How the Trojan Horse Affair Affected British Pakistanis

A scandal in 2014, known as the Trojan Horse affair, exposed what it’s like living in Britain as a British Pakistani.

#birmingham-england, #bradford-england, #colonization, #cricket-game, #discrimination, #education-k-12, #england, #great-britain, #hate-crimes, #immigration-and-emigration, #income-inequality, #khan-sadiq, #london-england, #malik-zayn, #minorities, #muslims-and-islam, #national-health-service, #oxford-university, #race-and-ethnicity, #reed-brian-journalist, #religion-and-belief

U.K.’s Other Health Crisis: A Huge Backlog of Delayed Non-Covid Care

The free health care system was known for delays, caused in part by whittled-down funding. But Covid made waits for transplants, cancer treatments and other essential care even longer.

#breast-cancer, #coronavirus-2019-ncov, #england, #great-britain, #national-health-service, #transplants

Fears of Omicron’s Rapid Spread Are Tempered by Signs of Milder Illness

“We can’t stop it,” Israel’s prime minister said of the Omicron variant, but that warning was blunted by early signs of potentially less-severe illness than with earlier coronavirus iterations.

#bennett-naftali, #castex-jean, #centers-for-disease-control-and-prevention, #coronavirus-2019-ncov, #coronavirus-omicron-variant, #england, #europe, #israel, #national-health-service

Despite Omicron Wave, Britons Are Set on Not Losing Another Christmas

For Christmas shoppers in central London this week, little seemed to dampen their spirits. But there was an undercurrent that the city was bracing for further coronavirus restrictions.

#christmas, #coronavirus-2019-ncov, #coronavirus-omicron-variant, #england, #great-britain, #johnson-boris, #london-england, #national-health-service, #shopping-and-retail, #vaccination-and-immunization

Welcome to the Charles Dickens Luxury Apartments

Want to understand London’s economic transformation? Have a look around the condo conversion of the workhouse that inspired “Oliver Twist.”

#dickens-charles, #historic-buildings-and-sites, #london-england, #national-health-service, #oliver-twist-book, #poverty, #real-estate-and-housing-residential

U.K. System Strained as Health Care Workers Get Covid Themselves

Hospitals, clinics and ambulance services say infections are winnowing their staffs, straining a system already taxed by nearly two years of dealing with the pandemic.

#anxiety-and-stress, #coronavirus-2019-ncov, #coronavirus-omicron-variant, #england, #great-britain, #hospitals, #london-england, #national-health-service

U.K. Weighing Lockdown Amid an Omicron Wave and Political Turmoil

Britain’s health secretary said on Sunday he wouldn’t rule out more restrictions before Christmas, but the prime minister would most likely face sharp pushback from his own party.

#british-broadcasting-corp, #conservative-party-great-britain, #coronavirus-2019-ncov, #coronavirus-omicron-variant, #great-britain, #javid-sajid-1969, #johnson-boris, #london-england, #national-health-service, #scientific-advisory-group-for-emergencies-great-britain

Omicron Wave Heads for U.K., but It’s Not Clear How Bad It’ll Be

Britain could be a bellwether of what other countries will see from the new coronavirus variant. Officials say Omicron could account for most cases within weeks.

#coronavirus-2019-ncov, #coronavirus-omicron-variant, #great-britain, #johnson-boris, #national-health-service, #vaccination-and-immunization, #world-health-organization

Rise in Cases and Deaths Tests Britain’s Gamble on Few Virus Restrictions

The country’s grand experiment — opening up with hardly any restrictions — is facing its toughest test yet.

#astrazeneca-plc, #coronavirus-2019-ncov, #coronavirus-reopenings, #disease-rates, #great-britain, #national-health-service, #politics-and-government, #vaccination-and-immunization

Patient monitoring startup Doccla secures $3.3M Seed funding for ‘virtual wards’ platform

Doccla, a healthtech startup with a platform that can monitor patients on hospital wards and in the home, has secured a $3.3 million Seed funding round, led by Giant Ventures and Speedinvest. The company allows hospitals to predict when beds will be freed up by monitoring patients remotely via wearable medical devices, thus helping to alleviate bottlenecks in the system.

Founded by health entrepreneur, Martin Ratz, and tech entrepreneur, Dag Larrson, Doccla says it has saved “thousands of bed days for the NHS,” achieving a 29% reduction in Emergency Admissions and a 20% reduction in A&E attendance, the company claimed.

Doccla is similar to competitors Current Health, Huma and Cadence. The latter recently raised $41 million in funding from Thrive and General Catalyst. The company offers a remote patient monitoring platform that enables clinicians to monitor patients at home and provide personalized feedback via texts and ‘video visits’. Doccla says it can also measure patients at home.

The cash raised will be used to invest in its technology, and integrate further with the medical wearables and journal record systems. It also plans to expand into European healthcare markets.
 
Once again, as we have seen with other technologies, Doccla’s development was propelled by the pandemic. It turned out that overwhelmed hospitals needed technologies like this to create ‘virtual wards’ in order to monitor patients’ journey both in the hospital and when they got home.

Dag Larsson, CEO and co-founder of Doccla said. “Our end-to-end virtual ward services are extremely easy for the care provider to take on and extremely hard for them to ignore. The NHS now faces a challenging winter season and we’re evolving our technology to support care providers.”

He added: “We differ a lot from the competition in that we support the entire patient journey (e.g all last-mile activities like logistics, customer service, and even pre-configured mobile phones). This has made us punch substantially over our weight and win contracts with extremely high patient and clinician approval.”

Cameron McLain, Managing Partner & Co-Founder from Giant Ventures added: “Doccla provides a vital solution for a strained healthcare system, delivering a product that improves the patient experience and tackles cost.”

Felix Faltin, Principal and Digital Health Lead at Speedinvest said “Doccla’s platform is more than a product, it’s a full-stack solution that makes care delivery more efficient for providers, cheaper for payors and safer for patients, long past COVID-19.”

#cadence, #europe, #general-catalyst, #giant-ventures, #health, #huma, #mobile-phones, #monitor, #national-health-service, #nhs, #speedinvest, #tc, #telehealth

Johnson, Inviting Battle, Prepares to Break Vow on Raising Taxes

Prime Minister Boris Johnson is expected to propose increasing the National Insurance tax to bolster social care services.

#conservative-party-great-britain, #federal-taxes-us, #great-britain, #health-insurance-and-managed-care, #johnson-boris, #labour-party-great-britain, #legislatures-and-parliaments, #may-theresa-m, #national-health-service, #politics-and-government, #rees-mogg-jacob, #sunak-rishi-1980

Coronavirus in UK: Britons, Unfazed by High Covid Rates, Weigh Their ‘Price of Freedom’

Britain is reporting more than 30,000 new coronavirus cases a day, but the public seems to have moved on. Experts say this could be a glimpse into the future for other countries.

#coronavirus-2019-ncov, #coronavirus-reopenings, #disease-rates, #england, #great-britain, #johnson-boris, #khan-sadiq, #national-health-service, #politics-and-government, #quarantines, #subways, #transit-systems, #vaccination-and-immunization

Britons, Unfazed by High Covid Rates, Weigh Their ‘Price of Freedom’

Britain is reporting more than 30,000 new coronavirus cases a day, but the public seems to have moved on. Experts say this could be a glimpse into the future for other countries.

