Introduction to Project Nightingale Project Nightingale is a data sharing project financed by Google and Ascension, a Catholic health care system comprising a chain of 2,600 hospitals, doctors’ offices and other related facilities, in 21 states, with tens of millions of patient records available for processing health care data. Ascension is one of the largest health-care systems in the United States with comprehensive and specific health care information of millions who are part of its system. Google is involved with Ascension to process this data, which began in secret sometime in 2018, without knowledge and consent of patients and doctors. Whistleblower A whistleblower who works in Project Nightingale, the secret transfer of the personal medical data of up to 50 million Americans from one of the largest healthcare providers in the US to Google, has expressed anger that patients are being kept in the dark about the massive deal. The anonymous whistleblower has posted a video on the social media platform Daily Motion that contains a document dump of hundreds of images of confidential files relating to Project Nightingale. The secret scheme, first reported by the Wall Street Journal, involves the transfer to Google of healthcare data held by Ascension, the second largest healthcare provider in the US. The data is being transferred with full personal details including name and medical history and can be accessed by Google staff. Unlike other similar efforts it has not been made anonymous though a process of removing personal information known as de-identification. The whistleblower introduces the video with the words: “I must speak out about the things that are going on behind the scenes.” Watch Video - https://www.dailymotion.com/video/x7nvz43 The Four Pillars Stage 1 - Infrastructure and Data Layer transformation Stage 2 - Collaboration and Productivity, G Suite Deployment Stage 3 - Healthcare information layer, EHR Search Stage 4 - Healthcare experience layer, Use cases Stage v Pillars Stage 1 and 2 - moving patient data not de-identified to the Google Cloud Stage 3 - Google using Ascension data to build its own framework in the cloud Stage 4 - Google uses Ascension data to mine patient info, run analytics, run AI algorithms, sell or share data with 3rd parties, create profiles of patients that they can later advertise to online with healthcare ads targeted to their specific healthcare issues Is Google allowed to access patient data? In a word, yes. Company insiders claim that Ascension patients are unaware that their medical data is being shared. While this may raise concerns among privacy advocates, Forbes states that privacy laws 'generally allow the sharing of patient data with third parties without notification if it is for purposes that “help it carry out its health care activities and functions.’” Google has also stressed that its agreement with Ascension means that it can only use patient data for its medical-related algorithms. “To be clear: under this arrangement, Ascension’s data cannot be used for any other purpose than for providing these services we’re offering under the agreement, and patient data cannot and will not be combined with any Google consumer data”, Google Cloud chief Tariq Shaukat wrote in a blogpost. Google Q&A - Was your work with Ascension a secret? "Our work with Ascension was not a secret. In fact, we first announced our partnership with Ascension in July, on our Q2 earnings call. And, as Ascension has stated, they informed acute care administrative and clinical leaders across their organization on the work, held enterprise-wide webinars, and briefed clinical leaders of their employed physician group in detail. In addition, Ascension directly engaged many front-line nurses and clinicians on the project." Google Q&A - Does Google combine patient data across customers? "No. We are building tools that a single customer (e.g., a hospital or primary care group) can use with their own patients’ data. The data is siloed, access controlled, and auditable. We do not combine data across partners, and we would not be allowed to under our agreements or the law." Google Q&A - What does the name “Nightingale” come from? "It’s actually the code name that both parties are using for this project, nothing more. We use code names for many different things--customers, products, etc." Sources : https://en.wikipedia.org/wiki/Project_Nightingale Sources : https://www.dailymotion.com/video/x7nvz43 Sources : https://www.irishtimes.com/business/technology/project-nightingale-google-s-secret-project-gathers-health-data-of-millions-1.4081492 Sources : https://www.theweek.co.uk/privacy/104293/google-project-nightingale-tens-of-millions-of-health-records-gathered-without Sources : https://cloud.google.com/blog/topics/inside-google-cloud/our-partnership-with-ascension

Proteus Digital Health’s CEO once confidently proclaimed that in a couple of decades, “every medicine will have a chip in it.” At a time when many companies are trying to break into the airy realm of digital health, and getting funded, Proteus seemed to not only be making headway toward its CEO’s ambitious vision, but to have the bona fides to back it up. Yet this week, as a CNBC report described it, Proteus is suddenly “desperate for cash.” Given that the company was considered one of the few validations of that chip-in-a-pill strategy, the news — combined with Sanofi CEO Paul Hudson’s just-announced plan to walk back Onduo, the firm’s diabetes management joint venture with Verily, and Sandoz’s October decision to relinquish commercial rights for prescription digital therapeutics to Pear Therapeutics — may have left some feeling unsure what this means for the future of so-called digital medicine. How did Proteus go from a $1.5 billion valuation to having trouble just keeping the lights on? “It’s all about evidence,” explained Everett Crosland, an expert in market access within the digital health field, when asked about the possible missteps that led to Proteus’ funding woes. That is, evidence development and commercialization based off of that evidence. Crosland — formerly VP of market access, reimbursement and governmental affairs for Pear — has become well familiar with that requirement. “There’s a learning curve occurring where multiple [digital therapy] companies raised money and told a story that, ‘Because we’re a new modality, we’re somehow excepted from the laws of healthcare physics.’ [But] we’re not. We have to meet thresholds and oftentimes exceed them because we are digital.” In the case of Proteus, the company said that its body of clinical evidence has shown improvements in cost effectiveness and quality of care. Nevertheless, according to the CNBC report, it’s undergoing a restructuring after failing to close a $100 million funding round that had forced it to furlough the majority of employees last month. The issue involved a lack of traction among patients, sources said, which made Otsuka hesitant to commit further investment from its pledged $88 million, five-year partnership, and other potential investors leery of doing so as well without further data from the partnership. The Redwood City, Calif., start-up, founded in 2001, had spent the ensuing decades developing a smart pill, a device designed to tell a smartphone app whether a patient has ingested a medicine. The firm applied for and secured FDA approval back in 2017 for Abilify MyCite, a product jointly developed with Otsuka that focused on the schizophrenia population. Late last year, Otsuka committed to help Proteus expand its menu of digital medicines to other areas of mental health. As of January, Proteus had begun pushing into oncology, too, and had raised a total of $487 million in funding over 11 rounds from backers including Novartis Venture Fund and Kaiser Permanente Ventures. That promising start made this week’s news all the more surprising. Which is why I asked Crosland for his take. He’s now SVP of commercial for AppliedVR, which markets virtual reality technology to hospitals for use in helping patients cope with pain and anxiety. He spoke with MM&M about what he sees as the reasons behind Proteus’ stumble, as well as the overall state of reimbursement in, and payers’ evolving attitudes toward, digital health. The following interview has been edited and condensed. Talking about Proteus, they’ve had quite a turnabout for a company that seemed to be doing things the right way. Why do you think they’re in this situation now? As a good steward in healthcare, if you’re selling and commercializing anything, you need to show it works and the only way to do that is through prospective studies. That comes in the form of randomized controlled clinical trials, health economics and outcomes research (HEOR) and value-based studies so that you know it works from a clinical perspective and a value perspective, that you’re creating value for health systems, payers and patients. Those are just table stakes. The Proteus news just reconfirms that. In the earlier days at Proteus — I’ve heard them speak on this — is that you have to ensure in your partnerships that you’re driving toward the same goal…which inevitably should be evidence development and commercialization based off of [that] evidence. What kind of evidence? These [digital medicines are approved for] serious conditions that require evidence both from a clinical perspective to get through regulatory hurdles and health economic evidence to ensure that we’re driving value and cost savings. We have to show more than a traditional drug because we have to demonstrate we’re clinically safe and effective and that patients will use our product, which if you’re a drug (for the most part) it’s assumed patients will use it, even though evidence shows poor adherence rates. Still, we have to hit that bar through randomized clinical trials. Do you think they had trouble hitting that bar? I can conjecture that what we’re all experiencing now is that the early pioneers of the industry — and there are a number of them — have signed…large, promise-based, bio-bucks deals that come in at $100 million to $300 million, if the product performs. For the product to perform, you have to invest significant dollars in the evidence development and ultimately in true commercialization and scaling efforts. For the field force, that’s often a rather unique sale. While Proteus has done some very impressive deals, it takes a few years for those deals to come to fruition…and to determine if a product is truly performing. And if you didn’t invest where you needed to invest in the early days, then it’s hard to catch up. That’s what ended up happening. As you look around the industry, what digital health companies are leading the way with outcomes data? A great example is Click Therapeutic’s [prescribable software] product for smoking cessation. They’re covered by 200 mid- and large-sized employers. And the reason they have that coverage is their evidence. Big Health’s Sleepio insomnia app has a mountain of evidence behind it and has coverage across the U.S. Evidence development drives coverage, and it’s a well-worn path. We are new in many ways but again, [there are] laws of healthcare physics that you’re never going to get around, [nor] should we try. We’re not selling bits and bobs; we’re selling healthcare products. If you don’t want to develop evidence, you shouldn’t be in healthcare. Sunday’s news story said pharma lacks a clear roadmap to get these products out to patients. Is there a demand problem? Of course there has to be demand for it, but you have to be out there with the on-ground sales force, and most of that is selling to payers and to physicians and educating the market to ensure that you’re changing the prescribing behavior that needs to be changed. You’re pulling through those prescribers, making it clear that this is a benefit to patients, and [that] we have an amazing opportunity to monitor that data in a quicker turnaround than any other modality. We can see when patients are using it, what’s working and what’s not. But at the same time, the sales force has to be out there educating. These products won’t sell themselves by any means. This is not a traditional pharma sale, but a modality where largely what we’re trying to do is change behavior, and a behavior-change sale is not a pill sale. Pharma and start-up don’t always adhere to the commercial roadmap, as we saw when Pear and Sandoz unraveled part of their co-promote recently. To what extent are these kinds of relationships fraught with friction? I think that we’re getting to a place between digital health and pharma where we’re really understanding how we work well together. I sat on a panel with Proteus and Otsuka a year and a half ago, and they talked about how when they first got together, their relationship…struggled but got to a place where they understood best practices in their alliance. More and more, we’ve got pharma players who have dealt with enough digital-health companies where they now know how best to work with us. At the same time, we as digital therapeutics companies have to ensure that we…are good partners. That requires us to ensure that our product team has dedicated resources and bandwidth in the roadmap so that when these pivotal partnerships come in the door, we have product [teams] tell us what’s possible in the deal-making phase and [inform] every step of the alliance. That’s an alliance digital-therapeutics companies are starting to understand. It’s not something that was clear even two years ago. Interestingly, the Pear-Sandoz breakup announcement was almost immediately followed by Bayer, Novartis and other pharma companies getting [deeper] into the space. There’s no slowing of these partnerships [due to] the precedent of Sandoz and Pear. Are the two ironing out their cultural differences? We both come to the table with distinct cultures and mindset. Pharmas come to the table with often decades…of process. Every decision has an incredible amount of rigor behind it. In our world, the start-up digital therapeutics world, we don’t have that legacy. That can help us move faster, scale faster, help us think more creatively and get into markets that a pharma probably would have overlooked or killed due to process. At the same time, we have to recognize there are limits to that agility and risks. And if we’re talking about a deal worth hundreds of millions of dollars, we need to find a middle ground between cultures. Most importantly, both need to understand it’s not our job to change the mindset of our partner’s organization. It’s not the digital therapy’s job to drive digital transformation at our pharma partner’s organization. It’s our job to execute on the deal in the timeframe we agreed to and make it a success. It’s not the pharma partner’s job to help [the start-up] grow up and be more process-driven. We just have to understand that there are middle grounds to be found, and our success is executing and pulling through on the deal ahead of schedule. That’s success, not driving some sort of ethereal or cultural change at the partner. Sunday’s story also alluded to a lack of clarity around patient monitoring for digital therapies. Do you agree? That’s an accurate general statement, and that would vary by health condition and disease state. Especially with MyCite and schizophrenia…when a schizophrenia patient isn’t following up and is struggling to adhere, I could absolutely see that being challenging. In other disease states, like with [ADHD], if a pediatric patient isn’t adhering you can find a primary care physician and the caregiver — most likely a parent — and follow up with them. Not every disease state is so clear, [certainly] not schizophrenia….We felt that at Pear in the opioid-use disorder area. The patient journey still has a lot of gaps in it. If a digital therapeutic fills those gaps, it can help bring clarity [i.e., data] to that patient journey that you just otherwise don’t have. But at the same time, we won’t be able to solve everything. How have payer views evolved in reimbursing digital-therapy combos? They’ve evolved more rapidly than I thought they would and in a positive direction. They’ve moved beyond “is this competitive with pharma” or “a replacement of pharma” and recognize there’s a role and need for both products, either alongside of, or within, the treatment paradigm. Just like any product for unmet need, it’s not replacing a drug but supplementing or filling in a gap in the current treatment paradigm. More importantly [payers] like Express Scripts, CVS Caremark, Solera with BCBS of California are putting in place the plumbing or infrastructure that facilitates payment and coverage of digital therapeutics. That wasn’t the case two years ago; every payer was different. Now, we’re seeing a move toward uniformity in the evidence payers require for coverage and payment, and mechanisms like billing and coding being put in place. When Express Scripts announced they were putting together a digital health formulary, and CVS Caremark followed suit, that was a watershed moment for the industry. Have regulators been moving rapidly enough in this area? The Food and Drug Administration has been very helpful and forward-thinking. They recognize the potential of these products to help patients. They also see the need for evidentiary rigor to be applied to these products because they’re going to be used, one way or the other, and need to be held to the gold standard. I haven’t seen anything to suggest they’re slowing down. The Centers for Medicare and Medicaid Services is behind the FDA in that regard. They have not put in the amount of thinking, have not engaged stakeholders in that way. They are lagging behind, and that will become an increasingly stark lag as CVS Caremark, Express Scripts and other payers start to facilitate coverage and payment for the commercial, Medicare Advantage and Medicaid managed care populations. When those populations start to be able to access these innovative solutions at scale and start to improve outcomes, and if those on traditional Medicare are unable to access these products, that will be a problem. Source : https://www.mmm-online.com/home/channel/whats-behind-smart-pill-maker-proteus-funding-woes-lack-of-evidence-to-convince-payers-of-value-says-one-expert/

