How Technology Enhances Patient and Clinician Safety with Naila Siddiqui Kamal, Fellow of the Royal College of Obstetricians and Gynecologists was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.
Saul Marquez:
Welcome back to the Outcomes Rocket. This program is made possible by the sponsors of Reach, including HP, Microsoft, Smooth Podcasting and listeners like you. Reach is a global nonprofit social impact organization whose mission is to create better health care experiences for both providers and patients. Reach is focused on sustainable, large scale improvements in the delivery of care and in the health journey of all people. Reach advocates, public health, thought, leadership, education and innovation. Be sure to share this podcast and visit them at w w w dot reach t l dot org. That’s w w w dot reach T.L. dot org.
Saul Marquez:
Welcome back to the Outcomes Rocket. And in today’s podcast interview on Population Health, sponsored by HP Population Health Solutions, I have the privilege of hosting the outstanding Dr. Naila Siddiqui Kamal. She is a fellow of the Royal College of Obstetricians and Gynecologists. She’s been affiliated with the NHS for the past twenty-eight years. She has several higher education qualifications, including Masters in Medical Education at Imperial and Certificate in Patient Safety, Quality, Informatics and Leadership from Harvard. She’s held senior positions such as Associate Dean at London Deanery, National Lead RCOG, Co-Opt member of the AoMRC Education Committee. She currently is clinically active and her subspecialty is ambulatory gynecological cancer. She’s also Associate Director of the Medical Education at her Trust and Senior Lecturer at Imperial School of Medicine. She has inventor status at Imperial for her work in developing an interacting learning resource using disruptive technologies. She has won several awards, including Distinguished Teacher Award, an excellent teacher award from Imperial Medical College, Highly Commendable award from Health Education England as well. She’s led on challenging transformational management projects where often disruptive technologies have been introduced, and she’s a frequent speaker on disruptive technologies and their place in futuristic healthcare. She’s moderated high level track sessions at World Summit of Information Society in 2019 Conference in Geneva and facilitated an inaugural session on SMART health ecosystems. An extraordinary individual And today on this podcast in Population Health, we’ll be diving into the impact of systems and technology and what they could do to better the lives of both physicians and patients. So, such a privilege to have you here, Dr. Kamaal. Thanks so much for joining. Thank you so much. And before we dive into the technical and the anecdotal things that can help the listeners on population health, why don’t you give us a little insight as to what inspires your work in health care?
Dr. Kamal:
Right. I think I know it sounds very cliche, but being a doctor or a clinician is not like any other profession. It often used to be called as the noble profession that is serving the humanity that is involved. And that takes a lot of dedication and focus. And there is something from inside that really motivates people. I think that is what makes a good doctor different from any doctor. So for me personally, I felt that this profession, I could not only excel in a skill but also make a difference to human beings who may be suffering because of illnesses or disease. So I think that is the main thing that drives me even up to this day. My subspecialty, as you mentioned, is cancer. And we are seeing various different presentations of cancer at different age groups, which we never had seen before, and making a difference in those people’s lives and more importantly, in the, you know, relatives and their families lives by being supportive. I think it’s a very important role that we have. I think it’s a privilege.
Saul Marquez:
And I certainly agree. And the specialty that you chose going into oncology and just, you know, the work being done there to help tackle this disease is really important and meaningful. You’re very interested in patient safety and physician safety and technology. I love to hear more about what you’re doing in those fields so that you can improve the lives of the people that you care for and also the environment in which that care is provided.
Dr. Kamal:
So patient safety, I mean, it is one of the basic tenants that us clinicians or any healthcare worker you have to consider very seriously because thou shall not harm is number one. And when the report, both in the U.S. and U.K., that it falls simultaneously in the year 2000 game in the U.K., named as two men in America, actually in America it is to err is human. In U.K. also it was called as an organization with a memory when emphasis was being made on the avoidable harm that happens while we are trying to deliver healthcare. And it is up to unacceptable levels. So my focus has always been trying to use innovation to reduce the avoidable harm and improve patient journey. So when I got involved in technology, especially after going to Harvard and doing the certificate in healthcare informatics and patient safety, I’ve become even more focused in trying to find innovative methods, innovation and target them in bringing more efficiency and safety in our health care delivery.
Dr. Kamal:
And so, you know, the EMR is oftentimes looked at as a burden. And, you know, for physicians and extra work away from patients and, you know, as it connects to what these systems can give us by way of data. And then, you know, implementing that with innovative technologies, how can we leverage those to both help populations and also the physicians caring for them?
