Dr. Videha Sharma: designing for prevention through genetic testing

Dr. Videha Sharma—NHS doctor, clinical innovation lead at the University of Manchester, and co-founder of Fava Health—joins host, Sam Menter from Healthia®, to explore how prevention-focused care, human-centered design, and genomic insights can reshape healthcare.

Dr. Sharma offers a unique perspective on the power of tailoring treatments to an individual’s genetic profile, shedding light on how this can help reduce adverse drug reactions and improve patient outcomes. From designing better digital tools and workflows, to ensuring clinicians and patients benefit from more coordinated data, this conversation shows how design-led thinking can drive change in the health system.

With examples drawn from Dr. Sharma’s frontline clinical experience and his work in digital health innovation, this episode offers valuable lessons for anyone looking to build a more proactive, patient-centred healthcare system. 

Whether you’re involved in service transformation, curious about integrating genomics, or simply passionate about prevention, this conversation uncovers practical and thought-provoking takeaways.

Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for health, care and public services.

Find out more about our work at healthia.services.

Episode Transcript

SPEAKER_01 (00:00):
Hello, this is Problems Worth Solving, the
podcast where we meet peopletransforming health and care
through human-centered designand digital innovation.
I'm Sam Mentor, ManagingDirector at Healthier, the

(00:21):
collaborative service designconsultancy.
If you enjoy listening, you cansubscribe to this podcast and
the accompanying newsletter athealthier.services.
Today, I'm joined by Dr.
Vidaya Sharma.
Vidaya is a practicing NHSdoctor.
He's clinical innovation lead atthe University of Manchester.

(00:42):
He's co-founder of Fava Health,where he's using genetics to
personalize medicineprescribing.
He holds a PhD in healthinformatics.
And on top of that, he's agraduate of the NHS Clinical
Entrepreneur Programme.
Suffice to say, if you'refeeling like an underachiever
right now, you're not alone.
In this episode, we'll beexploring Videa's fascinating
journey from transplant surgeryto technology and innovation.

(01:05):
We'll discuss his groundbreakingwork in pharmacogenetics, which
promises to reduce adverse drugreactions and improve treatment
outcomes by tailoring medicinesto patients' genetic profiles.
We'll also discuss thedesign-led approach that Videa
has been applying across hiswork in transplant care and in
driving genomic medicineinnovation.
Videa, it's an absolute pleasureto have you here.

(01:25):
To kick things off, could youtell us a bit about what first
drew you to medicine and howthat journey has evolved into
the work you're doing now?

SPEAKER_00 (01:31):
Hi Sam, thank you so much for having me and thank you
for the kind introduction.
Really excited to be here.
I am originally from theNetherlands.
I'm from Rotterdam, but I'm nowbased in Manchester in the UK.
I first came to the UK to studymedicine and I trained as a
surgeon.
and did my rotations around thenorthwest of England.

(01:52):
I was first attracted totraining as a doctor and
medicine generally, mainlybecause I have a younger brother
who has special needs or alearning disability and autism.
So growing up with him, I alwaysobserved him being looked after
by health professionals as wellas social care professionals.
And that really attracted me tothe idea of being able to help

(02:15):
people and make a difference topeople's lives.
And that was something thatstayed with me throughout my
formative years and drew me to acareer in healthcare.
Following studying medicine, Ihad a very traditional medical
career.
I was very much focused, as manyof my clinical colleagues are,
on going through the medicaltraining program.

(02:35):
I trained as a surgeon, morespecifically as a transplant
surgeon, and I there are as youcan imagine various exams and
competencies that anyone that'straining in these fields has to
go through and I was veryfocused on achieving those and I
didn't really experience muchoutside the hospital I loved the
on calls the nights the weekendsthe organ donation you know all

(03:00):
of those kind of unscheduledemergency experiences and that
was really my world that Ididn't really know any different
and I loved it for that reason Ididn't really think I wanted to
do anything different or didn'treally think of any other
careers or opportunities for mein hindsight is because I wasn't
really exposed to anything elseso as soon as I finished medical

(03:20):
school I straight went into thismedical career and didn't really
experience anything outside ofthe hospital really and that was
the case until I did a PhD and Iwas reflecting as a now senior
clinician on the fact that I wasregularly using technology and

(03:41):
IT systems as part of myeveryday work.
As much as I was seeing patientsor delivering clinical care, a
lot of my time was spent oncomputers, logging things on IT
systems.
And as I'm sure many healthcareprofessionals that work in the
NHS will have experienced, a lotof these systems do not meet the
needs and requirements of theend users.
So fueled by that problem area,I wondered whether there was

(04:03):
something that I could try tolearn about and contribute to
that space.
As I was Realizing that I wasusing technology increasingly as
part of my daily practice, Idecided to do a PhD in health
informatics and really try tounderstand why are these systems
not meeting our needs andrequirements?
Why are they not able to allowus to deliver care in an

(04:24):
improved way as we experiencelots of other digital products?
My PhD really focused on how dowe therefore design and develop
IT systems that are better atdelivering care across
organizational boundaries.
And that's because modernmedicine and modern healthcare
is not delivered out of singlecare settings or single

(04:45):
organizations.
And we could talk a little bitmore about what we learned
through that PhD during thecourse of this conversation.
But that really allowed me tobecome an expert in this thing
called interoperability.
So how do you get IT systems tospeak to each other?
And during my PhD, I alsolearned a lot about design,
which for me has becomeincreasingly part of my daily
work now.

(05:06):
And that brings me on to mycurrent role, which is being a
clinical innovation lead, whereI try to support researchers or
startups or even largerorganizations to translate their
ideas, research innovations intoreal world products or services
that can help patients within ahealthcare setting.
We're also trying to build ourown little startup where we're

(05:27):
trying to use genetics topersonalize medicines for people
and trying to make medicinesmore safe and effective um as we
try to make um healthcaresystems more modern and give
people a more individualizedexperience

SPEAKER_01 (05:42):
so you've built up an incredible suite of
professional skills as you'vegone through your career i'm
really interested in that movethat you've made from surgery
into technology and into designum To understand that a bit
more, I'd really like to learnabout what's it like when you're
working as a surgeon?
What did you enjoy about it andwhat were some of the
challenges?
What prompted you to move onfrom working as a surgeon?

SPEAKER_00 (06:05):
I think it's really different practicing as a
surgeon compared to practicingas a researcher or innovator or
as a designer.
And I think particularly asmedicine has become more
popular, complex, as thepatients we care for have got
more multiple diseases at thesame time, the challenges are

(06:29):
really quite varied.
And I think as time has gone on,perhaps there is an increasing
need to blur the lines betweenhealthcare professionals and
designers, because now some ofthe challenges are that complex
that you really need to start tothink differently.
I think one of the reflectionsthat I often think about is as a
doctor, as a As a medicalstudent, you know, we are taught

(06:53):
as soon as the patient walksinto the room, you try to
analyze them from top to toe,look for any clues that might be
able to help you identify whatcould be going on with this
person.
Changes of their nails.
Do they have any scars anywhere?
Do they walk in a particularway?
Who have they brought with them?
Almost like a Sherlock Holmes,you try to as quickly as
possible go from a list ofdiagnoses to a single diagnosis.

