Dean Koh

Sydney Neuroimaging Analysis Centre (SNAC), an Australian company co-located with the University of Sydney’s Brain and Mind Centre, is building AI tools to automate laborious analysis tasks in their research workflow, such as isolating brain images from head scans and segmenting brain lesions. Additional algorithms are in development and being validated for clinical use. One compares how a patient’s brain volume and lesions change over time. Another flags critical brain scans, so radiologists can more quickly attend to urgent cases. The researchers develop their algorithms using the NVIDIA Clara suite of medical imaging tools, as well as cuDNN libraries and TensorRT inference software. WHAT’S THE IMPACT SNAC analyses patient MRI and CT scans acquired at clinical sites around the world. With a training dataset of more than 15,000 three-dimensional CT and MRI images, SNAC is building its deep learning algorithms using the PyTorch and TensorFlow frameworks. One of the centre’s AI models automates the time-consuming task of cleaning up MRI images to isolate the brain from other parts of the head, such as the venous sinuses and fluid-filled compartments around the brain. Using the NVIDIA DGX-1 system for inference, SNAC can speed up this process by at least 10x. Using semi-automatic methods, the process would take SNAC’s analysts 20-30 minutes but now it can be reduced to two or three minutes of pure machine time, while performing better and more consistently than a human. Another tool tackles brain lesion analysis for multiple sclerosis cases. In research and clinical trials, image analysts typically segment brain lesions and determine their volume by manually examining scans — a process that takes up to 15 minutes. AI can shrink the time needed to determine lesion volume to just three seconds. That makes it possible for these metrics to be used in clinical practice as well, where due to time constraints, radiologists often simply eyeball scans to estimate lesion volumes. COLLABORATIONS AND FUTURE PLANS The centre collaborates with I-MED, one of the largest imaging providers in the world, as well as the computational neuroscience team at the University of Sydney’s Brain and Mind Centre. The group also works closely with radiologists at major Australian hospitals to validate its algorithms.  SNAC plans to integrate its analysis tools with systems already used by clinicians, so that once a scan is taken, it is automatically routed to a server and processed. The AI-evaluated scan is then passed on to radiologists’ viewers — giving them the analysis results without altering their workflow. THE LARGER TREND Also located in Sydney, Macquarie University and Macquarie Medical Imaging has recently partnered with GE Healthcare and Fujitsu Australia to research the ways artificial intelligence can help diagnose and monitor brain aneurysms on scans faster and more efficiently. The university will provide clinical expertise for the development and testing of the technology, which is provided by GE Healthcare, while Fujitsu will lead the initiative. Singapore’s National Neuroscience Institute (NNI) is working with local medtech company specialising in AI and surgical robotics, Iota MedTech to develop a system to sort brain scans of head injury patients in order of urgency, Healthcare IT News reported in May this year. The development of the priority sorting system will help ensure that patients requiring immediate medical attention receive the care they need. ON THE RECORD “We often refer to manual annotation as the gold standard for neuroimaging, when it’s actually probably not,” said Tim Wang, director of operations, SNAC in a statement. “In many cases, AI provides a more consistent, less biased evaluation than manual classification or segmentation.”

Jehangir Hospital, a 350-bed hospital in Pune, India, along with its research arm Jehangir Clinical Development Centre (JCDC), last week announced that it will join Clinerion’s Patient Network Explorer platform. Clinerion is a global data technology service company headquartered in Switzerland, while JCDC has over 60 principal investigators and conducts on average 25-30 clinical studies at any point of time. The Patient Network Explorer platform helps partner hospitals be visible to pharmaceutical companies seeking suitable patients and sites for their clinical trials. Queries based on trial protocols may be sent to partners to assess the count of eligible patients in their electronic health records. All patient data is de-identified and remains under the control of the hospital and inside its IT infrastructure.  However, Clinerion’s patented technology also enables authorised trial staff at the hospital to re-identify the patient for the purpose of trial recruitment, while maintaining strict personal data privacy standards. THE LARGER TREND Earlier this month, Clinerion partnered with Germany’s Dresden International University to offer their Master’s students access to a subset of real-world data from Clinerion’s Patient Network Explorer platform to formulate as evidence in their research. According to Clinerion’s website, their global network of partner hospitals that power their Patient Network Explorer platform is currently at 39.  ON THE RECORD “We at JCDC are delighted about partnering with Clinerion as there is an ideal alignment of Clinerion’s innovative technology and our clinical research expertise,” said Pathik Divate, CEO at JCDC. “We are excited about harnessing the power of this technology to leverage our diverse patient population and bring in further efficiency in patient recruitment.” “The population of India is significantly under-represented when it comes to participation in clinical research. Patient Network Explorer can cut a path through the forest, leading sponsors to the institutions and clinicians who can support clinical trials at an international level of expertise and facilities. This collaboration with Jehangir is just the first step in enabling a global population of eligible patients which reflects the diversity of the world, itself,” said Ian Rentsch, Clinerion's CEO.

