Advancing Diagnostic Testing and AI Integration: A Conversation with Dr. Michael Laposata
In this episode of The Pulse, Dr. Jochen Reiser, UTMB President and CEO of the UTMB Health System, sits down with Dr. Michael Laposata, Chair of Pathology, for a conversation about his inspiring journey into medicine and the defining experiences that shaped his career. Dr. Laposata discusses his pivotal work in the lab, highlighting how his team is advancing diagnostic processes and creating innovative approaches to patient care. He shares his vision for the future of pathology, emphasizing the importance of integrating laboratory medicine into the broader health care landscape to improve outcomes. Reflecting on his past, Dr. Laposata also underscores the value of mentorship and fostering a culture of discovery and collaboration in advancing medicine.
- 100:00:00,840 --> 00:00:09,600[Auto-generated transcript. Edits may have been applied for clarity.]Welcome to The Pulse: A UTMB health podcast, your gateway to the latest insights, ideas and innovations shaping our community and beyond.200:00:10,230 --> 00:00:16,530Stay tuned for engaging discussions, compelling stories, and the information you need to stay informed and connected.300:00:16,830 --> 00:00:24,650Right here on The Pulse. Hello and welcome back to the Pulse podcast.400:00:25,190 --> 00:00:30,800I'm Dr. Johan Reiser, president of UTMB and CEO of the UTMB Health System.500:00:31,310 --> 00:00:36,490On today's episode of The Pulse, I'm excited to welcome Dr. Michael Laposata,600:00:36,740 --> 00:00:40,250professor and chairman of the Department of Pathology at UTMB.700:00:41,060 --> 00:00:49,760Dr. Laposata is a nationally recognized leader in his field, making significant contributions to the way we approach diagnostic medicine.800:00:50,360 --> 00:00:54,770His work is shaping the future of health care here at UTMB and beyond.900:00:55,310 --> 00:00:59,750Dr. La Laposata, thank you for joining us today. It's great to have you here.1000:00:59,900 --> 00:01:07,760Thank you. Wonderful for me. Please tell me a little bit about your background and what led you to UTMB.1100:01:08,510 --> 00:01:12,470Sure. I've been here 11 years now. A very exciting 11 years.1200:01:12,830 --> 00:01:17,780I started out in the Johns Hopkins program for MD/PhD students.1300:01:18,260 --> 00:01:21,560And during that time I became interested in blood clotting.1400:01:22,040 --> 00:01:28,070So I went to the chairman of hematology at Hopkins and said, how do I become like you?1500:01:28,790 --> 00:01:32,149And he said, well, first you're going to have to be a pathologist.1600:01:32,150 --> 00:01:35,840And I said, how will that work if I'm interested in blood clotting?1700:01:36,350 --> 00:01:43,160He said, well, hematology and oncology emerged. And the hematology part is malignant hematology.1800:01:43,490 --> 00:01:47,820So if you want to study bleeding and clotting, you have to go through pathology.1900:01:47,840 --> 00:01:52,520That turned out to be a good thing because I learned all the tests.2000:01:52,790 --> 00:01:54,860And I also learned how to take care of patients.2100:01:55,250 --> 00:02:01,670So I had a foot in the lab for diagnostics, and I had a foot in front of the patients understanding what was needed.2200:02:02,300 --> 00:02:09,260So I took jobs in my field, running coagulation labs and seeing patients first at Penn for four years.2300:02:09,500 --> 00:02:14,510Harvard for 19 at the mass General started their first modern laboratory.2400:02:14,780 --> 00:02:18,950And then I spent six and a half years practicing for this job by going to Vanderbilt.2500:02:19,520 --> 00:02:24,830Wonderful, wonderful. Can you share more about your current roles at UTMB?2600:02:24,950 --> 00:02:28,640I hear you're balancing three different positions, which is quite impressive.2700:02:28,820 --> 00:02:34,490Thank you. Well, it's all evolved over time because I was interested in coagulation.2800:02:34,490 --> 00:02:40,100One of the first things I noticed is that coagulation results had to be explained to the doctors.2900:02:40,280 --> 00:02:43,670We had to tell them what the test meant and what they should do next.3000:02:44,060 --> 00:02:50,030So ultimately that evolved, and it started out as something that wasn't very