(07:15):
diagnosis as quickly as possibleand you really have that kind of
narrowing down looking down amagnifying glass type way of
thinking and that works reallywell when you're trying to make
a diagnosis if you know one ofthe things that doctors would
aspire to would be able to makea diagnosis on the spot just by
looking at someone somethingcalled a spot diagnosis that was

(07:35):
you know that's what you'reaiming for and in that pattern
of thinking you're encouraged togo with your assumptions.
Common things are common is aphrase that's often used.
And that is, again, fine ifyou're trying to go from a long
list of things to a singlediagnosis as quickly as
possible.
But if you're trying to solvecomplex, knotty problems like

(07:56):
how do we improve efficiency inan emergency department?
How do you reduce costs in anadministrative setting?
How do we make medicines moresafe or effective?
These are not problems that lendthemselves to thinking in that
narrowing down way, we need tothink like designers.
We need to think aboutbroadening our horizons.
We need to think about engagingthe people that are affected by

(08:17):
the problem, either thehealthcare professionals and all
the patients and bring them intothat thinking problem
understanding process before weeven move on to solution.
So as I started to learn aboutthe double diamond and started
to learn about various designframeworks, I started to
realize, gosh, these are reallyvaluable things that are
completely new to me, but arereally relevant to the problems

(08:40):
that we face in healthcare.
And how do we work togetheracross healthcare professionals
and designers to be able totackle these problems?
Because in isolation, certainlyhealthcare on its own will not
be able to solve these problemsin the same way.

SPEAKER_01 (08:53):
Vidaeus, some of the people listening won't know, for
example, what the double diamondis.
Can you give me a little exampleof how that's relevant to the
work you're doing and what thedouble diamond is?

SPEAKER_00 (09:02):
Sure.
So the double diamond is aframework for problem solving
and it describes a startingpoint where you've got a problem
area and what traditionally, andwe continue to do this, sadly,
in healthcare and othersettings, is that people will
often go from a problem straightto a solution.
I say, for example, to try toput some context to it, the

(09:25):
waiting times in A&E are toohigh.
We need more doctors.
Problem is, waiting times arehigh.
Solution, we need more doctors.
And people will jump to thatconclusion and might even go as
far as writing a business case.
They might even go as far ashiring more doctors to try to
solve this problem that theyhave concluded is there.
And with a double diamondsolution, framework encourages
thinkers or problem solvers todo is to say well before you go

(09:48):
down that path take a pausebroaden your thinking speak to
the people that are affected bythat problem immerse yourself in
that world spend a day in theemergency department see what's
happening try to understand whatthe other interdependencies of
an emergency department could beand really broaden your thinking
before you narrow down on what'scalled a problem statement or
narrow down to what the core ofthat problem is so for example

(10:10):
again if we go back to ouremergency department situation
if you went through that processof understanding the problem,
what you might realize is at theend of that process is, gosh,
actually, it isn't the fact thatwe haven't got enough doctors.
The problem is that the wardsare full.
And the reason why the wards arefull is because they're not able
to discharge patients.
That's why the waiting times inA&E are high.
You can increase as many doctorsas you want, but you're not

(10:32):
going to solve the problem thatyou're hoping to affect.
Then the second part of thedouble diamond, again,
encourages us to rather thansaying, okay, now that we've
figured out that the problem isthat there were waiting times in
the ward and patients not beingdischarged, again, rather than
jumping to a solution, again,take a moment of pause and say,
gosh, there could be multipleways of solving this problem.

(10:54):
Let's try out different ways.
Again, let's speak to the peoplethat are affected.
Now we're not speaking to peoplein the A&E department.
Now we're speaking to people onthe ward because that's actually
where the problem lies.
So now let's immerse ourselvesin that world and work with
those people to try tounderstand what potential
solutions could be and prototypeand test and ideate before we
then finalise on a solution thatwe can then implement.

SPEAKER_01 (11:13):
You talked about how different that is from the
approach you would take as aclinician to a medical problem.
Did you find that transition,that mindset, difficult to
change having gone throughclinical training?

SPEAKER_00 (11:25):
Yeah, absolutely.
I still struggle with it.
I had a great conversation withsomeone at a UX conference a few
years ago where they said, as adesigner, when they enter a
conversation with a client orwith an end user, they try to
enter that conversation as ablank slate.
They leave all their biases, tryto leave as many biases, as much

(11:46):
of their prior knowledge behindas they enter that conversation
and try to be as open andreceptive as possible.
This person said to me, but youas a doctor, whenever you have a
conversation with people, Peopleexpect you to have all the
knowledge and all the expertise.
That's why they're engaging intoa conversation with you.
And that's the mindset thatyou're in, that you are there
with the answers as opposed towith the questions.

(12:06):
So I thought that was reallyinteresting.
And I still am transitioning.
So when I try to put on mydesign hat, I am really
conscious of trying to leave mybiases behind and my prior
knowledge behind.
What I will say, and I don'tknow whether this is
self-complimentary or whatever,but I do wonder whether having

(12:27):
some of that background medicalknowledge does allow me to
potentially ask better questionsor does allow me to perhaps lead
a design practice that is morefocused and is able to get out
needs and requirements inpotentially different ways
compared to someone who did nothave any healthcare experience.
So I'm trying to combine thosethings and trying to make them
into a synergy as opposed toreally necessarily see them as

(12:49):
clashes.

SPEAKER_01 (12:51):
So you still work as a surgeon, but you're doing lots
of other things now.
I'm interested in what promptedyou to start doing other things
and move on to that focus.

SPEAKER_00 (13:01):
Lots of sleepless nights, lots of talking to
mentors, lots of getting adviceand other people who have had
these more diverse or portfoliotype careers.
Really wasn't easy to make thatdecision.
As I said, I was very focused onmy clinical career and it's not
common for doctors or surgeonsto deviate from that really

(13:22):
well-trodden path.
And that's combined with thefact that there isn't really a
alternative, well-delineatedpath pathway for healthcare
professionals to do differentcareers.
Having said that I also verymuch appreciated the opportunity
to be able to apply some ofthese additional skills that I

(13:42):
had learned so whether that'stechnology whether that's design
and try to have an impact notjust for individual patient care
but at scale and that'ssomething that really excited me
and really attracted me so thatwas one of the big drivers for
me wanting to diversify mycareer.
Having said that it stillrequired lots of reflection,
lots of introspection to be ableto make that leap.