Facebook's WhatsApp has been growing in user numbers to become one of the globally dominant and most widely used messaging apps. And as such, it was only a matter of time before it found its way expanding from the casual, private userbase to professionals, even in fields such as healthcare – that must surely rank as some of the most sensitive. The website providing a guide to the US Health Insurance Portability and Accountability Act of 1996 (HIPAA) asks the pertinent question: is using WhatsApp in a professional setting by healthcare workers compliant with the law? Specifically – if doctors and nurses choose to exchange information about their patients' health via WhatsApp – can patients count on this private data to remain safe – according to the standard set by the protected health information (PHI)? PHI regulates anything from information about a person's health status to their healthcare payments – in other words, it's a collection of extremely comprehensive and sensitive personal information. But could all that be getting out in the wild if professionals exchanged it via WhatsApp? The HIPAA guidance website analyses the circumstances both from the point of view of the legislation and the way WhatsApp is deployed to conclude a resounding – just don't do it. Despite WhatsApp deploying end-to-end encryption – and more on that later – the conclusion here is that the app, though it can still be used by healthcare professionals “for general communication” – is not up to par as a trusted app to transmit and exchange patients' electronic protected health information (ePHI) – though “de-identified PHI” can still be exchanged on the platform, the HIPAA website said. Then, there's UK's national healthcare service, the NHS, where nurses using the app to communicate about patients has raised privacy concerns. “We use WhatsApp for everything, reminding other nurses about problems with patients, which patients to be careful with or which patients have problem relatives who they need to look out for. Having a group chat for a ward can be quite useful to keep everyone up to date on what’s been going on,” one NHS nurse said to Reclaim The Net. Another shed some light on the treatment of patients' medical data: “It’s not so much the nurses that are sharing patient stuff, it’s usually the doctors that use it to share more personal stuff. Lots of doctors take photos of patients’ wounds and x-rays and share them with other doctors on WhatsApp. It's kind of worrying when you think that Facebook owns WhatsApp, and we all know what they're like with privacy.” However, the NHS has recently suffered other technological setbacks like the organization's slow and reluctant upgrading from some pretty abysmal existing technologies, like Microsoft's Windows XP. That, in the end, cost the NHS a lot of money and good faith in the 2017 WannaCry ransomware disaster. You might think – that was then. But even now, as MobiHealthNews reports that a St. George's University Hospital NHS Foundation Trust study has found that the NHS is “a privacy and clinical safety time-bomb.” The study is based on “77 staff members in the trauma and orthopedics department revealing that 87 percent of staff used smartphone apps to discuss patient cases at work, despite 56 percent not being sure whether the information was secure.” EU’s General Data Protection Regulation (GDPR) plays into the way the UK deals with this type of data and privacy issues. When and if the UK leaves the EU, the GDPR will continue to be enshrined in the national law – so it's particularly disconcerting that a recent Freedom of Information Act (FOI) request has found as many as 58 percent of 136 NHS trusts lacking any policy in place whatsoever when it comes to protecting patients' personal medical data from messaging apps. The study, that is yet to be published, is comprehensive – and one of the points it touches upon is Facebook's WhatsApp. Even if WhatsApp's redeeming feature seems to be its end-to-end encryption – there's more to the story than meets the eye. While direct communication may be protected – allowing backups on WhatsApp means that data stored in this way becomes vulnerable to outside snooping. That was revealed in one of the controversies of the day, back in the summer of 2018 – and Buzzfeed expanded on it at the time. On the other hand – it's a no brainer that emergency services, and those they work to assist in a crisis can greatly benefit from a real-time communication tool that will make their work as efficient as possible. But, as Nursing Times observes, – “Instant messaging can have clinical utility – but remember that the law places obligations on clinicians to protect patient confidentiality.” Outside the immediate medical tasks – UK's health service might have mitigated some damage from deploying vast amounts of outdated Windows operating systems that made it a soft target in 2017 for the WannaCry crisis. Digital Health writes that NHS staff using encrypted messaging apps like WhatsApp as an unofficial communication channel back then was not such a bad idea – the website claims that “national bodies and trusts told us it worked well during the incident.” But the NHS in 2018 felt it was the right time to introduce some new rules when it comes to using WhatsApp to exchange sensitive patient data. The guidance is designed to help doctors and nurses use messaging apps “safely to coordinate patients' care during emergencies.” The guidance recommends using messaging apps that “meet the NHS encryption standard”; not allowing other people to use their device and not allowing lock-screen notifications; and keeping “separate clinical records and deleting the original messaging notes once any advice has been transcribed and attributed in the medical record.” Source : https://reclaimthenet.org/hospitals-doctors-nurses-whatsapp-data-privacy/

Yesterday evening the German Parliament / Bundestag decided to pave the way for a broad usage and reimbursement of digital health applications and to improve the digitization of the German healthcare market. Until now, apps or other medical software offerings for patients could only be reimbursed by an insurance company on a case-by-case basis or under special selective agreements. The first-mentioned was a very complex process for the patient and did not open up a sustainable business model for the provider of the app or software. A selective agreement was and is a way of having the product reimbursed by statutory health insurers, but these agreements were limited in time and did not allow for comprehensive market coverage in Germany. Once the contract expired, there was no direct route to transition into the regulated reimbursement by all statutory health insurers in Germany. The new Digital Healthcare Act (DVG) now opens up a structured path to have digital health applications reimbursed by statutory health insurance funds, thus make them accessible to patients on a broad basis. But what does the Digital Healthcare Act actually mean for stakeholders in the healthcare market? What are the key implications for patients and providers? All such health apps, which can help patients to manage a diagnosed medical condition, can from January 2020 onwards be prescribed by their doctors. The costs are borne by the statutory health insurances, hence those insurances 73 million people in Germany are members of. To receive market clearance, apps have to undergo an assessment on data security and functionality by the Federal Institute for Drugs and Medical Devices (BfArM). It is important to know, however, that statutory health insurances will reimburse the costs provisionally for one year only. In order to qualify for cost reimbursement, providers of health apps have to generate proof for positive effects on care for their respective apps within these first twelve months. This process is referred to as the “Fast Track” into standard care in Germany. Such positive effects could be