Global Health & Digital Innovation Foundation

S4 Ep9 on The Startup Sensations Podcast, and we're 'Revolutionising Healthcare' with major player in the emerging health tech ecosystem, Dimitrios Kalogeropoulos, PhD. We learn about his passion for transformative innovation which is both revolutionary, and grounded in pragmatic steps towards equity, inclusion, and resilience. Bulent and Shelley find out about his role as Founding Director of the Global Health & Digital Innovation Foundation, and chat about the following key topics: ◆ The Role of AI in Transforming Healthcare Delivery ◆ Challenges and Opportunities in Global Health Collaboration ◆ The Impact of COVID-19 on Health Systems and Future Preparedness ◆ Navigating Regulatory Hurdles in the Health Tech Startup Scene Listen on Spotify https://lnkd.in/e2_WkNpS, Apple https://lnkd.in/eqiWi6CM, or wherever you get your podcasts. #startup #podcast #startupsensations #healthtech #founders

The truth about the state of healthcare data in Europe Fragmentation is a major health policy concern in Germany. The incentives for change are substantial. Integrated care improves the quality of care, patient experience, safety and health outcomes. At the system level, integrated care can make health systems more resilient and mitigate costs. Integrated care, initially perceived as a healthcare provision matter, is fundamentally about health data governance, shifting the focus from the continuum of care to the continuum of health data. Despite decades of political efforts, intersectoral care and health data integration in Germany remain controversial and underdeveloped. Neo-liberal corporatism, particularly the financing system that sustains the current healthcare governance model, plays a significant role. The fee-for-service model delays the adoption of innovations that are not yet reimbursed and require negotiation for reimbursement. This contrasts with hospitals, which benefit from the experience of the DRG payment system. ⏹ To achieve progress, a new problem-solving framework is needed. This approach should leverage the commitment of healthcare providers through clinical problem-solving, rather than adopting a centralized digital health solution. Overcoming the silo mentality requires incentives for collaboration, shifting the focus from volume to value and from disease-orientation to person-centred care. Integrated care payment schemes, such as bundled payments, encourage healthcare professionals to share financial and clinical responsibility for an entire episode of a patient's care. These schemes support a health system focused on patients' needs and make the best use of medical data. Policies fostering collaboration, such as the introduction of bundle-DRGs, as a useful instrument for person-centred care are crucial. ⤵ What we think While the reasoning behind integrated care is important, there are valuable lessons to be learned from the quasi-failing efforts in the US and the UK. These experiences underscore the necessity of a holistic approach to integrated care. We have a unique opportunity to enable change using telehealth and AI. By adopting an inclusive, data-coupled, and community-driven approach to collaborative innovation, we can achieve integrative data governance. This will facilitate seamless data sharing that reflects the context, quality, and continuity of care. Creating platforms and standards that empower all users is essential. This approach will foster innovation for prevention, promote sustainable economic development, and strengthen resilience within health systems and communities. I would love to hear what you think. https://lnkd.in/dkRczimV #EHR #HealthcareInnovation #Telehealth #AI #IntegratedCare #DataGovernance #EU #EHDS

Is a Workcation Something You Need? I love workcations. I take a workcation every summer, combining work with a vacation. This summer, however, this tradition has been disrupted for several practical reasons, prompting me to reflect on its significance in my personal and professional life. I find myself asking: Is the workcation fueling workaholism? Do I just never stop working? Or do I take these workcations by design because they genuinely benefit me both personally and professionally? Firstly, let me clarify one thing: Professionally speaking, workcations are incredibly productive! Think of them as a writer's retreat. They provide the space and freedom from distractions needed to focus on important issues, whether it's designing a new product, researching a review paper, strategizing, or course-correcting. Workcations are about maintaining sanity. They foster creativity and decision-making that isn't influenced by the invisible peer pressures of everyday work life or the doubts that constant responsiveness creates. Decisions and reflections during a workcation are pure and sane, free from second-guessing. By providing an environment conducive to deep thinking and creativity, workcations can help you achieve clarity and produce high-quality work, making them a valuable practice for anyone looking to combine productivity with rejuvenation. However, it’s essential to remember that these are workcations. The vacation part is a significant source of everything that makes workcations what they are. To ensure a healthy balance, work should occupy no more than a couple of hours each day. Mornings are great for productivity—researching while having breakfast works well when the mind is rested. After that, close the laptop and let the work brew, fostering fresh ideas for the following day. In the afternoon, you can arrange crucial meetings, but keep them relaxed and limited to what's necessary for your morning work context. After all, it is a holiday. Or is it not? I hope you enjoy your summer workcations and find them as beneficial as I do. Whether it's a stunning beachside office setup, a mountain retreat that sparked creativity, or simply the balance you found between work and leisure, I'd love to hear about it. Your insights and stories can inspire others to explore this wonderful way of working and vacationing. Enjoy Your Summer! #LinkedInInsiderUK #LinkedInNewsUK

