Friday, November 22, 2024

Technology end user driven ecosystem for healthcare

Lecture notes for November 28, shared publicly here in advance as part of a flipped classroom approach as, instead of reading out the below slides together with the offline audience there, we hope to have more questions and discussion in that one hour with them as well as spend more time in a live demonstration of how to capture tech end user, real patient data (after already having obtained patient consent and also discuss the process of obtaining ethical consent) and how to archive it for retrieval and reasoning toward optimal data driven healthcare.



First slide:

STATUTORY WARNING: There's too much information in this online presentation that can make anyone go TLDR (too long didn't read).

The gist of it is:

Understanding the role of technology end users in data capture to develop better predictive analytics toward improving patient outcomes.

This will be exemplified in a 3D offline demo with a real patient where our predictive analytics are likely to fail and the point we would make is that one can't solve the wicked problem of healthcare in one go for even a single patient but it's a journey! Our group does this as a 24x7 regular journey through user driven healthcare UDHC tools such as PaJR and CBBLE (more about them in links below). At the end in the opportunity section of the SWOT analysis we propose a CBBLE program to develop leadership and innovation skills through a medical humanities program the design of which is also linked below.

What literally is technology?


Etymology

The word techne comes from the Greek word for art, skill, craft, and technique. The modern-day English word technology comes from the prefix techne and the suffix ology; both words are of Greek origin.

https://en.m.wikipedia.org/wiki/Techne



Rhetoric: The techne/art/craft of human caring appears to be older than the invention of the wheel.

The trillion celled body itself appears to be a product crafted by a collaborative evolution of cells through ages. 

Rhetoric: Since it's early phases, healthcare technologists/craftsmen have been building a map to navigate individual illness journeys but that map is more like a static textbook and still not as dynamic as a current google map, which helps humans in their car driving journeys!

Healthcare is still largely 99.999% uncharted territory! Although the percentage perspective will vary with your years in healthcare. For example the first year medical student may think it's 99.99% charted territory!

Image with CC licence:https://commons.m.wikimedia.org/wiki/File:Greek_physician_and_patient,_plaster_cast_in_W.H.M.M._Wellcome_M0001578.jpg#mw-jump-to-license


Link to the actual lecture around this slide:

Slide 2: What literally is science?

May have originated from Proto-Indo-European language as *skh1-ie, *skh1-io, meaning "to incise". https://en.m.wikipedia.org/wiki/Science



Image with CC licence: https://commons.m.wikimedia.org/wiki/File:Sickle_and_throwing_knife_at_Manchester_Museum.jpg#mw-jump-to-license

And the image of the sickle and science is contained in an important writing tool for science! The question mark is a very important instrument of scientific scepticism:



Creative commons license: https://en.m.wikipedia.org/wiki/Question_mark#/media/File%3AQuestion_opening-closing.svg

Slide 3

Who are end users of technology?

Artists? Geniuses? Engineers, Developers, Ordinary Humans? Patients? Healthcare professionals?

EVERYONE!





The images show how any tech end user trying to drive a positive illness outcome through the healthcare system is akin to putting together a model art with different stages of uncertainty and finally some diagnostic and therapeutic confirmation in the second image rarely ever going near to the third in terms of certainty!

Image Source: https://youtu.be/sR0G23aC1Vw?feature=shared

More here from another lecture: https://youtu.be/XWUMogh96SM?feature=shared

Rhetoric: All human animals are genius artist end users of technology, carving their own life trajectories and designing their destiny. In recent times digital technology offers them a parallel space to create a digital twin of themselves in virtual universes that can further be embodied into robotic avatars in physical universes toward tech singularity!


Link to the actual lecture around this slide:

Slide 4: 

Science tries to know from events data and subsequent analysis

Technology otoh is artistic utilisation of knowledge to create a product?



Image with CC licence: https://en.m.wikipedia.org/wiki/Wheel#/media/File%3ARoue_primitive.png


Slide 5: Asynchronous communication of knowledge: asynchronous intelligence aka primordial AI and subsequently academic intelligence AI and finally current artificial intelligence AI

More here: https://medicinedepartment.blogspot.com/2021/06/introduction-to-evolution-of-human.html?m=0


Image CC licence: https://commons.m.wikimedia.org/wiki/File:Rock_Shelter_8,_Bhimbetka_02.jpg#mw-jump-to-license

Rhetoric: Human animals invented AI beginning with asynchronous intelligence through their ability to use cave painting tech to convert multidimensional real life data into two dimensional data in an xy axis cave wall that later evolved to paper and electronic media so that they could eventually manage their lives better as artistic modelling was easier in a two dimensional virtual plane than a multi dimensional real plane!

