I happened to read about the pharmacodynamics of parenteral versus oral furosemide when I came across a unique interaction between this commonest of diuretics and risperidone: Elderly dementia patients on risperidone have twice their expected mortality if also given furosemide. I knew that all atypical antipsychotics can double mortality in elderly dementia patients, but was unaware of the additional risperidone-furosemide risk. Epocrates only has a nonspecific warning to monitor blood pressure when prescribing both drugs.
This is interesting for a bunch of reasons. First it’s a good example of how technology is now being applied to help with the almost absurd complexity of modern medicine–complexity that technology has both added to and may yet cure. Secondly, Surveyor Health has been building its technology for several years and (FD) I’ve been advising them off and on since 2009 and know the principals well. Thirdly, and this is mostly for grins, it represents some of the absurd language used to describe our crazy health care system.
What does the tech do? Surveyor Health’s technology is very
complex optimization technology that examines the incredible number of symptoms
and interactions undergone by patients taking multiple medications. As you know
most chronically ill patients are on upwards of half a dozen medications and some
are on many more. The more medications, the more the potential for serious and
sometimes fatal drug-drug interactions, side effects and more. You only have to
think of the litany of celebrity drug deaths (Michael Jackson, Prince, Anna Nicole
Smith, Health Ledger, Tom Petty, to name a few) to understand the seriousness
of the issue. Erick von Schweber, a real theoretical physicist and CEO of
Surveyor Health tells me that when you get above 11 drugs the calculations
involved are more complex than what Google has to do to index the web. (And yes,
he now is allowing me to call it AI!)
Erick & Linda von Schweber started Surveyor Health around the time Health 2.0 started back in 2007, with the BHAG of massively improving medication safety using some very complex technology. And it has taken them a long time to embed themselves in the bowels of some huge health care organizations and to start getting traction. But it is finally happening and the impact may be substantial. I interviewed Erick and he gave me a comprehensive demo and update on their latest results. If you care about drugs and clinical care, this is compelling (if not lightweight!) viewing. (I suggest you switch to full screen for the demo).
Listen to them on Itunes or Spotify
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