(14:03):
And currently I'm able tocombine things.
So I still work as a clinician,maybe once a week or once every
two weeks for a day.
I mainly do outpatient clinics.
I don't operate much, or even ifI do, I usually just assist or
help senior colleagues out asopposed to lead operations.
I don't think that's quiteright.
So I'm still able to balanceseeing patients and This way, I

(14:25):
almost treat my clinical days asa day of user research.
a day of being able to speak tothose on the clinical front line
that are seeing patients day inday out to understand gosh what
are your challenges these dayswhat are your problems and be
able to even take some of theideas or innovations that we're
working on and say gosh we'reworking on genomics personalized
prescribing have you ever heardof this before do you think

(14:46):
that's relevant to your practicewhere do you think the nhs is up
to with that and that's a reallyuseful real world feedback that
i'm able to gather on a regularbasis which again is a bit of a
unique situation to be in to beable to do that

SPEAKER_01 (14:59):
do you I think that the way you approach those days
has changed since you've beendoing more work around design
and the double diamond and thatside of things.

SPEAKER_00 (15:07):
Absolutely.
On the one hand, I really lookforward to these days because,
as I said, I still love seeingpatients.
I still love engaging in thehealthcare setting as a
healthcare professional.
But at the same time, I do kindof walk away from those days
thinking, gosh, you know, I amenergized to go and do my
innovation work because there isstill so much more that we can

(15:29):
improve here.
The systems that we use, theprocesses that we have in place,
there's still a lot of workthat, you know, people like
myself or you, you know, peoplethat bring different skills can
really make a positive impact onhow healthcare is delivered.
And that is not just beinghealthcare professionals.

SPEAKER_01 (15:46):
So this podcast is called Problems Worth Solving,
and we try to find people whoare driven to solve problems in
the system or in healthcarethrough their work.
I'm interested in how you wouldsummarize the problem that
you're trying to solve throughyour work and why it matters to
you.

SPEAKER_00 (16:00):
Certainly from my experience from my PhD, the
problem that I very much focusedon was this challenge that we
have healthcare experiences,whether that's as people that
deliver care or people thatreceive care that feels
disjointed where not all theinformation for decision making
that's relevant to that timepoint is available and that is

(16:23):
really by and large technologyand design problem because we
have some of these it's not evena technology problem it probably
is more of a design problembecause we have a lot of the
technology to be able to sharedata or move information around.
We obviously all have smartdevices.

(16:44):
We use technology and data atall time and we have various.
And in fact, that's how my wholePhD started.
It started this conversationbetween me and my transplant
professor, Professor Augustine.
And we were talking about thefact how we have iCloud and we
have our photos in the cloud andthe fact that we're able to
move, you know, go from oneaccount to another account, the

(17:05):
fact that our photos are alwaysthere.
And this is the time that wewere completely technology
naive.
So a good four or five yearsago.
So I learned nothing abouttechnology at that point.
And I said, gosh, how is itpossible that we've got all of
this stuff in the cloud and theIT system is not able to talk to
each other.
We get a referral from ahospital down the road and it's
sent via email or faxed over orsent to the post and things like

(17:26):
that.
So we just said, gosh, we justneed to stick it all in the
cloud.
That the solution.
You know, again, like I said,this is pre-learning about how
to think about problems, how tosolve problems better, jumping
to a conclusion and saying,yeah, we just need to put it all
in the cloud and then we'll beable to solve the problem and
then we'll just have all thedata wherever we need it and
we'll be able to deliver bettercare.
And with that kind of idea, wewent to one of the health

(17:49):
informatics professors at theUniversity of Manchester to say,
yeah, we just want to puteverything in the cloud.
And he was very kind to humor usand say, okay, I can see this is
certainly a problem worthsolving.
or thinking about.
I don't think that you'll beable to put everything in the
cloud, but why don't you comeand do a PhD?
You can learn more about thisproblem.
And that was a great experience.
So I think trying to understandhow do we move away from this

(18:12):
more siloed way of managinghealthcare data to a way where
we manage healthcare data soit's available across systems,
settings, organizations issomething that I'm extremely
passionate about.
And yeah, I think one of themain ways that we found that
you're able to do that better isif you start to think about This
phrase that people may haveheard before, but this phrase

(18:35):
separating the data from theapplication.
So currently what happens isthat each IT system will have
the data locked within it allthe way through from the
database all the way to the userinterface.
Whereas a more contemporary ormore modern approach would be to
say, well, the data is stored ina vendor neutral or in an

(18:56):
agnostic way.
fashion.
It's stored separated from thedifferent applications where
that data might be used.
And then you start to movetowards an ecosystem where
people can develop and designuser interfaces or applications
that meet more specific needs orrequirements or feeding off the
same data.

SPEAKER_01 (19:12):
So just taking a step back, you're working as a
transplant surgeon and Thatworld, I don't know much about
the transplant world.
It sounds complex.
You know, you have donors, youhave recipients, there are
surgeons, administrative staff,there's lots of communication
and lots of information thatneeds to move around.
Can you tell me a bit about themechanics of that world and how

(19:34):
that relates to the work thatyou were trying to solve through
your PhD?

SPEAKER_00 (19:38):
So transplantation, like many other services, and I
work specifically in kidneytransplantation, is delivered
out of specialist centers.
So what that means is that therewill be one single large
organization which deliverstransplant services but it will
serve a large geographic areaand multiple regional hospitals

(19:59):
which will refer patients inthis is sometimes also described
as a hub and spoke model of careso for example in the uk we have
22 23 transplant centers but ofcourse we have well over 70 or
80 kidney units where peoplewith kidney disease are being
seen and all of these then feedinto these lesser number of
transplant centers And this isthe case for many other

(20:21):
services.
So cancer services arespecialized or some certain
surgical services arespecialized.
So this experience of referringpatients across organizations is
really common.
For us specifically inManchester, we have our own
local unit and then we have twoother large referral centers.
And what we used to find is thatthe number splits about a third

(20:42):
across each of the centers.
But of course, our referralsthat would come internally would
be quite streamlined.
They would maybe be referredelectronically.
There would be lots ofinformation about those patients
like test results or previousletters or previous diagnosis
that we'd be able to accesseasily.
But patients that were referredfrom the other hospitals would

(21:02):
require the local teams to postus information at a certain time
point or indeed fax us.
pieces of information and moremodern in the last few years
maybe attach a pdf to an emailthat was as cutting edge as we
got and then there would be anadministrative team within the
transplant center which oftenwould be highly trained nurses

(21:25):
who are experts intransplantation whose role
rather than being looking afterpatients or trying to support
clinical services would be anadministrative would be to
organize all of these differentpieces of information that that
are coming in from thesedifferent sites and creating
Excel databases or MicrosoftAccess databases, or maybe a

(21:49):
shared folder where each patienthas a file about their
information.
And that's how we would manageour electronic data.
That continues to this daybecause we haven't got IT
systems that support informationbeing transferred electronically
across organizationalboundaries.
So even though we of course haveone NHS, we haven't got one IT

(22:11):
system.
So we continue to have thisexperience of having to move
data around manually, really.
So what that would mean forsomeone like me, if I was in
clinic and I was seeing apatient that had been referred,
say from one of the otherhospitals, in the absence of a
single unified record for thispatient, we would have a paper

(22:32):
form that we would complete foreach patient.
And that paper form wouldconsist of all the different
data fields that are relevantfor transplantation.
So that could be the reason fortheir kidney failure, whether
they are on dialysis or not, ifthey are, how many times a week
that might be, what type ofdialysis.
There'd be loads of informationthat we need to capture.
But because it's all disparateacross different systems, you

(22:53):
needed a human, someone like me,a highly trained healthcare
professional, to fill in a paperform to summarize all that data
so it's in one place.
And that form, the transplantlisting form, as it was called,
would be the golden truth forthat patient.
It would be the most importantpiece of document that we would
be able to look back at to say,well, this is the information
about this patient.

