Audiobooks I’ve Enjoyed This Year – 2023

June 13, 2023June 11, 2023 hjsoch1 Comment

“I always have enjoyed people to read for me or to have the chance to listen to how they narrate a book.”
Deyth Banger

Even for people who love books, finding the opportunity to read can be challenging. Many, then, rely on audiobooks, a convenient alternative to old-fashioned reading. You can listen to the latest bestseller while commuting or cleaning up the house. We can debate whether listening to an audiobook constitutes “reading,” but there’s no doubt that audiobooks have continued to grow in popularity over the last few years.

Since I purchase all of my digital and audiobooks on Amazon, I like the ability to seamlessly jump back and forth between the printed page (to take notes or highlight a section to read again) and the audio version without having to search to find where I left off. I can even use my Alexa device to continue listening to audiobooks in my home office.

So, here are some of my favorite audiobooks from 2023 so far. Note that most are not healthcare related, and many aren’t focused on technology. They just hit my major criteria for selecting an audiobook, and they give me hours of enjoyment. (All hyperlinks are to the audiobook versions on Amazon.)

Look for Me There: Grieving My Father, Finding Myself by Luke Russert. “Look for me there,” news legend Tim Russert would tell his son, Luke, when confirming a pickup spot at an airport, sporting event, or rock concert. After Tim died unexpectedly, Luke kept looking for his father, following in Tim’s footsteps and carving out a highly successful career at NBC News. After eight years covering politics on television, Luke realized he had no good answer as to why he was chasing his father’s legacy. As the son of two accomplished parents—his mother is journalist Maureen Orth of Vanity Fair—Luke felt the pressure of high expectations but suddenly decided to leave the familiar path behind. Tim Russert was one of my favorite news anchors. So, anyone uncertain about the direction of their life or unsure of how to move forward after a loss, Look for Me There is a poignant reflection that offers encouragement to examine our choices, take risks, and discover our truest selves.

Empress of the Nile: The Daredevil Archaeologist Who Saved Egypt’s Ancient Temples from Destruction by Lynne Olsen. I’ve been passionate about ancient Egypt and archaeology since I was young. Growing up in Chicago, a visit to The Oriental Institute was always a highlight of the Summer. And when I finally made it to Egypt in 2019, and visited many of the ancient sites I was fulfilling a longstanding dream. This is the remarkable story of the intrepid French archaeologist who led the international effort to save ancient Egyptian temples from the floodwaters of the Aswan Dam. A willful real-life version of Indiana Jones, Desroches-Noblecourt refused to be cowed by anyone or anything. During World War II she joined the French Resistance and was held by the Nazis; in her fight to save the temples she challenged two of the postwar world’s most daunting leaders, Egypt’s President Nasser and France’s President de Gaulle.

Childhood’s End by Arthur C Clarke. I decided to revisit this novel primarily because of the narrator, who I’ve enjoyed in other audiobooks. The second reason was because it includes an exclusive introduction by Hugo Award-winning author Robert J. Sawyer, who explains why this novel, written in the 1950s, is still relevant today.

Fall in Love with the Problem, Not the Solution: A Handbook for Entrepreneurs by Uri Levine. Unicorns—companies that reach a valuation of more than $1 billion—are rare. Uri Levine has built two. Levine offers an inside look at the creation and sale of Waze and his second unicorn, Moovit, revealing the formula that drove those companies to compete with industry veterans and giants alike. He offers tips on: firing and hiring; disrupting “broken” markets; raising funding; understanding your users; reaching product market fit; making scale-up decisions; going global; and deciding when to sell.

Tech Trends in Practice: The 25 Technologies That Are Driving the 4th Industrial Revolution by Bernard Marr. How will the latest technologies transform your business? The book presents 25 real-world technology trends along with their potential contributions to organizational success. You’ll learn how to integrate existing advancements and plan for those that are on the way. I chose this specifically because there were several technologies that will directly impact healthcare and I wanted a broader opinion on their potential benefits.

