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Start-up Paves Way for More Inclusive Clinical Research: Honoring Black Founders of Acclinate with Google Cloud

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February is Black history month, honoring the contributions by Black Americans. Acclinate, a research start-up uses Google Cloud to grow business and drive inclusion in clinical research. Read their journey of scaling platform on Google Cloud.

Editor’s note: February is Black History Month—a time for us to come together to celebrate the diverse set of experiences, perspectives and identities that make up the Black experience. Over the next few weeks, we will highlight Black-led startups and how they use Google Cloud to grow their businesses. Today’s feature highlights Acclinate and its founders, Del and Tiffany. 

As patients, as caregivers, and as parents taking our own children to the doctor, we want recommended medications to be safe and effective. It’s a right everyone deserves.

It’s known that certain medications don’t work in the same way in all populations. For example, Albuterol, a medication often prescribed for asthma, is less effective in 67% of all Puerto Ricans and 47% of Black Americans. These problems—which can have deadly consequences—result from historically limited diversity in pharmaceutical clinical trials. 

We founded our startup Acclinate to integrate culture and technology to achieve more inclusive clinical research. Help pharmaceutical companies and healthcare organizations access and engage communities of color so research is more inclusive.

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Bridging the health equity gap by building trust

It’s important that health research organizations access and engage communities of color so their efforts reflect all the people they serve. Take a disease like diabetes, which affects a significantly higher proportion of Black Americans. When you look at even recent clinical trials for diabetic drugs, the representation of Black Americans among participants is only in the low single digits, despite comprising 13 percent of the U.S. population and more than 40 percent of diabetes patients in this country. Industry leaders have been aware of the lack of diversity issue, but some have chosen to ignore it or brush it aside. The biggest problem, in our opinion, is that there have been no penalties for not achieving higher diversity figures in clinical trials, and only minor financial repercussions to pharma/biotech companies when their treatments either do not work across all groups once approved, or there is a lack of uptake by all groups due to the lack of testing in those groups. The lack of clinical trial diversity has adversely impacted the reputation of the industry and the ability to recruit diverse populations in the future. 

Acclinate integrates culture and technology to promote diverse patient representation in medical research. Our approach is not transactional. We build trust through our  #NOWINCLUDED community, which is an ongoing, ever-expanding digital platform that educates and engages with communities of color on health issues.

#NOWINCLUDED includes a website app, and social media presence where members can learn information about diseases, particularly those with greater negative impacts on people of color, such as cancer, diabetes, and cardiovascular diseases. Members can share stories and ask questions. By providing access to trusted resources about these health issues and the latest clinical research, we empower Black people to take control of their health and consider  participating in research that is shaping the future of healthcare.  

For healthcare-related organizations, we offer the opportunity to better understand the attitudes, aspirations, and unmet needs of underrepresented minority communities. Data from #NOWINCLUDED feeds our HIPAA-compliant SaaS platform, e-DICT™ (Enhanced Diversity in Clinical Trials), which uses predictive analytics and machine learning to identify individuals matching the requirements and most likely to be receptive to participation in a particular clinical trial.

Acclinate scales its platform with Google Cloud

We rely on Google Cloud services, including Vertex AI, to know whom to ask, when to ask, and how to ask for clinical trial participation. With Vertex AI, we enjoy a unified platform for developing our artificial intelligence models, including tools for preparing and storing our datasets. We can easily train and compare models using AutoML, which requires minimal ML expertise or effort with its intuitive graphical interface. This allows us to leverage more than ten ordinal and categorical data points to determine in real time a community member’s likelihood to enroll, which we call our Participation Probability Index (PPI). Our models evolve in an iterative process the more we interact with, and learn about, our community members.

We follow the pay-per-use Google Cloud Platform architecture model using serverless technology, which helps reduce infrastructure management costs and lets us focus on product development and engaging with communities across the U.S.

CloudSQL, a fully managed relational database service, integrates easily with BigQuery so we can glean insights for our clients in real time, all with Google Cloud’s robust security, governance, and reliability controls. Virtual Private Cloud (VPC) gives us scalable and flexible networking for our cloud-based resources and services. We also use Identity and Access Management (IAM) to simplify oversight of Google Cloud resource permissions for different user groups and roles, with appropriate security protections. 

