Overcoming Data Challenges for AI in the Healthcare Industry

Health Technology, Digital Healthcare

Article | August 21, 2023

The COVID-19 virus (C19) pandemic is turning out to be the event of the century. Even World War seems timid in comparison. We are in the 4th month of the virus (in non-China countries) and have gone past the lockdown in many places. Isn’t it time we re-think the approach? What if there is another wave of C19 coming soon? What if C19 is the first of many such events in the future? Before we get into analysis and solution design, summarizing the C19 quirks: While a large section of the affected population is asymptomatic, for some it can be lethal There isn’t clarity on all the ways C19 spreads It’s known to affect the lungs, heart, and kidneys in patients with weak immunity It has been hard to identify a definitive pattern of the virus. Some observations in managing the C19 situation are: With no vaccine in sight, the end of this epidemic looks months or years away Health care personnel in hospitals need additional protection to treat patients Lockdowns lead to severe economic hardship and its repeated application can be damaging Quarantining people has an economic cost, especially in the weaker sections of society If one takes a step back to re-think about this, we are primarily solving 2 problems: Minimise deaths: Minimise the death of C19 and non-C19 patients in this period Maximise economic growth: The GDP output/growth should equal or higher than pre-C19 levels One needs to achieve the 2 goals in an environment of rising number of C19 cases. Minimise deaths An approach that can be applied to achieve this is: Data driven health care capacity planning Build a health repository of all the citizens with details like pre-existing diseases, comorbidity, health status, etc. The repository needs to be updated quarterly to account for patient data changes This health repository data is combined with the C19 profile (disease susceptibility) and/or other seasonal diseases to determine the healthcare capacity (medicines, doctors, etc.) needed The healthcare capacity deficit/excess needs to be analysed in categories (beds, equipment, medicine, personnel, etc.) and regions (city, state, etc.) and actions taken accordingly Regular capacity management will ensure patients aren’t deprived of timely treatment. In addition, such planning helps in the equitable distribution of healthcare across regions and optimising health care costs. Healthcare sector is better prepared to scale-up/down their operations Based on the analysis citizens can be informed about their probability of needing hospitalisation on contracting C19. Citizens with a higher health risk on C19 infection should be personally trained on prevention and tips to manage the disease on occurrence The diagram below explains the process Mechanism to increase hospital capacity without cost escalation Due to the nature of C19, health personnel are prone to infection and their safety is a big issue. There is also a shortage of hospitable beds available. Even non-C19 patients aren’t getting the required treatment because health personnel seek it as a risk. This resulted in, healthcare costs going up and availability reducing. To mitigate such issues, hospital layouts may need to be altered (as shown in the diagram below). The altered layout improves hospital capacity and availability of health care personnel. It also reduces the need for the arduous C19 protection procedures. Such procedures reduce the patient treatment capacity and puts a toll on hospital management. Over a period, the number of recovered C19 persons are going to increase significantly. We need to start tapping into their services to reduce the burden on the system. The hospitals need to be divided into 3 zones. The hospital zoning illustration shown below explains how this could be done. In the diagram, patients are shown in green and health care personnel are in light red. **Assumption: Infected and recovered C19 patients are immune to the disease. This is not clearly established Better enforcement of social factors The other reason for high number of infections in countries like India is a glaring disregard in following C19 rules in public places and the laxity in enforcement. Enforcement covers 2 parts, tracking incidents of violation and penalising the behaviour. Government should use modern mechanisms like crowd sourcing to track incidents and ride on the growing public fear to ensure penalty enforcement succeeds. The C19 pandemic has exposed governance limitations in not just following C19 rules, but also in other areas of public safety like road travel, sanitation, dietary habits, etc. Maximise economic growth The earlier lockdown has strained the economy. Adequate measures need to be taken to get the economy back on track. Some of the areas that need to be addressed are: One needs to evaluate the development needs of the country in different categories like growth impetus factors (e.g. building roads, electricity capacity increase), social factors (e.g. waste water treatment plants, health care capacity), and environmental factors (e.g. solar energy generation, EV charging stations). Governments need to accelerate funding in such projects so that that large numbers of unemployed people are hired and trained. Besides giving an immediate boost to the ailing economy such projects have a future payback. The governments should not get bogged down by the huge fiscal deficit such measures can create. Such a mechanism to get money out in the economy is far than better measures like QE (Quantitative Easing) or free money transfer into people’s bank accounts Certain items like smartphone, internet, masks, etc. have become critical (for work, education, critical government announcements). It’s essential to subsidise or reduce taxes so that these items are affordable and accessible to everyone without a financial impact The government shouldn’t put too many C19 related controls on service offerings (e.g. shops, schools, restaurants, cabs). Putting many controls increases the cost of the service which neither the seller not buyer is willing or able to pay. Where controls are put, the Govt should bear the costs or reduce taxes or figure out a mechanism so that the cost can be absorbed. An event like the C19 pandemic is a great opportunity to rationalise development imbalances in the country. Government funding should be channelized more to under-developed regions. This drives growth in regions that need it most. It also prevents excess migration that has resulted in uncontrolled and bad urbanisation that has made C19 management hard (guidelines like social distance are impossible to follow) Post-C19 lockdown, the business environment (need for sanitizers, masks, home furniture) has changed. To make people employable in new flourishing businesses there could be a need to re-skill people. Such an initiative can be taken up by the public/private sector The number of C19 infected asymptomatic patients is going to keep increasing. Building an economy around them (existing, recovered C19 patients) may not be a far-fetched idea. E.g. jobs for C19 infected daily wage earners, C19 infected taxi drivers to transport C19 patients, etc. In the last 100 years, mankind has conquered the destructive aspects of many a disease and natural mishap (hurricanes, floods, etc.). Human lives lost in such events has dramatically dropped over the years and our preparedness has never been this good. Nature seems to have caught up with mankind’s big strides in science and technology. C19 has been hard to reign in with no breakthrough yet. The C19 pandemic is here to stay for the near future. The more we accept this reality and change ourselves to live with it amidst us, the faster we can return to a new normal. A quote from Edward Jenner (inventor of Small Pox) seems apt in the situation – “The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases”.

