Dean Koh

Three representatives from their respective fields of AI – clinical practice, research and healthcare apps came together for a panel discussion around the current and future developments of AI in healthcare on the second day of the HIMSS Singapore eHealth & Health 2.0 Summit on April 24. The panel consisted of Dr Ali Parsa, Founder and CEO, Babylon Health, Dr Ngiam Kee Yuan, Group Chief Technology Officer, National University Health System, Singapore and Dr Hwang Hee, Chief Information Officer & Associate Professor, Department of Pediatrics, Seoul National University Bundang Hospital, South Korea. The hype cycle of AI in general and in healthcare Mr Neil Patel, President, Healthbox, Executive Vice President, HIMSS, USA, who was the panel moderator, began the discussion asking the panelists on their thoughts on the current hype cycle of AI broadly and in healthcare. “I think at the general level, we’re seeing a much greater update of machine learning and deep learning because of the availability of two things: one is the data that becomes available and secondly, relatively cheaper or cheap computing power that one can get today. That spurred a new revolution and allowed us to use information in ways we never thought possible. But it’s also created real challenges – one of the key things I tell every software developer is to ensure that the data is ‘clean’, that’s paramount. And I think from that point of view, we always have to think about AI with reference to the data we select,” said Dr Ngiam. He explained that the best way to describe ‘clean’ data is to reflect reality. In healthcare data, something is usually missing or there’s too much noise or extra data points that do not necessarily contribute to the desired outcome. Another way to look at it is that the data has to be appropriately selected for the specific purpose. For example, if the purpose is to predict the length of stay at a hospital, then the length of stay data has to be absolutely spot on and all the determinants of length of stay has to be within that dataset.  Citing from his experience in the varied use of AI in the Babylon Health app, Dr Parsa said: “I think we use the word AI for a whole set of different techniques. And each of those techniques are useful for different applications. For instance, for diagnosis, you cannot use what is currently called deep learning because the likelihood of misdiagnosis is very high and the technique to be used is probabilistic graphical modelling, which is very close to probability analysis – it just happens to be that machines are better at probability analysis that the human brain can be.” For Dr Parsa, the hype of AI is high and in the short-term, it will continue to do what it has done in the last few years but in the long-term it will surpass all the current imaginations. The observation by Dr Ngiam is that the healthcare vertical is lagging behind in the AI hype cycle compared to industries like finance and logistics. In healthcare, the use of AI is directly affecting patients so it has to bear the same standards as other medical devices that are currently in medical practice. AI technologies in healthcare are slightly overhyped but in terms of real adoption, there needs to be factors like a really mature EHR system, good data streams, finding ways to deploy these AI technologies and training doctors to ‘buy in’ into using these technologies. Augmenting, not replacing doctors There are reports or articles that get a lot of press, for instance, of AI algorithms being tested against real doctors and ‘beating’ the human doctors repeatedly. The debate of whether doctors are going to be ‘replaced’ by AI algorithms is also a polarising one. However, Dr Ngiam pointed out that one of the key principles that all can agree to is that AI tools are meant to augment, not replace doctors. “What we found which consistently (in studies) was that when the doctors took the machines’ suggestions, they were better than either the doctor or machine alone. I think that’s what we really want, that is, a combination of AI and a doctor is better than either of them.” Adding to Dr Ngiam’s statement, Dr Parsa said, “The augmentation (of AI) to existing services is unbelievably valuable and we should not underestimate the contribution technology makes today. The contribution it makes today makes those who use it significantly better than those who don’t, that in future, makes those who don’t use it, irrelevant.” Using AI to increase empathy From Dr Hwang’s personal experience as a clinician in South Korea, he feels that AI can help him concentrate more on his patients compared to the conventional way of practice. For example, he takes 30 minutes to an hour to do an electroencephalogram (EEG) interpretation compared to the AI software which just takes five minutes to do the same – that frees up more time for him to communicate with his patients.  One of the biggest complaints mentioned by Dr Ngiam is that doctors spend way too much time staring at screens and they may not be looking at patients sufficiently. He explained that AI can help doctors transact a consult with the empathy that is required or that patients want from a doctor – AI can help with the hard work of summarising of key points, so that doctors are better prepared to meet with the patient, rather than for them to read off a screen.  During one of the Babylon app tests, Dr Parsa found out that it was possible to reduce the time of consultation from 10 minutes to about five minutes, which would increase the satisfaction of patients. However, his 16-year old son who also did some of the tests – found that it was not very good as he had to repeat answering the doctor’s questions after he had answered the same questions via the app.  Dr Parsa’s point was to think about the changing perceptions of humans: “For the first time in history, an 18-year old in Singapore, Korea, Iran, India, the US and the UK are closer to each other in their mentality and culture than they are compared to the past – that had never happened before. You now have a generation of human beings that behave globally in a very similar manner.  That generation does not want to spend two hours or wait for a few days to see a doctor or get a surgery, and being asked the same questions over and over again, that’s just not the way they were brought up. And we need to be very careful not to forget that shifting human culture, which is very significant.”

