Growing older does not diminish a person’s inherent dignity and fundamental rights.

On 14 December 1990, the United Nations General Assembly designated October 1 as the International Day for Older Persons. This was preceded by initiatives such as the Vienna International Plan of Action on Ageing – which was adopted by the 1982 World Assembly on Ageing – and endorsed later that year by the UN General Assembly.

In 1991, the General Assembly adopted the United Nations Principles for Older Persons. In 2002, the Second World Assembly on Ageing adopted the Madrid International Plan of Action on Ageing, to respond to the opportunities and challenges of population ageing in the 21st century and to promote the development of a society for all ages.

Almost 700 million people are now over the age of 60. By 2050, 2 billion people, over 20 percent of the world’s population, will be 60 or older. The increase in the number of older people will be the greatest and the most rapid in the developing world, with Asia as the region with the largest number of older persons, and Africa facing the largest proportionate growth.

The interdependence between older persons’ social integration and the full enjoyment of their human rights cannot be ignored, as the degree to which older persons are socially integrated will directly affect their dignity and quality of life.

Older human rights champions today were born around the time of the adoption of the UDHR in 1948. They are as diverse as the society in which they live: from older people advocating for human rights at the grass root and community level to high profile figures on the international stage. Each and everyone demands equal respect and acknowledgment for their dedication and commitment to contributing to a world free from fear and free from want.

The 2018 theme aims to:

• Promote the rights enshrined in the Declaration and what it means in the daily lives of older persons;
• Raise the visibility of older people as participating members of society committed to improving the enjoyment of human rights in many areas of life and not just those that affect them immediately;
• Reflect on progress and challenges in ensuring full and equal enjoyment of human rights and fundamental freedoms by older persons; and
• Engage broad audiences across the world and mobilize people for human rights at all stages.

On the day of laying of foundation stone for ageing persons, Mr. JP Nadda, Union Minister of Health and Family Welfare, Mr. Ashwini Kumar Choubey and Smt. Anupriya Patel, Ministers of State for Health and Family Welfare were also present at the event.

Addressing the participants, PM Modi said that our government has been successful in taking healthcare out of the ambit of the Health Ministry and today we have Rural Development Ministry, Water and Sanitation Ministry, and Child Development Ministry and AYUSH Ministry with our vision of healthcare.

He further added that our vision is not limited to hospitals, diseases, medicines, and super specialty care but also with the idea that affordable and equitable healthcare should be ensured for every citizen. PM Modi said that the government is equipping existing hospitals with all the modern facilities and at the same time it is also making sure that the healthcare facilities reach the remotest areas of the countries. He added that 58 district hospitals are being upgraded to medical colleges and the government has also sanctioned budgets for 24 new medical colleges.

PM Modi added that the global target for eliminating TB is 2030, but we have set 2025 as our target for India to eliminate TB, five years before the global target. He further stated that the government is providing Rs. 500 to the TB patients towards nutritional support.

The Prime Minister also mentioned the Ayushman Bharat programme. He said that under the National Health Protection Mission, 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) will be provided a coverage up to 5 lakh rupees per family per year for secondary and tertiary care hospitalization. This will be the world’s largest government-funded healthcare programme, he stated.

Mr. Nadda said that there has been a visible change in the tertiary healthcare in the country and assured that the government is committed to ensuring that the new AIIMS will meet the same standards of service as AIIMS, New Delhi. No effort will be spared to make them the very best, he added. He said that that the new AIIMS will have the same work culture and the government is taking all the steps to ensure that. He further stated that the Ministry in the past 4 years has not left any stone unturned – from monitoring the clean and effective implementation of national programmes to establishing 13 new AIIMS like institutes across the country. Reiterating the commitment of the government, he said under Ayushman Bharat, 150,000 sub-centers will be converted into Health and Wellness Centres (HWCs) that will deliver comprehensive primary healthcare.

“The HWC would provide preventive, promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc. He further stated that the government has initiated universal screening of common NCDs such as diabetes, hypertension and common cancers along with Tuberculosis and Leprosy and everybody above the age of 30 years will be screened for these diseases and as such this will eventually help in reducing the disease burden of the country. “We will implement the vision of the Prime Minister in letter and spirit,” he added.

The underground tunnel is providing connecting facility between AIIMS and JPNA Trauma Centre and will reduce the commute time between the two centers. The completed length connectivity between two centers is approximately 1 km and has been completed at a cost of Rs. 44 crores.

