1. In envisioning the future of healthcare, we see a trend toward patient empowerment. Patient empowerment refers to the process of enhancing a patient's knowledge, skills, and confidence, allowing them to actively participate in their healthcare decisions. How do you believe these shifts toward patient empowerment will influence the way healthcare services are delivered, and what role do you foresee technology playing in this evolving landscape?

Tan Cher Heng: As Singapore moves away from a paternalistic model of care delivery, to one where patients are aware and activated to take care of their own medical conditions, more emphasis can be placed on providing patients with the autonomy to decide on the types of investigations and treatments for their medical conditions, that are aligned with the individual patient's values and attitudes. This would lead to greater compliance with prescribed treatments, and consequently better outcomes. Physicians can also focus on more upstream interventions to prevent, and not just to treat, diseases.

Technology will continue to play an even bigger role in the way care can be delivered. Machines are not limited by human factors of stress and fatigue, and can assist care providers to extend their reach, creating “higher touch” with patients and the population on a continuous basis. The advent of generative AI has created even greater potential for this to happen.

Mohammad Al-Ubaydli: Most healthcare professionals are unaware that most health care delivery is by patients: patients with long-term conditions are the ones taking the medications, changing their diet, and doing the exercise… or not. Patient empowerment increases the skills and effectiveness of patients. What’s missing is designing health care services with the recognition of patients’ potential, abilities, and importance. The urgency of the workforce crisis and funding crisis is finally making health care system designers aware of empowerment.

2. How would you describe the current state of AI adoption in healthcare, particularly in treatment and patient care? What are the primary areas where AI is making a tangible impact?

Konrad Dobschuetz: Treatment remains a clinical focused area where we see AI supporting but not leading. In mental health and well-being, we are seeing use of AI to suggest patient facing AI augmented treatments via Digital Therapeutics. As with all mental health interventions, it is crucial that the human factor is taken into consideration as remote treatments without sufficient clinical oversight can have an adverse impact on the patients. This counts for mental health in particular. In comparison in the diagnostics, patient flow and risk stratification space AI tools are emerging to be leading the decision process.

Personalized Medicine using a combination of AI and RNA tech-bio platforms is already entering the mainstream of patient impact treatments. Albeit still not widely available, it is an unstoppable trend.

3. How do you envision the integration of AI in breast cancer care evolving, considering the potential it holds for early detection and personalized treatment? What collaborative efforts or frameworks do you believe are crucial to harnessing AI's capabilities effectively across healthcare systems for the benefit of breast cancer patients worldwide?

Mohammad Al-Ubaydli: My medical training started as radiology was gaining in attractiveness as a career path - clinicians could work anywhere, anytime, thanks to digitisation. Today’s medical students are abandoning radiology as they see the extraordinary leaps in AI displacing their career prospects. I think they are unduly pessimistic - AI will multiply the radiologist’s abilities rather than displace them - but they are correct that that potential is huge. As more datasets become digital, including cancer biopsies and genomes, the training data set across a cancer’s lifecycle allows earlier detection, more personalisation, with fewer false alarms and more concise treatment. Countless lives will be saved and improved.

4. What aspects of your current role do you find most energizing and fulfilling? Conversely, are there tasks or situations that you find less engaging or draining? How do you navigate these different aspects to maintain your passion and productivity? Additionally, could you share any strategies or approaches you employ to address challenges and sustain enthusiasm in the dynamic field of healthcare technology?

Sheena Pirbhai: I founded Stress Point Health so that I could help as many people as possible with their mental health. Getting to do that, every day, is incredibly fulfilling and motivates me to keep going, even through difficult cycles that every start-up experiences.

Healthcare is a deeply personal and human area to be involved in and this comes with its own challenges. Hearing stories of how the healthcare system has failed so many people with their mental health, can be emotionally draining and difficult at times. But seeing the change we are making and impact on people’s lives keeps me productive and passionate every day.

It is particularly important in healthcare to put the patient first, understanding their needs and challenges and innovating to serve them. Innovation is essential but not at the expense of the patient experience. I always ensure time and resources are allocated to research in order to stay in touch with patients and their ever changing and growing needs.

5. Over the forthcoming biennium, AI and Big Data are anticipated to remain the most disruptive forces in the healthcare sector. Can you elaborate on specific examples or use cases where AI and Big Data have already demonstrated disruptive forces in healthcare? How have these technologies transformed processes, improved patient outcomes, or enhanced overall efficiency within healthcare systems?

