Precision medicine - using data to prevent heart disease and stroke
Curzon Healthcare Lead Chetan Trivedi in conversation with Dr Rameen Shakur MD PhD (Cantab), Massachusetts Institute of Technology, Boston. We explore precision medicine, the importance of a patient centric approach to data and how medical technology is improving healthcare accessibility.
Rameen is the founder of Cambridge Heartwear and the Jansen Fellow for Cardiology and precision medicine at Massachusetts Institute of Technology (MIT). This interview was not sponsored. All views are Dr Rameen Shakur’s and not that of MIT.
Watch a highlight of our conversation below
Precision medicine and technology
Precision medicine refers to the tailoring of medical treatment to the individual characteristics of each patient.
Precision medicine does not mean the creation of drugs or medical devices that are unique to a patient, but rather the ability to sub-classify individuals into populations that differ in their susceptibility to a particular disease. And for that to occur, Rameen argues we need “not just the therapeutic arm, the diagnostic arm, but also the analytical arm to all intermingle in one.”
Rameen is the founder of Cambridge Heartwear, a medical technology and AI device manufacturer. Through novel engineering, Rameen and his colleagues at University of Cambridge fused diagnostics, and real-time delivery of data and analytics. Cambridge Heartwear aims to reduce the impact of strokes by detecting irregular heart rhythms in real-time through a pairing monitoring device and artificial intelligence algorithms. This real-time wearable ECG (electrocardiogram) device has cut the diagnosis and treatment process down from three weeks to days. Rameen explains it is also a means to measure our physiology in more granularity.
Part of Cambridge Heartwear’s goal is more integrated healthcare across primary, secondary and tertiary care. Rameen explains “once you deal with that whole process of how to manage a system to amalgamate all of those together, then you make a real inroad into what we want to call precision medicine.”
Similar to many technology companies, such as HP and Apple, Rameen built the first prototype in a shed in his back garden.
Patient centric design
What makes Cambridge Heartwear disruptive is the focus on the patient. Throughout the design process, Rameen is “very patient centric”.
This carries through to the availability and ownership of data. “It’s patient centric because if we want to get to a view of precision medicine, you have to give access to people for that data. The point is it is their data. It is their own right to actually have that data, access that data and do as they please with that data.” From the patient perspective it is a means for them to obtain specific data related to the cardiovascular system for the first time, namely the whole electricity of the heart when they’re moving around. Consequently, access to this data enables people to have an informed conversation with physicians on treatment modalities.
This focus on the patient not only applies to data but the design of the wearable itself “We wanted a wearable that would be ergonomic”. The design encompassed:
- Real-time data and analytics transmission from patient to physician across the world
- Patient experience – “we wanted a system where you can go about your daily business”
Historically many medical technology companies have adopted a male-centric approach to data and design. Rameen was mindful of gender bias in his medical technology design, stating
“the whole design was done for the anatomical differences between males and females.”
Accessibility for all is at the heart of what Rameen’s trying to achieve. He believes that coronavirus has affected healthcare by firstly highlighting the health inequalities that exist in society and secondly adopting technology to break down those barriers. “who has access has power is no longer the statement that we want to hear”. The COVID-19 pandemic has also highlighted the important role of technology to deliver information from patients’ homes to hospitals and physicians.
The future of precision medicine
We ask Dr Rameen what precision medicine could look like in the next 30 years.
“Precision medicine I hope will garner a lot of technology, innovation and discovery. In our lab, for example, we are teasing out for the first time methodologies for risk stratification for patients who may have had the genetic test.
We are getting more and more nuanced in the way we collect data. Previously, for example when we talked about disease associations, we referred to a particular subpopulation, a particular racial population… For a complete picture, one needs to know and have a whole profile of different technologies that are applicable across the board, across society. I believe what we need to do is to bring that back to society and say, let’s talk about it in the context of the population of our global population.”
I believe we will likely see more integration of digital technology with the biotech fields… I hope to see more of this sort of collaboration where novel engineering comes head to head with medical technology processes, whereby the actual information is now being stored in biological systems, having a discourse with physicians at a much more accessible point. And I think this concept which has started to happen
“It’s a very exciting time within the next five to 10 years, we’re seeing a lots of big changes”.
The concepts of portability and real time data are “something that we are very proud to work on and something that’s also of interest to us as we move to our next phase of humanity into space.” Indeed, the emergence of space travel tourism launches an opportunity to observe medical data and physiology outside of the earth’s atmosphere.
But one thing’s for certain, the aim of medical technology is not to replace humans.
“I think one of the key points about technology is we have to get away from just being a tech company. You are a human company, which is dealing with humans and for the survival of patients, we need to have all in our armoury. So I make no apology to say that we would never want to replace the physician, but rather to make that whole process a lot easier and less journey as for all involved.”
