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Writer: Anzel Singh CEO and Head of Digital Health at Mercy Radiology and Clinics, and Healthcare Holdings Limited, Dr Lloyd McCann provides a snapshot of New Zealand’s Healthcare system adapting to the era of technology. Speaking on the great potential benefits of embracing Artificial Intelligence, Machine learning and utilization of Cloud-based solutions that ensure services are deployed more rapidly than ever before. Transformation of the Healthcare Industry enabled by technology proves to be an exciting time as service delivery shifts towards patient-centred care which not only puts you in the driver seat of your healthcare experience, but also leads to a more sustainable system. Currently working at the forefront of these changes Dr McCann discusses what is beyond the horizon.  Q: When will Digital Health just be referred to as Health in terms of normalisation of AI and how fast is this transformation occurring? Dr Lloyd McCann: One of the problems we have is that is referred to as digital health in the first place and not just health. We don’t talk about digital banking or digital travel we just refer to it as banking and travel. When is a hard question... I think we’ve entered a phase where we are accelerating towards digital delivery and digital services are becoming more embedded in healthcare. I think we’re still a few years away from it being integral to service delivery models, but I do think we’re starting to see this change speed up now. I don’t think it’s just about machine learning and artificial intelligence. There are so many other technological approaches and solutions that we’ve just been very slow to adopt in health. Things like robotic process automation, cloud services, mobile solutions and so many other proven approaches that we are yet to adopt at scale. Q: What disruptors on the horizon will be changing Healthcare and what should future Clinicians and Health IT specialists expect? Dr Lloyd McCann: There’s some work being done by the medical futurist, Dr Bertalan Mesko that I follow closely. One of the first things he’s put out is that in health we shouldn’t be worried that AI and machine learning approaches will replace health professionals. What health professionals need to understand is that health professionals that embrace AI and approaches like machine learning will probably replace those that don't. One of the reasons this is coming is because of the shift to a more consumer-centred model of care. Consumers expect convenience, rapid delivery of services and access at a time that makes sense for them. Consumers want information to be able to inform their decisions so the traditional model where we as medical professionals were the gatekeepers and custodians of that information is getting ripped apart and that’s a good thing for the consumer in my opinion. In terms of some real disruptors, if I was going to pick two would be machine learning and AI because I think as these systems mature and as we get more confidence in systems that information asymmetry does get challenged and addressed. The other big one for me is the increasing hybridisation of systems, biological systems meshing and being part of digital systems, whether that be a genomic sense or in a traditional clinical service delivery sense that mash-up between biological and digital systems creates some fascinating opportunities in terms of wearables and implantables so your ability to deliver care in different ways exponentially increases. A real world example is the digital therapeutics approach where we’re seeing entire treatment plans being delivered using a virtual model. Omada health in the US are getting better outcomes from a virtual service delivery model than an in-person service delivery model for the treatment of diabetes and it’s more cost effective. For professionals that embrace these technologies and approaches there are lots of opportunities, but for those that don't, I believe they’ll become less relevant in the future.  Q: What potential do Integrated Practice Units have in revolutionising healthcare and what other specialities besides Head and Neck will follow this system? Dr Lloyd McCann: Integrated Practice Units are not a new concept, it’s a concept that’s just been re-branded. Essentially we’re talking team-based care. Working in teams to get the best outcomes for patients is what it is all about. I think that is something that needs to be embraced in all areas of healthcare. Ultimately collaborative decision making means you’re making a more robust decision for the patient. I think all specialities need to embrace this approach. It’s better for the consumer since you have a multidisciplinary or consensus decision being made for the best treatment pathway for that patient. The way we’re organized doesn’t exactly lend itself to that at the moment so we’ve got to reorganise our system but we know that the evidence suggests when you are practising team-based care the outcomes and cost-effectiveness of the system is markedly improved. The head and neck example is where we took a 12 week pathway and compressed it down to a 45 minute appointment just by bringing the radiologist, the head and neck surgeon and pathologist together as an integrated practice unit. The interesting thing is the clinicians that work in these team-based models of care get more job satisfaction so it’s better for the clinicians too because they’re working in a collegial environment where they get to operate at the top of their scope. Getting to make good decisions for their patients in real time as opposed to working in an isolated manner is just better! Q: What role do Cloud-based solutions play in improving Clinician decision making and what’s currently happening in this space? Dr Lloyd McCann: If you think about decision making or even just having the right information at the right time to make the right decision; using cloud-based solutions allows us to be more flexible, cost-effective, deploy services much more rapidly than the traditional on-premise model. It also allows us to consume services in a much more flexible manner rather than needing to invest heavily in infrastructure or hardware upfront. There’s a lot we could and should be using the cloud for. Several organisations in the US have moved most of their applications to the cloud and they’re seeing real benefits. Utilizing providers like Amazon, Microsoft and Google where cloud service delivery models are their bread-and-butter means we leverage all that expertise. There are many different applications we could be leveraging and utilizing if we moved to more cloud-based services. We’ve just got to get more comfortable with that in health. And so you’re starting to see that progression in New Zealand, but we’re still taking baby steps.  Q: What are you most excited about in terms of future development in Health and what can we as patients/consumers look forward to?