#coronavirus-2019-ncov, #coronavirus-reopenings, #disease-rates, #england, #great-britain, #johnson-boris, #khan-sadiq, #national-health-service, #politics-and-government, #quarantines, #subways, #transit-systems, #vaccination-and-immunization

Google confirms it’s pulling the plug on Streams, its UK clinician support app

Google is infamous for spinning up products and killing them off, often in very short order. It’s an annoying enough habit when it’s stuff like messaging apps and games. But the tech giant’s ambitions stretch into many domains that touch human lives these days. Including, most directly, healthcare. And — it turns out — so does Google’s tendency to kill off products that its PR has previously touted as ‘life saving’.

To wit: Following a recent reconfiguration of Google’s health efforts — reported earlier by Business Insider — the tech giant confirmed to TechCrunch that it is decommissioning its clinician support app, Streams.

The app, which Google Health PR bills as a “mobile medical device”, was developed back in 2015 by DeepMind, an AI division of Google — and has been used by the UK’s National Health Service in the years since, with a number of NHS Trusts inking deals with DeepMind Health to roll out Streams to their clinicians.

At the time of writing, one NHS Trust — London’s Royal Free — is still using the app in its hospitals.

But, presumably, not for too much longer since Google is in the process of taking Streams out back to be shot and tossed into its deadpool — alongside the likes of its ill-fated social network, Google+, and Internet ballon company Loon, to name just two of a frankly endless list of now defunct Alphabet/Google products.

Other NHS Trusts we contacted which had previously rolled out Streams told us they have already stopped using the app.

University College London NHS Trust confirmed to TechCrunch that it severed ties with Google Health earlier this year.

“Our agreement with Google Health (initially DeepMind) came to an end in March 2021 as originally planned. Google Health deleted all the data it held at the end of the [Streams] project,” a UCL NHS Trust spokesperson told TechCrunch.

Imperial College Healthcare NHS Trust also told us it stopped using Streams this summer (in July) — and said patient data is in the process of being deleted.

“Following the decommissioning of Streams at the Trust earlier this summer, data that has been processed by Google Health to provide the service to the Trust will be deleted and the agreement has been terminated,” a spokesperson said.

“As per the data sharing agreement, any patient data that has been processed by Google Health to provide the service will be deleted. The deletion process is started once the agreement has been terminated,” they added, saying the contractual timeframe for Google deleting patient data is six months.

Another Trust, Taunton & Somerset, also confirmed its involvement with Streams had already ended. 

The Streams contracts DeepMind inked with the NHS Trusts were for five years — so these contracts were likely approaching the end of their terms, anyway.

Contract extensions would have had to be agreed by both parties. And Google’s decision to decommission Streams may be factoring in a lack of enthusiasm from involved Trusts to continue using the software — although if that’s the case it may, in turn, be a reflection of Trusts’ perceptions of Google’s weak commitment to the project.

Neither side is saying much publicly.

But as far as we’re aware the Royal Free is the only NHS Trust still using the clinician support app as Google prepares to cut off Stream’s life support.

No more Streams?

The Streams story has plenty of wrinkles, to put it politely.

For one thing, despite being developed by Google’s AI division — and despite DeepMind founder Mustafa Suleyman saying the goal for the project was to find ways to integrate AI into Streams so the app could generate predictive healthcare alerts — the Streams app doesn’t involve any artificial intelligence.

An algorithm in Streams alerts doctors to the risk of a patient developing acute kidney injury but relies on an existing AKI (acute kidney injury) algorithm developed by the NHS. So Streams essentially digitized and mobilized existing practice.

As a result, it always looked odd that an AI division of an adtech giant would be so interested in building, provisioning and supporting clinician support software over the long term. But then — as it panned out — neither DeepMind nor Google were in it for the long haul at the patient’s bedside.

DeepMind and the NHS Trust it worked with to develop Streams (the aforementioned Royal Free) started out with wider ambitions for their partnership — as detailed in an early 2016 memo we reported on, which set out a five year plan to bring AI to healthcare. Plus, as we noted above, Suleyman keep up the push for years — writing later in 2019 that: “Streams doesn’t use artificial intelligence at the moment, but the team now intends to find ways to safely integrate predictive AI models into Streams in order to provide clinicians with intelligent insights into patient deterioration.”

A key misstep for the project emerged in 2017 — through press reporting of a data scandal, as details of the full scope of the Royal Free-DeepMind data-sharing partnership were published by New Scientist (which used a freedom of information request to obtain contracts the pair had not made public).

The UK’s data protection watchdog went on to find that the Royal Free had not had a valid legal basis when it passed information on millions of patients’ to DeepMind during the development phase of Streams.

Which perhaps explains DeepMind’s eventually cooling ardour for a project it had initially thought — with the help of a willing NHS partner — would provide it with free and easy access to a rich supply of patient data for it to train up healthcare AIs which it would then be, seemingly, perfectly positioned to sell back into the self same service in future years. Price tbc.

No one involved in that thought had properly studied the detail of UK healthcare data regulation, clearly.

Or — most importantly — bothered to considered fundamental patient expectations about their private information.

So it was not actually surprising when, in 2018, DeepMind announced that it was stepping away from Streams — handing the app (and all its data) to Google Health — Google’s internal health-focused division — which went on to complete its takeover of DeepMind Health in 2019. (Although it was still shocking, as we opined at the time.)

It was Google Health that Suleyman suggested would be carrying forward the work to bake AI into Streams, writing at the time of the takeover that: “The combined experience, infrastructure and expertise of DeepMind Health teams alongside Google’s will help us continue to develop mobile tools that can support more clinicians, address critical patient safety issues and could, we hope, save thousands of lives globally.”

A particular irony attached to the Google Health takeover bit of the Streams saga is the fact that DeepMind had, when under fire over its intentions toward patient data, claimed people’s medical information would never be touched by its adtech parent.

Until of course it went on it hand the whole project off to Google — and then lauded the transfer as great news for clinicians and patients!

Google’s takeover of Streams meant NHS Trusts that wanted to continue using the app had to ink new contracts directly with Google Health. And all those who had rolled out the app did so. It’s not like they had much choice if they did want to continue.

Again, jump forward a couple of years and it’s Google Health now suddenly facing a major reorg — with Streams in the frame for the chop as part of Google’s perpetually reconfiguring project priorities.

It is quite the ignominious ending to an already infamous project.

DeepMind’s involvement with the NHS had previously been seized upon by the UK government — with former health secretary, Matt Hancock, trumpeting an AI research partnership between the company and Moorfield’s Eye Hospital as an exemplar of the kind of data-driven innovation he suggested would transform healthcare service provision in the UK.

Luckily for Hancock he didn’t pick Streams as his example of great “healthtech” innovation. (Moorfields confirmed to us that its research-focused partnership with Google Health is continuing.)

The hard lesson here appears to be don’t bet the nation’s health on an adtech giant that plays fast and loose with people’s data and doesn’t think twice about pulling the plug on digital medical devices as internal politics dictate another chair-shuffling reorg.

Patient data privacy advocacy group, MedConfidential — a key force in warning over the scope of the Royal Free’s DeepMind data-sharing deal — urged Google to ditch the spin and come clean about the Streams cock-up, once and for all.

“Streams is the Windows Vista of Google — a legacy it hopes to forget,” MedConfidential’s Sam Smith told us. “The NHS relies on trustworthy suppliers, but companies that move on after breaking things create legacy problems for the NHS, as we saw with wannacry. Google should admit the decision, delete the data, and learn that experimenting on patients is regulated for a reason.”

