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Improving Patient Outcomes with SAVI and Google Cloud’s Innovative Surgical Instrument Tracking

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Transform surgical instrument tracking on a global scale with SAVI and Google Cloud. Improve patient outcomes and optimize surgical workflows. Empower your team with real-time tracking and drive healthcare innovation.

Powered by Vertex AI (Google Cloud’s platform for accelerating development and deployment of machine learning models into production), SAVI (Semi Automated Vision Inspection)1 is transforming surgical instrument identification and cataloging, leading to fewer canceled surgeries and easing pressure on surgery waitlists.

Max Kelsen, an analytics and software agency that specializes in machine learning, has worked closely with Google Cloud and Johnson & Johnson MedTech to create a system that can manage tens of thousands of individual devices, their characteristics, and how they apply to each set or tray used by a surgeon. SAVI does this while delivering a one in 10,000 real-world error rate, much faster and more accurately than manual processes currently in use across the industry. Implementing SAVI can also unlock end-to-end visibility and traceability across the surgical set supply chain and provide advanced analytics and insights.

Eliminating time-consuming manual processes

Surgeons need a large number of specialist instruments and devices to complete complex, delicate procedures. Because each tray of these instruments can typically cost more than $350,000, and having every type of set on shelf at every surgical facility is not feasible, manufacturers generally loan them to hospitals for procedures, such as inserting one of the manufacturers’ implants into a patient’s knee. Once a procedure is complete, the hospital returns the instrument tray to the manufacturer for storage and re-distribution to other hospitals as needed.

Each time a hospital returns a tray, the manufacturer needs to check that each instrument is there, correctly placed, cleaned, and fit for the purpose of the next procedure. As each set may hold more than 400 instruments, completing this process manually is complex and time-consuming. While each tray is checked before and after surgery at the hospital, and again when it arrives and leaves the manufacturer’s facility, Max Kelsen finds that 5% of surgeries can still be affected by missing, broken or bent instruments. This has a severe downstream impact on private hospitals in particular, directly affecting patient safety and outcomes; in Australia, for example, around 60% of surgeries are performed in private hospitals.

Johnson & Johnson MedTech has 60,000 surgical trays across the Asia-Pacific, and loans these trays out about 100,000 times per month. The manufacturer approached Max Kelsen to help design and develop a solution to make the supply chain more efficient, and to give more visibility into asset movement. As a Google Cloud Partner specializing in applying machine learning at scale in healthcare contexts, Max Kelsen had the expertise and track record to meet Johnson & Johnson MedTech’s need for a globally scalable solution that was engineered for quality and performance.

The first step was to establish a baseline for the project by determining how long the manufacturer’s team took to process each tray, and to set an efficiency number. We then spent six months determining and evaluating how to deliver a robust, accurate solution that outperformed current manual and labor-intensive methods in processing instruments and trays, globally. Our work included extensive technical feasibility research involving a representative sample for the variety and complexity of sets, trays, and devices needed for different types of surgery, including orthopedics, spinal trauma, and maxillofacial groups.

Working with Google Cloud to accelerate and de-risk the project

This is a familiar problem that is industry-wide. The issue has been widely explored and tried with a number of technologies over several years without producing the scalability and performance results required to make this an appropriate and feasible solution. Google Cloud partnered with Max Kelsen to accelerate and de-risk this large and strategic project for a mutual customer.

Technical feasibility took four months, prior to a year-long production pilot of SAVl in a distribution center in Queensland that services over 100 hospitals. After obtaining enough real-world data and experience to validate that the solution was as scalable and as accurate as needed, an Asia-Pacific rollout of the system commenced. SAVI is now live across Johnson & Johnson MedTech’s operations in Australia, New Zealand, and Japan, garnering recognition with a JAISA excellence award.

Google Cloud machine learning is integral to SAVI. Google Cloud’s technologies were a big differentiator for Max Kelsen’s engineering team in delivering the breakthroughs needed at scale, and in production, to meet Johnson & Johnson MedTech’s needs.

