Improving Patient Outcomes with SAVI and Google Cloud’s Innovative Surgical Instrument Tracking
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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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Automation and machine learning technologies are changing the way marketers drive results for their customers and brands. But there’s still a significant gap between those who are just talking about machine learning and those who are taking action.
For marketers looking to become leaders in their field, this is an exciting time. It’s a chance to make your mark, get ahead of competitors, and drive real results.
To explore this shifting landscape, Google partnered with the Massachusetts Institute of Technology Sloan Management Review (MIT SMR) to conduct a global survey and interview over a dozen executives and academics about their use of automation and machine learning technology and the results they’re seeing.
The survey’s findings show there are clear opportunities for marketers to get ahead of the pack.
While nearly three-quarters of the survey’s respondents believe their organization’s current goals would be better achieved with greater investment in machine learning and automation, only half the surveyed organizations have any incentives to make such investments.
View the survey results and unearth ways your organization can embrace machine learning and grasp the opportunity. Download the whitepaper now!
Revolutionizing Cloud Computing: Introducing G2 VMs with NVIDIA L4 GPUs
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Organizations across industries are looking to AI to turn troves of data into intelligence, powered by the latest advances in generative AI. Yet for many organizations, there is a barrier to adopting the latest models because they can be costly to train or serve. A new class of cloud GPUs is needed to lower the cost of entry for businesses that want to tap the power of AI.
Today, we’re introducing G2, the newest addition to the Compute Engine GPU family in Google Cloud. G2 is the industry’s first cloud VM powered by the newly announced NVIDIA L4 Tensor Core GPU, and is purpose-built for large inference AI workloads like generative AI. G2 delivers cutting-edge performance-per-dollar for AI inference workloads that run on GPUs in the cloud. By switching from NVIDIA A10G GPUs to G2 instances with L4 GPUs, organizations can lower their production infrastructure costs up to 40%. We also found that customers switching from NVIDIA T4 GPUs to L4 GPUs can achieve 2x-4x better performance. As a universal GPU offering, G2 instances also help accelerate other workloads, offering significant performance improvements on HPC, graphics, and video transcoding. Currently in private preview, G2 VMs are both powerful and flexible, and scale easily from one up to eight GPUs.
Currently organizations require end-to-end enterprise ready infrastructure that will future proof their AI and HPC initiatives for a new era. G2s will be ready to be deployed on Vertex AI, GKE, and GCE, giving customers the freedom to architect their own custom software stack to meet their performance requirements and budget. With optimized Vertex AI support for G2 VMs, AI users can tap the latest generative AI models and technologies. With an easy to use UI and automated workflows, customers can access, tune and serve modern models for video, text, images, and audio without the toil of manual optimizations. The combination of these services with the power of G2 will help customers harness the power of complex machine models for their business.
NVIDIA L4 GPUs with Ada Lovelace Architecture
G2 machine families enable machine learning customers to run their production infrastructure in the cloud for a variety of applications such as language models, image classification, object detection, automated speech recognition, and language translation. Built on the Ada Lovelace architecture with fourth-generation Tensor Cores, the NVIDIA L4 GPU provides up to 30 TFLOPS of performance for FP32, and 242 TFLOPs for FP16. Newly added FP8 support, on top of existing INT8, BFLOAT16 and TF32 capabilities, makes the L4 ideal for ML inference.
With the latest third-generation RT Cores and DLSS 3.0 technology, G2 instances are also great for graphics-intensive workloads such as rendering and remote workstations when paired with NVIDIA RTX Virtual Workstation. NVIDIA L4 provides 3x video encoding and decoding performance, and adds new AV1 hardware-encoding capabilities. For example, G2 can enable gaming customers running game engines such as Unreal and Unity with modern graphics cards to run real-time applications. Likewise, media and entertainment customers that need GPU-enabled virtual workstations can use the L4 to create photo-realistic, high-resolution 3D content for movies, games, and AR/VR experiences using applications such as Autodesk Maya or 3D Studio Max.
