• Scripps Celebrates 100 Years of Medical Breakthroughs,Grace Kiehnle

    Scripps Celebrates 100 Years of Medical Breakthroughs

    It’s a big years for Scripps. The healthcare institution is celebrating its 100th birthday, and in its century in SD, it’s racked up its fair share of accolades: US News and World Report has named Scripps in the top 50 hospitals for cardiology and orthopedics for 19 and 11 years running, respectively.And it’s not letting age slow it down.At Scripps Clinic’s Shiley Center for Orthopaedic Research and Education (SCORE), scientists are currently in the discovery phase of developing tissue from human stem cells to use in rotator cuff treatment. The eventual goal is to create a biologically engineered tendon to replace or repair the patient’s torn rotator cuff.“This is a common injury, and as our population ages, there’s a pressing need to find new solutions,” says lead researcher Darryl D’Lima, MD, PhD, and director of orthopedic research for SCORE at Scripps Clinic.Courtesy of Scripps ClinicA Scripps Clinic cardiologist performs a pulsed field ablation procedure.This year also marked 40 years of the Mohs Micrographic Surgery and Dermatologic Oncology Fellowship, led for all four decades by Dr. Hubert Greenway. Dr. Greenway teaches doctors a technique pioneered by his mentor, Dr. Frederic Mohs, who developed a method of removing skin cancer layer by layer, checking for cancer cells along the way and preserving healthy tissue in the process. Dr. Greenway has performed 45,000 Mohs surgeries and trained 68 physicians to disseminate the technique as skin cancer cases increase each year.Aside from treating formidable health issues, Scripps Health faces a growing, industry-wide challenge: violence against healthcare workers. Workplace violence at all five Scripps hospital campuses jumped by 31 percent in 2023, reaching 2,335 total incidents. Healthcare staff experience demeaning comments, verbal abuse, and assaults on a regular basis. Scripps Health President & CEO Chris Van Gorder is part of a countywide task force addressing the problem, and the organization recently hired a retired FBI special agent to enhance staff security and safety training.Courtesy of Scripps Health FoundationNext up for Scripps Health? A new, 227,000-square-foot, three-story building that will expand acute care services and increase the number of hospital beds. Lusardi Tower at Scripps Encinitas is scheduled to open in 2025, housing private inpatient rooms, operating facilities, intensive and progressive care units, and a pulmonary institute.The post Scripps Celebrates 100 Years of Medical Breakthroughs appeared first on San Diego Magazine.

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  • 14 Women Working to Transform Human Health,Grace Kiehnle