related directly to medical outcomes for patients or to process and structural improvements. Providers of health apps which already generated proof for these positive effects can now apply at the BfArM to become component of German reimbursed standard care directly. What does the act mean for telemedicine and digitization? In 2018 the before then highly restrictive regulation on distant treatments had been opened towards remote/video consultations. Now, doctors are allowed to better inform patients about their video offerings, and video consultations will be reimbursable. In addition, there will be stronger incentives and regulations in place to further improve digitization of traditionally paper-bound documents, e.g. certificates for sick leaves, medical reports, and prescriptions. To allow for a more efficient exchange of data amongst all stakeholders in the healthcare sector, doctors, hospitals, and pharmacies are now obliged to connect to the German telematics infrastructure. Midwives, physiotherapists as well as rehabilitation and nursing facilities can voluntarily join the telematics infrastructure and will be reimbursed for that voluntary connection. As a consequence, the relevant preconditions for an electronic patient file will highly improve as well. Does it have an effect on funding options for start-ups? Yes, it does! Statutory health insurances are now allowed to support start-ups not only know how- and market-related, but also financially – by investing directly into VC funds with focus on digital solutions in the healthcare space. Up to approximately 400 million EUR out of the financial reserves of the German statutory health insurances could be potentially invested. The euphoria and excitement in Berlin’s digital health ecosystem is enormous. And the speed at which the Federal Ministry of Health has designed the new law is worthy of a start-up: in 18 months from the idea to the passing of the law. „As a former co-founder of a digital-health startup, I am relieved and impressed. Relieved, as the #DVG is a key milestone in Germany’s strategy to leapfrog its health system into the 21st century. And impressed, as the very robust but also rigid German system is now taking a pioneering role to open up for digital health innovations.”, says Dr. Henrik Matthies, managing director of Berlin based health innovation hub (health innovation hub) – think tank and digital transformation partner of the German Ministry of Health. Digital health start-ups can now prepare their market entry in a clearly defined regulatory environment. Patients can look forward to easy and fast access to their physician, pharmacy and digital healthcare applications, as well as improved medical care. And we healthcare investors can better assess the opportunities for our portfolio companies to enter the market. Source : https://www.frontiers.health/german-digital-healthcare-act/

Sony has entered the Digital Health market with a remote monitoring wearable device called mSafety. The product is a wristwatch designed to capture and track patient data such as blood pressure, blood sugar and heart rate continuously. mSafety Watch mSafety allows providers of health and safety services to monitor people remotely and keep them safe. Expand and improve your offer with this scalable, secure and energy-efficient platform. Remote monitoring Keeping people safe, without being intrusive. Whether you’re rescuing a kite surfer, monitoring employees in high risk occupations or aiding the elderly, remote monitoring via the mSafety connected wearable device maximises not only safety, but also the users’ sense of personal freedom. How remote IoT monitoring improves patient care As a healthcare provider, how can you continue offering high quality services in the future, without adding costs? Combining a power-efficient wearable with a secure backend solution, the mSafety platform from Sony addresses this question head on – allowing you to monitor patient data such as blood pressure, blood sugar and heart rate continuously from a remote location. With mSafety, you can provide an even better service to users while also reducing your costs. Low complexity wearable Easy to use, read and manage, this straightforward device eliminates many of the difficulties associated with smart phone apps. Thanks to energy-efficient IoT connectivity battery life is 7 days or more. Source : https://iot.sonynetworkcom.com

2019 Digital Health Prediction 1 : Apple, Amazon, Google or Microsoft acquires electronic record systems provider Epic (Epic Systems Corporation) to gain a foothold in Healthcare. The acquisition will effectivey be a "trojan horse" unlocking access to data, clinical technology, mobile technology, paying clients and research. Epic's market focus is large healthcare organizations and academic medical centers. Apple, Amazon, Google or Microsoft all need to combine the latest academic and medical research with massive patient/clinical data sets and their proprietary machine learning, deep learning and neural network algorithmns. In Q1 2017 Epic launched a new program App Orchard – serving physician practices and hospitals to help them build customized apps. The program also supports independent mobile app developers who target providers and patients. App Orchard, for its part, lets developers use a FHIR-based API to access an Epic development sandbox. This will allow the developers to address issues in connecting their apps to the Epic EMR. Previously, Epic wouldn’t let mobile app developers connect to its EMR until a customer requested permission on their behalf. In addition to providing the API, App Orchard will also serve as an online marketplace along the lines of Google Play or the Apple app store. However, end users won’t be able to download the app for their own use — only software developers and vendors will be able to do that. The idea is that these developers will create the apps on contract to customers. 2019 Digital Health Prediction 2 : Voice technology will be the first step to personalising pharma. By the end of the year we will see the use of Virtual Assistants by patients to help interact with their health data and "transact" via voice technology to order repeat prescriptions, pain management and medication requests. Google Voice, Siri, Cortana and Alexa will finally have connectivity to raw and comprehensive up-to-date data. Voice technology also has massive potential for clinical drug trials. Orbita, a provider of voice-first software for connected home healthcare and ERT, a global data and technology company focused on minimising risk in clinical trials, have recently put their heads together to research the potential of voice assistants to improve patient engagement and optimise data collection in the clinical trial setting. Their solution enables patients to use the power of voice to complete interactive surveys, verify completion of care tasks and report health concerns while clinical trials investigators and coordinators can use built-in analytics to track user engagement and respond to user input. 2019 Digital Health Prediction 3 : Healthbots will increasingly focus on solving automation problems in Healthcare, such as workflow data entry and fraud detection. Healthbots will become the new generation of chatbots, an additional layer on-top of the previously established eco-system of messaging apps. Healthbots will start to take over systematic and repetitive tasks like booking appointments, checking patients’ IDs, checking insurance information and coverage, asking for medical history and drug intake, and giving information about side effects and drug interactions. ( Source : Bots in healthcare: interview with Thomas Schulz, Organiser of Botscamp https://research2guidance.com/bots-in-healthcare-interview-with-thomas-schulz/ ) 2019 Digital Health Prediction 4 : Mobile phone manufacturers will follow Apple's lead on connecting to hospital EHRs using FHIR. Samsung, HTC, Nokia, Motorola will roll out native apps that can use FHIR to pull hospital and medical practice data onto their devices. In September 2016, Google Acquired Apigee, the leading provider of FHIR based API’s effectively stealing a march on its competitors, however we are yet to see the application of Apigee's technology in connecting hospital EHRs with Android (mobile operating system developed by Google) using FHIR. After years of ambition, hype and hope .... 