Life 3.0: Being Human in the Age of Artificial Intelligence by Max Tegmark. The rise of AI has the potential to transform our future more than any other technology – and there’s nobody better qualified or situated to explore that future than Max Tegmark, an MIT professor who’s helped mainstream research on how to keep AI beneficial. This book empowers you to join what may be the most important conversation of our time. It doesn’t shy away from the full range of viewpoints or from the most controversial issues – from superintelligence to meaning, consciousness, and the ultimate physical limits on life in the cosmos.

In the Blood: How Two Outsiders Solved a Centuries-Old Medical Mystery and Took On the US Army by Charles Barber. At the 1993 Battle of Mogadishu, dramatized by the popular film Black Hawk Down, the majority of soldiers who died were killed instantly or bled to death before they could reach an operating table. This tragedy reinforced the need for a revolutionary treatment that could transform trauma medicine. So, when Frank Hursey and Bart Gullong—who had no medical or military experience—discovered that a cheap, crushed rock called zeolite had blood‑clotting properties, they brought it to the military’s attention. The Marines and the Navy adopted the resulting product, QuikClot, immediately. The Army, however, resisted. It had two products of its own being developed to prevent excessive bleeds, one of which had already cost tens of millions of dollars. The other, “Factor Seven,” had a more dangerous complication: its side effects could be deadly. Unwilling to let its efforts end in failure—and led by the highly influential surgeon Colonel John Holcomb—the Army set out to smear QuikClot’s reputation. In the Blood recounts this little‑known David‑and‑Goliath story of corruption, greed, and power within the military—and the devastating consequences of unchecked institutional arrogance.

The People’s Hospital: Hope and Peril in American Medicine by Ricardo Nuila, MD. Where does one go without health insurance, when turned away by hospitals, clinics, and doctors? In The People’s Hospital, we follow the lives of five uninsured Houstonians as their struggle for survival leads them to a hospital where insurance comes second to genuine care. Each patient eventually lands at Ben Taub, the county hospital where Dr. Nuila has worked for over a decade. Nuila delves with empathy into the experiences of his patients, braiding their dramas into a singular narrative that contradicts the established idea that the only way to receive good healthcare is with good insurance.

Looking Back – Looking Forward

January 5, 2022January 5, 2022 hjsoch1 Comment

“A year of ending and beginning, a year of loss and finding and all of you were with me through the storm. I drink your health, your wealth, your fortune for long years to come, and I hope for many more days in which we can gather like this.”
C.J. Cherryh, American Author

For my first blog post of 2022, I wanted to review the material that readers found to be the most interesting and received the most impressions (over 13,000 in under six months) across all social media platforms. First, a big thank you to all who have read, shared, and commented on the material I published last year. Your comments, suggestions (more on those in a bit), and encouragement have been greatly appreciated.

Looking back –

In analyzing the data, the area of interest that generated the most engagement were the posts from my “Straight Talk” series on technologies in health care. These were intended to provide a snapshot of the current development of key technologies with examples of how they were being used to improve care delivery. Those posts (and associated links) are listed below:

The other posts that received a lot of attention were the lists of books, podcasts, and newsletters that I regularly use in my reading and research. Those are listed for you (with links) below:

Looking forward –

As I mentioned in my end-of-the-year post on Disruptors to Watch in 2022, and based on readers’ feedback on what you would like to see more of this year, I’m going to focus a lot on the topic “It’s About Time.” The ongoing pandemic has accelerated the deployment of technologies to support care delivery and remote care options. The associated workforce issues have created a dynamic tension between continuing to innovate while dealing with the stresses placed on the care team as the waves of patients needing care hit the system. So, while I’m going to continue to report on technology developments and applications in health care, I want to explore how the implementation of certain technologies can save time for patients, families, and providers in navigating our complex, fragmented, and confusing health care system. Watch for the first post in that series next week.

I’m also going to step back from discussing just the technology and share some examples of companies and organizations that I’ve personally interacted with who I believe are driving significant and sustainable change in the delivery of care in our country. Up until now, I’ve taken a “vendor agnostic” approach to posts on this blog. And while that will still be a part of my research and reporting, I think that sharing some personal examples of companies and organizations that are pushing the envelope in technology development and care delivery would be valuable to readers. I’d appreciate your feedback on these posts and recommendations on other companies and organizations to highlight throughout the year.

