The Pioneer team selected eight ideas to advance to Pitch Day out of more than 500 submissions. While the winning teams prepare their pitches, here’s a look at the 1,000-character proposals that got them this far:

• Breaking Barriers in Medical Knowledge
• Creating a Social Epidemic of Safety
• The Human Genome + the Human Exposome = Your Health
• Implementing Risk-Based Cancer Screening Using an Adaptive Learning Engine
• Let Us Decide How Research Funding is Allocated: Medical Innovation By the People and For the People
• MD 360
• Rapid Evaluation of Apps
• Use Randomization and Social Networking to Crowd Source Rigorous Lifestyle Health Experiments

• Breaking Barriers in Medical Knowledge

  Author: Fred Trotter
  Organization: Not Only Development

  Description: What if you could remove the barriers involved in accessing and understanding medical knowledge? What if engaged patients had a clear path to becoming experts in their own condition? What if primary care doctors had a clear path to understanding specialist topics? What if specialists had a clear path to understanding and disseminating advances in their field? Right now, the way information dissemination happens in healthcare is deeply broken. Patients cannot learn enough. Doctors don't have time to teach patients or each other. Medical students are overwhelmed with more and more information in each class. Medical science is leaping forward, but medical practice is not keeping up. We can fix this. How? I could go into how to merge Big Data, Crowd sourcing, Graph Analysis and Wikipedia to fix this problem. But then were would the mystery be in that? We think we have found a way to fix this problem. We would like to pitch you on how exactly.

• Creating a Social Epidemic of Safety

  Author: Sarah Henrickson Parker, Allan Fong and Raj Ratwani
  Organization: MedStar Health

  Description: Did you know the safest part of your visit to the hospital is your drive? Conservative estimates suggest 98k patients die annually in hospitals across the country from preventable error. We will change this by showing that safe care is contagious. Patient safety is fundamentally tied to the culture of the clinical staff. Changing culture involves not just implementing best practices, but correctly targeting the influencers and connectors in social networks. By utilizing technological advances in sociometric measurement and analysis to identify and target social influencers within a healthcare system, we will use their influence to improve safety. With expertise in human factors, sociometrics, healthcare and influence our team is poised to create lasting culture change. Our proposal leverages existing social networks within healthcare to create a social epidemic of safety. At some point, each one of us will be a patient –lets create the best and safest care possible together.

• The Human Genome + the Human Exposome = Your Health

  Authors: Elise Miller
  Organizations: Collaborative on Health and the Environment (CHE)

  Description: In the push towards personalized medicine, the human genome should only be considered part of the equation. Epigenetic markers, influenced by a range of environmental factors, are also crucial to understanding a person’s susceptibility to disease. Recently there’s been a call to map the human exposome – i.e., all environmental exposures starting from conception, including nutritional, chemical, psychosocial, etc. With this information, health professionals will be better able to reduce risk and prioritize prevention. Widespread use of electronic health records provides an opportunity to develop standardized questions about people’s exposures. Since early life development influences health across the lifespan, obstetric records are a good place to start. Not only would this enhance health professionals’ ability to make recommendations early on, it would provide a database for studying correlations between exposures and diseases that appear later in life – and in turn, radically increase options for improving individual and public health.

• Implementing Risk-Based Cancer Screening Using an Adaptive Learning Engine

  Author: Laura Esserman; Margaret (Peggy) O'Kane and Clarence So
  Organizations: Athena Breast Health Network (UCSF, UCLA, UCSD, UCD, UCI, Sanford Health); National Committee for Quality Assurance (NCQA); Salesforce

  Description: Cancer screening impacts every person costs billions of dollars and is mired in rancorous debate. We are not making progress in reducing false positives, over diagnosis or potential overtreatment. We need to disrupt this practice with a fundamentally new approach, a risk-based screening approach, incorporating scientific evidence for the most effective screening frequency, and new biomarkers of risk and patient choice. By profiling tumors that arise, we will learn who is at risk for what type of cancer and facilitate tailoring treatment to biology. Using an adaptive learning model, we can accelerate and implement effective change and precision medicine. A learning system will allow us to continuously improve screening and integrate prevention while reducing the negative consequences and cost of screening immediately, not 30 years from now. The Athena Breast Health Network, a collaboration of specialists integrating research and clinical care, is uniquely positioned to champion this change.