What customers are saying
A handful of early customers have been testing G2 and have seen great results in real-world applications. Here are what some of them have to say about the benefits that G2 with NVIDIA L4 GPUs bring:
AppLovin
AppLovin enables developers and marketers to grow with market leading technologies. Businesses rely on AppLovin to solve their mission-critical functions with a powerful, full stack solution including user acquisition, retention, monetization and measurement.
“AppLovin serves billions of AI powered recommendations per day, so scalability and value are essential to our business,” said Omer Hasan, Vice President, Operations at AppLovin. “With Google Cloud’s G2 we’re seeing that NVIDIA L4 GPUs offer a significant increase in the scalability of our business, giving us the power to grow faster than ever before.”
WOMBO
WOMBO aims to unleash everyone’s creativity through the magic of AI, transforming the way content is created, consumed, and distributed.
“WOMBO relies upon the latest AI technology for people to create immersive digital artwork from users’ prompts, letting them create high-quality, realistic art in any style with just an idea,” said Ben-Zion Benkhin, Co-Founder and CEO of WOMBO. “Google Cloud’s G2 instances powered by NVIDIA’s L4 GPUs will enable us to offer a better, more efficient image-generation experience for users seeking to create and share unique artwork.”
Descript
Descript’s AI-powered features and intuitive interface fuel YouTube and TikTok channels, top podcasts, and businesses using video for marketing, sales, and internal training and collaboration. Descript aims to make video a staple of every communicator’s toolkit, alongside docs and slides.
“G2 with L4’s AI Video capabilities allow us to deploy new features augmented by natural-language processing and generative AI to create studio-quality media with excellent performance and energy efficiency” said Kundan Kumar, Head of Artificial Intelligence at Descript.
Workspot
Workspot believes that the software-as-a-service (SaaS) model is the most secure, accessible and cost-effective way to deliver an enterprise desktop and should be central to accelerating the digital transformation of the modern enterprise.
“The Workspot team looks forward to continuing to evolve our partnership with Google Cloud and NVIDIA. Our customers have been seeing incredible performance leveraging NVIDIA’s T4 GPUs. The new G2 instances with L4 GPUS through Workspot’s remote Cloud PC workstations provide 2x and higher frame rates at 1280×711 and higher resolutions” said Jimmy Chang, Chief Product Officer at Workspot.
Pricing and availability
G2 instances are currently in private preview in the following regions: us-central1, asia-southeast1 and europe-west4. Submit your request here to join the private preview, or to receive a notification as when the public preview begins. Support will be coming to Google Kubernetes Engine (GKE), Vertex AI, and other Google Cloud services as well. We’ll share G2 public availability and pricing information later in the year.
Upgrade Your Contact Center with Knowlarity’s AI-powered Speech Analytics for Higher CX
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Did you know, everyday about 56 million hours worth of phone conversations, equalling to 420 billion spoken words are handled by contact centers? Knowlarity, a renowned cloud business communication service provider with nearly 6,000 customers and over a million virtual users, leverages AI-powered speech analytics that offer insights to gauge customer preferences and emotions, campaign performance, agent’s effectiveness and much more. Knowlarity’s programmatic speech analytics platform is built with Google Cloud to optimize contact center performance by transcribing and analyzing millions of calls to impact savings, operations, CX, customer loyalty and retention, and revenue generation.
Download the e-Book to learn more about Knowlarity’s speech analytics for your business’ contact centers and elevate your agents’ performance by leveraging ML, natural language processing (NLP) and AI capabilities.
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The Strange Phenomenon AI Revealed at Ride-Hailing Company Go-Jek
Go-Jek, Indonesia’s first billion-dollar startup, has seen an incredible amount of growth in both users and data over the past two years. Many of the ride-hailing company’s services are backed by machine learning models hosted on Google Cloud Platform. Models range from driver allocation, to dynamic surge pricing, to food recommendation, and process millions of bookings every day, leading to substantial increases in revenue and customer retention.
By embracing Google Cloud, Go-Jek has overcome many of the technical challenges brought on by its rapid growth. BigQuery has become the cornerstone of their data foundation, scaling seamlessly to meet their immense data storage and processing needs.
