Most of you who developed a sudden interest in healthcare this week WON’T be interested in this, so move along.
I’ve added 3 new posts (so far) to the Bredemarket Health page since November 2024:
Dr. Jones MD, NPE
Saving Money When Filling Prescriptions: Not You, The Companies
Medical Fraudsters: Birthday Party People
(And no, I have no real interest in addressing the recent murder of a healthcare executive. It’s a crime. End of discussion.)
I approach health and health product marketing from both an identity and technology perspective, recognizing the similarities and differences between biometrics and biometrics, and between PHI and PII.
For example, I could call a medical provider or go to a pharmacy and say that my name is Donald John Trump.
Do you know how many medical practitioners verify identities?
By asking for the person’s birthdate.
So there is the possibility that a medical practitioner, after I say that I am Donald John Trump, will simply ask for my birthday without a second thought.
I would reply “June 14, 1946.”
And some of these medical practitioners would immediately grant access!
Of course, the number of successful fraudulent accesses goes up substantially when the real person is NOT well known.
Yet birthdates are considered an acceptable form of security in some parts of the medical world.
Healthcare is complicated. When most of us receive prescriptions from our doctor, either the doctor gives us a physical slip of paper with the prescription, or the doctor electronically sends the prescription to your pharmacy of choice. After that, you deal with the pharmacy yourself. Normally it goes smoothly. Sometimes it doesn’t.
Maybe the patient’s insurance company doesn’t cover the prescription, or charges an exorbitant price for it.
Maybe the patient never picks the prescription up. (The industry term is “adherence.”)
There are a lot of companies that want to help drug companies, physicians, and others make this process more seamless and less costly (for example, by maximizing gross-to-net, or GTN).
How many companies want to help? One afternoon I estimated that 30 companies are in this market. Based upon past experience in the identity verification industry (namely, all those battlecards my team created), this means that there are probably really more than 100 companies in the market.
While the companies obviously have to please the patients who need the prescriptions, they’re not critically important because the patients (usually) don’t pay the companies for the improved service.
So the companies have to sell others on their services.
Alto Technologies: “Alto Technologies’ configurable platform integrates hub and dispensing capabilities into an automated and seamless single service provider solution that improves patient experience and reduces administrative burden.”
Medisafe: “Patient support begins with onboarding and continues throughout treatment, with intuitive guidance throughout every encounter. From initial prescription to benefits investigation and authorization to shipment tracking, patients receive streamlined support with educational information and real-time updates.”
Phil: “Streamline medication access for your patients and providers. Our digital hub platform empowers retail and specialty-lite manufacturers with an alternative channel solution…”
Truepill: “Whether you’re an established brand looking to reach your patients directly, or an emerging company planning your go-to-market strategy, Virtual Pharmacy is the digital pharmacy solution built to scale.”
I have a telehealth appointment next week with a medical professional whom I have previously met. And I assume she will participate in the telehealth appointment.
In the future, of course, she may not.
Way back in April 2013, I wrote a tymshft piece entitled “You will still take a cab to the doctor’s office. For a while.” It speculated about a future 2023 medical appointment in which the patient took a driverless cab to a medical facility. In the office, the patient was examined by remote staff…or so she thought.
“Well, I’m glad you’ve gotten used to the procedure,” replied the friendly voice. “I hope you like me!”
“I do,” said Edith. “You’ve been very helpful. But I’ve always wondered exactly WHERE you were. If you were in Los Angeles, or in Mississippi, or perhaps in India or China, or perhaps even in one of the low-cost places such as Chad. If you don’t mind my asking, exactly where ARE you?”
“I don’t mind answering the question,” replied the friendly voice, “and I hope you don’t take my response the wrong way, but I’m not really a person as you understand the term. I’m actually an application within the software package that runs the medical center. But my programmers want me to tell you that they’re really happy to serve you, and that Stanford sucks.” The voice paused for a moment. “I’m sorry, Edith. You have to forgive the programmers – they’re Berkeley grads.”