Finally, many readers commented that they enjoy the weekly health care technology news posts that hit the blog on Saturdays. This year I’m refining that weekly post to add an infographic of the week from either research or reading that I’ve come across. And I’ve been invited to participate in a beta test of a Zoom platform application called “On-Zoom.” So, for registered users on the WordPress blog site, you’ll be able to register for a weekly 15-minute live Zoom event that will provide an early look at the top technology news stories in health care that week. These will be on Fridays at Noon ET (one day before the blog post goes live), so subscribers will get the stories first. You can register on the Talking Healthcare Technology WordPress site here: https://healtech.blog and enter your email in the subscription section as shown below:

Talking Healthcare Technology WordPress site

Registered subscribers will receive an email invitation with the link to the On-Zoom sessions. You can choose to subscribe to a single session or the entire series by clicking on the link provided.

Hopefully, you’ll find this experiment interesting and valuable. As always, comments and suggestions for improvement are greatly appreciated.

Thanks again for reading!

Holiday Greetings

December 25, 2021December 23, 2021 hjsochLeave a comment

“What is Christmas? It is the tenderness of the past, courage for the present, and hope for the future.”
Agnes M. Pahro, Author, Artist

Thank you for reading, following, and sharing these blog posts. Your comments and encouragement have been greatly appreciated.
Whatever is beautiful. Whatever is meaningful. Whatever brings you happiness. May it be yours this holiday season and throughout the coming year.
Warmest regards, Henry Soch

Some Straight Talk on A.I. In Health Care

July 6, 2021July 22, 2021 hjsoch4 Comments

“Artificial Intelligence will help everyone become a better doctor in the future by eradicating waiting time, prioritizing emails, finding relevant information or making hard decisions rational.“
Bertalan Mesko, M.D. – Director, The Medical Futurist Institute

It’s important to separate the hype from the reality in our quest to incorporate A.I. into care delivery.

Image Credit: Sg2, Henry Soch Executive Summit presentation 2017

In a contributed article to Mobihealthnews on July 1st, Dr. Liz Kwo highlights her “Top 10 Use Cases for AI in Healthcare”. This comprehensive overview outlines the current major categories that health care providers are exploring to incorporate AI into the clinical care continuum. I applaud Dr. Kwo for synthesizing this information and share her enthusiasm for the potential of AI in supporting care teams in their daily work.

However, I do think it is important to balance the tremendous potential of the technology with the current reality. There’s an old saying that goes: “We overestimate the impact of technology in the short-term, and underestimate the impact in the long-term.” That certainly applies to AI in health care. The amount of “digital ink” devoted to the topic would fill several data warehouses.

CB Insights conducted a survey at the end of last year and asked which areas of healthcare would be impacted most by AI. The results are shown in the graphic below:

Every year, Gartner publishes their “Hype Cycle” analyses across multiple industries. Their methodology helps us to separate the hype from reality when considering whether (and when) we decide to incorporate AI into clinical workflow. If you are not familiar with the Gartner Hype Cycle model, this is the best book that I’ve found on the subject: “Mastering the Hype Cycle: How to Choose the Right Innovation at the Right Time.”

Below is the Gartner Hype Cycle for Healthcare Providers 2020.

We can see that, according to Gartner, AI is approaching the “Peak of Inflated Expectations”, and is not expected to reach “The Plateau of Productivity” for five to ten years. With that information as our baseline, let’s examine each of Dr. Kwo’s use cases and where we stand today.

1. AI supports medical imaging analysis – AI is used as a tool for case triage. It supports a clinician reviewing images and scans. This enables radiologists or cardiologists to identify essential insights for prioritizing critical cases, to avoid potential errors in reading electronic health records (EHRs), and to establish more precise diagnoses.

