VisualDx's Art Papier, Nada Elbuluk Discuss How Health IT Can Reduce Cognitive Bias, Racial Disparities in Healthcare

October 21, 2020
Briana Contreras
Briana Contreras

This week, Briana Contreras of Managed Healthcare Executive spoke with Doctors Art Papier and Nada Elbuluk of VisualDx. Art is a practicing dermatologist and associate professor of dermatology and medical informatics at University of Rochester, as well as the CEO of VisualDx. Nada is also a dermatologist in Los Angeles and she is Director of Clinical Impact for VisualDx. The three discussed how providers can leverage health IT to reduce cognitive bias and racial disparities in healthcare.

According to Art Papier, practicing dermatologist and associate professor of dermatology and medical informatics at University of Rochester, and CEO of VisualDx, racial bias is a part of a broader area of cognitive bias that, unfortunately, many clinicians unconsciously make poor decisions based on.

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There are a lot of biases that can come into play in healthcare like gender or racial, but the field of medical bias is much broader than just those two, he says.

However, Nada Elbuluk, dermatologist in Los Angeles and she is Director of Clinical Impact for VisualDx, says there's lots of racial biases in medicine across the board.

"We know that healthcare disparities exist, particularly for people of color in the United States," Nada says. "And within dermatology, specifically, there are biases which can occur due to just differences in how disease presents in different skin color, and that's where VisualDx is really working to have a very impactful role."

For example, the way a common disease may look in a lighter skin color can be very different than a darker skin color. If a clinician hasn't been trained to see that particular disease in darker skin type, they may miss diagnose it or under treat. Elbuluk says this can lead to many consequences downstream from not having that appropriate training.

In response, VisualDx is a platform that has thousands and thousands of images that have been collected over decades, which can help healthcare providers in avoiding these biases by allowing physicians to see a wide range of diseases and a wide range of skin types. This software, or something similar, would benefit physicians who haven't been trained on the specific disease or practiced in that area.

VisualDx provides software that can help providers diagnose common diseases, as well as emerging infectious diseases. Papier says it's a software that can help providers overcome cognitive bias or racial biases.

"So in terms of an overcoming cognitive bias, there's two ways we think one is fast, which is through pattern recognition," he says. "And the other is slow through analytical thinking. What the platform does, it provides to the user the ability to get help with both pattern recognition and analytical thinking. Rather than just searching by diagnosis, in VisualDx, you can quickly enter the patient factors. Or if you're in the electronic health record, information such as age and gender, and the problem less than the med list can come over from the EHR."

He says, specifically, with diagnosis and people of color, there's an important point around artificial intelligence.

Within their software, they have collected over 20 years worth of data and images around the world, sharing photos of diseases on all skin colors that can then be determined through patient imagery in their artificial intelligence machine learning algorithms, he says.

"So both from the AI perspective, but also from the patient engagement perspective, (software like) VisualDx can be used right in that exam room, and a really important point is educating patients."

Nada believes the patient engagement component is "really significant, because it has positive downstream consequences for improving relationships between the patient and physician. (This) can translate into increased patient compliance and trust between the physician and provider, which ultimately leads to improved healthcare outcomes, which is really the ultimate goal that we all want in medicine. So it seems like maybe a small feature, but it actually is really powerful."