Is the Evolution of Functionally Aggregated DHTs essentially an Ecosystem Challenge? The authors observe a phenomenon of "aggregated intended purposes" of digital health technologies (DHTs), or "device-aggregates," increasingly being applied in groups of clinical tasks and sub-tasks, from the perspective of regulatory approval. At the highest level, 'super device' aggregates or device suites may be 1) coupled to form loosely defined parts of digitally integrated care pathways, such as hospital-at-home, or 2) cascaded serially. Other pathways are participatory care and patient navigation pathways, and AI-powered anticipatory care pathways are important. This two-article analysis is significant because it highlights the gaps and key issues of regulatory, HTA and reimbursement aspects of data-coupled collaborative innovation. 🔷 Regulatory: Authors note the evolution from passive to active groupings. From cascaded effects to networked, interconnected devices with dynamic dependencies and combined effects that need to be regulated as such. The emergent "super devices" reduce human intervention, necessitating airtight regulation, especially considering the inclusion of non-MDs which are deregulated. Interpreting EU regulations, the “lead” manufacturers of super-MDs (SMD) would be responsible to obtain approval for all components, which could be impractical given their non-manufacturer status for some. 🔷 Reimbursement: Gathering cost-effectiveness evidence introduces new complexities. These include the absence of comparators and the complex estimation of initial investments. Ongoing performance monitoring might solve part of the problem but in the absence of evidence ecosystem standards this will be highly impractical. 🔷 Inclusive evidence: In addition to regulating emergent system properties that arise in interactions, building, testing and evaluating super-MDs in primary care and public health settings and pathways is a limitation. Part two observes the following modalities: 1️⃣ Single manufacturer develops and seeks approval for SMD/components to perform a specific function.   2️⃣ Multiple manufacturers develop approved components brought together and placed on the market by a single commercial entity. 3️⃣ Multiple manufacturers develop approved components brought together and placed on the market as a service provided by a single commercial entity. 4️⃣ Multiple entities brought together flexibly and dynamically and possibly also automatically. As (4) points to a collaborative innovation ecosystem, an overarching challenge emerges: the requirement for regulatory and HTA pathways built on evidence sandboxes and regulated evidence ecosystems, leveraging data frameworks for data governance such as IEEE’s P3493.1™.   PART-1 https://lnkd.in/dv78qpnK PART-2: https://lnkd.in/dVrCN24w #HealthcareInnovation #DigitalHealth #InnovationEcosystem #MDR #SaMD #RegulatoryPolicy #HTA

On Digital Inclusion, Health Equity and Justice The narrative that digital health can democratize healthcare through patient empowerment is challenged by evidence highlighting risk of intersectional harm. The current discourse focuses predominantly on individual empowerment, often through mere access to technology and absence of interference. This perspective lacks public health perspective and places undue emphasis on individual responsibility for health outcomes. ⏹ The prevailing neoliberal approach to ‘healthcare optimization’ is burdensome and unfair. Evidence suggests that much of digital health currently perpetuates and magnifies unequal health outcomes and health inequalities in already structurally disadvantaged and oppressed populations. The impact of underrepresentation in AI adoption is challenging. 1️⃣ A recent large‐scale study has shown that AI working with medical imaging data sets fails to deliver correct diagnosis in women, owing to the over‐representation of male data in publicly available X‐ray image databases and deep neural network architectures. 2️⃣ The distortion in data that begins at the clinic continues through the healthcare referral process. Research on skewed data sets in mammography screening reveals that clinicians spend less time with socioeconomically disadvantaged and negatively racialized women. Consequently, these women are less likely to be referred to specialists, and their diagnostic images often do not reach databases used to train machine learning systems. The absence of this training data disproportionately impacts these populations, as algorithmic discrimination exacerbates the risk of adverse outcomes for underrepresented groups over time. 3️⃣ Research on medical AI has identified that black Americans with sickle cell anemia have been over‐diagnosed and needlessly treated for diabetes based on data from clinical studies that exclude them. 4️⃣ In radiology, negatively racialized patients have been under‐diagnosed and thus deprived of health care. Alarmingly, research has shown that algorithmic discrimination in medical AI has deprived millions of black patients of access to health care in the U.S., as instead of interpreting their health data, an algorithm was inferring their diagnosis based on their lower health spending, which was in itself lower due to racial discrimination and the lack of referral of negatively racialized patients to specialists. ▶ In decolonising digital societies, support is needed for the development of digital health that serves communities under their own leadership and in line with requirement to safeguard data sovereignty. This requires a new approach focused on redressing harm and investing in community-driven health innovation. Hendl T, Shukla A. Can digital health democratize health care? Bioethics. 2024 Jul;38(6):491-502. doi: 10.1111/bioe.13266. I would love to hear your thoughts! #DigitalHealth #BioEthics #AI #HealthcareInnovation #HealthEquity