    14 Women Working to Transform Human Health

    Only about 37 percent of doctors in the US are women. When it comes to physician scientists—MDs engaged in medical research—the number of women drops to 33 percent. And thanks to a gender gap in clinical trials, women can find themselves suffering adverse effects from treatments and medications that were tested primarily on men. The Prebys Foundation is looking to change all that. In May, the San Diego–based charitable organization, in partnership with the Science Philanthropy Alliance, awarded $500,000 grants to 14 local women scientists working to transform human health. Intended to fund projects by research leaders from underrepresented groups, the org’s Research Heroes initiative also has the potential to transform treatments for cancer, Alzheimer’s, infectious viruses, and other illnesses. Meet the program’s first cohort.Xin JinXin Jin is an assistant professor of neuroscience at Scripps Research. She is exploring brain development’s cellular mechanisms to better understand and track the progression of disorders like autism and schizophrenia.Stephanie Fraley Stephanie Fraley is an associate professor of bioengineering at UC San Diego, leads a lab focused on improving infectious disease detection and finding treatments for cancer metastasis (or spread) to combat two leading causes of death around the globe.Rachel Blaser Rachel Blaser is a professor of psychological sciences at the University of San Diego. She was awarded the grant for her groundbreaking research on human cognition and memory, which aims to detect early signs of cognitive decline, potentially transforming the approach to diseases like Alzheimer’s.Dannielle Engle Danielle Engle is an assistant professor and the Helen McLoraine Developmental Chair at the Salk Institute for Biological Studies’ Regulatory Biology Laboratory. She’s working to discover a quick and simple diagnostic marker for pancreatic cancer, similar to the PSA test for prostate cancer or screenings for colon cancer.Razel Milo Razel Milo is an associate professor of nursing and health science at the University of San Diego, as well as a family nurse practitioner and behavioral science researcher. She’s creating surveys in Tagalog to measure the life satisfaction and stress levels of Filipino Americans, hoping to improve healthcare for that community.Angelica Riestra Angelica Riestra is an assistant professor of biology at San Diego State University. She is developing ways to fight the parasite that causes trichomoniasis, a common sexually transmitted infection with links to cervical cancer, HIV, and other health issues.Mia Huang Mia Huang is an associate professor of chemistry at Scripps Research, is studying the biological functions of glycans, a complex sugar molecule in the human body, with the aim to predict and reduce pregnancy health risks by finding early markers for potential complications.Marygorret ObonyoMarygorret Obonyo is an associate professor at UC San Diego School of Medicine, is finding new methods to identify genes that increase the risk of developing gastric cancer—the third leading cause of cancer-related deaths—and forge effective new treatments for the disease.Erica Ollman SaphireErica Ollman Saphire is the president and CEO of the La Jolla Institute for Immunology. She’s working to determine why we get sick by researching how viruses interact with the immune system. She captures images of pathogens to learn where they are susceptible to antibodies.Sonia SharmaSonia Sharma is an associate professor at the La Jolla Institute for Immunology, is studying immune system differences between sexes, with the ultimate goal of creating new treatments for Alzheimer’s, which disproportionately impacts women.Tatyana SharpeeTatyana Sharpee is a neuroscientist and professor at the Salk Institute for Biological Studies. Drawing on her background in physics, she’s creating an algorithm to predict the impact of strokes, schizophrenia, and other diagnoses on the brain.Sujan ShrestaSujan Shresta is a researcher and professor at the La Jolla Institute of Immunology. The grant will help fund her mission to develop a vaccine that inoculates against multiple flaviviruses, a category that includes dengue, Zika, and West Nile.Lisa StowersLisa Stowers is a neuroscientist and professor at Scripps Research focusing on the brain’s structure—especially the way it processes scents—in order to help progress treatments for depression, autism, dementia, Alzheimer’s, and other disorders.Daniela Valdez-JassoDaniela Valdez-Jasso is an associate professor of bioengineering at UC San Diego. She’s seeking ways to diagnose and treat pulmonary hypertension—high blood pressure of the lungs—before the need for a lung transplant.The post 14 Women Working to Transform Human Health appeared first on San Diego Magazine.

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  • How Will AI Change Our Healthcare?,Cole Novak

    How Will AI Change Our Healthcare?

