The democratization of medical science

An interview with Ash Damle of Lumiata on the role of data in healthcare.

Vinod Khosla has stirred up some controversy in the healthcare community over the last several years by suggesting that computers might be able to provide better care than doctors. This includes remarks he made at Strata Rx in 2012, including that, “We need to move from the practice of medicine to the science of medicine. And the science of medicine is way too complex for human beings to do.”

So when I saw the news that Khosla Ventures has just invested $4M in Series A funding into Lumiata (formerly MEDgle), a company that specializes in healthcare data analytics, I was very curious to hear more about that company’s vision. Ash Damle is the CEO at Lumiata. We recently spoke by phone to discuss how data can improve access to care and help level the playing field of care quality.

Tell me a little about Lumiata: what it is and what it does.

Lumiata network graph of diagnosis interrelation.

A Lumiata network graph of diagnosis interrelation.

Ash Damle: We’re bringing together the best of medical science and graph analytics to provide the best prescriptive analysis to those providing care. We data-mine all the publicly available data sources, such as journals, de-identified records, etc. We analyze the data to make sure we’re learning the right things and, most importantly, what the relationships are among the data. We have fundamentally delved into looking at that whole graph, the way Google does to provide you with relevant search results. We curate those relationships to make sure they’re sensible, and take into account behavioral and social factors.

Our goal is to apply the best of medical science in every health interaction possible. In the long term, we want to optimize health. In the short term, we want to optimize care.

What is the distinction between health and care?

Ash Damle: Right now we have care as a service, but not necessarily health as a service. Care is reactive, while health is proactive. If you had a physician who could spend three hours a week looking over all of your data, he could tell you the things you need to do each week to stay healthy and be proactive. But that’s not efficient. So we want to bring data science and the power of big data to bear, and we want to provide that anytime, anywhere.

Congratulations on raising $4M from Khosla Ventures! Your viewpoints seem like a natural fit, perhaps.

Patient timeline

Raw patient data plus Lumiata’s medicine graph create a comprehensive patient timeline.

Ash Damle: There’s so much medical science out there, but it’s really hard to apply it all within a limited amount of time. We’re just in the beginning of the datification of health, but if we can computationalize medical science with all the power and nuance that computers and data analysis have to offer, then suddenly we have a way to apply the best of medical science to everyone’s care all the time.

The advent of the variety and volume of big data presents an opportunity to better contextually understand what is happening with the patient, and what is likely to occur in the future. Everyday we are amazed by the brilliance of physicians. We want to democratize medical science and make it easier so that all kinds of medical staff—from advice nurses, to physician’s assistants, to doctors—can apply higher quality care.

We’re at the beginning of what we can do, and we’re excited about having such an extraordinary partner.

What about the role of human intuition and experience?

Ash Damle: Physicians and nurse practitioners and other providers are very empathetic people; part of why they do what they do is that they care. How do we superpower them and enable them to do the best they can by giving them the best tools?

The reality is that if a care provider is in the Southwest versus the Northeast of the United States, they’ll see different things, and so the way they think about what’s more likely will change based on local conditions. Experience is key and intuition is extraordinarily powerful. But intuition is the ability to synthesize huge numbers of variables and personal experience to deduce things from weak signals. In some sense, that’s also what we’re trying to enable, because not everyone has the same level of experience that our best physicians do. We want to democratize that brilliance so that everyone gets the best care. We believe tools improving and applying the science of care should be used to augment and amplify the intangible human components.

Getting to the right amount of information is tricky. Too little information, and there’s no context; too much information, and it’s overwhelming. How much information should providers and patients have?

Ash Damle: We’re trying to search through this extraordinarily complex space to determine the most important things to be thinking about. If we look at the number of degrees of freedom in making a diagnosis, there are literally trillions of options. It’s not about describing all of the possibilities, but the ones that are relevant for that person at that moment. Fifty million results are great, but worthless. Similarly, two results are great, but worthless. There’s an ordered list that matters, so we present that along with the things you need to find out next that are the biggest bang for your buck.

How do you know that the data you’re working with is accurate? Patients sometimes lie or omit crucial pieces of information because they’re embarrassed. Have you had any feedback about that?

Ash Damle: People say they like using a tool like this because it’s very personal (tailored) but impersonal—it’s easier to talk to a machine about sensitive things than to another individual. There’s no judgment from a machine. I hope that we can make people feel less self-conscious about getting the care that they need. And part of our hope is to optimize the physician’s time. If we can get all the right information and organize it, then the care provider can start on Step 5 instead of Step 0.

We believe that the majority of the use cases for our engine, our graph, in the short and medium term will be powering the highest quality institutions—both in the quality of their care and the quality of their data. That while some of the apps that will use our engine will respond to dynamic patient interaction, most of them will be used by a doc, an NP, or another affiliated health professional.

What are your hopes for the future?

Ash Damle: Our focus is obviously on understanding the individual, but that then relates to understanding the population. We want to take the deep understanding of what we do and apply it across a large set of people. So the next step is to better help people within organizations understand their populations and tell those stories, so that they can promote health within their organizations.


This interview was edited and condensed.

If the disruption of health care and associated opportunities interests you, O’Reilly has more to offer. Check out our ongoing coverage and our report, “Solving the Wanamaker problem for health care.”

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