Questions over Royal Free’s ongoing app use

Despite the Information Commissioner’s Office’s 2017 finding that the Royal Free’s original data-sharing deal with DeepMind was improper, it’s notable that the London Trust stuck with Streams — continuing to pass data to DeepMind.

The original patient data-set that was shared with DeepMind without a valid legal basis was never ordered to be deleted. Nor — presumably has it since been deleted. Hence the weight of the call for Google to delete the data now.

Ironically the improperly acquired data should (in theory) finally get deleted — once contractual timeframes for any final back-up purges elapse — but only because it’s Google itself planning to switch off Streams.

And yet the Royal Free confirmed to us that it is still using Streams, even as Google spins the dial on its commercial priorities for the umpteenth time and decides it’s not interested in this particular bit of clinician support, after all.

We put a number of questions to the Trust — including about the deletion of patient data — none of which it responded to.

Instead, two days later, it sent us this one-line statement which raises plenty more questions — saying only that: “The Streams app has not been decommissioned for the Royal Free London and our clinicians continue to use it for the benefit of patients in our hospitals.”

It is not clear how long the Trust will be able to use an app Google is decommissioning. Nor how wise that might be for patient safety — such as if the app won’t get necessary security updates, for example.

We’ve also asked Google how long it will continue to support the Royal Free’s usage — and when it plans to finally switch off the service. As well as which internal group will be responsible for any SLA requests coming from the Royal Free as the Trust continues to use software Google Health is decommissioning — and will update this report with any response. (Earlier a Google spokeswoman told us the Royal Free would continue to use Streams for the ‘near future’ — but she did not offer a specific end date.)

In press reports this month on the Google Health reorg — covering an internal memo first obtained by Business Insider —  teams working on various Google health projects were reported to be being split up to other areas, including some set to report into Google’s search and AI teams.

So which Google group will take over responsibility for the handling of the SLA with the Royal Free, as a result of the Google Health reshuffle, is an interesting question.

In earlier comments, Google’s spokeswoman told us the new structure for its reconfigured health efforts — which are still being badged ‘Google Health’ — will encompass all its work in health and wellness, including Fitbit, as well as AI health research, Google Cloud and more.

On Streams specifically, she said the app hasn’t made the cut because when Google assimilated DeepMind Health it decided to focus its efforts on another digital offering for clinicians — called Care Studio — which it’s currently piloting with two US health systems (namely: Ascension & Beth Israel Deaconess Medical Center). 

And anyone who’s ever tried to use a Google messaging app will surely have strong feelings of déjà vu on reading that…

DeepMind’s co-founder, meanwhile, appears to have remained blissfully ignorant of Google’s intentions to ditch Streams in favor of Care Studio — tweeting back in 2019 as Google completed the takeover of DeepMind Health that he had been “proud to be part of this journey”, and also touting “huge progress delivered already, and so much more to come for this incredible team”.

In the end, Streams isn’t being ‘supercharged’ (or levelled up to use current faddish political parlance) with AI — as his 2019 blog post had envisaged — Google is simply taking it out of service. Like it did with Reader or Allo or Tango or Google Play Music, or…. well, the list goes on.

Suleyman’s own story contains some wrinkles, too.

He is no longer at DeepMind but has himself been ‘folded into’ Google — joining as a VP of artificial intelligence policy, after initially being placed on an extended leave of absence from DeepMind.

In January, allegations that he had bullied staff were reported by the WSJ. And then, earlier this month, Business Insider expanded on that — reporting follow up allegations that there had been confidential settlements between DeepMind and former employees who had worked under Suleyman and complained about his conduct (although DeepMind denied any knowledge of such settlements).

In a statement to Business Insider, Suleyman apologized for his past behavior — and said that in 2019 he had “accepted feedback that, as a co-founder at DeepMind, I drove people too hard and at times my management style was not constructive”, adding that he had taken time out to start working with a coach and that that process had helped him “reflect, grow and learn personally and professionally”.

We asked Google if Suleyman would like to comment on the demise of Streams — and on his employer’s decision to kill the app — given his high hopes for the project and all the years of work he put into that particular health push. But the company did not engage with the request.

We also offered Suleyman the chance to comment directly. We’ll update this story if he responds.

#alphabet, #apps, #artificial-intelligence, #deepmind, #fitbit, #google, #google-health, #health, #health-systems, #healthcare, #information-commissioners-office, #london, #matt-hancock, #medconfidential, #moorfields-eye-hospital, #mustafa-suleyman, #national-health-service, #privacy, #uk-government

Patchwork Health raises £3.5M to fix the staff scheduling disaster inside stressed hospitals

The tyranny of the Excel spreadsheet continues, and especially in rostering staff. Nowhere is this more acutely felt in today’s COVID-pressured hospital wards, which are now depleted not just by the disease but by staff burnout from patchy-over or under-scheduling of staff hours. Two doctors realized this and decided to create a startup.

Patchwork Health has now raised £3.5m from Praetura Ventures and BMJ New Ventures, the investment arm of BMJ (global healthcare knowledge provider and publisher of The BMJ).

Founded in 2016 by NHS doctors Anas Nader and Jing Ouyang, the platform is now used by over 70 NHS sites to fill vacant shifts and offer staff flexible working. It couldn’t have come sooner: The NHS currently has 90,000 vacancies and 1 in 5 staff are said to be considering quitting due to stress and exhaustion.

Patchwork replaces this spreadsheet with a dashboard which predicts when temporary staff will be needed. Shifts are broadcast to an app and temporary staff use the app to select the shifts which suits them. The passporting of credentials, HR paperwork, and payments are all handled through the same system. Full-time healthcare workers can have their personal preferences reflected in their rotas without leaving NHS wards with staffing gaps, the startup says.

Dr Nader said: “We’re already partnering with over 70 NHS sites to tackle the root causes of burnout, offer full-time and temporary staff more choices, and create stronger staffing foundations for hospitals. Through our technology and services, flexible work and safely staffed wards can go hand in hand.”

David Foreman, Managing Director at Praetura Ventures and Non-Executive Director of Patchwork, added: “From the moment we met Anas and Jing, we could see the passion for their business. Patchwork is helping to solve a staffing crisis in the NHS. They’ve made real strides over the last 18 months and have the potential to make seismic changes in the way we organise staff in one of the world’s largest healthcare systems.”

#disease, #europe, #national-health-service, #nhs, #non, #tc

Healios raises $10M to scale its mental health platform for children scarred by the COVID-19 pandemic

Heaven knows what will happen to the mental health of children who’ve gone through this past year but if there’s one thing we need right now it’s mental health provision for young people that can scale. And as much as some of us can’t bear the thought of another video call, a UK startup reckons it’s come up with the magic formula for online therapy for children.

Now, Healios has raised a £7 million ($10M) Series A round to expand its platform across the UK. If the roll-out is successful, the startup is looking at expanding internationally. The round was led by InHealth Ventures with participation from existing investors AlbionVC.

Healios will use the funding to expand its AI, machine learning, and data science expertise, as well as add to the team. Healios says its platform digitises the clinical pathway, enabling children, adults, and their family members to use clinical services at home.