API Gateway manages our APIs using Cloud Functions, which both use consumption-based pricing, plus give our developers consistent and highly secure access to our services through a well-defined REST API. We use Memorystore for Redis to reduce platform latency. This is done with a fully managed service powered by the Redis in-memory data store, which builds application caches for fast data access. All of this comes together to provide an outstanding experience for our platform’s users and contributors.

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Expanding influence with the Google for Startups Accelerator for Black Founders

Three months of one-on-one Google support and mentorship as part of the most recent Google for Startups Accelerator : Black Founders cohort not only helped us build our product, but also helped us earn external credibility. People use Google every day, so whether we’re trying to engage in conversations with industry experts or with somebody in a rural community, it is helpful to have the buy-in of a globally-recognized brand as we take on a historically difficult, systemic issue with challenges around trust. Getting access to the products, best practices, and people we need to build and grow through the Accelerator program has been priceless. For example, working with the Google AdWords team helped us generate important traffic from people interested in learning more about #NOWINCLUDED or sharing their story with us. Jason Scott, who leads the Google for Startups Accelerator: Black Founders program, is still connecting us to people in his network and identifying key opportunities for us months after the program wrapped. He continues to demonstrate that he is invested in seeing us succeed. 

Our company has made great progress against our goals, in part thanks to receiving capital from the Google for Startups Black Founders Fund. We received $100K in non-dilutive funding along with Google Cloud credits, Google.org Ads grants, and hands-on support. We used the funds to pay for the transition and development costs associated with moving to Google Cloud. The Google support and accountability has been incredible. After receiving the Google for Startups Black Founders Fund award, we’ve gone on to raise another $1M and moved our cloud from Salesforce to Google Cloud. 

We also had the amazing opportunity to be selected as one of six companies to take part in a face-to-face web conference with Sundar Pichai, Google’s CEO. We were thrilled to hear him explain his vision around health equity and the role Google plays. Ultimately, for us, it’s not just about the funding we get, but we are also gratified to receive support from an entity that truly believes in addressing this issue. We know Google is aligned with our mission of health and racial equity. 

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Championing diversity in clinical trials

Our 2022 looks bright. We expanded our presence to Washington, D.C. as part of the Johnson & Johnson Innovation JLABS ecosystem. We were also selected to take part in the BLUE KNIGHT initiative created between Johnson & Johnson Innovation and the Biomedical Advanced Research and Development Authority (BARDA) under the U.S. Department of Health and Human Services. 

Acclinate is also on track to have contracts with five of the top 25 largest biopharmaceutical companies in the U.S this year. They’ve taken note, as has the Food and Drug Administration (FDA), that the lack of diversity in clinical trials represents a significant health concern—to the extent that the FDA has provided strong guidance for pharmaceutical companies to  diversify their clinical trials. At the same time, the industry is also responding to pressure from communities of people of color to make equitable representation a priority.

Today, we are in the fortunate but challenging position to have significant inbound opportunities coming our way. In response, we continue to recruit and hire talented people to join our team. On the technology side, we are happy to be aligned with Google Cloud to have powerful cloud infrastructure that will scale with us, as well as high-caliber champions united in partnership. With people’s lives at stake, we are passionate in our commitment to helping ensure medications do what they are supposed to do: heal and improve the quality of life for everyone who takes them. 

Hear Acclinate cofounders Del Smith and Tiffany Whitlow chat with Google’s Head of Startup Developer Ecosystem Jason Scott and fellow Black Founders Fund recipient Bobby Bryant about building on Google Cloud in a recent Google for Startups Instagram Live


If you want to learn more about how Google Cloud can help your startup, visit our page here to get more information about our program, and sign up for our communications to get a look at our community activities, digital events, special offers, and more

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Guide to Create and Manage Datasets with Vertex AI

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After Vertex AI's launch in Google I/O 2021 for managing ML projects, our experts offer guidance on four types of data, and how to create and manage those datasets in Vertex AI. Read this blog post to learn how Vertex AI supports your ML workflow.