With more than a decade of experience as a registered nurse, Angela Ryan combines her clinical experience with her knowledge in health informatics toward the practical, meaningful and integrated use of digital health tools in Australia. In this interview with Healthcare IT News, she shares more on her role as the chief clinical information officer (CCIO) at the Australian Digital Health Agency (ADHA) and talks about why the My Health Record is a key pillar in Australia’s National Digital Health Strategy. Q. Could you tell us more about your role as CCIO of ADHA and your background in healthcare? A. In my role as chief clinical information officer at the Australian Digital Health Agency, I work collaboratively across the health system to develop and maintain strong relationships with key stakeholders in the community to promote adoption and meaningful clinical use of digital health services and technologies, to deliver benefit to all Australians. A key priority is ensuring strong clinical engagement with the National Digital Health Strategy and associated programs and services – including the My Health Record system – and clinical input and assurance into the design, development and delivery of digital health systems. The role provides clinical leadership for the implementation, advancement and optimisation of digital systems nationally. I’m a clinician with a background in health informatics, and decades of experience in hospitals and public sector organisations, with an emphasis on governance, design, development and deployment of digital health strategies and technologies. Before moving into digital health, I had more than 14 years’ experience as a registered nurse, including paediatric and adult intensive care. I am now able to apply my understanding of health systems and practice not just to optimise technology design and rollout, but to act as an effective agent of change, building engagement and momentum around transformational programs. Q. What are some of the latest projects/developments that you are currently working on at ADHA? A. The Australian Digital Health Agency is setting out the pathway to achieve our goals in the National Digital Health Strategy, to support the premise that “A workforce confidently using digital health technologies to deliver health and care will be required to address the technology adoption challenge and calls for supporting the workforce to better adapt to, use and embrace the changes and opportunities created by digital health innovation.” A digitally enabled workforce for Australia will benefit consumers, healthcare professionals and the broader health system. In addition, future innovations and approaches to healthcare delivery, such as applied data analytics, and technologies such as machine learning, artificial intelligence (AI) and advanced robotics, will require a shift in the skills mix of the healthcare workforce in order to obtain the greatest benefit of these advances for healthcare consumers. To support this, the Agency is undertaking a program to consult the health sector and other relevant stakeholders on strategies to address the enablement of the workforce and any perceived gaps. Our aim is to develop a holistic understanding of the potential skills and workforce shortages and develop strategies to address them. This will culminate in the development of a National Digital Health Workforce and Education Roadmap. The roadmap will be a focal point for a National Digital Health Workforce and Education Summit being planned for later in 2019. This event will bring together stakeholders from across the sector to consider the roadmap and agree the practical actions required to deliver the workforce Australia needs. Q. From your experience both as nurse and in healthcare informatics, what do you feel are the greatest challenges in the journey toward achieving better health outcomes through digital health? A. Striving to deliver real-time improvements in clinician workflow is the holy grail for me, but I know that we aren’t there yet. That said, l also know that many of my colleagues are deeply invested in this as an outcome, and recognise that to truly deliver on improvements in patient outcomes, we need to improve the way digital tools and technologies work inside healthcare environments. It might keep me awake at night, but I do believe we’ll see real change in the not-so-distant future. Q. In 2017, you were awarded a Churchill Fellowship to study methods to prevent patient harm through national digital health safety governance. Could you share with us some of your key insights/findings from the study, especially through your visits to the UK, USA and Canada? A. My Fellowship trip was life-changing and I met so many people who gave their time, their insights and knowledge so generously – Australia can undoubtedly benefit from this wealth of experience.  I developed a set of recommendations that drew on the overall findings and principles articulated within my Churchill report. I also drew on the premise of the ‘Health Information Technology (HIT) Safety Center’ model developed in the USA. I did this in part as it is the only fully elaborated model supported by an extensive evidence base, the structure of which is informed by learnings beyond the USA borders. The Center was originally recommended by the Institute of Medicine (IOM) Report ‘Health IT and Patient Safety: Building Safer Systems for Better Care’, published in 2012, with a subsequent commitment by the Obama administration to establish the roadmap to develop the Center.  It was further endorsed through the USA Food and Drug Administration Safety and Innovation Act (FDASIA) of 2015. While the Center has not been implemented as it was originally envisioned, many of its proposed members are active in the ‘Partnership for Health IT Safety’, a multi-stakeholder collaborative of more than 50 organisations that come together to analyse safety events and hazards, identify, and share solutions and safe practices, and inform policymakers and the broader healthcare community about priorities for health IT safety. I contend that Australia should assemble a taskforce of experts from across the health sector, to include clinicians, consumers, government, researchers, policy makers and industry to develop the vision, mission, outcomes and roadmap for better coordinated digital health patient safety in Australia. The taskforce’s expressed purpose is to ensure digital health is safer for patients and will build upon the significant progress already made in Australia, and internationally. More information can be obtained here.   