Where we are – The best assessment of where we stand in the implementation of AI in imaging can be found in an Aunt Minnie article by Michael Cannavo (akaPACSMAN) here. To quote him: “Unless you perform a large volume of studies that would benefit from the use of a CT algorithm stroke protocol, lung CT algorithm, or others, you may be hard-pressed to justify the purchase of AI software without obtaining additional revenue. There are significant advantages to using AI, but no clear path for how it will pay for itself in hard dollars.”

2. AI can decrease the cost to develop medicines – Supercomputers have been used to predict from databases of molecular structures which potential medicines would and would not be effective for various diseases. By using convolutional neural networks, a technology similar to the one that makes cars drive by themselves, AtomNet could predict the binding of small molecules to proteins by analyzing hints from millions of experimental measurements and thousands of protein structures.

Where we are – While many pharmaceutical companies and academic medical centers are exploring the use of supercomputers to help identify and develop new drug targets, the benefits are as of yet unproven. The introduction of “high throughput screening,” using robots to test millions of compounds rapidly, generated mountains of leads in the early 2000s but notably failed to solve inefficiencies in the research process. When it comes to AI, big pharma is treading cautiously. The technology has yet to demonstrate it can successfully bring a new molecule from computer screen to lab to clinic and finally to market.

3. AI analyzes unstructured data – In many cases, health data and medical records of patients are stored as complex unstructured data, which makes it challenging to interpret and access. AI can seek, collect, store and standardize medical data regardless of the format, assisting repetitive tasks and supporting clinicians with fast, accurate, tailored treatment plans and medicine for their patients instead of being buried under the weight of searching, identifying, collecting, and transcribing the solutions they need from piles of paper formatted EHRs.

Where we are – The author’s assertion that AI can collect, aggregate, and standardize all of this data regardless of the format is much easier said than done. The lack of data standards in healthcare continues to be the key stumbling block to an accurate, longitudinal patient record. And, collecting disparate data sets and placing that data in the proper context for review is a daunting challenge that has yet to be overcome.

4. AI builds complex and consolidated platforms for drug discovery – AI algorithms can identify new drug applications, tracing their toxic potential as well as their mechanisms of action.

Where we are – See the comments under point number two above.

5. AI can forecast kidney disease – In 2019, the Department of Veterans Affairs (VA) and DeepMind Health created a ML tool that can predict Acute Kidney Injury (AKI) up to 48 hours in advance. The AI tool was able to identify more than 90% of acute AKI cases 48 hours earlier than with traditional care methods.

Where we are – The partnership between VA and DeepMind Health continues. Its next target is to identify how this ML tool can be installed in medical units. A user-friendly platform is also targeted to support clinicians in their treatment decisions that would improve the quality of life for Veterans suffering from AKI.

6. AI provides valuable assistance to emergency medical staff – During a sudden heart attack, the time between the 911 call to the ambulance arrival is crucial for recovery. For an increased chance of survival, emergency dispatchers must recognize the symptoms of a cardiac arrest to take appropriate measures. AI can analyze both verbal and nonverbal clues to establish a diagnostic from a distance.

Where we are – Implementing these types of AI-assisted tools in the EMS is an expensive proposition. That, coupled with the fact that most EMS departments are run at the local town or city level, makes it difficult to achieve scale in deploying these tools. Also, one must consider the training requirements for proper implementation as well.

7. AI contributes to cancer research and treatment, especially in radiation therapy. In some cases, radiation therapy can lack a digital database to collect and organize EHRs, making the study and treatment difficult. To assist clinicians in making informed decisions regarding radiation therapy for cancer patients, a platform has been developed that collects the relevant medical data of patients, evaluates the quality of care provided, optimizes treatments, and offers specific oncology outcomes, data, and imaging.