Yonsei University Health System (YUHS), one of the oldest and largest private university hospital networks in South Korea, has signed a Memorandum of Understanding (MoU) with SK Telecom, South Korea's largest wireless carrier, to build a 5G-powered digital hospital. Under the MOU, SK Telecom and  YUHS will work together to build a 5G network and develop specialised solutions for the Yongin Severance Hospital, which is scheduled to open in February 2020, by leveraging SK Telecom’s technological expertise in areas of 5G, AI, IoT and media. The 5G-powered digital hospital will be equipped with SK Telecom’s AI speaker NUGU to enable patients with physical difficulties to easily control their beds, lighting and TV with their voice. They can even use NUGU Call service to get medical assistance in case of emergencies. AR-based indoor navigation service through the application of indoor positioning and 3D mapping technologies to enhance the convenience of patients and visitors will also be introduced at the new 5G-powered hospital. SK Telecom is also considering to apply its quantum cryptography solutions to its network covering the Severance Hospital, Gangnam Severance Hospital and Yongin Severance Hospital (hospitals under the YUHS network) as a cybersecurity measure to prevent unauthorised access to sensitive medical information. What’s the trend It is important to note that 5G is not just an extension of 3G and 4G networks. The technology is rather a network that combines 4G, Wi-Fi, wireless access technologies and millimetre wave. It also leverages cloud infrastructure, intelligent edge services and virtualised network core. It promises a massive boost in transfer speeds that things like distributed computing or IoT devices in healthcare need to reach their full potential. 5G technology is not quite ready to be harnessed, but by 2019 the first vendors plan to bring this technology to its full potential. According to a Xinhua news article last month, China's Guangdong province will build its first 5G-based demonstration hospital, which is a joint partnership between Guangdong Provincial People's Hospital, China Mobile Group Guangdong Co., Ltd. (Guangdong Mobile), and the tech giant Huawei. In the US, Rush System for Health in Chicago has partnered with AT&T to become what it says is the first in the nation to use a standards-based 5G network in a healthcare setting.  On the record “Today is a high-tech digital era, so the digital transformation for hospitals is a must,” YUHS President and CEO Yoon Do-heum said in a statement. “Yongin Severance Hospital will become the core of Yonsei Medical Centre as an intelligent digital innovation hospital.” Park Jung-ho, President and CEO of SK Telecom, said: “SK Telecom’s partnership with Yonsei University Health System carries a significant meaning as it represents a new level of collaboration between two different industries.” “SK Telecom will work closely with the Yonsei University Health System to build the world’s best 5G-enabled hospital by utilising cutting-edge ICT.”