“Oh,” said Edith after a moment. “This is something new. I’m used to it in banking, but I didn’t realize that a computer program could run an entire medical center. Well…who picks up the trash?”
“That’s an extra question! Just kidding,” replied the friendly voice. “Much of the trash pickup is automated, but we do have a person to supervise the operation. Ron Hussein. You actually know him – he was your cab driver in 2018 when you came here.”
Re-reading this 2013 piece, I was amused at three things I got wrong.
First, Google, Facebook, and Apple did NOT merge to form Gaceapple, “the important merger that saved the tech industry in the United States from extinction.” American tech firms are still powerful…for now.
Second, my assumption of cab companies adopting driverless cars assumed the continued existence of cab companies. Ride share services have reduced the presence of traditional companies dramatically.
Third, my assumption that medical firms would sink untold sums of money into centralized automated medical examination rooms could be questioned…especially for routine appointments like Edith’s. Why not just let Edith’s smartphone—perhaps with a single attachment—gather the data?
Of course, there are medical ethics questions that underlie this entire discussion of remote telehealth and the use of non-person entities (NPEs). And we are struggling with those right now.
In my circles, people generally understand ‘biometrics’ to refer to one of several ways to identify an individual.
But for the folks at Merriam-Webster, this is only a secondary definition of the word “biometrics.” From their perspective, biometrics is primarily biometry, which can refer to “the statistical analysis of biological observations and phenomena” or to “measurement (as by ultrasound or MRI) of living tissue or bodily structures.” In other words, someone’s health, not someone’s identity.
Fun fact: if you go to the International Biometric Society and ask it for its opinion on the most recent FRVT 1:N tests, it won’t have an answer for you.
So Abbott salespeople, real or imagined, won’t be interested in what I’ve been doing for the last 30 years. ‘Cause you know sometimes words have two meanings.
But those of you who use biometrics (and other factors) for individualization WILL be interested. Click on the image to find out more.
Drive content results with Bredemarket Identity Firm Services.
As Identity and biometrics solution providers know, their applications are found in a variety of vertical markets.
A LARGE variety of vertical markets.
Seven of these markets include financial services, travel and hospitality, government services, education, health, criminal applications, and venues. (Among others.)
Which three vertical markets does the Prism Project examine?
To start this post, I’m going to cheat and “appropriate” the work already performed by the Prism Project.
This effort is managed by Maxine Most’s Acuity Market Intelligence and supported by a variety of partners (including industry partners).
The Prism Project has identified 3 (so far) critical vertical markets for identity and biometrics. While this doesn’t pretend to be a comprehensive list, it’s a good starting point to illustrate the breadth of markets that benefit from identity and biometrics.
The Prism Project has already released its report for financial services, which businesses can download here.
The Prism Project has started to develop its report for travel and hospitality. You can preview the report here.
Finally, the Prism Project plans to release a report addressing government services later in the year. For the latest status of this report, visit the Prism Project home page.
As you can see, identity and biometrics apply in wildly diverging vertical markets. You can use identity verification to open a bank account, enter your hotel room, or pay your taxes.
But those aren’t the only markets that use identity and biometrics.
Let me school you on two other markets, education and health
Let’s look at two markets that the Prism Project hasn’t covered…yet.
Education
Chaffey High School, Ontario, California.
Another example of a market that uses identity and biometrics is the education market.
Who is allowed on a physical campus? Students? Teachers? Staff? Parents and guardians?
Who is NOT allowed on a physical campus? Expelled students? Fired faculty and staff?
Who is taking that remotely-administered online test?
Bredemarket has written several posts about educational applications for identity and biometrics. You can read all my education writing on Bredemarket’s “Educational Identity” information page.
Health
What, did you expect me to post a Marcus Welby picture here? I’m sharing a real medical professional: Jonas Salk administering the polio vaccine. By Yousuf Karsh, photographer – Wisdom Magazine, Aug. 1956 (Vol 1, No. 8), PD-US, https://en.wikipedia.org/w/index.php?curid=27746788.