Tan Cher Heng: Big data and AI are synergistic in allowing for individualized care through data collection for continuous monitoring of biomarkers, behavioural nudges leveraging on generative AI, and analytics of multimodal datasets ranging from simple demographic to complex genomic datasets for risk stratification and more accurate disease prediction. When applied at the population level, this could help providers and payers better allocate their limited resources to achieve maximal gains in the healthcare system. At the care provision level, it could lead to better triaging of cases. For example, during COVID-19 when there was a surge in demand beyond capacity, Tan Tock Seng Hospital deployed an AI model that helped to prioritise patients with abnormal x-rays for urgent review by the radiologists, and consequently, the emergency care team. This lead to more expedient management of the sicker patients.

Konrad Dobschuetz: Here risk stratification is a key piece as it helps health systems to manage the ever growing number of patients that need specialist treatment.  We are also seeing discharge and the assessment of bed occupancy a key piece driving down waiting list, relieving pressures from the health system.

6. Innovations in healthcare are undergoing transformative shifts, notably driven by technological advancements. Could you provide specific examples of technological advancements that are currently reshaping the healthcare industry? How do these innovations contribute to improving patient care, streamlining processes, or addressing critical challenges within the healthcare ecosystem?

Mohammad Al-Ubaydli: A smartphone is the most extraordinary behaviour change tool, and behaviour change is the most important treatment. As everyone carries a phone and a phone measures everything, your phone will advise you what to do - and not to do - at the time you need it. It is the ultimate point of care tool.

By contrast, health care professionals receive little training in behaviour change and have even less time to deliver it. This is the biggest gap in health care as the biggest spending is on behaviour-driven diseases, i.e. long-term conditions. The falling price and rising usability of smartphones - including the natural language user interface of ChatGPT - are just what we need.

Sheena Pirbhai: Technological advancements are playing a crucial role in reshaping the healthcare industry. Telemedicine has enabled remote consultations where traditional healthcare may not always be accessible and remote patient monitoring provides timely interventions and personalised approaches to care.  This has improved the burden on healthcare systems, especially in a post-covid environment. Telemedicine has also helped in prioritising in-person visits and streamlining access to care thus allowing for continuous monitoring of patient’s health.

Artificial intelligence and machine learning have been effectively applied to diagnostics and predictive medicine.  The next generation of care advancements need to continue to personalised treatment plans and AI is at the forefront of these technologies.

The benefits of AI have the potential to be far reaching from enhanced diagnostic accuracy, quicker data analysis all leading to improved treatment outcomes by tailoring interventions to individual patient profiles.

Wearable devices and smart devices have advanced the ability to monitor patients remotely allowing real-time data collection, proactive health monitoring, and improved management of chronic diseases. Data from these devices can also be integrated into smartphone apps and digital therapeutics, improving their accuracy and personalisation.

7. What imminent impacts do you foresee these technologies having on the sector shortly?

Sheena Pirbhai: The imminent impacts of emerging technologies on the healthcare sector are substantial and are expected to influence various aspects of patient care, operational efficiency, and the overall healthcare ecosystem.

As telemedicine and virtual care continue to expand, this will providie patients with convenient access to healthcare services from the comfort of their homes. This has particular benefit for individuals in remote or underserved areas but also easing the burden on healthcare systems like the NHS.

The integration of AI and machine learning in diagnostics will lead to more accurate and timely diagnoses, which will contribute to personalised treatment plans based on individual patient data and characteristics.

Remote patient monitoring and wearable devices will enable proactive health management, allowing for early detection of potential issues and preventive interventions. This shift towards preventive care can reduce healthcare costs and improve overall population health.

In addition, advancements in telemedicine, remote monitoring, and AI-driven diagnostics have the potential to reduce healthcare costs by minimising the need for hospital admissions, preventing complications, and optimising resource utilisation.

However, while these advancements hold great promise, I do believe it is important to address challenges such as data privacy, ethical considerations, and the need for regulatory frameworks to ensure the responsible and effective implementation of these technologies in the healthcare sector. As innovators the needs and protection of the patient should always be paramount.

8. In the realm of emerging technologies, what industry trends are emerging regarding the adoption of these innovations to gain a competitive edge? Could you elaborate on specific instances where the utilization of emerging technologies has provided a substantial advantage within your respective domains?

