there are a handful of firms that see the need for using smartphones like a vehicle for collecting data to evaluate emotion, cognition, and behavior.

Mindstrong describes this as digital phenotyping. Cofounder and president Thomas Insel labored as director from the National Institute of Mental Health for 13 years before joining Google’s healthcare arm Verily and subsequently, Mindstrong.

In June, Mindstrong raised $14 million inside a Series A round brought by Foresite Capital and ARCH Venture Partners. Optum Ventures, Berggruen Holdings and also the One Mind Brain Health Impact Fund also required part within the funding round to assist support product and also the development of Mindstrong’s clinical operations team.

HealthRhythms is comparable but different for the reason that it aggregates data from the wider selection of devices. Additionally to smartphones, additionally, it taps wearables and connected devices, examines data on exercise and usage, rates of speech and appears for patterns that could indicat changes in behavioral health.

Photo: Andrzej Wokcicki, Getty Images

MedCity ENGAGE, October 23-24 in North Park, concentrates on the most recent strategies and innovations to boost patient engagement, care delivery and company wellness. Use code MCNTAG in order to save $50.

DiA Imaging Analysis enters partnership with GE Healthcare on automatic imaging analysis tools

“We’re very happy to work with DiA Imaging Analysis. GE Healthcare includes a lengthy good reputation for getting innovative methods to our customers all over the world,Inch Take advantage of Walton, gm of GE Healthcare Primary & Affordable Care commented. “These power tools will bring new abilities to ultrasound at the purpose of care.” 

Hila Goldman Aslan, DiA’s Ceo and Co-Founder, mentioned, “We’re excited with this particular collaboration, and expect to using a market leader for example GE Healthcare.  Our advanced automated tools for reason for care echo ultrasound analysis are first to promote, and we’re intending to soon launch additional automated imaging analysis tools included in our vision to enhance patient care.”

Arnon Toussia-Cohen, DiA’s Chairman and V . P . of economic Development, added.  “Up to now, we’re the only real company that provides automated tools for handheld ultrasound devices and we’re proud to work with GE Healthcare to supply immediate information at the purpose of care.”

The Organization is going to be showing its systems in the approaching Radiological Society of The United States (RSNA) meeting in Chicago in the Machine Learning Showcase,booth #8545.

DiA Imaging Analysis is really a medical imaging analysis software company supplying fully automated, implementable tools which allow quick, objective, and accurate imaging analysis, by having an initial concentrate on echocardiography.

EasyScan GO: AI Powered Malaria Parasite Counter



EasyScan GO, an AI powered microscope produced by Chinese manufacturer Motic, has got the capacity to instantly and precisely evaluate malaria parasites inside a bloodstream sample. Utilizing machine learning algorithms, the microscope is really efficient that it may identify the quantity of parasites contained in under twenty minutes. Premiered in the Worldwide Conference on Computer Vision in October, the AI outfitted microscope can evaluate malaria parasites on componen with experts, surpassing the abilities essential to be certified through the World Health Organization for Competency 1 microscope. The work would be a joint effort between Motic and Global Good, a partnership between Intellectual Ventures, a huge patent holder, and Bill Gates. “Our goal in integrating Global Good’s advanced software into Motic’s high-quality, affordable digital slide scanner would be to simplify and standardize malaria recognition,” stated Richard Yeung, V . P . of Motic China.

EasyScan GO works through a mix of digital slide checking along with a diagnostic software module according to machine learning and neural networking. The device was trained by feeding it a large number of bloodstream smear slides annotated by experts. These images were processed via a machine learning formula, adopted with a field tests that was printed and premiered in the Conference on Computer Vision.

Malaria affects 200 million people annually, and 400,000 of individuals cases are fatal. Typically present in tropical and subtropical countries, strains of malaria have become resistant against our best drugs. Though physicians will have rapid tests available, physicians and researchers rely on microscopes, such as the EasyScan GO, to evaluate the quantity and strain of malaria contained in an example. EasyScan GO makes monitoring drug effectiveness more effective, creating more expert microscopists in addition to making the opportunity to evaluate malarial strains open to the broader medical community.  “Malaria is among the hardest illnesses to recognize on the microscope slide,” stated David Bell, Director of worldwide Health Technologies supporting Global Good. “By putting machine learning-enabled microscopes at the disposal of laboratory technicians, we are able to overcome two major barriers to combating the mutating parasite—improving diagnosis in situation management and standardizing recognition across geographies and time.”