An important time for innovation in the UK
Rameen is proud of the work that UK engineers and manufacturers are doing right now. He believes that as a country
“we are very strong in artificial intelligence. We may not have previously been very vocal about that, but the proof is in the pudding. And I’m glad to say a lot of people are having the puddings!”
We can help you to improve patient outcomes with digital strategy, transformation and patient experience.
In conversation with
Dr Rameen Shakur MD PhD (Cantab), Massachusetts Institute of Technology, Founder of Cambridge Heartwear
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Global business risk and impact survey 2020
As many countries start to ease lockdown, companies will need to adjust their business models to a “new normal”. Companies must now construct a recovery plan focused on mitigating the main business risks and taking advantage of the main opportunities. To help our clients to prepare for recovery, we are launching the COVID-19 Global Business Risk and Impact Survey.
This will enable top executives to identify and evaluate the main risks which could affect their businesses given the current context of the COVID-19 crisis.
Through our partnership with the Nextcontinent network, the survey will be conducted in over 30 countries meaning we can identify trends at a global level with local insight.
By completing the survey you will receive a:
- customised report with a series of suggested measures to address the most critical risks in your business
- free meeting with one of our Partners to understand the results and what it means for your business
- consolidated analysis of the global responses
The survey takes approximately 15 minutes to complete.
We invite you to complete the risk and impact survey before June 26th.
Take our survey to receive a customised report and consolidated global findings.
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Digitalisation in building supplies
The global COVID-19 pandemic is changing customer behaviour across the UK. We explore the digitalisation adopted by many building supplies companies to meet new customer expectations.
Muhammad Ali, Curzon Consulting Principal, discusses the impact of coronavirus on customer expectations and digitalisation with David Young, Group CEO of The Bradfords Group. Bradfords is a leading independent Builders Merchants in the UK.
Watch the highlights of our conversation:
Changing customer expectations
Navigating supply and demand challenges brought about by COVID-19
David explains the challenges that the pandemic has created in the building supplies industry.
Initially, Bradfords’ shops remained open to support essential projects and self-employed customers. In March, the morning after the UK lockdown was announced, Bradfords experienced extraordinary levels of demand. They realised that although Bradfords had a number of social distancing measures in place, they wanted to create a new process to safely meet the rapid change in customer demand. They opened back up the next morning with a brand new process – to order either via phone and collect, or order through the website.
This generated “unprecedented demand on the phones”, increasing from around 1,500 calls per day to 15,000. Consequently, both trade and retail customers looked to other channels such as the website. David explains
“we started seeing a big uptick in our trade customers using our portal and then transacting online, and also retail customers”.
However this surge in online demand came with a new set of supply chain challenges. Therefore, to ensure that Bradfords could continue to supply products for essential products and key projects they:
- Temporarily closed their business to the retail customer base
- Rationalised their product range
Furthermore, showcasing fewer products created a better website user experience which in turn generated an increase in sales. In fact, the eCommerce sales are still increasing, even now Bradfords have reopened their shops and yard to customers.
Are these changes in customer behaviour expected to continue?
In the short to medium term, this changing end user behaviour is expected to continue. Trends include:
- Customers increasingly plan ahead
- Customers continue to buy online
- An increase in retail customers
- A spread of footfall across the day, rather than a concentration of customers in the morning
“What COVID-19 has forced customers to do is plan ahead” David Young explains. Due to extended lead times and the click & collect service, Bradfords have seen their customers become much more planned. This change in behaviour is also helping operations “it helps us manage our workloads and forecasting stock levels”.
Building a strong ecommerce offering
The growing focus on ecommerce in building products is mirrored in the wider UK retail market and high street. Companies like Bradfords have been “through a long journey on ecommerce” and now find themselves well positioned to generate new sales through this channel. This represents a shift in focus for the building materials industry. A renewed focus on driving sales through the website highlights the importance of understanding insights from data. David recognises that good data is an important investment and Bradfords work closely with suppliers to ensure they are capturing data.
Overall, the pandemic has led to a renewed focus on digital strategy.
“I think the pandemic has really forced people and businesses to really look at their digital platforms”.
What does the future of trade counter operations look like?
Digitalisation in building supplies merchants during coronavirus has caused a spread in footfall across the day in shops. David forsees that click and collect will become a bigger part of building merchant life, likely as a separate service. Offering click and collect on light and heavy side products, such as forklifts, will require companies to restructure the way they operate. Key considerations are:
- Resource to ensure they can offer customers quick turnaround time
- Speed and efficiency of processes
- Omni channel offering
- Flexibility around opening hours – digitalisation opens up a 24 hour service
- Product ranges
The ability to react quickly to meet changing demand is key, both within the business and across the supply chain. Indeed, David recognises the importance of planning ahead and sees the importance of builders merchants becoming “much more productive in the future”.
