Tech For Good - Issue 1

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TRACKING THE AGRITECH REVOLUTION REDEFINING ONLINE LEARNING ATLANTA‘S TALE OF TWO VIRUSES DIGITAL ETHICS AT SOPRA STERIA

Issue 01

US AGAINST THEM? As machine intelligence continues its relentless rise, we ask who’s in control and get specialist insights on the blueprint for an AI utopia



JAMES HENDERSON Content Director

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hen the Bulletin Media team got together six months ago to talk about launching a second platform, a number of ideas were thrown around. Some good and, it’s fair to say, some not so good. But there was one that stood out against all the others and one we all believed would only continue to grow in importance - that being ‘Tech For Good’. What we couldn’t have known was that a couple of extraordinary events would catapult the idea of technology for wider societal good into the mainstream. Firstly, with COVID-19, we’ve seen some of the world’s biggest technology companies working side-by-side to fight the spread of the disease. Apple and Google partnered to develop contact tracing technology, while Facebook, Google and Twitter teamed up to quell the spread of disinformation about the virus. Elsewhere, companies have pivoted their operations to manufacture vital medical equipment and PPE, while one brewery used its beer-making tooling to manufacture hand sanitiser.

And in the last few weeks, the reprehensible murder of George Floyd and the subsequent Black Lives Matter protests have led to the tech industry’s leading lights looking inward and reconsidering how their technologies have been used. At the time of publishing IBM, Microsoft and Amazon have all suspended sales of their facial recognition software to law enforcement agencies, with legislators now being called upon to review how the technology is used and to ensure any racial bias is removed. It brings into sharp focus the inherent risks that exist with AI; its potential is arguably unmatched, but its power needs harnessing and governance. It is a subject we explore in our cover feature with George Tilesch and Omar Hatamleh, the co-authors of BetweenBrains. Elsewhere you’ll find a number of other eye-opening interviews exploring technological advancements in healthtech, agrictech, the public sector and much, much more. We hope you enjoy our first edition. PUBLISHED BY BULLETIN MEDIA LTD, Norwich, UK Company No: 11454926 TALK TO US editorial@digitalbulletin.com business@digitalbulletin.com


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SOCIAL GOOD

Harnessing the power of AI

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ENVIRONMENT

Agritech and a timely food revolution

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PUBLIC SECTOR

City of Atlanta CIO, Gary Brantley on tackling two viruses

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EDUCATION

How cognitive science and tech is redefining online learning

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HEALTHCARE

Experts talk COVID-19 and the transformation of digital healthcare

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LEADERSHIP

Sopra Steria is taking Tech for Good to the mainstream

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EXPERT INSIGHT

An exclusive column from Medidata’s Paul O’Donohoe


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SEEKING AI’S TRUE PURPOSE Humans still hold power over what role artificial intelligence will play in our lives - but the clock is ticking. George Tilesch and Omar Hatamleh, co-authors of BetweenBrains, tackle some of the most important technology questions of our time AUTHOR: Ben Mouncer

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eorge Tilesch and Omar Hatamleh first met over a plate of sandwiches. Twenty minutes of “deep” conversation later, Hatamleh - a NASA technologist for more than two decades - had invited Tilesch to the space agency’s next Cross Industry Innovation Summit. “The rest is history,” laughs Tilesch as they settle in for an exclusive interview with Tech For Good. That encounter proved significant. This year, Tilesch and Hatamleh are celebrating the release of their first co-authored 6

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book. BetweenBrains is the outcome of that chance lunchtime exchange. The book is nothing if not broad and deep, confronting the multi-layered topic of artificial intelligence (AI) and exploring the immediate and near-term future of a divisive technology standing on the cusp of ubiquity. The pair are certainly well-qualified to assess the economic, societal and moral implications of AI. Tilesch is a former strategy chief at research giant Ipsos and an expert in technology governance