Where we are – In a classic case of hype versus reality, consider IBM’s Watson and cancer care. Watson’s entry into cancer care and interpretation of cancer genomics was, just like its appearance on Jeopardy!, highly hyped, with overwhelmingly positive press coverage and little in the way of skeptical examination of what, exactly, Watson could potentially do and whether it could improve patient outcomes. An article in STAT looked at Watson for Oncology’s use, marketing, and actual performance in hospitals around the world, interviewing dozens of doctors, IBM executives, and artificial intelligence experts and concluded that IBM released a product without having fully assessed or understood the challenges in deploying it and without having published any papers demonstrating that the technology works as advertised, noting that, as a result, “its flaws are getting exposed on the front lines of care by doctors and researchers who say that the system while promising in some respects, remains undeveloped.” Quoting the STAT authors:

Perhaps the most stunning overreach is in the company’s claim that Watson for Oncology, through artificial intelligence, can sift through reams of data to generate new insights and identify, as an IBM sales rep put it, “even new approaches” to cancer care. STAT found that the system doesn’t create new knowledge and is artificially intelligent only in the most rudimentary sense of the term.
STAT – Casey Ross & Ike Swetlitz

8. AI uses data collected for predictive analytics – Turning EHRs into an AI-driven predictive tool allows clinicians to be more effective with their workflows, medical decisions, and treatment plan. NLP and ML can read the entire medical history of a patient in real-time, connect it with symptoms, chronic affections, or an illness that affects other family members. They can turn the result into a predictive analytics tool that can catch and treat a disease before it becomes life-threatening.

Where we are – The buzzword fever around predictive analytics will likely continue to rise and fall. Unfortunately, lacking the proper infrastructure, staffing, and resource to act when something is predicted with high certainty to happen, we fall short of the full potential of harnessing historical trends and patterns in patient data. In other words, without the willpower for clinical intervention, any predictor – no matter how good – is not fully utilized.

9. AI accelerates the discovery and development of genetic medicine – AI is also used to help rapidly discover and develop medicine with a high rate of success. Genetic diseases are favored by altered molecular phenotypes, such as protein binding. Predicting these alterations means predicting the likelihood of genetic diseases emerging. This is possible by collecting data on all identified compounds and on biomarkers relevant to specific clinical trials.

Where we are – If you live in the U. S. you’ve undoubtedly seen various cancer treatment centers talking about their personalized therapy plans, and especially how they’ll tailor things to your DNA sequence and so on. You would get the impression that we have an arsenal of specifically targeted cancer therapies, waiting for patients to get their tumors sequenced so they can be paired with the optimal treatment. That’s not true. I wish it were, but it just isn’t.

There are estimates that only about 15% of patients total are currently even eligible (under FDA guidelines) to have their tumors sequenced in the hope of matching with a targeted therapy. About one-third of those may actually benefit from the process in the end. This is not exactly what you’d expect if all you knew about this stuff was what you heard on TV. The thing is, that’s actually a significant advance because the number used to be zero in both categories. We really are making progress, and the people who can benefit really can benefit. It’s just that there aren’t nearly as many of them as we’d like, not yet.

10. AI supports health equity – Those responsible for applying AI in healthcare must ensure AI algorithms are not only accurate but objective and fair.

Where we are – Unfortunately, as has been demonstrated in many of the AI algorithms that exist today, we cannot assume that all relevant factors were applied in the training set of the AI algorithms. The medical datasets openly available for use by AI researchers are notoriously biased, especially in the US. It’s not a secret: Healthcare data is extremely male and extremely white, which has real-world impacts. (For a deeper discussion on this topic, check out Amber M. Hamilton’s article in Slate’s Future Tense Silicon Valley Pretends That Algorithmic Bias Is Accidental. It’s Not.) Questions that need to be addressed include: Is the selection of the training factors evidence-based? Are race, gender, and ethnicity data included in the training data set?

Adding a link here to an excellent, insightful blog post from John Halamka, M.D. titled “Learning from AI’s Failures. I love his concluding paragraph:

If we are to learn from AI’s failures, we need to evaluate its products and services more carefully and develop them within an interdisciplinary environment that respects all stakeholders.
John Halamka. M.D., President, Mayo Clinic Platform

AI holds great potential in improving care delivery by optimizing the use of scarce resources and eliminating repetitive and non-value-adding work for the care team. However, AI adoption in healthcare continues to have challenges, such as a lack of trust in the results delivered by an ML system and the need to meet specific requirements. It is essential to take a realistic approach when considering the implementation of AI in your organization. At this time, the best Return on Investment (RoI) case for AI involves operational use cases (e.g., bed management, staffing management, supply chain optimization, etc.) Certain clinical use cases like imaging, dermatology, and pathology can improve workflow and prioritize work lists for those disciplines.