Using Pub/Sub as an event stream and Dataflow for unified batch and stream processing has prevented inconsistencies in production data, while simultaneously reducing costs through intelligent resource allocation.
Together, these technologies allow Go-Jek to react immediately to real world events, whether by retraining models with ML Engine, or refreshing data in a low latency data store like BigTable.
Find out how Go-Jek leverages Google Cloud and other lessons they have learned scaling machine learning.
Collateral IT: Leveraging Google Cloud for Enhanced Asset Allocation at HSBC
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Have you ever heard of an optimization problem? Imagine you have a million marbles, all of different sizes, colors, patterns, and weights. You need to fill up 1,000 jars of different sizes with them, but each jar has restrictions as to which colors, patterns, and how many marbles of each type it can hold. After filling all the jars, you may keep any leftover marbles, so you want to ensure that these are the shiniest ones in the bunch. How do you go about solving this puzzle? There are many possibilities, but what would be the most efficient way to guarantee you’ll reach the best possible outcome every time?
At HSBC, our Collateral Treasury desk and Collateral Management team have been solving a similar problem, but instead of marbles and jars, we work with around 50,000 assets that can be used as collateral, and 1,000s of collateral accounts.
Our Collateral Treasury Trading desk helps finance our Markets business by providing the required collateral, such as certain debt or equities, to cover its obligations to a client. The collateral could be used by HSBC for its margin requirements, CCPs (Central Counterparty Clearing Houses), or for securities financing transactions. Each obligation can have different eligibility criteria about what assets can be used as collateral for each client. These rules and restrictions revolve around the type of asset allowed or daily liquidity factors.
The process of matching collateral to obligations is known as an allocation, and it can get complicated the more diverse the collateral pool and the more customers you have. It is important to allocate collateral in the most efficient way and, traditionally, this business problem has been managed manually or by a third party against a set of simple rules.
But by collaborating with Google Cloud, we can improve collateral allocation through automation. Even small efficiency gains have the potential to make a significant difference when the amount of collateral inventory managed is tens of billions of dollars. It means the Collateral Treasury desk is much more efficient when managing its own funding costs or regulatory ratios such as the Liquidity Coverage Ratio (a key financial resource measure for banks that ensures sufficient high quality assets are readily available to survive periods of liquidity stress).
Leveraging AI to tackle a complex business problem
Our solution is OPTIC, a HSBC platform utilizing Google Operation Research Tools, or OR-Tools, an open-source optimization library provided by Google AI. Its main goal is to allow the Collateral Treasury desk to automate the collateral allocation process in the most optimal way on any given day. OPTIC’s architecture is based on microservices and provides the ability to handle large volumes of data, for which a scalable and self-managed infrastructure is needed. OPTIC runs on Google Kubernetes Engine, which provides it with workload rebalancing, auto-scaling capabilities, and high availability.
Additionally, we collaborated with Google Operations Research, which gave us access to the experience of Google AI engineers who were able to advise us on the best way to implement their optimization libraries to solve our business problem.
We’ve found that using linear programming solvers such as Google OR-Tools is the best way to achieve the optimization capability that fundamentally changes how we manage our inventory. It enables us to optimize for multiple outcomes and be certain that we are doing this in the most efficient way possible.
Finding the optimal way forward with automation
OPTIC works by consuming data feeds from a multitude of systems, then it standardizes the data, and combines with decision-making parameters and weightings Google OR-Tools can use, to understand and arrive at an optimal outcome. OPTIC can also provide insights and metrics that help optimize business decisions such as which assets can be added or removed in the future to make collateral allocation even more efficient.
Looking forward, this project makes us optimistic about using Google Kubernetes Engine to manage more of our microservices in other platforms. This will mean that we can scale without worrying about hardware or making big changes to our environment. With this solution, we’ll be able to mobilize and optimize our collateral according to our own view of the value and quality of the collateral, as well as the best fit for our exposures at any given time.
Over time, the project can bring visible long-term benefits to HSBC’s Markets business, including decreased operational risks and potential to save significant funding costs. Next, we will continue to add new capabilities and data sources to our solution to continue solving some of the most complex business challenges in our industry.
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