Thread by @VinceKuraitis

Way to go Mayo!

"Novel model deidentifies data, employs a federated learning model to retain data control."

Kudos @jhalamka, Cris Ross

cc: @bertcmiller @GYNOBioethicist

@jhalamka @bertcmiller @GYNOBioethicist 2/

A few more thoughts about the Mayo announcement.

Read more in the @HealthLeaders article by Mandy Roth:

"Mayo Clinic Designs Novel Data Privacy Model; Announces Venture to Accelerate Drug Discovery"

bit.ly/370GcnG

@jhalamka @bertcmiller @GYNOBioethicist @HealthLeaders 3/

First...

The Mayo announcement is a BFD among BFDs.

Let me repeat that.

The Mayo announcement is a BFD among BFDs.

@jhalamka @bertcmiller @GYNOBioethicist @HealthLeaders 4/

Caveat: not easy to wrap your head around this.

@bertcmiller & @GYNOBioethicist wrote about the technological possibilities in @THCBstaff
bit.ly/2QmDvXR

@jhalamka @bertcmiller @GYNOBioethicist @HealthLeaders @THCBstaff 5/

They posed a provocative question:

"What if there was a way for you to allow others to learn from your data without compromising your privacy?"

The Mayo project promises to do exactly that.

6/

Here are a few more details about the Mayo project (from the @HealthLeaders article):

* partnership with @_nference

* Reidentification is prohibited

* Mayo data cannot be combined with data from other sources

@HealthLeaders @_nference 7/

* From the article: "As the healthcare industry struggles to find a BALANCE between the desire for innovation and the need to protect patient data"

The word "balance" implies that there is an inherent tradeoff between innovation & data protection.

IMO, ain't necessarily so.

@HealthLeaders @_nference 8/

I'd rephrase:

As the healthcare industry struggles to OPTIMIZE the desire for innovation and the need to protect patient data.

"OPTIMIZE" suggests a need to maximize BOTH innovation & data protection and that there isn't necessarily a tradeoff

@HealthLeaders @_nference 9/

* Use only deidentified patient data

* Use independent experts to certify that the data has been fully deidentified.

* All parties are prohibited from pooling Mayo Clinic data with other data sources, such as consumer financial or geolocation data.

@HealthLeaders @_nference 10/

* Eliminate the possibility of reidentification by employing a federated learning model. While others can query the data set, Mayo Clinic retains full possession of it and only sends participants the results.

re: "federated" tech, see bit.ly/2QmDvXR

@HealthLeaders @_nference 11/

more info on "federated" concept: bit.ly/2ZS08WI

* Mayo Clinic's role in the process will be to piece together disease phenotypes and determine how to treat subpopulations of patients differently

@HealthLeaders @_nference 12/

Recall when @WSJ revealed details of Ascension deal w/ Google -- that patient ID would be shared:

* Outcries from privacy advocates
* Lashings from legislators & regulators
* Fed investigation by OCR

@HealthLeaders @_nference @WSJ 13/

I'd like to be a mouse in the corner when the Ascension CEO asks the CIO:

"Why didn't we do our deal with Google like Mayo did?"

@HealthLeaders @_nference @WSJ 14/

Let's think a bit further about the Mayo/ @_nerence partnership (federated learning model) & value creation/capture dynamics.

Strikes me that big tech co.s are unlikely to lead a march toward federated learning models.

@HealthLeaders @_nference @WSJ 15/

Why?

Current big tech business model is one of surveillance. Gather as much data as you can, analyze, profile. Rinse, repeat.

Federated learning changes power dynamic between health system & big tech co.s

@HealthLeaders @_nference @WSJ 16/

For a health system like Mayo that can negotiate a deal to keep patient data private, they have much greater opportunity BOTH to create & capture value from data.

This doesn't appear to be lost on Mayo and @MayoInvents.

@HealthLeaders @_nference @WSJ @MayoInvents 17/

Remains to be see how many health systems have the foresight, brand, resources, hutzpah like Mayo to negotiate a federated learning model (or blockchain, or ??) with big tech co.s.

Stay tuned.