Dr Lloyd McCann: I think there is a real opportunity of truly becoming a patient/consumer centred system. We’re still provider centred/lead and if you look at most other industries that’s not the way things work. Through utilizing digital tools, and more importantly changing the way we think and act to become consumer centred, we can have better outcomes for patients and the system. The evidence shows us that by delivering consumer centred models of care, we deliver better value - and it just makes sense. So that’s one of the things I’m most excited about. The opportunity to become truly consumer centred.
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Author: Eloise Young
24/4/19 Since the 1990’s women in healthcare have increased in their numbers, allowing them and society to look towards an industry of equality. Many of these women have been taking on lending roles such as presidents and CEOs in companies and are the central voices and faces of healthcare, and healthcare IT initiatives. Not only do women in health IT bring intuitive and differing minds to developing projects and systems within organizations- they bring hope and inspiration to women all around the globe who aspire to be a part of this growing industry. As dominate figures of companies in the healthcare sector, women are now strong influencers and guiders to new beneficial discoveries and technology breakthroughs in today’s healthcare. Through women obtaining primary roles within leading healthcare companies, they are showing how women are involved, driving ideas and leading the IT movements. It also shows that we as a global society are making steps to achieving gender balance in the dominating companies that strongly influence the public. Although the healthcare industry and the many various industries of our world are not quite there yet in terms of gender equality, there is still room for hope. This hope is due to the women taking on leading roles in both organizations and IT research groups. They represent to society that the world is not what it was before; the assigned roles of the past will remain in the past because of the confidence and empowerment that these women project. By women working in health IT organization teams, it enables them to be a part of the production of healthcare and to have the opportunities to help develop the way healthcare technology works. The women in the teams, research groups and all the diverse roles within the health industry represent how women are now a part of the problem solving and development. This not only produces a better, well rounded research team, it allows women to put their diligence and skills to practice and be a part of the growth, discoveries and evolution of today’s health IT corporations. With women in all the areas of healthcare technology it is opening up a bigger scope of thinking as it allows more minds, and more perspectives to analyze the problem and develop the solution. In the words of Alan Mulally “leadership is having a compelling vision, a comprehensive plan, relentless implementation, and talented people working together.” By both women and men working together in such an important and dominant global industry, it is allowing all kinds of various ways of thinking to solve problems and realize finer details that may have been overlooked with only limited perspectives. It is therefore crucial that equality is encouraged so that all possibilities can be brought to the drawing board. By doing so, it allows companies, organizations and greater industries as a whole to thrive and benefit everyone on our planet, for a better, more effective healthcare. Though there is a lot more work needed to close the gap and prejudice on gender roles in healthcare, it is safe to say that the gap is closing. Although women in this industry and all industries still feel masculine dominance, they need to remember that the situation is changing, and take pride in the fact that it is because of them that equality is now obtainable in the near future.  It is our pleasure to announce that We're taking part in the Pink Ribbon Breakfast campaign this year to help support Breast Cancer Foundation NZ's vital work. Please come visit us at the Women in Health IT Conference on 27th May to support.