According to UK government statistics, one in eight (12.8%) five to 19-year-olds in the UK have a mental health disorder but two-thirds are unable to access NHS care because of soaring demands. And the Covid-19 pandemic has made things worse.

Launched in 2013, Healios says it has now worked with 65% of NHS Mental Health Trusts, with 70,000 specialized clinical sessions delivered, which is a high success rate for a startup, considering how hard it is to get NHS approval.

The online, family-focused therapy program for young people zeros in on psychosis and schizophrenia. Healios says that studies have shown involving family members from the start can reduce suicide by as much as 90%. It also covers anxiety, low mood, autism and ADHD, as well as support to their families.

Unlike some startups in the area of mental health, Healios is not a marketplace of advisers but is an end-to-end provider of these services.

InHealth Ventures and InHealth Group Chair, Richard Bradford, will be joining the Healios board, alongside Cat McDonald of AlbionVC.

Rich Andrews, Founder, and CEO of Healios, said: “This funding will help us reach more families in need and enable us to develop further sector-leading interventions and therapies. By bringing together clinical experts and giving them the tools to reach their patients regardless of where they are, we are closing the access gap which has plagued mental health provision for far too long.”

Andrews also told me: “A young person will have an initial mental health assessment with us. If needed, we’ll make a diagnosis and then they’ll move on to other interventions with us, so this is a seamless experience.”

Dr Ben Evans, Managing Director of InHealth Ventures, said: “Healios is a standard-bearer for healthcare innovation. They bring together clinical excellence with digital expertise, working in partnership with the NHS to address a critical, but complex area of care delivery. Healios’ work to date speaks for itself; their holistic approach to diagnosis and treatment has had a substantive impact on clinical outcomes and patient experience.”

Cat McDonald, Investor at AlbionVC, added: “Covid has engendered a pace of innovation previously unseen in healthcare. In particular, we have seen that remote care not only works, but often works much better than traditional alternatives. The option to receive care remotely, at home and in a family-centric setting is the strong preference of most kids suffering from poor mental health.”

#artificial-intelligence, #autism, #ceo, #chair, #europe, #health, #health-care, #healthcare, #machine-learning, #mental-health, #national-health-service, #nhs, #online-therapy, #schizophrenia, #services, #tc, #uk-government, #united-kingdom

‘Every Time I’m Calling, Someone Has Died’: The Anguish of India’s Diaspora

In WhatsApp chats, video calls, Facebook groups and forums, a global community has scrambled to save, and sometimes mourn, Covid-stricken loved ones.

#ahmedabad-india, #bihar-india, #coronavirus-2019-ncov, #england, #families-and-family-life, #grief-emotion, #india, #indian-americans, #london-england, #national-health-service, #politics-and-government

Kry closes $312M Series D after use of its telehealth tools grows 100% yoy

Swedish digital health startup Kry, which offers a telehealth service (and software tools) to connect clinicians with patients for remote consultations, last raised just before the pandemic hit in Western Europe, netting a €140M Series C in January 2020.

Today it’s announcing an oversubscribed sequel: The Series D raise clocks in at $312M (€262M) and will be used to keep stepping on the growth gas in the region.

Investors in this latest round for the 2015-founded startup are a mix of old and new backers: The Series D is led by CPP Investments (aka, the Canadian Pension Plan Investment Board) and Fidelity Management & Research LLC, with participation from existing investors including The Ontario Teachers’ Pension Plan, as well as European-based VC firms Index Ventures, Accel, Creandum and Project A.

The need for people to socially distance during the coronavirus pandemic has given obvious uplift to the telehealth category, accelerating the rate of adoption of digital health tools that enable remote consultations by both patients and clinicians. Kry quickly stepped in to offer a free service for doctors to conduct web-based consultations last year, saying at the time that it felt a huge responsibility to help.

That agility in a time of public health crisis has clearly paid off. Kry’s year-over-year growth in 2020 was 100% — meaning that the ~1.6M digital doctors appointments it had served up a year ago now exceed 3M. Some 6,000 clinicians are also now using its telehealth platform and software tools. (It doesn’t break out registered patient numbers).

Yet co-founder and CEO, Johannes Schildt, says that, in some ways, it’s been a rather quiet 12 months for healthcare demand.

Sure the pandemic has driven specific demand, related to COVID-19 — including around testing for the disease (a service Kry offers in some of its markets) — but he says national lockdowns and coronavirus concerns have also dampened some of the usual demand for healthcare. So he’s confident that the 100% growth rate Kry has seen amid the COVID-19 public health crisis is just a taster of what’s to come — as healthcare provision shifts toward more digital delivery.

“Obviously we have been on the right side of a global pandemic. And if you look back the mega trend was obviously there long before the pandemic but the pandemic has accelerated the trend and it has served us and the industry well in terms of anchoring what we do. It’s now very well anchored across the globe — that telemedicine and digital healthcare is a crucial part of the healthcare systems moving forward,” Schildt tells TechCrunch.

“Demand has been increasing during the year, most obviously, but if you look at the broader picture of healthcare delivery — in most European markets — you actually have healthcare usage at an all time low. Because a lot of people are not as sick anymore given that you have tight restrictions. So it’s this rather strange dynamic. If you look at healthcare usage in general it’s actually at an all time low. But telemedicine is on an upward trend and we are operating on higher volumes… than we did before. And that is great, and we have been hiring a lot of great clinicians and been shipping a lot of great tools for clinicians to make the shift to digital.”

The free version of Kry’s tools for clinicians generated “big uplift” for the business, per Schildt, but he’s more excited about the wider service delivery shifts that are happening as the pandemic has accelerated uptake of digital health tools.

“For me the biggest thing has been that [telemedicine is] now very well established, it’s well anchored… There is still a different level of maturity between different European markets. Even [at the time of Kry’s Series C round last year] telemedicine was maybe not something that was a given — for us it’s always been of course; for me it’s always been crystal clear that this is the way of the future; it’s a necessity, you need to shift a lot of the healthcare delivery to digital. We just need to get there.”

The shift to digital is a necessary one, Schildt argues, in order to widen access to (inevitably) limited healthcare resources vs ever growing demand (current pandemic lockdown dampeners excepted). This is why Kry’s focus has always been on solving inefficiencies in healthcare delivery.

It seeks to do that in a variety of ways — including by offering support tools for clinicians working in public healthcare systems (for example, more than 60% of all the GPs in the UK market, where most healthcare is delivered via the taxpayer-funded NHS, is using Kry’s tools, per Schildt); as well as (in a few markets) running a full healthcare service itself where it combines telemedicine with a network of physical clinics where users can go when they need to be examined in person by a clinician. It also has partnerships with private healthcare providers in Europe.

In short, Kry is agnostic about how it helps deliver healthcare. That philosophy extends to the tech side — meaning video consultations are just one component of its telemedicine business which offers remote consultations for a range of medical issues, including infections, skin conditions, stomach problems and psychological disorders. (Obviously not every issue can be treated remotely but at the primary care level there are plenty of doctor-patient visits that don’t need to take place in person.)

Kry’s product roadmap — which is getting an investment boost with this new funding — involves expanding its patient-facing app to offer more digitally delivered treatments, such as Internet Cognitive Based Therapy (ICBT) and mental health self-assessment tools. It also plans to invest in digital healthcare tools to support chronic healthcare conditions — whether by developing more digital treatments itself (either by digitizing existing, proven treatments or coming up with novel approaches), and/or expanding its capabilities via acquisitions and strategic partnerships, according to Schildt.