Reducing checking and documentation time

Running SAVI in Google Cloud has reduced the time Johnson & Johnson MedTech needs to check and document inspections of these surgical instrument sets by over 40%. The application also delivers consistent measurable quality that is often hard to measure at scale when using manual processes. During the pandemic, the application enabled Johnson & Johnson MedTech to operate with a lower headcount for the same volume output, enabling the organization to quickly service a backlog of waiting list surgeries.

In addition, the automation delivered with SAVI has reduced the time required to bring technicians up to speed on quality control processes, from eight to 12 months down to just three months, enhancing productivity and performance while delivering a more robust workforce.

So how does SAVI work in a real-world context? SAVI is deployed via a tablet and a web-based application incorporates an API to photograph the medical device trays, as shown below. Max Kelsen captures the photograph and sends it to a range of different services, via an API endpoint hosted on Google Cloud:

  • Image information is stored in Cloud Storage
  • Data relating to the trays is stored in Cloud SQL for PostgreSQL
  • APIs and web UI components run in CloudRun
  • Analytics data is stored within BigQuery

Once this tray and device onboarding stage is completed, the next step is to perform inferences from the images and data. By hosting online models with Kubeflow model serving on GKE, we enable a model to identify all the instruments in a tray at low latency.

Vertex AI Workbench notebooks are used for data exploration and modeling. Kubeflow training pipelines hosted on GKE are executed to produce machine learning models for specific surgical instrument sets. Several hundred machine learning models are then hosted with Kubeflow model serving on GKE, with state and analytics managed using Firebase. Using machine learning to infer from images whether any devices are incorrectly placed, dirty, or otherwise not fit for purpose, the data is then returned to the tablet for the user to respond accordingly.

Based on our success to date with SAVI, it is now available on Google Cloud Marketplace to help healthcare organizations achieve machine learning-powered efficiencies across a range of use cases, and ultimately improve patient safety and outcomes.

Not to be confused with the usage of Visual Inspection Model (Assembly) available in Vertex AI Vision

Trend Analysis

Enterprises can Push the Limits of Edge Even Further!

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Powerful processors in edge devices help them perform heavy duty tasks that are outside the scope of traditional IT. Today, edge for businesses means opportunities that provide means to extend beyond corporate networks, cloud VPCs and hybrid!

Whether with the cloud or within their own data centers, enterprises have undergone a period of remarkable consolidation and centralization of their compute resources. But with the rise of ever more powerful mobile devices, and increasingly capable cellular networks, application architects are starting to think beyond the confines of the data center, and looking out to the edge. 

What exactly do we mean by edge? Think of the edge as distributed compute happening on a wide variety of non-traditional devices — mobile phones of course, but also equipment sensors in factories, industrial equipment, or even temperature and reaction monitoring in a remote lab. Edge devices are also connected devices, and can communicate back to the mothership over wireless or cellular networks. 

Equipped with increasingly powerful processors, these edge devices are being called upon to perform tasks that have thus far been outside the scope of traditional IT. For enterprises, this could mean pre-processing incoming telemetry in a vehicle, collecting video in kiosks at a mall, gathering quality control data with cameras in a warehouse, or delivering interactive media to retail stores. Enterprises are also relying on edge to ingest data from outposts or devices that have even more intermittent connectivity, e.g., oil rigs or farm equipment, filtering that data to improve quality, reducing it to right-size information load, and processing it in the cloud. New data and models are then pushed back to the edge; in addition, we can also push configuration, software, and media updates and decentralize processing workload.

Edge isn’t all about enabling new use cases – it’s also about right-sizing environments and improving resource utilization. For example, adopting an edge model can also relieve load on existing data centers. 

But while edge computing is full of promise for enterprises, there are many pieces that are still works in progress. Further, developing edge workloads is very different from developing traditional applications, which enjoy the benefits of persistent data connections and run on well-resourced hardware platforms. As such, cloud architects are still in the early days of figuring out how to use and implement edge for their organizations. 

Fortunately, there are tools you can use to help ease the transition to edge computing — and that likely fit into your organization’s existing computing systems. Kubernetes, of course, but also higher level management tools like Anthos, which provides a consistent control plane across cloud, private data center and edge locations. Other parts of the Anthos family – Anthos Config Management and Anthos Service Mesh — go one step further and provide consistent, centralized management to your edge and cloud deployments. And there’s more to come.

