Healthcare Analytics are the Problem. Applied AI is the Solution

aaeaaqaaaaaaaavoaaaajgmzotvinmzmlty2ntqtndfjzs1hzgm1lwu2nmvkogi1ztfhzaThe combination of electronic medical records, financial data, clinical data, and advanced analytics promised to revolutionize healthcare.

It hasn’t happened.

The common excuse is that healthcare wasn’t really prepared for the enormity and complexity of the data challenge and that, over time, with the next EMR implementation, that healthcare will be positioned to reap the benefits. Unfortunately, the next generation of EMR, or the one after that, isn’t going to solve the problem.

They problem is on the analytics side.

Healthcare analytics are still driven by a question-first approach. The start of our analytics journey still begins with the question. The challenge is which question? The more data we have at our disposal, the more potential questions there are and the lower the likelihood that we will ask the one that generates new value for the patient, the provider, or the payer. Even when we are successful in asking the right question, we have engaged in a confirmatory process – we have confirmed something we already knew.

Some will suggest that predictive analytics solves the problem, but it too is hypothesis driven – just in a different way. With predictive analytics, the set of variables selected, the choice of algorithms are, in effect, guesses as to what will produce the best outcome.

Ultimately, both approaches are flawed.

We need a new approach that surfaces trends we humans haven’t even considered, and that delivers a host of meaningful insights to clinicians before they even ask any questions. We need technology solutions that combine the best qualities of human intelligence (artificial intelligence) with the best computing capabilities that exceed human ability (machine learning). When these technologies are operationalized systematically across an enterprise, it’s called Applied AI. Applied AI is here to replace healthcare analytics, and we all stand to benefit.

Five Keys to Applied AI….more

Humble aspirin helping solve one-in-20 pregnancy threat

For most women, the first pregnancy is a joyous time that they will remember with tenderness for the rest of their lives. But for 5 % of all pregnant women around the world, the journey towards childbirth takes an unexpected turn for the worse. The culprit is a disorder that many young women expecting their first child have never heard of, a disease that kills 59 000 and affects approximately 800 000 women every year globally. Pre-eclampsia can go undetected until it’s too late, leading to complications of the liver and lungs or even to convulsion and stroke. It is characterised by high blood pressure and protein in urine, and the only known treatment is the delivery of the baby and the placenta. ‘If the disease occurs early in the pregnancy, the baby is born prematurely with various complications of low birth weight, incomplete organ maturation, blindness and motor and cognitive complications,’ said Hamutal Meiri, from the EU-backed project ASPRE with the company Hylabs Diagnostics, in Rehovot, Israel.

The multinational ASPRE team has paved the way for the roll-out of a preventive treatment targeting women at risk of developing pre-eclampsia early in the pregnancy, known as ‘pre-term pre-eclampsia’, when its occurrence is more dangerous and the prognosis mostly dire. The treatment is based on one simple ingredient, aspirin…..more

Zuma’s Dubai exit plan

0ecba19dd8594020baadf6a40dc59b36An email trail between the controversial Gupta family and their employees has blown the lid off how they have managed to do business with government, ingratiate themselves with senior officials, and go so far as to help move President Jacob Zuma and his family to Dubai.

The emails, obtained by City Press this week, also reveal how the Guptas seduced many senior government role players in their bid to capture departments and state-owned entities.

One of the most astonishing emails is from Gupta-owned Sahara Computers’ chief executive officer (CEO), Ashu Chawla, to Zuma’s son Duduzane. It contains a draft letter from the president to Abu Dhabi Crown Prince General Sheikh Mohammed bin Zayed Al Nahyan, and shows how close Zuma is to the Guptas…..more

A new film empowering girls and women with knowledge about processes that occur during puberty

Sunday the 28th May is Menstrual Hygiene Day, to mark this ​day ​we are ​excited to be ​launching a new film ​”Understanding your period”. The film provides an overview of menstruation and aims to empower girls and women with knowledge about ​the changes that occur during puberty, ​basic biology and hygiene practice.

The film was shot on location in Kenya alongside Carolina for Kibera, an international NGO that uses sports to teach healthy life choices. To find out more and watch the film click on the image below…..more

Timor Leste – Newborn care training programmes

World Health Assembly elects Dr Tedros Adhanom Ghebreyesus as new WHO Director-General

Today the Member States of WHO elected Dr Tedros Adhanom Ghebreyesus as the new Director-General of WHO.

Dr Tedros Adhanom Ghebreyesus was nominated by the Government of Ethiopia, and will begin his five-year term on 1 July 2017.

Prior to his election as WHO’s next Director-General, Dr Tedros Adhanom Ghebreyesus served as Minister of Foreign Affairs, Ethiopia from 2012–2016 and as Minister of Health, Ethiopia from 2005–2012. He has also served as chair of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria; as chair of the Roll Back Malaria (RBM) Partnership Board; and as co-chair of the Board of the Partnership for Maternal, Newborn and Child Health.