Over the past five+ years, a growing number of startups have been digitizing proven treatment programs, such as for disorders like insomnia and anxiety, or musculoskeletal and chronic conditions that might otherwise require accessing a physiotherapist in person. Options for partners for Kry to work with on expanding its platform are certainly plentiful — although it’s developed the ICBT programs in house so isn’t afraid to tackle the digital treatment side itself.

“Given that we are in the fourth round of this massive change and transition in healthcare it makes a lot of sense for us to continue to invest in great tools for clinicians to deliver high quality care at great efficiency and deepening the experience from the patient side so we can continue to help even more people,” says Schildt.

“A lot of what we do we do is through video and text but that’s just one part of it. Now we’re investing a lot in our mental health plans and doing ICBT treatment plans. We’re going deeper into chronic treatments. We have great tools for clinicians to deliver high quality care at scale. Both digitally and physically because our platform supports both of it. And we have put a lot of effort during this year to link together our digital healthcare delivery with our physical healthcare delivery that we sometimes run ourselves and we sometimes do in partnerships. So the video itself is just one piece of the puzzle. And for us it’s always been about making sure we saw this from the end consumer’s perspective, from the patient’s perspective.”

“I’m a patient myself and still a lot of what we do is driven by my own frustration on how inefficient the system is structured in some areas,” he adds. “You do have a lot of great clinicians out there but there’s truly a lack of patient focus and in a lot of European markets there’s a clear access problem. And that has always been our starting point — how can we make sure that we solve this in a better way for the patients? And then obviously that involves us both building strong tools and front ends for patients so they can easily access care and manage their health, be pro-active about their health. It also involves us building great tools for clinicians that they can operate and work within — and there we’re putting way more effort as well.

“A lot of clinicians are using our tools to deliver digital care — not only clinicians that we run ourselves but ones we’re partnering with. So we do a lot of it in partnerships. And then also, given that we are a European provider, it involves us partnering with both public and private payers to make sure that the end consumer can actually access care.”

Another batch of startups in the digital healthcare delivery space talk a big game about ‘democratizing’ access to healthcare with the help of AI-fuelled triage or even diagnosis chatbots — with the idea that these tools can replace at least some of the work done by human doctors. The loudest on that front is probably Babylon Health.

Kry, by contrast, has avoided flashy AI hype, even though its tools do frequently incorporate machine learning technology, per Schildt. It also doesn’t offer a diagnosis chatbot. The reason for its different emphasis comes back to the choice of problem to focus on: Inefficiencies in healthcare delivery — with Schildt arguing that decision-making by doctors isn’t anywhere near the top of the list of service pain-points in the sector.

“We’re obviously using what would be considered AI or machine learning tools in all products that we’re building. I think sometimes personally I’m a bit annoyed at companies screaming and shouting about the technology itself and less about what problem you are solving with it,” he tells us. “On the decision-support [front], we don’t have the same sort of chatbot system that some other companies do, no. It’s obviously something that we could build really effortlessly. But I think — for me — it’s always about asking yourself what is the problem that you’re solving for? For the patient. And to be honest I don’t find it very useful.

“In many cases, especially in primary care, you have two categories. You have patients that already know why they need help, because you have a urinary tract infection; you had it before. You have an eye infection. You have a rash —  you know that it’s a rash, you need to see someone, you need to get help. Or you’re worried about your symptoms and you’re not really sure what it is — and you need comfort. And I think we’re not there yet where a chatbot would give you that sort of comfort, if this is something severe or not. You still want to talk to a human being. So I think it’s of limited use.

“Then on the decision side of it — sort of making sure that clinicians are making better decisions — we are obviously doing decision support for our clinicians. But if it’s one thing clinicians are really good at it’s actually making decisions. And if you look into the inefficiencies in healthcare the decision-making process is not the inefficiency. The matching side is an inefficiency side.”

He gives the example of how much the Swedish healthcare system spends on translators (circa €200M) as a “huge inefficiency” that could be reduced simply — by smarter matching of multilingual clinicians to patients.

“Most of our doctors are bilingual but they’re not there at the same time as the patient. So on the matching side you have a lot of inefficiency — and that’s where we have spent time on, for example. How can we sort that, how can we make sure that a patient that is seeking help with us ends up with the right level of care? If that is someone that speaks your native language so you can actually understand each other. Is this something that could be fully treated by a nurse? Or should it be directly to a psychologist?”

“With all technology it’s always about how do we use technology to solve a real problem, it’s less about the technology itself,” he adds.

Another ‘inefficiency’ that can affect healthcare provision in Europe relates to a problematic incentive to try to shrink costs (and, if it’s private healthcare, maximize an insurer’s profits) by making it harder for patients to access primary medical care — whether through complicated claims processes or by offering a bare minimum of information and support to access services (or indeed limiting appointment availability), making patients do the legwork of tracking down a relevant professional for their particular complaint and obtaining a coveted slot to see them.

It’s a maddening dynamic in a sector that should be focused on making as many people as healthy as they possibly can be in order that they avoid as much disease as possible — obviously as that outcome is better for the patients themselves. But also given the costs involved in treating really sick people (medical and societal). A wide range of chronic conditions, from type 2 diabetes to lower back pain, can be particularly costly to treat and yet may be entirely preventable with the right interventions.

Schildt sees a key role for digital healthcare tools to drive a much needed shift toward the kind of preventative healthcare that would be better all round, for both patients and for healthcare costs.

“That annoys me a lot,” he says. “That’s sometimes how healthcare systems are structured because it’s just costly for them to deliver healthcare so they try to make it as hard as possible for people to access healthcare — which is an absurdity and also one of the reasons why you now have increasing costs in healthcare systems in general, it’s exactly that. Because you have a lack of access in the first point of contact, with primary care. And what happens is you do have a spillover effect to secondary care.

“We see that in the data in all European markets. You have people ending up in emergency rooms that should have been treated in primary care but they can’t access primary care because there’s no access — you don’t know how to get in there, it’s long waiting times, it’s just triaged to different levels without getting any help and you have people with urinary tract infections ending up in emergency rooms. It’s super costly… when you have healthcare systems trying to fend people off. That’s not the right way doing it. You have to — and I think we will be able to play a crucial role in that in the coming ten years — push the whole system into being more preventative and proactive and access is a key part of that.

“We want to make it very, very simple for the patients — that they should be able to reach out to us and we will direct you to the right level of care.”

With so much still to do tackling the challenges of healthcare delivery in Europe, Kry isn’t in a hurry to expand its services geographically. Its main markets are Sweden, Norway, France, Germany and the UK, where it operates a healthcare service itself (not necessarily nationwide), though it notes that it offers a video consultation service to 30 regional markets.

“Right now we are very European focused,” says Schildt, when asked whether it has any plans for a U.S. launch. “I would never say that we would never go outside of Europe but for here and now we are extremely focused on Europe, we know those markets very, very well. We know how to manoeuvre in the European systems.

“It’s a very different payer infrastructure in Europe vs the US and then it’s also so that focus is always king and Europe is the mega market. Healthcare is 10% of the GDP in all European markets, we don’t have to go outside of Europe to build a very big business. But for the time being I think it makes a lot of sense for us to stay focused.”