2018 will be the year, digital health is on FHIR :) 2019 Digital Health Prediction 5 : We will start to see the growth and adoption of "Persuasive Architecture" and 'Captology' in Digital Health - websites, mobile platforms and applications in healthcare becoming far more persuasive. Persuasive Architecture refers to a website, mobile platform or application that has been designed and developed in such a way as to convince users to take action. Captology is the study of computers as persuasive technologies. This includes the design, research, ethics and analysis of interactive computing products (computers, mobile phones, websites, wireless technologies, mobile applications, video games, etc.) created for the purpose of changing people’s attitudes or behaviors. One challenge of mobile health applications for example is the capability to establish long-lasting behaviour change among patients and their respective health care provider, or both. Early research by academics Mustafa Moosa Qasim, Mazida Ahmad and Mazni Omar in their paper "Analyzing Persuasive Mobile Healthcare Architecture Using Systematic Process Design" are leading the way in understanding how Persuasive Architecture can result in better patient outcomes. 'More broadly within the healthcare domain, the prospective value of persuasive mobile technology is seen in changing individuals by incorporating persuasion features into the design of mobile phone technology. In this regard, most of the researchers have paid attention to develop persuasive applications, but they yet failed to provide guidance on how the persuasive guidelines can be implemented, in particular in software architecture." https://www.researchgate.net/publication/320273454_Analyzing_Persuasive_Mobile_Healthcare_Architecture_Using_Systematic_Process_Design The Stanford Persuasive Tech Lab performs research into computers as persuasive technologies and its ethical use. It is part of H-STAR, the Human Sciences and Technologies Advanced Research Institute at Stanford University. The study of persuasive technology began at Stanford in the 1990s. As a Stanford doctoral student (1993-1997), BJ Fogg used methods from experimental psychology to demonstrate that computers can change people’s thoughts and behaviors in predictable ways. His thesis was entitled “Charismatic Computers.” BJ Fogg went on to found the lab in 1998. Persuasive technology is now a global area of research and design. In the early days, the lab was doing research, conducting classes, and organizing events at Stanford. Author - Lloyd Price https://www.linkedin.com/in/lloydgprice/ https://twitter.com/lloydgprice

Suddenly, everybody’s talking about ambient computing. I blame Intel, and I’ll tell you why in a minute. Ambient computing is real. It’s the next megatrend in computing. Ambient means “in the air” or “present on all sides” or “all around us.” To interact in an “ambient computing” context means to not care and not even necessarily know where exactly the devices are that you’re interacting with. When IoT devices and sensors are all around us, and artificial intelligence can understand human contexts for what’s happening and act accordingly and in our interests, then ambient computing will have arrived. In the past, computing existed inside a computer, which you saddled up to and consciously used. In the future, connected computing devices will be all around us, and we’ll always be interacting with them, even when we don’t know or think about it. As I told you last year, ambient computing isn’t a specific technology, but a general way to interact with digital devices and the internet. As with many technology revolutions, the buzzword ambient will precede the actual technology by many years. In fact, the marketing buzzword is suddenly here in full force. The actual technologies? Not so much. Instead, we’re on the brink of a revolution in what you might call “semi-ambient computing.” Intel dragged ambient computing into the spotlight a couple of weeks ago by unveiling a prototype laptop it calls an Ambient PC at its Technology Open House at Computex in Taiwan. The Ambient PC gets its label in part from a touchscreen edge that functions while the laptop lid is closed. The edge-screen shows icons, calendar information (it's running a calendar app in the image up above), buttons for controlling audio on the device and the laptop (while still closed), and microphones make the laptop work like an Amazon Echo appliance, offering Alexa just a wake-word away. Most interestingly, the laptop has a 360-degree camera that can log you in as you approach it using Windows Hello. It’s a stretch to call Intel’s Ambient PC idea an example of ambient computing. It basically does things while closed that regular laptops can do only when open. Containing these functions with the closed lid doesn’t make it ambient, just usable in a new configuration. I still want one. Alexa, are you ambient? Amazon’s Alexa virtual assistant shows up in many physical appliances these days, including Amazon’s own Echo and related lines of smart speakers and smart displays. Alexa, Siri, Google Assistant and Cortana enable hands-free interaction with information, “skills,” the internet and communication and are, as such, semi-ambient computing products. The best fraud prevention finds customer behaviour anomalies As digital security threats multiply online, companies are using predictive algorithms and machine learning to detect fraud—especially in financial services. They’re not fully ambient because they can’t yet use AI to synthesize several sensors to understand context. For now, they mostly operate through voice. When I’m having a conversation and mention Alexa, the Echo wakes up and says it doesn’t understand. And that’s right. Alexa has no ability to understand the context of my use of the A-word. The new Google ‘wave’ Rumors are circulating that Google’s next smartphones, the Pixel 4 line, may come with Soli built in. I told you in January about Google’s Project Soli, which may be called the “Aware” sensor or feature in the Pixel 4 — again, according to unconfirmed rumors. Soli or Aware capability means the Pixel 4 may accept in-the-air hand gestures, such as “skip” and “silence” during music playback. The new Google “wave” is a hand gesture. The ability to wave away music with a hand gesture brings the smartphone into the semi-ambient computing era. It basically adds natural hand gestures to natural-language processing. There’s no reason to believe that the Pixel 4 will synthesize these actions into context. The truth is that ambient computing for consumers is years away, and will likely first emerge in cars. As consumer electronics appliances, cars have an advantage for the introduction of sensors. The reason is that drivers and passengers are a captive audience — it’s clear where to point the sensors and even possible to build them into seats and seatbelts. The context of human activity or intent is also easier to guess in a car. Over the next five years, an increasing number of cars will gain the ability to identify the drivers and passengers (and adjust settings and preferences accordingly); monitor the driver for sleepiness, drunkenness and distraction; and safely wrench control from the human and pull over if necessary. Grocery stores will also become consumer-facing ambient computing locations. Amazon’s Go stores are already semi-ambient computing systems, where customers essentially shoplift with Amazon’s permission, and then pay for the nabbed items automatically. Smart glasses will one day function as consumer ambient computing devices. With advanced machine learning, glasses will monitor gaze and drip information about what we see into our ears (or though bone conduction), and provide context and extremely effective virtual-assistant functions in a seamless way. But the first place ambient computing will appear for real is in businesses, enterprises and healthcare facilities. Microsoft is going all-in on ambient computing, according to reports. Under the Surface brand, Microsoft is expected to release a range of ambient computing devices, features and services that probably involve its Cortana virtual assistant. Looking behind the scenes, it appears that Microsoft sees ambient computing as a concept for businesses and enterprises. In posted job listings, Microsoft says that its “Ambient Computing & Robotics team is creating applications for the era where computer vision, AI-based cognition, and autonomous electro-mechanicals pervade the workplace. We are using this convergence to transform physical work in construction sites, logistics yards, baggage handling areas, hospital corridors, factories, restaurants, farms and more.” Microsoft was mocked for its “Clippy” assistant, which the company released in 1996 as a way to provide friendly help for people using Microsoft Office. In the future, Microsoft may release what will essentially be a Clippy that works, because it will understand human context through AI. We’ll also see ambient computing showing up in medicine. Healthcare Nuance, the venerable speech-recognition company, is working on ambient computing for healthcare called Ambient Clinical Intelligence, or ACI. It works through a smart speaker mounted on the wall of a doctor’s examination room, which also has a camera. By applying deep learning to speech and visuals, ACI is able to document doctor visits. The idea is to enable the doctor to pay full attention to the patient, without worrying about writing everything down. ACI should start showing up in medical centers next year. Google also briefly talked last year about a healthcare assistant called Dr. Liz., which was described by former Google CEO Eric Schmidt as an ambient computing virtual assistant for doctors. We’ll see if Google ever ships a Dr. Liz product. Yes, ambient computing is real, and the Next Big Thing, showing up first in business, enterprises and healthcare. Source : https://www.computerworld.com/article/3402959/why-ambient-computing-is-just-a-marketing-buzzword-for-now.html