At Google I/O this year, we introduced Vertex AI to bring together all our ML offerings into a single environment that lets you build and manage the lifecycle of ML projects. In a previous post, we gave you an overview of Vertex AI, sharing how it supports your entire ML workflow—from data management all the way to predictions. Today, we’ll talk a little about how to manage ML datasets with Vertex AI.

Many enterprises want to use data to make meaningful predictions that can bolster their business or help them venture into new markets. This often requires using custom machine learning models—something not every business knows how to create or use. This is where Vertex AI can help. Vertex AI provides tools for every step of the machine learning workflow—from managing data sets to different ways of training the model, evaluating, deploying, and making predictions. It also supports varying levels of ML expertise, so you don’t need to be an ML expert to use Vertex AI.https://www.youtube.com/embed/CN2X6oIlnmI?enablejsapi=1&

Types of data you can use in Vertex AI

Datasets are the first step of the machine learning lifecycle—to get started you need data, and lots of it. Vertex AI currently supports managed datasets for four data types—image, tabular, text, and videos. 

Image

Image datasets let you do:

  • Image classification—Identifying items within an image.
  • Object detection—Identifying the location of an item in an image
  • Image segmentation—Assigning labels to pixel level regions in an image.

To ensure your model performs well in production, use training images similar to what your users will send. For example, if users are likely to send low quality images, be sure to have blurry and low resolution images in your data set. Don’t forget to include different angles, backgrounds, and resolutions. We recommend you include at least 1,000 images per label (item you want to identify), but you can always get started with 10 per label. The more examples you provide, the better your model will be.

Tabular

Tabular datasets enable you to do:

  • Regression—Predicting a numerical value.
  • Classification—Predicting a category associated with a particular example.
  • Forecasting—Predicting the likelihood of sudden events or demands.

Tabular data sets support hundreds of columns and millions of rows. 

Text

With text datasets, you can do:

  • Classification—Assigning one or more labels to an entire document.
  • Entity extraction—Identifying custom text entities within a document, like “too expensive” or “great value”.
  • Sentiment analysis—Identifying the overall sentiment expressed in a block of text, for example, if a customer was happy or upset or frustrated.

Video

Video datasets enable:

  • Classification—Labeling entire videos, shots, or frames.
  • Action recognition—Identifying clips video clips where specific actions occur.
  • Object tracking—Tracking specific objects in a video.

Creating and managing datasets in Vertex AI

Now that we’ve covered the different types of data you can use, let’s shift to creating and managing those datasets. In the Cloud Console, go to Vertex AI dashboard page and click Datasets, then click Create Project.

Say you want to classify items within a set of photos. Create an image dataset and select image classification. You can import files directly from your computer, which will be stored in Cloud Storage. Then, you’ll need to add the corresponding labels (items you want to identify) for your images. If you already have labels, you can use the Import File option to import a CSV with your image URLs and their labels. If your data is not labeled and you would like human help to label it, you can use the Vertex AI data labeling service. Once the files are uploaded, you can create labels and assign them to the images. You can also analyze the images in the data set, the number of images per label, and a few other properties. 

Depending on the type of data you use, your options might vary slightly. For example, if you want to use tabular data, you could upload a CSV file from your computer, use one from Cloud Storage, or select a table from BigQuery directly. Once you select the table, the data is available for analysis.

More to come

This concludes our overview of creating and managing datasets in Vertex AI. In a future installment, we’ll go over the next phase of the machine learning workflow: building and training ML models. 

If you enjoyed this post, keep an eye out for more AI Simplified episodes on YouTube. In the meantime, here’s where you can learn more about Vertex AI.

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SEED: The 4 Areas of a Well-functioning and Responsible AI

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The 4 essential components for a well-functioning and ethical AI strategy are SEED which refers to (S)security, (E)ethics, (E)explainability and (D)data. Read to learn how brands can leverage AI while staying on track with new laws and regulations.

The future of AI is better AI—designed with ethics and responsibility built in from the start. This means putting the brakes on AI-driven transformation until you have a well-functioning strategy and process in place to ensure your models deliver fair outcomes. Failing to recognize this imperative is a threat to your bottom line. The following post provides a simple framework to follow to keep your business on the right track as you place more trust in algorithms. 