Konrad Dobschuetz: We are looking at an increase in applicable and scalable AI solutions rather than silos. Data in structure, quality and quantity remain one of the key issues in designing successful AI augmented clinical interventions. The inclusion of prediction models in healthcare, especially in early cancer diagnosis is on the rise and one of the key elements of our work.

Mohammad Al-Ubaydli: I rarely come across useful competitive edges between health care providers - the dysfuctional financial incentives of health care mean that too often the competitive advantages are gaming the system, without improvements in health outcomes.

What’s more interesting to me is countries using innovation with a public health approach as a competitive advantage for their economies. Covid reminded us of the importance of vaccines for society. Sugar taxes and walkable cities are just as important as the new generation of weight loss drugs in tackling obesity.

9. With the escalating momentum of remote care adoption, a trend projected to surpass conventional in-person visits, could you elaborate on the factors propelling this shift? How might this transition impact healthcare practices and patient experiences, both nationally and globally, in the foreseeable future? Additionally, what potential challenges or concerns do you foresee associated with the widespread adoption of remote care, and how can these be effectively addressed within healthcare systems?

Konrad Dobschuetz: Key factors to consider here are a stretched health system, where in person treatment and beds have already become a much desired commodity to the empowered patient and the convergence of key technologies such as AI, blockchain, AR/VR and 5/6G for connectivity. Already we are looking at over 10,000 virtual wards beds in England and that will only expand dramatically in the coming years. We know that an effective virtual wards approach can lead to up to 50% of reduction in readmissions for example. One element that gets forgotten often is digital exclusion. According to the report by the Kings Fund from March 2023, close to 30% of people in England consider themselves digitally excluded from healthcare already or find it difficult to access it. That is a major factor and we have to take these people along, otherwise we are in danger of creating an ivory tower health and care system.

Tan Cher Heng: Remote care is heavily dependent on the audiovisual technologies that facilitate real-time communication between providers and patients, better known as telehealth. COVID-19 was certainly a catalyst for us to adopt this mode of care delivery into our workflows. The evolution of sensor technologies that are able to capture other aspects of human well-being, beyond history-taking, increases the confidence of physicians in making diagnosis and determining treatment for patients virtually.

The transition towards remote care as an accepted form of care delivery could disrupt our conventional models that are still largely bound by geographic, within large countries and internationally. Democratising access to care, if planned and implemented thoughtfully, can increase health equity and lead to more effective use of healthcare resources globally. That said, the reliance on digital and data systems to drive the provision of remote care would mean that it is intrinsically limited by provision of access to technology. Foreseeably, IT outages can pose a danger in the emergency or intensive care settings.

10. In what ways do you foresee AI contributing to the enhancement of mental health services? Could you delve into specific applications or advancements within AI that have the potential to significantly impact the field of mental health, and how might these innovations shape the future landscape of mental health care?

Sheena Pirbhai: The next generation of mental health treatment and support needs to have a more personalised and adaptive approach.  I believe that AI has the potential to significantly enhance mental health services by supporting digital mental health solutions with assessment, diagnoses and targeting treatment modalities.

AI-powered tools can analyse patterns in language, behaviour, and other data to identify early signs of mental health issues.  This data can be used to feed AI algorithms to analyse large datasets and identify effective treatment strategies based on individual patient characteristics. This enables the development of personalised treatment plans that take into account genetic, environmental, and lifestyle factors, improving the efficacy of interventions.

Emotional dysregulation is a key driver of mental health conditions. AI can be trained to recognise facial expressions, vocal tones, and other non-verbal cues to assess emotional states. This technology can aid in understanding patients' emotions, administering effective digital health treatments to regulate emotions and provide additional insights for mental health professionals. These tools can offer effective, accessible, and scalable mental health treatments.

AI-enabled wearables and IoT devices can continuously monitor physiological, emotional and behavioural indicators related to mental health. This real-time data can be used to assess the effectiveness of treatments, track mood patterns, and provide timely interventions when necessary.

Even with the advancements in the mental health there is a still stigma associated with seeking help.  Digital mental health platforms that focus on confidential and private treatment can help to reduce these stigmas.  Online platforms and virtual support groups powered by AI can create a more inclusive and supportive environment for individuals seeking help.

