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<h4 style="text-align: center;"><strong>Reunión con el Experto</strong></h4><h4 style="text-align: center;"><strong>Inteligencia Artificial, del concepto a la clínica</strong></h4><p>Como continuación a las cinco primeras reuniones, se ha realizado la sexta de las “<strong>Reuniones con el Experto</strong>” del <a href="http://www.agoraceg.org/system/files/folleto_foro_sanidad_2017.pdf" target="_blank">Foro Excelencia en Sanidad</a>. En esta ocasión nos acompañó Dr. <strong>Ignacio Hernández Medrano</strong>, Socio fundador de Savana Médica, neurólogo, empresario, divulgador y un experto en "Big Data”, concretamente en el sector sanitario. </p><p style="font-size: 12.8px; text-align: center;"><img alt="" class="imagecache-original_scale_600px" src="/sites/default/files/migrated/imagecache/original_scale_600px/foto_1_v2_0.jpg"></p><p style="font-size: 12.8px;">En estas reuniones se quiere compartir de forma concentrada la experiencia de un experto en una material específica, que ayude a los miembros del Foro Excelencia en Sanidad a profundizar en la mejora continua en sus organizaciones.</p><p style="font-size: 12.8px; text-align: center;"><img alt="" class="imagecache-original_scale_600px" src="/sites/default/files/migrated/imagecache/original_scale_600px/49248b73-161b-4173-b9f6-31aec68b1cfd.jpg"></p><p style="font-size: 12.8px;">Como es habitual, la sesión se ha realizado en dos formatos a la vez, de forma presencial en esta ocasión en Madrid:</p><p style="font-size: 12.8px; text-align: center;"><img alt="" class="imagecache-original_scale_600px" src="/sites/default/files/migrated/imagecache/original_scale_600px/4182111b-8794-4923-8a29-d6ef9adb8a60.jpg"></p><p style="font-size: 12.8px;">y de forma virtual en conexión en videostreaming:</p><p style="font-size: 12.8px; text-align: center;"><img alt="" class="imagecache-original_scale_600px" src="/sites/default/files/migrated/imagecache/original_scale_600px/20190327_093719_3.jpg"></p><p style="font-size: 12.8px; text-align: center;"><img alt="" class="imagecache-original_scale_600px" src="/sites/default/files/migrated/imagecache/original_scale_600px/hp_2.jpg"></p><p style="font-size: 12.8px;">Tras la intervención del ponente se ha abierto un diálogo entre los participantes en formato presencial y los participantes en virtual, del que realizamos el siguiente resumen:</p><p style="margin-top:0cm;margin-right:0cm;margin-bottom:12.0pt;margin-left:\r\n
0cm"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif;\r\n
color:#555555">Pregunta</span></strong><span style="font-size:10.0pt;\r\n
font-family:"Arial",sans-serif;color:#555555">: ¿Informática o cirugía, quien tiene más futuro?<o:p></o:p></span></p><p style="margin-top:0cm;margin-right:0cm;margin-bottom:12.0pt;margin-left:\r\n
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text-decoration-color: initial;word-spacing:0px"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#555555">Respuesta</span></strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#555555">: Un profesor de IA comentaba que “En sanidad, lo fácil es lo difícil, y lo difícil es lo fácil”. Hay niveles bajos de complejidad para cirugía (un apendicitis) pero que son de alta complejidad para una máquina. A los humanos nos gusta el ritual. Los médicos deberán aliarse con los analistas de datos.<o:p></o:p></span></p><p style="margin-top:0cm;margin-right:0cm;margin-bottom:12.0pt;margin-left:\r\n
0cm"> </p><p style="margin-top:0cm;margin-right:0cm;margin-bottom:12.0pt;margin-left:\r\n
0cm"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif;\r\n
color:#555555">Pregunta</span></strong><span style="font-size:10.0pt;\r\n
font-family:"Arial",sans-serif;color:#555555">: ¿Cómo va a cambiarnos la vida?<o:p></o:p></span></p><p style="margin-top:0cm;margin-right:0cm;margin-bottom:12.0pt;margin-left:\r\n
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text-decoration-color: initial;word-spacing:0px"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#555555">Respuesta</span></strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#555555">: La respuesta está en una pregunta ¿Qué tipo de sistema sanitario queremos?. Probablemente habrá una sanidad a dos niveles, los “pobres” con pocos humanos y los “ricos” disponiendo de un coach.</span></p><p style="margin-top:0cm;margin-right:0cm;margin-bottom:12.0pt;margin-left:\r\n