Goldman Sachs recently produced a 30-page report based on the the work of five research analysts focused on Amazon's likely ambitions to enter the Healthcare and Pharmaceutical industries. Some of the most notable predictions the report makes are ... 1) "Amazon could move into digital health by using the Echo in clinical settings and developing tools for telemedicine and remote patient monitoring. "Imagine seeing a virtual doctor on your Amazon app, having it prescribe you a certain medication, and then tapping a 'buy now' button -- all without leaving your home." 2) "Rather than replacing pharmacies right away, Amazon might start by partnering with a pharmacy benefits manager (PBM), which acts as an intermediary between payers, like health insurers, and the rest of the health system. That would provide "access to patient data and the potential to cross-sell related products." 3) "Amazon could also become an online pharmacy, retail and online pharmacy, integrated PBM and online pharmacy, or handle drug distribution to pharmacies. Leaving Pharma aside, I agree with Goldman Sachs and believe Amazon can disrupt the Healthcare industry within the next 2 years based on the following 5 steps and by executing their highly successful modus operandi .. Step 1 : Collect all the Data Legacy Issues - " Amazon's new team is currently looking at opportunities that involve pushing + pulling data from legacy electronic medical record systems.” Medical Records - "Amazon is looking for a machine learning director with experience in healthcare IT & analytics and knowledge of electronic medical records” Hospitals - "Amazon Web Services has hired health experts to beat out Microsoft and Google for contracts with large hospitals & pharmaceutical vendors” Amazon are clearly tackling one of the biggest issues in healthcare, the fact patient data and medical records are stored on legacy systems. This is a very smart approach because once Amazon has access to patient data and medical records, it can run machine learning algorithms across these large data sets to identify patterns, behaviours and potentially fraud. Step 2 : Own the Infrastructure My prediction is Amazon’s next move will be similar to Google’s acquisition of Apigee, the leading provider of FHIR based API’s. Amazon will acquire a FHIR based API company with specialist knowledge of healthcare & pharmaceuticals and then integrate it into Amazon Web Services to offer a market leading software as a service model. Infrastructure in Healthcare is all about scale, and scale is exactly what Amazon has ... Amazon Web Services’ Global Infrastructure operates 44 Availability Zones within 16 geographic Regions around the world, with announced plans for 14 more Availability Zones and five more Regions in China, France, Hong Kong, Sweden, and a second AWS GovCloud Region in the US. Step 3 : Distribute the Infrastructure Amazon have a history of building developer networks and actively encouraging 3rd parties to build on top of their infrastructure, healthcare will be no different. In the next 2 years expect to see "Amazon Health Dev Days" and workshops as Amazon invest heavily in distributing their technology across the healthcare market. Interested in building an Alexa powered voice commerce solution for older people in care homes to order presents for their grand children, no problem ... Interested to building a mobile application for your cousin with diabetes, no problem.. In May 2016, Amazon started giving away its most sophisticated personalisation technology. DSSTNE (pronounced “destiny”), an open source artificial intelligence framework that the company developed to power its product recommendation system. Now any company, researcher, or curious tinkerer can use it for their own AI applications. “We are releasing DSSTNE as open source software so that the promise of deep learning can extend beyond speech and language understanding and object recognition to other areas such as search and recommendations,” the Q&A section of Amazon’s DSSTNE GitHub page reads. Step 4 : Personalise Online Amazon has the best recommendation engine in the world, they were very early into massive machine learning projects to offer personalised products to every customer based on many inputs ... Purchased shopping carts = real money from real people spent on real items = powerful data and a lot of it. Items added to carts but abandoned. Pricing experiments online (A/B testing, etc.) where they offer the same products at different prices and see the results Packaging experiments (A/B testing, etc.) where they offer different products in different "bundles" or discount various pairings of items Wishlists - what's on them specifically for you - and in aggregate it can be treated similarly to another stream of basket analysis data Referral sites (identification of where you came in from can hint other items of interest) Dwell times (how long before you click back and pick a different item) Ratings by you or those in your social network/buying circles - if you rate things you like you get more of what you like and if you confirm with the "i already own it" button they create a very complete profile of you Demographic information (your shipping address, etc.) - they know what is popular in your general area for your kids, yourself, your spouse, etc. user segmentation = did you buy 3 books in separate months for a toddler? likely have a kid or more.. etc. Direct marketing click through data - did you get an email from them and click through? They know which email it was and what you clicked through on and whether you bought it as a result. Click paths in session - what did you view regardless of whether it went in your cart Number of times viewed an item before final purchase If you're dealing with a brick and mortar store they might have your physical purchase history to go off of as well (i.e. toys r us or something that is online and also a physical store) Now imagine all these factors and more applied to Healthcare ... Step 5 : Personalise Offline The final piece of the jigsaw, integrating your online customer experience with your offline customer experience. Imagine a world where Amazon recommends and personalises your food shopping based on your health? You have "opted in" to recommendations of what food to buy based on your medical record and medical history. You "click and collect" your order at the local Amazon Whole Foods and potentially pick up any medication you require. So now I have a "plant based diet" personal to me based on Amazon's machine learning algorithm which calculated the latest scientific research from tens of thousands of medical journals .... The ultimate online/offline customer experience could be only years away, order via your Amazon mobile app lying in the bath on Friday night, collect your Amazon order on Sunday morning from an Amazon Whole Foods store because you have a few questions to ask or wait for the Amazon delivery driver to knock on your door ... Let's continue the conservation and debate how quickly Amazon can disrupt Healthcare, tweet @lloydgprice :)

