Intelligent Health 2023, African healthcare innovations and melanoma detection

In an attempt to enjoy the last weeks of summer I have been swimming in the local river in addition to work activities like attending an AI in healthcare meeting and getting ready for the DIA Medical Information and Communications meeting in Brussels. If you plan to be there, drop me a line,so we can set up a meeting.

Today’s topics:

– Intelligent Health 2023 – learning about healthcare access from African Startups
-Pitching to your audience – how to build trust and how to lose it
-How to ensure your customer engagement channels are fit for purpose
-Leadership: Don’t blame your minions, read on to find out why

Intelligent Health 2023 – learning about healthcare access from African Startups

Last week I went to the Intelligent health 2023 conference in Basel run by Inspired Minds.

The talks range from the general “How AI is revolutionizing healthcare” to the practical “Revolutionizing surgery with surgical operating systems: The future of integrated healthcare” by Ozanan Meireles, director of the Surgical Artificial Intelligence and Innovation Laboratory (SAIIL) at the Massachusetts General Hospital.

Beyond main session presentations, I particularly enjoyed pitches by African startups because when limited resource meets huge medical need the only solution is innovation, which may provide some insights for struggling Western healthcare systems.

In conversations about African healthcare systems I was reminded that in most countries outside of a few regions including the US, Canada and Europe, patients pay for treatment out of pocket and upon admission to a healthcare facility. That standards of care are different, and that this in turn means that operating techniques are different, which translates to the fact that training materials or medication guides that are not generated with an African context in mind are unlikely to provide the desired value.

Presentations that stayed with me included providing patients with a zero interest credit card that gives them immediate access to healthcare when they need it, rather than when they have saved sufficient funds. A diagnostic tool that facilitates breast cancer and cervical cancer diagnosis, and two telemedicine services, one that provides clinics an online presence making it easier for patients to access medical consultations both online and in person with a physician of their choice and that also handles all payment related aspects so that healthcare providers and hospitals can focus on their core activity, providing healthcare. And the second that provides Ethiopian women with access to information and tools regarding sexual and reproductive health.There were also pitches on managing non-communicable diseases including hypertension and diabetes.

While not all the solutions presented can be implemented as is in other geographical regions, many of them harbour a seed that could, with minimal adaptation, grow elsewhere.

Key takeaway: When facing a challenge, look around for inspiration from other teams, departments, or systems. While unique contexts may yield specific solutions, with the right adjustments, these can often have broader applicability.

Pitching to your audience – how to build trust and how to potentially lose it

No, but it’s not really a problem, as darker skinned people don’t really get skin cancer” the presenter said, after some reflection, he added, “well only rarely” in response to an enquiry from an audience member on whether the melanoma app he was presenting is able to detect malignancies in brown, dark brown and black skin. He did qualify his statement with the information that for the trials they had run on his software they hadn’t had sufficient individuals with darker skin on which to train the application and that they would be remedying this soon, clarifying that this is in focus.

Up to that point the presentation had focused very much on the brilliance of the product, the fact that the product is much better than the competition, the size of the global market, projected patients in the years to come and in general on the great earning potential of this app; in short why investing in it would be a wonderful thing. It was a pitch after all.

However, following that comment, as I listened, I reflected on what I know about skin cancer and AI, which included: AI for facial recognition is known to perform better in white skinned individuals than in darker skinned individuals “because it is trained that way” (link WEF). Tech solutions are often designed to serve Caucasian populations. And, while the incidence of skin cancers in those with darker skins may be lower, they also often present with more advanced disease, and at a higher risk of lesions being misidentified and underdiagnosed due to a lack of awareness by health care professionals and patients alike.

Once at home I investigated further. The publication “Disparities in Dermatology AI Performance on a Diverse, Curated Clinical Image Set” published in August 2022 in the Journal Science Advances by Roxana Daneshjou et al, from Stanford University, with co-authors from the Sloan Kettering Cancer center, amongst others, on AI performance in the diagnosis of dermatological lesions, identifies three key issues when using/training AI algorithms to detect skin cancer including, the third of which is a human factor “there are differences in dermatologist visual consensus label performance, which is commonly used to train AI models, across skin tones and uncommon conditions”. The publication also noted that “access to dermatological care is a major issue with an estimated 3 billion people lacking access to care globally” (Link).