Health Technology, Digital Healthcare

Article | August 16, 2023

Yes, empathy has become a fad. Connecting to another human is actually something cool kids do now. If a brand doesn’t have an impact model that includes a practical social issue, consumers tend to not take that brand seriously. In this case, empathy needs to be revisited beyond the trend itself for these strategies to have real, lasting impact. Practical strategies around compassion meanwhile have similarly become an intrinsic part of social impact organisations. They have become so commonplace that prosocial behaviour has strayed into a kind of tokenism. It is common for instance for consumers to donate their hard-earned money to companies who focus their energies on trying to alleviate real-world issues. The question then is whether this proxy for compassion isn’t in fact watering down human connections, as well as our positive impact on the issues business and organisations seek to solve with our help. Postmodern behavioral science If it is, then we must understand why and how to change that. This is where postmodern behavioral science provides a possible better alternative to social impact strategies. Postmodern behavioral science suggests that the current approach to understanding human behaviour lacks even a rudimentary understanding of empathy, defined in the area of social impact as a discursive strategy that allows us to feel what the group we are trying to help is feeling. Of course, compassion has very close ties with empathy. Empathy is an innate ability we all have, one that we can learn to develop and fine-tune over time. It is our emotional connection to another human, though one that lies beyond our own ego. It takes the perspective of the person who is struggling and seeks to understand their life, their struggle, and their worldview. It also resolves to value and validate their perspective and experience — something that donating money to a social impact cause does not. In its broader definition, empathy is a shared interpersonal experience which is implicated in many aspects of social cognition, notably prosocial behavior, morality, and the regulation of aggression. Empathy has a host of positive after-effects when applied as an interpersonal experience. If a social impact organisation is preoccupied with raising capital, then it is likely to disregard the practical worth of empathy for those who truly want to achieve its mission. Immersive empathy One way that behavioral science can contribute is to utilise tools that can help augment the experience of those in need for those needing to understand those needs. Both AR and VR can help people visualise and follow the stories of those who require compassion. These create virtual environments for partners, governments, and consumers to experience with the people they seek to help. But of course, much of human behaviour is geared toward seeking pleasant experiences and avoiding unnecessary pain. Our in-built hedonic valuation systems guide decisions towards and away from experiences according to our survival instincts. This is precisely why business owners who want to encourage empathy in their customers go the easy route, but should seek a more participatory frameworks to inspire and provide experiences for those on board with a social mission. Then there are issues like financial literacy in underserved populations, access to clean water, education for women and girls, and environmental conservation, to name a few of the problems that social impact companies are attempting to tackle. If a company is trying to tackle an issue such as access to clean water, then rather than start there, it should first ask exactly how this issue arose and developed. It should question the beliefs that underpin this chronic social inequality, those that inform policies, practices, cultural taboos, and beliefs about water and people’s access to it. To simply respond to an issue in its developed form is to leave it unfixed. We must be willing to reverse engineer the origins of that issue that got us to where we are. In other words, human behaviour is not the only component to consider in this. The main behavioral framework public servants should take with them is to develop a nudge unit solely based on the relationship between behavioural science and technology. This is mainly because technology is an inevitable part of how we now relate to one another. Immersive Compassion meanwhile should embrace tools like AR/VR that seek to create empathetic environments and valuable impact longevity. To fully embrace empathy as an organisation is to create relevant and rigorous responses that go as far as to alter the infrastructure of its target goals. Optimising social impact comes down to optimising human experience.