Changing relationships across the supply chain
Will digitalisation disrupt the value chain? Does it change the relationship between manufacturer, distributor and end user?
David sees this as an evolution rather than disruption:
“I think the relationship between the merchant, and the supplier will change dramatically. You know data is so important and historically I’ve found that data within our supply chain is very poor… a lot of manufacturers just don’t hold the level of data needed in this new world…
I think there’s a big wakeup call coming”.
Merchants need to be mindful of potential risks, particularly if they:
- Are slow to react to digital customer demand and develop their eCommerce platforms
- Don’t react quickly – “actually some of the suppliers will vertically integrate and sell direct and cut us out.”
This evolution also presents a number of opportunities for building supplies merchants to:
- Work with suppliers that are invested in data and technology
- Build stronger vendor relationships
- Attract a new demographic of customer
- Understand the many payment platforms and react accordingly
In summary, digitalisation across building supplies gives businesses the opportunity to adopt digital, improve customer experience and improve supply chain relationships.
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Mental health and COVID-19: a clinician's perspective
The global COVID-19 pandemic has highlighted new and existing challenges around mental health care. One in four adults experience mental illness, (NHS England) and many more of us know and care for people who do. For many, the COVID-19 pandemic has created anxiety which is a normal response to uncertainty (WHO, 2020).
In his latest conversation, Chetan Trivedi discuss the impact of coronavirus on mental health with Dr Tarun Gupta, a General Practitioner and Occupational Health Physician based in the UK.
The impact of coronavirus on mental health
In our first video interview we explored the impact of COVID-19 on mental health. Dr. Gupta shared examples of what he is witnessing on the ground.
The impact of technology on mental health
In our second short video we discuss the impact of technology in healthcare generally, how technology plays a role in supporting patients with mental health conditions, and some of the limitations of technology.
Prevention, assessment and treatment
In our final segment, Dr. Gupta answers the question… if he was appointed Mental Health Tsar, how would he address mental health care in the UK?
Useful resources
- World Health Organisation mental health guidance
- NHS Mental Health and Wellbeing homepage
Contact us for more information or submit a request for proposal to our healthcare consulting team
The convergence of healthcare and travel
Airports and the wider transportation industry are facing a number of new challenges as they prepare for the realities of a post COVID-19 world.
Aviation and mass transit are dependent on density, the antithesis of social distancing. John Holland-Kaye, CEO, Heathrow Airport recently stated “It’s just physically impossible to socially distance with any volume of passengers in an airport.” He continued “The constraint is not about how many people you can fit on a plane; it will be how many people you can get through an airport safely”.
To address these constraints, many airports are considering how to adapt their existing operating models for the new reality and adhere to any new health and safety regulations.
What could the future of airports look like?
Already many airports, including those based in the UK, have introduced measures to enable essential travel based on government guidelines. Those guidelines include social distancing, ample distribution of hand sanitiser throughout airports and efforts to spread passengers evenly across terminals.
However, such measures may not be as easily implemented when capacity is ramped up towards pre COVID- 19 levels and therefore innovative and creative methods will be needed to help increase passenger confidence and change the narrative. Passenger confidence will be the key driver to getting back to some level of normality!
Accelerated automation across the customer journey
The passenger journey is changing. Post COVID-19, passengers may welcome the acceleration of automation across commercial aviation and urban mobility in order to limit physical contact.
A new era of automation is likely to extend from the basic such as the eradication of all remaining doors requiring pushing or pulling to the more advanced. These might include gesture or eye-movement-based interactions with payment kiosks and in-flight entertainment screens; robots and drones equipped with UV lights that continuously sanitize surfaces; and artificial intelligences that govern our previously clumsy attempts at everything from bus scheduling and curb usage to security screening and aircraft boarding.
We spoke with one passenger experience company, Elenium Automation, who are trialling ‘touchless travel’ technology. Etihad Airways recently announced that it plans to partner with Elenium Automation to trial new technology which allows self-service devices at airports. The technology will be used to help identify passengers with medical conditions, potentially including the early stages of COVID-19. Watch our interview with Elenium Automation here.
The new customer journey requires process optimisation and staff upskilling to ensure new regulations are complied with and the spread of viruses are mitigated.
The convergence of healthcare and aviation
Airports in Asia are one step ahead, having learnt from their experience dealing with SARS. For example, the Airport Authority Hong Kong are in the process of rolling out new measures that include the following:
- Full body disinfection channels
- Antimicrobial coatings
- Autonomous cleaning robots working 24/7
Bournemouth Airport are currently trialling thermal cameras in order to detect if passengers have fevers or other indications of disease. Airline passengers would simply walk through a series of tunnels, gardens, or other environments designed around new biometric-enabled security screening methodologies—without ever touching anything or even producing passports or other documents.
