With so much hype and expectation placed upon the shoulders of the two letter acronym AI, you may expect the letter ‘A’ to stand for Atlas. After all, it was Greek legend Atlas who carried “the weight of the world” on his shoulders. At this point in human evolution, AI is a ray of hope for our future. Excitement revolves around AI solving global issues too complex for human minds to comprehend, such as: how can we save the sea from plastic pollution? This week our Prime Minister, Teresa May, set a target for a “whole new industry around AI-in-healthcare”. But where did AI come from? The first use of the term AI can be traced back to 1956 in the American State of New Hampshire, when a summer conference was laid on by John McCarthy, an assistant professor of mathematics at Dartmouth College in Hanover. Along with three other researchers, Marvin Minsky of Harvard, Nathan Rochester of IBM and Claude Shannon of Bell Telephone Laboratories, they submitted a funding proposal to the Rockefeller Foundation that stated: “The study is to proceed on the basis of the conjecture that every aspect of learning or any other feature of intelligence can in principle be so precisely described that a machine can be made to simulate it. An attempt will be made to find how to make machines use language, form abstractions and concepts, solve kinds of problems now reserved for humans, and improve themselves.” As a shortened advertising pitch for the conference, the term Artificial Intelligence was coined. McCarthy was an aficionado of symbolic logic, a branch of mathematics that represents concepts as symbols. He wanted to expand the horizon of computers to be more than number crunchers and data processors, and push them into the next frontier of manipulating symbols to reason deductively from hypothesis to conclusion. In a similar way to Aristotle’s logical reasoning example: knowing that all men are mortal (major premise) and that Socrates is a man (minor premise), the valid conclusion is that Socrates is mortal. McCarthy was optimistic that computers could be far more than plain vanilla automation. However, it’s not clear if anything was accomplished during that summer conference, as the promised final report was never delivered. In fact, the same overly optimistic overtures have dogged the AI journey or roller coaster ride ever since. AI has travelled repeatedly from exaggerated optimistic highs, followed by deep dips of disappointment, quickly followed by new discoveries, renewed funding and a recumbent climb. By the mid-60’s AI had a funding stream with deep pockets, the US Department of Defence Millions of dollars were poured into nascent academic AI labs at MIT, Stanford University, and Carnegie Mellon University and some commercial research labs, such as SRI International. The consistent flow of money fostered multiple graduate students, who also went onto collaborate with other global universities. But by 1974, there was mounting criticism from the US Congress about the lack unproductive projects and not getting enough bang for their buck. As a result, the US government cut off exploratory research into AI and the British Government quickly followed suit. The following years were bleak and it became a struggle to obtain funding for AI research in a period that has since become known as the ‘AI winter’. It took until the 1980’s for ‘expert systems’ to be developed that created AI computer programs that deconstructed tasks into symbolic forms for facts, rules and relationships. But AI remained heavily reliant upon human programmers to painstakingly encode. Such symbol systems remained dogged with a common problem and plagued by the vast number of possible sequences. Combinational explosions made it too difficult to examine all the options. Take the everyday example of Lego, a mere six eight-studded bricks of the same colour could be combined together in 915,103,765 ways! By the late 1990s AI advanced further thanks to increasing computational power in accordance in Moore’s Law, so more advanced statistical techniques could be employed. The most famous step change came when Deep Blue, the first chess-playing system, beat the reigning world chess champion, Garry Kasparov on the 11th May 1997. It came as a surprise to the chess world and has been etched into the memory of the Russian grand master, who was forced to eat his words, after he had previously quipped “if any grand master has difficulty playing a computer – I’d happily offer advice.” It was hailed within the AI community as a major confidence boost to the entire sector and put AI firmly back on the global stage. Machine Learning The next breakthrough came with the upgrade to ‘machine learning’. Learning is perhaps key to all human intelligence, and is more than just knowledge, analogous to symbol systems that require code to be written upfront with knowledge captured, stored and used. Learning requires a more dynamic approach to problem solve novel situations, and has the ability to iterate improvements with training and practice. Machine learning has taken inspiration from neuroscientists who have studied neural networks in the brain. In the 2000’s, IBM worked on an AI machine to answer questions, such as those posed in natural language by the TV host in the quiz game Jeopardy! The team developed a machine consuming four terabytes of disk storage, and named it after IBM’s first CEO, Thomas Watson. In 2011 ‘IBM Watson’ went head to head against former Jeopardy winner’s Brad Rutter and Ken Jennings and neither human nor machine participant had access to the Internet. It was a nail biting time for the AI world with a winning first place prize of one million dollars. ‘IBM Watson’ consistently outperformed its human opponents and won. It showed that AI neural networks had been able to mimic the human ability to not only understand the question but to also ‘best guess’ the answer. By 2013 ‘IBM Watson’ software was used for its first commercial application in management decisions for lung cancer treatment at Memorial Sloan Kettering Cancer Centre in New York. March 2016 brought another exciting challenge for AI when it competed in the game Go. Go is far more difficult to play than other games, such as chess, and uses black and white pieces on a nineteen by nineteen board. The game dates back to ancient China and was considered to be an essential art for a cultured Chinese scholar, even getting a mention as a worthy pastime in the Analects of Confucius. Go is a prohibitively difficult game for traditional AI methods such as alpha-beta pruning, tree traversal and heuristic search. The AI machine developed was named AlphaGo and it succeeded in a significant milestone when it won four out of five games in a match against Go champion Lee Sedol. This feat should not be underestimated, as it leveraged two advancements. First, it harnessed more mathematical powerful processing units for matrix and vector calculations by using graphic processing units (GPUs) that came about thanks to the gaming industry. Second, it had the ability to spot patterns after learning and searching through thousands of games. Then it managed to combine these two feats in a famous move, so well known in the AI world, that it’s simply termed ‘move 37’ in the second game against Lee Sedol. It was at this moment that AlphaGo turned perceived wisdom about the Go game on its head. AlphaGo played an entirely unexpected yet beautiful move. No human player had ever played that move and legend goes that Lee Sedol had to leave the room momentarily with shock. AlphaGo had recognised patterns and played a novel move in a moment of genius, which not only turned the course of the game but perhaps changed history forever - AI had been creative! So, it’s clear that the optimism about AI has been worth the wait