Global Perspectives on Digital Health

What can we learn about creating real impact for underserved communities  from The Kingdom of Eswatini, a tiny country enveloped by South Africa?Join us on the latest episode of the Global Perspectives on Digital Health podcast where we hear from Executive Director of The Luke Commission, Echo Vanderwal about the way that set up healthcare services for those who needed it most and added digital in a way that enabled healthcare workers to deliver compassionate, high quality care. If you want to see how to create real impact for patients who have real transportation barriers rurally, then hear about what the Luke commission have done with :Telehealth hubs out of shipping containers with access to doctors by video, and secure vending machine for simple non controlled medications, all enabled via Starlink Drones piloted by local staff that deliver critical but high value medications like antivenom rapidly and effectively - and the impact this has had on the people who can now survive Black mamba neurotoxic envenomationOr if you want to learn how they:Enabled their community health workers by creating their own bespoke EHR and admin tool that was clinician centred and based on the fastest feedback loops possible (see the clip!)Created a culture of treating patients with compassion to overcome  and the values that helped them make decisions and get through some challenging timesUsed the end goal of what they wanted great healthcare to look like, and made decisions on how digital could help them get thereProactively worked with the country’s Civil Aviation Authority to work together on how to get in place what was necessary to be safe and deliver a high quality and reliable drone service (lesson here for regulators and developers on working closely together in unchartered territory with the end goal in mind - Stephen talked in episode 5 about how the regulator could and should be a facilitator. There’s so much insight packed into this episode - it was energising to record it to say the least and I’m really inspired by the work and impact they have had. If you are a healthcare leader, developer or working to create impact for the people rurally, you have got to give this one a listen and share it with others who might benefit from Echo’s insights. Links: https://www.lukecommission.org/https://www.luvelo.org/

SummaryIn this conversation, Shubs Upadhyay interviews Stephen Gilbert, a professor of medical device regulatory science, about the challenges and successes of digital health regulation and implementation. They discuss the need for flexibility in regulation, the importance of feedback from clinicians and patients, and the evaluation of digital health technologies. They also explore the concept of suites or groupings of digital devices and the need for regulatory approaches that acknowledge their flexibility. Gilbert emphasizes the need for regulation to adapt to the changing landscape of digital health and to ensure that it is fit for purpose. Stephen also talks about what health system leaders, policy makers and developers can learn from the challenges of the DiGA fast track reimbursement framework in Germany, the PECAN framework in France and what is coming in the UK. As well as calling out the stark differences in approach from the FDA and the EU, Stephen helps understand the deeper reasons for the different approaches.On evaluation of effectivenss, Stephen emphasizes the importance of integrating different technologies into a cohesive system rather than treating them as isolated tools. The discussion also highlights the role of regulation in facilitating interoperability and promoting the use of digital technologies in healthcare. A great section on the need for long-term thinking on exactly how we want to transform healthcare delivery, setting clear goals, and continuous feedback loops is emphasized, along with the recognition that digital transformation in healthcare requires investment, embedding and time to get back the ROI. TakeawaysFlexibility is crucial in digital health regulation to adapt to the rapidly changing landscape of technology and healthcare.Feedback from clinicians and patients should be actively encouraged and integrated into the regulatory process.The evaluation of digital health technologies should consider their unique characteristics and the need for holistic assessment.Regulatory approaches should acknowledge the flexibility and groupings of digital devices, such as suites, to ensure they are fit for purpose.Digital healthcare involves the integration of various technologies, such as teleconsultation and remote monitoring, into a cohesive system.Regulation plays a crucial role in promoting interoperability and facilitating the use of digital technologies in healthcare.Long-term thinking and clear goals are necessary for effective digital transformation in healthcare.Continuous feedback loops and monitoring are essential for evaluating the effectiveness of digital health tools.Investment is required for digital transformation in healthcare, and initial costs may be higher before yielding dividends.Links to papers mentioned:Paper on regulation, reimbursement approach: flexible groupingsPaper on regulation, reimbursement approach: flexible suites of technologiesA/B testing framework mentioned hereStephen Gilbert, Professor at the Faculty of Medicine, Dresden University of Technology (Else Kröner Fresenius Center for Digital Health), leads a multidisciplinary team specializing in regulatory science for medical devices and in vitro diagnostic devices. With over 15 years of expertise in clinical research, computational biology, and regulatory science, he is committed to advancing digital health innovation and governance.

Podcast Title: Global Perspectives on Digital HealthEpisode Title: Impact of LLMs in HIV and Rapid Diagnostic TestsGuest: Dino Rech, CEO at AudereIntroduction:In this episode, Dino, a pioneer in the digital health landscape, shares his insights on how digital solutions and AI are revolutionizing the healthcare industry. He discusses the critical challenges such as overcrowded healthcare facilities and the urgent need for support for healthcare professionals. Dino’s extensive work at Audere focuses on utilizing digital tools to improve healthcare delivery and outcomes, particularly in underserved communities.Key Topics Discussed:Digital Solutions for Overcrowded Healthcare Facilities: Dino explores how digital health can alleviate pressure on healthcare systems.AI Tools in Healthcare: The role of AI and language models in enhancing diagnostic and conversational capabilities in healthcare settings.Building Trust and Reliability: The importance of trust in technology, especially large language models, and how it's achieved through rigorous data handling and prompt engineering.Partnerships and Local Collaboration: How forming strong local partnerships contributes to the successful implementation of technology solutions in healthcare.Regulatory Support and Technology Verification: The necessity of regulatory backing in ensuring the safety and efficacy of new technologies.Impactful Insights:Improving access to rapid diagnostic testing through digital tools and AI.Enhancing patient-provider conversations with advanced language models to make healthcare more accessible and efficient.The significance of trust, reliability, and local partnerships in implementing successful digital health solutions.Utilization of specific data sets and prompt engineering to enhance the accuracy and relevance of responses from large language models.The role of specialization and niche focus in addressing particular healthcare and technology challenges.LinksAudere