Identification through temperature monitoring then is likely to funnel through to more rigorous and accurate healthcare assessment. Technology is simply the enabler. This flow through process needs to be designed, procured for and integrated into the overall operating model, which will require retraining of airport employees, third-party contracting staff, process and system changes.
Service based offering
Less footfall simply means less custom, just as it does on any high street. In addition to less footfall, customers may be less willing to browse, and there may be capacity constraints in entering retail spaces.
How will customers spend their time at airports? We may see a shift from retail to service-based airport offerings. We may start to see GP (physician) kiosks or pharmacies set up within airports to provide health check-ups or assessments.
Similarly, first class lounges may start to offer basic health check services, particularly for frequent flyer customers. In addition, this repurposed real estate could serve a highly valuable consumer segment that includes those retired and travelling throughout off-peak hours.
Virus passport integration
The aviation industry may increase health and safety measures through integrating passports or ID documents, “immunity passports” with recent medical records or vaccination history. However, the introduction of such solutions will likely open up the debate of civil liberties and data security.
The identification and rapid diagnosis of COVID-19 symptoms is key to limit the spread of the virus and implement next-steps such as track-and-trace, self-isolation or early warnings to the receiving/host country. There is evidence now emerging in the US and China, based on small studies, that a large percentage of the population may be asymptomatic. If true, then airports will also have to put in place measures to monitor passengers who might be asymptomatic (i.e. showing no symptoms, but may still carry an infectious virus).
Future direction of travel
As evident above, there are a number of complex nuances to any airport COVID-19 response. Ultimately, the response must strike the correct balance between ramping up capacity so passengers can begin to book fares and reassuring passengers that it’s safe to be on a plane and in an airport.
1 Response continuum
- An airport may choose to do the bare minimum. Taking this option, airport management may roll out a minimum cost and effort plan that includes temporary measures with the view to ramping up and down the measures as they see fit while capacity increases or the threat decreases.
- On the other end of the spectrum, an airport may invest heavily in technologies coming to market and seek to robustly implement health and safety guidelines.
Taking the latter option, its salient that management look to strongly embed this move in their infrastructure and operations, processes and technologies so that they look to benefit from the implementation in the long run irrespective of an increasing/decreasing COVID-19 threat. This may include catering for a ‘new norm’ of passengers who expect hygiene and safety measures in place. Availability heuristics refers a mental shortcut that relies on immediate examples that come to a given person’s mind when evaluating a specific concept and it is likely that passenger behaviour and expectations may shift drastically even if a vaccine is found in the near future.
Outside of the confines of the airport, there is also opportunity to look at what assurances could be provided pre-travel. Such measures could minimise the chances of spread from travel and re-write the narrative on airline travel as a conduit of illness spread.
2 Assess readiness
Rapid assessment and implementation of most effective and customer reassuring COVID-19 protection measures. This may include measures such as staff testing, upskilling and scaled approaches/scenario planning to a capacity ramp up. According to the Centre for Disease Control and Prevention in the US, global pandemics have been as strong, if not stronger in wave two. If this is the case, airports have a fiduciary responsibility to their staff, customers and shareholders to have scenario planned the impact of wave two to minimise the impact.
3 Analyse feasibility
Detailed customer journey analysis to identify highest points of risk and feasibility analysis of MedTech offerings to cater for above risks. The solution is likely to be different for inbound versus outbound travel. The question then arises about where the level of responsibility lies. Is it with the government who may own the airport, or with the airlines and/or airports or a combination or all of the above. Scenario planning and insight driven decision making is key to getting these essential business decisions correct.
4 Assess revenue opportunities
Identify and generate a business case for post coronavirus revenue drivers and opportunities such as service offerings. For example, vacant airport real estate could be utilized as a lead generator for a major UK private hospital and/or a retail pharmacy chain and also heighten confidence of consumers remiss to getting back to aviation travel. Health and general well-being are likely to propel up the consumer agenda going forward.
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Chetan Trivedi
Healthcare Partner
Nigel Brannan
Infrastructure Partner
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Pharmacy Disruption: an interview with Zottii
Taz Sheikh is CEO of medicine delivery start-up Zottii. He talks to Curzon Consulting about pharmacy disruption, the impact of COVID-19 and future of pharmacies.
The gap in medicine delivery models for retail pharmacies has been exacerbated by Coronavirus, increased demand and changing customer expectations.
Interview with Taz Sheikh, CEO of Zottii
We live in a day and age where we can get almost anything delivered on demand and on the same day, whether it be items on Amazon, to your groceries to take-away food or taxis. So you’d think the same will be the case when it comes to prescription medicines, but sadly is not. So in early 2019, I set about looking at ways to change that.
