Health Tech: Dr Art Papier On How VisualDx’s Technology Can Make An Important Impact On Our Overall Wellness
I value the grayness and ambiguity of the many decisions you must make while leading a company. Tolerating ambiguity in the workplace, particularly in our profession, allows me to work with our employees to transform complex problems into simpler solutions and compromises that work best for our company.
In recent years, Big Tech has gotten a bad rep. But of course many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing Dr. Art Papier.
Dr. Art Papier is the co-founder of VisualDx and Chief Executive Officer. A thought leader in health information technology, Dr. Papier maintains the overall vision for the VisualDx product with a keen focus on software integration and impacting costs in healthcare through clinical accuracy. His entrepreneurial drive, years of clinical experience, and passion for delivering impactful and useful healthcare solutions have propelled VisualDx clinical decision support to be the most widely used diagnostic system in healthcare.
Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?
I grew up in New York City. I worked with my hands growing up and studied art in addition to working as a carpenter and printmaker after college.
My father was a physician, and it was not in my plans to become a physician. So instead, I received a degree in studio art from Wesleyan University. From there, I had the fortune of working at the Guggenheim Museum in New York City, helping construct sculpture bases and frames and installing the artwork for each visiting show. I also worked renovating apartments in the city.
I later decided to attend Columbia University to take the required pre-med courses. I completed my pre-medical courses at Columbia and earned my M.D. from the University of Vermont’s College of Medicine in the late 80s.
Can you share the most interesting story that happened to you since you began your career?
In 2001, VisualDx co-founder Dr. Lowell Goldsmith introduced me to Dr. Donald “DA” Henderson, a renowned physician and public health expert. At our first meeting, I showed him the prototype for VisualDx, which at the time was a diagnostic tool aiding emergency physicians for patients presenting with a fever and a rash. He asked where smallpox was in our platform, and I replied that it had been eradicated. This was of course a joke played on me by Dr. Goldsmith and Dr. Henderson — who led the international efforts to eradicate smallpox and won the Presidential Medal of Freedom for that work!
About a year later, around the time of 9/11, President Bush selected Dr. Henderson to head up HHS’ Office of Public Health Emergency Preparedness. When anthrax was spread in the U.S. mail, I received a phone call from Dr. Henderson asking if our company could help the CDC develop a new website on smallpox vaccination and its adverse events. VisualDx then pivoted to working with state, county, and city health departments to evaluate patients with a fever and rash, which are big markers for bioterrorism diseases.
We had no idea when we founded VisualDx that it would become a public health informatics company, but that transformation really helped us bridge the chasm since, at the time, we were trying to offer diagnostic tools at a time when many doctors were not using computers to aid their thinking.
When the first smartphones emerged around 2008, we transitioned back to the company we initially intended to be, one that would improve decision-making in the exam room. It’s a bit ironic because people are once again interested in our ability to bring public health to the point of care as it relates to Covid-19 or monkeypox, and how this technology can help remove the siloes that exist between public health and the individual provider.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
As a first-year medical student at the University of Vermont I saw a sign for a brown bag lunch by a physician I did not know of. It turned out the talk was given by Dr. Lawrence Weed, a legend in medicine in the late ’60s and early ’70s for creating the problem-oriented medical record and the SOAP note format. the creator of the problem-oriented medical record and the SOAP note format (a legend in medicine in the late ’60s and early ‘70s).
At the seminar he talked about how you can’t memorize everything in medicine, how medical practice lacked precision and thoroughness, and why the patient needs to be involved in their own health decisions. He was talking about participatory medicine before there was a name for it. Many of my classmates thought he was arrogant and didn’t believe in his core assertions, but I found him to be inspiring and honest about the problems we faced then and continue to face now. I approached him after the talk and he invited me to his office to learn more.