Earlier this week, the Western Australia (WA) Government announced the establishment of a new Ministerial Council that will advise the State Government on opportunities to further develop and support precision health advances. Precision health uses new and emerging technologies to enhance disease prevention and early detection, and improve patient outcomes through treatments tailored to patients' individual genetic profiles, as well as their variable responses to the environment and lifestyle.  The Precision Health Council will be chaired by South Metropolitan MLC Kate Doust and is expected to hold its first meeting within the coming months. According to the official statement, the council will comprise stakeholder representatives from medicine, science, industry, Aboriginal health, patient organisations, medical research and commercialisation, as well as experts from key precision health-related technologies of genomics, phenomics, informatics and geographical information systems. Early priorities of the council will include identifying and enhancing successful precision health initiatives already operating in WA's health system, and determining key areas that could benefit from increased integration of precision health measures. On the record “Western Australia already benefits from emerging precision health initiatives such as the Undiagnosed Diseases Program of WA (which provides earlier diagnosis for people with rare and baffling medical conditions), and the Australian Genomics Cancer Medicine Program (which harnesses precision genomics technology to match patients with rare and untreatable cancers to tailored clinical trials).” “I look forward to being advised by the new council about potential advances in this exciting field,” said Health Minister Roger Cook in a statement.

Healthcare leader representatives from Singapore, Australia and the Philippines took centre stage as the HIMSS Singapore eHealth & Health 2.0 Summit officially kicked off on April 23 with the CXO Panel session on the topic of disruptive innovation for value-based care.  “Today’s healthcare model is based on ‘more is better,’ but I think the healthcare model of tomorrow ought to be when ‘better is more.’ When we look at that shift from the volume to value-driven care approach to how we are going to look after our patients, and take care of them with themselves being ‘activated’ to so, it will change the paradigm of how healthcare is interpreted and can be delivered,” explained Dr. Eugene Soh, chief executive officer, Tan Tock Seng Hospital, Singapore.  According to Dr. Soh, what value-based care means to him is the idea of how to expand value over time and space because value is delivered today in a very episodic manner and he believes the future will be a more relationship-based model. From his experience working in the Philippines, Mr. Christian Besler, chief digital officer, Ayala Healthcare, said that what value-based care means to him is threefold: bringing about affordability, accessibility and quality of healthcare to the masses, especially in a country where good quality healthcare tends to be concentrated in urban areas. The role of telehealth Dr. Stephen Chan, chief medical information officer, Woodlands Health Campus Singapore, who was also the panel moderator, posed the question on the role of telehealth in Singapore to the panel: Despite the country’s small geographical size, could telehealth be customised to the local population? Is it more than just “access” for the modern day consumer?  Dr. Soh cautioned that the idea of telehealth should not just be transactional in nature but that care can follow the patient – it is about a community of carers that work with the patient. Mr. Besler echoed a similar sentiment: “Telehealth should not just be about the monetary value, it should be about bringing value to patient, allowing them to choose encounters with healthcare based on their time and convenience.”  Although he did not have a direct experience from the perspective of a private healthcare provider in Singapore, Dr. Peng Chung Mien, chief executive officer, Farrer Park Hospital, said that his hospital is currently on a trial with insurance companies to use telehealth for assessment to see if clients need to physically go to an emergency department for treatment. This is in the context in which there are a lot of instances of people going into hospitals’ emergency departments for non-emergency-related cases. He added that the Ministry of Health’s regulation is that the first consultation of the patient with the doctor should always be in-person, and only subsequently followed up with telehealth sessions if required after the relationship has been established. Rethinking the patient experience  The ongoing theme during the panel session was back to the fundamentals in healthcare: how to bring about value, ultimately for patients and how to empower them. In short, how can patients be empowered to have ownership of their care? Mr. Besler shared that it helps to give patients access to their healthcare data and records, empowering them with information and advice, having that constant encounter of care that will improve their experience.  Sharing his perspective from Australia, Mr. Chris Mitchell, executive director of Information Communications & Technology, Hunter New England Health District, said that while it is relatively new, there is a movement toward the tagline "Nothing about me, without me," that is, really putting patients at the centre of care and any decisions being made is made in consultation with the patient. Parking of cars might be an afterthought for hospital design, but one of the patient-centric features that Dr. Peng said is happening at Farrer Park Hospital are parking spaces that allow two cars to park alongside each other yet also accommodate space for wheelchair and lift access.  “I think patient experience assumes a very linear relationship with the patient, one that happens at intervals and transactions in the healthcare model. My dream is that we have a better way to build a relationship with our patients,” Dr. Soh ended the session on a philosophical note.