(23:15):
So that's the way the clinicalservice was delivered.
And that's really what we wantedto try to improve.

SPEAKER_01 (23:21):
And what did you decide needed to change?
So

SPEAKER_00 (23:25):
after lots of work, lots of speaking to patients,
speaking to clients, clinicalcolleagues across different
sites.
We did a national survey of allthe 23 transplant centers to try
to understand, you know, is thisa national problem, which it
was.
After doing all of that work,what we concluded was if you

(23:45):
want to move to a world where ITdoes support services like this,
you really need to fulfill tworequirements.
Firstly, any kind of IT systemneeds to be able to to surface
data across organizationalboundaries.
So you need to be able tosurface data regardless of where
that data was collected.

(24:06):
And secondly, you want yoursystem to be able to provide a
view of that data that meets theclinical workflow.
So what it is that a healthcareprofessional is trying to do, so
in this case, list a patient onthe transplant waiting list, add
a patient to the transplantwaiting list, You want to get a
view of the data in a way thatallows that healthcare

(24:28):
professional to complete thattask.
Sounds like pretty basicrequirements, but at present we
don't have any systems that areable to fulfill these needs,
which is why we have all theseworkarounds.

SPEAKER_01 (24:41):
So you built or designed thinking into the way
you approached this problem.
I'm interested in how thataffected the work.
And how do you think it wouldhave been different if you
hadn't taken this approach?

SPEAKER_00 (24:50):
So basically, The best way that we were able to
use design was firstly being atthe University of Manchester
within the informaticsdepartment.
This was a strategic choicebecause originally there was
this question mark about where Ias a PhD student would sit.
Would I sit within thetransplant department or would I
sit in the informaticsdepartment?

(25:12):
I very purposefully selected tosit in the informatics
department.
And that's because I wanted tobuild a local network of people
that are working in this space.
So I very quickly built up ateam of a user researcher, a
graphic designer, and even a devteam and a technical project
manager as well.
And we actually went on to evenstart to build some small

(25:33):
things.
But certainly for that earlyideation phase, having those
people really close was reallyimportant.
So they taught me a lot aboutdesign and taught me a lot about
prototyping and drawing wireframes and all those kinds of
things that are normal in thekind of design world, but were
completely new to me as ahealthcare professional.

(25:53):
And then I think it was, again,that combination of being a
healthcare professional withinthe system.
I used to sketch out things,walk around the wards, grab a
duty doctor and say, hey, gosh,what do you think about this?
Go up to the consultant'soffices and say, hey, can I show
you something on my laptop?
I've been thinking about this.
What do you think?
And really rapidly get thatfeedback, which I can then take

(26:16):
back to the design team.
And we could prototype ideas.
We could draw things on Figma.
We could put it into a littleprototype on a little app or
something and get people toreally interact with it.
And I think that was really,really helpful.
If we had taken a less of adesign-led approach, It's hard
for me to really imagine whetherwe would have made any progress,

(26:36):
certainly not in this kind ofway, because I don't really
think that you can reallyinnovate without understanding
what user needs are.
Certainly, if you do, you'rebound to fail.
So I find it hard to imagine.
And again, this is inretrospect, we're very lucky to
have made those choices at thetime and build that team around
us to deliver the work in thatway.

(26:56):
Alternatively, I can't see ushaving had much success.

SPEAKER_01 (27:00):
And where did you get to with the work?

SPEAKER_00 (27:03):
So we were able to get far with the work, certainly
in terms of there were twostrands to it.
One was the design and the userexperience part.
What do transplant healthcareprofessionals want to see on a
screen that allows them todeliver that work?
And that really drove also a lotof the...
technical requirements.

(27:23):
So if this is what users want tobe able to do on the screen,
well, what does a backend and atechnical architecture need to
look like to enable this kind ofuser experience?
So we were really led by what isthe workflow?
What are those things that needto be done on the shop floor?
And how do we then take thatback as we want to try to think
about a technical solution?
We prototyped that.

(27:45):
We built a mini electronichealth record for transplants
specifically.
And we published that as aresearch paper and presented at
a large conference as well.
And then we went a step furtherto think, okay, well, if we do
want to build a solution likethis in the real world, you need
to start to think about thedata.

(28:06):
You need to start to think aboutthe database that drives a user
interface like this.
And we then mapped all thosedata points out, identified
which one of those we hadalready within our systems and
which ones we didn't.
And then again, we wrote that upas a technical architecture
document.
as with lots of health ITprojects in the NHS or lots of

(28:28):
projects in the NHS or any kindof large system.
Generally, there are lots ofvariables that come into play
with regards to decision-making.
So we got as far as speaking toa local shared care record
provider about potentiallytrying to build this, but then
our local hospital procured anew electronic patient record
and a lot of the IT resource wasshifted towards that

(28:49):
implementation.
So we never got to carry on withthat and ultimately build that
in the real world, but wecertainly learned a a whole ton
about how do you do this in thereal world and how do you ensure
being user-led and allow that todrive your technical
requirements.

SPEAKER_01 (29:03):
What would it take to actually make it happen?
So you've done a lot of work tocreate this kind of ideal system
that would really work forclinicians and staff.
Can you tell me a bit about whatyou think would need to change
for it to actually beimplemented?

SPEAKER_00 (29:15):
Yeah, really good question.
So it's super complex and thelayers of complexity are
technical, social,organizational, and even beyond
system level, at a politicallevel and international level.
So there's lots of layers ofcomplexity there.
I think from a technical level,one of the things that we need

(29:37):
to start to do more and thinkmore about is this concept of
separating the data fromapplication.
And that really comes down toagreeing what stuff is called.
We have lots of language that weuse as humans, which are very
comfortable with, but machinesdon't communicate like humans.
So in order for us to be able tomore seamlessly share

(29:59):
information between differentcomputer systems, we need to
agree as humans that this iswhat stuff is called.
So for example, something assimple as blood pressure, which
is a concept that a lot ofpeople will have heard of will
be coded in these IT systemsdifferently.
In one system, it might becalled BP.
In another system, it might becalled blood underscore

(30:22):
pressure.
In another system, it might becalled systolic blood pressure.
And there are ways ofstandardizing that.
So that's where this term datastandards comes in.
And there are various datastandards that exist.
The important thing if we wantto start to move to a world
where we have bettercommunication between systems is
to use what's called openstandards.