AI is inherently sociotechnical. AI systems represent the interconnectedness of humans and technology. They are designed to be used by and to inform humans within specific contexts, and the speed and scale of AI means that any lack of responsibility—such as bias, safety, privacy, scientific excellence etc—will also replicate at that same speed and scale. Without ethics and responsibility built in by design, AI systems lack the critical “inputs” or societal context that enable long term success. 

Lawsuits stemming from AI systems that are biased towards certain groups are stacking up. In August 2020, IBM was forced to settle a lawsuit with the city of Los Angeles for misappropriating data it collected for its weather channel app. Health services company, Optum, is being investigated by regulators for creating an algorithm that allegedly recommended that doctors and nurses pay more attention to white patients than to sicker black patients. And Facebook, which granted Cambridge Analytica, a political firm, access to the personal data of more than 50 million people, is buried in legal work.  Google has also run into its share of issues with algorithms making egregious mistakes

While lawsuits are real, the foundational reason ethical AI is critical to your bottom line is trust. Without it, increasingly, consumers will ignore you and choose a brand they do trust. Research from Kantar, which runs one of the largest global brand equity studies (4 million consumers, 18,000 brands, across 50 markets), revealed that almost 9% of a brand’s equity is driven by corporate reputation, of which responsibility is a key attribute. Over the last decade, the importance of responsibility to consumers in relation to making brand choices has tripled. 

The study stated brands perceived to be among the world’s most trusted and responsible shared three crucial factors that proved particularly important for building consumer trust and confidence, even when a brand might be new to a market. These are:

  • Honesty and openness
  • Respect and inclusion
  • Identifying with and caring for customers

Brands that develop these associations more strongly tend to outperform their competitors in defending and growing their brand value.

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Technology and business leaders need to focus on four areas to accomplish a well-functioning ethical AI strategy. Lopez Research refers to this group of tasks as SEED, which stands for security, ethics, explainability, and data (SEED). Each of these topics could be an article in itself, but this post will define several essential components. 

SECURITY (S)  

It might not seem obvious, but a robust AI strategy requires an embedded security strategy. Companies should look for hardware-level security in components such as GPUs and CPUs. IT leaders should build software security into models to minimize attacks such as poisoning, evasion, deepfakes, backdoors, and model extraction. The threat of adversarial data poisoning attacks machine learning models by maliciously introducing inaccurate data designed to corrupt the model’s ability to be accurate. Another security threat is model extraction, also known as model cloning, where a hacker finds a way to either reconstruct a black-box machine learning model or extract the training data. The first line of defense against all security attacks is to design security at the outset, but the next best step is to frequently test models to ensure they are operating as planned. Business leaders, data science experts, and IT leaders must work together to regularly review the outcomes of AI models.

ETHICS (E)

Today, organizations must understand that ethics should be designed into the solution at its outset. The ethics process starts with defining the potential positive and negative outcomes of the model that your business is creating. Once the team has evaluated potential harmful effects, which means unpacking the systems, beliefs, power hierarchies and dynamics that interconnect with the technology, it’s your responsibility to eliminate or minimize the impact of these outcomes. It’s also critically important to review the impact of models in production and shut down models demonstrating issues. An example of this was the public beta release of the Tay chatbot that Microsoft deployed and rapidly shut down because it propagated negative biases. 

Yet, many organizations aren’t taking this action. The FICO study revealed that 93% of companies said responsible AI was critical for success but only 33% of these companies were measuring AI model outputs to ensure these models were operating as expected (measuring for model drift). Another survey by Pew Research revealed that 68% believe that ethical principles focused primarily on the public good will not be employed in most AI systems by 2030. 

Regulations may turn this tide, regardless of whether organizations plan to adopt an ethical AI framework. Laws governing the ethical use of data in AI are expected to be finalized as soon as 2022, such as the European Commission’s proposed legal framework for AI. Organizations that start with ethical use of AI in mind will be better positioned to deal with customer privacy concerns and regulatory compliance.