and although Hollywood has a tendency to anthropomorphise AI, from here it should be less about being scared if AI will supplant humans, and more focused on what AI will do for the world. In a similar way to Brunel being able to build a bridge, the most important quandary became how to build a bridge to safely ensure passage from one side to the other. AI is not just intellectually fascinating, it is morally crucial to consider as how it evolves as it will affect the future of life, including healthcare. About the Author Dr Michelle Tempest MA LLM MB BChir (Cantab) ACAT has expertise in medicine, psychiatry, psychotherapy, business, law and politics. She has been a Partner at Candesic since 2013 and has led multiple projects reviewing market opportunities for investors, public and private providers to develop beneficial partnerships. She has delivered projects for NHS Trusts (acute, community and mental health), Private Hospitals, Specialist Hospitals, Private Patient Units (PPUs), Community Providers, Care Home and Care at Home. In 2006 she edited the book 'The Future of the NHS' and more recently has delivered strategy projects for the UK government on ‘new ways of working’. She has an expert interest in medical technology companies, and has worked with several MedTech companies on expansion plans and advised throughout the entire life cycle of deals. Previously Michelle worked as a hospital doctor and liaison psychiatrist for over a decade, and continues to lecture in 'medical ethics and law' at Cambridge University. Twitter @DrMTempest mtempest@candesic.com

What do Canada, Estonia, Israel, New Zealand, South Korea, Uruguay and the United Kingdom have in common? They form a group known as The D7, and argue that they’re the most advanced digital nations in the world. They exclude a few strong contenders like China and Singapore on the basis of also requiring the members to be committed to open systems and democracy. The definition of a digitally advanced nation is that government services are delivered online in all areas from administration and security to education and healthcare. D7 Charter 1. The Treasury Board of Canada Secretariat, the Ministry of Economic Affairs and Communications of the Republic of Estonia, the Prime Minister’s Office of the Government of Israel, the Ministry of the Interior and Safety of the Government of the Republic of Korea, the Department of Internal Affairs of the Government of New Zealand, the Department of Digital, Culture, Media and Sport of the Government of the United Kingdom, and the Office of the President of the Oriental Republic of Uruguay, hereinafter individually referred to as "the Participant" and collectively as "the Participants" have reached the following understanding: 2. The Participants have mutually decided to expand from the D5 to the D7, a group of the most digitally advanced governments in the world. The D7 will provide a focused forum to share best practice, identify how to improve the Participants' digital services, collaborate on common projects and to support and champion our growing digital economies. 3. The Participants have decided to commit to working towards the following principles of digital development, acknowledging that they will not be able to meet all of the criteria on joining: 3.1. User needs - the design of public services that work for the citizen 3.2. Open standards - technology requires interoperability and so a clear commitment to a credible royalty free open standards policy for software is needed 3.3. Open source - where possible all future Government systems, tradecraft, manuals and standards are created as open source and are shareable between participants are 3.4. Open markets - in government procurement create true competition for companies regardless of size. Encourage and support a start-up culture and promote economic growth through open markets 3.5. Open government (transparency) - be a member of the Open Government Partnership and use open licences to produce and consume open data 3.6. Connectivity - enable an online population through comprehensive and high quality digital infrastructure 3.7. Teach children to code - commitment to offer all children the opportunity to learn to code and build the next generation of skills 3.8. Assisted digital - a commitment to support all its citizens to access digital services 3.9. Commitment to share and learn - all participants commit to work together to help solve each other’s issues wherever they can 4. The Participants acknowledge that Digital Government is evolving, and will update these principles as work together refines them, and in the light of new challenges and opportunities. 5. Each Participant will lead by example and contribute to advancing digital government in other D7 countries by sharing best practices and expertise, on a non-binding, voluntary basis. 6. The Participants’ collective goal is to harness the potential global power of digital technology and help each Participant to become an even better digital government faster and more efficiently through sharing and learning from each other. 7. D7 will meet once a year with a rolling host nation who will chair the meeting. All Participants will be invited to each Conference. 8. Following the establishment of the D7 it has been mutually determined that a joint working group will establish: 8.1. future chair / host nations, and themes for future conferences 8.2. principles and arrangements for expanding the circle of countries involved. The group will be open to include upon consensus of all Participants additional countries that meet the principles as stated above 8.3. The principles may iterate and evolve as part of this work 9. The Participants will decide on a case by case basis how any joint initiatives will be funded and resourced. 10. Any differences arising from the interpretation or implementation of this Charter will be settled amicably through consultations and negotiations between the Participants without reference to any third party or international tribunal. 11. Each Participant may, as appropriate, designate another institution(s) or institutions to lead and (or) participate in the initiatives. 12. This Charter is not legally binding. It will come into effect on the date of the signature of all Participants and will continue to have effect for a period of five (5) years unless terminated by a Participant giving three (3) months written notice to current Chair. 13. Signed digitally in Wellington, New Zealand on the 22 February 2018 in English Language. Source : http://www.tomorrowtodayglobal.com/2018/04/21/the-d7-digital-nations-worth-watching/

It seems incredible, but today, the vast majority of NHS trusts still post paper letters to their patients. In fact, the average UK hospital sends over 1M paper letters to patients each year. Patients are informed of their appointments in a letter and have to call the hospital to make appointment changes. It's an expensive and frustratingly inefficient system. At Zesty we've been working hard with a group of NHS trusts to digitally transform outpatient appointment management. The Zesty patient portal is simple to use, designed for mobile devices first and very cost effective. Patients love to use it, with adoption rates by specialty of more than 50%. Managing hospital appointments is complex, expensive and time consuming for both patients and NHS staff. Our patient portal has been built from the ground up with appointment management as its core function, ensuring a secure, robust and friction free patient experience. Provide patients access to their letters instantly and give them the ability to ‘opt out’ of paper completely. Our patient portal enables you to rapidly deploy forms and interactive data capture tools on a per specialty basis, with all results securely available for write-back to your EPR. Our platform verifies the patient’s identity via a completely remote 2 factor authentication engine. Portals don’t work without patients. We have a wealth of expertise in ensuring digital services are actually used by consumers. We see overall adoption of 30-40% with active adoption at 70%+ Source : https://www.zesty.co.uk/enterprise

