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Clinical Decision Solutions-- disruptive Medical software

by Michael Best, MD

12 million Americans yearly are affected by misdiagnosis in medicine; we significantly improve diagnostic accuracy and treatment

Louisville, KY Health Information Technology

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About this project

The problem we solve:
• Mayo Clinic-20-40% of all initial diagnoses are incorrect. • McGlynn- (NEJM) evidence-based, best care is provided only about 50% of the time. • A multiple choice competency exam in musculoskeletal medicine found that only 22% of family physicians could pass Problems solved --Poor diagnosis..poor care and treatment...poor skills...SOLVED
About our solution:
We present an interactive vertical component, analyzing all data. A standardized set of questions are software- generated for each complaint, illness or injury. As the past history is gathered and the present history of symptoms is delineated, our software produces for the Physician a list of the 5 most likely diagnoses. An interactive touch screen adds improved accuracy from an analysis of "where does it hurt". The physical exam mandates certain diagnostic procedures; further refining the accuracy of these most likely diagnosis.... the system therefore continues to get "smarter" throughout the process. (If the Physician is unfamiliar with an exam procedure, the software offers a 1 min video for physician education) Then, at the conclusion of the H&P, the physician is presented the 5 most likely diagnoses, he chooses the best diagnosis and our software system them generates the evidence-based best care specific to that condition. A patient education video is presented to the patient
Progress to date: Our software is presented via an iPad or tablet, but it can be accessed on any interactive Internet technology platform. The servers reside in the Cloud, so the technology and the service is easily scalable. We have used this system at multi-national companies and enjoyed an average of 32% reduction in healthcare costs.... better diagnosis and treatment..the only way to lower costs

About Our Team


Dr. Michael Best, MD
Orthopedic Surgery , Practicing Physician
Location: Louisville, Kentucky
Medical school: University of Louisville School of Medicine
Bio: I am an Orthopedic and Spine Surgeon of 30 years A Associate Clinical Professor of Orthopedic Surgery. As medical practice has become more time consuming, with less patient interaction, I have developed a CDSS software that is an aid to the physician, improves accuracy of diagnosis and outlines evidence-based treatments. We have demonstrated reduced costs, better care and less un-necessary suffering. We are an IBM Partner, working in the fields of Artificial Intelligence and Workers Comp.
Practice: The Assessment Centers
Hospital Affiliation: University of Louisville
Title: Clinical Decision Solutions

About Our Company

Clinical Decision Solutions
Location: Louisville, Kentucky
Product stage: ready
Sales: Working on it
Employees: 5-10

How We Help Patients

U.S. healthcare expenditures per capita are 2.3 times higher than that of other developed countries and are projected to increase 83 percent over the next ten years. Despite this spending, there are quality concerns. The Institute of Medicine, 15 years ago, noted medical errors cause between 48,000 and 98,000 patient deaths each year. Little progress is noted by the IOM in 2015."One in every ten diagnoses is wrong and 6 to 17% of ambulatory diagnostic encounters result in harm." Misdiagnosis is therefore too big of a problem to be ignored, After all, diagnosis is the first step in the medical process. If you get it wrong, then everything that follows—prescriptions, surgeries and other therapies—will be wrong, too. Harvard Medical Institutions researchers were surprised to find that the diagnoses missed were not of rare diseases or unusual presentations. We can/must do better.

How We Help Education

There are probably no cognitive tasks more challenging than diagnosis in medicine. There are over 10,000 known diseases and this list grows every year. Being able to match a patient’s problems to one of these entities requires a remarkable ability to synthesize information and integrate this with knowledge acquired over years of training and experience. Knowledge, however, continues to grow exponentially with 2500 peer reviewed medical journal articles published monthly for family physicians alone. Unfortunately, EHRs are failing to live up to their promise of reducing patient harm. Our software system is intuitive and easy to use; developed by Physicians, for the use by Physicians. It is designed to aid and educate the physician.

How We Help Physicians

The initial patient complaint, illness or injury generates questions from the current medical literature. The answers are "scored" and "graded" producing the most likely diagnosis. Co-existing factors from the past history are next factored in... refining the diagnosis. An interactive iPad touch screen further refines the diagnosis. These initial data gathering functions may be performed by physician or medical assistant. (a summary page of answers is provided). The physician is then required to perform certain physical exam techniques. Videos and illustrations of these procedures are provided for physician education. The findings are scored and enter into the final determination of the 5 most likely diagnosis. The physician chooses the most likely diagnosis. This diagnosis generates a list of the appropriate treatments for that specific diagnosis, medications and dosages and "red flags". A patient education video is provided. Physician accuracy is determined.

Challenge Mission

Mission: Our software teaches the physician and residents and medical students, teaches their patient, improves diagnosis, provides evidence-based treatments... improving the health of our nation and worldwide
Use of funds: Our use of funding will be used 100% for additional software development. We have recently been provided the opportunity to work with IBM Curam and Watson. Our software and algorithms will be subject to real time evaluation and updates, improving medical care and treatment on a real time basis.
Intellectual Property Status: Our IP rests within our algorithms and data tables.
FDA Status: We do not require FDA approval
Personal Message: The U.S. healthcare system is on an unsustainable path that will force its transformation.The environment in which U.S. health plans operate is fundamentally changing as the healthcare system struggles to address ever increasing cost, quality and access pressures. We provide a solution.

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    04/26/2016 Jacob Petrosky - Resident

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Michael Best, MD
Physician
Clinical Decision Solutions
University of Louisville School of Medicine

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