The state of Virginia had phenomenal leadership and vision. They didn’t just talk about interoperability that could move data from A to B. They’re goal was real coordination. It’s called the EDCC — Emergency Department Care Coordination — initiative because it starts in the emergency department, the front door of the healthcare continuum for so many vulnerable patients. Virginia is seeking to instantiate workflow broadly out into the rest of the community. Not just through interoperability, but by actually prompting coordinated sequences of engagement of various providers across specific patient archetypes to drive resolution.
The company has an intriguing startup story. Fifteen years ago, one of the founders’ mother, Patti Green, was an emergency department social worker in Boise, Idaho, and suspected that some patients were opioid seekers. She set up a rudimentary collaborative care plan for providers to use to identify and help these patients. “It is easy for us now to talk about the opioid epidemic. Nobody was really talking about it 15 years ago, but she was seeing it on the ground,” says Chris Klomp, Collective’s CEO, “and she did something about it.”
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Still, Marion noted, even the concept of AI, as applied to imaging informatics, remains an area with some areas lacking in clarity. “The reality, he said, “is that I think it means different things to different people. The difference between last year and this year is that some things are coming to fruition; it’s more real. And so some vendors are offering viable solutions. The message I’m hearing from vendors this year is, I have this platform, and if a third party wants to develop an application or I develop an application, or even an academic institution develops a solution, I can run it on my platform. They’re trying to become as vendor-agnostic as possible.”
As a young adult, I was in a very serious car accident. I broke a lot of bones — my second vertebrae, my neck, ribs, a compound fracture in my leg... It’s a miracle I’m not a quadriplegic. I was on a respirator and couldn’t breathe because there was fluid between my lung and ribcage. I couldn’t move because I had this thing holding up my head. A nurse around every few hours to help me cough so I wouldn’t get pneumonia. Eventually after getting off the respirator, one nurse came around and he mentioned cannabis. He said, “Did you know cannabis does the same type of thing to your lungs? It’s a bronchial dilator. The drug I’m pumping into your lungs is a bronchial dilator.” From that point on I realized I had a choice. I never took another pain pill. I just used cannabis for the next eleven months to recover. I always loved cannabis, but now I had an even more personal connection to the plant.
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Google, Facebook and Twitter all have advertising policies that restrict the promotion of the sale of cannabis. Google’s policy prohibits ads that promote “substances that alter mental state for the purpose of recreation.” Facebook restricts any “illegal, prescription, or recreational drugs.” And Twitter bans “illegal drugs” as well as substances that cause “legal highs.” Instagram and Facebook have decided to go a step further by removing pages of cannabis related businesses.
Of course, inevitably, there was talk around the talk of the hype cycle involving artificial intelligence. One of those engaging in that discussion was Paul Chang, M.D.., a practicing radiologist and medical director of enterprise imaging at the University of Chicago. Dr. Chang gave a presentation on Tuesday about AI. According a report by Michael Walter in Radiology Business, Dr. Chang said, “AI is not new or spooky. It’s been around for decades. So why the hype?” He described computer-aided detection (CAD) as a form of artificial intelligence, one that radiologists have been making use of for years.
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Collective Medical currently has relationships with each US national health plan and hundreds of hospitals and health systems, according to a statement. There are 13 states currently on Collective's network, with plans to add another 10 states scheduled for 2018. In August, the company was featured for the first time on Inc. Magazine’s Inc 5,000 list of fastest growing companies in America, with $5.8 million in 2016 revenue and 561 percent growth over the last three years.

Similar results have been experienced across the country. “Collective Medical has been an integral part of our hospital system’s efforts to coordinate care for patients with complex needs,” says Dr. Maria Raven, MPH, MSc, a practicing emergency medicine physician and health services researcher and an associate professor of emergency medicine at UCSF. “With our partnership, we’re collaborating on our at-risk patients’ social determinants as well as curbing the opioid epidemic.”

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Both sides of the argument were present during the discussion as members of the public took to the dais. Law officials rebuked the statement made by pro-cannabis – that by allowing legal marijuana, the black market would disappear – arguing that the imposed taxes would raise costs significantly and drive those who could not afford legal cannabis back to the black market. However, they provided no counters to any claims made by the medical marijuana community which consisted of relief for symptoms of cancer, physical pain, anxiety, and insomnia to name a few. It is perhaps, the driving reason behind the City Council’s move to revisit the total ban.

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“Certainly, this is another year where machine learning is absolutely dominating the conversation,” said James Whitfill, M.D., CMO at Innovation Care Partners in Scottsdale, Ariz., on Monday. “In radiology, we continue to be aware of how the hype of machine learning is giving way to the reality; that it’s not a wholesale replacement of physicians. There have already been tremendous advances in, for example, interpreting chest x-rays; some of the work that Stanford’s done. They’ve got algorithms that can diagnose 15 different pathological findings. So there is true material advancement taking place.”
Baumgartner’s relationship with cannabis started in her teens, around the same time she was diagnosed with anxiety. Refusing to take pills to deal with her nerves, she took on a move natural approach that included surfing and smoking weed. “My Italian-Catholic mother was horrified,” Baumgartner joked, but clearly her system worked. Now, at age 49, she’s staying ahead of her anxiety in a similar way, with smoking, surfing, meditation and eating right, she’s able to live a successful and productive life.
“We’re dedicated to supporting our 100 member hospitals and health systems as they improve the quality and safety of patient care,” says Thornton Kirby, FACHE, President and CEO of SCHA. “Our partnership with Collective is a testament to that dedication. The solution has been supporting the integration of behavioral and physical health in states like Washington, Oregon and California for several years and we’re excited to see how it can impact patient outcomes in South Carolina.”
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Mitigating the opioid epidemic is a single but timely demonstration of the power of the Collective Medical network. Using the company’s partnership with Washington State as an example, care team collaboration and coordination through Collective Medical has reduced opioid prescriptions coming out of the ED by 24 percent since the program’s inception.
Collective Medical is a Salt Lake City-based developer of collaboration software. I started working on the company with two of my best friends from Boise, Idaho. We grew up together and we all went to Brigham Young University together. Two of us studied computer science and I was the token business guy. I went off to Bain & Company and then Bain Capital for roughly a decade.
In three months, he and his roommate van den Akker, also a computer science student, delivered a web-based application. It included documentation, such as demographics, social determinants, medical history highlights, ER visits and treatment plan. “We tried to minimize the effort hospitals had to expend,” says van den Akker. “If you go after a big data ask, you get pushback.” Still, St. Luke’s didn’t purchase the software. “Hospitals didn’t want to take a bet on two kids in college with no experience in healthcare,” says Green.
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One of the ex-ganja peddlers from Fateh Nagar said, `the area is under complete surveillance and many have left such illegal businesses in the locality. However, few of the peddlers continue to sell ganja as they own a vehicle which helps them deliver the drug at a different and preferably safe spot in the city. ``The buyers have the contact details and everything is planned over a phone call”, he said. 
As of January 1st, medical and recreational (adult use) marijuana became legal in the state of California. Per the Prop 64 measure, adults over the age of 21 can now consume, purchase, possess, and grow cannabis without the fear of prosecution so long as they are within the regulation of the new law… and in accordance with any other policies put in place by the city in which they reside.
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