Prof. Dr. Mathias Goyen is Chief Medical Officer Europe at GE Healthcare. Medicine is undergoing a double paradigm shift, the transition to molecular medicine and digitization itself. Digitization in hospitals is not an end in itself, but serves to optimize processes and to improve the quality of patient care. A Smart Hospital relies on optimized and automated processes aimed at improving existing patient care procedures and introducing new capabilities. It relies on the big data revolution – the ‘Fourth Industrial Revolution’ – which combines connected devices with cloud computing, big data analytics and artificial intelligence (AI) – to ensure that the critical infrastructure is ‘smart’. The overarching objective of a Smart Hospital is that patients will experience this as a place of personal and warm-hearted care with top-notch medical treatment. What is often missing, though, is the right infrastructure to network the various digital initiatives. In addition, the data and information generated in different places must be brought together and used in the interests of the patients to increase the quality of care. However, connected medical devices are already transforming the way the healthcare industry works. By 2020 the widespread adoption of technology-enabled care will ensure that the concept of the Smart Hospital becomes a reality. Smart Hospitals in Germany The University Medical Center of my hometown Essen / Germany is a major health care provider of the Ruhr Metropolitan Region and is to be further developed as one of the first hospitals in Germany to become a Smart Hospital. The University Medical Center and its subsidiaries are restructured with the clear goal of significantly improving patient care through a digital transformation and to relieve the highly specialist staff of numerous non-specialist activities through the use of modern IT systems. According to Prof. Dr. Jochen A. Werner, the CEO of the University Medical Center Essen, the development of a Smart Hospital is not just about process optimization or data-based treatments. Rather, it is about a digitization process in numerous steps that needs to be shared with patients and employees. For this reason, the digitization of a hospital requires a comprehensive internal change process, which must be done step by step and cannot be prescribed. At the same time, the challenges associated with digitization must be identified, openly addressed and solutions worked out. This includes the communication of expected results and impacts, which must motivate all participants to support the change process. EPR and Smart Apps An electronic patient record is the cornerstone of a Smart Hospital, which in Essen will include several other support systems and elements such as a digitally supported call center, the connection of a cross-sector telemedicine network, an App Store for optimized patient care, a Center for Artificial Intelligence in Medicine, a robotics center, a department for 3D printing as well as a data validation center. These and other components are implemented in a defined order in the context of the Smart Hospital Master Plan. Some things can be implemented faster, some slower, others are a continuous digitization process, always geared towards the two key target groups for successful hospital digitization: patients and employees. The University Medical Center Essen comprehensively incorporates the expertise of patients on its way to become a Smart Hospital by having founded a Patient Experience Center which is closely involved in the digital restructuring processes. Digitalization is therefore the key to putting patients back into the focus of hospital treatment. Developing a Smart Hospital means pioneering work. The early movers such as the University Medical Center Essen see the digital transformation as a great opportunity. Using this not only requires courage, but also a great effort to get everyone involved on track for digitization. For this to succeed, all internal stakeholders are to be closely involved in this change process. Source : https://www.linkedin.com/pulse/making-smart-hospital-reality-mathias-goyen-prof-dr-med-

I love shopping on the internet, it’s so easy! When the Ocado delivery driver arrives with all my shopping I have a moment of delight that I’ve saved 2 hours of my time and someone else is huffing and puffing with all my bags, carrying my shopping into my flat. It’s genius! Amazon began as an internet retailer of books and expanded to a wide variety of products and services, more recently video and audio streaming. Amazon.com is currently the world's largest Internet sales company in the world, as well as the world's largest provider of cloud infrastructure services, Amazon Web services. Amazon’s success has grown with their customer’s desire for convenience. Their product marketplace is extensive, their move into video and audio streaming, Alexa and IOT, their acquisition of WholeFoods shows they are focused on the “whole customer journey.” There are rumours that Amazon may soon be entering the healthcare market, specifically the prescription-drug market. Bloomberg reported on the 9th October that the US-based distribution giant is likely to start selling drugs as early as 2019. CNBC, instead, reported that Amazon could start on-line drug sales even this year. (Source: Bloomberg) I don’t want to focus on Amazon, but I’m using them to demonstrate their thinking. Their model demonstrates the value they bring to our lives as well as becoming a vital part of our day to day lives. We are becoming “Amazonians”!!! We live our lives alongside amazon, who facilitate our needs. It’s a brilliant business model, they metaphorically “own us”! So park that thought for a moment and think about how the healthcare market has developed over the last 10 years. We have seen lots of activity in the digital health space, lots of exciting innovations and transformational products and services. But one thing that hit’s me is the sporadic nature of this journey. Focussing on one problem, one disease area, 1000s of possible solutions. 1000s of companies selling their transformational product to the same institutions. The same institutions that have to filter and sort and work out even if it’s worth justifying a business plan to spend money on an innovation with a company that has existing for less than 5 years, limited track record and limited funds. We want our healthcare institutions to engage with innovation and introduce transformation to our care, but the risks of investment on both sides are huge. This is what has always baffled me. Big Pharma: GSK, Novartis, Roche, Pfizer have a proven business model. Their research and development budgets are in the hundreds of millions, of course developing new drugs, clinical trials is expensive and takes a long time. But what if some of that money was re-directed into a new initiative. The model that is proving it’s value for Amazon. What if the Pharma companies started to think about really “Owning the Patient Journey”. Having worked in Pharma and devices for some of the biggest companies it’s easy to see why they are complacent. But as patents end, pipelines become weaker and revenues fall there is a need to make some changes. Those changes in my opinion could be quiet straightforward for big Pharma. What if you redirected some of the R and D budget into digital transformation. Committed