I ended up volunteering for Dr. Weed for four years as a medical student. That lunch and his mentorship really activated the idea that we need information and knowledge at the point of care, and that tools are necessary in the exam room to augment the physician’s (or other advanced practitioner’s) expertise and experience.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
To be honest, I don’t have a favorite life lesson quote I keep coming back to as a source of inspiration. Ironic and sardonic quotes feel more relevant to today’s issues and seem to be the ones that stick with me most — perhaps that’s just my nature. For example, Albert Einstein quipped that, “Three great forces rule the world: stupidity, fear and greed.” Not exactly uplifting, but it speaks to the reality of the world we live in right now. I’m just not the kind of leader that has aspirational ‘climb mountain’ quotes on my desk. To me, good leaders need to be honest about what is going on more broadly in the world.
You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
- I value the grayness and ambiguity of the many decisions you must make while leading a company. Tolerating ambiguity in the workplace, particularly in our profession, allows me to work with our employees to transform complex problems into simpler solutions and compromises that work best for our company.
- Believing in the forest view and always being interested in the big picture rather than all the details. And knowing this about myself, I attribute my success to surrounding myself with driven, detail-oriented employees, allowing me to bring together various opinions and diverse perspectives to see the big picture — the forest. I enjoy working with people with different personalities, abilities, and points of view from myself, which makes for better conversation and ensures that we solve problems together by looking at the entire spectrum.
- A willingness to challenge myself and never settle for comfort. Surrounding myself with people who challenge me and my thinking has helped me grow personally and as a leader, coaching and mentoring employees and students. No matter how uncomfortable it can be, constantly challenging myself has helped me get to where VisualDx and I are today.
Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?
VisualDx helps reduce diagnostic error and solve complex decision problems that all clinicians, educators, and patients face in the exam room, classroom, or at home. Evidence suggests that 18 million diagnostic errors occur yearly in the United States and cost the healthcare industry $1.6 billion annually in malpractice payments.
We focus on skin-related problems and infectious disease in particular, but now with our new Chief Medical Officer, JT Finnell MD, an emergency physician, we are expanding VisualDx to cover the full spectrum of disease. Many rheumatologic, allergic, immunologic, metabolic, environmental, drug reactions, and other diseases present visually and are easily missed or misdiagnosed. People see patterns and prefer images and graphics; therefore, physicians of all specialties — general practitioners, dermatologists, emergency physicians, etc. — require adequate training and assisting tools to improve pattern recognition and spot subtle variations of disease to enhance diagnostic accuracy and provide quality care and treatment.
Another area of medicine that physicians require assistance in is public health support, such as diagnosing and treating Covid-19 and Monkeypox as timely examples. It’s unreasonable to think physicians can prepare to treat novel viruses or outbreaks of rare infectious diseases they may have never encountered in clinical settings.
Our company is similarly committed to empowering patients in their care journey. Patients are not medical experts and face uphill battles in navigating the complexities of healthcare on their own. For example, when patients develop symptoms like a rash, they lack expert guidance and often consult the internet or “Dr. Google” to self-diagnose themselves.
As a dermatologist, I have seen first-hand how this is all problematic. Our industry expects too much of physicians and patients, who need access to technology that better informs decision-making and our understanding of the diagnosis to improve outcomes, treatment adherence, and lower the cost of care.
How do you think your technology can address this?
Traditional digital health applications are used with the expectation that the doctor already knows what the patient has. VisualDx is unique because we are physician-founded and led, allowing us to design technology with the clinician and patient at the center. As such, we’ve built technology that effectively guides and teaches the end-user throughout the diagnostic journey. After 20 years, we’re the most widely used diagnostic support tool, which has grown to cover over 3,400 diagnoses and 45,000 professional medical images.
Physicians can harness the unique power of visualization with our technology and build differential diagnoses on a patient by starting with symptoms and background (age, gender, allergies, travel history, etc.). In addition, the output grants access to specialist knowledge and visual aids that physicians can reference to facilitate logical clinical reasoning to improve diagnostic accuracy and patient engagement at the point of care.