For the remainder of this blog post, we’ll dive deeper into the past and current state of edge computing, and the benefits that architects and developers can expect to see from edge computing. In a next post, we’ll take a deeper look at some of the challenges that designing for edge introduces, and some of the advantages the average enterprise has in adopting the edge model. Finally, we’ll look at the Google Cloud tools that are available today to help you build out your edge environment, and look at some early customer examples that highlight what’s possible today — and that will spark your imagination for what to do tomorrow. 

The evolution of edge computing 

The edge is not a new concept. In fact, it’s been around for the last two decades, spanning many use cases that are prevalent today. One of the first applications for edge was to use content delivery networks (CDN) to cache and serve daily static website pages near clients, for example, web servers in California data centers serving financial data to European customers. 

As connectivity has improved and software evolved, the edge has evolved too, and the focus has shifted towards using edge to distribute services. First, simple services expanded from static HTML to javascript libraries or image repositories. Common functions like image transformation, credit and address validation support services followed. Soon, organizations were deploying more complex cloudlet and clustered microservices installations, as well as distributed and replicated datasets. The term “endpoint” became ubiquitous, and APIs profilerated. 

In parallel, there’s been an explosion of creativity in hardware, microcontrollers and dedicated edge devices. Fit-for-purpose products were deployed globally. Services like Google Cloud IoT Core extended our ability to manage and securely connect these dispersed devices, allowing platform managers to register tools and leverage managed services like Pub/Sub and Dataflow for data ingestion. And with Kubernetes, large remote clusters — mini private clouds in and of themselves — operate as self-healing, autoscaling services across the broader internet, opening the door to new models for applications and architectural patterns. In short, both distributed asynchronous systems and economies have blossomed.

What does this mean for enterprises? For the purposes of this series, edge means you can now go beyond the corporate network, beyond cloud VPCs, and beyond hybrid. The modern edge is not sitting at a major remote data center, nor is it a CDN, cloud provider, or in a corporate data center rack — it’s just as likely to look like 100 of these attached to a thousand sensors.

Raspi K8s Cluster.jpg
Raspi K8s Cluster

Edge, in short, is about having hardware and devices installed at remote locations that can process and communicate back the information they collect and generate. The edge management challenge, meanwhile, is being able to push configuration and software/model/media updates to these remote locations when they are connected.

Enable new use cases

Today, we have reached a new threshold for edge computing — one where micro-data-processing centers are deployed as the edge of a fractal arm, as it were. Together, they form a broad, geographically distributed, always-on framework for streaming, collecting, processing and serving asynchronous data. This big, loosely coupled application system lives, breathes and grows. Always changing, always learning from the data it collects — and always pushing out updated models when the tendrils are connected. 

Right now, the rise of 5G is pushing the limits of edge even further. Devices enabled with 5G can transmit using a mobile network — no ISP required — enabling connectivity anywhere within reach of a cell tower. Granted, these networks have lower bandwidth, but they are often more than adequate for certain types of data, for example fire sensors in forests bordering remote towns that emit temperature or carbon monoxide data periodically. Recently, Google Cloud partnered with AT&T to enhance business use of 5G edge technology but there is so much more that can be done. 

Reduce data center investments

In addition to enabling the digitization of a broad range of new use cases, adopting edge can also benefit your existing data center.

Let’s face it: data centers are expensive to maintain. Moving some data center load to edge locations can reduce your data center infrastructure investment, as well as compute time spent there. Edge services tend to have much lower service level objectives (SLOs) than data center services, driving lower levels of hardware investment. Edge installations also tend to tolerate disconnectedness, and thus function perfectly well with lower SLOs — and lower costs. 

Let’s look at an example of where edge can really reduce costs: big data. Back in the day, we used to build monolithic serial processors — state machines — that had to keep track of where they were in processing in case of failure. But time and again, we’ve seen that smaller, more distributed processing can break down big, expensive problems into smaller, more cost-effective chunks. 