the same funds that lots of independent start-ups are now playing with $10 - $20 million, but with the infrastructure and relationships as a base. This could be transformational. Big Pharma already have the customers. Millions of people on their therapies. But they currently are fairly ineffective in communicating with their customers. Regulation plays a big part in this, but why can’t they “own the patient journey”? Patients are vulnerable, they need to be guided with reassurance by the GP/Physician/Nurse, trust plays a huge role in their care. Why can’t the Pharma companies be part of that circle? You are taking their drugs, but have no idea who they are! Pharma has the opportunity to slot themselves into the patient journey to support and manage the patient. Patient expectations are changing rapidly, the timing is perfect for Pharma to engage with technology and really support patients directly. How can Pharma engage their customers using technology? Information Source: become the trusted and validated patient information source Drug Compliance: help manage compliance by building an integrated alert system to remind the patient to take their drugs Prescriptions: manage the prescription journey Telehealth offerings: be the support network offering advice, opportunities to speak to experts about side effects, recommended diet and exercise and discuss concerns around their disease. Alongside owning the patient journey this approach would also take huge pressure off “the system”, reducing the need for follow up consultations and helping the patients manage themselves with a credible support structure in place. All these ideas exist, but are disparate in the marketplace in the form of 1000s of start up digital health companies. Big Pharma can aggregate these ideas in one stroke it just needs the will. When Pharma really owns the customer journey think about the possibilities. Go back to what Amazon is achieving and how it’s innovating. This approach in collaboration makes opportunities for growth even greater and at the same time enhancing the whole patient experience. ________________________________________________________________________________________________________ Julie Pelta https://uk.linkedin.com/in/juliepelta With over 20 years experience in healthcare. From classic corporate roles through to consultancy and medical device distribution. Experience in working with Med-Tech product and service companies. From product innovation, delivering enhanced patient outcomes to digital service innovation. About Us Industry knowledge specialists who work across the vertical to minimize risk. We use our network and in-depth understanding of the system, and how to navigate it. We work in areas from Digital Health to Med-Tech; Education to Service provision; Commissioning to Investing; our experience is vast and track record impressive. Activities undertaken with companies developing products : Whether an SME or corporate, the need to build a proof of concept and validate the market early is essential. We believe “fail fast, change quickly” is the key to success and the only way to develop “market-ready” products at pace. Activities undertaken with companies developing products: • Market Validation • Co-Design: Demonstrating demand side articulation of need • Stakeholder Mapping • NHS Readiness Assessment Activities undertaken with companies investing in products: Making objective decisions based on limited due diligence in an opaque marketplace like the NHS is tough and risky. Deep knowledge allowing for informed decision-making should be central to any investment strategy. We will provide the clarity needed. Our due diligence services for companies investing: • Opportunity Sizing • Market Validation • Risk Assessment • Competitor Analysis We will make sure that your organization is equipped with the tools to make the right decisions and that your product has the highest chances of success that it can. This includes support during product design, creation of your go-to-market strategy, managing stakeholder engagement and general understanding of the health economy. With over 20 years of experience working with people that commission services and those that provide them, we understand the barriers and how to overcome them. Being successful starts by clearly articulating your product or service and defining a precise problem that it solves. This is our core business. To help you become more successful. We work with start-ups, SMEs and established corporates all at different stages of their product life cycles, but who all face similar challenges. Contact Us: j@jpmed.co.uk +44 (0)7866 501 084

Antidote.me The age of digital health is upon us. For those of us who have been working for the last several years to bring the tools and technology that have transformed shopping, travelling and banking to healthcare, there is evidence that we are finally making a real difference to the lives of patients. Even the big players such as Apple, Google and Amazon are focusing on making us live longer, healthier lives, surely a sign that digital health is going mainstream. My own journey in digital health began in Argentina. I always wanted to be a doctor, except for the few months when I considered being an astronaut until I realised Argentina didn’t have a space program. After high school I would ride my bike to the local hospital where my friend Jessica was training to be a surgeon and imagine myself heroically saving lives in the ER, just like George Clooney. But political upheaval sent me in a different direction; to Europe, business school and a career building web-based businesses. It would take another twenty years before a conversation with Jessica, by then an eminent heart surgeon, inspired me to start Antidote and bring together my passion for medicine with my experience building internet marketplaces. Antidote is solving one of the biggest problems in medicine and drug development, matching patients and clinical trials, so breakthroughs happen faster. It’s incredible to me that you can find and book a flight to anywhere in the world, but it’s almost impossible to find a suitable clinical trial. Many of the lessons I learned connecting travellers to flights or shoppers to handbags helped me understand and solve the fundamental problems in clinical trials: The first challenge was that, although there was a lot of information about clinical trials online, it was very hard to find the right trial. Search for a breast cancer trial on clinicaltrials.gov and you will find sixty-nine trials in San Francisco with thousands of lines of medical jargon. We took all that data and structured it so an algorithm can match you with a high degree of precision to trials near you. It took a large team and several years to do this work, but we can now say that we have made almost 75% of all US trials much easier to find and apply for. The second major obstacle is that the vast majority of patients today don’t know that clinical trials are an option for them. In an NIH survey regarding cancer clinical trials, an area where research participation can be life changing, 85% of patients were either unaware or unsure that participation in a clinical trial was an option at the time of diagnosis, but if they had known, 75% would have been willing to enroll. There has never been a more promising time in medicine, especially for diseases like cancer, but the fact that so few patients take part in trials is delaying the development of new drugs by years. Our mission is to shorten the time it takes to get new treatments to the people who so badly need them. Community A couple of weeks ago, I went to a meeting organized by a patient community. What made that meeting special is that I didn't go representing Antidote - I went as an actual