Everything you need to know about MAIA

Question by Mr. Heinrich Prokop at the ESAC-Pitching Event, 03|28|17:

Not every patient has the same level of education. How will you ensure that everybody can understand all the information on the MAIA website? It could concern a medical doctor with a lot of knowledge about medicine as well as people who never went to school.

Every patient has a different level of knowledge of – and frankly – interest in medical topics.
Teaching patients about their treatment or illness demands high levels of abstraction. We specialize in creating visual abstracts of complex medical information. It is the heart and soul of our work. The voiceover explanations in our movies are edited in a way that the information is medically correct, but presented as easily understandable as possible. Compared to standardized informed consent forms, our information is exponentially easier to understand. Our clinical studies prove this. We have found significant differences in the amount of correct answers patients gave when asked about their surgery. At the time of consenting to their surgery, patients who had watched one of our movies gave more correct answers about their surgery than patients who had just been given a standardized text.

In any case, if a patient completely skips the website, the doctor in the clinic will now know that fact for sure. MAIA enables the doctor in such a case, to react to that patient as well and ask them if they didn’t want to inform themselves on purpose, or if they were just uninterested, if they had no time, or else.In that particular situation, doctors find themselves in the same situation as they now do with the paper pamphlets. They have no particular information about their patient, so they will have to explain the surgery entirely. If a patient refuses the informed consent explanations, MAIA will also be able to document that situation.

The MAIA website will feature certified information in many types of media. Texts, pictures, 3D-animations, 2D-animations. As the patient dives deeper into the information, the level of complexity gehts higher. With the mix of medial variants, we hope to find the right information source for every patient. So it is one of our core missions to provide information in such a way that it is understandable for all.

Thank you for the question, Mr. Prokop! Feel free to contact us if there’s more you’d like to know.

Question by Dr. Bernd Litzka at the ESAC-Pitching Event, 03|28|17:

Doctors are only humans as well, so they can make mistakes. For example they could forget to tell the patient about a certain risk of their surgery, or mix some information up. Isn’t it dangerous to record their conversations with patients then? A recording could make them very vulnerable in a court of law, when those little mistakes are proven by the recording.

Yes, a recording could indeed also be used against doctors in a court of law.
That is why MAIA will not store the conversation between doctors and patients. MAIA will listen to the conversation and indeed record it. After processing and analyzing the recording with the natural language transcription AI, the recording will be deleted immediately. 

MAIA will create a contentual documentation of the conversation, not record it word-for-word.
This means that it will check the doctor’s checklist autonomously and additionally display a list of the topics that have been discussed with the patient. MAIA can also warn the doctor in case they missed some vital part of the informed consent explanation, like for example a serious risk factor.

We are aware of some doctors and hospitals who already use recordings of their informed consent conversations. In that case, we can of course offer our clients to actually keep the original recordings instead of immediately deleting them. That option, however, will only be available upon explicit customer request.

Thank you for the question, Dr. Litzka! Feel free to contact us if there’s more you’d like to know.

Question by the audience at the ESAC-Pitching Event, 03|28|17:

There are so many different healthcare IT systems out there on the market. How can you ensure to be able to connect to all of them? The integration cost & efforts will be very high.

Almost all providers of hospital IT solutions use the same web-based interfaces. MAIA will use these interfaces to communicate with other systems in both directions: while importing patient data and during anonymization of data packages, as well as for saving finished informed consent documentations back in the IT system.
The technical side of this is simpler than it sounds, nowadays many machines and systems connect to hospital IT systems through those interfaces, including fully automated radiology machines or media providers at bedside terminals. The main factor for success is working with the actual providers of the hospitals IT system so that it knows what to do with the data MAIA sends back through the webinterfaces.

Thank you for the question, sir! Feel free to contact us if there’s more you’d like to know.

Question by the audience at the ESAC-Pitching Event, 03|28|17:

Can you create a valid digital signature? Because it is not legal in medicine, and if it is not valid at all and a problem (lawsuit) occurs, you will be in big trouble.

This is a brilliant question. Signature law might vary a bit depending on the country we are talking about, but let’s stick to Austria for now. In Austria, the „Handysignatur“, a form of digital signature that connects the Austrian citizen ID-card with a signature done via cell-phone, is currently the only form of signature that has the same legal „quality“ as a manual signature on paper.
However, there are many signatures that do not have that same „quality“, but still are valid in most use cases. For example when we sign for a parcel at a post office or when we sign a contract at the bank, we sign digitally. Signatures are performed on sign pads that are hardware-certified. This certification of the device is always paired with a special software certification as well. Both in combination ensure that after a signature was embedded into a document at a certain point in time, it hasn’t been altered.

MAIA can offer that double-certified secure signature. We expect legislation to soon catch up with these digital signatures as well.

We also would like to clarify one thing: In most countries, a signature is not even needed for informed consent. It is sufficient for the patient to agree to a treatment by talking to their doctor. It is then the doctor’s task to document this agreement comprehensibly. In Austria, there is no law that requires a written signature to consent to medical treatment, altough almost all healthcare providers demand a signature for proof of consent and obvious legal reasons.

In our opinion, the quality of the signature is not an issue. When a patient sues a doctor/hospital for malpractise or failure of the disclosure of information needed for an informed consent, the signature itself is never the problem. Information is. Not knowing about a risk or side effect or treatment alternative is what could cause patients to actually decide against a treatment. So most of the time, patients will confirm that they signed a paper because they thought they had to in order to be treated, even when they did not know all the risks and did not understand all the information.

Thank you for the question, sir! Feel free to contact us if there’s more you’d like to know.