Health Technology, Digital Healthcare

Article | September 7, 2023

NIS2 Cybersecurity Rules Approaching: Is Your Organization Prepared? The EU NIS cybersecurity regulations are evolving for 2024, and if you’re not currently aware of how they’ll apply to your organization, now is the time to get up to speed with the desired requirements. Not only is the directive being tightened, but an extended range of healthcare and related organizations will be added to the list of ‘critical entities’ that must comply. These include certain medical device manufacturers, pharmaceutical companies, and organizations that carry out R&D. The Network and Information Systems (NIS) standards were set up in 2016 to protect essential services – such as water, energy, healthcare, transport, and digital infrastructure – from online cyberattacks. The updated legislation, NIS2, will have stricter rules,reporting requirements, and higher penalties for non-compliance. They will apply to medium-sized and large businesses that operate within one or more EU countries. Those based only in the UK can’t sit back; however, the original NIS regulations will still apply as part of British law. What’s more, a UK version of the rules is coming very soon, and it’s likely that the framework will closely resemble the EU’s. What will the requirements cover? There are a number of cyber risk management measures that all organizations that come under the scope of NIS2 will be required to put in place. For instance, they will need to conduct regular security assessments and risk analyses, adopt incident response and handling plans, and appoint a chief information security officer (CISO), among other obligations. The new directive will streamline and strengthen incident reporting requirements. Entities must notify regulators of any incident that has compromised data or had a significant impact on the provision of their services, such as causing severe operational disruption or financial loss. Applying information system security policies and business continuity plans will form part of the obligations, as will conducting cybersecurity testing and training for all staff. The use of multi-factor authentication (MFA) and encryption, wherever appropriate, will also be mandated. There is plenty of focus within the directive on the cornerstones of cybersecurity best practices particularly, the proper control of administrator-level account credentials, privileged access, and endpoints, all of which are prime targets for attackers. Under NIS2, organizations are being separated into ‘critical’ and ‘important’ entities. It’s important to determine which category yours’ will fall under, as each has different requirements. The third-party threat will also be addressed in NIS2 by pulling in managed service providers (MSPs) to the list of ‘critical entities’, with the aim of keeping digital supply chains secure. MSPs are often granted privileged access to clients’ corporate systems and networks, which creates security risks. What are the consequences of non-compliance? Organizations that come under the regulations’ purview will be subject to random checks, regular security audits, on-site inspections, and off-site supervision. For those found to be in breach, sanctions could include warnings, temporary suspension of certain activities, and temporary prohibition to exercise certain managerial functions. Financial penalties could be as high as 10 million Euros or 2% of an organization’s global turnover, whichever is higher. What steps should healthcare organizations take now? Organizations should take action to establish whether the EU or UK NIS2 regulations will apply to them and what their responsibilities will be. Having identified any gaps in existing cybersecurity processes, policies, and practices, they must determine what changes need to be made to address them. As a priority, they must review their incident response plans and incident management and reporting procedures. It’s also a good idea to begin assessing the security posture of partners and third parties in the supply chain and incorporating relevant security requirements into contracts. Given the framework’s focus on protecting privileged admin accounts, organizations should implement controls limiting the number of staff members with these robust credentials. Implementing privileged access management (PAM) will allow IT to control who is granted access to which systems, applications, and services, for how long, and what they can do while using them. Preparing for the introduction of the EU NIS2 regulations should be considered more than just a compliance exercise. By meeting the strengthened requirements, healthcare organizations will be building a foundation of resilience that protects them, their customers, and the essential services they provide.

Article | April 15, 2021

Government bodies have organized vaccination drives from the days of paper, pen and file folders. Nations across the globe have successfully run vaccination programs on a large scale. In countries such as India, with the second-largest population, a vaccination campaign to eradicate polio was delivered at specified centers and going door-to-door. India was declared officially polio-free in March 2014. All without technology! Routine vaccination administration has always been either by a scheduled or walk-in appointment. Vaccinating populations for polio, smallpox or similar diseases has always been a part of a multi-year plan for governments.