Known as the ‘Father of FHIR’ and an experienced healthcare interoperability consultant, Grahame Grieve is FHIR Product Director at HL7 International. He has a background in laboratory medicine, software vendor development, clinical research, open source development and has also conceived, developed and sold interoperability and clinical document solutions and products in the Australian market and around the world. Grahame shares some updates on the current developments for FHIR and is increasingly convinced that clinical interoperability is not an Information Technology/Information Management (IT/IM) problem, but a clinical practice problem. Q. Could you tell us more about your role as FHIR Product Director at HL7 International? A. Fast Healthcare Interoperability Resources (FHIR) has two aspects – it’s a technical standard, and it’s also a community. The “FHIR Product” is really both parts, and as the product director, my role is to grow the community, manage HL7’s provision of processes that the community can follow so that it can produce technical agreements consistently, and then to integrate that growth into HL7’s business so that HL7 can flourish as the best host for the technical standard – which includes meeting its formal obligations as a standards organization. Q. Being an FHIR architect and interoperability consultant, what are some of the recent broad trends you observe in the development of healthcare data interoperability? Any insights with regard to the Asia Pacific region? A. Classically, healthcare integration within institutions has focused on a push-based messaging model – using mainly HL7, along with messaging routing and transformation services. Then a new model arose for cross-enterprise integration based on a common repository using documents (XDS/CDA). Unfortunately, these were 2 separate frameworks.  Now, people are increasingly looking for integration – a single framework using a combination of push, pull and subscription so that institutions and regions/countries can manage their data with much more flexibility, and build more integrated workflows. All the nodes in that framework should link up with both messaging and repositories as well – integration spans over time and place. In terms of Asia/Pacific – a combination of factors has generally meant that Asia/Pacific have been followers in terms of data integration, with adoption taking longer. This is both a risk and an opportunity – a risk that business manages (conservative everywhere) won’t take the risk to try building better workflows, but also an opportunity that because there’s less prior investment, the fallacy of sunk cost is less of a problem. But on the whole it seems premature to me to talk about general trends in such a wide area with great variation in culture and funding models. Q. You will be giving a keynote titled “How FHIR can really make a difference” at the upcoming HIMSS AsiaPac19 conference in October in Bangkok, Thailand. For those who are new to FHIR, what are three important things you would like to highlight about FHIR? 1. FHIR is a community and technical standard founded on the basis that openness – in both the standards process, and the health data management process – allows for great new possibilities that couldn’t arise in a closed system, and that those possibilities can transform health outcomes. 2. FHIR is the web, for healthcare. All the things that the web has meant in other industries – that can happen in healthcare.  3. FHIR is a small part of the overall picture – technical standards are only useful if they are used, and that’s a business/cultural/governance decision. There are many problems in those areas and these are big bad problems. Q. What are some of the most current developments/updates for FHIR? A. As a standard, FHIR is maturing; increasingly the standard is stable and becoming ready for large scale adoption. At a technical level, our work is mainly around building out the eco-system to allow things like large scale data extraction for analysis and research, and stabilizing the clinical summary content.  In terms of community, the set of participants is expanding quickly and we are focusing on how to scale our community processes, and collaborate much more directly with key partners such as HIMSS and IHE (we’ve collaborated with them for years, but now we need a much deeper partnership). Q. What are your thoughts on the future of healthcare data interoperability in the next 3-5 years? A. The most common question I get is ‘when will FHIR be widely deployed’. And I don’t actually know the answer to that; obviously, it will grow, but in many/most countries, how quickly that happens actually depends on key decisions made by very few people for political or business reasons, and so it’s very hard to predict how far it will go in that timeframe. I’m personally far more interested in how we as a community will come to understand that Clinical Interoperability (the ability to switch patients, teams, and algorithms/AI between different care providers) is not an IT/IM problem, but a clinical practice problem. It seems to me that change will be driven by business and wider cultural considerations and that sponsors of the changes (governments/businesses) will assume Clinical Interoperability exists. The fact that it doesn’t will prove expensive – but I wonder whether we’ll learn the right lessons.  Big questions there – but what I do see now is that people working in healthcare interoperability are going to be busier than ever over the next 3-5 years. Grahame Grieve will be giving a keynote titled “How FHIR Can Really Make a Difference” at the upcoming HIMSS AsiaPac19 conference happening from October 7-10 2019 in Bangkok, Thailand. Registration for the conference is open and more details can be found here. 

