The People behind Healthcare Innovation: Interview with Wieland Sommer, professor in radiology and founder of Smart Reporting

As part of my work, I have the privilege to speak with many inspiring innovators. However, the business community usually focuses more on companies, pitches and valuations, and less on the innovator. I think it would be interesting to learn a bit more about the people behind healthcare innovation. Therefore, I'm going to share some of my conversations with innovators in condensed form: 6 questions, 6 answers about their experience, their opinions and learnings.

The seventh conversation is with Wieland Sommer, professor in radiology and founder of Smart Reporting.

Tobias: What’s your story, how did you become an innovator in healthcare?

Wieland: After graduating in medicine, I specialized in radiology and practiced at Ludwig-Maximilians-University, Munich. I became a professor of radiology when I was 34 years old and was on track to a career in academic medicine.

Like all radiologists, I examined medical images and summarized my interpretations in medical reports. Although technology has advanced significantly in the last few decades, the workflow pattern has essentially remained the same. The central limitation is the lack of standardized reports; historically, these have been dictated as free-form texts. If the same images are shown to three radiologists each will use a different style and vocabulary and will apply them with different diagnostic criteria. This lack of uniformity creates confusion for attending physicians and limits statistical analysis. This non-standardized pattern also represents the dead end of innovation. Artificial intelligence (AI) is steadily infiltrating medicine and the standardization of reports will be essential in the application of diagnostic AI algorithms to medical imaging.

In 2014, I started the platform “Smart Radiology”. As opposed to relying on free-form texts, this software uses intelligent decision trees to generate medical reports. This approach guides the radiologist, standardizes the workflow, and provides fully machine-readable data. Furthermore, the software is adaptable to AI algorithms. The result will be better quality and greater efficiency in medical reports, alongside a quicker workflow pattern.

We currently have several thousand users around the world; the platform is growing rapidly and our software has been integrated by vendors such as Agfa, General Electric, and Siemens Healthineers. We will soon expand our software to pathology. The company is growing continuously and currently has around 40 employees.

Tobias: How do you see the field of digital radiology play out in the next 10 years?

Wieland: Artificial Intelligence will inevitably change the way radiology is practiced. There are several hundred companies worldwide working on diagnostic AI algorithms in medicine. The previous decades have been characterized by fantastic progress in medical hardware but the next wave of changes will be software-based. The tedious detection of cancer or the comparison of lesions in follow-up examinations in thousands of images will be assisted or wholly taken over by algorithms. The more AI algorithms become available, the more workflow will be automated, and the more quantitative data will be available to make personalized treatment decisions.

The British computer scientist, Geoffrey Hinton, famously said: “It’s completely obvious that we should stop training radiologists right now.”

I don’t agree with this opinion. Rather, I think that the role of the radiologist will change. Radiology will, I think, move from an imaging science to a data science. We should also recognize that there are many other important activities in radiology unrelated to the interpretation of images, in particular, communication with other physicians and with patients. These responsibilities are central to the practice of medicine and cannot be replaced by computers.

Tobias: What are the biggest opportunities and obstacles you see for innovation in the healthcare environment?

Wieland: Do you remember your last visit to a hospital? You often see people working with pen and paper rather than electronic tablets. There is immense opportunity for improvement in the fast-growing healthcare market. There is also a political imperative towards the implementation of quality initiatives that help ensure healthcare remains affordable. The large amount of data available, combined with AI, creates high potential for the disruption of healthcare particularly within the context of diagnostic medicine.

 On the other hand, the healthcare market is highly regulated in terms of the certification of medical devices and data privacy. It is relatively conservative in the adoption of new technologies and sales cycles are much longer than in other markets. It often takes years to develop a minimally viable product and to generate revenue. These factors make start-ups much more challenging in the healthcare sector.

Tobias: When you look at the health system as a whole — providers, payors, regulators, doctors, patients — where do you see the most and least openness to innovation? 

Wieland: There is a lot of openness and interest in innovation by all stakeholders in the healthcare system. However, the pivotal questions to consider are: Who will pay for it? Who is willing to adopt it or move to a new system?

Innovation in healthcare often requires a change in workflow. This is always a significant barrier and the reason many initiatives fail. The workload in healthcare is constantly increasing and is made more challenging by limited resources. These factors stifle change, especially in routine work.

The benefits of digitalization are generally long-term but the costs associated with changing a system are immediate. Therefore, good project- and change-management are essential for successful introduction of innovations into clinical practice.

Tobias: What’s the single most important thing policymakers could do to enable digital transformation of their health systems?

Wieland: The digital transformation has enormous potential to make the entire healthcare system more efficient. However, incentives are needed for individual stakeholders to overcome initial barriers and adopt standardization and digitalization. The healthcare system is diverse with innumerous different IT systems, different formats, and non-standardized documentation.

Establishing the framework and incentives for the digitalization of processes and data is the single most important prerequisite for transforming any healthcare system.

Tobias: What do you know now that you wish you had known when you were starting out as an innovator and entrepreneur? 

Wieland: As a medical student, and even as a young radiologist, I was ignorant of entrepreneurship and start-ups. I became aware of medical entrepreneurship when I continued my studies in the U.S., earning a master’s degree from the Harvard University School of Public Health. There was a long period of learning, balancing risks and chances, and it took time for me to take the full leap into entrepreneurship. This opened up many new opportunities and was the best decision I have made. I realized I could have a huge impact and achieve enormous benefits in society. It is creative and fulfilling to build a company which solves a major problem in healthcare.

As a physician, you have a clear view of the problems in healthcare. For example, I have previously been involved in a successful university spin-off called Planerio, a program which automates the tedious scheduling of physicians and nurses in hospitals (www.planerio.com). Planerio has evolved to become a fast-growing start-up. Once you have an entrepreneurial view of medicine and know the problems in healthcare, you become aware of its needs and can foresee opportunities for improvement.

Looking back, I encourage young physicians to investigate entrepreneurship and adapt this perspective to medicine. Entrepreneurship drives innovation and should be covered in the medical curriculum. 

For more information, see Wieland Sommer and www.smart-radiology.com