Starting with the explosion of MapReduce almost 20 years ago, big-data workloads were parallelized across clusters on a network, and state management was simplified with intermediate output to share, wait for, or restart processing from checkpoints. Those monolithic systems were replaced by cheaper, smarter, networked clusters and data repositories where parallel work could be executed and rendered into workable datasets. 

Flash forward to today, and we are seeing those same concepts applied and distributed to edge data-collection points. In this evolution of big data processing, we are scaling up and out to the point where observation data is so massive that it must first be prefiltered, and then preprocessed down to a manageable size and still be actionable. Only then should it be written back to the main data repositories for more resource-intensive processing and model building.

In short, data collection, cleanup, and potentially initial aggregation happens at the edge location, which reduces the amount of junk data sitting in costly data stores. This increases performance of the core data warehouse, and reduces the size and cost of network transfers and storage! 

The edge is a huge opportunity for today’s enterprises. But designing environments that can make effective use of the edge isn’t without its challenges. Stick around for part two of this series, where we look at some of the architectural challenges typically encountered while designing for the edge and how we begin to address them.

Case Study

Home Depot’s Interconnected Retail Experience by Virtue of Google Cloud Migration for SAP Applications

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In 2017, home improvement brand Home Depot began its Google Cloud migration for SAP applications. The migration strategy had a multifold impact on the brand's CX and retail shopping experiences with better flexibility, speed and scale.

With nearly 2,300 stores, The Home Depot is the world’s largest home-improvement chain — a brand that professional contractors and DIYers alike have come to depend on. The home improvement industry continues to experience unprecedented demand and dramatic increases in online ordering accompanied by expanding consumer expectations for things like curbside pickup and same day delivery. The Home Depot’s decision to migrate to cloud-based infrastructure, including the migration of the company’s SAP applications on Google Cloud which began in 2017, has set it up for success in an increasingly digital world, and helped the company adapt to changing market conditions quickly. 

Interconnected retail at scale

Building on a strong customer-first philosophy, The Home Depot aims to create what it calls interconnected retail—allowing customers to shop however, whenever, and wherever they want. “So many companies are focused on omni-channel retail,” explains Sam Moses, Vice President of Corporate Systems. “At The Home Depot, we wanted to take it to the next level. Interconnected retail puts the customer at the center of everything and enables them to shop in store, online, or both. Customers can begin a transaction online and continue in-store, or vice-versa.”

To support this strategy, the company’s SAP environment needed to be more agile. Running  everything on-premises, from central finance to POS systems, meant that The Home Depot’s IT teams experienced redundancy and repetitive, manual processes. Their data warehouse needed an upgrade to process and analyze growing and increasingly diverse data sets. The Home Depot chose to migrate its SAP environment to Google Cloud to support both the velocity and scale needed for the business as well as critical analytics capabilities needed for its bold digital initiatives. “We chose Google Cloud to support our SAP implementation. Our decision had a lot to do with the relationship between Google Cloud and SAP and also for the applications and services that are offered by Google Cloud, like BigQuery, which are helping to enable data and analytics within our organization,” Moses explains.

After migrating its SAP applications—including S/4HANA, its customer activity repository (CAR), general ledger, e-commerce system, enterprise data warehouse and more to Google Cloud, the company now has the speed, scale and flexibility to tackle enormous spikes in the business, all while staying fully available for their customers. Additionally, The Home Depot was able to transform its financial systems and make them more agile to deliver critical information across multiple business functions in real time.

Maximizing data insights to support customer experiences

By migrating to Google Cloud, The Home Depot is leveraging Google Cloud analytics to build   the industry’s most efficient supply chain including more robust demand forecasting, supplier lead times, estimated delivery times and more, all while maintaining better security than before. “We experienced unprecedented change in our customers’ behavior and their buying patterns, which puts a lot of pressure on our supply chain,” explains Moses. “So having the ability to leverage data and analytics gives us insights to know exactly what it is that our customers need.” 

The company’s analysts now use BigQuery ML for machine learning directly against the company’s BigQuery data and use AutoML to determine the best model for predictions. The Home Depot’s engineers have also adapted BigQuery to monitor, analyze, and act on application performance data across all its stores and warehouses in real time—capabilities that were not as seamless in the on-premises environment.