eHealth NSW has been established as a distinct organisation within the New South Wales (NSW) Ministry of Health in Australia to provide statewide leadership on the shape, delivery and management of ICT-led healthcare. One of the most recent appointments at the agency is its new Chief Clinical Information Officer, Dr Mark Simpson, who joined in January this year. Healthcare IT News learnt from Dr Simpson in an email interview about his new role at eHealth NSW, major projects that he will be working on, as well as his thoughts on the evolving role of the CCIO. Could you tell us more about your role as CCIO at eHealth NSW? I’m hugely excited to have started work as the Chief Clinical Information Officer for eHealth NSW, a role in which I am working collaboratively with NSW Health clinicians from across the state on transformative digital health strategies, programs and services. It’s an exciting time to join eHealth NSW. The 10-year eHealth Strategy for NSW Health: 2016-2026 has led to a great core level of coordinated delivery of digital services across the state, and the next six years will secure the consolidation of that fantastic start – as well as encouraging a much broader engagement of the clinical nursing and allied health professionals who are at the heart of this digital strategy.   You mentioned in an online article by digitalhealth.net that that if there was one top line to describe your CCIO role at NHS, it would be to foster clinical engagement in a broad sense with the clinical team. Does this statement still apply to your new role at eHealth NSW? Based on your experience, how do you think the CCIO role has expanded or evolved? The CCIO role I hold here has very much the same aspirations and expectations as my previous one did at the NHS. In NSW, the state lead role for CCIO does cover all of the local health districts in Australia’s largest state with a population of near eight million. The role is very much a bridge between eHealth NSW, the frontline clinical teams and the implementation teams and my CCIO role is focused on ensuring clinical engagement is at the heart of all projects. There’s a particular focus on how the design of the end products can incorporate Human Centred Design and the kind of user experience that truly enhances the interactions of all clinical staff in a wider sense, including medical, nursing and allied health professionals. Having been one of the first CCIOs in England in 2012, the original CCIO role back then was overall very much as an enthusiastic clinician who was the first of my type in a large tertiary teaching centre which was very much focused on delivering digital systems such as the EMR into a large complex hospital, and in the ensuing seven years the CCIO role has of course matured.  The role has evolved to encompass much more strategic thinking, with many of the complexities of safely implementing large-scale projects into many and varied clinical environments such as secondary hospitals, specialist units, mental health and also bridging into community and primary care. A smaller number of CCIOs have taken on a more formal role of sitting on executive boards and representing the clinical informatics aspect of care at the executive level. This really starts to change the model and engagement for future CCIOs to one in which they can encompass the next level of engagement with the concept, the innovation, the design phase, the safe implementation and the post implementation optimisation lessons learned, which can then feed back into next-level projects. It's also afforded us a larger population of CCIOs, and that’s now evidenced by the great opportunity to deliver teaching, training, education and a level of standardisation of career expectations through such advances as the Digital Academy in the UK. eHealth NSW Chief Executive and Chief Information Officer Dr Zoran Bolevich mentioned at the HealthShare NSW and eHealth NSW Expo 2018 in Sydney that “the next phase of eHealth NSW’s journey will see the organisation embark on bringing a digitally fragmented patient records system together.” Is that something that you will be working on directly? Absolutely; this is one of the central aspects of the process, to engage at a state level with the widest possible clinical engagement process. In NSW the digital landscape is maturing and still somewhat fragmented and this means that information related to patient care is not always available as seamlessly as possible, so the next phase is to look at how to optimise the concept of a potential single digital patient record.  At this stage, the processes involve how engagement with both CIOs, CCIOs and the program governance will manifest itself going forward. The opportunities to ensure clear and seamless transfer of patient information – so that it is always available at the right place and at the right time, and optimises the right care – is something that is absolutely central to my role as CCIO. Could you share with us some of the major projects that you would be embarking on at eHealth NSW?                                                                                                                                                                   