AMA, others strike long-term partnership with Human Diagnosis Project

By Mike Miliard
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More underserved patients could soon benefit from expanded access to specialists, as several top medical societies pledged a long-term partnership with the Human Diagnosis Project, which plans to scale up to close gaps in care for as many as 30 million Americans.

The Human Diagnosis Project, or Human Dx, is an open, online platform that deploys machine learning algorithms to help providers to find specialty treatment for their patients, connecting them with curated expertise from other physicians worldwide.

The system enables primary care docs at smaller or remote practices to tap into that collected wisdom and gain access to tests, opinions or diagnoses that they wouldn't have otherwise.

Led by the American Medical Association – which will encourage its vast physician membership to volunteer on the Human Dx project – other groups have also signed on to the initiative, including American Board of  Internal  Medicine, the American Board of Medical Specialties, the Association of American Medical Colleges, the Association of Clinicians for the Underserved, the National Association of Community Health Centers and the Dartmouth Institute for Health Policy and Clinical Practice.

"We look forward to working with Human Dx as part of this important Alliance to help more uninsured and underinsured patients gain access to the specialty care they need," said AMA President David O. Barbe, MD.

Human Dx also has ongoing research collaborations with Harvard Medical School, Johns Hopkins University School of Medicine and UC San Francisco Medical Center.

That broad commitment will help the Human Dx Alliance grow over the next five years, expanding the system to help connect the safety net population with specialty care more urban patients might take for granted. In the years ahead, the hope is to expand Human Dx globally, said its founder, Jayanth Komarneni.

"Millions in this country and more than a billion people worldwide lack access to the health care they need, so they choose between paying for it themselves and being forced into poverty, or not getting it and becoming sicker or dying as a result," said Komarneni. "Thousands of doctors from over 70 countries are tired of this and have come together to build a solution. By contributing to Human Dx doctors will expand access to help people get the care they need, beginning with the underserved: first here in America, and ultimately worldwide."

Uninsured safety net patients at the 1,300 or so community health centers and free clinics in the U.S. are able get basic medical treatment, but don't have timely and affordable access to specialists such as cardiologists or oncologists. Gaining access to their expertise requires long waits and large out-of-pocket costs.

But sometimes getting the right care doesn't depend on expansive and expensive treatment, just the right expertise at the right time. By amassing specialists' medical knowledge in an open and widely accessible system, technology can help deliver that, according to Komarneni.

Human Dx enables doctors get electronic consults for their patients, accessing targeted knowledge from specialists. A primary care doc can just log a patient's background and medical findings into the platform, which are then posted for specialists around the world to review and offer recommendations for tests or diagnoses.

"Generally, doctors can diagnose better than computers. But doctors supported by technology like the Human Dx system could help improve the accuracy of clinical decisions across the board," said David Bates, MD, professor of health policy and management at Harvard's T.H. Chan School of Public Health.

The system is built upon the insights, amassed over the past three years, of more than 6,000 physicians – representing more than 40 medical specialties – at more than 500 institutions in some 70 countries, according to Human Dx.

It uses machine learning tools to analyze that specialist input – in tandem with patient's symptoms, exam results, medical history, imaging, labs and more – to help the physician make a more informed decision.

Eventually, the platform will also help with more precision treatment, incorporating genomics, epigenomics, proteomics, published medical research and more.

Margaret Nora, MD, president and CEO of American Board of Medical Specialties, which oversees U.S. physician specialty certification, recognizes that a gap exists for vulnerable populations with regard to specialty care. "Human Dx has the potential to improve the health and wellbeing of patients in this country, and ultimately across the globe," she said.

"Clinical reasoning is a fundamental skill for doctors," said Sanjay Desai, MD, director of the Osler Medical Training Program at the Johns Hopkins School of Medicine. "However, we have no current method for measuring this skill aside from using a combination of the subjective opinions of more senior doctors and surrogate markers such as exams. Human Dx is the first tool I have seen that begins to address this unmet need."