With hundreds of projects on Google Cloud, The Home Depot’s cloud journey is well on track, but the company is always looking to the future. “As our customers’ needs have continued to evolve, and as technology has continued to evolve, our relationship with Google will continue to advance — to be able to innovate together, to be able to find new solutions together, to better serve our customers.”

Learn more about how The Home Depot is renovating its retail operation with SAP on Google Cloud.

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How Apna is using data and AI to drive the gig economy in India

Powered by Vertex AI (Google Cloud’s platform for accelerating development and deployment of machine learning models into production), SAVI (Semi Automated Vision Inspection)1 is transforming surgical instrument identification and cataloging, leading to fewer canceled surgeries and easing pressure on surgery waitlists.

Max Kelsen, an analytics and software agency that specializes in machine learning, has worked closely with Google Cloud and Johnson & Johnson MedTech to create a system that can manage tens of thousands of individual devices, their characteristics, and how they apply to each set or tray used by a surgeon. SAVI does this while delivering a one in 10,000 real-world error rate, much faster and more accurately than manual processes currently in use across the industry. Implementing SAVI can also unlock end-to-end visibility and traceability across the surgical set supply chain and provide advanced analytics and insights.

Eliminating time-consuming manual processes

Surgeons need a large number of specialist instruments and devices to complete complex, delicate procedures. Because each tray of these instruments can typically cost more than $350,000, and having every type of set on shelf at every surgical facility is not feasible, manufacturers generally loan them to hospitals for procedures, such as inserting one of the manufacturers’ implants into a patient’s knee. Once a procedure is complete, the hospital returns the instrument tray to the manufacturer for storage and re-distribution to other hospitals as needed.

Each time a hospital returns a tray, the manufacturer needs to check that each instrument is there, correctly placed, cleaned, and fit for the purpose of the next procedure. As each set may hold more than 400 instruments, completing this process manually is complex and time-consuming. While each tray is checked before and after surgery at the hospital, and again when it arrives and leaves the manufacturer’s facility, Max Kelsen finds that 5% of surgeries can still be affected by missing, broken or bent instruments. This has a severe downstream impact on private hospitals in particular, directly affecting patient safety and outcomes; in Australia, for example, around 60% of surgeries are performed in private hospitals.

Johnson & Johnson MedTech has 60,000 surgical trays across the Asia-Pacific, and loans these trays out about 100,000 times per month. The manufacturer approached Max Kelsen to help design and develop a solution to make the supply chain more efficient, and to give more visibility into asset movement. As a Google Cloud Partner specializing in applying machine learning at scale in healthcare contexts, Max Kelsen had the expertise and track record to meet Johnson & Johnson MedTech’s need for a globally scalable solution that was engineered for quality and performance.

The first step was to establish a baseline for the project by determining how long the manufacturer’s team took to process each tray, and to set an efficiency number. We then spent six months determining and evaluating how to deliver a robust, accurate solution that outperformed current manual and labor-intensive methods in processing instruments and trays, globally. Our work included extensive technical feasibility research involving a representative sample for the variety and complexity of sets, trays, and devices needed for different types of surgery, including orthopedics, spinal trauma, and maxillofacial groups.

Working with Google Cloud to accelerate and de-risk the project

This is a familiar problem that is industry-wide. The issue has been widely explored and tried with a number of technologies over several years without producing the scalability and performance results required to make this an appropriate and feasible solution. Google Cloud partnered with Max Kelsen to accelerate and de-risk this large and strategic project for a mutual customer.

Technical feasibility took four months, prior to a year-long production pilot of SAVl in a distribution center in Queensland that services over 100 hospitals. After obtaining enough real-world data and experience to validate that the solution was as scalable and as accurate as needed, an Asia-Pacific rollout of the system commenced. SAVI is now live across Johnson & Johnson MedTech’s operations in Australia, New Zealand, and Japan, garnering recognition with a JAISA excellence award.

Google Cloud machine learning is integral to SAVI. Google Cloud’s technologies were a big differentiator for Max Kelsen’s engineering team in delivering the breakthroughs needed at scale, and in production, to meet Johnson & Johnson MedTech’s needs.