By taking part, you’ll be helping all those affected, as well as bringing us one step closer to our vision of zero deaths from breast cancer. We think everyone deserves access to the latest and most effective treatments. We also want people to have all the support they need during their breast cancer journey and recovery, including rehabilitation, counselling, advice and access to a supportive online patient community. The money raised will be used to fund research projects and medical grants to help improve survivorship, as well as support patients and their families during treatment and recovery. Donate today to help make zero deaths from breast cancer a reality. You can either donate online or on the day of the conference. http://pinkribbonbreakfast.co.nz/page/healthcaretechnologyassociationnz  Author: Eloise Young 20/03/19 The Healthcare Technology Association (HTANZ) hosted an after hour event on Friday, 15th march which brought both students and health professionals together to educate, inspire and share the upcoming digitalisation processes in healthcare. The Decima Glenn Room at the University of Auckland Business School bustled with an eager audience to hear what the three health organization speakers had to say about the future of our healthcare system. But before the speakers could hit the spotlight the Healthcare Technology Association’s very own founder and president, Christiane Zhao warmly welcomed the room expressing what an honour it was to be there, and have all of us there to share this moment of her career, and the exciting news of health technology together. First to present Orion Health’s developed technology in clinical information searching was their former clinical product specialist, Michael Hosking (who recently became the director of Clinnovation Limited). Hosking’s work of more efficient and accurate patient searching within the healthcare system he states, will give New Zealanders “more confidence in their healthcare professional having access to accurate information more quickly than currently exists.” This development, Hosking further explained in his presentation will not only improve time scheduling and workload for clinicians but will also save patients time and money. The underlying NLP technology behind Hosking’s work he claims has uses other than system efficiency, “some other uses could include: real-time bio-surveillance to improve national responses to infectious disease outbreaks; similarity analytics which supports scenarios for more individualistic care plans; and advanced clinical decision support informing disease prevention.” When I asked Michael what students should take away from this event, his answer was one directed towards those who wish to be a part of this growing industry and advice to current technology tasks, “clinical engagement and active ownership of the problem and solution is critical- ensure this early and often to improve the likelihood of success of any digital project.” Hosking’s future in health technology is something he looks at with an open mind as he expressed “I believe the opportunities are boundless. My passion lies in sustainable, data driven, healthcare system design and workforce development”, which reminds us all to keep our doors open, keep our passions close by and look forward to what lies ahead. Next to bring laughter all around but also the incredibly futuristic world of healthcare was Vensa Health’s business strategist, Dr. Tom Varghese. Varghese’s presentation explored the technology of AI ‘communication’ with patients nationwide. The idea that patients can simply type their symptoms into a message-like forum and a computer will reply with a diagnosis. This of course lead me to ask Tom a question a vast majority of us were thinking, why should people trust a computer? Tom’s response was simple, “a human being comes with inherent errors and flaws, you forget, you say things you’re not meant to say, you’re not sometimes empathetic, a machine won’t do that.” It seemed understandable enough, and yet some of us were still sceptical so Tom further explained, “a machine is fed a bit of information and follows an algorithm, responds with data, reproduces that over and over again. So as a clinician, I would trust a machine because I’m able to get consistency, I cannot demand consistency from a human being.” Varghese’s answer truly connected the dots that in order to have easy access, affordability and convenience in healthcare we must put trust in the very thing society has had queries about for decades. In terms of patient information security Varghese commented, “My personal take is information is never 100% bulletproof, you could have the best encrypted data procedures and you could still get hacked into, but what we do with that is, we learn and reiterate and we get better.” Which is why of course Vensa Health’s project will keep all patient information in the cloud rather than in “a little box sitting under your doctor’s desk.” When I asked Dr. Tom Varghese my final question of why university students should take an interest in this area of the health industry, his reply I believe not only spoke out to those aspirating to be involved in health, but all of us aspiring to be involved in the future, Tom said, “You’re a digital generation, thinking differently is part of your DNA. Those people sitting there making those decisions, they probably don’t understand or comprehend it that well. Why should you be involved in it? Exactly that, because it is you inheriting this legacy.” To wrap up the evening Dr. Lloyd McCann took centre stage to talk about the overall ambitions and obstacles of health technology and about digitalisation from a private company's perspective. McCann brought to light the problems the healthcare system will face when undergoing this digital transition. He stated, “with any change you create some friction, which is not necessarily a bad thing. I think there are ways we can change our thinking and the way we act that allows us to get better at doing it.” In foreseeing the digital health uptake McCann predicted, “we probably will reach that point, the tipping point theory, where there is suddenly a very sharp rise in uptakes and adoption in terms of digital approaches.” Healthcare, as we all know is one of the pillars that hold up the world we live in today and what these three health technology professionals subconsciously projected through their presentations is that this pillar must not only be maintained, but also improved. With these new, exciting developments in health technology, we can all share in the life changing opportunities of this growing industry.  Join us at the 3rd annual Emerging Tech in Health symposium in Christchurch on 21+22 May