 

#accel, #artificial-intelligence, #canadian-pension-plan-investment-board, #covid-19, #digital-health, #digital-healthcare, #europe, #fundings-exits, #germany, #health, #healthcare, #johannes-schildt, #kry, #machine-learning, #machine-learning-technology, #national-health-service, #nhs, #sweden, #tc, #telehealth, #telemedicine

150,000 Painted Hearts, Each for a Life Lost to Covid-19 in Britain

The National Covid Memorial Wall in London aims to remember those who die during the pandemic. “It’s therapeutic,” said a volunteering painter who lost her grandmother to the disease.

#coronavirus-2019-ncov, #deaths-fatalities, #great-britain, #johnson-boris, #london-england, #national-health-service, #river-thames-england

Entitled to Vaccines, Undocumented Immigrants in U.K. Struggle for Access

The government has said inoculation centers won’t check immigration status, but many people remain fearful and confused about health care services.

#coronavirus-2019-ncov, #great-britain, #illegal-immigration, #national-health-service, #politics-and-government, #vaccination-and-immunization

Some Covid-19 Patients Say They’re Left With Ringing Ears

Scientists are examining a possible link to tinnitus. A businessman’s suicide has lent urgency to the research.

#coronavirus-2019-ncov, #depression-mental, #ears-and-hearing, #great-britain, #national-health-service, #quarantine-life-and-culture, #taylor-kent-1955, #texas-roadhouse-inc, #tinnitus, #united-states

Opera Singers Help Covid-19 Patients Learn to Breathe Again

A six-week program developed by the English National Opera and a London hospital offers customized vocal lessons to aid coronavirus recovery.

#chronic-condition-health, #coronavirus-2019-ncov, #english-national-opera, #national-health-service, #opera, #voice-and-speech

‘I Did Something Useful’: Unemployed Workers Take On the Virus in Temp Jobs

Some workers in devastated industries in Britain are finding solace and using their old skills as coronavirus testers, contact-tracing callers and hospital housekeeping workers.

#coronavirus-2019-ncov, #great-britain, #labor-and-jobs, #layoffs-and-job-reductions, #national-health-service

Captain Tom, Who Raised Millions for U.K. Health Workers, Is Hospitalized

Tom Moore, 100, raised $40 million in the spring by walking laps in his garden. He was admitted to a hospital on Sunday with the coronavirus, his daughter said.

#coronavirus-2019-ncov, #great-britain, #longevity, #moore-tom-1920, #national-health-service, #philanthropy

Vaccine Rollout Gives U.K. a Rare Win in Pandemic

“Vaccination is the one thing we’ve gotten right”: How a country that botched so much of its pandemic response has managed one of the fastest distributions in the world.

#astrazeneca-plc, #clinical-trials, #coronavirus-2019-ncov, #great-britain, #johnson-boris, #national-health-service, #oxford-university, #politics-and-government, #vaccination-and-immunization

U.K. Hospitals Struggle to Cope With a New Coronavirus Variant

Hospitals are straining to cope with a new coronavirus variant, despite warnings last year that more preparations were needed for an expected surge of cases in the winter.

#coronavirus-2019-ncov, #great-britain, #hospitals, #national-health-service, #nursing-and-nurses

In U.K. Hospitals, a Desperate Battle Against a Threat Many Saw Coming

Hospitals are straining to cope with a new coronavirus variant, despite warnings last year that more preparations were needed for an expected surge of cases in the winter.

#coronavirus-2019-ncov, #great-britain, #hospitals, #national-health-service, #nursing-and-nurses

As Crisis Grows in Britain Over Coronavirus Variant, a Reprieve for Johnson

The public health threat of the new coronavirus variant has stilled the British prime minister’s critics and offered a chance to redeem past failures.

#coronavirus-2019-ncov, #great-britain, #johnson-boris, #national-health-service, #starmer-keir

U.K. to Ease Rules on Blood Donations by Gay and Bisexual Men

The new policy, which will take effect next summer, was described by Britain’s health secretary as a landmark and by an activist as “a fundamental shift toward recognizing people are individuals.”

#blood-donation, #discrimination, #great-britain, #homosexuality-and-bisexuality, #men-and-boys, #national-health-service

How the US, UK and Canada Will Roll Out the Covid Vaccine

Within days, all three countries could be giving the Pfizer-BioNTech vaccine, but they have varying strategies and challenges. The U.S. plan, working through the states, is the least centralized.

#astrazeneca-plc, #coronavirus-2019-ncov, #european-union, #great-britain, #moderna-inc, #national-health-service, #national-institutes-of-health, #oxford-university, #pfizer-inc, #united-states, #vaccination-and-immunization

U.K. Tackles Giant Vaccine Rollout After Botched Covid Response

Britain left hospitals short of masks and gowns, and stumbled on testing and tracing, so can it vaccinate tens of millions of people in a matter of months? Experts think it can.

#astrazeneca-plc, #biontech-se, #coronavirus-2019-ncov, #cyberattacks-and-hackers, #great-britain, #interpol-international-criminal-police-organization, #moderna-inc, #national-health-service, #pfizer-inc, #vaccination-and-immunization

I’m Autistic. I Didn’t Know Until I Was 27.

Autism spectrum disorder is inseparable from who I am. I wish only that it hadn’t taken so long to find out.

#attention-deficit-hyperactivity-disorder, #autism, #great-britain, #medicine-and-health, #national-health-service, #women-and-girls

For Boris Johnson, Vaccine Rollout Offers Last Chance to Show Competence

With the vaccine rollout and a potential Brexit deal looming, his government has a chance to wash away its reputation for chaos and mismanagement.

#biontech-se, #coronavirus-2019-ncov, #great-britain, #great-britain-withdrawal-from-eu-brexit, #johnson-boris, #national-health-service, #pfizer-inc, #vaccination-and-immunization

Why the U.K. Approved the Pfizer Covid Vaccine First

When early results from the final trials began to roll in, scientists were well prepared. Now, they face the logistical challenge of putting the vaccine to work.

#belgium, #biontech-se, #coronavirus-2019-ncov, #european-medicines-agency, #great-britain, #national-health-service, #nursing-homes, #pfizer-inc, #vaccination-and-immunization

U.K. Approves Pfizer Coronavirus Vaccine, a First in the West

Emergency approval of the vaccine, ahead of the United States and the European Union, clears the way for Britain to begin mass inoculations.

#coronavirus-2019-ncov, #european-medicines-agency, #great-britain, #medicines-and-healthcare-products-regulatory-agency-uk, #national-health-service, #pfizer-inc, #politics-and-government, #regulation-and-deregulation-of-industry, #rumors-and-misinformation, #vaccination-and-immunization

English Gyms Find Themselves on the Front Lines of Lockdown Revolt

Despite police raids and the threat of heavy fines, some health clubs have stayed open in an act of defiance against a coronavirus lockdown.

#anxiety-and-stress, #coronavirus-2019-ncov, #health-clubs, #johnson-boris, #london-england, #martial-arts, #national-health-service

England Weighs Another Nationwide Virus Lockdown

Prime Minister Boris Johnson’s cabinet met on Saturday as medical experts warned that the virus would soon overwhelm hospitals if the government did not take draconian action.

#conservative-party-great-britain, #coronavirus-2019-ncov, #great-britain, #johnson-boris, #labour-party-great-britain, #national-health-service, #shutdowns-institutional, #starmer-keir

Britain’s Health Workers Face 2nd Virus Wave, but This Time With Less Support

Public backing for the efforts of the country’s health service is eroding amid a lack of a clear government policy to deal with the pandemic, many medical workers say.