Reducing checking and documentation time

Running SAVI in Google Cloud has reduced the time Johnson & Johnson MedTech needs to check and document inspections of these surgical instrument sets by over 40%. The application also delivers consistent measurable quality that is often hard to measure at scale when using manual processes. During the pandemic, the application enabled Johnson & Johnson MedTech to operate with a lower headcount for the same volume output, enabling the organization to quickly service a backlog of waiting list surgeries.

In addition, the automation delivered with SAVI has reduced the time required to bring technicians up to speed on quality control processes, from eight to 12 months down to just three months, enhancing productivity and performance while delivering a more robust workforce.

So how does SAVI work in a real-world context? SAVI is deployed via a tablet and a web-based application incorporates an API to photograph the medical device trays, as shown below. Max Kelsen captures the photograph and sends it to a range of different services, via an API endpoint hosted on Google Cloud:

  • Image information is stored in Cloud Storage
  • Data relating to the trays is stored in Cloud SQL for PostgreSQL
  • APIs and web UI components run in CloudRun
  • Analytics data is stored within BigQuery

Once this tray and device onboarding stage is completed, the next step is to perform inferences from the images and data. By hosting online models with Kubeflow model serving on GKE, we enable a model to identify all the instruments in a tray at low latency.

Vertex AI Workbench notebooks are used for data exploration and modeling. Kubeflow training pipelines hosted on GKE are executed to produce machine learning models for specific surgical instrument sets. Several hundred machine learning models are then hosted with Kubeflow model serving on GKE, with state and analytics managed using Firebase. Using machine learning to infer from images whether any devices are incorrectly placed, dirty, or otherwise not fit for purpose, the data is then returned to the tablet for the user to respond accordingly.

Based on our success to date with SAVI, it is now available on Google Cloud Marketplace to help healthcare organizations achieve machine learning-powered efficiencies across a range of use cases, and ultimately improve patient safety and outcomes.

Not to be confused with the usage of Visual Inspection Model (Assembly) available in Vertex AI Vision

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Explore the Innovations and Architecture Powering Spanner and BigQuery

Previously, databases had architectures with tightly coupled storage and compute. This resulted in higher latency, and with faster networks these constraints no longer surface. With Google Cloud’s BigQuery and CloudSpanner, the storage and compute architecture have been separated, allowing for better scalability and availability to address businesses’ high throughput data needs.

Watch the video to understand how these database and analysis products leverage Google’s distributed storage system, in-house custom network hardware and software, internal cluster management system and more!

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NLP in Healthcare Can Unlock Clinical Insights beyond Typical Data Format Barriers

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Unstructured data in healthcare and life sciences are a glaring reality. To derive value and meaningful insights that helps steer clinical interventions and medical research, Google Cloud's Healthcare Natural Language API holds the key. Read further!

Aches and pains. What, if anything, is the difference between those? And do you know a “myocardial infarction” from a “heart attack”? What about an “MI”? Is that shorthand, or part of the address of a hospital in Michigan?

For people, it can be easy to understand the distinctions and nuances between similar words, phrases, and concepts, even technical ones, like those found throughout the medical field. Yet even for the most advanced AI, the contextual clues that give humans accurate comprehension of words and images remain an elusive challenge. It’s a challenge well worth solving, though: As much as 80% of all healthcare data is said to be unstructured.

It’s the kind of complicated data management challenge that natural language processing was built to solve.

Healthcare and life sciences organizations are generating vast amounts of unstructured data as part of clinical and operational workflows, which presents an enormous opportunity to derive meaningful insights for medical research, population health, and patient care. For example, clinical notes and lab reports have useful, actionable information that, when unlocked, can help improve the overall quality of patient care, accelerate the discovery of new treatments, and increase the efficiency of healthcare delivery.

This approach is at the heart of Google Cloud’s Healthcare Natural Language API, in enabling healthcare organizations to build open, intelligent systems that unlock value from healthcare data. The open cloud approach enables our partners to innovate more easily, and scale more efficiently. We believe this approach will further advance interoperability—and ultimately lead to healthier and fuller lives.