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text-decoration-color: initial;word-spacing:0px"><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#555555"><o:p></o:p></span></p><p><strong>Pregunta</strong>: ¿Hay ejemplos de inteligencia artificial para análisis de condiciones socioeconómicas y socioculturales, en tanto en cuanto, son determinantes de la salud en cantidad y calidad?</p><p><strong>Respuesta</strong>: Tenemos a veces la tentación de poner muchas capas de datos…. Y esto es peligroso ya que podemos caer en una parálisis por el análisis. Esto se aplica en el “socialoma”… trabajemos con lo que tengamos hoy. Hay que ser pragmático.</p><p><strong>Pregunta</strong>: ¿Cómo nos protegemos y protegeremos las “cajas negras” de los riesgos asociados frente a un entorno de riesgos de ciberseguridad?</p><p><strong>Respuesta</strong>: Es un gran tema la ciberseguridad y hackeo… es poco inevitable e inherente. Debemos tender a sistemas de privacidad por diseño. Hay técnicas y estrategias. Es importante conceptualizar que el peligro está. Tomar las medidas, aunque no será infalibles.</p><p><strong>Pregunta</strong>: ¿Cuáles son los principales frenos para la creación de un “Banco genómico” en España a un nivel comparable a los más desarrollados?</p><p><strong>Respuesta</strong>: El freno son las autonomías</p><p><strong>Pregunta: </strong>¿Cuándo se ponga una denuncia contra el médico que no haya consultado a la caja negra y al algoritmo… habrá gente que querrá quitar al médico y otros al algoritmo?</p><p>Hay médicos muy reaccionarios… cuando empiece esta transformación… ¿cómo va a ser esta transformación? ¿Por ejemplo un adjunto en radiología? ¿En que nos transformaremos? ¿Cómo evolucionarán los centros?</p><p><strong>Respuesta</strong>: Los Centros serán lugares de cuidados e interacción (lo físico), no de conocimiento (lo no físico).</p><p>El Clínico, el radiólogo utiliza desde hace tiempo herramientas, creo que con ello podrán hacer mejor su trabajo.</p><p>Recordemos que en el nacimiento del Termómetro… los médicos dijeron que era un instrumento absurdo… ya que la sensibilidad de su mano era mucho más eficaz.</p><p><strong>Pregunta:</strong> ¿Pero vamos a necesitar los mismos radiólogos?</p><p><strong>Respuesta</strong>: Efectivamente, vamos a necesitar menor número de expertos.</p><p>Parece cienciaficción, pero es el día a día, hace ya un par de años, que se está aplicando en algunas UVIs el reconocimiento facial para saber si los pacientes tienen dolor. Reconocimiento facial para la medición del dolor</p><p>En las Mamografía con la máquina está el tema superado.</p><p><strong>Pregunta:</strong> ¿Qué le dirías a los estudiantes? ¿Hay competencias directivas que influyen decisivamente? ¿Qué les dirías a los directivos y gerentes de un hospital en este aspecto… que tienen que generarse un cambio en la gestión?</p><p><strong>Respuesta</strong>: El caso de UK es un buen ejemplo (aceleradora de 200 startups, base de datos abierta, clínicos integrados en el desarrollo…)</p><p><strong>Pregunta:</strong> ¿Qué formación debemos dar a los médicos, si el ámbito de la IA está avanzando… un sistema me va a superar… los estamos preparando bien (médicos y enfermeras)?</p><p><strong>Respuesta</strong>: Durante una temporada larga, seguiremos necesitando a los cirujanos… habrá un tiempo de transición. Cada vez las olas son más rápidas. El QUÉ pero no el CÓMO y el PORQUÉ… que podría haber pasado… el Machine Learning es muy bueno en lo frecuente… no en lo que está en el lateral, el poner en el contexto. Seguramente en la “humanización” la máquina no tendrá acceso. Las máquinas pueden tomar decisiones, pero no pueden juzgar ya que no tienen conciencia. De las máquinas me fío, pero de los humanos confío.</p><p>Quedaron por contestar algunas preguntas en el chat, que el <span style="color: rgb(85, 85, 85); font-family: arial; font-size: 13px; background-color: rgb(255, 255, 255);">Dr. </span><strong style="color: rgb(85, 85, 85); font-family: arial; font-size: 13px; background-color: rgb(255, 255, 255);">Ignacio Hernández Medrano </strong>nos ha contestado amablemente vía email y adjuntamos a continuación:</p><p><strong style="background-color: rgb(255, 255, 255);">Pregunta:</strong><span style="background-color: rgb(255, 255, 255);"> ¿</span>Los algoritmos son funciones matemáticas que remandan los fenómenos biológicos y el análisis te indica las variables de esas funciones?