(30:44):
And open standards really justrefers to the fact that we have
agreed a group of experts ordomain people that work in that
particular domain have agreedwhat stuff is called.
And they have then publishedthat openly and made that
available for people that buildIT solutions to use.
As opposed to a company saying,having a proprietary, a closed

(31:08):
way of storing data within theirsystem, not making other people
aware of how that data isstored.
And what that means that if youdid want to communicate with
that system, you would mostlikely have to pay the owner of
that system to say, gosh, can weplease extract data or exchange
data from your system that we donot know how it's stored?
And therefore we need to do abunch of translation and mapping

(31:30):
and things like that to be ableto exchange data with your
system.
So trying to encourage theadoption of open standards is
certainly a something from atechnical perspective that's
really important.

SPEAKER_01 (31:38):
And do shared care records have open data?

SPEAKER_00 (31:43):
Not at present, no.
So most shared care recordsystems are still proprietary.
There are examples of peopleusing open standards.
A really good example is theUniversal Care Plan in London,
which uses the one London sharedcare record and particular
pieces of data around the aperson's wishes around their end

(32:05):
of life or their personal wishesare stored using open standards.
That's been reallytransformative because in a
really short period of time,they were able to make this
really important piece ofclinical information available
across the entire Londonecosystem.
Increasing this way of workingis something that's perhaps
opposed by the commercialentities who are already in

(32:27):
place.
As you said, there are alreadylots of companies that provide
health IT solutions, electronicpatient record solutions, and
this way of working might not bein line with them, but it's
certainly what is right forpatients.
So that's something at atechnical level.
I think there are still largecultural shifts that we need to
make.
So this is both amongsthealthcare professionals as well

(32:50):
as healthcare decision makers.
where we need to, even though werecognize that there is an
importance in data beingavailable at the point of care,
there is still a culture oforganizations thinking about
their individual interestsbefore the interests of a region
or perhaps the system.

(33:12):
So, for example, the procurementof electronic patient records
does not include considering howdoes this system share data with
a wider audience.
healthcare ecosystem.
So even though procuring anelectronic patient record might
be transformative for a singleorganization, it does not

(33:32):
necessarily mean that nowsuddenly the GP has also got
access to the patient recordfrom the hospital.
Arguably, it might even be theopposite, that now there is less
access to that information in ahospital.
So I think these decisions aredifficult.
And I think we would benefitfrom having more of a system
approach.
And that doesn't need to be anational approach.

(33:53):
I think probably national is toohard, but perhaps at a more
regional or perhaps an ICS levelto think more about, it's an
integrated care system level.
So at a regional level, thinkmore about how do we design and
implement IT solutions thatbenefit our region, not just our
individual organisations.

SPEAKER_01 (34:12):
You've also mentioned previously kind of
resistance to change and howthat can be difficult.

SPEAKER_00 (34:16):
Yeah, and I think this is a challenge, right?
Trying to get healthcareprofessionals or any kind of
busy healthcare under pressureprofessionals to adopt new
practices is challenging.
And again, this is of coursewhere design comes in and an
ability to be able to convinceyour end users that this is
going to enhance theirexperience of work is an

(34:40):
argument that, you know, we canmake better and this is I think
really where people are drawn inor convinced by visual
representation so usingprototypes or using you know
videos or using examples of realworld that I think helps
convince people that this issomething that is worth adopting

(35:01):
and will therefore have apositive impact on their work
having said that in reality andagain this is me being candid
and reflecting on my ownexperience of having used lots
of IT systems in healthcare careis that they don't always
enhance the experience ofdelivering care.
And they can detract from beingan empathetic, caring

(35:22):
professional because they areburdensome.
They are clunky.
They take a lot of time to load.
They do not complement theworkflow that healthcare
professionals are delivering.
And you have these experiencesthat people describe that are
because of the IT system, I haveto change my practice as opposed
to IT system adopting to mypractice and my workflow.

(35:43):
There's a great New Yorkerarticle by Atul Gawande.
It's relatively old now, butit's titled Why Doctors Hate
Their Computers, which I'drecommend people checking out.
It's a real candid and honestanalysis of how, as healthcare
professionals, we are notnecessarily trained to sit
behind computers, right?
That's not part of our training.

(36:05):
That's not part of what wethought being a doctor or even a
nurse is about.
But it is a very big part of ourwork today.
So there is a lot of change thatwe need to drive, maybe even
through education, to make thatadoption more successful.

SPEAKER_01 (36:23):
I'd like to move on to talk a bit about your work
around genomics now.
You've been looking at the waygenomics can increase the
efficacy of medicineprescribing.
Can you tell me a bit about theproblem you've been trying to
solve here?

SPEAKER_00 (36:34):
Yeah, I really fall in love with this problem over
the course of the last three orfour years.
And that's because we know thatpeople respond differently to
medicines.
We know that a big part of thatresponse is determined by our
genes.
We know that sometimes medicineswork well, sometimes people have
side effects, or sometimesmedicines don't work at all.

(36:58):
However, in reality, We don'tprescribe medicines based on
individual characteristics orindividual genetic
characteristics, certainly,which to me seemed like a huge
health opportunity because weknow that the science around
this is mature, but thechallenge is really how do you
operationalize something likethis?

(37:19):
How do you make something likethis part of everyday care?
In other words, how to design aservice that allows people to
have their genes tested, forthat information to be made
available to a healthcareprofessional, to a healthcare
system, so that it can informprescribing at every given
opportunity.
And when I first learned aboutthis problem, I had this great

(37:41):
experience of being in a roomfull of incredibly smart people
who are scientists and expertsin this field.
And, you know, were telling meall about the evidence base and
the background of this and I wasreally impressed because it was
about common medicines that weprescribe every day in the NHS.
So things like medicines tolower your cholesterol,

(38:02):
medicines for anxiety ordepression, medicines for
heartburn and reflux.
So the types of things that areprescribed every day in a large
healthcare system like the NHScould be improved potentially if
we had genetic information aboutpatients that influences their
response.
So this is not about generalgenetic information or testing

(38:25):
all genes in people.
It's specifically looking atgenes that relate to how people
respond to medicines.
And that science that links yourgenes to how you respond to
medicines is known aspharmacogenetics.
So pharmacogenetics is thatscience that links those two.
And when I first learned aboutthis, I very quickly realized

(38:45):
this is not a scientificproblem.
And the thing that I always sayto my colleagues is like, it
sounds like you've done thescience.
If anything, stop doing thescience.
This is an implementationproblem.
This is a how do you make thispart of everyday care problem,
which is, you know, very much inthe space of design and
technology and digital health.

