Reetam Ganguli once pitched his technology, to rescue women from pregnancy complications, in an airplane bathroom. He often works all night, when other recent college graduates are partying. And he sometimes goes weeks without seeing his girlfriend — or any friend at all.
But in the midst of his sacrifices, things are looking up.
Ganguli’s story as a startup founder is the centerpiece of a new documentary from the makers of “To Err is Human,” a 2018 film about patient safety that followed a 1999 landmark report of the same title by the National Institute of Medicine. The sequel, titled “The Pitch,” spotlights how a new generation of technology stands to improve patient safety in the United States — that is, if young entrepreneurs like Ganguli can get an audience with the physicians, insurers, and executives who are the health care system’s gatekeepers.
“That’s what your entire ability to help patients hinges on — just someone happening to be slightly interested in you,” Ganguli told STAT.
In the film, set to debut this week, Ganguli, a 23-year-old Brown University graduate, is the picture of a pitchman. He thinks and talks fast. He speaks from his heart. He tells the camera, and anyone who will listen, that applying machine learning to huge amounts of patient data can detect problems that human caregivers sometimes miss. Failing to leverage the technology, he says, is a missed opportunity to help patients, including expectant mothers.
“Your Instagram algorithm to recommend ads is more advanced than what doctors use to understand if you’re likely to die or not,” Ganguli says in the film, referring to current methods to warn of potential pregnancy complications. “We’re allowing our doctors to use these systems from the 1970s and manually calculate it for moms at risk.”
His argument — that medicine should embrace, not resist — the potential of rapidly advancing technology is ping-ponging across health care on a daily basis. The question sits in the subtext of almost every transaction. Why is getting quality health care, and navigating the industry’s bureaucracy, so much harder than doing everything else in American commerce? Why can’t health care companies use AI and novel software to be faster, better, and more convenient?
The debate, explored in the film, is much more nuanced than a clash between tech bros and clinicians, or evidenced-based medicine versus the move-fast-and-break-things ethos of Silicon Valley. It also extends beyond Ganguli’s own story, to many clinicians in the documentary who themselves are taking up advancing technologies, such as virtual reality and genomic sequencing, to root out hospital-acquired infections and make surgeries safer.
Its director, Mike Eisenberg — son of the late John Eisenberg, former director of the Agency for Heathcare Research and Quality — said he wanted to follow his father’s example by highlighting opportunities to improve patient safety, rather than emphasizing its intractability as a problem. About one in four patients admitted to a hospital in the U.S. suffers from a medical error. And care of pregnant women is particularly abysmal, with 23.8 deaths for every 100,000 live births — the worst, by far, of any developed country.
“The numbers are real and the numbers are sort of shocking, and you can use that to enter people into a conversation,” Eisenberg said. “But from there, I really liked the opportunity of having a voice in this patient safety conversation that was positive by showing people the work that was being done.”
Ganguli’s company, Elythea, is hoping to head off life-threatening pregnancy complications such as pre-term birth and preeclampsia, or high blood pressure, by identifying at-risk women at an earlier stage, when doctors can deliver preventive care. A high-risk patient might be assigned a doula for additional support, or a nutritionist to improve eating habits.
“Traditionally you’re only assigned these resources after your 7th month when you have physiologic onset of pre-eclampsia and everyone’s rushing to do damage control,” Ganguli said in an interview. “But in the new paradigm of medicine we’re imagining, you get this (care) from month one.”
Ganguli is seeking to sell the company’s services to Medicaid managed care organizations looking to save money on the care of pregnant women. If he is able to improve outcomes, and reduce costs, his company takes a cut of the savings.
He is also pitching to large providers who take on financial risk for improving outcomes. But the process of getting adoption, or even a foot in the door, is slow and sometimes disheartening. Emails don’t get returned. Promising leads go nowhere. Ganguli said that so many entrepreneurs are pitching AI tools to health systems that he’s dropped the word from his talks and pitch decks altogether.
“There’s an AI fatigue,” he said, adding that he focuses instead on how his solution addresses pain points throughout the care delivery process and enables clinicians to better support pregnant women.
The film ends with Ganguli seeking to set up a randomized controlled trial of his technology at Beth Israel Deaconess Medical Center in Boston, a process that is still playing out today. He’s already got preliminary results from a trial under way in five African countries, and expects to publish those data soon. But he also understands that generating rigorous evidence is only part of what he must do to get uptake — and drive change.
Eisenberg, the film’s director, said that’s what made Ganguli attractive as the “emotional center” of the documentary. His story reveals how much work it takes to introduce a new innovation in health care — and hints at the consequences of the industry’s resistance to change.
“If health care isn’t saying that they have problems that need fixing, then no one’s going to try to fix anything,” Eisenberg said. “That’s the chicken and the egg here and why I think it’s important that we release this film now — not to capitalize on the AI hot button topic, but because this is something that we need to really generate a culture around innovating for patient safety.”