caregiver. Our mission to help patients and accelerate clinical research is very real. I met so many people at this meeting with unmet medical needs, families looking for answers and hope. I've been in this sector for many years, but only now that I've been on the other side of table I can say I truly appreciate the importance of what we do, and how much I really want to serve this community. So how are we doing this? We are giving away for free our Antidote Match tool to online sites where patients go for support and information. I learned this lesson from Google and Kayak. By giving away the widget, you can reach millions of people at no cost. Today, more than 250 + patient communities such as Healthline, Lung Cancer Alliance, and the Multiple Sclerosis Society of America are using Match to connect their patients with trials. But we are not stopping there. We are using the big platforms such as Facebook and Google, which reach billions of people, to educate people about clinical trials as an important care option, not just as a last ditch desperate attempt to extend life or quality of life. The other critical thing you need to do when you are trying to connect two groups of people, for example those trying to buy tickets for a flight and airlines trying to fill seats or, in our case, patients and medical researchers, is to build the infrastructure so that the two groups can find and engage with each other. That’s exactly what we’ve done with our new product Antidote Base. In the same way that Match makes it easier to find trials, Base makes it easier for researchers and clinical sites to find the patients who are a good fit for their studies. Of course there are other companies trying to solve this important problem, but no company except Antidote has truly tackled the underlying fundamentals of structuring all the data, building the digital infrastructure and tools to connect hundreds of thousands of patients to researchers all over the world. Patients Ultimately our work comes back to patients. A couple of years ago, we received an email from an ALS patient called Eric. Eric is completely paralyzed and communicates via computer by moving his right eye. This is what he said: “Clinical trial information today is almost impossible to find and understand unless you are a medical professional,” said ALS patient Eric Valor. “Having a better option than clinicaltrials.gov, which many patients simply cannot navigate or decipher, is a great resource.” It’s patients like Eric that have kept us going through the early years of Antidote. We are finally starting to have the impact we set out to have, but we still have a long way to go. The day when there are no delays in the development of new drugs and treatments because of a shortage of patients to take part in medical research is the day we can say our job is done. About the Author Pablo is a seasoned entrepreneur with a track record that includes some of the most successful internet companies in Europe. He was responsible for e-commerce at NetJuice, Europe’s biggest incubator, in the late 1990s. He later took the role of MD at DondeComprar.com, the first shopping directory in Spanish, and led the merger with Kelkoo.com to create the largest price comparison and #3 e-commerce destination in Europe. Kelkoo was acquired in 2004 by Yahoo! (NASDAQ: YHOO) for $575m. Pablo was Kayak.com’s first employee outside of the US (NASDAQ: KYAK), spearheading the international roll-out of the company in 2006, and later Commercial Director for ValueClick (NASDAQ: VCLK), a position he left to found TrialReach in early 2009. TrialReach rebranded to Antidote.me Pablo graduated as Bachelor in Business Studies at Universidad Antonio de Nebrija and studied Biology at Universidad Autonoma de Madrid. He lives in London and is a regular speaker at Internet and digital health conferences. https://twitter.com/antidote_me Source : https://www.antidote.me

In December 2015, the Sri Lanka Medical Association, nominated Prof. Vajira H. W. Dissanayake to be its nominee for the President of the Commonwealth Medical Association (CMA) [http://www.commonwelathdoctors.org] from 2016 to 2019. Prof. Dissanayake, with is background in genomics and biomedical informatics, propose the setting up of a Commonwealth Digital Health Network as the flagship project of his Presidency. He presented this to the Commonwealth Advisory Committee on Health (CACH) at its meeting from 17 to 18 March 2016 and invited the CACH to convene in Colombo in October 2016 during the CMA’s Triennial Conference. Prof. Dissanayake presented his plans for the network to the Council of the CMA at its meeting on 13 October 2016 and it was accepted. The Commonwealth Medical Association (CMA) The Commonwealth Medical Association (CMA) held its 24th Triennial Conference on the theme ‘Digital Health for Health and Wellbeing’ in Colombo, Sri Lanka from 14 to 16 October 2016 [http://www.cma2016.org]. This conference was preceded by the meeting of the Commonwealth Advisory Committee on Health (CACH) from 12 to 13 October 2016. The deliberations of the CACH and the deliberations during the 24th Triennial Conference of the CMA resulted in the ‘Colombo Declaration’. The declaration emphasized the importance of Digital Health. The Commitment was further strengthened during a visit of the Foreign Minister of Sri Lanka to the Commonwealth Secretariat on 16 January 2017 [https://www.thecommonwealth-healthhub.net/cwidh/]. The CACH met again from 21 to 23 March 2017 in London, UK and approved the Commonwealth Policy brief on “Digital Systems for One Health Global – Health Security and Health Systems Strengthening in the Digital Era”. This policy brief was presented to the commonwealth health ministers at the annual Commonwealth Health Ministers Meeting (CHMM) on 21 May 2017 in Geneva, Switzerland. It was envisaged that a Commonwealth Digital Health Network be set up with a central hub based in London working in collaboration with regional hubs in Commonwealth nations. This commitment was reaffirmed at the 2nd Commonwealth Digital Health Conference held in Colombo from 10 to 12 October 2017 [http://cmadhc.org]. The Commonwealth Center for Digital Health (CWCDH) which would be formally launched at the Commonwealth Heads of Government (CHOGM) meeting in London on 20 April 2018 would serve as the central hub of the Commonwealth Digital Health Network. The Commonwealth Digital Health Initiative (CWDHI) is a project of the Commonwealth Medical Association. The vision of the CWDHI is to empower commonwealth countries to take leadership in digital health. Mission The mission of CWDHI is to build an advocacy network of professionals in Commonwealth who can uplift health sector by supporting the development of digital health infrastructure and human resource by fostering multi-sector collaboration and public-private partnerships. Activities To hold an annual digital health conference. [In 2018 this would be held during the digital health week in Colombo, Sri Lanka from 8 to 12 October 2018 – http://www.dhw2018.org] To conduct an annual digital health awards programme and make the awards at the annual digital health conference. To hold a side meeting at the World Health Assembly in Geneva, Switzerland in May every year to showcase the award-winning scalable digital health solutions to Commonwealth health ministers. To identify funding partners to support implementation and scaling up of projects selected by health ministers for implementation in their countries. These activities would be supported and coordinated through the Commonwealth Centre for Digital Health and the Commonwealth Digital Health Accelerator. International Advisory Committee The executive of the Commonwealth Medical Association would serve as the international advisory committee of the CWDHI. The current membership is as follows: President – Prof. Vajira H. W. Dissanayake [Sri Lanka] Immediate Past President – Dr. Sulaiman Juman [Trinidad and Tobago] Secretary General – Dr. Jaun Paul Tabone [Malta] Treasurer – Dr. Mary Colman [Ghana] Vice President for Europe – Dr. Gordon Caruana Dingli [Malta] Vice President for Caribbean Islands and Canada – Dr. Colin Able [Jamaica] Vice President for West Africa – Dr. Osahon Enabulele [Nigeria] Vice President for South and Central Asia – Dr. R. A. Jaylal [India] Vice President for South East Asia and Australia – Dr. Ravindra Naidu [Malaysia] President of the Commonwealth Medical Association Trust – Dr. Sundram Arulrhaj [India] Secretary of the Commonwealth Medical Association Trust – Dr. Oheneba Owusu-Danso [Ghana] Project Director Prof. Vajira H. W. Dissanayake Project Technical Support Partners Health Informatics Society of Sri Lanka – for conference organization and administering the awards programme Dr. Roshan Hewapathirana Dr. Pandula Siribaddana Dr. Achala Jayathilake KPMG – for supervising the awards selection process. Source : https://cwcdh.org/history/