Platform domination is a feature of several industry sectors, especially ones where there is a winner-takes-all outcome that is hard to replicate or compete against. Google dominates search. Amazon dominates e-commerce. Facebook dominates social media. And so on. In several industries, dominant incumbent firms have also developed their own platforms to get in front of disruptive innovation. Research by consulting firm McKinsey suggests that across sectors in developed economies, a single digital platform prevails 75% of the time, citing examples of Daimler, Nike, and Unilever. So, how far away is healthcare from a platform-dominated digital business model? Over the past few years, several healthcare focused cloud-based digital platforms – or health clouds - have been announced by big tech firms such as Salesforce, Microsoft, and Google. These platforms are intended to emulate the winner-take-all models that we have come to see in social media or search advertising. The McKinsey report notes that industries with lower digital maturity, such as Pharma and healthcare, see a lower level of prevalence of platforms, citing the lack of network effects, which require a large section of market participants to elect to participate in a single dominant platform, as one of the primary reasons. In a recent conversation on my podcast, John Sculley, former CEO of Apple, stated that platform technologies have revolutionized industry after industry with one big exception – healthcare. Let’s explore a few of the reasons for why that is the case. Most platforms fail, regardless of the sector they operate in A study of 250 platforms, published in the Harvard Business Review, provides a sobering view of the prospects for platforms in general. For every VC-fueled Uber and Airbnb that goes for world-domination through first mover advantage and network effects, there are several that do not make it past their fifth anniversary. The reasons range from late entry to mispricing, lack of trust, and not paying attention to competition. Healthcare has historically been a low-trust economy, with payers, providers, and pharma companies in largely adversarial relationships in a zero-sum game. For platforms to succeed, market participants must share data and invest in collaborative initiatives to improve healthcare outcomes and reduce costs for the sector. The closest we have come to this ideal in healthcare is in health information exchanges (HIE), and even those have failed to gain traction due to a variety of issues. Users are slow to adopt digital health platforms For a platform economy to succeed, consumers have to use the platforms. Even telehealth platforms, seen as a transformative way to deliver healthcare, are seeing relatively low adoption rates among physicians (the American Hospital Association has documented the key issues – including coverage and reimbursement by Medicare for telehealth visits). Analyst Mary Meeker’s widely read annual Internet Trends Report suggests that consumers are using digital health tools primarily for basic activities such as online health information and for researching provider ratings. This suggests a gap between the billions spent by big tech firms on building platforms, and the market’s readiness for the platforms. It is all about the data, and who owns it Healthcare IT has been bedeviled by interoperability challenges, as everyone knows. For now, the custodianship of the data rests with health systems and their electronic health record (EHR) vendors. There is growing activism about handing over the ownership of the data to consumers (including a proposed CMS rule that will make it mandatory for consumers to be provided access to all their medical information), but we are still in early stages. Even if we were to get to grips with secure and seamless data exchange among participants in the health IT ecosystem, there is growing realization that the fundamental building block for driving innovation, namely a universal patient identifier, does not exist (recent legislative action could change that). Big tech firms, for their part, have to overcome a general lack of trust by consumers for sharing personal medical information on their platforms. Notwithstanding their relative lack of digital maturity, healthcare enterprises are choosing their own pathways for adopting digital platforms. Health systems are choosing a combination of best-in-class point solutions and enterprise-scale platforms, sitting alongside their core EHR systems, to reimagine patient and caregiver experiences. Health insurance companies have firmly adopted consumerism as the focus of their digital efforts. They are providing the emerging marketplace with pricing information, health and wellness counselling, and treatment alternatives. Pharma companies are looking hard at digital therapeutics to extend brand revenues by building digital “wrappers” around their products, and to develop new drugs-as-software that cost a lot less to develop and monetize compared to traditional drug discovery models. So far, one thing is clear. No single tech firm seems positioned to dominate healthcare in the short term. The market seems to have plenty of room for companies - incumbents, innovators, or startups - to carve out a role in the digital transformation of healthcare. For all these reasons, platforms are only just gaining significance, and it may be early days yet. John Sculley, who is an advisor to RxAdvance, a company looking to disrupt the PBM industry with a PBM cloud offering, thinks that healthcare industry platforms are probably the greatest examples of digital health enablement. He also believes that we are going to see more and more success stories by 2020 and beyond. Perhaps the new players will demonstrate that healthcare is just as important an opportunity for platform technologies as all those other industries have been. Source : https://www.cio.com/article/3404529/how-close-are-we-to-platform-domination-in-healthcares-digital-business-models.html

Allow me to raise this question: what will happen to a pharma company’s diabetes, respiratory or cardiology drugs if in 10 years time, we are able to fully use 3D organ printing? Well, it would most likely disrupt its traditional business models of selling drugs for those diseases, wouldn’t it? It seems that there is hardly any event, article or discussion on healthcare that is not loaded with the term disruption, or in its milder version, transformation. Yet, the true consequences for all healthcare stakeholders are often the elephant in the room. Many incumbents seem to still believe (or at least hope) that disruption is all about technology or digital innovation, and that it will stop there and not touch the very essence of their businesses or roles within the healthcare system. Indeed, there is a very strong chance that they are dramatically wrong. It is perfectly alright to be skeptical. We have been talking about disruption and transformation in healthcare for a very long time and in many places and markets, nothing seems to have substantially changed. If we take Germany as an example, the country still spends around 35% of total healthcare expenditures on hospitals, 17% on drugs and about the same amount on doctors. Guess how the distribution of expenditures was 15 years ago: yes, it was almost exactly the same (with slightly higher expenditures on drugs then). If we look at disruption as being innovations transforming markets or sectors and improve simplicity, convenience, accessibility and affordability, we need to come to the conclusion that in many places, there is still a long way to go. So why should healthcare stakeholders bother? What is different this time? I think that there is one element in the healthcare arena that has the potential to fundamentally change the whole scenery: the shifting expectations of citizens, patients and doctors. This is often referred to as the “Amazon-Effect” and leads to a situation where individuals in the healthcare system are no longer willing to accept receiving care in silos that do not communicate with each other, being thrown into an anonymous hospital machinery that does not care about their wants and needs, or being obliged to tediously decipher their medical data (if at all they get a hold of them). Doctors will be increasingly reluctant to push heaps of paper through hospital corridors and not having instant access to patients’ health status, diagnostics or medication. Digitalization in healthcare is about managing the changing expectations of citizens, patients, and medical professionals CDO’s of healthcare related organizations and enterprises should move away from trying to apply digital technology, solutions and services to their traditional ways of operating. They might miss the point, as their existing business- and operational models could vanish in the not-so-far future. And the strongest driver behind all of this are the consumers – and to an increasing extent – the providers of healthcare. Simply because the established ways of working and the provision of healthcare services are not serving peoples’ wants and needs anymore. The emergence of a mix of a game-changing dynamics Apart from shifting expectations, there are other drivers and catalysts that will strongly contribute to disrupting the healthcare system as we know it. The new thing about this is, that all of it is happening at the same time: Regulatory changes: in many countries legislation is finally