Dr. Kamal:
So it’s a very important topic these days because there are certain thought groups that think that technology in itself is a big burden on clinicians.
Dr. Kamal:
And in many cases, if technology is used not in the correct way, that can be the case. However, I’ve been always the advocate of engaging with technology and using it in a way that helps us rather than making a liability to make it kind of a helpful resource. So, for example, EMR is in themselves a bit clinical decision support systems, artificial intelligence back, you know, repetitive tasks being done through A.I. These are things where we can really use technology for a benefit. I would say, you know, even if we look back about a decade or two decades ago, the way we used to practice medicine, we didn’t have many technical things which were used. And in this day and age, we are using those as mainstream. You wouldn’t think in my line, I wouldn’t think of assessing a patient totally without having an MRI or a C.T. scan when I’m suspecting guns. So what is that? That is also a form of technology. The only difference is now that we are faced with a lot more innovation in health informatics and the scale of healthcare being delivered to the population. It’s simply not possible to do things manually. And if technology can help us, I think we should, rather than alienate from it, engage with it.
Saul Marquez:
I think it’s such a great perspective and it oftentimes is the perspective that we choose to take on a particular matter like EMR or technology innovation, that that makes up how we actually work with it and implement things. Do you have anything in particular that you want to share around that? And maybe a way that you’ve improved outcomes or workflow in the practice that you run or even in academia, right. Because you do a lot of things as an academic.
Dr. Kamal:
Yeah. There are two examples that come to mind. One is in academia and Imperial College. So this is going back. I mean, I people are talking about technology right now while as I think I was lucky enough to be in that research environment where in 2008 we were using Second Life, which is a virtual world to deliver healthcare. So second life for those who don’t, who are not aware. It’s a virtual world where people can make avatars and log in. And it’s not just a game, it’s game-based learning game based doing are routine, whatever work we do. So there are at the Mayo Clinic, there are other hospitals I’ve I’ve heard of are in Second Life and in Beta also had a site. So we had opened a clinic where teenagers who wanted to see contraceptive advice and were fairly stable otherwise to go into physically into a clinic would come and seek help. So this was, I think, a very good novel experience of the time, using technology in delivering of healthcare, overcoming a barrier which would restrict, you know, teenage pregnancies, were work on the Right..
Dr. Kamal:
And this was this was a really good innovation that helped us at that time. And another example comes more in the clinical side. In the UK, we have pathways for various different clinical presentations so that the cancer patients are referred from the primary practitioner or the GP, we call on a two week pathway. It means that within two weeks we have to see the patient. There are timelines within 28 days, that diagnosis has to be done within 63 days, the whole procedure and everything has to be done.
Dr. Kamal:
So there are very tight timelines. This was converted on a platform so that every single step which is involved from the patient being referred to investigations, to diagnostics, to surgery, to post-op care get everything has now been streamed on to a technical pathway. So these are things that will help us all in the delivery of our care. So these are the two examples that come to mind immediately.
Saul Marquez:
Some great examples, removing barriers to technology, facilitating the way that we provide care. These are these are all great things. And like you said, very much necessary if we’re going to scale the care that we provide to patients and also facilitate the lives of providers. Would you say in your life and in your career, Nyla has been a win and something that you’re very proud of?
Recently, if I give you the example of the COVID 19 situation, I got an e-mail from a colleague or a friend of mine who I’d met at WSIS, which is the World Summit of Information Society United Nations conference in Geneva last year. She said she’s from the Caribbean and she mentioned that there are having a challenging time and they want to do something for their population. And as a clinician, she wanted me to help out in developing a digital tool. And we sat down to think, OK, what would be the best solution at this moment in time for their population? We’ve come up with something called the COVIDCHK Bot. It’s bot, which has got not only symptom checker, but it’s got digital companion functionalities, UP-TO-DATE information. It’s got a calendar with the symptom diary guarding with tracing contact. And another good thing is we’ve collaborated with the telehealth provider so that it is linked with the daily health portal as well. So people who are in isolation, they have something valid and reliable as a source of information which is linked with CDC and updates. It has got risks, stratifier so that they know what their particular risk is. But most importantly, I consider that it’s a behavioral change solution. Because now from post-COVID, life is going to be very different, in my opinion. The way we practice medicine, the way individuals will be looking after themselves or being more vigilant.