    The year was 2018, and Dr. Gabriel Wardi saw a potential solution to a long-running problem in healthcare: sepsis. Wardi, the medical director for hospital sepsis at UC San Diego Health, says sepsis—an overzealous immune system response to an infection—kills about 10 million people a year worldwide, including 350,000 people in the United States.Part of the problem with sepsis is that there are a lot of ways it can present, which makes it tricky to diagnose. For years, Wardi had been trying to see if electronic health records could trigger an alert for doctors and nurses when someone becomes at risk.“Unfortunately, those early alerts were wrong almost all the time, and you can imagine that in a busy hospital, your initial reaction is, ‘Get this thing away from me,’ because it’s wrong all the time, it changes your workflow, and no one likes it,” he says.But when artificial intelligence entered the scene, Wardi wondered if AI models could more accurately predict who’s going to get sepsis.“We focused on coming up with a way to pull data out of our emergency department in near real-time, look at about 150 variables, and generate an hourly prediction [for] who’s going to develop sepsis in the next four to six hours,” Wardi says, adding that the resulting deep-learning model is helping save some 50 lives a year at UC San Diego Health.Across San Diego County, AI is reshaping healthcare. It transcribes audio from appointments and summarizes patient notes. It helps drug companies decode genetic data. It writes draft responses to patient questions. It chats with people with mild cognitive impairments. It even identifies breastfeeding-related conditions from pictures taken with a phone.All of these enhancements are leading to lasting changes that will dramatically improve medicine, says Dr. Christopher Longhurst, chief medical officer at UC San Diego Health.“I think the promise is a little overhyped in the next two or three years, but in the next seven to nine years, it’s going to completely change healthcare delivery,” Longhurst adds. “It’s going to be the biggest thing since antibiotics, because it’s going to lift every single doctor to be the best possible doctor and it’s going to empower patients in ways they never have been before.”These may sound like high ideals, but the money piece of this equation seems to speak to a bright future for AI in healthcare. Investors are taking note of the technology’s promise. According to a recent Rock Health report, a third of the almost $6 billion invested in US digital health startups this year went to companies using AI.However, all of these innovations come with big questions: Do patients know when AI is being used? Is patient data protected? Will human jobs be replaced? Does anyone really want to talk to a robot about their health? Some worry the technology is progressing so quickly that these concerns will go unaddressed.“I just hope we don’t get too excited before the technology is really where it needs to be,” says Jillian Tullis, the director of biomedical ethics at University of San Diego. “I’m thinking of Jurassic Park—just because we can do it doesn’t mean we should do it.”Illustration by Cam CottrillThe promise—and pitfalls—of AI as a diagnostic toolEven providers themselves aren’t always keen on utilizing AI programs such as Wardi’s sepsis model.“Doctors and nurses are usually very, very smart people, and not all of them are going to be excited about having some kind of form of artificial intelligence suggest that someone might be developing sepsis,” Wardi says. “The more senior the physician, the more likely they are not to find value in the model. It could be a generational thing … Younger people are more excited about AI.”Wardi compares the skepticism around AI to 19th-century physicians’ resistance to the stethoscope. “[Doctors thought] it had no value and would ruin the profession,” he says. “Now, it’s a symbol of medicine.”Methods like the sepsis model can be expanded to predict the risk of other diseases, such as cardiovascular conditions, Alzheimer’s, and cancer, says Dr. Eric Topol, director and founder of the Scripps Research Translational Institute.Courtesy of Scripps Health“So we take all of a person’s data—that includes their electronic health record, their lab tests, their scans, their genome, their gut microbiome, [and their] sensor data, environmental data, and social determinant data,” he explains. “We can fold that all together and be able to very precisely say this person is at high risk for this particular condition.” According to Topol, Scripps researchers are even using pictures of the retina to predict Alzheimer’s and Parkinson’s years before any symptoms show up. “Machine eyes or digital eyes can see things that humans will never see,” Topol adds.Meanwhile, at the San Diego biotech company Illumina, researchers are using an algorithm to analyze genetic information and find mutations that cause disease.But creating this type of intelligence is a challenge compared to building programs like ChatGPT, which train on data from the internet. Dr. Kyle Farh, VP of Illumina’s Artificial Intelligence Lab, has turned to primates, sequencing their DNA and using that data to train the company’s model, PrimateAI-3D. He hopes to one day use the model to diagnose rare genetic diseases.Tullis at USD says she’s all for predicting and preventing illness, but she’s worried about the other uses of AI.“When I read stories about doctors who are fighting with insurance companies about whether or not patients should get certain procedures or treatment, but the insurance company uses an algorithm to make a determination… I get really nervous,” she says.Diagnosis often requires a human touch, she adds.“You can look at people’s nail beds; you can look at lumps or rashes in particular ways; you can feel people’s skin if it’s clammy and cold,” she says. “The algorithm can’t do that.”Illustration by Cam CottrillSaving time while protecting patient dataAnyone who’s used an AI model to draft an email or write a cover letter knows it can save a massive amount of time. And doctors and nurses in San Diego are already utilizing AI to take care of some of their more menial tasks.Several health systems, including Scripps Health, use AI to generate post-exam notes, answer patient questions, and summarize clinical appointments. It can reduce documentation time to “about seven to 10 seconds,” says Shane Thielman, chief information officer at Scripps. “It’s enabled certain physicians to be able to see additional patients in the course of a given shift or day.”Courtesy of UC San Diego HealthUCSD uses a similar system. According to Longhurst, it’s freed doctors up to focus on patients—not computer screens—during appointments.