The major projects I’m focusing on as eHealth NSW’s CCIO are many and varied. Significant work is underway as part of the eHealth Strategy for NSW Health, which commenced in 2016 with large-scale programs of work including the optimisation of the electronic medical record, the continued success and roll-out of the electronic medication management, along with many other EMR-related projects including managing deteriorating patients, diabetes and end of life care for example.  Looking ahead, large topics for my agenda include the single digital patient record, the safety and quality aspects of all delivery of digital care across the state, and the utilisation of mobility including how that truly impacts and supports frontline clinicians, nurses and allied health professionals. I’m also focusing on the ability to harness new and novel ideas through innovation, research and academia into production and delivery to coalface clinical staff so that they have the most optimal impact on patient care and the safe delivery of services.  The drive to optimise the electronic medical record will be well understood by our frontline staff but I want to ensure everyone has the opportunity to offer feedback and improve the service they cherish while at the same time being part of a broader team of clinicians, nurses and allied health professionals who together are realising the next major milestones of the eHealth Strategy for NSW Health. Patient records and clinical information is inextricably intertwined with big data. How do you see yourself working with colleagues who handle data and analytics at eHealth NSW?           Above photo: eHealth NSW's Clinical Engagement and Patient Safety team. Credit: eHealth NSW The role of eHealth NSW CCIO encompasses the areas of clinical engagement and patient safety and quality assurance and these are the key areas on which my team and I will work closely in the coming four years.  The use of focused data and analytics, including big data and population data, is central to a much closer understanding between the impact of digital care and its safe and optimal delivery of service. I also see some golden opportunities to increase the level of support and open the feedback loop from the analytical aspects of the data to better understanding areas where excellent practice exists and what we can do to share that in practice. This will help us to clearly highlight areas where there are other pressures or challenging situations which require either further resources or more specific and targeted clinical engagement. What are some of the milestones or goals that you would like to achieve as the new CCIO of eHealth NSW?         This is a fantastic opportunity which has brought me halfway around the world to be a part of this digital health strategy as the CCIO of eHealth NSW. My goals are to ensure, to the very best of my abilities, full engagement across the widest possible clinical network. This includes engaging all of the CXIOs, as well as those who are involved in clinical informatics in all guises within the local health districts, so that a wide and active clinical network becomes one of the central pieces to delivering truly impactful digitally enabled healthcare to the people of NSW.   Some other major goals I've set myself is to increase patient and consumer engagement, as this has the opportunity to impact on both the outcome of our digital programs through partnering with those who have the most to gain from the digital strategy itself. Mobility-harnessing innovation through future design is high on the agenda over the coming four years, given the great opportunities to address the significant user challenges in converting design into optimal delivery befitting the clinical environments and having a true patient safety impact. I’m also very interested in engaging with the educational training and undergraduate postgraduate trainers to start delivering a structured career path for future generations of CCIOs or equivalents both across NSW and indeed Australia. Many of the lessons learned globally could be utilised in delivering a career framework that will help guide all staff with an interest in patient safety through digital health to ensure a smooth and focused career path which hopefully will lead to succession planning for Australia’s next generation of CCIOs.                                                     

Swinburne University of Technology, a public university located in Melbourne, Australia, has partnered with Coviu, a telehealth software platform, to further embed digital health technology in the classroom, clinic and research. What’s it about The partnership will engage students studying health-related courses, and the wider community, in using the latest telehealth technology, equipping them to treat Australians remotely and redefine models of healthcare. Coviu, a company that specialises in online health consultations, will provide access to its technology for Swinburne students, researchers and clinical services. Coviu is also a finalist and winner of the 4th Innovations Challenge Award for their PhysioROM solution at the HIMSS AsiaPac Conference in 2018. Students will learn how to break down the barriers created by distance between healthcare professionals and patients. Swinburne will embed Coviu’s technology into the curriculum of nursing, occupational therapy, psychology, dietetics, health science, and digital health and informatics. These will be taught through Swinburne’s new Health Precinct, which utilises the latest in technology and facilities. The technology will also be implemented into Swinburne’s new Master of Physiotherapy, and Graduate Certificate in