While the product might be wonderful, what stayed with me was the presenter’s statement about detecting skin cancer in non-white individuals.

Key takeaways: It is hard to predict what your audience will take away from your presentation; but being prepared, thoughtful, knowledgeable and transparent about the strengths and weaknesses of your product goes a long way to building trust.

How to ensure your customer engagement channels are fit for purpose

A friend of mine, who recently moved to the states tells me that her most frequent sentence when engaging with company contact channels is “I want to speak to a human”. I too often try this sentence, tragically the response is often “I didn’t understand, please rephrase”.

This raises the following question:

When considering how advanced and effective your customer engagement strategy is, do you look at the channels you have implemented, and say, we are well set up? Or do you look at how the channels perform to meet customer needs?

Many companies measure their success by the fact they have transitioned from a multichannel to an omni-channel approach, by the fact that customers seem to be using these channels and by the number of channels that are available to customers.

However, what really matters is that the channels work.

I recently tried to contact an international service provider using a web form. When I didn’t hear back, I called the help-desk. After waiting on hold for a while, I was informed that the lines were unmanned and instructed to leave a message. However, the mailbox was full, and the call was subsequently disconnected. After failing to reach the company both via web form and phone I finally went the personal route, messaging a LinkedIn connection at the company. I received a response within an hour.

This is but one example of many. If you are the sole provider of a product or service clients will persevere in their attempts to contact you, for everyone else, it’s worth making it easy for customers to engage with you.

Key take ways: Regularly evaluate your customer engagement channels for functionality and user-friendliness. Regularly monitor your service for underperformance, check for technical issues, see if you can enhance usability, and review customer engagement

Leadership: Don’t blame your minions, read on to find out why

Whether you are in the UK, and interested in the UK health system or not, you currently read about it every two weeks courtesy of my musings. This week I am intrigued by Prime Minister Rishi Sunak’s approach to evolving NHS wait times.

In January 2023 Sunak reportedly said, “NHS waiting lists will fall and people will get the care they need more quickly,” a promise he has unsurprisingly, considering the challenge, failed to deliver upon.

What is surprising, however, is that in an article by Chris Mason, published on the website on the 15 September 2023 Mason writes this about Sunak’s self-assessment on performance against goals: according to Sunak “the government was making “very good progress” before the strikes. And without them, he (Sunak) reckons, he would have kept his promise”. Link.

In not so many words Sunak lays the blame for his failure at the feet of junior doctors and consultants who are going on strike for a pay rise.

To quote Chris Mason: “It sets up an invitation for you to decide who you blame: Medics on picket lines or the prime minister?”

The NHS, a cornerstone of UK health, has faced criticism for years. From long waiting lists for treatment and prolonged A&E wait times to a scarcity of healthcare professionals—a situation worsened by Brexit. News articles recounting infant deaths and subpar clinical care in numerous trusts bear testimony to the system’s struggles. The system cannot be fixed without the help of the healthcare professionals, naturally the strikes are impacting NHS wait times, but the strikes are not the reason for the wait times. The junior doctors did not break the system.

What is astonishing in a situation as clear cut as this is that a leader would attempt to shirk accountability. When leaders fault juniors instead of leading them to find solutions, they show their true limitations as a leader. Moreover, if such behavior is evident in clear-cut situations, it likely reflects a habitual approach, which does not foster trust.

Key takeaway: How you treat others says a lot about you: never blame your minions.

Thank you for reading, I enjoy sharing my thoughts and I love hearing what piqued your interest or any feedback and thoughts. If you are currently working on a demanding project in the fields of medical, digital, systems, analytics, channels, or facing any team or personal challenges, feel free to reach out to me for an informal chat. I am always happy to explore how I might be able to support you.

Best wishes

Isabelle C. Widmer MD

Photo Credit: Francisco Venancio @ Unsplash