@HealthLeaders @_nference @WSJ @MayoInvents 18/

Strikes me that it would be smart for ALL health systems immediately to shift to insisting on federated learning models in their deals with big tech co.s:

* Opportunity for health systems to create/capture the value from data

@HealthLeaders @_nference @WSJ @MayoInvents 19/

* The more health systems that did this, the less influence for big tech co.s

Expect pushback from big tech co.s that want unfettered access to & use of data.

@HealthLeaders @_nference @WSJ @MayoInvents 20/

More details on Mayo federated learning model | @FierceBiotech

The project aims to digitize 25 million pathology slides within the next 2 1/2 years, which would provide the single largest source of labeled medical data in the world
-- per @_nference co-founder @in4ence

@HealthLeaders @_nference @WSJ @MayoInvents @FierceBiotech @in4ence 21/

“Platform business models have been a force of disruption in many sectors"
-- @jhalamka

Notable that @MayoClinic
focus is shifting to biz models, not just platform techologies

@HealthLeaders @_nference @WSJ @MayoInvents @FierceBiotech @in4ence @jhalamka @MayoClinic 22/

I'm thinkin' that Joe-the-Plumber hasn't yet figured out how transformative this @MayoClinic / @MayoInvents
federated learning model could be.

@HealthLeaders @_nference @WSJ @MayoInvents @FierceBiotech @in4ence @jhalamka @MayoClinic 23/

John Halamka ( @jhalamka ), President of Mayo Clinic Platform, posted his own take on their federated learning model:

"Cloud-hosted, de-identified, federated learning in which the tools are brought to the data instead of sending data to the tools"
geekdoctor.blogspot.com/2020/01/a-new-…

@HealthLeaders @_nference @WSJ @MayoInvents @FierceBiotech @in4ence @jhalamka @MayoClinic 24/

Thinking out loud re: further possible implications of @MayoClinic platform partnership w/ @_nference.

Q. What biz model(s) could maximize potential for network effects, especially DATA network effects?

@HealthLeaders @_nference @WSJ @MayoInvents @FierceBiotech @in4ence @jhalamka @MayoClinic 25/

What are "data network effects"?

"When a product’s value increases with more data, and when additional usage of that product yields data..."
bit.ly/3aDWlBJ

@HealthLeaders @_nference @WSJ @MayoInvents @FierceBiotech @in4ence @jhalamka @MayoClinic 26/

Consider alternative federated learning models:

a) AI/ML algorithms can be run on one provider's data -- likely a few million patients

b) AI/ML algorithms can be run on multiple providers' data -- possibly HUNDREDS OF MILLIONS of patients over time

c) ??

@HealthLeaders @_nference @WSJ @MayoInvents @FierceBiotech @in4ence @jhalamka @MayoClinic 27/

Data network effects will grow exponentially based on number of patients.

Could be especially important where n of patients is very low, e.g. rare diseases (HT @bertcmiller )

My hypothesis (speculation) is that win/win biz model is (b).

Why?

28/

From deals announced so far that I've seen, big tech co. (e.g. @Google) partnering w/ providers has been prohibited from combining one provider's data w/ another.

I infer due to:
* fear of PR backlash
* lack of trust of big tech co.
* lack of using a FL model?
* other?

@Google 29/

BUT...if the "network" was viewed as controlled by Mayo -- using FL tech -- IMO there's potential for higher level of trust and potential for combining data ACROSS providers.

A win/win biz & clinical model?

Speculative for now but potential is there.

@Google 30/

Also worth thinking about biz model implications from Mayo partner POV, i.e, @_nference.

Do they have an opportunity to be a hub/platform across networks of patient data?

The co. secured a $60 M earlier this month, including @MayoInvents

@Google @_nference @MayoInvents 31/

We don't know the terms of the investment or the terms of the contract between @_nference & @MayoClinic,

so it's hard to speculate.

...but worth keeping an eye on this.

@Google @_nference @MayoInvents @MayoClinic 32/

Detailed dive into @_nference & @MayoClinic partnership

by @nversel bit.ly/37Ln5OH

"What Nference & Mayo are beginning to do together is to understand the human genotype-phenotype relationship at a scale here that is likely unprecedented"
-- @in4ence, CEO nference

33/

More broadly, the @MayoClinic
Platform increasingly looks COMPETITIVE to the Google Health Platform:

Google Health’s Platform Play: Is Google Creating the Android for Doctors? | @Applico

bit.ly/37MKUpq