Teleaudiology, set to launch from mid-2019. On the record “Having our students prepared for a workforce where healthcare is increasingly delivered remotely is imperative and something that is at the core of digital health’s future in Australia. We need graduates that are comfortable using this technology and Swinburne will produce them,” said Dr Mark Merolli, Academic Director of Digital Health and Informatics at Swinburne in a statement. “Health and digital technology go hand in hand, and this partnership reflects Swinburne’s commitment to being a leader in digital health and our passion for innovation in all aspects of teaching, training and research,” he added. “Research has shown that up to 80 per cent of clinician visits can be provided online with comparable clinical outcomes. We’ve worked hard to make our telehealth technology simple to use for both patients and providers, however it’s absolutely essential that the next generation of medical professionals are equipped with the necessary tools and knowledge to make online consultations as effective as possible. Our partnership with Swinburne will ensure that this process takes place,” said Dr Silvia Pfeiffer, CEO and co-founder of Coviu.

China’s National Health Commission (NHC) officially launched a capacity building platform designed for community-level healthcare services, according to a report by Xinhua News on April 15.  At the 19th National Congress of the Communist Party of China held in October 2017, a report summarised that community-level healthcare services should be improved and the work of general practitioners strengthened. In 2018, the NHC launched a capacity building and training program for community level talents and was preparing to establish a capacity building platform combining online and offline efforts.  “Talent team building is the key component to enhancing community level healthcare services”, said Wang Hesheng, NHC deputy director. In February this year, Fang Laiying, a member of Chinese People's Political Consultative Conference (CPPCC) and vice-president of the Chinese Hospital Association, said that despite the rapid development of China’s health industry at the grass-roots level, the scarcest resource in the medical industry currently in China are medical talents catering to the needs at the grass-roots level, not professors. Fang added that cultivating a grass-root talent team has been a top priority in the reform of the medical health industry.

Fiona McDonald, director of data sharing and online patient preference setting for Great North Care Record at NHS, recently spoke with Healthcare IT News about what the U.K. data exchange initiative means, described some of her ongoing projects there and explained what patient-centricity means to her as a digital clinical champion. Q. Could you tell us about more about your roles as Director at Great North Care Record and Digital Clinical Champion at the NHS in England? A. I am a clinician with a background in nursing with 12 years involvement in national programmes developing and promoting the use of digital solutions to improve healthcare and patient experience. In 2018 I became the workstream director for collecting citizen preferences for the Great North Care Record. The Great North Care Record is a new way of sharing medical information across the North East and North Cumbria which is accessed by authorised health and social care practitioners. It means that key information about patients’ health such as diagnoses, medications, details of hospitals admissions and treatments is shared between different healthcare services including hospitals, out of hours and ambulance services, all of whom may all be involved in caring for a patient. Currently, local health services hold different and/or duplicate pieces of information about patients, as information isn’t easily shared between different organisations. Through sharing this information electronically via the Great North Care Record, healthcare practitioners can then use it to access the most current patient details, which are consistent and up to date, 24/7. Getting the public to set their own data sharing preferences is a founding principle of the Great North Care Record. We want people to be in control over how their data is shared. We need the public to understand how their information will be used and the benefits it brings to them, others within their community and those with similar conditions.  We want patients to actively opt-in to the Great North Care Record. The value of healthcare data is enormous for the NHS and for researchers. As a high-level strategic goal, we want to be able to unlock the data held in healthcare IT systems. Through doing this we can make the North East and North Cumbria one of the best places in the world to carry out healthcare research. To ensure that all considerations around safety, security and user experience are worked through, an advisory group has been set up, which brings together clinicians, information governance experts, academics and people who have led on projects from around the North East and North Cumbria specialising in setting up and gathering data sharing preferences. The aim is to produce a user-friendly mechanism for the people of the North East and North Cumbria to set their data sharing preferences. The group meets on a regular basis, and has already explored the issues, and bringing in real life experience, around getting individual’s permission to share their data for purposes beyond their direct care. At the same time, we are asking people for their communication preferences, so that researchers can contact people directly to participate in research studies. We want the region to be a consent rich research environment.  