I really thought that there’s got to be a better way a better experience for me as a potential patient, for doctors and for the whole healthcare system as a whole.
And hence I decided to create Zottii.
Challenges in retail pharmacy
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It’s behind the times. And it’s not really set up for those people who need their medications in a hurry, or who physically cannot get to a pharmacy
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It’s inconvenient. You know we all live very busy lives today. So find the time to visit a pharmacy, it’s not ideal, you know, particularly if you’re a busy working professional like yourselves, or you’re a single parent or you’re, you have young children
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The biggest problem right now within retail pharmacies is the out-of-stock situation, it’s common for pharmacies to be out-of-stock of your particular medication 40% of the time. Most do not have the appropriate inventory systems to ensure a continuous supply of the right medications
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This out-of-stock situation leads to something what we called poor drug compliance. And the inability of people being able to get their medications when they need which often leads them to not actually taking their medications at all. And this potentially causes further problems, not only for the patient, but also for the whole healthcare system as a whole as delayed treatment ultimately does result in worse outcomes.
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Most pharmacies are just not set up to offer on-demand or same day delivery, and those that do somehow offer that service, quite often it’s complicated as it involves third party couriers, and it can be quite costly. The current suite of online pharmacies use the Royal Mail [UK’s postal service], which often means patients have to wait 2-5 days to receive their medications
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[Retail pharmacies] are really designed to get people to the door because they’re selling makeup shower gels, toiletries. And most shelves are used up to stock those particular items. And if you actually look at their actual dispensary of prescription medicines, often is a very small space, they don’t always have the space to stock all the inventory
Benefits of online medicine delivery
Opportunity for pharmacy disruption
If new disruptors do not come into this sector and use technology to be able to streamline the whole process it will create more of a burden in the future, not only for patients and for doctors but for the whole healthcare system as a whole.
You’ve had many people look at the front end of healthcare, the likes of these very prominent video consultation platforms. Some of these platforms use AI technology but sometimes people forget about the most crucial element, you still need to get the medicines that are being prescribed into the patient’s hands. It doesn’t matter how many remote consultation platforms you have out there. If people are still not getting their medicines it means nothing.
Evolving customer expectations
We want to bring pharmacy as it is into the current time and we wanted to be a service that’s more aligned with consumer expectations today, as in getting your medications delivered on demand on the same day to a time and place or location that suits you.
The other thing is that we’re trying to make it more convenient.
Ultimately, our service is really designed to help those who need the service get their medications in a timely fashion. Whether you be elderly, single parent, busy working professional, or whether you be someone who’s incredibly tech savvy.
We’re already seeing a younger generation who are basically choosing healthcare on their own terms. They’re using services like video consultations, or chat enabled AI systems. All those systems lend themselves very well to a delivery service such as what we’re offering. It’s completely plausible to expect to have your medications delivered to your home if you’re having a video consultation with your doctor at home.
Predictive software
The reason we are also trying to avoid that no-stock situation is because we’re employing certain types of predictive inventory software and we’re looking at the data around what medications are most consumed. And we also look at the most commonly prescribed drugs of a doctor who uses our service to always ensure that we have an adequate supply.
Faster treatment
By offering free same day delivery, often within one to three hours, we’re quite setup for those people who’ve got time critical care needs. We’re helping people get treated faster, which results in better drug compliance, which results in better medicine adherence.
Continuity of care
Doctors love the service because not only can they send their prescription to us electronically but they also are notified the moment deliveries made so from a continuity of care point of view. And it’s also a value added service for them because as it stands today there’s a detachment from pharmacy and doctor.
Your doctor doesn’t know the challenges that you’re going to face as a patient to try to get your medication. They don’t even know necessarily if you’re going to take your medication because of the fact that you can’t get it, but with a service like AWS they have the comfort knowing that we’ve received their prescription.
Impact of COVID-19
The Coronavirus pandemic has seen the acceleration of digital transformation for many industries, including pharmacy disruption. We discuss the long term impact of the change in behaviour and customer expectations exacerbated by COVID-19.
Increase in demand
The demand for our services absolutely has gone through the roof.
We were originally delivering in (London) zones one to four. We have now stretched out to zones one to six.
Change in operations
What I’ve noticed over the past few weeks with the current COVID-19 lockdown is that a number of the pharmaceutical wholesalers have had to really streamline their delivery services.
Our delivery drivers have obviously had to change the way they operate and work within this current lockdown situation. We’ve had to focus purely on online payments.
Change in mindset
People don’t want to go out and pick up the medicine because they don’t want to risk exposing themselves to other people. And if anything, this whole pandemic really hits home two key things:
- Sick people shouldn’t have to go to the pharmacy. When you’re unwell you can get anything else delivered to your home… Why should you not get your medicines delivered to you?
