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Vital Signs

Image by Edmon De Haro
The signs of strain were there long before the pandemic: Health care workers had been managing under tremendous pressures while working long hours in understaffed hospitals. Then COVID unleashed an unprecedented strain on the system, causing the rates of burnout among this population to triple. That kind of churn has had far-ranging, systemic effects and has been linked to everything from reduced quality of care to substantial costs for the system. Underlying that problem is the fact that there simply aren’t enough doctors to go around: Estimates suggest a shortfall of about 4 million health care workers worldwide, but the World Health Organization predicts that figure will stretch to 10 million by 2030.
Those industry trends are among the factors that drive Lorin Gresser (MBA 1998), founder of DemDx, to her London-based office every day. An abbreviation of “demonstrating diagnostics,” DemDx is a software platform with embedded AI technology that guides health care providers through all the necessary questions in a patient examination to speed the patient onto the right path for treatment, while minimizing the chance of errors along the way. Accessed by a mobile phone, tablet, or web application, the software also builds medical notes throughout the consultation. Those notes, along with the management plan or any necessary referrals, feed directly into a patient’s medical record. The automation ensures patients receive thorough and consistent assessments but also saves precious time for the practitioner, Gresser says.
The idea of deploying algorithms and AI’s processing power to this initial patient consultation had seemed so obvious to Gresser that she was shocked to discover it didn’t exist before DemDx. (Others had taken aim at this market, but none had fully addressed the specific challenge of empowering front-line health workers, she adds.) Gresser had seen firsthand its potential utility: After getting her MBA and pursuing a career in consulting, she decided to retrain and got her medical degree at King’s College London. There, in the great tradition of med students everywhere, she committed to memory the encyclopedic volume of information about diseases and their multiple presentations. That bedrock of knowledge is absolutely critical for health workers to learn, Gresser says, but it’s not representative of what happens when a patient appears in a doctor’s office.
“A patient doesn’t tend to walk into your office and announce that they have TB. Instead they might say, ‘I have a cough.’ You as the clinician have to reverse engineer all your teachings and run through all the possibilities of what it could be,” Gresser says. The principle of that work is unbelievably difficult, she adds. It’s also an acute challenge to minimize errors given such a vast volume of possibilities for the clinician to consider—and that’s before you factor in human elements that can affect accuracy, such as cognitive bias or basic, late-afternoon fatigue, Gresser adds.
As much as she believes that AI can help correct for human imperfections, she’s also adamant that technology is no substitute for the clinician in the room or the knowledge and nuance that they bring to the encounter. Practitioners who use DemDx still need to know all the right medical questions to ask, as well as national guidelines and protocols, explains Gresser, who consulted with 200 medical experts in developing the product. The tool puts all of this key information into an easy framework, which frees up the clinician’s attention to focus on listening to the patient and the invaluable human interactions.
The National Health Service (NHS) hospitals and practices that have adopted the tool are reporting 20 percent productivity gains (between senior physicians requiring less input and general time saved). But perhaps the greatest benefit is the tool’s ability to give clinicians confidence over a wider range of expertise, Gresser says. Health systems in the UK and elsewhere have been responding to the staffing shortages by recruiting more nurse practitioners, paramedics, and physician assistants to work at the front lines; even pharmacists are being asked to take on more initial assessments for minor illnesses in some settings.
“Innovation will continue to be a really powerful way to help improve health care systems globally and raise the standard of patient care at a time when it is needed most.”
“We are looking to support this new dynamic workforce to make sure they work at the top of their licenses,” Gresser says. “We are empowering and augmenting their decision-making because that first set of health decisions is one of the key determinants of a positive outcome.”
The fact that it’s a software product, rather than hardware, means that DemDx has the potential to scale quickly and globally. It also can be customized to different health care systems and national guidelines. While there are some geographic differences in patient care—with regional differences in patient populations and the prevalence of certain diseases, for example—the human body is the same the world over, Gresser points out. “It’s a very exciting proposition to have a truly global product.”
That said, innovation can be slow to take hold in the industry, which tends to be conservative and tightly regulated for all the right reasons, Gresser observes. “But innovation will continue to be a really powerful way to help improve health care systems globally and raise the standard of patient care at a time when it is needed most.”
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