In addition, I am a clinical advisor providing clinical leadership and clinical engagement for the Primary Care Digital Transformation programme at NHS England.  Recently, a large element of this has been the introduction of a safe and secure way for patients to order prescriptions, book online appointments and access elements of their GP record, including test results, to support self-management of long-term conditions and improve health literacy. We want patients to be able to access validated information rather than rely on google searches. Q. The term ‘patient-centric’ is quite commonly used now in the context of healthcare – in your experience, what does being patient-centric mean and how can the use of technology empower patients? A. In a nutshell, the health service has historically been set up to support staff and clinicians, often not focusing on patient pathways, patient journeys or ease of digital access for patients. We need to focus on these and ensure that the technology enables safe services and easy access; to me this is the essence of patient-centric. Technology already in use in primary care allows patients to set or change a community pharmacy ‘nomination’, allowing electronic prescriptions to be sent securely from the prescriber to the pharmacy of the patient’s choice. Add to this the option of ordering prescriptions online, which provides a more convenient (24-hour access), and time saving (not having to visit the practice to make the request) solution for the public. The profession also benefits from clear prescription requests, which are safer, quicker and easier to process, and an end to end audit trail for prescriptions, from ordering to dispensing and collection. Providing patients with access to their own GP record, enables them to be more involved in managing their own care, and making informed decisions about the care they choose to receive.  They can choose to share their information with other care professionals, which is particularly useful if they need to be treated when they are outside their geographical area or abroad.  Fundamentally, we need to develop systems based on patients’ requirements, listening to their feedback and input, and avoid trying to shoe horn elements of technology into often disparate and out of date systems. Q. You mentioned in an article by Digital Health that “digital transformation would not happen in the NHS unless it offered more equal representation across its workforce” – what do you think can be done to encourage more women to take up leadership roles in the NHS? A. I believe part of the issue within technology is the terminology used. When we talk about IT, digital or electronic, the assumption is often a very ‘technical’ IT and male preferred environment. We need to change the language to include ‘clinical system’ supporting and enabling safe care.  There are a number of strategies that organizations need to adopt, including flexible working, senior and managerial positions offered at part-time or job share arrangements.  Managerial and senior leadership in all organizations should loosely resemble the workforce. So if there are 60% women in the workforce, then this should be representative, without of course, compromising ability and suitability.  The opportunities for development need to be broadened, offering not just training and leadership courses but shadowing, peer review, and mentoring schemes. Q. You are going to share on the topic, “The path to patient self-care and management using online access in England” at the HIMSS Singapore eHealth & Health 2.0 Summit in April. Could you tell us about two key takeaways/lessons from the session that can be applied outside of the NHS? A. "Never underestimate the amount of workforce engagement required and the cultural change needed." While some of the systems we have deployed could be described as ‘a no brainer’ to save time and improve efficiency, unless this is supported by engagement, business change and wide communication the system will not be utilized to maximum efficiency.  "What’s in it for me?" Think about your audience, and what they will get from the system. If this is for patients or customers it needs to be easy to use, reliable, and available when they want to use it. The usability needs to be excellent, it is said that an app will be used or discarded within the first 30 seconds after download, so workflow needs to be seamless.  "Why" is an often-overlooked element, and needs to be fully explored and easily articulated, many projects fail because the why has not been fully developed.  It may be a non-cash releasing benefit such as improving safety, security and convenience.  It could also be time saving, in which case toolkits such as easy to use time saving calculators should be made available to demonstrate this benefit. All these must be supported by interactive, searchable and to the point guidance documents, which allows for quick access to the information the user is searching for. Fiona McDonald is a speaker at the upcoming HIMSS Singapore eHealth & Health 2.0 Summit from April 23-24. Registration is still open and you can register for the event here.