ETIH19 is part of NZ Tech Week'19. Attend one day or both, depending on your areas of interest:
Programme Keynote speakers
Health Informatics New Zealand (HiNZ) is a not-for-profit organisation with a focus on events, education and networking. HiNZ supports the field of health informatics and runs a range of events. Its annual conference is the largest digital health event in New Zealand and it has an extensive archive of expert presentations on digital health. HiNZ delegates and members come from a diverse range of areas within healthcare, technology, and government. HiNZ builds and strengthens connections between these groups and provides an impartial meeting place for sharing ideas and building knowledge about the use of IT in the health sector. HiNZ offer students a free membership and discounted rates for our events/conferences. For details for students please refer to https://www.hinz.org.nz/page/Studentmember  The common theme to highlight for the International Women’s Day is #BalanceForBetter
Gender Equality is for all genders, not just women. In 2019, however women still struggle to rise up the ranks of both health and science. Gender discrimination, implicit bias, sexual harassment, and assault have been found to be systemic barriers to women’s advancement in global health careers. Female health workers comprise 70% of the health workforce worldwide yet women occupy only 25% of leadership positions in health and just 12% of the membership of national science academies worldwide. However, we are keep seeing positive signs that things are changing, better work arrangement, more comprehensive policies on gender discrimination and harassment, more and more mentorship programme and leadership training for female… And all these help us to overcome the challenges and empowering women in act independently and powerfully in global health. On 27th May, we are hosting a Women in Health IT Conference in Auckland, New Zealand. Together, we can do better. The Women in Health IT conference brings together established and emerging leaders from across sectors and cultures to work towards gender equity in health leadership and to improve health for all. Join us in addressing the gender gap in health information and technology, and the need for more community, resources and recognition of women who have made a difference sector-wide. Engage with your peers and take the next step to further your career while connecting with and empowering women in our field. This conference is open to all genders. #BalanceForBetter Recently, Deloitte released a report entitled “2019 Global Health Care Outlook: Shaping the Future”, which details the above situation and introduces existing feasible solutions. The Arterial Network compiled and compiled some of the contents of the report for you. The following are the core points:
Global health care spending is expected to grow at a rate of 5.4% per year in 2018-2022, compared to 2.9% per year in 2013-2017. This increase reflects the strength of the dollar against the euro and other currencies, the expansion of coverage of health insurance in developing markets, the increased demand for care for the elderly, advances in medical technology, and rising medical labor costs. Per capita health care spending is expected to continue to vary widely, from $11,674 in the United States to $54 in Pakistan in 2022. Efforts to close this gap will be limited by the acceleration of population growth in developing countries. Higher per capita spending does not always mean higher quality health care services. Compared with 10 developed countries, the United States ranks unsatisfactory in terms of overall health care performance, which is highlighted by a 50% higher per capita expenditure than the countries ranked after it, but ranked in terms of efficiency, fairness and healthy living. Life expectancy seems to continue to climb. It is estimated that by 2022, the average life expectancy of the population over 65 years old will increase from 73.5 years in 2018 to 74.4 years, more than 668 million, accounting for 11.6% of the global population. Increasing life expectancy and life expectancy is a major achievement in health care, as the increase in per capita output is related to an increase in real per capita GDP. This effect is expected to be most pronounced in Japan, which is likely to reach nearly 29%. In Western Europe, this ratio is estimated to be close to 22%. Even some developing countries such as Argentina, Thailand and China have begun to see similar situations. Efforts to combat infectious diseases are making significant progress by improving sanitation, improving living conditions and wider access to health care services. Thanks to advances in medical technology, the number of AIDS-related deaths has fallen from 2.3 million in 2005 to 940,000 in 2017. Tuberculosis infections are down by about 2% per year. The number of malaria deaths worldwide has fallen from nearly 1 million in 2000 to 445,000 in 2016. The widespread use of new vaccines and treated nets reduces the infection rate and mortality of all mosquito-borne diseases. Noncommunicable diseases Cancer, heart disease and diabetes accounted for 71% of the 56.9 million deaths reported globally in 2016. In most developed markets, this proportion has exceeded 80%. Urbanization, sedentary lifestyles, changing diets and rising levels of obesity are driving the growth of non-communicable diseases markets in both developed and developing countries. Health care stakeholders—health care providers, governments, payers, consumers, and other companies/organizations—are working to meet clinical, operational, and financial challenges. Looking to the future, with the help of digital technology, new business and health care delivery models may help solve today's problems and build a sustainable foundation for affordable, accessible, high-quality health care. This idea is more likely to become a reality. If all stakeholders are actively involved in shaping the future, it is necessary to shift the focus of philosophy from the disease care system of patients after illness treatment to health care that supports health, prevention and early intervention. system. However, today's healthcare systems and participants are unlikely to achieve this transformation on their own. They may need to work with other traditional sectors such as employment, housing, education and transportation to address healthy social determinants and work with new sectors such as retail, banking and technology giants to improve data and platform interoperability. The potential of “digitalization” in the “business core” operations Cutting-edge technologies that patients, members, and customers can see