White, Dr. James

2019 Finalist: ASTech Awards

Personalized Data to Improve Patient Care

Dr. James White develops innovative digital health tools designed to collect, standardize and integrate patient-specific diagnostic test data instrumental in predicting cardiovascular issues in individual patients before they occur. Dr. White founded Cohesic Inc., an Alberta-based company that commercially delivers these cloud-based tools to healthcare institutions across Canada and around the world.

What problem or opportunity did you identify and seek to address?

As a cardiologist I see patients every day. I saw there was a tremendous amount of information generated by the tests I was ordering on my patients, but all I received was a general summary or impression of these findings.  While I knew the original data held answers about how to better treat my patient, I simply couldn’t access it. 

I specialized my practice in cardiac imaging, so I now interpret tests every day on patients with all types of heart disease.  We collect some of the richest data about the appearance of each patient’s heart, how it moves, and what damage has occurred. Over a decade ago I started to develop new ways to capture and curate this data on a patient-by-patient basis with an aim to build personalized data models for each heart. I believed we could use these as “fingerprints” to predict what was going to happen to each patient.

Over the last decade, we’ve developed more and more tools to extract high quality data in large numbers of patients. It turns out that, if you collect enough of this data in a structured way, it can be more powerful than we thought in predicting individual patient outcomes.

What has been the impact?

I’ve learned that in the process of capturing and organizing data from individual patients, and engaging patients to allow us to learn from this data, it can inform how we can interpret tests better, and improve patient care today.  While we have been focussed on developing algorithms for the future, I feel we’ve advanced patient care today in Alberta.

We’ve also discovered a great deal about the inefficiency of our current healthcare system. One of the opportunities we saw was improving the “quality per unit cost” of healthcare delivery. By conducting tests with an aim to get more meaningful information about each patient, we can have a greater impact on that patient’s care.  In doing this, we serve both the individual patient and the entire healthcare system.

While building research systems to accomplish this ,we realized that incorporating them into our local healthcare system, and expanding this to other sites was not going to be easy, largely because of a heavy regulatory environment and need for inter-operability with hospital information systems.  The only way to do it was to create a commercial company that could accomplish this. So, I formed Cohesic, a company focussed on bringing a “cohesive” approach to high-quality data collection and personalized test reporting to clinical practice.

Over the last several years, Cohesic has developed a range of software products that allow us to implement research-quality data collection in day-to-day clinical practice.  This data is already used to improve patient decisions in Alberta, and is expanding internationally to develop one of the richest standardized health datasets for development of personalized cardiovascular care.

How has being in Alberta helped you find success?

There’s a tremendous amount of diversification already happening in Alberta that the public may not be aware of. There are a number of tech companies that are established and forming that are finding incredible success within Alberta. It is starting to change the landscape of what Alberta can offer. The ability to identify investors and institutions within Alberta willing to participate and work with us has been instrumental to our success.

By building relationships with corporations like Alberta Health Services we can accelerate our core mission to deliver Better Care Through Better Data. They have some very progressive ideas about improving patient care as well as the efficiency of healthcare delivery. We’re working on strategies to improve healthcare delivery across the province and want to be a demonstration project for other healthcare institutions across Canada and around the globe.

By working directly with organizations like AHS and other Alberta-based health software companies we’re able to grow quicker.  Alberta uniquely understands the importance of data quality in healthcare because the whole population is managed through a common organization. This provides opportunities for us to build and validate novel data-driven tools “at scale”, and to demonstrate meaningful impact in the population.

One of our primary interests is in building data models that can predict patient outcomes, demonstrate they’re valid, and then apply them to other patients to improve their care. This work requires large amounts of high-quality data and Alberta provides an ideal population for achieving these goals, one that is highly engaged in innovation and healthcare research. By bridging efforts with Alberta’s healthcare and academic institutions we are leading innovation that will be relevant for a global patient community.

Who have been your major supporters?

Over the past decade my research has been funded by organizations such as the Canadian Institutes of Health Research (CIHR), the Heart and Stroke Foundation of Canada, Mitacs, Alberta Innovates, the Calgary Health Trust and other organizations. Most recently, tremendous support has been provided through the Stephenson Cardiac Imaging Centre at the Libin Cardiovascular Institute.  As Director of the Centre for the past 6 years, I have been able to rapidly adapt our clinical service and clinically translate innovation into patient care at an unusually fast pace.  The support of the Libin Institute and Alberta Health Services have been instrumental to the success of the Centre, founded and sustained through Alberta-based philanthropy led by Ken Stephenson. 

Alberta is where these resources and support exist.  I find it hard to imagine achieving all that we have accomplished anywhere else.

What are the plans for the future?

My research continues to grow and we have established a large data science program surrounding risk modelling and personalized cardiovascular care. Currently I am supervising a junior scientist, two PhD students, four Master students, and a number of undergraduate students engaged in machine learning-based analysis of diagnostic testing for improving patient care decisions.  We are trying to break down the barriers of capturing and using high quality data from diagnostic testing in daily clinical practice to reduce healthcare costs while improving patient outcomes. 

A majority of my research is now using machine learning-based techniques or “big data” analytics.  It has been through necessity, as the volume of data that we are collecting and analyzing simply cannot be appropriately managed using traditional statistical techniques.  Our growth will largely be through refining these techniques and discovering the most appropriate ways to introduce artificial intelligence into clinical practice.  As we explore these techniques, we’re as much interested in how physicians and patients want to be assisted by this technology as we are in its ability to accomplish this and improve health outcomes.

How does it feel to be an ASTech Finalist?

I’m incredibly honoured to be named an ASTech Award Finalist. If you look back at the prior award recipients and finalists, I realize the company that we’re in is extremely impressive.

These awards shine a light on the innovation occurring in Alberta and it is a fantastic initiative. I am humbled and privileged to be in such fantastic and highly respected company with all the other finalists.