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Unchecked algorithmled social media has led to societal discord and a loss of public trust in institutions. I cannot emphasise enough how that has led to the present, sorry state of the world” George Tilesch

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- a central theme in the book - and has acted as a consultant to governments, global social innovation leaders, international corporates and everything in between. Hatamleh was until very recently the head of engineering innovation at NASA and has four engineering degrees. “The great value is how George and I complement each other,” says Hatamleh. “I come from a perspective of being a technical person and an engineer, and George from a law background and being expert in tech policy, corporate citizenship and social innovation. That contributed to there being an excellent synergy which was reflected very well in the book.” A broad perspective is highly recommended if you brave the subject of AI. As is so often the case with public discourse in this era, a bi-polar signal emerges from the noise: those vehemently “for” or “against” AI’s capabilities. Tilesch and Hatamleh have deliberately adopted a position of balanced impartiality, with both caution and optimism shared throughout our hour-long conversation. Many AI texts, and there are a lot, pontificate on what influence AI may have on the world over the next half-century. Tilesch and Hatamleh prefer to discuss what AI is doing for (and to) us right now, where it may lead soon, and what needs to be done in the short-term to ensure


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BetweenBrains, the book co-authored by Tilesch and Hatamleh future generations reap the benefits of this extraordinarily powerful toolset. Tilesch begins by highlighting AI’s rapid evolution and how our outlook on this technology has changed, even in the time that he and Hatamleh have been collaborating. “Three years ago this was a very, very different subject from today,” he explains. “At that time it was like a toy of the few. Omar then put the NASA X Summit together around when businesses, governments and venture capital started to be hungry for AI. At the time we started writing, there was an overall optimistic and ambitious tone

- yet almost nobody was talking about the challenges.” Challenges there are plenty, and both Tilesch and Hatamleh aren’t hiding from them. Early applications of AI have been a major factor in shaping a world where the spread of disinformation is rife, and where a global shift towards digital-first interpersonal communication appears to have created a very divided society. “There are some examples right now where we say ‘the roof is on fire’,” adds Tilesch. “This means that direct intervention is needed in the very shortterm. I’ve been doing a lot of work with the [World Leadership Alliance] Club ISSUE 01

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de Madrid on AI trust and democracy. Unchecked algorithm-led social media has led to societal discord and a loss of public trust in institutions. I cannot emphasise enough how that has led to the present, sorry state of the world.” It’s a damning verdict. While there are positive examples of AI’s role online, not least in the areas of customer and user experience, AI has also been deployed in controversial ways by technology companies to exploit data (remember Cambridge Analytica?), and also by bad actors intent on causing disruption via cybersecurity breaches or the manipulation of social media. Hatamleh points to the rise of “deep fakes” - where advanced AI is used to

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make text, audio, images and videos of fake events - as a pertinent example to back up Tilesch’s view. “Imagine that one day before the release of a company’s profits, somebody creates a deep fake statement from the CEO designed to destroy the market for that company,” he speculates. “People get their news nowadays from online sources, so we need to ensure it is bias-free, unaltered and accurate.” But Hatamleh also highlights AI’s capacity to combat nefarious activity in an “AI vs AI” scenario, and it is this race between “good” and “bad” AI that both men continually reference. In the example of deep fakes, this is the potential for “good” AI to identify and remove such materials before much damage has occurred, or even before they’ve been disseminated. Tilesch, with his strong background in policy, is demanding more policies around online media and how information is shared in the public sphere. “We are talking about at least 20 policy recommendations for the public-dialogue domain but I think the most important factor is that trust is ebbing and at historic lows,” he adds. “Very focused attention and intervention is needed to build new kinds of frameworks of trust that people will appreciate.


