Lung cancer is the leading cause of cancer death in the United States and like any cancer, early detection is crucial to survival. Screening at-risk populations is an important part of reducing mortality, and if concerning nodules are found on imaging, further testing may be required. Today, we’ll share how Northwell Health uses Google Cloud products such as Cloud Healthcare APIs and BigQuery to increase caregiver productivity and deliver better care for patients with findings that indicate potential development of lung cancer.

Northwell is New York’s largest healthcare provider

Northwell Health is New York’s largest healthcare provider with 23 hospitals and nearly 800 outpatient facilities. Northwell’s nearly 4,000 doctors care for millions of patients each year, and at this scale, there is an immense amount of healthcare data to manage. To better manage and leverage this data, Northwell Health partnered with Google Cloud starting in 2018.

Enabling caregivers to spend more time with patients

Nic Lorenzen, the lead developer of Northwell Emerging Technology and Innovation team, has a mission to put together data for caregivers in a way that makes sense. It is no secret that inefficient electronic health records systems have a negative impact on a physician’s ability to deliver quality care. Traditional EHRs have information distributed across many tabs, which forces caregivers to spend considerable time at the computer trying to find information. Moreover, speed of care matters. If care is delayed, patients may have to spend more time in the hospital and may suffer worse health outcomes.

To solve this problem, Nic’s team focused on giving caregivers the most relevant pieces of data at the right time by developing an intelligent clinician rounding app. The data needed to derive these insights can depend on the caregiver’s role–a nurse cares about different things than a cardiologist. This system aggregates multiple data sources, and provides patient-specific insights to caregivers.

This system would not have been possible before with traditional EHRs and data warehouses that have proprietary data models and rarely sync data in real time. Now with data easily accessible through Google Cloud’s Healthcare solutions, Nic’s team can deliver the right clinical information to the right people instantly. These days, Nic says, “instead of spending 75% of our time dealing with architecting the underlying platforms, we spend 75% of our time focused on  higher value use cases for clinicians and patients. Google Cloud’s Healthcare solutions have greatly improved our developer productivity and time to value.”

Caregivers have found this new system to be a game changer.Before the implementation of this system, caregivers would spend, on average, seven to nine minutes finding the data needed to make medical decisions for one patient. Now, that aggregated information is delivered to a caregiver’s mobile device in less than a second.

Ensuring patients get the right care with the power of AI

There are a number of reasons why patients might not get the care that they need. For example, patients today can go to multiple hospitals and clinics settings, and coordinating care across multiple facilities is complex. Regional hospitals and clinics have their own siloed view of their data, so pertinent information gathered by one clinic might not be seen by another. These gaps in clinical data lead to gaps in patient care.

When a patient gets radiologic imaging, they may have findings unrelated to the reason they initially got the imaging. For example, a chest CT for a car accident might reveal an incidental lung nodule that could be cancerous. Unfortunately, research shows that a large portion of patients do not get follow up for these incidental findings because it isn’t the primary reason why the patient is seeing a doctor. Moreover, social determinants of health are a factor that affects which patients receive follow-up care. Identifying these patients and providing the necessary follow up care prevents adverse events related to delayed detection of cancer.

With Cloud Healthcare solutions, Northwell built an AI model to identify these patients so that oncologists can appropriately follow up with patients who have findings suspicious for lung cancer. The AI model detects incidental pulmonary nodules in radiology reports so that doctors can then contact the patients that need follow-up care. Nic says his team was able to build this system in a week: “Google Cloud did a lot of heavy-lifting for us and allowed us to get to the AI applications much faster. It allowed us to build a platform that just works.” 

Healthcare systems can now rapidly generate healthcare insights with one end-to-end solution, Google Cloud Healthcare Data Engine. It builds on and extends the core capabilities of the Google Cloud Healthcare API to make healthcare data more immediately useful by enabling an interoperable, longitudinal record of patient data. Northwell Health uses Google Cloud as the core of their platform, enabling their developers to create solutions to the most pressing healthcare problems.

Special thanks to Kalyan Pamarthy, Product Management Lead on Cloud Healthcare and Natural Language APIs for contributing to this blog post.

Investment management is a heavily data-driven industry—portfolio managers and investment researchers require a large number of data sources to guide them in shaping their investment strategies. 

New cloud capabilities and technologies enable investment managers to process data faster than ever before and iterate on ideas quickly to fuel innovation in the signal generation process and gain a competitive edge. 