Let's look at where we have come all the way from primordial AI (aka asynchronous intelligence) to modern AI that models primordial AI to produce some currently interesting results particularly if the data capture is asynchronously hyperlocal.


Link to the actual lecture around this slide:


Slide 6:

Role of Hyperlocality in designing care for the Tech end user 

Introduction: https://medicinedepartment.blogspot.com/2024/11/udlco-ai-healthcare-complexity-and.html?m=1


Rhetoric:

Global learning toward hyperlocal caring:

https://userdrivenhealthcare.blogspot.com/2015/06/global-learning-toward-local-caring.html?m=1

Creating persistent clinical encounters to extend the scope of health care beyond its conventional boundaries utilizing social networking technology 

https://www.researchgate.net/publication/344227236_Persistent_Clinical_Encounters_in_User_Driven_E-Health_Care

Slide 7

Evolution of above workflow prototype in different institutions 

https://medicinedepartment.blogspot.com/2021/06/evolution-of-model-forpatient-centered.html?m=1

Formal departmental workflow:


Patient as a teacher:


Rhetoric: 

Blooming real patient OSCE driven CBMEs: 

Most learning is a process of objectively structuring subjective complex multidimensional real life data (blooms level 3-5) into a two dimensional space (blooms level 1 aka knowledge) that can be stored forwarded asynchronously and modeled conceptually to gain understanding (blooms level 2) through further analysis ( level 4) and evaluation (level 5) and then relooped into the learning ecosystem as creative communication/publication (level 6). This learning is cyclic and one can keep moving in and out of these levels at any entry or exit point regardless of level numbers. 

More:https://medicinedepartment.blogspot.com/2023/12/ongoing-project-draft-optimizing.html?m=1

Current workflow: 


Theory driven workflow with Gaurd Rails for all technology end users: 

https://userdrivenhealthcare.blogspot.com/2022/09/current-pajr-workflow-and-how-to-make.html?m=1

https://userdrivenhealthcare.blogspot.com/2024/09/pajr-current-roles-and-responsibilities.html?m=1

https://userdrivenhealthcare.blogspot.com/2024/08/template-for-pajr-user-driven-history.html?m=1

https://www.hipaajournal.com/de-identification-protected-health-information/

https://classworkdecjan.blogspot.com/2017/11/de-identifying-patient-data.html?m=1

https://userdrivenhealthcare.blogspot.com/2023/11/glossary-of-user-driven-healthcare.html?m=1

Theory driven workflow with Gaurd Rails for Health professional technology end users:

https://userdrivenhealthcare.blogspot.com/2023/12/pajr-checklist-for-inpatient-interns-in.html?m=1

https://durgakrishna09.blogspot.com/2023/08/graphical-patient-timeline-in-soap.html

http://medicinedepartment.blogspot.com/2020/05/informed-patient-consent-and.html?m=1

https://medicinedepartment.blogspot.com/2023/08/project-illustration-of-how-to-process.html?m=0

Reflective notes: https://medicinedepartment.blogspot.com/2023/06/?m=0

https://userdrivenhealthcare.blogspot.com/2024/01/generalized-feedback-for-internship.html?m=1

https://kandrucherishrollno68.blogspot.com/2023/09/35-year-old-female-presented-with-co.html?m=1

Slide 8: Demo 

Participatory medicine session real time video capture link: 





Previous demos here: https://medicinedepartment.blogspot.com/2023/10/medicine-department-presentations-2023.html?m=1

Our main focus during the one hour session shall be to provide a physical offline demo in the venue as we plan to bring one of our 80 year old patient right there on that day with his and his spouse's signed informed consent.