Unlockinging value from clinical documents and research materials
Over the past two years, we have seen just how powerful AI can be in expediting drug discovery efforts for COVID-19, forecasting and modeling COVID-19 cases, and building better models for a host of public health measures. The opportunities extend well beyond battling the pandemic, too, to helping combat cancers, diabetes, and disabilities, and accelerating drug discovery.

As healthcare and life sciences organizations look to incorporate new data sources in their analytics and AI workflows, Google Cloud has been investing in providing open, flexible, and easy to use API services that customers and partners can integrate into their solutions, to accelerate their development with the power of Google’s AI technology.

The Cloud Healthcare Natural Language API is one such example, and aims to provide fully managed services that deliver the latest advances in natural language processing in an easy to use and easy to integrate manner. Healthcare organizations can then build intelligent systems to improve care and reduce cost while not having to worry about the complexities of the underlying and fast-changing technology, thus enabling more open innovation in the development of healthcare applications.

A number of healthcare innovators are exploring the potential for natural language processing.

“Patients come to Mayo Clinic with a history, and that history is well-documented, but often buried in clinical notes. Extracting information from unstructured healthcare data across thousands of patients is a complex problem,” says Vish Anantraman, M.D., Chief Technology Officer at Mayo Clinic. “Custom natural language processing solutions have a great potential to extract higher quality insights from these notes and to deliver more timely, and holistic patient care.”

The best insights can often be the unexpected ones, and that is precisely what Hackensack Meridian Health, in northern New Jersey, is looking for.

“Doctor’s notes are a rich space to create structured information from their natural workflow,” says Michael Draugelis, vice president for predictive health at Hackensack Meridian Health. “We are designing new AI-powered solutions to connect clinical teams, patients, and the community automatically from these insights—without creating cumbersome screen clicks and prompts. This automation allows our clinical teams to focus on connecting with the patient.”

Hospital leaders there are testing Google’s NLP API to gather information such as social determinants of health and behavioral health signals from large amounts of clinical notes, with approximately 35 million processed. Seeking to achieve the greatest value from natural language processing, the team at Hackensack Meridian Health have specifically focused on extracting information that is inherently not easy to capture in more traditional electronic health records.

“The extracted insights from the Google NLP API creates a foundational component to map clinical protocols, pathways, and outcomes, to better understand and improve patient care,” Draugelis says.

And at the National Institutes of Health and elsewhere, researchers are exploring how natural-language-derived variables could offer an additional predictive value over and above the Veteran Health Administrations’s structured EMR-based suicide prediction model.

To help healthcare organizations achieve goals like the ones above, we at Google draw on the expertise of tens of thousands of data scientists across the company who work every day on building better AI and decades of AI research in language understanding to power the development of services such as the Cloud Healthcare Natural Language API.

According to independent benchmarking of Cloud providers offering fully managed healthcare natural language service by tech analysts GigaOm, the Google Cloud Healthcare Natural Language API was among the most accurate in the industry, outperforming other service providers in terms of correctly classified medical entities and relationships, and with very few misclassifications.

Using AI to connect systems and enhance healthcare interoperability


As an industry, healthcare and life sciences organizations have been talking about the importance of data and data interoperability for a while. But our experiences from the past couple years have demonstrated that we cannot be fully prepared for the next global health crisis without greater connections within and between organizations.

Starting with the Healthcare Data Engine, organizations have been integrating and harmonizing data securely across many of their sources—patients, members, operations, research, and public databases—so they can quickly analyze it to get insights, and then make smarter, faster decisions.

This is the start of a broader vision for a new kind of healthcare and life sciences connected world where enterprises, institutions, and startups will securely collaborate to deliver on the next generation of care. Such a future relies on cloud-based solutions that are as open and flexible as they are user-friendly, compliance-ready, and secure.

We envision a future where healthcare organizations can seamlessly connect data from various systems, unlock the value from data regardless of source or format, and break down barriers in healthcare interoperability and AI to improve healthcare and save lives.

With these goals in mind, we continue to enhance the hybrid data clouds that customers are building to organize and analyze their information, and we and our partners continue to build on our data capabilities. Given the complexities both within the field and within each organization, we believe the greatest value comes from having partners and tools available to build the AI and NLP technologies most relevant to your unique needs.

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