While AI holds great promise in transforming mental health services, ethical considerations such as data privacy, transparency, and accountability must be carefully addressed.  There have been concerning cases around AI chat bots encouraging suicidal ideation and being counterproductive to patient’s mental health. Clinical intervention is still necessary but being able to combine innovation with traditional pathways can have a powerful impact. Additionally, collaboration between AI developers, mental health professionals, and regulatory bodies is crucial to ensure the responsible and ethical implementation of these technologies in mental healthcare.

Mohammad Al-Ubaydli: I want to take a slightly different angle. One of the biggest blows to advancement was the world’s reaction to Facebook’s publication of its research on mental health. Facebook tried to measure the effect of changing its feed on the mental health of its users. We all need every service to do more of this research. Instead the reaction in the press ended all transparency around such research. We must do more, more publicly, what’s missing is a mature attitude in the press.

11. How do the absence of specific skills and talents, inadequate funding, and the presence of organizational silos impede the adoption and progress of emerging technologies?

Tan Cher Heng: Using AI as an example, we now face challenges with its adoption, primarily due to the presence of legacy enterprise digital systems (e.g. electronic medical records) that are not able to easily incorporate the myriad of AI solutions emanating from the start-up ecosystem, many of which could effectively support the transformation of health services. The need for compliance with ever increasing cybersecurity regulations further limits our agility to adopt novel AI algorithms into our clinical and operational workflows. Organisational silos impose constraints on data sharing, compounding our inefficiencies not just in developing algorithms that can be generalisable, but also in cross-validating AI models that are already proven to be of value in other practice settings.

Konrad Dobschuetz: Any of these elements are big issues in themselves. In England for example we are looking at 42 Integrated Care Systems (ICSs) that all represent a number of hospitals and care centers.  These ICSs have significant procurement powers, albeit this is still in the early days. We can already see some silos emerging and differentiation in the adoption of AI driven solutions, depending on the maturity of the system as well as willingness to adopt. Funding is another big topic with currently widely unsustainable funding models, running for only a small number of years in any. The flaw in the system currently is an annual funding cycle nationally which in time hopefully will be resolved and revert back to a longer period.

12. In the era of accelerated digital transformation, how do we balance the drive for innovation with the critical need to safeguard digital privacy and ensure data security? Can you explore specific strategies or frameworks that organizations can adopt to effectively balance the pursuit of innovation with the imperative of maintaining robust digital privacy and data security measures in the healthcare sector?

Mohammad Al-Ubaydli: I don’t think there is a conflict between innovation and security. Security is more important than ever as we store more data digitally. And innovation is more necessary than ever as we face multiple crises in health care from current approaches. What’s missing is a safe environment in which to learn how to improve security. Coverage of data breaches is premature and sensationalist, exaggerating problems and decreasing trust. The aviation industry shows us how to improve safety while embracing innovation through constant, non-judgemental disclosure.

Sheena Pirbhai: Balancing the drive for innovation with the imperative of maintaining robust digital privacy and data security is a critical challenge, especially in the healthcare sector where sensitive patient information is involved.

Integrating privacy and security measures into the development process is essential from the outset. This means considering data protection and security at every stage of product or service design and development, rather than treating them as add-ons.

Whilst regulation is a constantly evolving landscape, adhering to existing and emerging privacy and security regulations, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States or the General Data Protection Regulation (GDPR) in Europe is vital. I recommend regularly updating policies and procedures to ensure compliance with regulatory requirements.

Conducting thorough risk assessments to identify potential threats and vulnerabilities in the technology infrastructure is important to keep patients safe. Designing and executing robust risk management strategies to mitigate and address these risks, will prioritise the protection of sensitive healthcare data.

Being prepared and responsive for incident resolution should be a high priority in the development of technology solutions. Developing and regularly testing incident response plans will ensure a swift and effective response to data breaches or security incidents. This includes having a clear communication plan to notify affected parties promptly.

I think it is also essential to maintain transparent communication with patients and stakeholders regarding data collection, usage, and security measures. Clearly articulate how data is handled and protected, will build trust and transparency.

Within our organisation we have also established a culture of ethics and accountability. This involves considering the ethical implications of data use, ensuring transparency, and holding individuals and the organization accountable for adhering to privacy and security principles.

By adopting these strategies and frameworks, healthcare organisations can balance the drive for innovation with the critical need to safeguard digital privacy and ensure data security. This approach is essential for maintaining trust among patients, complying with regulations, and protecting sensitive healthcare information in an era of accelerated digital transformation.