Johannes decided to become a medical animator after his girlfriend (now wife) Lena was hit and run over by an 18-ton construction site truck in 2006. Lena spent almost an entire year in hospital and rehab centers and has had over 35 surgeries since the day of the accident.
One day before a rather complicated surgery, Lena and Johannes sat in a doctor‘s office were given in-formed consent forms to read and sign, with an endless list of risks and side effects. Despite reading the pamphlet and talking to the surgeon for almost an hour, they both did not understand the procedure properly. This incident was decisive in Johannes‘ decision to focus on medical animation.

Yes. Since MAIA will need an installation with your clinic servers, we will work closely together with your media and IT departments. As a standard service, we offer our clients a full Corporate Design adaption of MAIA.

There is a fee for the initial installation and connection to the clinics‘ IT system. Apart from the initial set-up fee and single licenses, there will be no costs to our customers. Only when a major update of MAIA is being released, customers can decide to opt for the newer version, which will trigger another installation fee.

Currently, we estimate our single patient licenses to level in at EUR 0,20.

Yes, but only anonymous and encrypted data. See other FAQ about security for further information.

The MAIA web-plattform is encrypted and secured. Entry is only granted when a valid key (generated in a hospital) is entered on the site.
All patient data will be anonymous. Once a patient is allocated to a specific informed consent routine on the site, all their information and clear names will be anonymized. The data can not be reunited with specific patients until MAIA identifies individual data strings and redirects them to the clinics IT system. This process can only occur in the same hospital/IT system where the patient routine was initially created and it is happening within the clinics own IT infrastructure.

This means that outside the hospital, all patient data is completely obscured and worthless to intruders. Inside the hospital, patient data handeled by MAIA is as safe as all other digital data in that hospital.

Yes. Many security details and layers of automated documentation allow us to track a lot more detailed information about the whole informed consent process than handwritten notes and scribbles on paper forms.

Artificial Intelligence solutions are trendy. However, that is not the reason for our strive to revolutionize patient education with AI.
Years of experience and patient studies have shown us that only entirely new ideas and technologies can improve informed consent procedures in large scale.

All variants of the common paper consent form as well as their digital pendants require manual input and a lot of time. Digital solutions can not supersede paper forms by ways of effort, time and legal security when every input for documentation is done by hand just like on the paper version.

The automation of legal documentation in informed consent processes is the only way of moving forward and creating an innovation that actually improves this already precarious situation.

We are fairly confident that the NLP will work perfectly. Speech recognition technologies are emerging faster than almost all other AI technologies at the moment due to their high impact on mobile devices and interactive applications.

See what our partners at Microsoft have to say about NLP: https://www.microsoft.com/en-us/research/group/natural-language-processing/

In a medical context, understanding language can be tricky. Focusing on patient education and informed consent conversations actually helps a lot in this particular case.

• Surgeries have a pre-defined set of steps that are needed to successfully complete them. (Apart from unusual incidents, of course)
• Every surgery has a very specific number of affiliated risks and side effects that occur in certain percentages of surgeries.

When a doctor talks to a patient in a hospital, MAIA already knows the type of surgery, the medical specialization, all the surgical steps as well as all the risks. Additionally, all the data coming in through our online plattform for each patient help to narrow down subjects and conversational topics. This makes it easier for the NLP to look for „buzzwords“, identifiers that trigger actions and documentation lines.

Most of our competitors originate in the analog world. Most of them are still relying on paper forms as a baseline product for their informed consent media. The shift towards digital media is happening, but slowly. Many digital solutions on the market right now are basically digital versions of the paper form, e.g. an interactive PDF document. The technological development is lagging behind the actual possibilities by about ten to fifteen years. Even movies and 3D-animations as informational media are only very slowly becoming more standard.

The reason behind this effect lies in the effectivity of the old system. Paper forms are still, and have been for decades, the most practicable solution. They are relatively cheap to maintain and quick to produce. They do their job relatively well and offer a nice solution to the informed consent practice, while generating a lot of steady revenue. Rising numbers of lawsuits against informed consent processes are not even the real reason behind the switch from paper to software. The real reason is digitalization of medicine itself. When every system, task and function within the hospital is digitally administrated, using a paper form suddenly becomes impracticable.

The current race to the top is being decided wit practicability. Impractical solutions, that are digital but offer little to no major advantages compared to paper, will stay behind in the long run. MAIA might seem futuristic and far fetched, but we are convinced that artificial intelligence and natural language processing are the only practical approaches in the long run, to really improve informed consent procedures.

Legally, doctors are ultimately responsible for how they explain procedures to their patients and the media they use. This means that every doctor using our movies, texts and software must know exactly what MAIA presents to patients and how it works.

Of course, defects in the system itself will be repaired immediately as they occur. However, MAIA will not be held responsible for any medical malpractise, failure to obtain informed consent or documentation errors.

Our main monetarization will come from single use licenses that hospitals pay to inform their patients.
Additionally, revenue will come in from discreet advertisement at the entry points of the online information plattform and single commission movie productions (e.g. for private practises and pharmaceutical companies).

We have conducted various test runs and patient studies to prove that animated videos can teach patients about their surgery. In those studies, we found our that patients knew up to 20% more about their surgery, when asked about it shortly before the surgery. For more information about our studies and progress, feel free to contact us at any time.

Our production team has specialized in medical animation and patient education for over 8 years. We are working with our programmers since 2013 and have many associate doctors, specialists in their respective fields, who inspect our informational media closely to ensure highest quality and medical accuracy. The two co-founders of MAIA have a lot of experience in running a startup and leading it to success. Johannes has already founded two startups, Christoph has even founded 6 consecutive companies and exited many of them successfully.

Hospitals and primary care facilities, private care centers and surgical specialists.
Production will focus on high-risk surgeries with a high number of complaints, and surgeries where patients have to make decisions (e.g. if there is more than one course of treatment) and where a surgery is not medically indicated (e.g. plastic surgery).