scalable,3100:02:50,180 --> 00:02:58,219where we could do 10 or 15 cases in an hour or two, but we realized that the need was much bigger and it was needed in auto-immunity.3200:02:58,220 --> 00:03:01,310It was needed in all kinds of fields of medicine.3300:03:01,670 --> 00:03:07,670So technology arrived, and then with artificial intelligence and large language models,3400:03:07,970 --> 00:03:14,390we realized through the COVID pandemic that we could interpret as many as 2000 cases of anything in a day.3500:03:14,990 --> 00:03:18,800So it was during that time that we learned how to move forward.3600:03:19,040 --> 00:03:27,080So the role of being chairman of the department evolved into a role of being head of a diagnostic center, as we call it.3700:03:27,560 --> 00:03:30,860And, uh... and I'm also head of the MD PhD program.3800:03:31,040 --> 00:03:34,280Wow. It's just incredible what you all covering.3900:03:34,730 --> 00:03:40,610So you referred to it... One of the roles is director of the Sealy Diagnostic Center at UTMB.4000:03:40,910 --> 00:03:45,660How does the center work and is it still in preparation or open for business.4100:03:45,680 --> 00:03:50,330So we're doing work right now mostly for UTMB patients.4200:03:50,750 --> 00:03:59,150So for example um, if a patient comes in and is found to have anemia, we then can respond to a consult.4300:03:59,600 --> 00:04:06,860Um, and we look at everything in the medical record to determine what kind of anemia it is,4400:04:06,860 --> 00:04:13,010because that will tell us how to treat it so we can diagnose simple anemia like iron deficiency.4500:04:13,160 --> 00:04:21,110Or I just tested the system today to see if it can find a rare coagulation disorder called Glanzmann thrombasthenia.4600:04:21,380 --> 00:04:24,980And I told it to platelet aggregation studies and a little about the patient.4700:04:25,250 --> 00:04:31,850And it gave me this language model with the knowledge base that we've created in the diagnostic center,4800:04:32,000 --> 00:04:38,510what the diagnosis was, what we should do for the next set of tests, and what the genetic alterations might be.4900:04:38,930 --> 00:04:46,160So running this diagnostic center has allowed us to take care of UTMB patients for a variety of areas.5000:04:46,190 --> 00:04:51,350Pharmacogenomics is another one. You don't respond to medicines well for all those we can be paid,5100:04:51,740 --> 00:04:57,379but we really think that this is a market that virtually all of us need, so it could go well beyond UTMB.5200:04:57,380 --> 00:04:59,000Be very interesting.5300:04:59,420 --> 00:05:08,940Is the Sealy Diagnostic Center using AI already, and in what way? Can you give a few examples of how AI can help doctors and their patients?5400:05:08,960 --> 00:05:14,660Yeah. First, let me tell you a little bit about AI when it comes to laboratory tests exclusively.5500:05:14,960 --> 00:05:20,960So um, in the example that I just gave, uh, one of our pathologists, Chris Zauner.5600:05:21,650 --> 00:05:29,540Created more than 50 different large language models that cover about 80% of the known diseases.5700:05:30,110 --> 00:05:34,170And so Glanzmann thrombasthenia has its pages and it....5800:05:34,180 --> 00:05:40,910And, what we do is to use artificial intelligence and say... interrogate our large language models.5900:05:41,060 --> 00:05:44,210We might subsequently ask it to check the internet,6000:05:44,570 --> 00:05:50,000but the large language model then picks the verbiage and makes it understandable6100:05:50,000 --> 00:05:56,120to the doctor, so that we can then present the information to the doctor.6200:05:56,420 --> 00:06:01,399So, we are certainly using it now for UTMB patients.6300:06:01,400 --> 00:06:08,270And, and uh, we will go forward. Artificial intelligence is the part where it puts all of the facts together.6400:06:08,720 --> 00:06:14,090Now that's only half the story. The other half of artificial intelligence is for image studies.6500:06:14,360 --> 00:06:20,420So, we know in radiology that artificial intelligence can be used to look at an MRI.6600:06:20,480 --> 00:06:24,740And, it finds what the anomaly is. So why not a biopsy.6700:06:24,860 --> 00:06:26,870Why can't we use it to find a tumor.6800:06:27,170 --> 00:06:35,480And, just this past