- Sick people shouldn’t be going out in public: They shouldn’t be going to the pharmacy risking exposure to the pharmacist, they shouldn’t be using public transportation risking exposure to other people. They should stay at home and let services, such as Zotti or similar, come and deliver their medicines to them at home.
Future of Pharmacies
The role of robotics
By the year 2050 the majority of dispensaries will have some form of robotic dispensing capability because:
- they can operate 24/7
- they can be linked to whatever system they need to be. They can be linked directly to a doctor’s prescribing platform
- the use of AI technology can also be in place to minimise any mistakes doctors may make
I think it’s a given pharmacy of the future will be more tech enabled, it will be more integrated and they will be a logistics element attached to the end of it.
The value chain
In terms of the whole ecosystem, I think a more integrated and more thorough pharmacy element is definitely required, certainly in terms of dealing with not only primary care patients but secondary care patients as well. A service such as what we offer does not have to be just focused on prescription medication. We could also be delivering Over the Counter (OTC) products and other products you would typically get in the pharmacy. We already know what the most popular Stock Keeping Units (SKUs) are within the pharmacy. And if you’re delivering medications to a particular individual, why not also deliver the other types of products that they would traditionally get from their pharmacy?
Pharmacists of the future
I think the reality is that there will always be a place for pharmacists… technology will not completely replace the need for a superintendent pharmacist.
But I think the question is who will they work for. There certainly will be in the future options to work for some of these technology disruptors within this space or the ability to embrace technology in their own pharmacy.
I think the industry as a whole needs to give more powers to pharmacists. We’re already seeing more and more pharmacists, with the ability to prescribe. And I think that will start to increase.
Is retail pharmacy ready for disruption?
Curzon Consulting helps organisations with digital strategy and transformation. If you would like to discuss how a multi-channel strategy could be implemented into your current business model, get in touch.
Contact us for more information or submit a request for proposal to our healthcare consulting team
Touchless Travel: automation in airports post COVID-19
Automation in airports may enable touchless travel. The global COVID-19 pandemic has caused widespread disruption around the world and brought with it a lot of uncertainty. The response from many healthcare systems and technology companies highlights the increased adoption of digital tools and innovative solutions.
Curzon Consulting Partner Chetan Trivedi interviews innovators in the UK healthcare sector. In his latest conversation, Chetan explores automation in airports post COVID-19.
Bob Kwik, Director Europe at Elenium Automation, a passenger experience company focused on improving the journey using automation and technology.
The company is also working with hospitals to roll-out self-service triage solutions. Etihad Airways recently announced that it plans to partner with Elenium Automation to trial new technology which allows self-service devices at airports. The technology will be used to help identify travellers with medical conditions, potentially including the early stages of COVID-19. Etihad will initially trial the monitoring technology at its hub airport in Abu Dhabi in May and June 2020.
Get in touch to discuss how digital strategy and transformation can be applied in your organisation.
Contact us for more information or submit a request for proposal to our healthcare consulting team
Remote working during COVID-19 - "Kudos is better than caffeine"
In his first blog post, senior consultant Phil Hanson explores seven lessons he learned in the army that can be applied to remote working during COVID-19.
Image courtesy of Johnny Fenn Photography
People naturally avoid difficult conversations
Ten years in the Army taught me more than I could possibly convey in a single thought leadership piece. However, some of my experience, including front-line combat in Afghanistan, left me some unique insights into team dynamics and leadership in extreme circumstances, many of them pertinent to the COVID-19 pandemic. The seven lessons I learned during my Army career I feel most useful for thriving under difficult conditions are:
Everyone responds differently to stress, and that’s OK
Like infectious diseases, stress responses have a lag time which can vary enormously by individual. This means treating people with patience, followed-up with a bit more patience.
Personality is a poor predictor of stress-response; I have witnessed shy, retiring individuals quietly carrying teams through astonishing adversity. The only consistent truth is that the appropriate response involves patience, compassion and understanding.
Consider the most candid conversation you’ve ever had; someone truly opening up to you about something personal. Now reflect on how it began. It probably meandered through small-talk before finally settling on the real issue once they felt comfortable enough to raise it.
Remote-working makes it too easy to close conversations early. Give people your time, make them feel valued and listened to: Make difficult conversations that bit easier.
Trust is not optional in high-performing teams
It’s often said that what sets the British Army apart is the quality of its Non-Commissioned Officers: Highly-trained, empowered junior mangers who are told what to achieve, not how to achieve it, in a concept known as Mission Command. This reciprocal-trust environment brings out best of the team’s collective strengths.
Virtually everyone responds best to a default position of trust; and will strive to justify this faith placed in them. The rare exceptions to this rule are rapidly exposed, rendering the concept of “respect is earned” redundant in the modern consulting profession.