adapted to provide a solid regulatory base for digital solutions and services to be used and to foster. The same is true for the usage of aggregated health data and respective AI-based innovations. Even in slow-moving countries such as Germany, such legislative changes are currently being launched. New reimbursement rules: apart from a reliable legal basis, innovation leading to disruption needs a second prerequisite to flourish, namely a scalable business perspective. With the introduction of favorable reimbursements for e.g. digital solutions and services, this is by now well under way in many countries. Changing social norms: citizens do not look to doctors as the single source of knowledge anymore. Whereas in previous generations, individuals willingly accepted to be sheep-like recipients of healthcare services, nowadays, they have grown into critical and confident healthcare customers. Genomics-based therapies and reproduction technologies: in areas such as oncology, we start to better understand the role of genetic dispositions in the proliferation of cancer. This allows for a much more targeted therapeutic approach. These new therapy approaches will gain a foothold in more and more disease areas, as well as in diagnostics or prevention. Moreover, new reproduction technologies such as 3D organ printing will significantly alter and improve current therapies. How to ride the disruption wave in healthcare – start developing your future game plan One could for sure get lost amidst the plethora of articles, papers and events on the subject. Do not put the cart before the horse and let yourself be drawn into a premature technology discussion. First of all, start by developing scenarios on how the world could look like for your organization or your markets and address questions such as: what are your customers’ expectations, what are the relevant technological innovations, will there be new players in your market space, how does this affect your organization, your people and your future role in the system? Developing the future game plan should be the starting point of your disruption ride. It is only afterwards that you should start to think about how e.g. digital technology can support you in achieving the often needed organizational transformation, your future operations and your wanted position. And bear in mind: disruption is by nature not linear. Especially in healthcare, it will rather happen on a market-by-market basis instead of on a national level. And in most cases it will unfold itself in certain fields or pockets across the healthcare system and not invade the system as a whole right from the beginning. Finally, how long will this take to unfold? Well, how long did it take to replace horse-drawn carriages with cars: about 8-10 years? I think this is a fair estimation. Source : https://research2guidance.com/disruption-in-healthcare-what-will-be-the-new-normal/

British telecom operator Vodafone with the backing of the UK Department for International Trade has bagged a £100m contract to help Egypt develop a new health insurance IT system in the lines of the NHS. The contract won by Vodafone will be an important part of the Egyptian government’s push to introduce NHS-style universal healthcare for every citizen in the country. Egypt wants the IT system to support a new primary healthcare system identical to the one that operates in the UK. Vodafone will be partnered by DXC Technology, which is already engaged in providing the IT infrastructure services across the NHS supply chain. The duo will join forces to create a digital healthcare services platform to enable the launch of Egypt’s universal health insurance scheme. The project will start off as a pilot in Port Said, before it is introduced to four other governorates and then throughout Egypt. Vodafone is among the major telecom operators in Egypt with 40 million subscribers, which is twice the number it has in the UK. The Department for International Trade said that the contract to Vodafone comes as British firms and government are working in tandem to carry out a variety of other healthcare activity, to share the benefits of the NHS and British pharma industry with Egypt. UK Secretary of State for International Trade Liam Fox said: “We in Britain are proud of our NHS and how it provides access to healthcare for everyone. I myself used to be an NHS doctor before becoming an MP, so I know how important it is. “It is a system that is respected around the world and we want to help other countries do what they can to secure the same benefits for their people. “That’s why we’ve stood by Vodafone as it sought and secured this contract which, as part of the Egyptian government’s reforms, will help revolutionise healthcare for people here – It is the beginning of an Egyptian NHS for the Egyptian people.” Source : https://www.governmentcomputing.com/healthcare/news/vodafone-egyptian-nhs-contract

The insurance industry is changing, and its changing fast. The forces driving the change in insurance include skyrocketing healthcare costs, rising protection gap and a shift in the way consumers prefer to interact with brands. These new realities are pressuring the insurance industry to embrace insurtech. Prudential is among those in Malaysia’s insurance scene that have adopted this digital doctrine. Nic Nicandrou, CEO, Prudential Asia, revealed to us that the group as a whole has stepped their tech investment to over £400 Million this year. On Malaysia’s front we were also informed that they are looking to invest over RM 250 million in these key areas; removing inefficiencies, improving customer services, and increasing accessibility to Prudential’s services. Part of that renewed focus into digital technologies and insurtech is their soon-to-be-launched digital health tool, Pulse. We were given the opportunity to take sneak peek at the beta version of their app during their media preview session. Though Pulse made its first appearance at Singapore Fintech Festival 2018, Nic shared with us that Malaysia will be the first market that they will be debuting Pulse. A Glance at Prudential’s New AppThere are 4 key functions to Prudential’s AI powered digital health tool — Health Assessment, Symptom Checker, Online Consultation and Dengue Alert. All these functionalities were made possible thanks to partnership with startups like Babylon Health, DoctorOnCall and AIME. One of the the flashier functions within the Pulse app is the “digital twin”. Once you’ve completed a very detailed interaction with its chatbot, the app will generate an interactive diagram of your body along with some helpful graphs. The colours represent the level of health risk of each of your organ. When you tap on one of the organs it will list down what are the risks you face and recommend options that you can take to improve the situation. According to its partner Babylon, the symptom check function uses over 50 million data points to provide users a diagnosis. The app will then recommend if a visit to the doctor is needed.Should that need arise users of the may opt to use their built in tele-health capabilities to get a consultation from certified doctors via video calls. Once that’s done users can have medicine delivered directly to their doorstep and payments can also be made within the app using credit/debit card and your Boost e-wallet. The myriad of services offered within the app is definitely a step in the right direction for Prudential, this is especially true in Malaysia where 71% of health related searches happens on the mobile and the fact that 23% of apps downloaded are health related apps. We were also pleased to learn that this app is also made available to non-Prudential customers. However, there are some areas that the app requires improvement. The necessary interaction to generate the health assessment report is too lengthy, which took roughly 15 minutes to complete. While it is understandable that such level of detail is necessary to generate an accurate report, perhaps it might work better to gamify that aspect of it and get users to complete that interaction in phases. Another area that would benefit from some fine tuning is the language that’s used, while it’s clear that effort has been made to use simpler language there are still quite a number of medical jargons that many users might find difficult to understand. For a beta version of the app it is pretty refined and I’d imagine they will iron out some of these minor kinks prior to an official launch. The beta version of the app is now available for download in Google Play and Apple Store, it is a free-to-use app with the exception of the online consultation service. Source : https://fintechnews.my/20652/insurtech-malaysia/prudential-insurtech-pulse/