#coronavirus-2019-ncov, #great-britain, #johnson-boris, #national-health-service

Replace legacy healthcare staffing with a vertical marketplace for workers

Over the last several months, we’ve seen dramatic swings in the demand for healthcare across the country. While hospitals in some cities were overwhelmed by an influx of COVID-19 patients, others sat empty — and in many cases experienced financial distress — as patients postponed elective surgeries and care for non-life-threatening matters. Cities went from relative safe zones to dangerous hotspots and back again within a matter of a few months.

This “COVID-19 whipsaw” has brought into focus a problem that has long been simmering in healthcare: The movement of labor is highly inefficient. We need a new paradigm in healthcare labor markets.

The pandemic has exposed systemic vulnerabilities

Early in the pandemic, many clinicians moved across state lines to answer Governor Andrew Cuomo’s calls for help in New York, only to be told upon arrival that their contracts had been canceled because the hospitals had overestimated their need. The imbalance of nurse and physician labor across states, which existed well before the pandemic, reached a terrifying apex during the height of the pandemic. In some parts of the country, clinicians were being furloughed or laid off, while in others they were stretched to their full capacity working around the clock to save lives. With each month came new hotspots — New York, Detroit, Miami, Phoenix, Los Angeles — and with each new hotspot a near disaster caused by a shortage of healthcare workers.

The marathon of addressing COVID-19 has imposed severe stress, depression and anxiety on our nation as a whole, with our healthcare providers at the epicenter. Clinician burnout was a serious issue even before COVID-19, but it has only gotten worse in recent months, especially for those working in geographic hotspots.

Healthcare workers across the country have found themselves delivering care for a high volume of acutely ill patients, often with severely limited supplies of personal protective equipment (PPE), magnifying their own risk. Many have watched colleagues fall sick and even die, while others have been asked to ration patient care. Multiple studies have highlighted increased instances of depression, anxiety, insomnia and psychological distress amongst frontline workers, and some clinicians have even taken their own lives.

Challenges with the legacy staffing model

Prior to the pandemic, our healthcare system had long dealt with seasonal and geographic differences in healthcare demand. Flu season, for example, causes more demand for healthcare in December than July. Florida experiences more demand for care in February than June because snowbirds migrate from the northeast in the winter and bring their healthcare needs with them.

In the past, temporary or contingent workers — travel nurses, per diem nurses and locum tenens doctors — helped to balance supply of labor with the seasonal and geographic peaks and troughs in demand. Staffing agencies worked with these temporary clinicians to match them with opportunities at hospitals, ambulatory surgical centers, long-term care facilities and other providers. Many people don’t realize that temporary clinicians are an important part of the healthcare workforce. Estimates are that supplemental staffing accounts for more than 30% of total nursing hours in the U.S.

Staffing agencies, however, cannot scale for pandemic scale events because they are using outdated tools and processes. Recruiters at staffing agencies make phone calls and send emails to communicate with the clinicians who are frequently annoyed by inconvenient and unwanted solicitations. More importantly, these tools are not fast enough when we experience sudden unpredicted spikes in different geographic areas like those in the past six months.

Outdated regulations are partly to blame. Licensure for nurses is handled state-by-state, which creates obstacles that prohibit nurses from working in states where they are not licensed. There are approximately 35 states that are part of a licensing compact that offers mutual recognition, but many of the largest states and those hit hardest by the early days of the pandemic — like California, New York and Washington — are not part of the compact. In California, it takes six weeks on average to get a license for an out-of-state nurse, a number that has not budged even as the state’s COVID-19 cases have skyrocketed.

Some states that are not part of the compact have used executive actions or emergency declarations to allow nurses to cross state lines, but many of those are now expiring and were never meant to be a long-term solution. The pandemic has highlighted the need for new regulations as part of the solution described below that allow for a more fluid movement of clinicians across state lines. Are patients and diseases in California really that different from the patients and diseases in Texas such that we need different regulatory standards and license requirements in each state?

The solution: A vertical marketplace for healthcare workers

We need to move beyond the antiquated staffing agency model to facilitate a more rapid response, a better clinician experience and more efficient matching. The good news is that we are starting to see companies addressing this problem with a software-centric model: the vertical labor marketplace. Some examples of these marketplaces include Trusted Health and Nomad Health.

Like StubHub, the company I started 20 years ago, these marketplaces use the power of the internet to connect supply with demand. In the case of these healthcare labor marketplaces, the clinicians make up the supply while the hospitals and other care facilities make up the demand. Rather than scouring the job boards for individual hospitals or fielding calls from recruiters, clinicians can see all available positions that meet their skills and experience, along with compensation and other job details. They can check the marketplace when it is convenient without getting inundated by phone calls or emails.

Clinicians can use the marketplaces to come in and out of the labor pool as they wish. This helps to reduce stress and increase work-life balance before burnout sets in. Some nurses might choose to leverage the marketplace to move to Florida in the winter to serve the snowbirds while others may choose to take the summer off and work during flu season. The marketplace also creates financial opportunities for underutilized clinicians by better allocating their labor to geographies and hospitals that need them. Hospitals and other providers benefit from these simple-to-use cloud-based marketplaces that allow them to quickly ramp up capacity when they need it most.

The system needs more contingent workers

In the staffing agency paradigm, when an independent hospital experiences a spike in demand it must work with a staffing agency to bring in temporary clinicians quickly. A multihospital health system has the advantage of being able to move clinicians from lower demand hospitals to a sister-hospital that is experiencing an unexpected peak. A widely adopted national marketplace would theoretically have an even greater advantage because its broader visibility across more hospitals would allow it to move resources from hospitals with excess capacity to those with the highest demand, even if the two hospitals are unaffiliated.

There have been heroic doctors and nurses who have volunteered to move to areas with the highest demand. However, hospitals and health systems are not incentivized to lend out their doctors and nurses to nonaffiliated hospitals. Therefore, the solution requires more clinicians to be in the contingent workforce (like travel and per diem nurses). If the mix between contingent nurses and permanent nurses were 70/30 instead of 30/70, peaks and troughs would be more easily handled since a larger percentage of the resources would be shared across a larger network of hospitals. The marketplaces would have an even greater impact on our society because they would be able to allocate even more resources to the hospitals with the most acute needs.

There are two possible sources of additional contingent workers. First, permanent healthcare workers may decide to terminate their affiliation with a single hospital or health system in favor of contingent work because they are attracted to the flexibility. Second, workers in other industries may choose to enter the healthcare industry because it provides more options for contingent work. Regardless of the path, an expansion of the supply of contingent healthcare workers is a necessary part of the solution.

A side benefit: Stronger financial health for our hospitals

During the pandemic, patients across the country chose to postpone many elective surgeries and non-life-threatening procedures because they were scared of contracting the virus at the hospital. As a result, hospitals lost revenue from profitable elective procedures. Because hospitals have huge fixed costs (salaries are a big component), the government has provided tens of billions of stimulus money for hospitals in financial distress.

In addition to all the other benefits described above, a more widely adopted vertical labor marketplace for healthcare workers would provide relief to hospitals by shifting a larger portion of clinician labor from a fixed cost to a variable cost. Hospitals would have a smaller number of permanent employees and a larger number of temporary contingent workers. When demand drops, hospitals would use fewer contingent clinicians. When demand rises, they could tap into the marketplace to bring on more capacity.