Professionalism is a mindset
In 2015 my Battalion received new Colours from the Queen: The parade was the culmination of months of painstaking rehearsals and uniform preparation. The result of this was that on the day, leathers polished and medals shining, I felt utterly prepared to perform in front of 20,000 people. Equally, I would never deploy on operations without every bit of my kit being just-so. Both scenarios boil down to one principle: Being every-inch the professional soldier.
Wearing pyjamas whilst WFH every other Friday may be an understandable novelty, but long-term, looking and feeling in work-mode is critical to working in work-mode. It also helps delineate work-life balance.
You have to look after yourself in order to take care of others
Being an infantry officer often involves rapid decision-making whilst exhausted, soaking wet, and freezing cold. Typically, this means making personal sacrifices for the sake of your soldiers, but a good leader knows they need to take sufficient care of themselves to make the right tactical decisions.
It’s too easy to neglect ourselves, convinced we’re doing right by colleagues, friends and family. Granted it’s a tricky balance to strike, but the longer difficult scenarios last, the more important it is to take care of ourselves too. It’s what’s best for the whole team.
Followership is just as important as leadership
Despite all knowing that too many cooks spoil the broth, when we analyse team dynamics, we too often focus exclusively on leadership qualities at the expense of others.
Whether you call it followership, or just being a team player, the art of knowing your role, doing it to the best of your ability and supporting leaders is an often-overlooked critical success factor for high-performing teams.
Kudos is better than caffeine
Whilst it may not exactly be ground-breaking news, it’s nonetheless true that most people could be better at giving credit to others. When the going gets tough, it’s easier than ever to forget to say well-done, despite it being more important than ever.
Coffee may flow through the veins of many consultants, but recognition for job well-done provides a boost that is far more enduring than a caffeine fix.
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Virtual Care: delivering healthcare in the new reality
The global COVID-19 pandemic has caused widespread disruption around the world and brought with it a lot of uncertainty. The response from many healthcare systems is showing the increased adoption of digital tools and innovative solutions.
Whilst Virtual Care services are nothing new, the COVID-19 pandemic has pushed Virtual Care solutions like Telehealth to the top of the healthcare agenda. In order to deal with increased demand for healthcare services, governments around the world have pushed through regulatory changes to allow the widespread use of Virtual Care models. These Virtual Care platforms are an indispensable tool in an environment where health systems try to keep up supply (clinical assessments and triage) with demand (patients).
In a post COVID-19 world, care delivery models around the world will be transformed and there will be widespread adoption of Virtual Care models in virtually every healthcare setting. This is part of a wider digital transformation agenda in healthcare. Care that used to take place exclusively in physical settings (e.g Doctor’s office) can now take place digitally. Every healthcare organisation (payors, hospitals, life sciences, pharma, medical devices etc.) across the entire value chain (prevention, primary care, secondary care, tertiary care, social care, palliative care, etc.) are exploring a variety of virtual care models, many of which are enabled by telehealth technology.
Hospitals are already using Virtual Care to improve accessibility, availability and affordability of care. As demands for healthcare services increase, driven by an aging population requiring more complex care, Virtual Care offers a smart way to leverage finite healthcare resources.
Virtual Care and digital healthcare enable a model of care that is more affordable and integrated into patients’ lives. Consumer behaviour is also shifting. As Dr. Eric Topol describes in his book titled “The Patient Will See You Now”, patients seek to access healthcare on their own terms (time and place).
Hospitals and health systems that take a proactive approach towards Virtual Care will be well-positioned to meet patient demands in the future.
Definitions
Virtual care is comprised of four categories:
Real-time interaction with the most appropriate clinical team to support patient requiring immediate advice. Post virtual triage, a follow face-to-face consultation with the most appropriate clinician team (doctor, nurse, pharmacist, etc.) can take place.
Modern information and communication technologies, data such as bio-signals or medical images can be acquired from the patient and then stored or sent to the specialist when needed. The field of Pathology, Radiology, and Dermatology are those using such services already. For example, with a shortage of Radiologists in certain countries, scans can be read and reported on by specialists remotely. If Artificial Intelligence (AI) is layered on top, certain scans can be read by AI to act as a “second pair of eyes” to human reads.
Uses a range of technological devices in order to remotely monitor clinical signs and health of a patient. Remote monitoring is extensively used in the management of chronic diseases such as asthma, diabetes mellitus, and cardiovascular disease.
According to the Centers for Disease Control and Prevention, 6 in 10 adult Americans live with at least one chronic disease and 4 in 10 adults live with two or more chronic diseases. Among the benefits of virtual care include greater patient satisfaction, more frequent monitoring, and cost effectiveness.
There is a strong tendency that patients are involving more in monitoring their own health through the use of smartphone applications and wearable devices designed to help them track and improve various health indicators.
