January 25, 2021
By Alisa Kim
As a student in the Executive Master of Health Informatics (EMHI) program at the Institute of Health Policy, Management and Evaluation, Santiago Luna was tasked with a project: come up with an idea using information technology to improve health outcomes.
For the assignment, Luna drew on his experience as a sonographer specializing in echocardiograms, an ultrasound exam that checks the structure and function of the heart. An echocardiogram, also called echo, is a very commonly prescribed test used to assess and diagnose diseases like heart failure, where the heart is too weak to meet the body’s pumping needs.
As a manager of a team of cardiac sonographers, Luna says “it was only natural that the project would have to do with making the ultrasounds better in terms of workflow and process for both clinicians and patients.”
Luna and fellow alums of the EMHI program, Oliver Tsai and Prabhdeep Dhaliwal, have developed cloud-based software that works with any ultrasound machine and applies the latest clinical guidelines to anatomical measurements taken during an echo. The software helps sonographers with the written summary of the echo that they provide to cardiologists. It saves time by sparing the sonographer from having to type out the findings of the exam.
He notes that by shaving just five minutes off the time it takes to write the report, the technology enables a sonographer to do 240 more echos per year. In jurisdictions like Manitoba, where the wait time for the test is a staggering 18 months, the improved efficiency of the report-generating process could reduce wait times by one-third.
Moreover, the software, which Luna describes as a clinical virtual assistant, processes the anatomical measurements against current clinical guidelines for echocardiograms and highlights, for example, any anatomical issues that may be of concern. “Our technology automates the report, which makes the reporting a lot faster and simpler, and makes the adherence to clinical guidelines a lot higher. As a result, the quality of the report is significantly improved,” says Luna.
Currently, there is no way to know if sonographers are working with the most up-to-date clinical echo guidelines, much less enforce their use. Luna notes that like other medical specialties, it’s hard to stay abreast of all the latest research. “When you train as a sonographer or cardiologist, there’s a massive amount of information [to learn]. You study a lot and 10 years later, you’re practicing and still using the same guidelines from 10 years ago. When new guidelines come out, you get a continuing education credit, but it’s not practical to implement into practice,” Luna says.
He emphasizes that the tool does not replace the clinician. “We are not telling the cardiologist or clinician what they should be diagnosing or what the diagnosis is,” he explains. “What we’re doing is putting the information they need at their fingertips so that they can do what clinicians do: take better images and make a diagnosis—which is what they’re good at.”
With Dhaliwal and Tsai, he is commercializing the software. They’ve named the product Augmented Reporting and have formed a corporation. Their efforts to move the technology to the medical marketplace are bolstered by seed money from the Lo Family Social Venture Fund, which will enable them to hire people to accelerate development of the tool.
Luna says that the EMHI program provided vital training to get the venture off the ground. “Julia Zarb, the program director at the time, was instrumental in encouraging me, shaping the idea, and letting me run wild with my imagination while keeping me in line with what the future stakes would need to be,” he says. “The program gave me the foundational knowledge I needed—from project management to IT fundamentals. On top of that, it connected me with my co-founder and partner, Oliver Tsai. Without him, this would not be what it is right now.”
The ultimate goal is to be able to provide this tool everywhere to enable better and more equitable cardiac care. Luna envisions the software being used in rural areas, for example, where there is less access to cardiology expertise, so that the quality of echos done in these areas is on par with that of echos done in big cities. “The hope is to have a sustainable product that can make enough profit in metropolitan areas to subsidize the areas that do not have the resources to get something like this. The idea is to have technology do what it should do for clinicians: free their time so they can do what they’re supposed to be doing—diagnosing and doing medicine. That’s my hope.”