The Medical Interoperability Gateway (MIG) The MIG is a secure middleware technology which provides a two-way exchange of real time patient records. Unlike other technologies it doesn’t use a repository to share data and can be integrated with any health or social care system. The MIG can be scaled to work with any system and adopts the national interoperability standards. 110 Clinical Commissioning Groups are using the MIG to connect a wide range of different health and social care organisations. As the MIG uses a local data sharing model, GPs have greater control of their information and who has access to it. Detailed Care Record (DCR) The Detailed Care Record is the standard content model for the MIG and provides ten datasets of information which includes patient diagnosis, medication, risks and examinations. The MIG also provides specialist GP data, which can be used to inform complex care planning for chronic health conditions. Specialist datasets include information from a range of community, mental health and social care settings. This means the MIG can embed data from multiple systems to provide a holistic view of a patient’s record in one place. Summary Care Record (SCR) The NHS in England uses an electronic record called the Summary Care Record to support patient care. It’s a central repository which provides healthcare professionals with access to information about a patient’s medication, allergies and any previous adverse reactions to medicines. Other information such as significant medical history, care plans, patient wishes or preferences (and other relevant information) can be added with the consent of the patient. Comparing the DCR and SCR Want more information? For more information about the MIG, speak to one of our team by phone 0845 601 2642 or email enquiries@healthcaregateway.co.uk. Our website www.healthcaregateway.co.uk provides more information about our core services and includes case studies from our existing customers. Source : https://healthcaregateway.co.uk/wp-content/uploads/2016/10/Detailed-Care-Record-compared-to-Summary-Care-Record.pdf

The health sector by its very nature collects masses of personal data to deliver services to patients. But how patient data is managed is about to be radically altered, as the European Union’s General Data Protection Regulation (GDPR) comes into force on 25 May. The GDPR will affect almost all industries, but in health the new regulations give every patient more control over the personal data that is being collected about them, as well as how this information is used. Hefty penalties are another core component, with a maximum fine of €20m or 4% of turnover for noncompliance. But what does this all mean in reality? Here are five ways the GDPR will affect the healthcare industry over the coming years. 1) Safer personal data Under the GDR, healthcare organizations must better understand how their patient information is collected and where it is stored. Digital data is of course affected, but this change also affects paper records. The GDPR mandates that data breaches must be reported within 72 hours. Naturally, this will drive healthcare professionals and organizations to take better care of the data they hold and, of course, the higher fines in play will act as another incentive to dramatically improve data security. “Many companies are concerned that GDPR will severely impact their ability to engage with customers and prospects, owing to the new restrictions on right to erasure, right to be informed and right to object,” says Michael Geary, Co-founder and CEO of medical practice software company Consentz. “However, given the backdrop of hackers, data breaches from multiple household names and concern about how social media companies use our personal information, GDPR presents a great opportunity to reset relationships and build trust between companies, staff and customers or patients.” 2) Detailed patient profiles With data collected at points ranging from doctor’s surgeries to specialized healthcare organizations, the data footprint of an individual is usually highly fragmented. One of the core components of the GDPR is ensuring that there’s more available information about the purpose and location of any data that’s collected. This means healthcare providers will have a more detailed view of their patients, which could lead to better and more accurate diagnosis, as well as more targeted treatments at lower cost. The counterpoint, though is that the GDPR enshrines the right to be forgotten, which could emerge as a barrier to improved diagnosis. A person’s right to be forgotten could conflict with the legal requirement to retain data following a patient’s or resident’s discharge or death. James Kilmister, Product Director Health & Care at Civica “It is a legal requirement for all healthcare providers to retain records for a prescribed period in case of query. This will need to be tracked closely to both ensure the record is not disposed of prematurely or the subject is denied a disposal when it is valid to do so.” Mandating that patient data has more structure could be hugely beneficial to HCPs. The GDPR places a framework around how this data can be collected, used and in which scenarios it must be deleted, but individual patient care should benefit from reduced fragmentation. 3) Putting patients in control Healthcare is the one area of our lives that has remained highly sensitive and private. But test results are often shared widely to reach a diagnosis, with the patient having little insight into how this information is collected, who has access to it and how it is stored. GDPR places individuals firmly in charge of their data. Giving customers control can help to shape relationships in a positive way, Helen Goldthorpe, Associate Solicitor at law firm Shulmans LLP. “Some of the new data-subject rights also help customers feel in control – for example, they have stronger rights to stop how their data is to be used if they change their mind about consent. Demonstrating that you have thought about how you use data and have put appropriate protection in place can definitely help, even where the customer has no choice.” However, Lee Dentith, CEO and Founder of telehealth company Now Healthcare Group thinks there is still a way to go: “The framework is there to give the user control but how? How are people going to be educated? How will this be facilitated? GDPR goes part of the way in definition but there is no easy way for the individual to control their data. In short the potential is there but how successful it will be is yet to be seen. 4) Using new data sources According to Future Health Index data, 57% of patients