can help healthcare organizations stand out. But the core technology, the technology that most people have never seen before, can make an organization work. Back-ofce systems and their quality of connectivity to front-end enterprise functions are key infrastructures that enable pricing, product availability, logistics, quality, finance, and other "business core" information to be used when needed. While health care organizations are embarking on digital empowerment from multiple perspectives, one issue is always important: using emerging technologies to redefine core systems and back-end processes to define how day-to-day work is done . Some supplier organizations have begun to take steps to improve their two main core functions: machine learning and robotic process automation (RPA), cloud-based software-as-a-service (SaaS) and forecasting tools: revenue cycle and supply chain. Significant advances in wireless technology, miniaturization and computing power have led to an exponential increase in the speed and scale of digital healthcare innovation, where innovation is emerging and affecting clinical and commercial operations. These advances have also prompted consumers to increasingly expect “digitalization”, which seems to be a new demand for all medical institutions. Digital innovations such as blockchain, cloud computing, virtual health, artificial intelligence and robotics, digital reality, medical Internet of Things (IoMT) are helping to reshape the future of healthcare, making healthcare more efficient and accessible. Increasing data access and data sharing through digital solutions is improving personalized self-service and patient experiences. More benefits from digitalization may be at hand. For example, blockchain has the potential to enhance collaboration, trust, interoperability, and traceability in a range of functions including clinical trials, supply chain management, financial transactions, certification, and claims processing. Sex and auditability. In the life sciences and health care sectors, the transition from blockchain to blockchain (the network of networks) is particularly striking. In this area, different sectors work together in a broadly interdependent ecosystem. The industry application of blockchain is still in its infancy, but a survey by Deloitte shows that the number of life sciences and medical institutions (35%) planned to deploy blockchain in 2017 exceeds similar expectations in other industries. Health systems around the world are investing in digital technology with varying degrees of enthusiasm Australia is launching the My Health Record (PHR) service, which links patients' personal health record data to different parts of the health value chain and patients can opt out. The UK recently announced an investment of 37.5 million euros to establish a digital innovation center to address the UK's biggest health challenges. In other digital developments, more and more people in the country use the innovative company Babylon Health as a way to get primary care. New members of the healthcare industry are entering the EHR market, which may reduce the overall cost of implementation. In addition, they have a number of activities in automated AI-assisted diagnostics, remote health and comprehensive health records. In 2017, the Chinese government issued the “13th Five-Year” National Science and Technology Innovation Program, aiming to develop precision medical technology and integrate it into a multi-level knowledge base to create a national biomedical big data sharing platform. Over time, with the support of evidence-based technology, patients who are about to receive treatment or are receiving treatment will benefit from better quality of service and personalized care. A new Japanese law is expected to significantly increase the sharing of electronic medical record (EMR) data. Almost all hospitals in Japan have electronic medical records. The problem is that each hospital uses a slightly different system. Therefore, data is not designed to be aggregated at the national level and is not the best way to improve national health systems. In addition, the hospital's electronic medical records should be linked to the primary care data set to provide a true understanding of the patient's path. In the Netherlands , patient-centred healthcare is supported by electronic health solutions and is a top priority for hospitals and healthcare organizations. However, the goal of the health system is to go beyond the pilot and move toward mainstream applications. Ba Xi some of the company's human resources department is to increase employee participation in health and chronic care programs through the game of. India 's health system is launching many conceivable and cutting-edge small-scale pilot projects around mobile health, telemedicine and IoMT, although they are rarely implemented on a large scale. Many public and private hospitals are turning to online patient registration and service delivery systems, and digital marketing is becoming more commonplace through appointments, online payments, downloading test reports, and sharing health tips. A list of digital technologies that can help healthcare providers, payers, and governments achieve the three goals of improving healthcare, improving health, and reducing spending are expanding and growing. Let's take a closer look at three of these innovations: artificial intelligence and robotics, digital reality, and the Medical Internet of Things (IoMT). Focus on digital medical innovation Artificial intelligence and robots Artificial intelligence is expected to change the healthcare industry by performing clinical and commercial tasks currently performed by humans faster and more accurately, and using fewer resources. Artificial intelligence can provide decision support and physician assistance for tasks such as diagnosing patients and early detection of disease outbreaks; speeding up the development of new drugs and equipment; streamlining the Chief Executive's middle and post functions, such as doctor referrals, patient path coding, and claims approval. An example of artificial intelligence-assisted workflow management is DeloitteASSIST, a patient communication solution that combines speech recognition, natural language processing, and artificial intelligence to enable patients to request help without pressing a button. By simply saying the request, the nurse can understand their needs, prioritize the request through artificial intelligence, and route it intelligently to the appropriate resources (caregiver, patient support assistant, volunteer) to meet the patient's needs. demand. Importantly, healthcare stakeholders need to recognize that artificial intelligence technology