NxOpinion Gains Early Recognition

    GRAND RAPIDS — The Robertson Research Institute didn’t take home the prize at the Computerworld Honors 21st Century Achievement Awards last week.

    But the international recognition was an award in itself — as was being nominated for the award by none other than industry giant Microsoft.

    More than 250 nominees from 33 states and 26 countries vied for Computerworld Achievement Awards, which honor the year’s most innovative technology applications in 10 categories.

    The institute’s medical technology initiative, NxOpinion, was one of six finalists for the information technology project award in the category of medicine. Steve Ballmer, CEO of Microsoft, nominated RRI for the award.

    NxOpinion is an unprecedented medical diagnostic and treatment software application being developed for worldwide use by RRI. RRI is supplying the medical expertise, and Grand Rapids-based Sagestone Consulting, Microsoft Services and Hewlett-Packard, are supplying the technical know-how.

    It is the first medical diagnosis and treatment software to use artificial intelligence to lead users through a series of questions in order to arrive at a diagnosis and proposed treatments. It runs on a desktop PC, a Tablet PC or Pocket PC.

    The software continuously scans the relationships between evidence entered by the physician — symptoms, patient history, test or imaging results and demographics — and all of the diseases in NxOpinion’s profile and then correlates the information into an immediate, at-the-fingertips diagnosis. The diagnosis is refined with each additional finding.

    The institute expects that the production release of the NxOpinion solution will cover up to 10,000 symptoms and 7,000 diagnoses.

    The software will be multi-lingual, multi-cultural and will take into account the skill level of the medical practitioner and differences in Eastern vs. Western approaches to medicine.

    What’s also unique about the NxOpinion initiative is that it is both humanitarian and philanthropical in nature. The purpose is to save lives through medical technology, not to make a profit from the medical system, its creators say.

    Beginning next year, the nonprofit RRI will distribute NxOpinion free to underdeveloped areas of the world where medical facilities and resources are scarce and, domestically, to facilities in great need.

    The need is very great in terms of domestic ER rooms and overwhelmingly great in terms of locations where health care is delivered in primitive settings, said Keith Brophy, president and CEO of Sagestone Consulting and chief technology officer on the project.

    RRI founder and President Joel Robertson, Pharm.D., said his vision was for a global medical solution that would save lives through faster and more accurate diagnosis.

    He teamed with Sagestone, along with Microsoft, Hewlett Packard and several West Michigan-area subcontractors, to turn the vision into reality, and opened an RRI research and development office in Grand Rapids last August.

    “Essentially, our skills set has come out of West Michigan and that’s pretty much a statement of where the talent lies,” Robertson remarked.

    Robertson said he’s a little taken aback by the level of recognition NxOpinion has gained so early on.

    “It really surprised me, especially because we have done most of our work internally and haven’t gone out to seek support from big companies. They’ve kind of tracked us down.

    “We’re just trying to build a good piece of software so we can show the world the future, but the world jumped in and started to look early. It’s really great to have these honors, but it does raise the level of expectation and responsibility higher.”

    He said the institute receives a few calls a week from physicians that have seen the prototype and companies around the world that have heard about NxOpinion. He guesses many of them have seen Microsoft’s case study video on NxOpinion early pilot studies in the Dominican Republic late last year.

    Microsoft does 10 or 12 video case studies a year on innovative technologies, so the case study itself represented significant recognition, Robertson noted.

    Brophy thinks the recognition to date is on the mark.

    “When you look at the focus of the vision and the power of the technology behind it, it really is a phenomenal undertaking with phenomenal progress so far,” he said. “Microsoft has been great at recognizing the accomplishments of the program and the potential of the program.”

    Pilots also were undertaken in the United States last year. Locally, nurses from the research area of Spectrum Health participated in usability pilot sessions.

    “We’ve had consistently positive responses across the board as we’ve shown the solution,” Brophy said. “The technology behind the solution is very strong, but I think what’s striking to practitioners is the usability of the solution. We used usability experts and design gurus to come up with a super-strong, usable, intuitive interface. It complements and enhances physicians daily activities.”

    More pilots are planned for this year and next as the software continues to be tweaked and refined based on physician feedback.

    A lot of the focus this year is on content management and ease of use, Robertson said, pointing out that it will be a multi-year, multi-phase effort for the software to mature to its full level of sophistication.

    He said RRI could do a release of NxOpinion right now with limited diagnostic capabilities, but before it goes out to the public, he wants it “right.”

    This fall, RRI is going to put NxOpinion in the hands of “select people,” who will use it in real life situations and supply the NxOpinion team with additional feedback.

    RRI’s goal is to release about 5,000 of the software applications in 2005.

    “What we’re shooting for in the first release next year is meeting the needs of rural physicians in the United States and Second World countries that are reasonably developed. That takes a certain level of database integration, and we’ll be ready for that. In the next level, we’ll start looking at family practices, preventative medicine and universities.”

    NxOpinion Medical Director Mark W. Bates, M.D., said he was strongly attracted to the project because of its “charitable flavor” and the power and sophistication of NxOpinion’s technology.

    “We’re going to just put it out there and put it into the hands of people who need it. What also struck me was that, finally, here was a program that as a practicing physician I would find useful,” Bates said.

    Bates has a private practice in Rockford and is a clinical instructor with Michigan State University’s Family and Community Medicine.

    As medical director, Bates provides the medical guidance for how the software is supposed to work, assures that the medical content is evidence based, and coordinates feedback from physicians in the pilot studies.

    “The next major improvement in development in the medical database is the ability for the program to tap in to geographically specific diseases. It has built into its foundation the ability to track where the provider is practicing and what the prevalence is of different diseases in that area.”

    In America, for example, fever and abdominal pain might point to the possibility of an appendicitis or gall bladder attack, whereas in the Dominican Republic or Egypt those same symptoms might be more indicative of parasitic infection because it’s more common there.

    Since NxOpinion is multi-faceted, Bates said, it has the potential for use in emergency rooms, outpatient clinics and medical education environments.           BJ

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