Saving babies’ lives and the development of artificial intelligence in radiology were among the San Antonio success stories shared this week as the city’s burgeoning bioscience industry took center stage.
“I’ve never been more excited or more optimistic about the future of San Antonio,” Mayor Ron Nirenberg said at the start of the State of the Industry event by The Health Cell, a local group of health care leaders. The mayor said San Antonio’s bioscience ecosystem is one of the city’s “largest, most innovative, and highest-paying sectors.”
The local bioscience and health care industry has grown rapidly in the past decade, employing 1 in 6 workers in San Antonio, or about 180,000 people.
Dr. Cynthia Blanco, professor of pediatrics at UT Health San Antonio, told health care professionals and community members at the Grand Hyatt downtown Wednesday evening about a lifesaving treatment for babies needing to be fed intravenously because of gastrointestinal problems.
Over time, IV nutrition can cause liver failure, but Blanco and her team learned of a nutritional formula with fish oil that decreases the risk of liver failure. In 2009, she secured permission from the FDA to enroll patients in a clinical trial to test the formula, which is being used in Germany.
“I came to this university because I wanted to teach, I wanted to make a difference, I wanted to advance medicine,” Blanco said. “I just never dreamed that I was going to do such a big research project.”
She said this formula has saved the lives of 64 babies at UT Health, with no signs of long-term side effects over the past 10 years. Blanco is providing data to the federal Food and Drug Administration about the efficacy and safety of this treatment, with the goal of making it more widely accessible.
“Not in my wildest dreams did I imagine that this was going to turn into 64 patients that are alive now because of this study,” Blanco told the audience.
Radiologist Dr. Lance Reinsmith spoke about the promise and perils of artificial intelligence in medicine. He has been developing algorithms to read chest X-rays and separate normal images from those needing further medical attention.
Piggy-backing on Google’s neural networks that identify images of everyday objects like ice cream cones and fire hydrants, Reinsmith tweaked those models to look at chest X-rays.
“The result is a model that’s about 90 percent sensitive in determining whether a chest X-ray is normal,” he said.
Reinsmith believes the technology won’t replace radiologists. “I think they’re going to give us our jobs back. What I mean is they’re going to allow us to be physicians again – and better physicians.”
But Reinsmith shared a number of cautions.
Neural network models can be so complex that “we may never understand exactly how they work,” he said. “So we have to ask ourselves if we’re willing to take this leap of faith and trust in these models.” Another issue is privacy: “Do we really want computer models to be looking at our medical records?”
Regardless, these technologies are coming, and physicians in San Antonio are at the forefront of their development, he said. “My colleagues and I at Intrinsic Imaging work with these companies, developing these technologies to validate their models, to make sure they do what they say they do and to make sure they don’t cause more harm than good.”
Other speakers at Wednesday’s event told of their successes in getting a new product – a breathing tube that reduces the risk of complications during anesthesia – ready for commercial use and about some collaborative efforts, including those to improve care for the most vulnerable San Antonians while reducing costs.
“It’s hard to innovate when you have been in a field for a long time,” said UT Health anesthesiologist Dr. Steven Venticinque, who recounted weekends in his garage, tinkering with breathing tube prototypes to test in the clinic. Although the journey has had its ups and downs, “it’s been more fulfilling than I could have ever imagined,” he said.
Oanh Maroney-Omitade and Sarah Hogan of the Southwest Texas Crisis Collaborative talked about a trio of initiatives aimed at providing the proper psychiatric care when appropriate and creating an acute care station at Haven for Hope to reduce unnecessary EMS calls.
Dr. Lillian Liao, the pediatric trauma and burn director at University Health System, spoke about the November 2017 mass shooting at the First Baptist Church of Sutherland Springs and the collaborative nature of the medical response, thanks to the Southwest Texas Regional Advisory Council.
STRAC is made up of hospitals in Southwest Texas that work together to improve the survival of injured people. It is the only trauma response system in the nation that is built on a civilian and military partnership.
“Because of this system, we were able to respond to one of the worst tragedies in Texas history,” Liao said, recalling that attack, which killed 26 worshippers. The STRAC network allowed ambulances to get the injured to the most appropriate place for care in the shortest amount of time.
Twenty-one injured people made it to hospitals alive, and “I’m proud to say that your trauma system was able to save 20 of them,” Liao said. “You have the best trauma system in the country and perhaps the world, and that’s based on survival statistics across the country.”