The Powergrid Vishram Sadan has a 300 bedded night shelter facility meant for the patients and their relatives visiting AIIMS main hospital and JPNA Trauma center at AIIMS. The 11-floor facility has been constructed at a cost of Rs. 32.67 crores and funded by the Power Grid Corporation.

New emergency block at Safdarjung Hospital will house 64 triage beds, red zone for children & adults and 90 ICU beds for victims of road traffic accidents, acute trauma suffered by individuals at home or work, acute poisoning and severe medical and surgical emergencies. The block has been developed at a cost of Rs. 346 crores.

Super Specialty Block at Safdarjung Hospital holds tertiary care facilities in the areas of cardiovascular sciences, neurosciences, pulmonary medicine, nephrology, and endocrinology and shall be offering the facility of a Heart Command Centre, respiratory care facility, sleep labs, 24×7 dialysis unit, MRI guided Braine Suite, etc. It also has a 228-bedded private ward. The super specialty block has been developed at a cost of Rs. 920 crores.

Also present at the event were Smt. Preeti Sudan, Secretary (Health); Prof. Randeep Guleria, Director, AIIMS New Delhi; Dr. Rajendra Sharma, Medical Superintendent, VMMC & Safdarjung Hospital, New Delhi and Mr. IS Jha, CMD, Powergrid Corporation along with the senior officers from the Health Ministry and faculty of AIIMS.

Hospitals are the core of health and medical care and adaptation of new technology and innovations will make the biggest difference to our medical needs while improving the health conditions of all.

Highlighting the concern of data security and reluctance to depend on technology because of that concern, the keynote speaker for the first session Dr. Vijay Agarwal shared his views on the subject emphasizing on the fact that technology is rolling out at a very fast pace. Stating an example of landline telephones that took more than 100 years to reach the one billion mark of users, was reduced to less than 20 years for mobile technology to do the same. This way he highlighted the fact that newer technology will be very rapid in implementation requiring hospitals and clinics to adapt and be prepared to utilize it rather than be apprehensive about it.

Professor AK Gupta of the esteemed PGI Hospital in Chandigarh, also, supported this view and shared his personal experiences and experimentation with management and administration of the hospital. He emphasized that it’s not just in the medical and clinical field that we have to embrace innovations and technology, but in fact it will fetch very positively encouraging results if adopted in the management and administration of hospitals. He shared his views on reducing the time stay of patients in hospitals by means of using an innovative approach provided by tailored software and mobile apps. These efforts were recognized by the hospital; national level authorities and even internationally and was rightly awarded for this approach. He concluded his speech by asserting that you don’t have to discover new technology, but innovative utilization of existing technology can also provide very good results.

Touching the humane element in the hospitals, Prof Arti Maria of RML Hospital shared her experiences of involving mothers and non-hospital staff in caring for the young ones in ICU units. “A soft touch by the mothers, who are otherwise distanced outside the ICU units, has resulted on faster recovery of infants in the ICU.”

“In fact, this experimentation has also resulted in enhanced confidence of mothers and improved their social status with respect to their husbands, families and the social fabric as such.” Prof Maria, who specializes in Neonatology as Head of that Department is keenly working with other authorities beyond the hospital to promote this concept and is getting very encouraging results from hospitals, and relevant bodies.

Partha Dey, with years of experience at IBM shed some light on the subject of innovations with the simplicity that the IBM is known for. The three products and services of IBM, Watson, Block Chain and Cloud data are the way forward, according to Mr. Dey, Healthcare Leader and SME and IBM, India.

Watson, according to Mr Dey, is the most innovative friend for health care workers and doctors alike, as it understands many languages, including regional and Oncology. This helps medical staff to interpret and diagnose ailments with a high grade of accuracy and ease. Watson can, not only, analyze and conclude at a faster pace, but can also eliminate human error contributed in the form of emotional stress and personal bias.

Block Chain, on the other hand is the best mode of data utilization and can contribute to tracking of product and their status. Block Chain can also help eliminate counterfeit medicines by clever tracking of products and their batches.

IBM is constantly pushing the boundaries of innovations with introduction of new products and services. Watson and Block Chain are latest in the field of health and medical welfare.

In totality, the high profile panel of speakers from different fields of health and medical facilities explored the option of inducing innovations and new technology in the operations of hospitals and clinics beyond clinical procedures, leading to heightened efficiency and operational advantages resulting in a healthier society and population at large.