As Minister of Health, Ethiopia, Dr Tedros Adhanom Ghebreyesus led a comprehensive reform effort of the country’s health system, including the expansion of the country’s health infrastructure, creating 3500 health centres and 16 000 health posts; expanded the health workforce by 38 000 health extension workers; and initiated financing mechanisms to expand health insurance coverage. As Minister of Foreign Affairs, he led the effort to negotiate the Addis Ababa Action Agenda, in which 193 countries committed to the financing necessary to achieve the Sustainable Development Goals.

As Chair of the Global Fund and of RBM, Dr Tedros Adhanom Ghebreyesus secured record funding for the two organizations and created the Global Malaria Action Plan, which expanded RBM’s reach beyond Africa to Asia and Latin America.

Dr Tedros Adhanom Ghebreyesus will succeed Dr Margaret Chan, who has been WHO’s Director-General since 1 January 2007.


The WHO’s new African leader could be a shot in the arm for poorer countries

The article below was published online by the Conversation. The article was written by Professor David Sanders a founding and Steering Committe member and of People’s Health Movement -South Africa and the current Co-Chair of the People’s Health Movement Global. 

Dr Tedros Ghebreyesus is the first African to be elected as the Director-General of the World Health Organisation (WHO) in its 70 year history. The WHO is the United Nations body that directs its member states on international health issues. David Sanders explains to The Conversation Africa some of the main challenges Ghebreyesus will face in his five-year term.

What is the significance of this appointment?

This is the first time the entire 194-strong WHO assembly voted for the position. Votes were cast by secret ballot. Previously the organisation’s Executive Board selected the DG. The massive margin for Tedros – 133 votes vs 50 for the UK candidate David Nabarro – suggests that the entire Global South voted for him. The size of the landslide had not been expected.

The vote almost certainly represents a vote against big power domination and machinations in the WHO which often appears to ignore the main challenges and aspirations of low and middle income countries.

What does he bring to the table?

As Ethiopia’s former Minister of Health Ghebreyesus spearheaded major reforms to their health system. This included a massive expansion of primary health care infrastructure and a dramatic increase in health human resources at all levels. He oversaw a rapid increase in the training of doctors, shifted the responsibility for key interventions such as caesarean sections to mid-level workers, and the introduction of community-level workers (Health Extension Agents).

All contributed to impressive improvements in health outcomes – especially in child health.

This track record is certainly behind his election. But he’ll have his work cut out for him. The WHO is experiencing its greatest crisis since its founding in 1948. It’s biggest challenges are finance-related.

The organisation is facing a financial crisis with a US$ 456 million deficit this year. This is bound to mean that there will have to be a major cuts to some programmes. Some might even have to be closed. Retrenchments are also on the cards.

For the past few decades the organisation has increasingly relied on donor funds because member states – particularly richer ones – have been reducing their contributions. A full 80% of the organisation’s funding is now from sources other than member states. Donors such as the Bill and Melinda Gates Foundation are making major contributions.

This means that the priorities of donors tend to dominate, thus making it difficult for the WHO to carry out the policies identified by its member states. In addition, intergovernmental bodies such as the World Bank have weakened the WHO’s role.

And some key programmes have had their budgets significantly reduced. One example is the programme to control non-communicable diseases. They are now the top cause of morbidity and mortality globally, and in low and middle-income countries.

Some vital programmes central to the WHO’s mandate remain underfunded. Sometimes this is due to the fact that they conflict with the interests of rich countries and big donors, particularly those with links to industry. For example, governments have consistently opposed putting in place food regulations to address the rise in consumption of unhealthy food. This is presumably because they would affect big corporations that are prominent investors in those countries.

The result has been that the WHO’s leadership role in global health has been undermined.

Another big challenge is strengthening health systems. The Ebola epidemic in West Africa in 2014 showed up weaknesses in the WHO as well as in the health systems of low and middle income countries.

Finally, health systems, particularly in Africa and Asia, face drastic resource shortages. Huge investments are required in human resources, the most expensive and important component. Africa in particular has an extreme shortage of health workers. Their numbers are further threatened by inadequate training programmes and external migration (‘brain drain’) to rich countries. A WHO Voluntary Code of Practice on International Recruitment of Health Personnel has failed to impact positively on such losses. The clear challenge remains for health human resource shortages to be urgently and effectively addressed.

What does he need to do to deal with these challenges?

Ghebreyesus needs to use his strong mandate – notably from the Global South – to truly reform the WHO and its operations in favour of the world’s poor majority.

To do this, he needs to push strongly for member states to honour their commitments to the WHO and to rapidly and significantly increase their financial contributions.