Similarly Bredemarket has written several posts about healthcare applications for identity and biometrics, including some that dwell on the unique privacy legislation that covers healthcare. You can read all my health writing on Bredemarket’s “Health” information page. (It’s not called “Health Identity” because healthcare has both identity and technology aspects.)
Another source on finance
By the way, Bredemarket also has a page on “Financial Identity,” but the Prism Project’s content is more comprehensive.
But wait…there’s more!
So this is the point where Ed McMahon intones, “So Acuity Market Intelligence and Bredemarket have identified all five of the markets that benefit from the use of identity and biometrics!”
So let’s look at two more markets that benefit from the use of identity and biometrics-two markets that I know very well from the beginning and end of my time at Printrak/Motorola/MorphoTrak/IDEMIA.
Criminal applications
There are government services, and then there are government services.
I started my biometric journey over 29 years ago when I wrote proposals addressed to law enforcement agencies who wanted to find out who left their fingerprints on a crime scene, and whether the person being arrested was who they said they were.
I don’t know if Maxine Most is going to classify criminal applications as a subset of government services, but there are clear reasons that she may not want to do this.
When you pay your taxes or apply for unemployment benefits, you WANT the biometric system to identify you correctly.
When you steal a car or rob a bank, you do NOT want the biometric system to identify you correctly.
Big difference.
Stadiums, concert halls, and other venues
If someone asked me in late 2019 what my career five year plan was, I would have had a great story to tell.
As I was wrapping up over 24 years in identity and biometrics, I was about to help my then-employer IDEMIA enter a new market, the venue market. This market, which CLEAR was already exploring at the time, replaced the cumbersome ticketing process with the use of frictionless biometrics to enter sports stadiums, concert halls, trade shows, and related venues. Imagine using your face or IDEMIA’s contactless fingerprint solution MorphoWave to enter a venue, enter secure restricted areas, or even order food and beverages.
Imagine the convenience that benefit consumer and venue operator alike.
What could go wrong? I mean, the market was robust, and we certainly would NEVER face a situation in which all the stadiums and all the concert halls and all the trade shows would suddenly close down.
Since early 2020 when a worldwide pandemic DID shut down a lot of things, many identity/biometric firms have entered the venue market with a slew of solutions to benefit fans, teams, and venues alike.
And still more
There are many more vertical markets than these seven, ranging from agriculture to automobile access to computer physical/logical access to construction to customer service (mainly voice) to critical infrastructure to gaming (computer gaming) to gaming (gambling) to the gig economy to manufacturing to real estate to retail to telecommunications to transportation (planes, trains, buses, taxis, and cruise ships).
And all these markets have a biometric story to tell.
Can Bredemarket help you describe how your identity/biometric solution addresses one or more of these markets?
The FBI and others are letting us know that June 3 through June 9 is Medicare Fraud Prevention Week. Pro Seniors:
Fraud costs Medicare an estimated $60 billion per year. It costs Medicare beneficiaries in time, stress, their medical identities, and potentially their health. It costs families, friends, and caregivers in worry and lost work when helping their loved ones recover from falling victim to Medicare fraud.
Of course my primary interest in the topic is ensuring that only the proper people can access Medicare data, preferably through a robust method of identity verification that uses multiple factors.
Not multiple modalities, especially ones that are well-known such as your Social Security Number and your mother’s maiden name.
Multiple factors, such as your government-issued driver’s license, your biometrics, and your geolocation.
For more information, see what these vendors are saying about using biometrics to counter healthcare fraud attempts.
It discussed both large language models and large multimodal models. In this case “multimodal” is used in a way that I normally DON’T use it, namely to refer to the different modes in which humans interact (text, images, sounds, videos). Of course, I gravitated to a discussion in which an image of a person’s face was one of the modes.
In this post I will look at LMMs…and I will also look at LMMs. There’s a difference. And a ton of power when LMMs and LMMs work together for the common good.