EXPLAINABILITY(E)

As models have become more sophisticated, it’s also become increasingly difficult to explain why a model created a specific outcome. In the FICO Responsible AI  report, 65% of respondents could not explain how specific AI model decisions or predictions are made, and only 35% said their organization made an effort to use AI in a way that was transparent and accountable.  However, it’s never been more important to clarify how AI models came to conclusions such as why a loan was denied, why a particular strategy should be implemented, and how AI selected a set of resumes to review for a position. The goal is to create an explainable AI model from the outset but many of today’s models lack this capability. Every business should review its existing models and use open-source toolkits that can be found on Github.com that support the interpretability and explainability of machine learning models. 

Keep in mind that explainability isn’t one-size-fits-all. Different stakeholders need different types of information. Much of explainability to date has focused on “opening the black box” which gets equated to information that is only useful for other data scientists. That’s important, but it doesn’t help the line of business users whose workflows AI is integrated into, or end users who deserve information about how decisions are made; or policymakers who don’t have data science backgrounds, and so on. 

DATA (D) 

An equally important item in ethics is data. Ethics starts with ensuring you have the correct data to create and update models. Three main issues include representative data, inherent biases within existing data, and inaccurate data. A critical issue that most companies miss in creating models is that current data sets frequently lack full market representation. A recent Capgemini Research Institute report revealed that 65% of executives “were aware of the issue of discriminatory bias” with these systems.

Awareness is the first step, but organizations must take action to remedy this issue. Historical data may no longer serve a company’s current needs for model creation. Historical records may contain biases against certain groups. For example, historical criminal data records show an imbalance in ethnic groups’ incarceration, which would lead to model biases. Additionally, laws and societal norms also change. Certain groups were prosecuted for sexual preference in the past, but today this information would create an inaccurate model. 

Companies have also discovered that using demographic data, a common practice in marketing, can also lead to model bias. For example, individuals that primarily used cash for transactions and others that lived in specific zip codes were at a disadvantage in banking models to determine creditworthiness. To minimize these issues, a company needs to augment its data with full representation in areas such as ethnicity, gender, age, behavioral and economic profiles.

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Design AI models with a continuous feedback loop

Another, more prominent, yet tricky issue is data accuracy. As the adage says, garbage in, equals garbage out. The least appreciated but arguably the most essential component of the AI model lifecycle is ensuring the model has accurate data at all times. Inaccurate data from either poor data hygiene or data that was tampered with for security purposes can cause model failures. Organizations need to invest the time and resources to ensure they have the correct data. Data privacy is another key element that businesses must address, but the concepts of data privacy, sovereignty, and security are significant enough that we will come back to this in a separate article. 

Overall, it’s clear that while we may have an abundance of data, it most likely doesn’t represent what we want to model for the future. A successful AI strategy is an ethical AI strategy that requires the organization to be thoughtful in its model creation by ensuring it has a broad representation of accurate data and testing the outcomes to ensure the models are secure and operating as expected. 

Organizations that define an AI model lifecycle with a continuous feedback loop will reap the benefits of better intelligence. This will increasingly mean stronger, longer lasting trust with customers and staying on the right side of new laws and regulations.

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UKG Ready: Meeting the Needs of Complex Machine Learning Models and Distributed Data Sets

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UKG Ready, an HR software for smaller teams, wanted to help SMBs get the variety of data needed to create a dynamic and agile organization. Read to know how Google Cloud Services helped build a common vocabulary of customers’ business entities.

Business Problem
UKG Ready primarily operates in the Small and Medium Business (SMB) space, so inherently many customers are forced to operate and make key business decisions with less Workforce Management (WFM) / Human Capital Management (HCM) data. In addition to volume, SMB lacks the variety of data needed to create a dynamic and agile organization. This puts SMB at a major disadvantage compared to larger segments.

Project Goals
People Insights module is committed to surfacing insights to customers in the context of their day-to-day duties and aid in decision making. With the SMB customer data limitations mentioned above, the goal of this project was to create a global dataset that augments individual customer data to bring light to less obvious, yet important information.