He also needs to ensure that the influence of the food, beverage, alcohol and tobacco industries to control non communicable diseases is resisted. This will be difficult given that a framework has been passed that allows non-state actors to participate in WHO policy-making processes.

On top of this Ghebreyesus must ensure that the health systems of low and middle income countries are strengthened so that health emergencies such as infectious disease outbreaks can be contained.

The current investments in building surveillance capacity for infectious diseases are welcomed. But these efforts will remain inadequate without sustained investment in health systems.

This will ensure that agenda for health security isn’t focused on securing the health of rich country populations against contagion from the poor but on protecting all, particularly the most vulnerable.

What will be interesting to watch over the next five years is whether the evident solidarity between low and middle income countries in voting in Ghebreyesus as their candidate is maintained during the debates and decisions about world health. Until now, rich countries have been dominant in WHO meetings.

Gauteng’s negligent medical ‘professionals’ get off scot-free

Gauteng Health has paid out over R1bn since January 2015 to settle medical negligence, yet not a single disciplinary actionhas been taken against any of the staff involved, reports City Press. Total potential liability claims  stand at R13.5bn.

More than R1bn has been coughed up for medical negligent payouts since January 2015, but no action has been taken against Gauteng Health Department professionals. City Press reports that this is according to DA Gauteng spokesperson for health, Jack Bloom who was quoting a written response by Gauteng Health MEC Gwen Ramokgopa to questions from the DA. The response showed that the provincial health department paid more than R1.017bn since January 2015, to settle 185 medical negligence claims…..more

Why the NHI may take softer approach

Cabinet subcommittee to vote on revised health insurance plan, which Health Minister Aaron Motsoaledi says will initially let private plans continue.  Health Minister Aaron Motsoaledi says he will present a revised version of the National Health Insurance (NHI) white paper to a cabinet subcommittee on Tuesday. If the subcommittee approves the blueprint, it will then be considered by the Cabinet. If the Cabinet approves the plans, the legislative process to enact the policy will begin. A key aspect that will be scrutinised is the future role of SA’s medical schemes and administrators. The paper proposes mandatory membership of NHI and a reduced role for medical schemes to providing only “complementary services”….more

Public health is in critical condition, and the NHI cannot save it

Aaron Motsoaledi deflects attack by Cosatu on national health scheme

Health Minister Aaron Motsoaledi moved on Tuesday to defend his position on National Health Insurance (NHI) after Cosatu accused him of betraying voters by offering medical schemes a lifeline. The NHI white paper released in 2015 says a single NHI fund should be established to pay for services and relegates medical schemes to providing “complementary” services. Health director-general Precious Matsoso and Motsoaledi have recently signalled a potentially softer approach, in which medical schemes would continue to exist…..more

No matter what, Motsoaledi determined to win NHI ‘war’

No matter what the opposition from the private health sector, SA‘s National Health Insurance plan will be implemented, said Dr Aaron Motsoaledi, Minister of Health, and Naledi Pandor, Minister of Science and Technology. Both ministers formed part of the ANC national executive committee subcommittee on health, education, and science and technology, reports IOL. Earlier, in Pretoria, Motsoaledi said that the government had a constitutional responsibility to provide affordable healthcare to all citizens, irrespective of their economic status.

He said the World Health Organisation recommended that countries spend 5% of its gross domestic product on healthcare, but that South Africa spends more than the recommended amount, and in a disproportionate manner. “South Africa currently spends 8.5% of GDP on health.” “The private sector spends 4.4% of GDP on health but only provides care to 16% of the population.” “The public sector spends 4.1% of GDP on health but has to provide care to 84% of the population,” he said. “So this current financing system is unjust and needs to be reorganised so we can pool public and private sector funds to provide quality and affordable healthcare to all South Africans,” he argued…..more

Debt and patronage lay waste Gauteng’s health budget

Gauteng Health’s R40bn health budget is insufficient and the department cannot carry out the tasks it is required to do because of its sizeable debt and questionable contracts.

Health MEC Gwen Ramokgopa says that the budget of the province’s health department grew from R37.6bn in 2016 to R40.2bn in 2017. It is the department with the second-largest allocation in the province’s total budget, reports  Business Day.

The budget of the province’s health department grew from R37.6bn in 2016 to R40.2bn in 2017. It is the department with the second-largest allocation in the province’s total budget.

At the province’s Health Consultative Forum, Ramokgopa is quoted as saying the challenges that plagued the public health system included high equipment prices, poor-quality services and inadequate human resources. Of the total budget, R23.8bn was earmarked for compensation of employees and R16.3bn for goods and services, while an estimated R6bn was allocated to accruals, she said. ….more

Motsoaledi denies ‘sell out’ of NHI over medical schemes

SA‘s Department of Health has done an apparent U-turn on its plan to scrap medical aid schemes, saying they should work with the state when it rolls out National Health Insurance instead, reports Business Day. However, Health Minister Dr Aaaron Motsoaledi denies any ‘sell out’.