According to Statista, there are 3.2 billion smart phone users out of a total population of 7.7 billion people around the world. This information and these devices can be also used by policymakers, practitioners, and leaders in the medical and health care industry in order to identify and act on health trends, inform treatment decisions, and even provide outgoing communication to the public.
Such solutions can also deliver basic care to parts of the population living in remote locations. For example, nutrition advice can be provided remotely to pregnant women and/or mothers with young children in small villages with virtually no access to care, but may have access to mobile technology.
“Use” cases
By increasing access points and redistributing expertise where it’s needed, Virtual Care can address disparities and improve outcomes. Virtual Care platforms can be used to provide a range of services such as, but not limited to:
Primary Care
- Chronic care management, recording vital signs through home-monitoring systems and sending alerts to clinicians when readings fall out of the normal range.
- Pharmacy services, including medication review and prescription verification, for patients with chronic diseases such as diabetes, hypertension, etc.
- Diagnostic screening for diabetes-related eye disease, increasing the number of diabetes patients who receive eye exams to help prevent blindness.
- Sleep disorders, monitoring patients with sleep apnoea for sleep patterns, body positions and breathing.
- Tele-psychiatry, assisting patients in need of behavioural health services.
- Tele-physiotherapy, assisting patients with physiotherapy sessions remotely.
Acute/Hyper-Acute
- Tele-stroke services, creating access to the limited supply of stroke neurologists and targeted use of therapies that preserve brain function and save lives. Tele-stroke services can also help facilitate a “hub and spoke” model, where a hyper-acuity stroke unit can provide remote support to a stroke centre.
- Tele-ICU tools, providing 24-hour intensive support to deliver optimal local care to the most acute patients. ICU beds can all be monitored from one, central control room anywhere in the world.
- Pre & Post Op Consultations, ensuring more efficient use of resources across the health system where a physical exam on the day is not required. For example, a patient scheduled for a cardiac ablation procedure can be consulted remotely prior to the procedure, once certain tests have been performed in advance.
- Post-surgical recovery, allowing patients to self-manage recovery process with support from clinical teams as needed remotely. Sophisticated solutions can also include apps to capture progressive pain scores, wound images, etc. so that clinical teams can monitor recovery remotely.
Adoption Challenges
There are some barriers to expanding access to care through Virtual Care. The eight most significant barriers are:
- The lack of leadership and organisational commitment to develop an overarching strategy and integrate care delivery within the clinical pathway (e.g. pre and post op consultation)
- Inadequate clinical engagement and readiness without consideration of user (clinicians and patients) experience and workflows
- Restrictions on how Virtual Care services are reimbursed
- Licensure laws and regulations that limit the ability to provide Virtual Care services across multiple jurisdictions (i.e. from one state to another within the US)
- The lack of “connectivity” or adequate internet services in some areas to support Virtual Care
- Decentralised departmental solutions and pilot programs without governance structure and dedicated management and potentially competing propositions
- The high cost of technologies and infrastructure and a lack of funding
- Evolving measures of success and key performance indicators hampering scaled platforms
As a result of COVID-19, many of these hurdles are being taken down rapidly to help drive quicker adoption of Virtual Care services.
Key Success Factors
How do hospitals and health systems begin to harness the benefits of Virtual Care?
Virtual Care is not about technology. Technology is simply an enabler! It starts with culture—and culture starts with the Board and Executive Management team. The governing board and senior management can ignite cultural change with a vision statement that embraces virtual care as an extension of what the hospital or health system already does, rather than as something new or different.
Successful hospital and health system Virtual Care programs require discerning technology choices and critical vendor selection. Success also demands uncomfortable cultural changes and the right executive to create a comprehensive virtual care delivery system for patients.
We can help your organisation develop a business case for virtual care. We can help you redesign clinical pathways so that virtual care is not a standalone model, but is truly integrated into the delivery of patient care along the entire pathway.
Contact us for more information or submit a request for proposal to our healthcare consulting team
Future of Infrastructure 2020 report
This 2020 report by Raconteur explores the future of infrastructure, including:
- Smart cities, digital and new technologies
- Sustainability and the challenge of achieving net-zero
- Public perceptions of infrastructure in G8 countries
- Future-proofing infrastructure against climate risks
- Reusing existing assets to bring buildings into the circular economy
How we can help infrastructure organisations
At Curzon Consulting, we understand it’s about the destination and the journey.
We work with rail, road and utilities organisations to deliver tangible results. Our award winning management consultants help our clients get where they need to be through:
- Digital Monetisation and Transformation
- Data Driven Decision Making
- Operating Model Future Proofing
- Value Enhancing Strategies
Visit our infrastructure page or contact our Infrastructure Lead, Nigel Brannan, to find out more
Download ‘Future of Infrastructure 2020’ report from Raconteur, The Times
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