A marketplace approach to America’s healthcare and its clinicians is long overdue. While the pandemic magnified our current system’s vulnerabilities, they have been there all along. By leveraging the technology and marketplace paradigm that has made so many other industries efficient, we can improve not only our healthcare system and clinician quality of life, but also our hospitals’ bottom line. Let’s galvanize the collective distress COVID-19 has created and use it to pioneer a more efficient model for all.

* Craft is an investor in Trusted.

#column, #covid-19, #flu, #health, #health-care, #health-systems, #healthcare, #national-health-service, #novel-coronavirus, #nursing, #opinion, #policy, #tc

American Clinical Research Needs to Step Up Its Game Against Covid-19

Here’s how: Follow Britain’s example.

#clinical-trials, #coronavirus-2019-ncov, #food-and-drug-administration, #great-britain, #national-health-service, #national-institutes-of-health, #research, #united-states

England’s Flawed Virus Contact Tracing Will Be Revamped

After months of complaints about its centralized, privatized system, Prime Minister Boris Johnson’s government says resources will be diverted to local public health authorities.

#contact-tracing-public-health, #coronavirus-2019-ncov, #england, #great-britain, #johnson-boris, #layoffs-and-job-reductions, #national-health-service, #serco-group-plc

U.K.’s New Coronavirus Tactic: Urge Britons to Lose Weight

The prime minister, who cited his own problems with obesity, said his hospitalization with Covid-19 had prompted his push to tighten regulations on junk food.

#advertising-and-marketing, #coronavirus-2019-ncov, #diet-and-nutrition, #great-britain, #johnson-boris, #labeling-and-labels-product, #national-health-service, #obesity

Europe Said It Was Pandemic-Ready. Pride Was Its Downfall.

The coronavirus exposed European countries’ misplaced confidence in faulty models, bureaucratic busywork and their own wealth.

#belgium, #china, #coronavirus-2019-ncov, #disease-rates, #england, #epidemics, #europe, #european-union, #ferguson-neil-m, #france, #great-britain, #imperial-college-london, #johnson-boris, #macron-emmanuel-1977, #national-health-service, #politics-and-government, #protective-clothing-and-gear, #scientific-advisory-group-for-emergencies-great-britain, #south-korea, #swine-influenza, #united-states

Long Waits for U.K. Hospital Treatment as N.H.S. Fights Coronavirus

With routine operations in England curtailed, some patients have experienced a significant deterioration.

#coronavirus-2019-ncov, #england, #hospitals, #national-health-service, #surgery-and-surgeons, #tests-medical

England’s ‘World Beating’ System to Track Coronavirus Is Anything But

Like a lot of the country’s pandemic response, contact tracing has been hampered by inconsistency, with much promised but little delivered.

#contact-tracing-public-health, #coronavirus-2019-ncov, #coronavirus-reopenings, #england, #government-contracts-and-procurement, #great-britain, #johnson-boris, #london-england, #national-health-service, #politics-and-government, #serco-group-plc

UK’s COVID-19 health data contracts with Google and Palantir finally emerge

Contracts for a number of coronavirus data deals that the U.K. government inked in haste with U.S. tech giants, including Google and Palantir, plus a U.K.-based AI firm called Faculty, have been published today by openDemocracy and law firm Foxglove — which had threatened legal action for withholding the information.

Concerns had been raised about what is an unprecedented transfer of health data on millions of U.K. citizens to private tech companies, including those with a commercial interest in acquiring data to train and build AI models. Freedom of Information requests for the contracts had been deferred up to now.

In a blog post today, openDemocracy and Foxglove write that the data store contracts show tech companies were “originally granted intellectual property rights (including the creation of databases), and were allowed to train their models and profit off their unprecedented access to NHS data.”

“Government lawyers have now claimed that a subsequent (undisclosed) amendment to the contract with Faculty has cured this problem, however they have not released the further contract. openDemocracy and Foxglove are demanding its immediate release,” they add.

They also say the contracts show that the terms of at least one of the deals — with Faculty — were changed “after initial demands for transparency under the Freedom of Information Act.”

They have published PDFs of the original contracts for Faculty, Google, Microsoft and Palantir. Amazon Web Services was also contracted by the NHS to provide cloud hosting services for the data store.

An excerpt from the Faculty contract regarding IP rights

Back in March, as concern about the looming impact of COVID-19 on the UK’s National Health Service (NHS) took hold, the government revealed plans for the health service to work with the aforementioned tech companies to develop a “data platform” — to help coordinate its response, touting the “power” of “secure, reliable and timely data” to inform “effective” pandemic decisions.

However the government’s lack of transparency around such massive health data deals with commercial tech giants — including the controversial firm Palantir, which has a track record of working with intelligence and law enforcement agencies to track individuals, such as supplying tech to ICE to aid deportations — raises major flags.

As does the ongoing failure by the government to publish the amended contracts — with the claimed tightened IP clauses.

The (now published, original) Google contract — to provide “technical, advisory and other support” to NHSX to tackle COVID-19 — is dated March 1, and specifies that services will be provided by Google to the NHS for zero charge. 

The Palantir contract, for provision of its Foundry data management platform services, is dated as beginning March 12 and expiring June 11 — with the company charging a mere £1 ($1.27) for services provided.

While the Faculty contract — providing “strategic support to the NHSX AI Lab” — has a value in excess of £1M (including VAT), and an earlier commencement date (February 3), with an expiry date of August 3.

The government announced its plan to launch an AI Lab within NHSX, the digital transformation branch of the health service, just under a year ago — saying then that it would plough in £250 million to apply AI to healthcare related challenges, and touting the potential for “earlier cancer detection, discovering new treatments and relieving the workload on our NHS workforce.”

The lab had been slated to start spending on AI in 2021. Yet the Faculty contract, in which the AI firm is providing “strategic support to the NHSX AI Lab,” and described as an “AI Lab Strategic Partner,” suggests the pandemic nudged the government to accelerate its plan.

We’ve reached out to the Department of Health with questions.

Last month, NHS England and NHS Improvement responded to an FOI request that TechCrunch filed in early April asking for the contracts — but only to say a response was delayed, already around a month after our original request. (The normal response time for U.K. FOIs is within 20 working days, although the law allows for “a reasonable extension of time to consider the public interest test.”)

Earlier this month, The Telegraph reported that Google-owned DeepMind co-founder Mustafa Suleyman — who has since moved over to work for Google in a policy role — was temporarily taken on by the NHS in March, in a pro bono advisory capacity that reportedly included discussing how to collect patient data.

An NHSX spokesperson told Digital Health that Suleyman had “volunteered his time and expertise for free to help the NHS during the greatest public health threat in a century,” and denied there had been any conflict of interest.

The latter refers to the fact that when Suleyman was still leading DeepMind the company inked a number of data-sharing agreements with NHS Trusts — gaining access to patient health data as part of an app development project. One of these contracts, with the Royal Free NHS Trust, was subsequently found to have breached U.K. data protection law. Regulators said patients could not have “reasonably expected” their information to be shared for this purpose. The Trust was also reprimanded over a lack of transparency.

Google has since taken over DeepMind’s health division and taken on most of the contracts it had inked with the NHS — despite Suleyman’s prior insistence that NHS patient data would not be shared with Google.

 

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