Product page: EasyScan GO…

Via: Motic…

Thomas Obisesan

Thomas is really a finish Howard College, with a love for medicine, technology, and innovation. He’s labored in several labs such as the Georgetown Neuroscience and Psychology Lab, The Veterans Association Clinic, along with the Neuroscience lab at his alma mater, Howard College. Thomas has earned a b -.Utes. In biology from Howard College, and it is going after his MD/PhD. Have burning questions, or technology you need to see covered? You can make contact with him. Happy Studying.

Blackfynn will get $2.3M, adds partners for data integration tools to accelerate neuroscience research

artificial intelligence, ai, machine learning, deep learning, brain, circuit

Philadelphia-based existence sciences data analytics startup Blackfynn developed a method to aggregate data to aid translational research in neuroscience. It’s  received $2.3 million and added a brand new group of collaboration partners because it is constantly on the build and extend its data analytics tools for development and research to some wider users list.

New funding for Blackfynn comes through the National Institutes of Health’s Common Fund program — Stimulating Peripheral Activity to alleviate Conditions or SPARC— Other Transactions Award. Included in winning the funding award, Blackfynn will get the Data Core for the whole SPARC consortium. The organization is among three to get this funding.

The mission behind SPARC would be to further the peripheral neuromodulation field to precision medicine by looking into making the reasons of nerve-organ interactions simpler to know. The aim is to enable the introduction of a brand new generation of therapeutic devices, based on an announcement.

In another development, Blackfynn is poised to produce a platform to accelerate translational research in the approaching Society for Neurosciences meeting in Washington, D.C. in a few days. The woking platform will initially be accessible to some small group of investigators and foundations prior to it being folded to the educational community. Among early adopters are College of Pennsylvania’s  Center for Neuroengineering and Therapeutics, the College of Pittsburgh, the College of Utah, the Epilepsy Foundation and Massachusetts General Hospital, based on the news release.

Within an interview captured, Blackfynn Cofounder and President Dr. Amanda Christini noted that among the greatest obstacles facing everybody from Fortune 500 companies in pharma and medtech, hospitals right lower to healthcare startups may be the fragmented nature from the data they will use, making the task to do development and research tough.

“We listen to researchers they spend 90 % of time putting research data right into a format where they are able to utilize it and 10 percent of time really utilizing it. Whether they can take more time on [by using their data to] recognizing patterns …it might be transformative.”

Individually, Blackfynn has some medtech partners within the mix. It’s collaborating with Medtronic around the medical device giant’s bioelectronic device to record and understand neurosignals to assisted in the management of nerve conditions, particularly epilepsy. Mayo Clinic and College of Pennsylvania also have collaborated around the project. Blackfynn is developing an interactive event dashboard component for that device that may track the condition with time.

In another lindsey stirling, the organization works with medical device business Moberg ICU Solutions. They’ll develop and commercialize applications enlisting Blackfynn data platform and Moberg devices to complete realtime patient monitoring of EEG along with other physiological data. The concept is that clinical researchers can make use of this data to place patterns and generate insights on predicting outcomes or identifying biomarkers for disease progression.

Captured, Christini acknowledged the task of working out the easiest method to manage a lot data.

“As a health care provider myself, I realize the difficulties people face with managing all of this data. We’re concentrating on therapeutic product since the value and also the need are extremely great. One good reason we’re not jumping in to the clinical space is since it is not apparent how to achieve that.Inches

Photo: John Lund, Getty Images

MedCity ENGAGE, October 23-24 in North Park, concentrates on the most recent strategies and innovations to boost patient engagement, care delivery and company wellness. Use code MCNTAG in order to save $50.