It’s unreasonable to expect physicians to memorize all of medicine, and we have been diligent in expanding our platform to cover all infectious diseases and other issues like drug reactions. Monkeypox, for instance, is not a common disease that U.S. providers have experience treating. That’s where VisualDx comes in. We are responsive to public health needs and incorporate relevant information, history, and imagery on diseases like monkeypox to aid frontline clinicians in diagnosis or treatment.
Visualization also strengthens the patient-provider relationship by building patient trust, confidence, and alleviating anxiety that a patient may have about their diagnosis. By referencing images or providing handouts, physicians can walk patients through their diagnosis and inform them about their treatment to improve adherence.
Our consumer-facing application, Aysa, similarly helps patients analyze skin conditions and receive information that guides them to make informed decisions on when and where to seek care. Of course, information on the internet isn’t always helpful, but this is one example of a powerful resource that patients can use to stay in control of their healthcare.
Can you tell us the backstory about what inspired you to originally feel passionate about this cause?
I mentioned earlier that I had the good fortune to meet Dr. Lawrence Weed, a legend in medicine during the late ’60s and early ’70s, whom I worked closely with for many years. I fully credit him for VisualDx as our company is derivative of Dr. Weed’s ideas, many of which were long before his time and are now standard practice.
Another experience that inspired me was practicing medicine in rural areas. I saw first-hand how challenging it is for primary care physicians to know all of medicine (and are expected to). I witnessed frequent diagnostic errors because the healthcare system expects too much of our physicians. My passion for medical informatics grew, and I believed that technology would provide physicians with virtual second opinions to overcome these errors.
How do you think this might change the world?
The world needs a medical map where information for physicians and patients is easily accessible and reproducible to enhance our rapid understanding and decision-making.
Medical education and standard medical practice have long consisted of a memory-based paradigm that requires physicians to act purely on memorization. Unfortunately, these expectations are unrealistic and quite dangerous. We can transform healthcare globally if we transition to a memory-assisted paradigm and provide access to tools that visualize conditions and break complex information down to make it easier and more practical for clinicians.
In aviation, for example, pilots are trained in simulators that resemble the cockpit of a 737 Boeing. Pilots create checklists of reproducible tasks and apply their skills from working on similar instruments from the simulator to flying a real Boeing 737.
VisualDx is changing the world by creating the cockpit of medicine.
One unintended consequence is over-reliance on technology and mistakenly believing these tools are 100% accurate. Technology isn’t a panacea to fix all medicine, and it becomes even more problematic when physicians expect technology to make decisions for them. Over-reliance on technology increases the likelihood of poor, uniformed choices that result in diagnostic error, patient harm, or even worse, both. Instead, technology is incredibly powerful if physicians use it properly as a guidance system to augment their intelligence and clinical reasoning, not replace it.
Amid the hype around artificial intelligence and machine learning in healthcare, the industry must be wary of overpromising AI/ML capabilities. For example, if the data sets training the algorithms comprise mainly of one population, the model won’t be nearly as effective or accurate in treating other populations. Far too often, the data sets used to train these tools significantly lack representative data or images of darker skin, resulting in biases that lead to worse care decisions and outcomes for patients with pigmented skin.
In my area of dermatology and VisualDx’s focus on skin conditions, this is an issue we are continuing to overcome and solve. We have built medicine’s most extensive and equitable image library over the last 20 years. Our diverse image collection ensures that our machine learning is representative and equitable to all populations.
Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”? (Please share a story or an example, for each.)
- Understand your end-user.
- Understand the environment of the end-user.
- Understand how to share and disseminate your technology.
- Understand how to market your ideas.
- Understand how to leverage network effects.
If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?
Find your purpose and a career that aligns with your values to truly drive meaning in your work every day, whether that’s to improve health, wellbeing, or the environment. That’s where success will come.
Is there a person in the world, or in the U.S. with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. 🙂
Bill Gates. He is a humanist using his great wealth to have a real impact on the world. He focuses on the greater good of improving our environment, public and global health.
How can our readers further follow your work online?
Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.
Health Tech: Dr Art Papier On How VisualDx’s Technology Can Make An Important Impact On Our Overall… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.