(39:06):
So that's how I first learnedabout this and realizing that I
probably had skills andexpertise that perhaps the team
the laboratory, the scientists,the genetics teams that have
been working on thishistorically did not have, we
found that there was a realcomplement of skills and
expertise that allowed us tostart to think about, okay, how
do we make this happen ineveryday care?

(39:27):
And that's what we've beenworking on over the last few
years.
But we are doing this at scalewithin the NHS at present.
And at the same time, we're alsothinking about how do we
potentially In order toaccelerate this, build something
independently that supports thehealthcare system to implement
this more quickly.

SPEAKER_01 (39:45):
So this would mean genetic testing for anyone who's
going to be prescribed medicine?

SPEAKER_00 (39:48):
That's right.
So there are different ways ofhow this could be implemented.
So people sometimes talk aboutpre-emptive genetic testing.
So that's genetic testing, say,at a certain age or at a certain
time point when you have a firstmedicine, for example, or when
you have a diagnosis ofsomething like heart disease,
you're then on offered thisgenetic test as part of that.

(40:10):
And then that information needsto be available at different
time points when you'represcribed medicines in the
future.
So we know people that receiveone medicine are more likely to
receive a second medicine aspart of their health journey.
And together with that, we alsoknow that the prescribing of
medicines is the most commontherapeutic thing that we do in
healthcare.
It's the most common thing thathealthcare professionals do

(40:32):
actively is prescribingmedicine.
So we think that the opportunityis huge if we're able to put
this into practice.
Of course, putting it intopractice is really hard.

SPEAKER_01 (40:42):
Have you had to do a calculation where you say,
actually, if we're going tostart doing this testing on all
these patients, the benefitoutweighs the extra costs of
doing that genetic testing?

SPEAKER_00 (40:52):
Yeah, absolutely.
So there have been lots ofcalculations along that line.
The challenge with this ismultifold.
And we have very clever healtheconomists who are trying to
work on some of thesecost-effectiveness analyses.
And it's complicated because thecost of genetic testing has been

(41:14):
rapidly declining.
So year on year, that investmentwould potentially change.
The other thing that's reallyhard is that even though you
could maybe quite accuratelyestimate how much it would cost
to test an individual person sayit costs 150 pounds per genetic
test to do this for examplethat's quite predictable even if

(41:34):
that's relatively stable mightbe 140 pounds next year or 125
pounds a year after or whateverthat's or certainly if you start
to scale that cost might evencome further down but that's
relatively predictable what'shard to predict is what would be
the infrastructure investment tosupport the digital and data
part of making this part ofeveryday care?

(41:55):
So you could test people and youcould have that data, you could
have those genomic insights, buthow do you then make that
insight available within aprescribing workflow for a GP,
for example, or how do you makethat information available to a
pharmacist who's dispensing amedication?
And what would be the cost ofdeveloping systems that enable

(42:15):
that information transfer.
And that's hard to predict.
It's hard to know exactly howmuch that would cost.
As you know, integrating systemswithin the NHS is challenging,
and this would again be adifficult challenge.
One of the potential advantagesthat I think this space has, a
reason why it attracted me, iscompared to all the other data
that we have in healthcare,Thinking back about the

(42:39):
transplant example, so thingslike blood pressure or blood
tests that we've been doing for20, 30, 40 years and have been
storing electronically, they'realready trapped in all these
silos.
And it's really hard to unpickthat.
So potentially the place that wecould innovate in this more open
data way is in these new usecases.

(43:01):
So genomic data, thispharmacogenetic data, has not
been locked up.
into all these electronicpatient records for the last 20,
30 years?
Can we take an approach that isinteroperable by design?
Can we think about andappreciate the fact that we're
going to need this informationacross the healthcare system
from the outset and thereforenot lock it up into different

(43:21):
silos?
And again, to support that, wehave ourselves developed the
open data model for apharmacogenetic test result,
which we just published a coupleof weeks ago.
So we're super proud about that.
And that is something that'spublicly available.
So anybody that does want tobuild an IT solution to store
pharmacogenetic data can usethis open data model to do that

(43:41):
and therefore be, in theory,interoperable.

SPEAKER_01 (43:45):
And have you got a percentage on how much more
effective medicine can be withspecific conditions if you take
this approach into account?

SPEAKER_00 (43:54):
Yeah, so a large study was published in The
Lancet last year, which was aninternational study randomized
controlled trial, so a very highlevel of scientific rigor in
that approach, where they lookedat people that were having
pharmacogenetic testing versusthose who weren't and were being
prescribed medicines.
And really the headline figurethat people take away from that

(44:17):
study is that people that werehaving pharmacogenetic testing
had up to a 30% reduction inadverse side effects, so adverse
events, which is a really highnumber.
So 30%, and this again relatesto the fact that A, these are
commonly prescribed medicines.
So these are things likeantidepressants, statins for

(44:39):
cholesterol.
So the opportunity there to makea real impact is significant.

SPEAKER_01 (44:46):
Are they able to measure outcomes as well as side
effects?
Does this impact outcomes or isit about making the medicine
more effective in its day-to-dayuse?

SPEAKER_00 (44:55):
Yeah, so...
As I said, a lot of these thingsare complex because it's about
different medicines which aregiven for different reasons.
Measuring outcomes, for example,in something like depression
might be harder because, again,there are multiple different
factors that might lead tosomeone having low mood.
Having said that, yes,absolutely, in the context of
depression, there's lots of goodscientific evidence that this

(45:17):
does improve the number ofmedication switches that people
have, the amount of time ittakes for them to show an
improvement in their depressionscores.
So there is evidence aroundthat.
And then perhaps another goodexample might be around
something that we are againdoing in the context of the NHS
at the moment is trying toreduce the risk of something

(45:39):
like a stroke.
So we know that a goodproportion of people within the
UK population, around 32% ofpeople, do not respond to the
most common blood thinner thatis given after a stroke.
we give everybody this bloodthinner, but if we were to do
this genetic test, we'd be ableto identify those people for

(46:00):
whom it's not effective andtherefore give them an
alternative.
And we know that people that dohave the genetic changes that
mean that that blood doesn'twork, have a 42% higher chance
of having another stroke after afirst stroke.
So again, that's a significantfigure.
So we know that this genetictesting can both improve

(46:20):
outcomes and therefore reducecosts.
So if you are preventing peoplehaving further strokes, of
course, you're having anincredible impact on that
individual person, but you'realso having a huge impact on the
health service because a strokeis a significantly expensive
experience for health systemsnot just for the acute care but
of course for a person who'sunfortunately had a stroke will

(46:42):
have likely a significantdisability that they are left
with and therefore be a cost toa social healthcare system.
So being able to prevent thoseand improve the outcomes of
things like stroke or heartdisease is again something that
we think are huge opportunitiesthat they were looking forward
to.

SPEAKER_01 (47:01):
That must be hugely motivating once you start seeing
the potential for the work.