</p><p><strong style="background-color: rgb(255, 255, 255);">Respuesta</strong><span style="background-color: rgb(255, 255, 255);">: </span>Me parece una definición bastante correcta. Tratamos de modelizar cómo se comporta la Biología, en base a los casos previos, para anticipar lo que ocurrirá a cada individuo. Ese modelo se basa en variables y su peso.</p><p><strong style="background-color: rgb(255, 255, 255);">Pregunta:</strong><span style="background-color: rgb(255, 255, 255);"> </span>¿Cómo de “fácil” o “difícil” es montar este modelo SAVANA en un ámbito hospitalario con una historia clínica propia?</p><p><strong style="background-color: rgb(255, 255, 255);">Respuesta</strong><span style="background-color: rgb(255, 255, 255);">: </span>Es extremadamente fácil. Disponemos de un sistema que lee "texto plano", por lo que se hace completamente independiente del sistema de HC que se esté usando. Nuestro equipo hace un análisis encaminado a adaptarse al centro, para que éste no tenga que cambiar nada.</p><p><strong style="background-color: rgb(255, 255, 255);">Pregunta:</strong><span style="background-color: rgb(255, 255, 255);"> </span>¿Cómo hacer realidad la IA en un hospital? ¿Hay que buscar a los proveedores de estas app para “COMPRAR SUS SERVICIOS"? ¿Cuál es tu experiencia con servicios públicos de salud en España?</p><p><strong style="background-color: rgb(255, 255, 255);">Respuesta</strong><span style="background-color: rgb(255, 255, 255);">: </span>La clave está en unirse a los "data scientist", que son las personas que recogen nuestros datos + pregunta clínica y montan el modelo para que posteriormente podamos validarlo.</p><p>Estos “data scientist” se encuentran en instituciones públicas y privadas, académicas y empresariales... hay en realidad muchas opciones. Sí hay que tener en cuenta que las empresas (y más son pequeñas) son las más ágiles a la hora de dar una respuesta eficaz. En mi experiencia, la mejor forma de llegar a un resultado es contratarla, aprovechando los programas de "investigación independiente promovida por el investigador" que financian las empresas farmacéuticas.</p><p>También puede ocurrir que un algoritmo de este tipo interese a un gestor, en tanto mejore el proceso asistencial en eficiencia (ej: algoritmo que predice qué pacientes NO van a beneficiarse de un fármaco biológico de alto precio).</p><p>Y el ponente ha acabado con una frase final:</p><h5 style="text-align: center;"><strong>Si son capaces de encontrar un solo caso de un directivo en Sanidad que haya apostado por la tecnología y haya perdido… me lo dicen.</strong></h5><p style="font-size: 12.8px;"> </p><p style="font-size: 12.8px;">El coordinador del Foro Excelencia en Sanidad, Dr. Alberto Pardo, ha anunciado la nueva Reunión con el Experto, que se realizará presencialmente en Barcelona y virtualmente el próximo 7 de mayo de 2019: <a href="http://www.agoraceg.org/event/reunion-con-el-experto-cambio-climatico-impacto-en-la-gestion-sanitaria" target="_blank">aquí</a> </p><p style="font-size: 12.8px;"> </p><p style="margin-bottom: 10px; margin-left: 80px; font-size: 12.8px; text-align: justify; color: rgb(51, 51, 51);"><strong>Documentos adjuntos disponibles:</strong></p><ul style="margin-left: 0px; font-size: 12.8px;"><li style="margin-bottom: 10px; padding-left: 11px; line-height: 19.2px; background: transparent; list-style: none; text-align: justify; color: rgb(51, 51, 51);"><p style="margin-left: 80px;"><strong>- Presentación</strong> de la ponencia.</p></li><li style="margin-bottom: 10px; padding-left: 11px; line-height: 19.2px; background: transparent; list-style: none; text-align: justify; color: rgb(51, 51, 51);"><p style="margin-left: 80px;"> </p></li></ul><p style="font-size: 12.8px;">Agradecemos a <a href="https://www.savanamed.com/" target="_blank"><img alt="" class="imagecache-Small" src="/sites/default/files/migrated/imagecache/Small/logo_savana_0.jpg"></a>, colaborador del <a href="http://www.clubexcelencia.org" target="_blank">Club Excelencia en Gestión</a>, compartir esta documentación.</p>