“That’s really about rehumanizing the exam room experience,” he says. Since they don’t have to take notes, physicians can make eye contact with patients while the tech transcribes their conversations.But the approach raises concerns about consent and data privacy. Jeeyun (Sophia) Baik, an assistant professor who researches communication technology at University of San Diego, recently studied loopholes in federal HIPAA law that health data can fall into.HIPAA does not currently protect health data collected by things like fitness apps or Apple Watches, she says. And that legislative gap “could apply to any emerging use cases of AI in the areas of medicine and healthcare, as well,” Baik adds.For example, if physicians want to utilize protected health data for any purpose beyond providing healthcare services directly to the patient, they’re supposed to get the patient’s authorization. But it’s debatable whether that applies if healthcare providers start to use the information to train artificial intelligence.“It can be controversial, in some cases, whether the use of AI aligns with the original purpose of healthcare service provisions the patients initially agreed to,” Baik says. “So there are definitely some gray areas that would merit further clarification and regulations or guidelines from the government.”A recent California state bill, SB 1120, attempts to clear up those gray areas by requiring health insurers that use artificial intelligence to ensure the tool meets specified safety and equity criteria.Thielman with Scripps Health says patients must always give consent before the AI tool takes notes on appointments. If a patient declines, providers won’t use the technology. However, “it happens very rarely that we have a patient that doesn’t consent,” he adds.And, he continues, a human always looks over automated, AI-generated messages answering patient questions. But Scripps doesn’t tell patients that it’s using AI “because we have an appropriate member of the care team doing a formal review and signing off before they release the note,” he says.It’s the same case at UCSD.“There’s no button that says, ‘Just send [the message to the patient] now,’” Longhurst explains. “You have to edit the draft if you’re going to use the AI-generated draft. That’s adhering to our principle of accountability.”Jon McManus, chief data, AI and development officer for Sharp HealthCare, says he realized an internal AI model was necessary to ensure employees and providers didn’t accidentally input patient data into less secure algorithms like ChatGPT. “We were able to block most commercial AI websites from the Sharp Network,” he explains. Instead, his team created a program called SharpAI. It’s used for tasks like summarizing meeting minutes, creating training curriculum, and drafting proposed nutrition plans.Fixing mistakes—and possibly making themWith artificial intelligence technology, telehealth services could get way more advanced—Jessica de Souza, a graduate student in electrical and computer engineering at UCSD, is currently working on a system that would allow parents experiencing breastfeeding problems to send photos of their breasts to lactation consultants, who could use AI to diagnose what’s wrong. De Souza created a dataset of breast diseases and trained AI to identify patterns that could indicate issues such as nipple trauma.Meanwhile, Laurel Riek, a computer science professor at UCSD, designed a small, tabletop robot called “Cognitively Assistive Robot for Motivation and Neurorehabilitation,” or CARMEN (the name is inspired by Carmen San Diego). CARMEN helps people with mild cognitive impairment improve memory and attention and learn skills to better function at home.Courtesy of UCSD“Many [patients] were not able to access care,” she says. “The idea behind CARMEN is that it could help transfer practices from the clinic into the home.”Uses like these offer another vision for AI in healthcare: to improve patient care by helping doctors assess conditions and find mistakes.“One of the big things is getting rid of medical errors, which are prevalent,” Topol says. “Each year in the United States, there are 12 million diagnostic medical errors.” According to Topol, those errors cause serious, disabling conditions or death for about 800,000 Americans per year.He believes that AI can help shrink that number considerably. For example, doctors are utilizing it to review cardiograms, checking if there’s anything a human review missed.But, Topol cautions, you can’t rely solely on AI. “In anything involving a patient, you don’t want to have the AI promote errors,” he says. “That’s the thing we’re trying to get rid of. So that’s why a human in [the] loop is so important. You don’t let the AI do things on its own. You just integrate that with the oversight of a nurse, doctor, [or] clinician.”No matter how advanced artificial intelligence programs get, he sees no future where AI would handle diagnosis without human eyes.“You don’t want to flub that up,” he says. “And patients should demand it.”Algorithmic biasAn additional hope for AI is that it could correct for implicit racism in medicine, since machines, in theory, don’t see skin color. But the data on which algorithms are built is inherently imperfect.“The medical bias could be already built into the existing information that’s out there,” Tullis says. “And, if you’re drawing from that information, then the bias is still there. I think that’s a work in progress.”For example, an AI tool designed to detect breast cancer risk would be trained on previously gathered population data. “But they didn’t get as many Black women as they would like to be included in that data,” Tullis explains. “And then what does that mean for the quality of the data that has been used to maybe make decisions?”Courtesy of Scripps HealthBut there’s bias in every data set, Longhurst says. The key is to choose the right data for the population you’re working with to help address disparities. He points back to the sepsis model. That algorithm, he says, actually performed far better in UCSD’s Hillcrest hospital than in La Jolla.“Why is that? Well, we tuned the algorithm to identify cases of sepsis that weren’t being picked up [by physicians] until later,” he adds. “We serve different populations in those different emergency departments.”Patients at the Hillcrest location tend to be younger, which makes it harder to diagnose sepsis early, he says. But the AI algorithm helped to close that gap.“These tools are going to change healthcare delivery more in the next 10 years than healthcare has changed in the last 50,” Longhurst says. But he hopes the industry doesn’t get ahead of itself—after all, he suggests, what if the FDA approved a new drug for breast cancer and simply said, “It has very few side effects?”“You’re like, ‘Well, that’s great, but how does it work?’ They’re like, ‘Well, we don’t really know. We don’t have the data,’” he continues. “That’s what’s going on now. It’s like the Wild West. Our argument is that we really need local testing that is focused on real outcomes that matter to patients. That’s it.”The post How Will AI Change Our Healthcare? appeared first on San Diego Magazine.

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