Want to write for InnoHEALTH? send us your article at  magazine@innovatiocuris.com

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2 
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz 
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw 
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 4 (October to December 2017) – http://amzn.to/2B2UMLw
InnoHEALTH Volume 3 Issue 1 (January to March 2018) – https://goo.gl/fksdQx

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A new paradigm for use of machine intelligence in healthcare

Many national economies are on the brink of collapse under the burden of state-supported health insurance programs. For example in the US, a country that does not provide universal healthcare, the national debt is expected to double as a result of healthcare related liabilities over the next three decades. There is an even greater price to pay for the inefficiencies found in healthcare systems. When already overburdened systems are pushed to their limits, healthcare professionals are forced to make bad decisions.

In a startling example, during Hurricane Katrina, doctors and nurses at New Orleans’ Memorial Hospital found themselves incapable of making even simple decisions. In her Pulitzer Prize-winning coverage, Sheri Fink reported how patients deemed the least likely to survive, were injected with a lethal combination of drugs — even as the evacuation was already on its way.

This chilling anecdote sheds light on a greater problem underpinning many of the biggest threats hurting human society and the eco-system of our planet.

We humans are not equipped for making good decisions under stress. Positive outcomes across a multitude of fields, including healthcare, largely depend on the ability to make good decisions under unpredictable and stress inducing conditions. We, humans, are not only bad at making decisions under pressure but are poorly equipped for making any rational decisions at all.

Daniel Kahneman, in his Nobel Prize winning work on decision making, explains how after years of deliberation leading to a single decision, the person making the decision might still completely ignore the entire process of deliberation and instead make a decision driven by emotions in a whim of the moment.

An Age of Automated Decision Making

As the information age is about the focus on automating processes related to access to information, the next age, the age of “decisioning”, will focus on automation of processes related to decision making. Whereas humans are excellent in pattern detection and pattern making, an essential requirement for creating intelligent computer systems, computers are strong in making decisions where processing of facts is of vital importance. This almost magical ability of computing systems to process information includes the capability to identify and utilize extremely subtle connections between otherwise seemingly disconnected pieces of information, a feat us humans could never do on our own with the kind of precision and scale even a simple computer system can. In no other field, rational decisions are of such vital importance as in healthcare.

Not only healthcare is the most significant economic liability for many nations, but it is also the only field of practice affecting people’s everyday lives that can be considered truly as “life and death” matter. It is, therefore, the area where the human society most desperately needs help.

Computer-aided decision systems can be categorized into three evolutionary stages, each with a corresponding quality of results, and the requirement for a level of human involvement.

Whereas up until a few years ago, most systems were still ‘descriptive’ with some examples of ‘predictive’ decision- making support systems, in the last two years the developments in the field of machine intelligence have for the first time made the dream of prescriptive expert systems realistic. Recent advancements in both open source software and commercial hardware have paved the way for rapid prototyping of ideas that promise to revolutionize the way decisions are made across a multitude of fields, including healthcare.

Examples of these advancements include deep learning platforms such as Google’s TensorFlow and Keras, unstructured data processing innovations such as word vectorization, and Nvidia’s data processing focused GPU product-line.

Regardless of the tremendous promise and the recent hype surrounding machine intelligence, some significant concerns remain without any serious attention. While machine intelligence innovators would like to focus on showcasing “what’s possible,” before introducing new ideas and processes into the healthcare apparatus, it is far more important to ask “what could go wrong”.

Morality and Healthcare Algorithms

Every machine intelligence solution can be reduced into two aspects; the data inputs available for the solution, and the means by which the solution process those inputs. These two act as the causes for the result the system provides. Algorithms underpin every decision a computer system makes, regardless of the kind of system it is. The unique feature in this regard, of modern machine intelligence systems, such as those based on neural networks and the deep learning method, is that humans cannot audit them. It is for this reason that we can get surprising results us humans could not arrive at without working with machine intelligence, and it is important to understand that surprising results may also be negative results. In many cases, adverse results in the healthcare context arise from causes that were set years or even decades before, and as of today, it is virtually impossible to establish true causality in such cases. This means that it would be almost impossible to know if a given machine intelligence solution is contributing positively in the long term or just driving shortterm efficiency. This will hold true at least for the next 100 years, or as long as it takes to understand causality in results that take decades to mature.

When in the 1980’s game theory-based principles were widely introduced in the western healthcare context, nobody predicted the consequences. For example, while nurses and doctors were incentivized to meet certain productivity quotas such as the number of days spent in the ICU, mortality rates of patients skyrocketed as a result of ICU beds being more available. In effect, a quota scheme is an example of a simple algorithm and can be used to highlight the danger that comes with introducing machine intelligence into healthcare.