• Let Us Decide How Research Funding is Allocated: Medical Innovation By the People and For the People

  Author: Alex Fair
  Organization: MedStartr, Inc.

  Description: New ideas are needed to make better medicines, develop better devices, and provide better care. These ideas are generally developed through grants and investments. While we pay the taxes and overpay for devices and medicines to fund this R & D, we have No Say in what ideas are selected for grants or investments. Of the 100 Billion dollars spent in 2011 on healthcare innovations, executives at pharma companies decided 50B; our government decided another 30B, and investors decided 17B. Isn't it time we, the people, had a say in what ideas come next medical innovation? We just ran the first ever government-sponsored contest to see where 40,000 taxpayer dollars would be invested, in which medical innovation. Would you believe that the public not only voted, but also kicked in another $16,000 of their own voluntarily! This is democracy in action where we decide what is best, and our government allocates funding accordingly. It works, now let's scale it up!

• MD 360

  Author: Tara Bishop
  Organization: Weill Cornell Medical College

  Description: There are essentially three ways that people, products, or services can be rated. First, ratings can use objective measures such as grades or scores. The New York City Department of Health uses an objective grading system to assign cleanliness grades to restaurants. Second, ratings can be based on expert opinion or someone we trust like the food or movie critic. Finally, ratings can be based on users’ or recipients’ feedback like those found on website like Yelp and Tripadvisor. Individually, each rating system has merits but also flaws. For example, objective ratings may miss areas that are important but difficult to measure. Expert opinion and crowdsourcing may be too subjective. Ideally, we would have a rating system for doctors and other healthcare providers that incorporates all of these elements: objective measures, reputation among peers, and crowd rating. MD 360 will develop a three-pronged approach to rating doctors by compiling available information on objective measures of quality, reputation among peers, and websites like Yelp, Healthgrades, and Vital Signs. MD 360 has the potential to significantly improve the way we rate doctors and healthcare

• Rapid Evaluation of Apps

  Author:  Bianca Frogner, PhD
  Organization: The George Washington University

  Description: Approximately 40,000 medical and health apps are available on the market and the number is on the rise. Identifying the “most effective” health app by rigorous evaluation methods is a challenge because a good health outcome is nebulous to define, the technological environment is changing rapidly, the pool of talented evaluators is small, and funding levels are low relative to the number of available apps. But the goal may become critical as medical providers want move towards prescribing apps the way they would prescribe a pill, and insurers reimburse for such services. My vision is to develop a rapid evaluation system that establishes standard metrics, and integrates expert and user experience, download statistics, rate of return measures, and spatial search patterns. The evaluation system will combine tools from economics and engineering. The evaluation system will be designed to integrate into electronic health record systems, and used by medical providers and insurers to identify the “most effective” health app.

• Use Randomization and Social Networking to Crowd Source Rigorous Lifestyle Health Experiments

  Author: Christopher T. Robertson
  Organization: University of Arizona/Harvard Law School
  
  

  Description: Randomization is the primary tool for scientists to make causal inferences. The public too loves games of chance: gambling and lotteries are huge industries and important pastimes. Can these be linked? Lifestyles drive much of health spending, but the public is prudent to be wary of elite claims to knowledge (think: new fasting diets based on tiny studies, and the reversal of decades of sodium advice). Let’s create a platform that engages social networks to enroll millions of people in large-scale randomized experiments. Use mobile phones, apps, and linked devices (e.g., cameras, activity monitors, and scales) to collect data and provide feedback and encouragement. Let citizen-scientists design their own studies, within a rigorous safe, scientific, and ethical environment. Even aside from the gold-standard scientific findings, behavioral science suggests that the pre-commitment, randomization, monitoring, and social support may help individuals try and succeed in lifestyle changes that would otherwise elude them.