When Google announced its Gemini series of AI models, it made a big deal about how they were “natively multimodal.” Instead of having different modules tacked on to give the appearance of multimodality, they were apparently trained from the start to be able to handle text, images, audio, video, and more.
Other AI models are starting to function in a TRULY multimodal way, rather than using separate models to handle the different modes.
So now that we know that LLMs are large multimodal models, we need to…
…um, wait a minute…
Introducing the Large Medical Model (LMM)
It turns out that the health people have a DIFFERENT definition of the acronym LMM. Rather than using it to refer to a large multimodal model, they refer to a large MEDICAL model.
Our first of a kind Large Medical Model or LMM for short is a type of machine learning model that is specifically designed for healthcare and medical purposes. It is trained on a large dataset of medical records, claims, and other healthcare information including ICD, CPT, RxNorm, Claim Approvals/Denials, price and cost information, etc.
I don’t think I’m stepping out on a limb if I state that medical records cannot be classified as “natural” language. So the GenHealth.AI model is trained specifically on those attributes found in medical records, and not on people hemming and hawing and asking what a Pekingese dog looks like.
But there is still more work to do.
What about the LMM that is also an LMM?
Unless I’m missing something, the Large Medical Model described above is designed to work with only one mode of data, textual data.
But what if the Large Medical Model were also a Large Multimodal Model?
Rather than converting a medical professional’s voice notes to text, the LMM-LMM would work directly with the voice data. This could lead to increased accuracy: compare the tone of voice of an offhand comment “This doesn’t look good” with the tone of voice of a shocked comment “This doesn’t look good.” They appear the same when reduced to text format, but the original voice data conveys significant differences.
Rather than just using the textual codes associated with an X-ray, the LMM-LMM would read the X-ray itself. If the image model has adequate training, it will again pick up subtleties in the X-ray data that are not present when the data is reduced to a single medical code.
In short, the LMM-LMM (large medical model-large multimodal model) would accept ALL the medical outputs: text, voice, image, video, biometric readings, and everything else. And the LMM-LMM would deal with all of it natively, increasing the speed and accuracy of healthcare by removing the need to convert everything to textual codes.
A tall order, but imagine how healthcare would be revolutionized if you didn’t have to convert everything into text format to get things done. And if you could use the actual image, video, audio, or other data rather than someone’s textual summation of it.
Obviously you’d need a ton of training data to develop an LMM-LMM that could perform all these tasks. And you’d have to obtain the training data in a way that conforms to privacy requirements: in this case protected health information (PHI) requirements such as HIPAA requirements.
But if someone successfully pulls this off, the benefits are enormous.
You’ve come a long way, baby.
Robert Young (“Marcus Welby”) and Jane Wyatt (“Margaret Anderson” on a different show). By ABC TelevisionUploaded by We hope at en.wikipedia – eBay itemphoto informationTransferred from en.wikipedia by SreeBot, Public Domain, https://commons.wikimedia.org/w/index.php?curid=16472486.
(T)here were 7,887 nurses who recently ended their healthcare careers between 2018 and 2021….39% of respondents said their decision to leave healthcare was due to a planned retirement. However, 26% of respondents cited burnout or emotional exhaustion, and 21% cited insufficient staffing.
And this is ALL nurses. Not just the forensic nurses who have to deal with upsetting examinations that (literally) probe into sexual assault and child abuse. All nurses have it tough.
At Artisight we are committed to reversing this trend through AI-driven technology that is bringing the joy back to medicine!!
Can artificial intelligence bots truly relieve the exhaustion of overworked health professionals? Let’s look at two AI solutions from 3M and Artisight and see whether they truly benefit medical staff.
3M, a former competitor to MorphoTrak until 3M sold its biometric offerings (as did MorphoTrak’s parent Safran), has invested heavily into healthcare artificial intelligence solutions. This includes a solution that addresses the bane of medical professionals everywhere—keeping up with the paperwork (and checking for potentially catastrophic errors).