The NHI policy documents wanted all 80 or so medical aid schemes merged into one state-run fund. About eight million South Africans – or 17% of the population – have medical aid cover and use private hospitals and doctors.

Department director-general Precious Matsoso met leaders of the medical aid plan sector and asked that they work together to reform healthcare in South Africa.

“This is big news,” said Graham Anderson, principal officer of Profmed.

In a further Business Day report, Motsoaledi has moved to defend his position on NHI after Cosatu accused him of betraying voters by offering medical schemes a lifeline.

Cosatu accused the Department of Health of prioritising the needs of what it called ‘private health profiteers’ over those of poor people. “The Department of Health is betraying NHI by handing over the NHI to private hands, and is also betraying the voters who were promised a single-payer NHI in the 2014 (ANC) election manifesto,” it said. ….more

Pharmacists to have key role in NHI – PSSA

Pharmacists are gearing up to play a key role under National Heath Insurance (NHI) when South Africa enters the second phase of implementing the universal health coverage policy, reports Business Day. Pharmacists are important in the healthcare system because of the role they play in under-resourced areas, where they provide affordable diagnosis, education and screening.

The Pharmaceutical Society of SA’s (PSSA’s) Lorraine Osman said that following a meeting with Department of Health director-general Malebona Matsoso to discuss the next steps for pharmacists in terms of the NHI, introduced by Health Minister Aaron Motsoaledi in 2015, a task team has been formed to develop practical proposals for pharmacists’ involvement in the system.

The PSSA, which has more than 8,000 members, is the biggest representative body for pharmacists, pharmacists’ assistants and pharmacy students in the country and has been asked to work with Dr Anban Pillay, deputy director-general for health regulation and compliance management, to map the way forward. The organisation is to host a combined conference in July to identify ways in which pharmacists can prepare themselves to participate in NHI, the report says…..more

10 breakthroughs to shape Europe for the next 60 years….relevance for Africa?

mosaic-1-983pxThis year marks the 60th anniversary of the Treaty of Rome, which established the European Economic Community, the predecessor of the EU. During that time, the EU has provided more than EUR 200 billion to advance our understanding of the world around us and develop innovations to tackle the challenges faced by our society. At the halfway point of the EU’s biggest research and innovation funding programme, Horizon 2020, we explore a selection of EU-funded projects whose breakthroughs could help to shape Europe during the next 60 years…..more

‘Microscopic Lego’ to keep scientists busy ‘for next 50 years’

2d20materialsAtom-scale building blocks that have been compared to microscopic Lego are allowing researchers to play with the properties of common materials, and the possibilities are so great that it could keep scientists busy for the next 50 years.  From the Stone Age to Silicon Valley, materials have defined the technological capabilities of civilisations.

Professor Andre Geim at the University of Manchester in the UK is well acquainted with the toolbox available today. In 2010, he was awarded the Nobel Prize in Physics for extending it with an exotic form of carbon known as graphene.

Unlike materials sourced from nature, graphene is a creation of science. It is peeled off graphite in honeycomb motifs as thin as a single atom. The quantum laws prevailing at these tiny scales cause electrons to move through graphene in unusual ways. ‘Graphene can be stronger than steel, more conductive than copper and as transparent as glass,’ said Prof. Geim. ‘It is unlike any substance found in nature.’……more

What Type of Leader Do I Wish to Be?

We have all heard the expression of praise that a person “is a born leader.” Despite the admiration captured in these words, they imply that excellent leadership is innate only to a few, and that the rest of us not born with such talents must accept, with grace, a second-class standard.

Throughout my career as a practicing physician (SBK), I have observed various styles of compelling leadership. Those with whom I work teach me, model for me, the complex array of what it means to be a fine leader. I respect and value what I have witnessed. I try to assimilate their admirable qualities, combine their best attributes, and then apply them to my own skills and personality. And I have come to see that great leaders are not born. They model and learn and grow…..more

Five Changes Great Leaders Make to Develop an Improvement Culture

Care Redesign Survey: What Data Can Really Do for Health Care

Over the past few years, physicians and provider leaders have been frustrated with the limitations of health care data. Much like the anticipation over EMRs in the early days, providers expected big data to solve all of health care’s problems. When it didn’t, disillusion set in.

In our newest NEJM Catalyst Insights Report on Care Redesign, we took a read on the effectiveness of health care data, both today and in five years. We found that the landscape is shifting from one of despair over the unfulfilled promises of big data to a more realistic vision of what sophisticated analytics can do to transform health care delivery…..more

most-useful-sources-of-health-care-data-today-and-in-5-years