Demo through real patient case reports made by patient advocate volunteers:

https://pajrcasereporter.blogspot.com/2024/10/80m-diabetes-hypertension-30yrs-ckd.html?m=1

https://24fpatient.blogspot.com/2024/11/52m-hypertension-diabetes-5-years-wb.html?m=1

https://narmeenshah.blogspot.com/2024/07/3-year-old-child-type1-diabetes-insulin.html?m=1

https://2patienthealthreport.blogspot.com/2024/06/patienthealthreport.html?m=1

Demo by few health profession students present in the venue sharing their experiences from their online learning portfolios below:

https://96sanjanapalakodeti.blogspot.com/?m=1

https://shivanikommera.blogspot.com

https://sreetejapalakonda29.blogspot.com/?m=1

https://himajav.blogspot.com

More tech end users online learning portfolios:

Informal healthcare learning and awareness volunteers (engineering , humanities, medicine) at our elective student learning hall of fame here: https://medicinedepartment.blogspot.com/2021/03/medicine-department-training-programs.html?m=1

Formal health professional students: 5000 cases in 1000 tech end user online learning portfolios:

https://medicinedepartment.blogspot.com/2022/02/?m=1

Rhetoric: Lectures are largely rhetorical and while they do embellish learning, demonstrations are a practical way to quickly get into the skin of the learning ecosystem!


Last slide: 



Creative commons license: https://commons.m.wikimedia.org/wiki/File:User-FastFission-brain.gif#mw-jump-to-license

SO  WHAT?? 


S

trengths 

Cherry picked and shared above 

Rhetorical past Foundations:




 https://www.amazon.in/User-Driven-Healthcare-Narrative-Medicine-Collaborative/dp/1609600975




https://www.amazon.in/Clinical-Solutions-Progress-User-Driven-Healthcare/dp/1466618760/ref=mp_s_a_1_7?dib=eyJ2IjoiMSJ9.hoaqPiWFhtqEMwMQQwMHh6XA3sAjvmg2CLCeKl5g5H0Ialw2OuleMzx8buI_Uy38jwXVQMd0DmaWlRRrlazufIw_5ZaexQ9p2PXyFOVw5dEa44eog_fkWlg4PrxhAkDUVHYa2f9ZAD_DEirz7irF6A.vddqDkHyAHumWw0iwm8nzCAMqU1uuBI_1AIACU9G4Kg&dib_tag=se&qid=1732295190&refinements=p_27%3ARakesh+Biswas&s=books&sr=1-7


https://www.igi-global.com/journal/international-journal-user-driven-healthcare/41022

W

eaknesses


Hint: A system is only as competent and efficient as it's individual components and participants 

Rhetoric: Practice, practice, practice! The only way to beat weakness toward strength and power is gaining regular knowledge through a life long journey of self directed learning!



O

pportunities

Rhetoric:
User driven alchemy of patient centered learning:
More here in the description box of the video: https://youtu.be/lDd1ikdL94A?feature=shared
Internal motivation chemistry toward generating leaders

Rhetoric: Formal medical education has currently given up trying to encourage real patient centred interaction among medical students during their training phase such that for a few who may engage in it at some point in their careers (even after they become faculty) would realise that the very interaction with real patients who are also humans would be transformative in their understanding of humans (again not everyone may be able to do that on one's own and there is an accepted dearth of faculty who can train people in doing that), which is the kind of training a real politician needs, to understand their polity and work for them rather than their own selves! It has been exemplified in the past by...more here:https://medicinedepartment.blogspot.com/2024/11/udlco-political-training-in-medicine.html?m=1

Our group does this as a 24x7 regular journey through user driven healthcare UDHC tools such as PaJR and CBBLE (more about them in links below). We propose this opportunity for a CBBLE program to develop leadership and innovation skills through a medical humanities program the design of which is also linked below.

T

hreats  

Thorns of clinical complexity amidst the guardrails



Picture taken from the garden this Sunday after pruning the Indian jujube tree:https://en.m.wikipedia.org/wiki/Ziziphus_mauritiana

Stakeholder trade offs in negotiating virtual transparency accountability vs real threat to privacy and security!

Rhetoric: Healthcare is not easy! It's a journey full of challenges and threats and yet a fantastic way to live life using science and technology to create one's life work of art!


Links to the lecture preceding the demo:

Post lecture demo discussion video:


What's the ask?