SNUH serves more than 8,000 cancer patients per year across 16 cancer specialty centres, 10 multidisciplinary cancer treatment centres, and a cancer clinical trials centre.

Representatives from the health departments of Malaysia and the Philippines recently signed a Memorandum of Understanding (MoU) to collaborate further on the advancement of the health sector in the two countries. Secretary of Health Francisco Duque III of the Philippines and Malaysian Health Minister YB Datuk Seri Dr. Dzulkefly bin Ahmad met in Putrajaya, Malaysia on July 31 to discuss the strengthening of the two countries’ bilateral ties through collaborative activities for healthcare. WHAT’S IT ABOUT Under the MoU, both countries agreed to collaborate in the areas of: primary healthcare;  reproductive health;  health education;  human resources for health development;  nutrition;  exchange of information on issues related to food safety and quality including but not limited to rapid alert systems related to imported products;  prevention and control of communicable diseases;  prevention and control of non-communicable disease;  regulatory control of pharmaceuticals; traditional medicines, herbal medicine, health supplements and cosmetic products;  medical devices;  health tourism;  health researches; and  healthcare services. A Joint Technical Working Group (JTWG), led by designated officials from the Health Ministries of both countries will be formed to facilitate and develop collaborative activities and oversee, monitor and evaluate the implementation of the said MoU on Cooperation in the Field of Health. Exchanges of information and documentation on health will also be done through this joint committee.  Both parties also reaffirmed their commitment to support each other in joint activities, such as port-port collaboration on healthcare and vaccination programme for children in Alternative Learnings Centers, as part of efforts to help realize Universal Health Care under ASEAN. RECENT DEVELOPMENTS IN MALAYSIA & THE PHILIPPINES Malaysian Health Minister YB Datuk Seri Dr. Dzulkefly bin Ahmad said in July that it would cost up to RM1.5B to implement an EMR system for the 145 hospitals nationwide in Malaysia over the next five years. In February 2019, President Rodrigo R. Duterte of the Philippines officially signed the Universal Health Care (UHC) Act into law, which guarantees equitable access to quality and affordable healthcare services for all Filipinos. However, it still remains to be seen how the UHC Act will be implemented exactly. ON THE RECORD “We both hope that the outcome of this meeting will further strengthen the ties and cooperation in the management of cross-border issues relating to the health of both our countries and across various stakeholders, and we look forward to a lasting collaboration between both countries in tackling and resolving health issues,” Philippine Health Secretary Duque concluded in a statement.

Swinburne University’s National eTherapy Centre has partnered with medtech startup Coviu to allow Australians to access quality mental health services through encrypted, real-time text chat sessions. The service is offered as part of Swinburne’s Mental Health Online, which is free for all Australians and provides access to treatment programs for common mental health issues including depression and anxiety. Real-time text chat sessions with clinicians will now be a part of the service, alongside email and video calls, offering an additional modality to suit a broader remit of needs within the community.   THE LARGER TREND In April this year, Swinburne partnered with Coviu for telehealth education. The partnership sees Swinburne embedding Coviu’s technology into the curriculum of nursing, occupational therapy, psychology, dietetics, health science, and digital health and informatics. The technology has also been implemented into Swinburne’s new Master of Physiotherapy and Graduate Certificate in Teleaudiology. ON THE RECORD “Since being rolled out in March this year, the chat sessions have become a very popular option amongst our clients. It’s now one of the most common modalities we use to support clients in completing their online mental health program. For many clients, a real-time text chat session is a practical first step into talking with a health practitioner, which for some can be quite confronting,” said Dr Liz Seabrook, Digital Mental Health Fellow at Swinburne, in a statement. CEO and co-founder of Coviu Dr Silvia Pfeiffer said: “Our goal is to make healthcare services easily accessible and usable to all citizens, and this partnership with Swinburne’s Mental Health Online service takes us another step closer. We work hard to ensure our telehealth technology is easy to use, and are constantly looking at new ways for people to use the service. I’m thrilled to hear the text-only chat sessions are helping hundreds of people across Australia.”

