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SPOTLIGHTS
Healthcare Advancement: "Healthcare is a National Right, Not a Privilege"
Sanjay Joshi
Global Chief Technology Officer, Healthcare and Life Sciences, Emerging Technologies Division, Dell EMC

Sanjay Joshi is the Global Chief Technology Officer of Healthcare and Life Sciences at the Emerging Technologies Division of Dell EMC. Based in Seattle, Sanjay's 28+ year career has spanned the entire gamut of life-sciences and healthcare from clinical and biotechnology research to healthcare informatics to medical devices.

His current focus is a systems view of Genomics and Proteomics for infrastructures and informatics. Recent experience has included Electronic Medical Records; Proteomics and Flow Cytometry; FDA and HIPAA validations; Lab Information Management Systems (LIMS); Translational Genomics research and Imaging. Sanjay holds a patent in multi-dimensional flow cytometry analytics. He began his career developing and building X-Ray machines.

Sanjay was the recipient of a National Institutes of Health (NIH) Small Business Innovation Research (SBIR) grant and has been a consultant or co-Principal-Investigator on several NIH grants. He is actively involved in non-profit biotech networking and educational organizations in the Seattle area and beyond.

Sanjay holds a Master of Biomedical Engineering from the University of New South Wales, Sydney and a Bachelor of Instrumentation Technology from Bangalore University. He has completed several medical school and PhD level courses.

1. In your opinion, what are some challenges currently facing or will be faced by healthcare organizations in Asia region?

At the macro level, the healthcare challenges of Asia are clean air and drinking water, communicable diseases and an aging population with chronic diseases.

Three pervasive trends will drive the adoption of technology: patient-centric care, new business models and digitization. All three challenges entail the exchange of information among people, processes and even machines.

2. How can the healthcare organizations in Asia overcome their obstacles and deliver greater level of healthcare?

In India, for example, the largest threat come from overuse (and under-compliance) of antibiotics, a viral disease load that keeps changing yearly (Dengue, Chikungunya, Zika, etc.). In more developed countries in Asia, it is chronic diseases like hypertension, diabetes and cancer. Drs. Leroy Hood and Stephen Friend coined the term “P4 medicine” in the mid-90s: Predictive, Preventive, Personalized (Precision) and Participatory.

Asia stands ready to provide the scale necessary to understand the human body at the cellular level. Checklists, team medicine, “real-world” clinical analytics, best quality practices (with continuous integration and improvement into automating workflows) and a genuine approach to care for the patient at the last kilometre are ways healthcare organizations can deliver greater levels of care.

I believe that automation, integration and analytics at scale using various information technologies is the lever to overcome the obstacles currently facing healthcare in Asia.

3. What are some measures carrying out in Asia, and what would drive the healthcare organizations to integrate better healthcare systems/practices?

This is an important point. In spite of all the information and technological advances, integrating the various silos of information and technology remain a very large hurdle to cross. Information Technology is the enabler for breaking down these silos and provides the conversion, migration, standardized integration and interoperability.

The exchange of information is important in today’s fast-paced, connected economy, where patient-consumer is more well-informed and demanding, and the industry is constantly in motion under the strain of increased healthcare burden and economic challenges. This is the premise for organizations to better integrate their healthcare systems and practices – to ensure there are no data silos and organizations have maximum visibility into their operations, and patient data to make informed decisions.

4. Which countries of the world can be the role models for developing countries in Asia to achieve healthcare advancement?

To me, healthcare advancement is achieving the following: higher QALY (quality adjusted life years) score nationally along with a high “healthy lifespan” age, lower per-capita spending as a ratio of GDP, better air and water quality, affordable access to healthcare and to approach healthcare as a national right and not a privilege.

Other national initiatives should include a centralized approach to communicable and chronic diseases, cost and quality control of drugs and a population based approach to care. With those criteria as backdrop, let me start with Asia: Singapore, Japan, South Korea and Australia are countries that are role models.

Recently, the World Health Organization called out Singapore as a role model in handling the Zika virus, citing quick transparency, quick reporting, retrospective analysis and vector control measures that were rolled out within days of the first case confirmed. Clearly, the enormous amount of work was only possible because agencies were able to collaborate quickly, and share important data.

Globally, the best five countries for these criteria as per the Bloomberg rankings in late 2015 are Singapore (which topped the world’s healthiest countries list), followed by Italy, Australia, Switzerland and Japan. One site your readers would be interested in visiting is the IHME (Institute for Health Metrics and Evaluation, based in my home town of Seattle) at https://healthdata.org/.

5. What can your company offer to help these healthcare organizations?

Dell EMC provides the healthcare infrastructure of more than 50% of the US hospital systems. Modern healthcare is information-centric, digitized and is transforming the health and care of the population of Asia. Our digitization infrastructure support includes the electronic medical record (EMR), supporting radiology PACS (picture archiving and communications systems), integrating radiology and other imaging silos into a VNA (vendor neutral archive). Dell EMC supports the world’s leading instrumentation and software vendors in each of these areas. Healthcare analytics is the other transformative technology that Dell EMC is deeply involved in. In my group, the Emerging Technologies Division, we are actively building several products to tackle the vast world of “unstructured” data (which are not in databases or transactional systems) which exceeds 80% of the healthcare information universe.

6. How do you foresee the future of healthcare in Asia? Do you think it has anything to do with Big Data?

Let me qualify the term “Big Data” – an oversimplified and overused marketing term.

What is data in healthcare? It is the journey of a byte of information from the “units of source” which can be bits, words or images (from devices, instruments and information from healthcare and laboratory staff), to “group of source-units” which can reside in systems and applications to “organized groups” which are dictionaries, ontologies and decision support systems, to the ultimate business needs of “knowledge groups” which is the inference of the provider community or the experience of the patient. Big Data is all of these things that drives the patient experience, care economics and clinical decision making at various levels.

The origin of this healthcare data is “broad” – multi-protocol and multi-input. The destination is “contextual” and “dense” – from analytics to clinical decision making. It is easier to use the catch-phrase “Big Data” than all of the details above.

The famous nuclear scientist, Niels Bohr, is attributed to the saying that “prediction is hard, especially about the future.” To care for and protect the health of almost 60% of the world’s population – Asia – healthcare needs to be implemented at scale. Our approach is the “Data Lake” which is a large, scalable, secure, multi-protocol (input and output). This scalable Data Lake is where all raw data resides, where applications are born based on the data, where compute is brought to the data (instead of the other way around), where integrating with transactional systems and data warehouses happens via web services and APIs and where Analytics can be performed at various levels.

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