Podcast Title: Global Perspectives on Digital HealthEpisode Title: Bridging the Gap: The Last Mile of HealthcareGuest: Bilal Mateen, Executive Director of Digital Square @ PATHSummary:In this episode, Shubs Upadhyay interviews Bilal Mateen, Executive Director of Digital Square at PATH about digital health challenges and successes in underserved communities. They explore the importance of safety, regulatory considerations, and the need for inclusive data sets and data infrastructure. The discussion also covers the role of community health workers and the impact of AI and large language models in healthcare.Key Topics:Digital Public Goods: Exploring how digital solutions can be accessible public goods.Health Data Poverty: Discussing how this issue affects global health equity.AI in Healthcare: Insights on the use of AI and large language models to improve healthcare outcomes.Chapters:00:00 Introduction and Background05:06 Digital Public Goods07:04 How Health Data Poverty Plays Out08:59 Reaching the Last Mile of Healthcare15:47 AI and Large Language Models in Healthcare29:00 Investing in Data Science Ecosystems and Regulatory Frameworks32:59 More Global Representation in Regulation37:03 Considering Local Nuances in AI Deployment39:12 Divergent Approaches to Regulating LLMs45:28 Regulation of LLMs as Medical Devices48:40 Recommendations to Innovators about Healthcare RegulationLinks:AMIE paper by Alan Karthikesalingam et alDigitalsquare.orgAudere WebsiteViamo Canada Call CentreSiontis et al Paper on Diagnostic test comparisons

Episode 2: Practical Solutions to Health Data PovertyIn this episode, we continue our exploration of health data poverty, showcasing a team that's making a real difference based on the issues discussed in Part 1 with Dr. Xiao Liu.We're thrilled to have spoken with Prof. Alexandre Filho, a Professor of Machine Learning in Sao Paulo, Brazil. He shared insights on how his team has been maximizing the impact of data-driven technology in Brazil. Prof. Filho's remark, "The world is becoming more like Brazil," sets the stage for a discussion on what the global community can learn from Brazil's approach to data diversity, especially in serving underserved communities.Key Topics:Global Lessons from Local Successes: How Brazil's high-quality, diverse data sets serve as a model for the world.Overcoming Data Challenges: Tackling issues with data availability and the performance limitations of algorithms developed in affluent settings when deployed in rural areas.Leveraging Local Data: Details on the team's work, including a paper on neonatal mortality prediction using routinely collected data.Direct Benefits to Data Providers: Ensuring that those from whom data is collected see benefits from its use.Balancing Impact and Scalability: The trade-offs between highly tuned, local solutions and the need for scalable models that perform well across broader contexts.Benchmarking for Better Health: Extended efforts in the ITU/WHO focus group on AI for health, evaluating the performance of models across different LMIC settings.Advancing Local Impact: The use of transfer learning to enhance model performance and impact locally.Prof. Filho’s Recommendations: Key advice for innovators and implementers in the EU, US, and UK.Guest Bio:Alexandre Chiavegatto Filho is an Associate Professor of Machine Learning in Healthcare at the Department of Epidemiology, School of Public Health, University of São Paulo. He directs the Laboratory of Big Data and Predictive Analysis in Health (Labdaps), which includes a team of 30 researchers focused on developing AI algorithms to improve healthcare decisions.Find the team's work on Google Scholar 

Welcome to Global Perspectives on Digital Health, a podcast series dedicated to exploring the use of digital health in underserved communities around the world). Each episode unpacks unique insights into the challenges and successes of implementing digital tools and how we can bring this back to our own efforts. Episode 1: Health data poverty : what can we do about it?Join us as we dive into a crucial conversation with Dr. Xiao Liu, a leading figure in AI ethics, evaluation, and regulation. This episode focuses on one of the most pressing issues in the field: health data povertyKey Topics:Defining Health Data Poverty: What it means and why it matters for global health.Relevance to Developed Nations: Understanding the implications for the US, EU, and UK.In-Depth Analysis: Discussing a 2021 Lancet paper co-authored by Dr. Liu.Real-world Examples: Exploring instances of health data poverty and its impacts.Expert Recommendations: Dr. Liu shares her views on current progress and the steps ahead.Broader Implications: How can society and the healthcare ecosystem address these challenges comprehensively?Looking Ahead:Stay tuned for Part 2, where we will showcase implemented initiatives addressing these issues in Brazil.Resources:Standing Together Lancet articlehttps://www.datadiversity.org/

Welcome to the trailer for the Global Perspectives on Digital Health Podcast. Join Shubs as he unpacks insights from experts and innovators creating real impact for underserved communities around the world. Shubs is a physician working in digital health. With experience across product development and deployment, regulation and also with the ITU/WHO focus group AI for healthcare as co-chair of the working group on clinical evaluation Shubs has seen the challenges across the digital and healthcare ecosystem. Join these conversations as he seeks out innovators and experts to unpack what we can do to create real impact for those who need innovation the most around the world. Get a truly global perspective on digital health.