Tuesday, we turned on artificial intelligence, one of two academic medical centers in the United States today.6900:06:35,840 --> 00:06:42,260And, it was so impressive. Everybody stood up like a rocket launch when Harsh Thaker, head of anatomic pathology,7000:06:42,500 --> 00:06:49,160push the button and suddenly all the tumor lit up in red and it was not visible before.7100:06:49,520 --> 00:06:58,940So really with both anatomic path and clinical path, we're picking up lots of things that we never, never would have because of AI.7200:06:59,300 --> 00:07:04,300Wonderful. I actually shared that moment on the social media platform.7300:07:04,310 --> 00:07:06,470I was so excited about it. Yes.7400:07:06,950 --> 00:07:15,290So it seems like our patients are already being able to participate in all these new technologies in your pathology department.7500:07:15,770 --> 00:07:21,420And, and are they covered these tests that you're mentioning, uh, these new technologies by insurance.7600:07:21,440 --> 00:07:30,350Yes. So certainly the prostate biopsy was covered because they needed a prostate biopsy interpretation, and we did it faster and more reliably.7700:07:31,130 --> 00:07:36,110Uh, certainly the anemia case was covered because the patient was anemic and needed an interpretation.7800:07:36,500 --> 00:07:39,739What's not covered is most of the preventative things.7900:07:39,740 --> 00:07:42,290And I'll give you a perfect personal example.8000:07:42,770 --> 00:07:48,950My daughter got married not long ago to a fine gentleman whose father died in the Detroit airport when he was six.8100:07:49,430 --> 00:07:58,470He had sudden cardiac death. So he's now my son in law, and I know enough about cardiac disease.8200:07:58,490 --> 00:08:02,750I was worried that he might have an elevated value of certain lipoprotein,8300:08:02,750 --> 00:08:08,810called lipoprotein little A, which is responsible for sudden cardiac death in young people.8400:08:09,680 --> 00:08:13,130So, the value that's normal goes up to 30.8500:08:13,700 --> 00:08:23,840And so when Nick approached his doctor and said, can I get this test not covered because he didn't have any cardiac symptoms, so I paid for the test.8600:08:24,020 --> 00:08:32,540His lipoprotein level was 122, and I want my grandchildren to have a dad, and not till age six only.8700:08:32,990 --> 00:08:39,680So what I've learned through this is that we ultimately have to pay far more attention to the preventive part,8800:08:39,800 --> 00:08:43,850because it'll save us a fortune on the other end and greatly improve care.8900:08:44,090 --> 00:08:51,229So that's where it is right now. I think insurance companies are going to realize that paying $30 for a lipoprotein9000:08:51,230 --> 00:08:57,350little A test is way to their benefit... than letting the sudden cardiac death occur.9100:08:57,800 --> 00:09:01,640That's a very powerful example. And so thanks for sharing that experience.9200:09:02,240 --> 00:09:06,770Well, uh, Doctor Laposata, it was very inspiring to have you on the pulse today.9300:09:07,100 --> 00:09:11,960And I'll. Sure, we'll follow up with you more about exciting news from the pathology department at UTMB.9400:09:12,260 --> 00:09:15,980Thanks, Doctor Reiser. Thank you for tuning in to the pulse.9500:09:16,460 --> 00:09:21,710We hope you've gained valuable insights, discover new perspectives, and feel inspired by the stories shared today.9600:09:23,000 --> 00:09:27,830Please join us for future episodes to stay informed and connected right here on The Pulse.
More Information
Dr. Michael Laposata is a leading expert in blood coagulation and laboratory medicine. He specializes in diagnosing bleeding and clotting disorders and currently focuses on evaluating children accused of child abuse. His work has led to the reunification of over 40 families by identifying misdiagnosed medical conditions. Dr. Laposata has published over 190 peer-reviewed articles and edited nine books. He is recognized for his research in fatty acids and diagnostic errors, contributing to the National Academy of Medicine’s report on improving diagnosis in healthcare. He also oversees UTMB’s clinical laboratories, specializing in complex diagnostic cases.
For a full bibliography of Dr. Laposata’s publications, visit the NIH website.