own or use a connected care device to monitor various health indicators, but only one-third of these individuals (33%) have ever shared this information with their doctor. Furthermore, FHI research found that healthcare is the industry the general public most trusts with its personal data. There is, therefore, a strong foundation from which to make health data collection part of more peoples’ lives. On the HCP side, technologies from social networking are increasingly being used to deliver patient care and support. Healthcare professionals regularly use networks such as Whatsapp to send patient data to each other. As this information moves across the network, this could mean sensitive data is held outside of the EU, breaching GDPR regulations. James Flint is the CEO of Hospify, which has developed a Whatsapp-like messaging service to enable healthcare teams to securely send patient data over an EU-based network. “Hospify encrypts and delivers text messages from phone-to-phone and then deletes the message from its servers within 72 hours, so the only copies are in the phones of the people in the conversation or group in question,” he says. “This design massively reduces the potential for security breaches or for legal liabilities around patient data access requests and keeps legal liability exactly where it should be – with the individual patients or clinicians involved in any given conversation.” 5) From data insights to better prevention Speaking at the ‘Big data: Connected solutions for better healthcare’ conference held in Brussels earlier in the year, EU health commissioner Vytenis Andriukaitis referred to the European Reference Networks (ERNs) that aim to promote cross-border healthcare: “The success of ERNs also depends on big data: they will compile fragmented health data sets, generate new clinical, genetic, behavioural and environmental data, and make use of these data.” The masses of data that healthcare organizations have been collecting for decades is still often unstructured and inaccessible. The ideas behind big data and how it can unlock the insights contained with healthcare information is a major reason why GDPR could offer the healthcare industry a huge opportunity. The insights that come from the drive to structure and integrate data could accelerate new therapies and bolster moves to improve prevention. Overall, the GDPR is a reason for the health sector to be excited – it could help unlock the potential in huge stores of data that have remained dormant for decades. About the Author Dave Howell is a journalist and author with over 20 years of experience specializing in technology and business subjects. His work has appeared in the national press, specialist magazines and websites. Source : https://www.futurehealthindex.com/2018/03/29/gdpr-will-change-healthcare/

Millennials may be a bit obsessed with self-care — and it’s beginning to pay off for the makers of self-care and digital wellness apps. According to data from multiple app store intelligence firms, the category is now seeing notable growth. In the first quarter of 2018, the top 10 grossing self-care apps in the U.S. earned $15 million in combined iOS and Android revenue, and $27 million in worldwide revenue, according to Sensor Tower. The firm also found that the top 10 wellness apps (e.g. mindfulness and meditation) made about 170 percent more revenue worldwide in Q1 2018 than the top 10 wellness apps did in Q1 2017 across both the App Store and Google Play. In the U.S., they made about 167 percent more. However, a big chunk of self-care apps’ revenue is being claimed by just two apps — Calm and Headspace, both of which focus on mindfulness and meditation. Calm, the top grosser, earned about half the total revenue in the U.S. and worldwide, equating to roughly $8 million in the U.S. and $13.5 million worldwide. Combined with Headspace, the two generated more than 90 percent of the top 10 apps’ revenue last quarter. Apptopia is also reporting a surge in self-care app revenues and installs, but its numbers don’t agree with Sensor Tower data. Both firms agreed on the top three, however: Calm, followed by Headspace, then 10% Happier: Meditation Daily. Other mindfulness apps appeared on both charts, including The Mindfulness App and Stop, Breathe & Think. The discrepancies may be attributed to how the companies define “self-care” — as it’s not a specific app store category — as well as data quality. Apptopia also claimed self-care app installs are up year-over-year, with more new self-care apps arriving every year. Regardless of which firm is closer to actual, the trend is clear: self-care app adoption is booming. Apple, for example, pegged self-care as one of its top four breakout trends for 2017, saying “never before have we seen such a surge in apps focused specifically on mental health, mindfulness and stress reduction.” As to why self-care apps are the latest craze, that’s a bit more complicated. Some experts say millennials’ use of the informational resources on the internet increased awareness about self-care in general; others would say the always-on news cycle of the web combined with the depressing nature of social media led to a growing need for self-care tools. And, of course, cynics would argue it’s simply because millennials are more self-absorbed than other generations, and this trendy focus on self-care is the proof. But there are plenty of other factors beyond that. Millennials married later and were slower to buy homes as a result — that may have led them to have more time to remained self-focused, as they may not have had the same set of distracting responsibilities as their parents. (Or the related drains on their extraneous funds!) Meanwhile, the stigma around mental illness is also on the decline, which aids a self-care app surge. However, not all self-care apps are a replacement for traditional mental health care, when it comes to more serious matters. Some of the talk therapy apps were found to be ineffective, expensive, inconsistent in the quality of care provided and, at worst, potentially dangerous. For those problems that can’t be meditated away, please still call a doctor or an emergency hotline. Source : https://techcrunch.com/2018/04/02/self-care-apps-are-booming/ Source : https://blog.apptopia.com/self-care-apps-growing

Overview This book explores how digital storytelling can catalyze change in healthcare. Edited by the co-founders of the award-winning Patient Voices Programme, the authors discuss various applications for this technique; from using digital storytelling as a reflective process, to the use of digital stories in augmenting quantitative data. Through six main sections this second edition covers areas including healthcare education, patient engagement, quality improvement and the use of digital storytelling research. The chapters illuminate how digital storytelling can lead to greater humanity, understanding and, ultimately, compassion. This collection will appeal to those involved in delivering, managing or receiving healthcare and healthcare education and research, as well as people interested in digital storytelling and participatory media. Reviews “Stories have tremendous transformational potential. This updated edition by Pip Hardy, Tony Sumner and colleagues draws on a wealth of experience of collecting, analysing and disseminating the stories of patients and staff to transform organisations using digital media. There is no magic formula here but many rich examples from which we can learn.” (Trish Greenhalgh, Professor of Primary Care Health Sciences, University of Oxford, UK) “This excellent book provides a clear and succinct background to the philosophy and application of Patient Voices. Grounded in practice, the book emphasises the importance of service user