I listed seven ways to prepare for incorporating AI in health care organizations during one of my presentations in 2017. I think they are still relevant today.

If you are interested in digging a bit deeper into the topic of AI in health care, I highly recommend this online learning course from my friend and colleague Tom Giordano. His “Plain and Simple” series of courses are excellent.

Summer Reading 2021

July 1, 2021July 9, 2021 hjsoch1 Comment

“Reading is to the mind what exercise is to the body.” — Richard Steele

I’m certainly no Bill Gates. But with the Independence Day Holiday weekend upon us, I’m going to poach his idea of a “Think Week,” albeit in shorter form, to dig into some books that have been piling up since the beginning of the year. There are a wealth of options to choose from, but here are some of my top recommendations.

I will read anything that Walter Isaacson publishes. I loved his biographies of Albert Einstein and Leonardo DaVinci. So it is no surprise that one of my top recommendations is his book The Code Breaker, his biography of CRISPR pioneer Dr. Jennifer Doudna. The development of CRISPR by Nobel Prize Winner Doudna and her colleagues launched a revolution that will have dramatic implications for science and medicine in the future. Isaacson makes the science understandable and probes other ethical concerns that the development of this tool creates.

Dr. Robert Pearl’s latest book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients” is another must-read. In this critical and timely book, Dr. Robert Pearl shines a light on the unseen and often toxic culture of medicine. Today’s physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us. To get a sense of the importance of this book, you can view this YouTube interview with Dr. Pearl by Dr. Zubin Damania (aka ZDOGGMD) here.

From former head of Obamacare Andy Slavitt, Preventable is an inside account of the United States’ failed response to the Coronavirus pandemic. Slavitt chronicles what he saw and how much could have been prevented – an unflinching investigation of the cultural, political, and economic drivers that led to unnecessary loss of life. A sobering account of the response to the COVID-19 pandemic from someone on the front lines. A link to Slavitt’s interview with The Washington Post is here.

Dr. Makary is a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health and prolific writer on medicine and healthcare policy. One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine’s noble heritage of caring for people when they are vulnerable. He and his team have testified in court proceedings for patients & their families who have been sued for outstanding charges and won victory after victory. Dr. Zubin Damania interviews Makary about his book here.

Scott Galloway is a professor at the NYU Stern School and an entrepreneur, podcaster, and critically acclaimed writer. In this book, Galloway argues that the pandemic has not been a change agent so much as an accelerant of trends already well underway. In Post Corona, he outlines the contours of the crisis and the opportunities that lie ahead. Some businesses, like the powerful tech monopolies, will thrive as a result of the disruption. Other industries, like higher education, will struggle to maintain a value proposition that no longer makes sense when we can’t stand shoulder to shoulder. And the pandemic has accelerated deeper trends in government and society, exposing a widening gap between our vision of America as a land of opportunity and the troubling realities of our declining wellbeing. He co-hosts the podcast Pivot with New York Times tech reporter Kara Swisher. You can find their episodes here.

Although not technically a “tech” book, Michael Lewis’s book The Premonition highlights the work of a band of medical visionaries against the wall of ignorance that was the official response to the outbreak of COVID-19. A great read.

Cybersecurity is a huge issue in healthcare. Every week we hear of new attacks on health systems, insurance companies and other care providers. Millions of dollars have been paid to bad actors to regain access to health record systems that have been held hostage, delaying care and exposing the protected health information of millions of patients. Frankly, this book scared the !$%^ out of me. New York Times cybersecurity reporter Nicole Perlroth’s in-depth reporting exposes the dark underworld of “zero-day” exploits, revealing the urgent threat faced by us all if we cannot bring the global cyber arms race to heel.

I hope you find these books as enjoyable as I have. If I’ve missed one of your favorites, or you have suggestions for additional reading, please leave them in the comments to this post. Happy reading!