is designed to support and increase staff so that highly trained resources can focus on more valuable, patient-oriented activities rather than replacing them. . For example, robotics can improve the formulation of drugs, disinfect medical devices, and reconfigure human resources into more valuable areas. Driverless cars can take patients to see a doctor and improve the continuity of care. Drones can pick up drugs that the old man falls on the ground. The use of robots in pharmacies and surgery is currently in use, although the full potential of the technology has not yet been realized. In some applications, such as surgery, the cost of these technologies remains a challenge, and it is unclear whether the use of robotics can improve efficiency and effectiveness to justify increased costs. Artificial intelligence and robotics applications are still in the early stages of adoption among healthcare stakeholders and patients. Increased acceptance may depend on the innovator's ability to reduce costs and improve the accuracy of natural language processing, big data and cognitive technologies, as well as the acceptance and trust of healthcare professionals and patients with new tools. AliveCor is the maker of the iPhone's KardiaMobile ECG monitor and Apple Watch's KardiaBand ECG recorder, which is collecting data from its devices, which may one day be entered into a machine learning system to help doctors find the disease. In a potential application, “bloodless testing” will observe subtle changes in the ECG, which is a characteristic of elevated levels of potassium, and artificial intelligence has unique skills in identifying this feature. Measuring the indicator in real time with the convenience of a cell phone or smart watch may change the way clinicians treat their patients after a heart attack. Digital reality Digital Reality (DR) is a general term for augmented reality (AR), virtual reality (VR), mixed reality (MR), 360-degree and immersive technologies. With the advent of many new digital features, these technologies have entered the consumer world for the first time in the form of games and entertainment. Now, the use of these technologies is reaching a tipping point, and companies and organizations are beginning to use more than entertainment. Barriers to technology, cost and content are beginning to diminish, and early adopters are already working hard to create solutions to help change health care. Deloitte and McLaren are working together to create a data-driven solution that combines specialized hardware and software with sophisticated algorithms to improve the performance of each function and organization. Healthcare applications can include creating digital copies of hospital processes, then applying advanced analytics and running millions of potential scenarios to identify root causes and test different interventions before applying. In the life sciences and healthcare sectors, the virtual patient simulation market is expected to grow at a rate of nearly 20% per year and will become a $1.5 billion industry by 2025. Among suppliers, the use of AR and VR is currently concentrated in several discrete areas. For patients, these techniques can speed up their understanding of the condition or treatment plan. When technology is used for imagination and relaxation exercises, they can even be used as a treatment. Applications in opioid addiction treatment, phantom limb treatment, phobia treatment, cancer treatment planning, perioperative planning, post-traumatic stress disorder and general pain management have been established. DR tools can help maintain mental acuity by participating in certain situations, and some VR-based therapies are beginning to appear to help Alzheimer's patients improve their memory. In a clinical setting, AR and VR can help doctors and care teams perform care work. For example, the surgeon can use a heads-up display to provide a data coverage of the patient's body during the procedure or to visualize the entire procedure in a preoperative plan. In combination with medical imaging, augmented reality technology is beginning to provide clinicians with the ability to project medical images (such as CT scans) directly onto the patient and to be consistent with the patient's body, even as the patient moves, augmented reality is also The clinician provides the ability to project a clearer line of sight onto the internal anatomy. In the context of education, courses in undergraduate, postgraduate, continuing medical education programs and institutions are increasingly being combined with AR and VR support. Take the physician VR training as an example. Physician VR training Virtual reality technology The immersive experience and real-life scenarios of surgeons and emergency doctors are changing the process of medical training. The latest developments in VR training include: Surgical Theater is a VR specialist that provides pre-operative rehearsal platforms for complex surgeries. The Johnson & Johnson Institute has recently launched a VR training program to help orthopedic surgeons and nurses prepare for total knee arthroplasty and hip fracture treatment procedures, and plans to expand to other operations. Oculus VR is conducting a trial to test VR simulations of emergency department (ED) staff in high-risk child trauma situations. London-based Fundamental VR has developed a “Fundamental Surgery” virtual reality application that simulates the surgical environment and the physical feel of the body. Embodied Labs produced a VR program called We Are Alfred, in which Alfred is a 74-year-old macular degeneration. The device places the nurse or doctor in an individual location of the extreme patient so that they can understand the patient's condition. Medical internet of things The Medical Internet of Things (IoMT) is an infrastructure that connects medical devices, software applications, health systems, and services. IoMT combines people (patients, caregivers and clinicians), data (patient or performance data), processes (care delivery and patient support) and startup procedures (sensors, connected medical devices and mobile applications) to be more effective Improve patient outcomes. The rise in the number of medical devices capable of generating, collecting, analyzing, or transmitting health data or images and connecting to provider networks, transferring data to cloud repositories, or internal servers has driven the rise of IoMT. Importantly, IoMT generates intelligent and measurable information to help more effectively improve the speed and accuracy of diagnosis and treatment As new technologies evolve, new business models will emerge, and these new business models are expected to have a profound impact on the