involvement, focuses on topical issues and is of particular relevance to promoting care, compassion, team working and communication. New chapters for the second edition promote the power of storytelling to the process of interprofessional education in end of life care and to the support and facilitation of resilience amongst health care staff. This valuable contribution to practice is highly relevant at the present time and recommended to all professionals working in health and social care.” (Dr Richard Gray, Chair of the Centre for Advancement of Interprofessional Education, UK) “Hardy’s and Sumner’s newest edition provides a thoughtful, useful process for understanding other human beings more deeply. Timely and relevant to educators, researchers, and the general public, the stories in this book capture urgent topics of interest for all while encouraging reflection on our own stories and those of others while looking for new ways to enhance communicating on our collaborative learning journeys.” (Dr Jo Ann Bamdas, Director, Office of Interprofessional Education, Florida Atlantic University, USA) “This excellent book is an important contribution to the growing body of literature on digital storytelling where scholars and practitioners worldwide share their experiences and collaborate in developing both the many ways digital storytelling is used and our understanding of how and why this approach to knowledge is so powerful. I frequently introduce Patient Voices stories to my students, both in healthcare and other programs, to inspire their own reflective work towards developing a personal professional identity. The particular value of this book, from an educationalist point of view, is the solid foundation of lived experience combined with reflections and theoretical discussions - and the way these perspectives mutually enrich each other.” (Grete Jamissen, professor emerita, Oslo and Akershus University College, Oslo, Norway) “Discovering Pip, Tony, Patient Voices and Digital Storytelling [all in one go!] has, without shadow of doubt, been the most pivotal experience of my whole career. There’s something magical about where a digital story takes our imagination, provoking us into new ways of seeing the world. This second edition of ‘Cultivating Compassion’ includes a new chapter dedicated to ‘The DNA of Care’, an NHS England project that emphasised the importance of reflecting the experiences of NHS staff…human beings, with needs and stories of our own to share. This book is a ‘must read’ for medical educators looking for new ways to inspire their learners & promote reflection but it is also for anyone who wishes to recall the joy & privilege to be had in hearing & learning from our patients’ stories, which, after all, lies at the heart of providing our best and most ethical care.” (Dr Ruth Bromley, Lead for Ethics & Law, Manchester Medical School and Clinical Fellow in Clinical Communication Skills, Ethics and Law, University Hospital of South Manchester NHS Foundation Trust, UK) “There is an increased understanding in healthcare that safe, compassionate care involves hearing and working with a multiplicity of voices - patients foremost, but also all members of the wider healthcare team. This comprehensive collection of essays provides thoughtful guidance for incorporating patient and staff narratives into all aspects of care improvement: from education to research to safety. It will be invaluable to anyone involved in the endeavour of improving care.” (Dr Cat Chatfield, Quality Improvement Editor, the BMJ) About the Authors Pip Hardy is a co-founder of the Patient Voices Programme. She has degrees in English Literature and Lifelong Learning and qualifications in counseling and adult education. Her PhD examined the potential of digital storytelling to transform healthcare. Tony Sumner is a co-founder of the Patient Voices Programme. He has degrees in physics, astronomy and astrophysics and a background in the software industry. His research interests relate to the possibilities afforded by technology to promote deep reflection Click here to order the book on Amazon - https://www.amazon.co.uk/Cultivating-Compassion-Storytelling-Transforming-Healthcare/dp/331964145X/ref=sr_1_31?ie=UTF8&qid=1522482112&sr=8-31&keywords=digital+health

The Future of Healthcare You would be forgiven for thinking the future of healthcare looks bleak in the UK. However, technological advances present a wealth of potential to ease the burden on the NHS and give people more control of their wellbeing. The Future of Healthcare special report, published in The Times, features expert opinion on coping with an ageing population, evolving technology in medical research and Amazon’s move into corporate healthcare. Also featured is the debate on how effective antidepressants are and an infographic on wearable healthcare devices. https://www.raconteur.net/future-healthcare-2018 1) Preventative healthcare and tackling challenges of an ageing population As the UK population ages, the need for preventative healthcare and societal change has become immediate. https://www.raconteur.net/healthcare/preventative-healthcare-tackling-challenges-ageing-population 2) Digital healthcare puts patients in control of their health Development of digital technology is helping to deliver personalised treatments which involve patients in their healthcare https://www.raconteur.net/healthcare/digital-healthcare-puts-patients-control-health 3) How 3D printing is transforming healthcare Technological advances look set to make 3D printing the most rapidly evolving technology in medical research, with the potential to transform healthcare https://www.raconteur.net/healthcare/3d-printing-transforming-healthcare 4) The benefits of value-based healthcare Moving from volume to value-based healthcare is not without its challenges, but puts patients’ wellbeing first https://www.raconteur.net/healthcare/benefits-value-based-healthcare 5) ‘It’s time the NHS recognised the potential of medical technology’ The NHS is creaking under the strain of an ageing population, a growth in costly long-term conditions and mounting budget deficits https://www.raconteur.net/healthcare/time-nhs-recognised-potential-medical-technology 6) Debate: Do antidepressants work? “Doctor please, some more of these” moaned Rolling Stone Mick Jagger on the 1966 track Mother’s Little Helper as a generation turned on to the prescribed drugs deemed to blunt the corrosive impact of modern life. Fifty years later and 64.7 million prescriptions for antidepressants were handed out in 2016 by doctors in the UK, but debate rages over how effective they are. https://www.raconteur.net/healthcare/debate-antidepressants-work 7) The healthcare case for sharing medical data with blockchain Health services need to improve data-sharing for better patient care, treatment and research outcomes, but whether blockchain is the right facilitator remains to be seen https://www.raconteur.net/healthcare/healthcare-case-sharing-medical-data-blockchain 8) Company cover for workplace wellness Companies are increasingly providing private health cover for employees in a bid to gain flexibility and convenience, while at the same time helping to relieve pressure on the NHS https://www.raconteur.net/healthcare/company-cover-workplace-wellness 9) Help for people living longer with dementia The increase of dementia among the UK’s ageing population calls for urgent action to avoid the health service being overwhelmed by elderly sufferers https://www.raconteur.net/healthcare/help-people-living-longer-dementia 10) Feeling the pain of an opioid crisis Prescription and illegal painkillers are wreaking havoc in the United States, so how can the UK avoid an escalating opioid crisis? https://www.raconteur.net/healthcare/feeling-pain-opioid-crisis