SPEAKER_00 (47:05):
Absolutely and certainly for me it's that
motivation about the potentialimpact.
And also it's the opportunity towork with real dynamic talented
people from really differentworlds so i get to interact with
people that work in geneticlaboratories i get to work with
people that deliver stroke careon the ward i get to work with

(47:27):
researchers at a university andbeing able to have that real
diverse group of voices expertsaround me is really stimulating
for me as an individual tryingto learn and grow and develop

SPEAKER_01 (47:41):
and how has your design thinking and your
design-led approach influencedthis work?

SPEAKER_00 (47:46):
Yeah it's something I talk about all the time and
maybe a really good anecdote Ican share is as part of this
work around personalizingprevention after stroke I've
been leading a large-scalenational pilot to implement this
as a service across four sites.
We've presented this to seniorHS stakeholders.

(48:08):
But the approach we presented isto take this design approach
where we want to start small andincrementally learn.
And even the phrase we've usedis we want to design a minimally
viable service.
So we're not trying to designthe perfect service, all kinds
of phrases that might be quitecommon in the technology or in
the design world, but certainlyfrom an NHS perspective.
system, NHS national perspectiveare still quite new phrases, new

(48:32):
ideas, new concepts.
And we've really enjoyed beingable to bring those concepts to
them.
And I've worked really closelywith a service designer called
Emma Parnell on this, who's beenreally instrumental in being
able to bring a designer intothe project has been really,
really helpful because that'sreally helped shape how this
project's being delivered.
But setting that tone from theoutset was really important and

(48:54):
then we did a similar exercisewhere we explained this to the
pilot sites that we were workingwith so we said you know we
don't want you to treat this asa project.
We don't want you to wrap thisup in cotton wool and try to
make it perfect just for thesake of the pilot.
We want you to try to do this asif this is a real world service.
And we want you to try to thinkabout this not as something that

(49:15):
you're just doing for threemonths or six months or
whatever.
We want you to really try tothink about how would this work
in the real world.
And we just had a joint workshopwith all the three pilot sites
last week and two out of threeof them played exactly this back
to us saying oh but you know aswe've been trying to think about
this we really want to try tothink about this how this would
work in the real world you knownot just for the pilot but also
beyond the pilot and it wasreally great to hear them

(49:38):
basically take on the principlesthat we were trying to share
with them and really go with itand really learn from that.

SPEAKER_01 (49:45):
And what's been the impact of taking that approach?

SPEAKER_00 (49:49):
Probably the best way to describe the impact of
that approach is the fact thatWithin two months, one of the
pilot sites has been able to gofrom having absolutely nothing
never having done a genetic testbefore never thought about how
this would work to just lastweek started genetic testing on

(50:10):
patients who are coming intohospital with a stroke so within
two months and of course we wereable to provide that design
support to them so Emma andmyself visited all these
different pilot sites we walkedthe shop floor we interacted
with them we ran workshops withthem and we constantly
communicated with them andprovided them with ideas and an
opportunity to feedback and tookthat iterative approach but that

(50:31):
did allow us to go from twomonths having you know within
two months having nothing tostarting to test patients and
maybe put that into context youknow in other settings it would
comfortably take you at leastsix months if not longer to set
something like this up and eventhen there would be lots of
potential challenges whereasbeing able to really immerse
ourselves in that world reallyget onto the shop floor really

(50:53):
think about the nitty and grittychallenges allowed us to be far
more rapid.

SPEAKER_01 (51:00):
Would you refer to what you've been doing as a
trial?

SPEAKER_00 (51:02):
So it's not a research trial, which is maybe
an important distinction.
So I think I could definitelyrefer to it as a trial in the
context of we are trying thisout in the real world with a
view of this transitioning intoa real life service.
I think that's another conceptthat we have been increasingly
talking about today.

(51:23):
which is a challenge within theNHS is that what we often do is
we deliver projects withoutnecessarily thinking about what
is the outcome and the output ofthat project there might be an
output but not necessarily anoutcome whereas what i'm trying
to encourage our teams to thinkabout is that the outcome of
this project should be either aservice or a product that you
leave behind or something thatyou leave behind that continues

(51:45):
to run not something that startsand then finishes we need to be
able to leave something behindthat's sustainable and that's
again a mindset shift Butsomething I think is really
important and something thatwill allow us to innovate in a
far more sustainable way.

SPEAKER_01 (52:00):
I mean, there's lots of parallels there with work in
the government digital service,which has always emphasised
funding teams rather thanprojects because of the, you
know, you want to create changeand continue to support that
change on an ongoing basis.
If someone were to hand you fivemillion pounds after listening
to you on here and going, thatworks amazing, we should be
funding that.
I'm curious as to what you woulddo with that 5 million and what

(52:22):
would be the shape of the teamyou'd fund?
What would you work on?

SPEAKER_00 (52:27):
Great question.
I would love to innovate at thatintersection of genomics and
digital health.
So being able to put some ofthis preventative, personalised
technology data and insights onindividuals into practice.

(52:47):
One of the things that we'vebeen thinking a lot about
recently with regards to where abig part of the problem is that
people have talked for a longtime about being able to go from
data to insights.
You'll have companies orinnovators who'll say, oh, we
create insight from data andthat's really powerful.
But actually the space or thegap that I think still remains

(53:09):
in the space that we want tooperate in is how do you go from
insights to action?
Okay, insight, you've nowtranslated that data into
something meaningful.
Sometimes you can talk aboutactionable insights.
Oh, we created actionableinsights.
We created a report of someone'sgenetic profile or we created an
app or whatever.
But how do you actually put thatinto action?

(53:29):
And the action bit in thecontext of this personalized
medicines, for example, reallyonly comes to life if someone
who is prescribing a medicineprescribes something that they
weren't going to prescribebecause of that action.
actionable insight and until yourealize that everything you did
before is not meaningless but itdoes not provide a return on

(53:53):
your investment until yourealize an action how do you put
that action into practice isreally really hard and that's
where we are working on so we'reworking on this concept called
clinical decision supportsystems or CDS, which are things
like alerts or pop-ups or thingsthat appear within a workflow at

(54:14):
the right time to provideinformation that allows an
individual to take an action.
And that's the place where wecould innovate a lot more.
You could make those actionseasier to accept.
For example, if someone neededto prescribe an alternative, you
could have a one-click so theycan automatically activate
prescribe that alternativerather than have to go back in

(54:34):
their workflow.
So there's lots of innovationand user experience ideas that
you could bring into that spaceto make that action more easy to
do and therefore realize thebenefit of all of that genetic
testing or data to insight ortranslation or whatever that
you've done before.
I think the team to be able todeliver something like that

(54:55):
absolutely needs to be designheavy.
So, you know, we certainly wouldhave to have a design team
department, if you like.
And that's not just from a userexperience and a workflow
perspective, but also from avisual and a graphic
perspective.
So I think that makes a bigdifference with regards to how
users engage with their apps orwith their solutions if
something is visually designedin a way that makes that easy to

(55:17):
do.
And I think the other big partof the team that we'd have to
develop would be around thattechnical, how do you store the
data in an open way in order tomake that data available in
different places?
So thinking about people thatwork with open data more
regularly, and for example, thedata standard that we work with
is something called Open Air orOpen EHR, which is a very

(55:40):
well-known open data standardnow.
So people that are experts inthat space would be attractive.
And then you've got your usualpeople that can wear multiple
hats that I think are alwayssuper attractive.
So people that are comfortablewith ambiguity.
So this could be a clinician whomaybe has done an MSC in design
or maybe a clinician who'sworked in a startup or maybe
someone who's built a startupwho now wants to build in

(56:01):
healthcare.
Those kinds of individuals Ithink are always really exciting
and bring real energy andopen-mindedness to teams.