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<h4 style="margin-top: 0px; margin-bottom: 8px; font-size: 18px; color: rgb(153, 153, 153); background-color: rgb(255, 255, 255); text-align: center;"><span style="color:#696969;"><strong>Reunión con el Experto</strong></span></h4><h4 style="text-align: center;"><strong>Inteligencia Artificial, del concepto a la clínica</strong></h4><p style="text-align: center;"><img alt="" class="imagecache-Small" src="/sites/default/files/migrated/imagecache/Small/logo_foro_excelencia_en_sanidad_2017_19.jpg"> </p><h5 style="margin-left: 35.4pt;">¿Cuál es el potencial impacto de las tecnologías exponenciales y de la inteligencia artificial en la salud digital?</h5><h5 style="margin-left: 35.4pt;">¿Cuál será el papel del Big Data y su impacto en los estudios de secuenciación del genoma y, por ende, en la medicina de precisión o medicina personalizada?</h5><p style="margin-left: 35.4pt; text-align: center;"><img alt="" class="imagecache-original_scale_600px" src="/sites/default/files/migrated/imagecache/original_scale_600px/foto_1_v2.jpg"><!--break--></p><p style="margin-left:35.4pt;">Cómo continuación a las cinco primeras Reuniones con el Experto, hemos planificado la sexta de las “<strong>Reuniones con el Experto</strong>” del Foro Excelencia en Sanidad. En esta ocasión nos acompañará un renombrado experto en "<em>big data</em> en Salud ", el Dr. <strong>Ignacio Hernández Medrano, </strong>neurólogo, empresario y divulgador.</p><p style="margin-left: 35.4pt; text-align: center;"><img alt="" class="imagecache-original_scale_600px" src="/sites/default/files/migrated/imagecache/original_scale_600px/medrano.jpg"></p><p style="margin-left:35.4pt;">El desarrollo de la inteligencia artificial permite avanzar en diferentes aspectos clave de la medicina con el objetivo de seleccionar el tratamiento más adecuado e individualizado para cada paciente. La incorporación de herramientas Big Data provocará un cambio de paradigma en el abordaje diagnóstico, de monitorización y de pronóstico de las enfermedades a la vez que ya permite que las computadoras aprendan patrones gracias a una técnica llamada 'Machine Learning' o aprendizaje automático que trastoca las estadísticas clásicas. Donde la mente humana no puede llegar, sí que podemos permitirnos el diseño de algoritmos predictivos que, basados en la inteligencia artificial, pueden alterar en un futuro próximo la atención sanitaria, permitiendo la medicina de precisión.</p><p style="margin-left: 35.4pt; text-align: center;"> </p><h5 style="margin-left: 35.4pt; text-align: center;"><u><strong>Programa e Inscripciones</strong></u>: <strong><a href="http://microsites.clubexcelencia.org/inteligencia_artificial" target="_blank">aquí</a></strong></h5><h5 style="margin-left: 35.4pt; text-align: center;"><u><strong>Para conectarse en directo</strong></u>: <strong><a href="https://youtu.be/i-vgsHlfIls" target="_blank">aquí</a></strong></h5><p style="margin-top:0cm;margin-right:0cm;margin-bottom:12.0pt;margin-left:\r\n
35.4pt;background:white"><span style="font-size:9.5pt;font-family:"Arial",sans-serif;\r\n
color:#555555;background:white">Como ya es habitual en este tipo de actividad, los socios del Club Excelencia en Gestión, podrán participar en dos formatos:</span></p><p style="margin: 0cm 0cm 12pt 80px; background: white;"><span style="font-size:9.5pt;font-family:"Arial",sans-serif;\r\n
color:#555555;background:white">- <strong><span style="font-family:"Arial",sans-serif">presencialmente</span></strong>, en esta ocasión acercándote al Salón de Actos de Ilunion – Madrid, </span></p><p style="margin: 0cm 0cm 12pt 80px; background: white;"><span style="font-size:9.5pt;font-family:"Arial",sans-serif;\r\n
color:#555555;background:white"><span style="font-family:"Arial",sans-serif">-</span><span style="font-family:"Arial",sans-serif"> </span><strong><span style="font-family:"Arial",sans-serif">virtualmente</span></strong>, a través de videoconferencia (en la propia sede del Club Excelencia en Gestión en Barcelona Via laietana, 39, donde hemos reservado una sala en la tercera planta, o tu propia oficina, te enviaremos un enlace Webex). </span></p><p style="margin: 0cm 0cm 12pt 80px; background: white; text-align: center;"><span style="font-size:9.5pt;font-family:"Arial",sans-serif;\r\n
color:#555555;background:white"><o:p></o:p></span><span style="text-align: center;">Con la colaboración de: </span><img alt="" class="imagecache-Small" src="/sites/default/files/migrated/imagecache/Small/savana_medica.png" style="text-align: center;"></p>
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