Your are invited to join IEEE P3493.1™ I am thrilled to extend an invitation for your participation in the Working Group P3493.1™ to develop a Standard Framework for Secure, Compliant, Coordinated, and Inclusive Healthcare Data Recycling (HDR). HDR facilitates the coordinated sharing of comprehensive clinical data throughout the patient care experience, helping to ensure the development of a cohesive data set reflective of care context and outcomes. Why Get Involved? The lack of harmonisation in regulatory policies and standards within the rapidly expanding mHealth/telehealth innovation landscape represents a missed opportunity to improve the quality, population coverage, and diversity of datasets essential for building robust and trustworthy AI. Addressing disparities from biased datasets requires bridging innovation gaps with integrative data governance standards, enabling seamless digital collaboration. This fosters fair representation and inclusion in datasets, improving access to care and ensuring safer AI use. Leveraging telehealth can provide shareable insights reflecting care quality and continuity throughout the patient journey, empowering users from diverse backgrounds in an inclusive, community-driven environment. However, the absence of widely adopted standards for data repurposing poses challenges, impacting privacy, transparency, and data quality. These issues affect various healthcare aspects, including clinical trials, regulatory processes, and the development and evaluation of digital health interventions and AI applications. JOIN TODAY! Express your interest in becoming a part of this working group, receive details on balloting, and get notifications related to the project. Join the interest list here: https://lnkd.in/dny7zMPy Kick-Off Meeting: DATE: 7 August 2024 TIME: 10:00am EST Let's work together to shape the future of healthcare data standards and drive innovation in digital health!

I am delighted to be speaking at the 3rd Family Office Investment Summit in Rome, Italy. Join me on September 24-25, 2024, for an exclusive two-day event gathering the region's top family offices. Together, we'll explore the evolving role of AI in investment strategies and rethink innovation funding in the era of rapid AI advancements. I'll delve into how systems capital in healthcare can bridge innovation gaps, benefiting patients and the health workforce alike. By diversifying investments to include AI, we can significantly enhance operational efficiencies in healthcare and life sciences. Systems capital creates a fertile ground for AI and other advanced technologies, fostering synergies and maximising returns on investment. Don't miss out on this opportunity to learn and network with industry leaders. Looking forward to seeing you there! For more information: Alea Global Group 🌏 https://lnkd.in/dwzCbAyQ #AI #DigitalHealth #InnovationInHealthcare #FamilyOffice #InvestmentSummit #Rome2024 #PrivateEquity #VentureCapital #ImpactInvesting #WealthManagement #HealthcareInnovation #SystemsCapital

On the Need to Build Syndemics Evidence Ecosystems The Covid-19 pandemic has transformed our understanding of disease dynamics, highlighting the importance of the term 'syndemic,' introduced in 1992 to describe synergistic interactions between co-occurring epidemics. This concept has gained renewed focus due to Covid-19’s interplay with other conditions, revealing stark disparities in morbidity and mortality among different populations. 🔷 People with pre-existing conditions such as cancer, diabetes, and HIV, particularly in lower-income countries, have shown an increased risk of severe Covid-19 outcomes. Factors such as weakened immune systems and the inflammatory pathways associated with these conditions exacerbate these risks, further compounded by social and political determinants of health. For instance, musculoskeletal conditions have been linked to higher Covid-19 fatality rates in lower-income countries, potentially due to inadequate existing care and chronic inflammation. 🔷 Understanding the emergence of these clustered epidemics, or syndemics, is crucial for developing effective intervention strategies. Syndemic thinking necessitates a shift in clinical practice and a transformation of the models and evidence ecosystems that underpin digital health and Artificial Intelligence adoption. It requires a holistic approach, considering how conditions such as social distress and chronic stress can undermine medical interventions for co-occurring conditions. 🔷 To address this, protective factors such as community support groups, social support networks, cultural resources, home visits, and mental healthcare must be integral to syndemic interventions. Future efforts should aim to integrate these multi-faceted influences and evidence into clinical care and digital health pathways, promoting health and wellness throughout individuals' lives. 🌏 https://lnkd.in/dgr4BNCw Mendenhall E, Kohrt BA, Logie CH, Tsai AC. Syndemics and clinical science. Nat Med. 2022 Jul;28(7):1359-1362. doi: 10.1038/s41591-022-01888-y. #Syndemics #PublicHealth #DigitalHealth #MentalHealth #Covid19 #AI #DiseaseModels #DiseasePhenotyping #ClimateHealth #EvidenceEcosystems #InnovationInHealthcare #Prevention