Challenges
UKG Ready is a highly configurable application that gives customers the opportunity to build solutions on a platform that meets their specific business needs. High configurability gives high flexibility to customers in their usage of the software. However, it becomes nearly impossible to create a global dataset for machine learning and data insights. UKG Ready manages just under 4 million of the US workforce and some 30,000+ customers. Despite the large employee dataset size, machine learning models that are specific to customers are starved for data because the individual customers have a relatively small employee population. Does that mean we cannot support our SMB customers’ decision making with ML?

Result
Partnering with Google, we were able to develop an approach that allowed us to standardize various domain entities (pay categories, time off codes, job titles, etc.) so that we could build a global dataset to augment SMB customer data. Using machine learning we were able to build a common vocabulary across our customer base. This common vocabulary encapsulates the nuances of how our customers manage their business and yet is generalized and standardized such that the data can be aggregated over the variety of customer configurations. This allows us to serve up practical insights to customers through various use cases. Our partnership allowed us to leverage Google Cloud Services to meet the needs of our complex machine learning models, distributed data sets and CI/CD processes.

How
UKG Ready decided to partner with Google for an end-to-end solution for the analytics offering. This allowed us to focus on our core business logic without having to worry about the platform, environment configurations, performance and scalability of the entire solution. We make use of various Google Cloud services such as Cloud Triggers, Cloud Storage, Cloud Functions, Cloud Composer, Cloud Dataflow, Big Query, Vertex AI, Cloud Pub/Sub… to host our analytics solution. Jenkins manages the entire CI/CD pipelines and cloud environments are configured and deployed using Terraform.

The standardization of business entities problem was solved in three distinct steps:

Step 1: Collecting aggregated data
We needed an approach to collect aggregated data from our highly distributed, sharded, multi-tenant data sources. We developed a custom solution that allows us to extract data aggregated at source for PII and GDPR considerations and transfer to Google Cloud Storage in the fastest manner possible. Data is then transformed and stored in Big Query. Services used: GCS, Cloud Functions, DataFlow, Cloud Composer and Big Query. All processes are orchestrated using Cloud Composer and detailed logging is available in Cloud Logging (Stackdriver).

Step 2: Applying NLP (Natural Language Processing)
Once we had the variety of customer configurations or the business entities available, we then applied NLP algorithms to categorize and standardize these in buckets. This approach assumes that customers use natural language for configurations like job titles, pay codes etc.

String Preparation
The input data for string preparation process is an entity string or several strings, that describe one entity object (like name-description pair or code-name pair). The output represents set of tokens that may be used to run a classification/clustering model. The process of string preparation tokenizes strings, replaces shortcuts, handles abbreviations, translates tokens, handles grammatical errors and mistypes

ML Models

Statistical
The idea of the model is to use defined target classes (clusters) and assign several tokens (anchors) to each of them an entity that has any of those tokens would be “attracted” to appropriate class. All other tokens are weighted according to frequencies of usage of theses tokens in the entities with anchor tokens:

Using anchor tokens, we are building kind-of Word2Vec - dimensionality of vector is equal to number of target classes. The higher the specific dimension (cluster) value, the higher the probability of entity to be included in appropriate cluster. Final prediction for entity tokens list for specific class is sum of weights of all the tokens included. Predicted cluster is a cluster that has maximal prediction score.

Lexical Model
We managed to generate reasonable amount of labeled data during statistical model implementation and testing. That opens a possibility to build “classical” NLP model that uses labeled data to train classification neural network using pretrained layers to produce token embeddings or even string embeddings. We started experimentation with pre-trained models like GloVe and got good results with single words and bi-grams but started getting issues in handling of n-grams. Our Google account team came to our rescue and recommended some white papers that helped formulate our strategy. We now use Tensorflow nnlm-en-dim128 model to produce string embeddings – it was trained on 200B records English Google News corpus and produces for each input string 128-dimensional vector. After that we use several Dense and Dropout layers to build a classification model.

Ensembling
To perform ensembling all the model results for each class are cast to probabilities using softmax transformation with scale normalization. Final predicted probability is maximal average score of both models among all the classes scores – appropriate class is predicted class.

The machine learning models are deployed on Vertex AI and are used in batch predictions. Model performance is captured at every prediction boundary and monitored for quality in production.