development of healthcare as they blur the boundaries and promote cross-sectoral and cross-industry integration. The resulting “super cluster” of public and private sector providers, payers and market disruptors can use the smart health community approach to drive innovation, increase availability and affordability, and improve through more efficient delivery models. Quality and cost reduction Article retrieved from Wang Shiwei arterial new medicine Here is a “hello” from the other side of the world. While writing this month’s newsletter, I am currently waiting for my flight to Tokyo, Japan. In the past few Health-Tech conferences held this year, we have studied Health Informatics cases of how the Japanese government is withstanding Japan’s aging population by spreading the use of technical products. Japan is also taking a leading role in the field of medical research and technology innovation. On 22nd November, I will attend the "HOSPEX Japan 2018” exhibitions, which bring together hundreds of medical and technology companies in the Tokyo Big Sight. I also have the honor to attend one of the biggest health-tech conferences of the year in Japan. The “Health 2.0 Asia” annual conference has picked Tokyo this year. Health 2.0 has started in California in 2007 and keeps its outstanding position to introduce cutting-edge technologies in healthcare technology. As the management team announced the merge with HIMSS last year, this year's conference accelerates its progress more than ever. It will be my pleasure to share useful market resources with you, so please keep an eye on our newsletter and Facebook. It has been a year since the establishment of the Healthcare Technology Association. The size of our community has expanded tremendously; we are able to reach more talented and active young professionals in the Auckland region, as well as the rest of New Zealand. We successfully held three professional networking events from June to December this year, including one event hosted by the University of Auckland. We are expecting more regular events to be held next year, and we cannot wait to see you again. I and the rest of the HTA committee would like to wish you a Merry Christmas and a happy new year. We believe every step we have taken together and every single connection we built will accelerate the process of health tech integration. Cheers, Christiane and the HTA team    Director of the AUT Centre for eHealth and former Clinical Psychologist, Dr Duncan Babbage explains the purpose of his face-name recognition app ‘Intro’. He gives insight on what cognitive prosthetics are and what features the holy grail of one would have—as well as why learning from your mistakes isn’t how you should learn. Highlighting future aims of the industry from personalized medicine—which is already being implemented locally through kiwi cardiologists who have genome sequencing machines on their desk—to clinician efficiency having the potential to be improved through health technology. Possibilities are endless in this field you should have on your radar. Dr Babbage shares his thoughts. Q: What did you visualize Intro would do for people going through neurorehabilitation? Dr Duncan Babbage: The Intro app (http://intro.app) came out of work I was doing with people with significant brain injuries, and partly out of my own experiences. Personally, there would be times I would see someone I should have known relatively well and have no idea who they were, or sometimes I would know exactly who they were but still wouldn’t be able to retrieve their name. And so for me, it’s been a real challenge for years. Alongside this, I was doing work with people with significant brain injuries, which developed into an interest in the face-name recognition difficulties experienced by some people with brain injuries also. Dr Phil Howard, a clinical psychologist who did his doctoral studies with me, focussed his research on how to support people with brain injuries who had these difficulties to be more effective at these kinds of tasks. He and I developed a prototype app as part of that research. While that app was separate from Intro, and took a somewhat different focus, it was the the start of a journey. Along the way, I heard from lots of people in the general population who said, “I really need an app like that!” Intro is the result. The purpose of Intro is to give people a tool to help them be more effective at learning names. Intro is starting from some of the same problem space as that earlier research, but explicitly focuses firstly on the general population—with the likelihood that it will be applicable with some people with brain injury as well and that’s actually the ideal cognitive prosthetic. Babbage breaks down face-name learning in the Intro app through two key principles of Errorless Learning and Spaced Retrieval. Babbage: Errorless learning research demonstrated that for people who have any difficulty remembering something, the last thing you ever want to do is make a mistake. We say people learn from their mistakes, but actually mistakes very powerfully compete with your ability to correctly recall the right answer. The right way to learn something new, if you’re going to have any difficulty remembering it, is to always get it right every time. Use as many supports as you need to make sure you keep getting it right and then gradually remove those training wheels, so you continue to get it right without ever making a mistake. That’s ‘errorless learning’—don’t let yourself make any errors. The tricky thing is it’s hard to give yourself an errorless learning experience. In trying to learn someone’s name, the real world might only give me three or four opportunities to hear it before it’s assumed I should know this person’s name—and maybe I need to hear that name thirteen times. It’s socially difficult to get the extra ten, so if you have a tool like Intro that can help you get that extra practice, that’s great. The other principle underlying Intro’s name learning tool is spaced retrieval. The way your brain decides what you still need to store is do you use that piece of information or not? The things that are still going to be retrievable later are the things you’ve continued to access over time. Your brain says, ‘this is clearly important—I will make sure to maintain and improve the connection of this information’—and so you can recall it again. Again, activating this function is powerful. You can make efforts to do this yourself, but it’s fairly impractical to do this systematically without a tool that ensures you’re getting this carefully graded experience. Q: What are cognitive prosthetics and how do you think they will be playing a part in future healthcare? Babbage: A cognitive prosthetic is any tool that helps your brain processes be more effective than they otherwise would be. They should be something you want to integrate with your day to day life, be as easy to use as possible, and be something that will continue to support your functioning over time, rather than being a training tool that just goes away. In the context of people who have a neurological impairment of some kind there are a few things that make a cognitive prosthetic better. One of them is that it’s something that is desirable to use—something that looks like something your peers would use. So a smartphone is great because it’s normal… there’s nothing abnormal about it. The third thing that makes a great cognitive prosthetic is if you can pick it up and use it correctly the first time, without any training. That’s the holy grail for a cognitive prosthetic, because it means that even if you forget any training you have received, you’ll still use it correctly. And that, of course, contributes to an errorless learning process. Usability testing and thinking about how to simplify as much as possible the tools that we’re creating is really important. At the recent /dev/world software development conference in Melbourne (26-28 August), I spoke about practical approaches to cognitive accessibility in software design. One of the starting points of that talk was suggesting to software designers and devlopers that thinking about designing software for people with brain injuries is a really good idea, because we often overcomplicate our solutions. This therefore leads to better tools for everyone. I also talked at that conference about mechanisms for providing users with choice about the level of complexity they want to have in a tool like a mobile app—would they prefer the standard interface, a simpler interface that provides only the most central one or two features of the app, or do they want expert mode, with maximum features and controls? Giving greater flexibility again provides better experiences for everyone. Q: What do you imagine healthcare to look like in 10 years with reference to technological advancements? Babbage: I think the future of technology in healthcare is in most cases not nearly as sci-fi as people imagine—but hopefully it's much more important in terms of actually creating some useful change. A big part of that is going to be solving how we close up the gaps in health information storage in ways that give end users both more control over their information and also more access to it—enabling them to get a better insight into what’s going on in their own health. Personalized medicine is often the term which is used, referring to analysing your genetics and then deciding what treatment you should receive on the basis of your genome. There’s a cardiologist at Auckland Hospital that has a genome sequencing machine on his desk. By sequencing the genome of patients he’s able to ensure that patients who would not benefit from the standard medication can go straight to one that will actually protect them. Babbage carries on to explain hearing about a subgroup of Pacific Islanders that aren’t responsive to the first line of heart medication so through using this system they’re able to be put on the treatment that will actually work. Babbage says this is a great practical example of personalized medicine actually at work in New Zealand, stressing the importance of making sure information doesn’t get into the wrong hands and is there to better the people of the country. Babbage: It’s about increasing population health, vitality and our autonomy as New Zealanders—rather than feeding into the disparities between rich, super healthy people and poor downtrodden people. Q: What is an area in health that you feel has a lot of potential for positive change through introducing or increasing technological advancements? Babbage: Clinician efficiency. I just think a lot of us, not just clinicians, are doing work for computers instead of the other way around. A focus on the workflow of clinicians would unlock significant benefits, through thinking about how can we help them do more of the parts of their work that are unique and spend less time on administration and data and all other things that create friction in their day. It would also lead to happier clinicians, and happier health service users. This is not about complex health technologies, it’s about doing the hard work of implementing solutions to make things work better. Q: What opportunities can young professionals coming from data science and non-health related backgrounds expect in health technology, when it comes to skills that would be useful for the industry? Babbage: In reference to health, it's really about drawing on the expertise from the people who have thought long and hard about these things—because if these were easy problems to solve they would’ve already been solved. On the technology side, there’s an enormous amount that can be contributed, because people in the health system often aren’t technically savvy. But what’s really important to understand is what a technologist brings to a situation needs to still be focused on human behaviours as the primary question. Build expertise in co-design, engaging with end users, and really understanding service-user perspectives and clinician perspectives. Understand why these end users might not be enthusiastic about your particular technology, and look at how it can actually make their life better, rather than harder. Thinking about what it would really mean for them to be using this in their practice as opposed to what do you think of my tool. If you can straddle those two worlds by bringing a technology background, you’ll be making a valuable contribution.  Reporter Anzel is interviewing Mr. Duncan Babbage Author: Anzel Singh
Photographer: Victor Chateau Editor: Christiane Zhao Copyright By HTA. Dr. Bertalan Mesko has published a new report, called "Digital Health Best Practices For Policy Makers". Healthcare in the 21st century is facing several challenges such as a growing demand for the management of chronic conditions and the increasing costs of healthcare. Digital technologies provide a pathway by which healthcare becomes sustainable and meets the most important goals: improving health, improving patient satisfaction and reducing costs. In the 21st century, this has significantly changed as pressure also comes from consumers who can access data, information and technologies. They don’t wait anymore for policy makers to make a technology available but turn to new technologies if that helps alleviate pain, better manage their disease or lead to a cure.  
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