Understanding the ethical and legal implications of implementing digital health autonomy for early detection and screening: The oesophageal cancer (OC) use case ⤵ This post follows my last, giving an example of the implications of regulatory practices on innovation relating to risk prediction in primary care and public health, making use of digitally integrated patient pathways. OC is a well-suited application domain as it has significant morbidity and mortality, with late diagnosis being common due to the frequent misinterpretation of early signs of disease. The project aims to facilitate earlier detection through ‘targeted screening’ of patients registered with a GP, using data not typically accessible to GPs. The approach involves assessing risk factors for Barrett’s oesophagus, including prescriptions for acid-reducing medications, combined with a non-invasive, low-cost sampling device (NSD). The authors suggest that incorporating additional data sources, such as antacid sales linked to loyalty card information and self-reported symptoms of disease (gastro-oesophageal reflux), could effectively identify at-risk individuals in the wider population (by engaging patients in digital peri-interventional support). ⏹ The project tests a primary care option using mobile screening sites in three locations with different social determinants of health. At each site, patients self-refer for a NSD if they meet criteria like dyspepsia symptoms and medication use. Although the number of self-referred patients was small, a consistent proportion was eligible for follow-up endoscopy. This suggests the feasibility of a digital-first pathway involving NSD screening without prior GP referral (thus easing the workload on clinicians). Yet, embedding personalized prevention strategies and pathways for Barrett’s oesophagus/ OC in primary care (and ultimately public health) poses significant regulatory challenges. Successful implementation involves several challenges, including equitable implementation when using #AI to incorporate genomics into robust risk tools. ⏹ For the public health modality, deploying these tools for public use faces additional regulatory obstacles, despite the potential to improve detection and outcomes, as the tool is now intended for medical use and qualifies as a medical device under EU/UK MDR. Civic engagement strategies are required. This poses significant implementation barriers despite the fact the approach offers access to an evidence ecosystem that allows testing the safety and efficacy of the screening methods, affecting overall uptake. Understanding cost-effectiveness for different patient pathway elements is crucial for building trust and influencing uptake, eventually also enabling uptake in the modality of civic engagement, digital health autonomy and scaled innovation, rather than integrating into existing clinical pathways. https://lnkd.in/dvysACuu #DigitalHealth #Regulation

Applying the principles of adaptive leadership to digitally enable and enhance person-centred care (PCC), innovation and regulation "Prescribing a new treatment or self-management regimen may be unsuccessful in achieving the desired outcomes unless clinicians take the time to understand their patients’ needs, co-develop a workable plan and inspire change through enabling, ongoing and trusting relationships." Leadership in these relationships requires collaboration and adaptability, and these cannot be achieved or meaningfully implemented without the ability to empower patients that engage and participate with digital health autonomy (DHA). DHA means equity of access is improved and hence diverse outcomes can be integrated into decisions, embracing learning health systems that explore the experiences of all patients during peri-interventional intervals. A digital approach to adaptive leadership helps implement complex engagement-communication channels with adaptive conversation, observation, interpretation, and intervention (COIIN). The latter are N-of-1 trials, personalised to adapt over time. Interventions should be clearly connected to a shared purpose and consider all available resources. Just-in-time adaptive interventions (JITAI) emerge to provide important shared insights in real-world settings and within previously unidentified cohorts. Addressing adaptive challenges in an evolving context of care requires embracing technologies such as AI, that effectively bridge innovation gaps, particularly the peri-interventional COIIN gaps widened by precision medicine, shifting delivery channels further upstream, necessitating digital collaboration and involving patient communities. The concept of PCC and the adaptive challenges created highlight the need to extend beyond traditional acute care systems and improve the efficiency of technologies used to understand disease and treatment impact. A digitally enhanced approach mitigates unreasonable demands on healthcare professionals and reduces patient risk. A PCC approach to disease management, especially in the context of multimorbidity, relies on access to evidence ecosystems that support problem-oriented thinking and patient participation in bridging innovation gaps. Data standards are essential not only for interoperability between medical records but for maintaining multiple interacting clinical contexts with ecological validity along the patient experience. Integrated care is enabled by integrative data standards. Equally central is the concept of patient-centred access, i.e., to expand access to care with equity, identifying and using a breadth of access improvement opportunities with digital technology designs that support adaptive processes. Adaptive leadership is crucial as it can weave together technological approaches to complex clinical challenges. I would love to hear your thoughts! https://lnkd.in/dk-8Z3Ag #DigitalHealth #Leadership #AI #InnovationInHealthcare