Step 3: Making available common vocabulary
Having the standardized vocabulary, we then needed a mechanism to have the results be available in UKG Ready reports and customer specific models like Flight Risk and Fatigue. For this we again used Google Services for orchestration, data transformation and data storage.

Once the modeling is complete, we made the customer specific models leveraging the above architecture be available in Reports. We utilized our proven existing technology choices in GCP for orchestration, data transformation and data storage

Results
We are able to build a common vocabulary of our customers’ business entities with good confidence. And be an expert advisor to our SMB customers in their decision-making using machine learning. With the advice of our Google account team and using Google services we can add value to our product in a relatively short amount of time. And we are not done! We continue to use this platform for new use cases, complex business problems and innovative machine learning solutions.

Sample result:


Special thanks to Kanchana Patlolla , AI Specialist, Google for the collaboration in bringing this to light

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Telehealth Improves Patient and Clinical Experiences across Continuum of Care

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The future of healthcare includes cloud technologies like EHR-integrated telehealth platforms combined with AI, healthcare-trained virtual agents and in-person care. Telehealth's transformative shift will impact patient outcomes and experiences!

According to a National Academy of Medicine discussion paper, social determinants of health (SDoH) account for upwards of 80% of a population’s health outcomes. Breaking this down further, 50% come just from socioeconomic and physical environment factors such as education, employment, income, family and social support, community safety, air and water quality, and access to housing and transit. SDoH determine access to and quality of healthcare, and are contributors to a system of disparate access to care.

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We believe that to more efficiently provide comprehensive healthcare access to more people, providers will leverage technology to blend in-person and virtual modes of care delivery.

In this article, Amwell and Google Cloud examine five ways telehealth – as part of a provider’s overall care model – can help democratize access to healthcare. (graphic url

Remove distance as a barrier to care

8.6 million Americans live more than 30 minutes from their nearest hospital. Long drives can deter patients from seeking care or maintaining routine visits. On the flip side, 92% of Americans nationwide have access to wired broadband in the home or through mobile broadband. Therefore, having a virtual visit just a click away can help remove barriers to care, like distance.

Eliminate the risk of unnecessary exposure

Virtual care means that patients don’t have to worry about potential exposure in transit, while sitting in waiting rooms, or from direct interactions during in-person health visits. This is particularly relevant when it comes to those with chronic diseases or underlying conditions. Telehealth provides patients who may be more susceptible to diseases with access to continuous healthcare without putting them at higher risk for developing more severe symptoms. Virtual visits can occur in the comfort –and safety– of patients’ homes.

Extend access to specialized care

55% of preventable hospitalization or mortality in rural settings is due to lack of access to specialty care. With telehealth, physical proximity to specialized services–typically in urban areas–can be reduced as a limiting factor. Virtual solutions grant everyone access to top specialists, regardless of location.

Save time and money

By augmenting in-person visits with telehealth applications, providers can benefit from greater efficiencies in scheduling, helping to improve their bottom line, and add more flexibility to their workday. Meanwhile, patients can spend less on travel and childcare, limit time taken off work, and save on other costs associated with in-person visits — for a savings of $35 to $690 per visit. In a survey by the COVID-19 Healthcare Coalition, 76% of the 2,000+ patients surveyed across the US responded that transportation was removed as a barrier, 65% reported they no longer had to take time off from work for an appointment, and 67 percent reporting lower costs than an in-person visit.

Combat physician shortage and fatigue

Research shows there will be a shortage of more than 100,000 doctors by 2030. In the midst of a physician shortage, telehealth can help improve care delivery and make it more efficient, ensuring more people can still have their healthcare needs addressed. Additionally, by integrating intelligence such as case triaging along with telehealth into a virtual care model, providers can help reduce clinician burnout.

Amwell and Google Cloud are partnering to deliver transformative telehealth solutions that will make it easier for more patients to receive care and improve patient and clinician experiences across the continuum of care. One example includes embedding real-time captioning and translation services powered by Google Cloud’s AI and NLP technologies within the Amwell platform to increase health access and understanding for more people.

As physicians, we are excited that the future of healthcare will continue to blend cloud technologies like EHR-integrated telehealth platforms, AI, healthcare-trained virtual agents along with in-person care to create an integrated hybrid care model that will improve patient outcomes and unburden providers, all while expanding access to broader patient populations.