Our solutions use artificial intelligence (AI) to alleviate administrative burden and proactively identify gaps and inconsistencies within clinical documentation. Supporting completeness and accuracy every step of the way, from capture to code, means rework doesn’t end up on the physician’s plate before or even after discharge. That enables you to keep your focus where it needs to be – on the patient right in front of you.
But what about Artisight, whose assertion inspired this post in the first place?
A recent PYMNTS article interviewed Artisight President Stephanie Lahr to uncover Artight’s approach.
The Artisight platform marries IoT sensors with machine learning and large language models. The overall goal in a hospital setting is to streamline safe patient care, including virtual nursing. Compliance with HIPAA, according to Lahr, has been an important part of the platform’s development, which includes computer vision, voice recognition, vital sign monitoring, indoor positioning capabilities and actionable analytics reports.
In more detail, a hospital patient room is equipped with Al-powered devices such as high-quality, two-way audio and video with multiple participants for virtual care. Ultra-wideband technology tracks the movement and flow of assets throughout the hospital. Remote nurses and observers monitor patient room activity off-site and interact virtually with patients and clinicians.
At a minimum, this reduces the need for nurses to run down the hall just to check things. At a maximum, tracking of asset flows and actionable analytics reports make the job of everyone in the hospital easier.
So how can 3M’s and Artisight’s artificial intelligence offerings benefit medical facilities?
Allow medical professionals to concentrate on care. Patients don’t need medical professionals who are buried in paperwork. Patients need medical professionals who are spending time with them. The circumstances that land a patient in a hospital are bad enough, and to have people who are forced to ignore patient needs makes it worse. Maybe some day we’ll even get back to Welbycare.
Free medical professionals from routine tasks. Assuming the solutions work as advertised, they eliminate the need to double-check a report for errors, or the need to walk down the hall to capture vital signs.
Save lives. Yeah, medical professionals do that. If the Marcus Welby AI bot spots an error in a report, or if the bot detects a negative change in vital signs while a nurse is occupied with another patient, the technology could very well save a life.
The 438 U.S. federal agencies (as of today) probably have over 439 different security requirements. When you add state and local agencies to the list, security compliance becomes a mind-numbing exercise.
For example, the U.S. Federal Bureau of Investigation has its Criminal Justice Information Systems Security Policy (version 5.9 is here). This not only applies to the FBI, but to any government agency or private organization that interfaces to the relevant FBI systems.
The Federal Risk and Authorization Management Program (FedRAMP®) was established in 2011 to provide a cost-effective, risk-based approach for the adoption and use of cloud services by the federal government. FedRAMP empowers agencies to use modern cloud technologies, with an emphasis on security and protection of federal information. In December 2022, the FedRAMP Authorization Act was signed as part of the FY23 National Defense Authorization Act (NDAA). The Act codifies the FedRAMP program as the authoritative standardized approach to security assessment and authorization for cloud computing products and services that process unclassified federal information.
Note the critical word “unclassified.” So FedRAMP doesn’t cover EVERYTHING. But it does cover enough to allow federal agencies to move away from huge on-premise server rooms and enjoy the same SaaS advantages that private entities enjoy.
It turns out that a number of other FedRAMP-authorized products are partially dependent upon Microsoft Azure Government’s FedRAMP authorization, so continued maintenance of this authorization is essential to Microsoft, a number of other vendors, and all the agencies that require secure cloud solutions.
They can only hope that the GSA Inspector General doesn’t find fault with THEM.
Is FedRAMP compliance worth it?
But assuming that doesn’t happen, is it worthwhile for vendors to pursue FedRAMP compliance?
If you are a company with a cloud service, there are likely quite a few questions you are asking yourself about your pursuits in the Federal market. When will the upward trajectory of cloud adoption begin? What agency will be the next to migrate to the cloud? What technologies will be migrated? As you move forward with your business development strategy you will also question whether FedRAMP compliance is something you should pursue?
The answer to the last question is simple: Yes. If you want the Federal Government to purchase your cloud service offering you will, sooner or later, have to successfully navigate the FedRAMP process.
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