Ping An Smart Healthcare (PASH), a subsidiary of the Ping An Group (Ping An) in China, has introduced AskBob, an artificial intelligence (AI)-based medical decision support tool, to Singapore through collaborations with SingHealth and the National University Health System (NUHS). AskBob, developed by Ping An, provides critical and up-to-date medical information to clinicians when dealing with patients at the point of care and for medical research and self-learning such as case discussions. WHY IT MATTERS At the point of care scenario, AskBob provides precise diagnosis and treatment recommendations for more than 1,500 diseases. Unlike other clinical decision support systems (CDSS), AskBob is a “knowledge + data” two-wheeled drive intelligent CDSS based on millions of anonymous patient medical records, clinical guidelines and a core medical knowledge graph covering tens of millions of medical data. The treatment recommendations AskBob provides are authoritative, personalised and patient-centric. For medical research and self-learning, AskBob makes use of Ping An’s leading medical knowledge graph and advanced natural language processing technologies (NLP) to perform more user-friendly, intuitive and precise online searches and literature analyses. AskBob can provide up-to-date literature analysis summaries and predict scientific research trends. It can also track the scholar team network in a certain research field to connect researchers around the world. COLLABORATIONS WITH SINGHEALTH AND NUHS The collaboration with SingHealth, one of Singapore’s largest public healthcare groups, started in April this year. It aims to provide doctors with personalised treatment recommendations for Type 2 diabetes patients at the point of care. Diabetes is a serious health issue in Singapore, with one in nine Singapore residents aged 18 to 69 having diabetes. AskBob’s recommendations can potentially help achieve better diabetes control and health outcomes, including reducing diabetic complications such as stroke and kidney failure. NUHS, an academic health sciences centre in Singapore, is piloting AskBob with clinicians for smart literature search and medical research trend analysis. ON THE RECORD “We are delighted to cooperate with SingHealth and the National University Health System. They are both authoritative healthcare institutions in Singapore,” said Dr. Xie Guotong, Chief Healthcare Scientist of Ping An Group in a statement. Dr. Bee Yong Mong, Head of the SingHealth Duke-NUS Diabetes Centre said: “An AI-based clinical decision support system could potentially help doctors increase the accuracy and efficiency of diabetes treatment. With the tool, we hope to better predict risks of complications and offer more personalised treatment recommendations to patients.” Prof. Ngiam Kee Yuan, Group Chief Technology Officer from NUHS, said: “More than a search engine, AskBob uses a medical knowledge graph and a natural language processing engine to empower precise literature analysis without giving you information that you don’t need. This is the power of using AskBob. I believe it will be extremely helpful for clinicians in medical research and case discussions.”