13. In a fast-paced industry where innovations constantly evolve, how do you personally ensure you are always up-to-date with the latest trends and advancements? Could you share specific sources, forums, or platforms you and your organization utilize to stay current and ahead of the curve in the rapidly changing landscape of healthcare technology?

Tan Cher Heng: I believe that the best way to stay up-to-date with the latest innovations is to “walk the talk”, i.e. to be directly involved with any technology by either developing or deploying it. As a clinical radiologist myself, I have come across numerous deep machine learning models that are touted to be as accurate or even more accurate than a human radiologist in interpreting medical images to diagnose diseases. My team and I have learnt the most through a process of discovery by developing and deploying AI algorithms, based on our hospital’s ground-truth datasets, together with our scientific collaborators. We now have a deep appreciation of the infrastructure required to facilitate the mainstream application of image-based AI in a clinical setting. I have been able to extend my understanding towards facilitating AI adoption in non-clinical settings in my role of leading the Centre for Healthcare Innovation. CHI now works closely with industry partners and government agencies like Synapxe, to accelerate the process of adoption, not just of AI but also, other technologies such as medical 3D printing, extended reality, digital automation and telehealth.

Sheena Pirbhai: There are number of key ways in which I stay on top of trends. It is important to continuously learn from others through industry conferences, webinars and workshops to ensure continuous professional development of new technologies and innovations.

Networking through professional organisations and associations is a great way to meet like-minded peers and exchange ideas and information.  Actively engaging with online communities is also a great way get insights from industry experts.

As innovators I think it is key to read scientific journals and read articles, case studies, and whitepapers to stay informed about the latest medical advancements advances. In addition, reputable healthcare technology publications, journals, and blogs are a good source of background information and varied points of view.

Collaboration and partnerships are essential in healthcare and working with other organisations such as universities, or research institutions can give you access to cutting-edge research and innovations.

Lastly market research is the final building block of staying up-to-date. Conducting regular market research to identify emerging trends, competitors, and market demands and analysing industry reports and market intelligence will help to inform strategic decisions.

14. In the landscape of cancer care, AI innovations have played a pivotal role in reshaping early detection, diagnosis, and treatment methodologies. Could you provide insights into some of the most impactful AI-driven advancements in each phase of the cancer control continuum? Specifically, are there any particular AI-driven advancements that have significantly impacted cancer care in recent years?

Konrad Dobschuetz: As mentioned before, there are significant improvements for example in image analysis of potential lung cancers as well as breast cancers. Another piece is the multi cancer detection via a single blood test, detecting over 50 cancers. This is being rolled out in England.

15. How do you envision the integration of AI in cancer diagnosis and treatment evolving in the next five years, and what challenges do you foresee in implementing these advancements on a larger scale within the healthcare system? Additionally, could you share insights on potential ethical considerations or societal impacts associated with the widespread implementation of AI in cancer diagnosis and treatment, and how these aspects should be addressed moving forward?

Tan Cher Heng: For diagnosis of cancer, AI can democratise the expertise of radiologists and procedurists, to scale up efforts in increasing the penetration of population based screening, such as for breast and colorectal cancer. It can also be used to implement new screening modalities like CT scans for lung cancer. By combining the biomarkers across different modalities, AI can assist physicians in segmenting patients into low and high risk groups, allowing for tailored surveillance and therapeutic regimes. As with other potential medical applications of AI, we need to be mindful of ethical issues that pertain to data privacy and confidentiality and societal concerns that relate to health equity and access.

Konrad Dobschuetz: I can see a straight line from to at home blood tests to genomics, and prediction algorithms leading a much earlier and personalized cancer detection. We are already able to for example identify stage 1 GI cancers via a simple test, so why wouldn’t we be able to do this for others? Crispr in combination with TechBio platforms using AI and RNA technology will provide us with the ability to switch a cancer off before it becomes dangerous. Thinking beyond that, on a population health level all main cancers should be close to eradicated by 2050 and no longer be the leading cause of death.

A heartfelt thank you for your invaluable insights during our panel discussion on "Emerging Trends and Transformative Technologies in the Healthcare Sector." Your expertise and thoughtful responses have made a lasting impact on our audience, providing a clear understanding of the complexities and potentials of healthcare technology.

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