Using the cloud for investment research workflows makes it easier to onboard data from data providers, spin up large compute workloads in the midst of market volatility or during heavy research cycles, and manage complex machine learning or natural language workflows to gain market insights.

We hear from industry leaders that they’re exploring new ways to run investment research. “Differentiated investment strategies require new types of information sources, and new ways to process that information,” David Easthope, senior analyst, Market Structure and Technology, Greenwich Associates. “And that, of course, relies heavily on having access to reliable and scalable storage, computational, and AI / ML resources. More specifically, quantitative strategies can benefit from the computational platforms and embedded AI/ML capabilities the cloud can offer.” 

Google Cloud gives investment managers essential components to work and operate faster as they bring their investment research workflows to the cloud. Here are the key highlights:

1. Simplify, speed up your data acquisition, discovery, and analytics

The foundation of any investment strategy starts with data—acquiring it, detecting patterns, and analyzing it for insights. Enabling data providers to easily share large datasets such as tick history within a high-performance analytics engine can greatly reduce the data engineering overhead when possible.

Once data is onboarded, you can tag business and technical metadata related to your datasets and provide portfolio managers the ability to discover these datasets via a search interface.

We further review analytics options for various scenarios, including aggregating massive datasets, creating dashboards, and incorporating streaming analytics workloads.

2. Take advantage of burst compute workloads

Data engineers and researchers require ready access to burst compute capabilities to perform backtesting, portfolio simulations and run risk calculations. Cloud works well for these workloads due to its elasticity, consumption-based models, and hardware evolution.

Many investment managers are shifting to a container-based strategy along with a Kubernetes-based scheduler for greater consistency, scaling and efficiency in environments with a large number of researchers. Cloud managed services and a rich suite of CI/CD tools can make this vision a reality while improving security and developer productivity.

3. Tackle machine learning (ML) and model deployment with the help from cloud

Quantitative researchers scour vast amounts of market and alternative data sources searching for signals and correlations, while ML engineers have the challenge of taking these signals and moving them to production.

Google Cloud empowers users to create and operationalize their models without wasting valuable time with a comprehensive set of MLOps tools. 

In this paper, we explore multiple solutions for ML and model deployment. Those capabilities reduce the amount of time operationalizing ML models, so quants and data scientists have more time to devote to differentiating activities. 

4. Get the data you need in less time with Natural Language and Document AI

Thousands of financial filings, news articles, and sell-side research reports are generated every day, and it’s difficult for humans alone to process this volume of information. These documents are often generated in many languages and the ability to do entity recognition, sentiment or syntactical analysis in those languages, or perhaps translate them into the language of the portfolio manager is of critical importance. Google Cloud provides these capabilities through pre-trained models, or allows you to train high-quality models with your own datasets.

Getting started

There are plenty of emerging technologies, tools, and approaches available to help investment managers today. At Google Cloud, we can help you access, organize, and utilize these essential components to make your research faster, reliable, and more valuable.

To learn more about these four keys to better investment research, check out our whitepaper for more.

Background

At IKEA we have multiple places in our customer journey in various channels where different kinds of personalization can deliver a superior customer experience. Product recommendations in the shopping basket, content recommendations in editorial sections, inspirational recommendations on product pages and more. After a while in the broader “recommendations” team there was a decision to split the team to have one sub-team focused on product recommendations. The pandemic altered customer behavior and needs as well. At that inflection point we decided to change our way of working and dive head-first into a more scientific approach to handle the operational complexities of delivering high quality product recommendations at scale. We deemed this necessary to improve our level of personalization and to have a holistic understanding of our customers.

Data Driven Decisions

The first step was to radically improve our ability to get high-quality quantitative information to understand how our ‘recommendation’ solutions affected personalization. We did this through high volume A/B testing on customer behaviour and after initial experimentation, we had a few key learnings:  

1. The mix of both UX and algorithms are really important for a cohesive customer experience. 
2. The quality of personalization can’t be measured in silos. Statistical significance  can be attained  by testing several groups of recommendations at once.

Once we came up with a solid framework for gathering data and acknowledged how little we knew about our customers, we were able to explore an incredible number of creative options – nothing was off the table. This was a very humbling experience, in that it opened up new perspectives for personalization, a more curious and less confined way of thinking. We learned to trust the data because it might show you things you don’t expect. 

Experimentation and Learning Framework

Our teams created ways to quickly deploy experimental modifications to our existing solution. This enabled experimentation in the front-end with the user experience, including details in headings and images. This also covered tweaks in the backend with anything from detailed manual additions or removals of recommendations to mixing and matching of various algorithms both home grown and from Recommendations AI.