Posted by at No comments:

Thursday, November 21, 2024

UDLCO: Political training in medicine and the hidden curriculum

 

Summary: The term "hidden curriculum" is loaded with infinite variability of meanings that are largely hidden. Medical education has currently given up trying to encourage real patient centred interaction among medical students during their training phase such that for a few who may engage in it at some point in their careers (even after they become faculty) would realise that the very interaction with real patients who are also humans would be transformative in their understanding of humans (again not everyone may be able to do that on one's own and there is an accepted dearth of faculty who can train people in doing that), which is the kind of training a real politician needs to understand their polity and work for them rather than themselves! It has been exemplified in the past by BC Roy and reading his biography available full text here:https://archive.org/details/bidhanchandraroy00seng/page/n7/mode/1up may provide better insights to the kind of real patient centred medical education that existed during his time and it's current dearth that sometimes gets filled in by a hidden curriculum! The other rhetoric often shared around "medicine is politics" is as old as Virchow and one can read more about it here: https://pubmed.ncbi.nlm.nih.gov/19052033/


Conversational Transcripts:

[21/11, 10:09]vs: Members of the armed forces, scientists, and teachers topped the list of professions Indians trust the most, a new survey has found. According to the Ipsos Global Trustworthiness Index 2022, 64% Indians trusted armed forces members, followed by scientists at 63%, and teachers at 62%. These three professions were closely followed by doctors (55%) and judges (54%). 

The online survey was conducted between May 27 and June 10 among 21,515 adults in 28 countries. The survey also identified the most untrustworthy professions around the world. In India, politicians were to be most untrustworthy with 50% of the respondents holding unfavourable opinion towards them. Ministers in government came in second in the list of most untrustworthy professions in India at 43%, followed by journalists at 35%.

Unquote: https://www.financialexpress.com/life/lifestyle-ipsos-global-survey-indias-most-trustworthy-professions-doctors-armed-forces-2618043/

[21/11, 10:09] rb: Solution:

Let mbbs be the basic qualification for every politician.

MBBS and subsequent residencies are probably the only place where humans get mandatory training in politics as part of a hidden curriculum!

[21/11, 13:44] N: Politics or polytricks   are the hidden curriculum in every field I hope ....it's a part of being in society ..as each one of us have our selfish motives

[21/11, 14:01]Prof Meu: Being selfish and looking after one's own self is no crime, even the old saying " God helps them who help themselves.  But your way of looking after yourself should not damage another person. So being in society, and ensuring your own survival, it is of utmost importance to be diplomatic, yet ethical and humane and that is perhaps the greatest skill one needs to learn and practice.

[21/11, 14:33] A: So very well said !

[21/11, 15:40] N: I am here talking about the bigger picture ......and I am sorry if it's offended you ..nothing personal

[21/11, 15:41] N: I was telling that polytics   is just not only in MBBS  ..but everywhere humans are  ...I hope I made my point clear 😊...

[21/11, 15:43] N: Looking after ones own self is your personal responsibility and utmost priority it's not at all selfish  ..but where do you draw line between self satisfaction and greed ....is.....each one's decision ....

[21/11, 15:44]ss: All Humans are social, political & economic animals! 😷🤐

[21/11, 15:44]N: I am sorry you missed to see my point of view ...

[21/11, 15:44] N: So very true...can add few more adjectives

[21/11, 15:46]Prof Meu: I am not offended

And why should I?

Just as you talked about bigger picture I did the same, but from a different perspective..

😁😁

[21/11, 15:46] N: Oh   great

[21/11, 15:46] N: Thank you for understanding dear😍😍

[21/11, 15:47] N: Vasudhaiva kutukmb kam

[21/11, 15:47]N: All of us are one big family...

[21/11, 15:48]Prof Meu: And in that family some are Pandavas while many are Kauravas....🤣🤣🤣🤣

[21/11, 15:49] N: Exactly you read my mind ...😍🧐

[21/11, 15:49] N: That's exactly what I wanted to say ...😅👍

[22/11, 08:21]rb: Yes the term "hidden curriculum" is loaded with infinite variability of meanings that are largely hidden and I should have been more explicit about what I meant by it!

Medical education has currently given up trying to encourage real patient centred interaction among medical students during their training phase such that for a few who may engage in it at some point in their careers (even after they become faculty) would realise that the very interaction with real patients who are also humans would be transformative in their understanding of humans (again not everyone may be able to do that on one's own and there is an accepted dearth of faculty who can train people in doing that), which is the kind of training a real politician needs to understand their polity and work for them rather than themselves!

It has been exemplified in the past by BC Roy and reading his biography available full text here:https://archive.org/details/bidhanchandraroy00seng/page/n7/mode/1up may provide better insights to the kind of real patient centred medical education that existed during his time and it's current dearth!



Posted by at No comments:
Subscribe to: Posts (Atom)