Dr. Kamal:
Hopefully these tools will help and, you know, identify trends, because what is the biggest thing that has hit us with COVID 19 crisis? In my opinion, it is that we were caught off guard. If there was if there were methods and mechanisms where the symptoms, as soon as they were emerging were being collected and data was being analyzed and there were dashboards somewhere in population health stakeholders, you know, forums, they would have picked up that look there is something odd that is happening rather than when the deaths started happening. So as we are expecting a second or third wave, as we are told, it is very important that tools like these are taken seriously and people start showing a behavioral change in recording or, you know, being more vigilant of their symptoms.
Dr. Kamal:
And this tool, the beauty of it, is it’s totally anonymized. That is no private data that is taken. So it is you know, there’s no issue with that. I’m very proud of that because I think after my Harvard certificate, this is the first big project that I’ve kind of done with collaboration with a tech company. And the clinical algorithms for EIB decisions were all done by myself based on the data that was emerging from a Lancet study and all the peer-reviewed journals, whether in, you know, the valid data was published. But having said that, COVID is you know, it is here that it does mutate. The virus is mutating and remutating. So it’s very important to keep an eye out for new emerging symptoms.
Saul Marquez:
It’s a very serious virus. And just thinking about this platform that you helped create, you know, collaborated with them in a major way. What a great way to both provide the people meeting that care and the information, as well as helping the physicians, you know, scale themselves. It’s just a really neat way. So how do people get access to this? Is this something that’s available today for folks listening? Can you tell us a little more about that?
Dr. Kamal:
There is a link. It’s COVIDCHK dot I play x y z dot com
Saul Marquez:
So there you go, folks, the link to to check out this amazing resource that Naila collaborated on and led. And it’s just phenomenal, you know, to take what you know and apply it to a situation my COVID in such a way that’s going to help scale care but also help so many people. I just want to give you big kudos for that Dr. Kamal. Thank you. So talk to us a little bit about a setback or something that you’ve experienced that provided a key learning set back.
Dr. Kamal:
I would say, as I was mentioning before, I’m I’m kind of a positive person and setbacks I take them as an opportunity for new things to do. But the setback, I think, that really impacted my career was that health reasons. I was unable to do the type of surgery I trained for so a keyhole surgery, minimal access with my very severe hand arthritis. So that actually opened new avenues. One of my mentors mentioned to me that, Naila, whatever you do, make sure that you, you know, get accreditation for it. So I went on and did a Masters in Medical Education at Imperial. And my thesis was based on game based learning and digital technology. Who was to know at that time? This was about 12 years ago that disruptive technologies would be the future. And how we will be practicing medicine will be very dependent on that. So it opened more avenues for me, more enjoyable avenues. And although I you know, I do miss operating as I used to and not being able to be in that environment. But having said that, I use virtual reality and other technologies to immerse in that virtual environment and teach my students.
Saul Marquez:
I think that’s great. And you are a very positive person by nature. And I think that’s what’s a big part of what’s helped you be successful and help others develop within your leadership roles. So tell me a little bit more about the virtual reality components. How are you guys utilizing those? I’m curious about that.
Dr. Kamal:
So, again, I’ll give you a very latest example so with COVID-19 situation. Our last batch of students was meant to do a rotation just before their exams. Obviously cannot be on the clinical side. So in order to give them although we are doing, you know, online lectures and theoretical teaching is ongoing. But in order to give them the real feel of the clinical environment, I initiated a project which was completed within a week. Collaborated with our technology team and these some 360 virtual reality immersive film of the theaters of the Yellow Labor Ward. Of all the places that they would have gone and visited. Obviously, due to privacy and confidentiality, we are not able to show real life delivery’s and procedures. But they get an invite feel of the environment where they would be, and the prerecorded surgeries from various different clinicians who have consent from patients and our organization are also applauded for the pay for the students to get nearly as much exposure as they would have been there. So, again, a situation created a need. The need was captured by innovative thinking and getting the resource aligned within a short period of time and delivering and fulfilling the need.
Saul Marquez:
I think that’s such a great use of it. And you got you got it done in a week. That’s pretty impressive.
Dr. Kamal:
I’m that person, you know, a viable project. I get I really bug people until they deliver.
Saul Marquez:
I love it. I love it. That is a valuable skill. Well, congratulations on that as well. If you had to think about one thing that you’re most excited about today, what would you say that is?