This applies in particular in countries with universal healthcare and poorly performing national economy. Under such conditions, humans that make the decisions about the use of machine intelligence in the national healthcare system, are under tremendous stress. Not only their decisions affect individual patients’ lives but also have the potential for changing the destiny of an entire nation. It is very hard to see how under such conditions, non-experts, being bombarded with endless hype by self-proclaimed machine intelligence experts, would be able to make the right decisions.

In fact, government officials, healthcare professionals, nor computer and data scientists, are formally trained in morality and often lack even the most basic understanding of ontology, epistemology, and formal logic. The three legs of the stool on which rational decisions sit. As a result, as we have seen through examples in financial markets, online advertising, and other early embracers of algorithmic decision making, we end up with so-called greedy algorithms that optimize towards a given end ruthlessly without caring about anything else.

Unlike healthcare professionals, these algorithms are not afraid of losing their livelihood and reputation as a result of making the wrong decision that ends up hurting people.

While a healthcare facility or a professional working in one, could be sued for damages, in the case of machine intelligence systems, liabilities in the healthcare context have so far not been defined.

Security in Healthcare Systems

In the light of the recent events regarding ransomware, and the rapid growth in its popularity as a cybercrime tool, it does not seem too far-fetched that in the near-future entire hospitals will be targeted and held for ransom. Indeed many hospitals had already become victims of ransomware as a consequence of passive global or national attacks. In the recent WannaCrypt ransomware attack individual medical devices were rendered temporarily useless after being infected.

Siemens released multiple warnings about its healthcare devices being possibly vulnerable to WannaCrypt. Beau Woods, deputy director of Cyber Statecraft Initiative at the Atlantic Council said that it was likely that many important medical devices such as MRIs and other crucial computer-aided systems were rendered temporarily useless by the attack.

These examples show how healthcare organizations and their technology partners are currently incapable of securing important systems. Whereas in the human operated healthcare apparatus, the devastation is so easy to create, in a highly automated machine intelligence based healthcare apparatus, the problem would be significantly amplified.

Here too, regarding security and healthcare systems, we have to seriously consider the implications of the machine intelligence ideas that are adopted today, regarding the threat landscape over the next few decades.

For example, current cryptographic methods are all based on so-called key exchange cryptography. Any sudden improvement in computation power, for instance in the form of quantum computing becoming practical, will lead to an immediate collapse of the key exchange based security paradigm. In a machine intelligence dominated healthcare apparatus, collapse of the key exchange based security paradigm has the potential for leading to the greatest human travesty in the history of the world. In the absence of serious discussion about such longer-term threats, it will not be possible to make the right decisions regarding decision-making automation and wider adoption of machine intelligence based expert systems in healthcare.

The Importance of Human Touch

Sometime in the distant future, we may be able to completely automate certain key aspects of healthcare, such as triage management. Even then it is of significant importance to not lose sight of the essence of healthcare; taking care of people. Taking care of people is one part taking care of their physical body, and one part taking care of their feelings.

In a completely machine intelligence and robotics based triage management approach it would be hard for patients to feel that they are being taken care of in the way they feel when an actual doctor is treating them.

On the other hand, in a very short period of time, the doctors would lose their ability to deal with the basic day-to-day taking care of patients that still today keep them overworked.

Because algorithms don’t feel anything, for example, empathy, it is also likely that as specialist doctors increasingly get their inputs from those algorithms, they become further distanced from the human aspect that some argue is necessary for healing practice. In this light, perhaps it’s more reasonable for the allopathic medicine to seek intelligence from its eastern counterparts such as TCM, TTM, and Ayurveda, as opposed to seeking it from machines. Machines that ultimate base their decisions on the combination of the information they are receiving and the algorithms that process the information. Both the information and the algorithms being a product of, and therefore limited by, the people who produce them.

Combining the instruments and other marvels of the western symptomatic healthcare approach with the more holistic but in some cases inferior Eastern practices, have the potential for driving significant change within the healthcare system as we know it today.

In terms of specific machine intelligence implementations, as the point-of-view presented in this article clearly shows, the focus should be on long-term macro effects of such implementations, as opposed to focusing on short-term and micro context.

Perhaps in a future world where the western and eastern medicinal practices are better integrated and institutionalized into a new era of taking care of patients, we will be better equipped to handle the challenges that come with machine intelligence focused healthcare.

Want to write for InnoHEALTH? send us your article at  magazine@innovatiocuris.com

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2 
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz 
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw 
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 4 (October to December 2017) – http://amzn.to/2B2UMLw

Connect with InnovatioCuris on:
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