This flexibility came with an overhead–more complexity and cost relative to directly retrieving recommendations from Recommendations AI. However, the benefit was that we were no longer dependent on manual evaluation of what made for a good recommendation system. We aligned on a data-driven and qualitative approach to provisioning recommendations and significantly accelerated our experimentation timeline. Together with optimization of the CI/CD pipeline this enabled the team to take an idea or hypothesis from inception to A/B testing with customers in less than half an hour.

Recommendations AI Experiments

Our team’s infrastructure was already running on GCP and when we received early access to Recommendations AI, the requirements to get started were minimal and that allowed us to start with initial tests requiring minimal effort and investment.

We started with a few use-cases and identified places where our existing recommendation algorithms needed improvement or complementary recommendations. We also explored additional ways where more useful information could be presented to the customers through personalized recommendations. 

Recommendations AI Model Combinations

While Recommendations AI might be considered a simple API to get a set of product recommendations, as we dove deeper into the solution it became apparent that it could be tweaked in several different ways to offer many fine tuning configurations to meet business goals. While too much fine tuning and customization could lead to subpar performance, in general we found that it was a great strategy to give us several versions of ML powered recommendations to work with. The further you personalize the experience, the more options you have to likely pick the best one for the customer.

Recommendations AI models like  ‘Recommended for you’, ‘Frequently Bought Together’ and ‘Others you may like’; are coupled with business goals like optimizing for conversion rate, click through rate and revenue. We experimented with many different model combinations and custom rules. All this was easily configurable right in the GCP console. One of the simplest custom configurations we used was to only recommend items that were in stock, and when items were out of stock we looked at similar items that were available to augment the experience. 

Collaboration with Google

Our collaboration with Google Cloud accelerated our learning process during experimentation. We worked closely together early in the product development. Additionally, their model provided flexibility to change direction and allow for more options than we had previously. Ultimately, this provided us a way to drastically improve our time to market with a product that produced tremendous results that we could not have accomplished on our own.

Results and Takeaways

With more personalized and real-time recommendations available we saw great success. We were able to increase the number of relevant recommendations displayed on a page by +400%. To accommodate the wider repertoire of recommendations we had to change the user experience. For example, in some places we had horizontally scrolling displays of product recommendations which were much easier for customers to use.

Another consequence of displaying more personalized recommendations was tangible improvement to conversion rate and average order value. Recommendations AI algorithms helped customers in two ways: 

1. Customers were able to find products that they liked quickly and establish their preferred choice among other options more quickly as well, giving them confidence to make a purchase through much fewer clicks. Even though we previously already had well tuned recommendations of several types, with Recommendations AI we measured +30% improvement in click through rates. 
2. Average order value saw a +2% surge with numerous examples of how Recommendations AI could help customers find both attractive and directly complementary products, expanding the customer purchase from a single product to an entire home furnishing solution.

As a direct effect of having stronger business results, the team started exploring more places in the customer journey where our growing buffet of recommendations could be used. We’d start with an initial experiment to answer if displaying recommendations in the specific context made sense at all. Frequently the data that emerged from these experiments prodded us to iterate further on what additional types of recommendations would be most appropriate to show to the customer as the customer’s behaviour evolved. Today, most of IKEA’s site recommendations are powered by Recommendations AI.

One key takeaway is that for some types of personalized recommendations there are benefits to using advanced algorithms that require a lot of high level data science and engineering competence to build since they outperform simplistic approaches. In some places, simplistic approaches work very well and in others the right decision is to not have product recommendations at all. For an effective use of product recommendations you need to have all the above options and the ability to tell when to use which one.

Next steps

When working with something so tightly related to customer experience, there is a constant change in user behaviour and new learnings to observe and adapt to. Product recommendations are rarely the main stand alone experience and frequently something that is used to help and enhance an experience. We see a lot of value in having a large toolbox of possible options and a team with a relentless focus on collaboration to improve the customer experience. We’re working directly with the Recommendations AI team and experimenting with several new features that we’re excited about. 

In the future we see opportunities of improving the customer journey through a more visual experience that inspires the customer rather than relying on customers to use their imagination to visualize groups of products together. Vision Product Search provides that and is something we’re looking into deploying next. We’ll be sharing more about our journey with Recommendations AI at the Google Cloud Retail Summit session ‘IKEA’s Approach to Building a Powerful Recommendations Engine’ on July 27th 2021.

Best wishes to all developers from the IKEA product recommendations team & the Google Recommendations AI team!