BioticsAI Uses Machine Learning to Supercharge Prenatal Ultrasound
Founders Robhy Bustami and Salman Khan are using AI to give an instant second opinion to ultrasound techs, offering a lifeline to overworked OB/GYNs.
Investors, get a first look at how you can back health moonshots through StartUp Health’s new rolling impact fund.
Challenge
For expectant moms, the prenatal ultrasound is a rite of passage. During the first trimester, it’s the ultrasound tech who first identifies a heartbeat and prints out the inscrutable scans to be shared far and wide as proof of what is to come.
In the second trimester, things get even more real with the highly anticipated 20-week ultrasound. This scan paints a fuller picture of the baby’s health and overall status. This is also when healthcare providers are able to detect the vast majority (about 90%) of fetal abnormalities.
So far so good. The problem is that there is a critical shortage of the Obstetric and Gynecological physicians (OB/GYNs) needed to interpret these 2nd-trimester scans. The American Congress of Obstetricians and Gynecologists puts the shortage at roughly 9000 OB/GYNs in the United States. More than half of the counties in the United States don’t have a single Obstetrician. In many countries around the globe, it’s much, much worse. That means that expectant mothers in these regions have to either drive hours away for care or work with a local ultrasound tech and arrange a long-distance consult. These kinds of arrangements are often still conducted with photocopies and fax machines. The result is wasted time, money, and sometimes critical errors of judgment.
The OB/GYN shortage is only getting worse. It’s projected that the US will have a deficit of 22,000 by 2050 due to an aging workforce and a vicious cycle of long hours and an overabundance of malpractice suits. According to a recent Medscape report, 85% of OBGYNs will be sued during their career, with most getting sued multiple times. As if the picture wasn’t dim enough, add on new reporting requirements each year and you end up with exhausted clinicians who get less and less time with their patients, which is the whole reason they got into the practice in the first place.
Into this gap steps BioticsAI, a startup using artificial intelligence to improve how we read 2nd trimester ultrasounds while smoothing out compliance workflows and giving precious time back to physicians.
Origin Story
Robhy Bustami was sitting in a common room at a community college in Oakland, California when Salman Khan sidled up, looking every bit the West Coast native in short shorts and a “Save the Rainforests” t-shirt. Bustami had just moved to San Francisco from the United Arab Emirates and knew no one, so he showed up at an event sponsored by the school’s Muslim Students Association.
“I remember this like it was yesterday,” says Khan, flashing a wide grin. “Robhy was this 17-year-old kid fresh off the plane from Abu Dhabi. We sat down next to each other and started talking. We’ve been best friends ever since.”
Bustami’s studies took him through computer science into computer vision where he focused on object detection and augmented reality. After graduating he worked at IBM Watson. Khan dreamed of becoming a lawyer or politician, but then post-grad jobs at Oracle and Kaiser changed his mind and set him on the road towards tech and business. It wasn’t long before both men were bitten by the bug of the nearby Silicon Valley startup scene.
“We really wanted to tackle major issues that were personal to all of us,” says Bustami.
That’s when something important happened: they realized they were both carrying around a similar story about our broken healthcare system. Stories about anxious parents, misdiagnosis, and fatal consequences for children.
Salman Khan was born in Karachi, Pakistan, and as early as he can remember, he was told how his elder sister had died because of a misdiagnosis at the age of one. Bustami was a grown-up when he watched a misdiagnosis play out with his childhood best friend who was expecting a baby. When the friend and his wife went in for initial ultrasound scans, the ultrasound tech incorrectly informed the parents that their unborn child had serious health defects — abnormalities of the heart and brain. Later, the obstetrician found that the tech was wrong and that the baby was fine. But emotionally, a lot of damage had been done. The stress on the mother led to increased high blood pressure which in turn led to further complications and premature birth.
These might have remained mere stories, related tales of medical misdiagnosis, had Bustami and Khan not met Dr. Hisham Elgammal, a professor of Maternal Fetal Medicine. Teaming up with his brother, Hamdy Elgammal, a data & machine learning engineer, Dr. Elgammal had done extensive research into AI-powered fetal diagnosis and published an award-winning paper on the topic. The Elgammal brothers opened up for Bustami and Khan the specific challenge of using technology to improve fetal ultrasound and through their machine learning research saw their vision for impact come into focus.
Under the Hood
Once Bustami and Khan decided to create an AI platform for improving prenatal ultrasound they knew what they had to do first: Teach the machine. So they built a medical data and machine learning team and partnered with three health clinics. For almost three years, they fed more than a million 2nd trimester ultrasound images into their machine learning algorithms so that they could recognize abnormalities and significant anatomical regions accurately. Once the two founders felt that their AI engine was robust enough to begin trials, they officially launched BioticsAI.
While the back-end math is complex, the front-end concept is simple. BioticsAI integrates with the normal ultrasound process and uses artificial intelligence to automatically detect fetal abnormalities and flag them up for both techs and OB/GYNs. The AI identifies individual scans to review but also highlights the specific region of the scan that is problematic. It’s an instant, automatic second opinion, another pair of eyes making sure you didn’t miss anything important. Research has shown that a second opinion reduces misdiagnosis by 77%.
The platform also automates documentation and reporting, saving techs and physicians precious time.
“We’re assisting doctors and techs, we’re not replacing them at all,” says Khan. “We’re also helping with documentation. Compliance is a huge issue. They have to take images of 20 different planes and store it in their PACS system.” That’s a labor-intensive process that can be largely automated, says Khan. BioticsAI’s early case studies have shown that they can reduce reporting time from around 15 minutes down to less than five minutes.
BioticsAI integrates through a standard API with a hospital’s PACS system, which is the most common way that radiology images are stored in healthcare.
Why We’re Proud to Invest
When we met Robhy Bustami and Salman Khan this quarter, there were a number of reasons why we were excited to back them. Right off the bat, we could see that in their partnership they had some of the critical ingredients for success. Their combination of experience at IBM Watson, Oracle, and Kaiser gives them a cross-sectional view of the tech industry and how tools like AI and the cloud are being used at an enterprise level. Bustami brings a deep understanding of the core technology while Khan offers a range of business development skills honed while scaling Oracle’s cloud services division. All of that is layered on top of a true friendship that has stood the test of time, and which will bolster them when they hit setbacks.
We’re also excited to back BioticsAI because the need is so pressing, and by all accounts, it’s getting worse. We’re facing a dramatic OB/GYN shortage and it's reaching crisis levels in rural America and many parts of the globe. By giving these overworked and over-litigated physicians an automatic second opinion, we have the ability to not only improve care for moms but to improve the practice of physicians and reduce burnout. Tools like BioticsAI have the ability to create a more inviting atmosphere for would-be OB/GYNs and potentially turn the physician shortage around.
Finally, we’re bullish on BioticsAI because delivering more accurate prenatal ultrasounds is a health moonshot-sized global health issue. Bustami and Khan are starting in the United States, but with their family and friends in the Middle East, they’re quick to understand the global potential for their platform. After all, in parts of the world, prenatal ultrasound isn’t just hard to come by, it’s completely non-existent. A tech-enabled ultrasound solution like BioticsAI could one day extend the life-saving technology of advanced ultrasound to regions in desperate need of prenatal care, opening up critical access to care for millions.
Investors: Learn how you can invest in Health Moonshots through StartUp Health’s new rolling impact fund.
Digital health entrepreneur? Don’t make the journey alone. Learn more about the StartUp Health Community and how StartUp Health invests.
Sign up for StartUp Health Insider™ to get funding insights, news, and special updates delivered to your inbox.