Chinese healthcare ecosystem platform Ping An Good Doctor has reached strategic cooperation with nearly 50 hospitals across China, including the Aviation General Hospital of China Medical University, Sichuan Second Traditional Chinese Medicine Hospital, and the Fourth Affiliated Hospital of Nanchang University, to jointly develop a new “internet hospital” model, the company recently announced. DEVELOPMENTS LEADING TO THE INTERNET HOSPITAL MODEL Since 2018, the Chinese State Council and the National Health Commission have issued policies such as the Opinions on Promoting the Development of “Internet + Healthcare” and Measures for the Administration of Internet Hospitals (for Trial Implementation), among other policies, pursuant to which, permission is granted for the development of internet hospitals by relying on medical institutions, application of internet technology for provision of safe and proper medical services, launch of online follow-up consultation for some common diseases and chronic diseases, and launch of online medication prescription for some common diseases and chronic diseases. As such, clear regulation and guidance have been provided with regard to the development of internet hospitals. Last month, the State Council issued the 2019 Major Task List on Deepening the Medical and Healthcare System Reform, which clearly indicates that the National Healthcare Security Administration shall by the end of September 2019 complete the drafting of the policy document regarding fees and charges of internet diagnosis and treatment and medical insurance payment. WHAT’S THE IMPACT The “Hospital Cloud” system of Ping An Good Doctor will be connected to the HIS system of cooperative hospitals to form the three-in-one internet hospital management platform featuring online diagnosis platform, prescription sharing platform and health management platform. This new “internet hospital” model can help hospitals resolve such problems as absence in outpatient appointments, overcome geographical constraints, and expand the scope of hospital service. In addition, internet hospitals will also serve as a data integration and sharing platform to facilitate information exchange and real-time sharing among entities, forming a full-fledged, closed-loop system combining online and offline medical services. THE LARGER TREND Since the start of this year, Ping An Good Doctor has been partnering with different companies such as China Everbright Bank and Wyeth to provide more value to their clients and to build their ecosystem outside of the traditional healthcare domain. Developing the internet hospital model with local hospitals has the enormous potential of reducing data/information silos – something that has plagued healthcare providers all over the world. The integration of healthcare data, if done correctly, will give both Ping An Good Doctor and the partner hospitals the opportunity to provide a better quality of care for patients/clients, particularly for those outside Tier 1 cities. ON THE RECORD “The uniform management platform to be developed by both parties could achieve a seamless connection between patients, hospitals, internet hospitals and supply chains, providing patients with integrated healthcare services such as online follow-up consultation, prescription circulation, drug delivery and chronic disease management, etc.” a Ping An Good Doctor spokesperson said in a statement.

Thailand’s population is ageing rapidly with almost half of its electorate above 50 years old by 2025. Healthcare costs are rising and it is not tenable in the long-run to keep building hospitals. One possible consideration for the country is the shift towards value-based healthcare (VBHC), which is about improving healthcare outcomes at lower cost. It focuses on what patients value and allocates resources according to the health outcomes delivered by the system, rather the traditional model of a volume or visit-based healthcare system. While VBHC sounds promising, the reality is that it is challenging to achieve as transforming a health system that is truly patient-centred and outcome based requires a lot of work. According to an article by the World Economic Forum, the transformation to a value-based health system requires:  - Sufficient technical expertise about VBHC to design and implement its core features. - Leaders committed to trying ideas and willing to accept the risks involved. - Cooperation among different organisations working together to improve outcomes for patients. The same article offers four key lessons for a successful switch to VBHC. Firstly, it is to focus on outcomes that matter to patients, rather than merely focusing on processes or costs. In the context of Thailand, this could mean bringing care to people especially in rural areas in which healthcare is not easily accessible. In that regard, Thailand has begun development of its telemedicine programme at 32 hospitals located in rural areas in eight provinces since March this year. Telemedicine services will be offered by the initial 32 hospitals as soon as by the fourth quarter of 2019. Another key lesson for a successful switch to VBHC is to engage partners from across the whole health system. In order to achieve meaningful system-wide change, transformation efforts have to include organisations from across the entire system, including the private sector. The unique advantage that Thailand has is its advanced development of the private healthcare sector, given the country’s reputation as a regional medical tourism hub. However, the challenge lies in how government institutions such as the Ministry of Public Health (MOPH) can meaningfully engage the private healthcare sector in moving towards VBHC. Next, stakeholders need to acknowledge that systems change is going to be hard, and they need to adopt a long-term perspective rather than looking only for “quick wins” or easy answers. eHealth is one of the tools that could be used towards achieving VBHC, and the MOPH has a long-term strategy to drive the growth and development of eHealth from 2017-2026. At its core, the aim is to develop a capable and interoperable health information system as well as digital health technologies to bring about value and improved standards of care. The last lesson is to take a problem-driven approach. In healthcare, it is often easy to ‘cut and paste’ solutions from other health systems but sometimes the answers or successful models may lie within. Telemedicine policies, for example, are still being studied in Thailand and the government is looking into more investments and getting the timing right to provide on-demand digital care to locals, expats and tourists, according to an article by Healthcare Asia.  With the theme of “Empowering Value Creation”, the upcoming HIMSS AsiaPac19 conference will be held in Bangkok, Thailand from October 7 to October 10 2019, featuring five main tracks: (i) Sustainability and growth (ii) Patient experience (iii) Unlocking the value of AI (iv) Value-based care (v) Health 2.0 Learn more about the HIMSS AsiaPac19 event here and those who are interested to speak or present at the event can sign up here.