The Voluntary Health Insurance Scheme (VHIS) officially launched on April 1, 2019, in Hong Kong. Consumers may now choose to purchase Certified Plans as offered by the participating insurance companies.  The scheme is a policy initiative implemented by the Food and Health Bureau to regulate indemnity hospital insurance plans offered to individuals, with voluntary participation by insurance companies and consumers. To alleviate the strain on the public healthcare system, especially during peak periods such as winter surge, Certified Plans under the VHIS have a number of standard features for increasing consumers' confidence in purchasing hospital insurance, thereby facilitating their use of private healthcare services when necessary. At the launch ceremony of the VHIS last week, the Secretary for Food and Health, Professor Sophia Chan, said that the VHIS will provide individual indemnity hospital insurance. To tie in with the publicity slogan "Choose with Confidence," all Certified Plans under the VHIS must meet the benefit standard prescribed by the scheme, including standardised policy terms and conditions, benefit coverage and benefit amounts. The features of Certified Plans include: Guaranteed renewal up to the age of 100 regardless of change in the health conditions of the insured persons (without reunderwriting); No limit on "lifetime benefit"; Coverage extended to cover unknown pre-existing conditions and day case surgical procedures (including endoscopy), etc.; Tax deduction for taxpayers who purchase Certified Plans for themselves and/or specified relatives and pay the premium on or after April 1, 2019; and Transparency on the premiums of Certified Plans. The premium schedules are accessible on the VHIS website. According to an official statement by the VHIS, the VHIS Office will continue work on the registration of participating insurers, vetting of individual indemnity hospital insurance plans for certification of compliance status, enforcement of scheme regulations, etc. Currently, there are 36 companies registered on the list of VHIS Providers on the VHIS website.

Singapore Prime Minister Lee Hsien Loong recently announced the appointment of a Public Sector Data Security Review Committee to conduct a comprehensive review of data security practices across the entire public service. The committee will look at measures and processes related to the collection and protection of citizens’ personal data by public sector agencies, as well as by vendors who handle personal data on behalf of the government, according to a statement issued on March 31 by the Prime Minister’s Office (PMO). Deputy Prime Minister and Coordinating Minister for National Security Mr Teo Chee Hean will be the chair for the committee, which also includes private sector representatives with expertise in data security and technology. Ministers involved in Singapore’s Smart Nation efforts – Dr Vivian Balakrishnan, Mr S Iswaran, Mr Chan Chun Sing, and Dr Janil Puthucheary – will also be part of the committee. The committee will review how the government is securing and protecting citizens’ data from end to end, including the role of vendors and other authorised third parties. It will also recommend technical measures, processes and capabilities to improve the government’s protection of citizens’ data, and response to incidents. An action plan of immediate steps and longer term measures to implement the recommendations will be developed as well. International experts and industry professionals, from both the private and public sectors, will also be consulted by the committee, and an inter-agency taskforce formed by public officers across the entire public sector will support the committee. Although security measures such as the Internet Surfing Separation policy in 2016 and the disabling of USB ports from being accessed by unauthorised devices in 2017 have been implemented across the public sector to safeguard sensitive data, the PMO said that the review is “essential to uphold public confidence and deliver a high quality of public service to our citizens through the use of data.” The Public Sector Data Security Review Committee was appointed in light of a series of four data-related incidents that occurred to the Health Ministry in the past 10 months. Notably, the Health Sciences Authority (HSA) also said in a statement on March 30 that one of its vendors, Secur Solutions Group (SSG), reported that there was more unauthorised access to the personal information of 800,000 blood donors as previously reported. The data was uploaded online and left unsecured over a period of two months. The Committee will submit its findings and recommendations to the Prime Minister by November 30 2019.