UNKNOWN (56:08):
Yeah.

SPEAKER_01 (56:08):
It feels like we're living in a time where things
are moving really fast.
Technology is changing.
There's lots of new technologieson the horizon.
What are you curious about inyour work and what are you
excited about?
I

SPEAKER_00 (56:20):
would love for us to be able to focus more and more
on prevention and trying to movecare upstream.
As I even practice today, Istill see lots of patients who I
might be seeing for a yearpotential bowel cancer referral
or for some kind of surgicalproblem, but who I can see have

(56:43):
got lots of preventative or whohave lots of diagnoses that
could be managed much better.
But we're failing to do that.
And that's because the NHS, ashealthcare systems around the
frontline services.
And that just leaves themincapable of being able to

(57:04):
really innovate and shift thedial on moving care upstream.
So a phrase that comes to mindis a Dutch phrase, which is
dweile met de kraan open, whichbasically means we're mopping
the floor whilst the tap's stillrunning.
So we are really focused ondelivering services, trying to

(57:26):
dry up that soppy wet floor, andwe're focusing and we innovate
and we're making robotic mops,we're making shiny mops, faster
mops, etc.
But I'd love for us to be ableto move our attention to the tap
and shift people's attention to,okay, how do we actually start
to close this tap a little bitmore?
And that's not going to beovernight, of course, but I'd

(57:46):
love to shift people's attentionto that, which is really hard,
of course, in the economicclimate.
That's something that I'mexcited about and trying to work
with more people on that.

SPEAKER_01 (57:54):
And how do you see AI impacting both prevention and
your work over the next fewyears?

SPEAKER_00 (58:00):
So I think the main place where I see AI having an
impact today would be around howdo we improve data management
and analytics aroundadministrative data?
So not necessarily clinicaldata, but how do we, for

(58:21):
example, identify efficienciesin waiting times or in making
clinics appointment times morestreamlined?
Or how do we reduce the numberof people who might not attend
their appointment by being ableto automate certain processes
around reminders or being ableto identify patients that are
perhaps more likely to not beable to make their appointment?

(58:43):
So I wonder whether that's whereI'm seeing AI perhaps making a
difference today in the realworld.
Of course, there's lots ofresearch and excitement and work
going on in the AI space, but interms of having an impact on the
shop floor, I wonder whetherthat's a space where AI can make
a difference today, alongside,of course, an impact in
radiology and more image-basedspecialties, where I think AI

(59:06):
also plays a big role.
Certainly going forward, I wouldlove for AI to start, you know,
for us to be able to start touse AI to automate some of our
workflows and simplify some ofthe manual data entry exercises
that healthcare professionalshave to do.
So lots of healthcare is stillaround collecting bits of data
that already exists somewhere inthe system, but it's not

(59:29):
available at the point where youneed it.
And I wonder whether certainlywith Gen AI, perhaps this
challenge around that data notbeing standardized across
different systems perhapsthere's an opportunity for AI to
move to a world where it is ableto interpret data a bit more
like we do as humans andtherefore you lose that need to

(59:50):
be able to really systemsystematically translate and map
between different IT systems andperhaps AI could play a really
big role in improving that datasharing across different IT
systems or different systems inhealthcare setting and make that
more readily available at thepoint of care.

SPEAKER_01 (01:00:06):
You might have answered this next question
through talking about AI, whichis almost a bit magic, it feels
like at the moment.
But if you could wave a magicwand and change one thing about
the health system now, whatwould you change?

SPEAKER_00 (01:00:16):
If I had to choose one thing, I would probably love
for healthcare professionals.
So that's not just people thatdeliver to hospitals.
work to deliver services butpeople that work in healthcare
generally to be able to workmore effectively together i
wonder whether we still work toomuch in silos and that's could

(01:00:41):
be between clinical departmentsthat could be within
administrative departmentsversus clinical departments
managerial roles innovationoffices etc i would love for us
to be able to get to a spacewhere we're able to work more
effectively together I wonderwhether the reason why it's
really hard for us to work moreeffectively and collaboratively

(01:01:02):
is because the system is justunder such incredible strain at
the moment.
So even with a lot of the workthat I do, I describe it as
innovating under pressurebecause you are trying to do new
things, you're trying to bringnew ideas to the forefront, but
the environment in which you'retrying to do that is not really

(01:01:23):
able to accept and adopt newways of doing things.
I'd love to be able to take thepressure off and I think that
will then naturally allow anenvironment to flourish where
people are able to work morecreatively together and start to
blur those boundaries because Ithink we all want the best for
patients and we all want to tryto deliver better care.

(01:01:44):
Being able to work better acrossdisciplines will allow us to do
that far more effectively.

SPEAKER_01 (01:01:49):
What's next for you, Vidya?
And is there anything else thatyou'd like to share with us?

SPEAKER_00 (01:01:54):
I'm looking forward to next year.
I'm looking forward to 2025.
I've had the opportunity tospeak a lot this year and
present my work and gather lotsof feedback over the course of
the last 12 months to 18 months,particularly around the work
that we're doing aroundpersonalized medicines.
Now we're looking forward toputting some of that work into

(01:02:14):
action, some of that feedbackinto action and to start to
build really.
We've just been lucky enough toget selected for a small
business development grant.
So we've got a little bit ofcash here.
to build with.
And yeah, we've just found alittle team.
We've got a developer that we'vejust onboarded a couple of weeks
ago.
So we're really looking forwardto starting to build.
And that's what I'm reallyexcited about and continuing to

(01:02:35):
hopefully speak to people likeyou and other creative people
that are working in healthcareto continue to get feedback and
learn and improve.

SPEAKER_01 (01:02:43):
Fantastic.
It's been a pleasure talking toyou, Fidea.
Thanks so much for taking thetime to come along today.
And I hope our paths cross inthe not too distant future.

SPEAKER_00 (01:02:51):
Thank you, Sam.
Great to see you.

SPEAKER_01 (01:02:53):
problems worth solving is brought to you by
healthier the collaborativeservice design consultancy for
transformation in health careand public services find out
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(01:03:16):
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