To learn more, download the whitepaper “Healthcare’s Virtual Transformation,” written in conjunction with Becker’s Hospital Review.


1: “Social Determinants of Health 101 for Health Care: Five Plus Five,” National Academy of Medicine, October 2017

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Making Your Pictures Worth a Thousand Labels! (with Cloud Vision API)

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Discover the power of Google Cloud Vision API in extracting valuable insights from your images, automating workflows, and enhancing data interpretation. Learn more...

In this post, I’ll be showing some amazing ways the Vision API can extract meaning from your images  – keep reading, or jump directly into a tutorial using PythonNode.jsGo, or Java! This tutorial can be completed at no cost within the Google Cloud Free Tier.

They say a picture is worth a thousand words. But how do you make those words available and useful? Around the world, we are generating more images than ever before, and it’s no surprise that businesses are turning to image recognition technology to help meet the immense opportunities created with this growing set of data.

Cloud Vision API is a powerful tool that enables you to perform a variety of tasks including label detection, text recognition, and object tracking on your image data. Whether it’s identifying products in a retail store, analyzing social media posts for brand mentions, or scanning through millions of images to find a specific object, the Cloud Vision API can help businesses automate their image analysis workflows and gain valuable insights from their visual data.  To protect privacy, and help you build responsibly, the Cloud Vision API offers features to limit personal identification, such as person blur, which hides identifiable features. 

Let’s explore a few of the key features of the Cloud Vision API.

Detect famous landmarks

Landmark detection allows you to analyze images to identify specific landmarks such as buildings, natural features, and other recognizable locations. Cloud Vision API recognizes landmarks and provides information about them, including their name, location, and other relevant details. Perhaps you are trying to identify the landmarks in images shared by customers as part of social campaigns, or want to build a mobile app that provides information to tourists on famous landmarks.

In the below left-hand side image, Cloud Vision API has detected the Eiffel Tower, shown in the visualized response. Not shown in this visualization here, but also detected, were Pont de Bir-Hakeim (the bridge) and Champs de Mars (the park in front of the Eiffel Tower).

Response from landmark detection feature visualized. Original image courtesy of John Towner.

Detect objects and label images

Object detection and labels are two related features that enable you to identify and classify objects within an image. Object detection detects and locates objects within an image, and provides information such as the position, size, and orientation of each object.  Labels, on the other hand, provide a general classification of the content within an image.

Object detection has practical applications in many industries such as self-driving vehicles (where it’s critical), retail, manufacturing and more, while labels can be used to help classify and organize large collections of images, or to categorize and filter content.

You can see the similarities and differences in the responses provided by the object detection and labeling features in this image taken in Setagaya.

Response from object detection feature visualized. The green bounding boxes were added to the original image with the response data from the Cloud Vision API. Original image courtesy of Alex Knight.
Response from labels feature visualized. Original image courtesy of Alex Knight.

Detect text

Cloud Vision API detects and extracts text from any image, even if it’s handwritten or in different languages. Once it detects text, the API can provide information about the position, orientation, and size of each text element, as well as individual words, and their bounding boxes.

In this image of a traffic sign, Cloud Vision API has detected the text and provided it in the response.

Response from text detection feature visualized.

Detect explicit content

Cloud Vision API can automatically identify and flag explicit or inappropriate content within an image using five categories: adult, spoof, medical, violence, and racy. The API provides a score that indicates the likelihood for each category in the image, which you can use to set thresholds in your application and decide how to handle those that exceed them. This feature is particularly useful for filtering or moderating user-generated content. 

Luckily for the images I shared here, each category has been deemed “very unlikely” to be present. Phew!

Responses from explicit content feature visualized.

Next Steps

These are just a few features of the Cloud Vision API and how it can help your business with automating image analysis workflows and gaining valuable insights from your visual data. 

Head to the interactive walkthrough tutorials in PythonNode.jsGo, and Java to see step-by-step how to access the API and learn more about all the features that you can integrate into your own applications! Again, this tutorial can be completed at no cost within the Google Cloud Free Tier.

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