Dr. Kamal:
Well, I feel that, you know, one of the barriers to digital transformation wasn’t inertia from clinicians, from hierarchy and a lot of red tape. I don’t know about the states, but in the UK is definitely a people who are very risk averse in the sense, you know, not engaging with technology. What COVID situation has done has catapulted the digital transformation right at number one position and everyone’s priority list. And things that used to take months, if not years to get a sign-off, now people are requesting it to be done. So I’m really excited that now that we have the go ahead. This is the opportune moment where people that innovative ideas should be given the opportunity to really benefit because disruptive technology is one thing that people should note about disruptive and sustainable technology is what I understand. Disruptive means things being done in a way that they totally take away what how things were done previously. And the beauty of it is that disruptive technologies will keep on coming. So what we think is very noble idea right now, maybe not so noble in a few months or a year or so’s time because this is the difference between the fifth industrial revolution. We are in the fifth industrial revolution. The previous ones took decades to take over the one before, but this one from the fourth or the fifth is a very short time. From just being, you know, computers learning to computers making decisions is now very short time. So who knows what’s next in line. So we need to be open to all of these things. Obviously. Ethics is a very important component. And I lecture on medical ethics a lot. And with these open floodgates of technology, one needs to be very conscious about the ethical principles. And I think the stakeholders need to very quickly put in some regulations in place so that we are using technology for the best, for humanity in the best way possible and not get sidetracked without overenthusiasm and fall into the trap of unethical practice.
Saul Marquez:
Some great call outs. Dr. Kamal. Embracing ethics as things do scale quite quickly with this, you know, fifth industrial revolution, as you called that. I think it’s critical for all of us and everyone listening to keep in mind. It’s coming and we’ve got to have a good ethical framework to deal with this change. And so if you had to highlight one book, I know you’re a voracious reader. Dr. Kamal, what book would you recommend or what book would you say is your favorite?
Dr. Kamal:
If I’m being totally honest, I love to say that my book range will be all to do with medical profession and out of them. I would say the Dewhurst Textbook of Obstetrics and Gynaecology. I’m sorry to disappoint those readers who expected me to say some, you know, biography or an autobiography of someone. But to me, what really interests is my profession and everything related to it. So I really enjoy reading those books. I love it.
Saul Marquez:
I love it. Well, you know, it’s a testament to the fact that you chose the right path and that’s what you love to read. You know, if I needed the services, you’d be the one I choose.
Dr. Kamal:
That’s an honor that I’m very humbled by that.
Saul Marquez:
Naila, thank you for that recommendation. And so, you know, it’s been it’s been a wonderful discussion. We’ve covered so much. And if you had to leave the listeners with one thing, you know, what closing thought would you leave them with? And then what would the best place be that they could continue the conversation with you or find out more about your work?
Dr. Kamal:
I would say to the listeners that, you know, don’t let small setbacks get into the way of your positiveness. I think the biggest thing that has helped me in my career is resilience. And resilience, how I can explain it is that there have been many times when you feel that, you know, you’ve given your best and you’re not got the outcomes which you really deserve. But then you bounce back with full vitality and energy to say that, okay, I can overcome this. And there is a bigger and a better thing that I can do. Because otherwise we get into the trap of burnout. I know we talk about physician burnout, but burnout is for anyone and in whatever profession we are in. Mundane things of our life and other challenges. Sometimes, you know, just take out the positiveness. Sometimes life experiences, etc.. And it’s important to give yourself that much of a bounce back because otherwise we are not doing justice to ourselves. Everyone is a winner and we need to just find that place where it will suddenly click and everything we’ll be aligned and you’ll get the positive outcome that you made. With regards to contacting me. Best is an e mail. I have a web site, which is medret.goal.uk. But my email is best, which is NYLA dot kamal Kamalon at medret dot com.
Saul Marquez:
Beautiful. Love that. Appreciate the invitation to connect Naila and also the insights he shared. Just an incredible opportunity for the listeners to leverage technology, put the right perspective in the place to help both providers and patients. And you’re doing such an extraordinary job in practice and also in academia. So thanks again for all that you shared today.
Dr. Kamal:
Thank you so much, Saul, for your time and giving me this opportunity. I’m really humbled.
Saul Marquez:
This program is made possible by the sponsors of Reach, including HP, Microsoft, Smooth Podcasting and listeners like you. Reach is a global nonprofit social impact organization whose mission is to create better health care experiences for both providers and patients. Reach is focused on sustainable, large scale improvements in the delivery of care and in the health journey of all people. Reach advocates, public health, thought, leadership, education and innovation. Be sure to share this podcast and visit them at w w w dot reach T L dot org. That’s w w w dot reach t l dot org.
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