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It has been voiced for many years that this is an issue but I don’t see a lot happening on the ground. If we are not fixing the trust and the authority factor of that, then we are in terrible trouble.” Then there is the age-old question of jobs. While the impact of AI on the distribution and consumption of media is being felt right now - we can see its effects on the streets, and in voting booths - there continues to be an underlying concern about its greater effect on the labour market that needs continuous scrutiny. You will find multiple studies and hear opinions supporting both arguments: Either AI will displace us, or it will augment us and be the catalyst for a happier and more productive workforce. The oft-quoted 2018 World Economic Forum report on the future of jobs presented evidence that backs both theories. It forecasted that, by 2022, humans will carry out 58% of task hours compared to 71% in 2018. But it also projected that, while technology advances could displace as many as 75 million jobs, emerging tasks are to generate upward of 130 million new roles. Therein lies an inherent truth: it’s nighon impossible to say where the AI and jobs debate is going in the long-term. For now, however, Tilesch is clear. “In the near-term it will definitely take away more jobs than it adds. So that’s

What’s more creative than painting, art, poetry or music? Well we’re starting to see the emergence of AI into all these fields. That’s when you start to see how incredible the impact could be in different segments” Omar Hatamleh

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something that society needs to prepare for,” he admits. “Currently we are in an age that we call the ‘artificial narrow intelligence age’. The baby is still a baby, but it’s very impressive in certain narrow applications, and it’s getting more powerful as AI becomes general-purpose tech - and then maybe general intelligence (AGI). We don’t know if the AGI milestone will be in three years, five years, 10 years or never – but we’ll have hybrid AI systems out in the world with huge impact. We have to get anticipatory, fluid policy-making, and conversations within nations as well as global social movements about what kind of AI we want.”

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Hatamleh adds: “The way we see it evolving is that any repetitive jobs will be the first ones to go. The problem we’re then looking at is that the more mature this system becomes, it might reach a point where AI does the whole job. That’s when things will start becoming critical and iffy - and it may be too late by then.” He goes on to give radical examples of white-collar jobs where AI could have a transformative impact: doctors who are superseded by AI that can call on billions of medical records in a matter of seconds to make more accurate diagnoses, or engineers who cannot match a system performing solid modelling in the blink of an eye. “If you ask me about any job, I see a big impact,” Hatamleh continues. “Even if you start diving into creative jobs, too. What’s more creative than painting, art, poetry or music? Well we’re starting to see the emergence of AI into all these fields. That’s when you start to see how incredible the impact could be in different segments.” It’s easy to become overwhelmed by the possibilities presented by AI, both negative and positive. As Tilesch and Hatamleh have alluded to, it has the


SEEKING AI’S TRUE PURPOSE

With well-defined visions and a lot of hard steering work, AI also has the potential to augment our civilisation, even create some kind of utopia. The question is how to get to it and do we want to get there?” George Tilesch

It concluded that while existing frameworks have surfaced the major ethical concerns and make recommendations for governments to manage them, notable gaps exist and that there is a “clear need” for the development of viable and applicable legislation that will confront the multifaceted challenges associated with AI. Tilesch agrees, saying that AI is crying out for more vision, action and leadership. “The leadership is currently not in line with the power, speed and application of the technology itself,” he states. “Countries and political leaders, together with communities and the social sector, have to be bolder in defining the actual purposes of AI. The problem right now is

power to filter into any industry and to change any job. But the growing pervasiveness of AI-powered applications today means we have reached a critical point in how we choose to govern this revolution. At the beginning of March, the European Parliament published a 128-page report titled “The Ethics of Artificial Intelligence: Issues and Initiatives”. The paper examined many of the topics Tilesch and Hatamleh touch on in BetweenBrains, before then auditing the current frameworks that are directing crucial policy-making in this field. ISSUE 01

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Look at the beginning of the 19th century and how the Industrial Revolution disrupted people and jobs but, eventually, it was an engine for creating incredible economies” Omar Hatamleh

that they are in catchup mode - they were in catchup mode with previous waves of technology, but AI, which is improving at hyperspeed, is something that needs a new kind of policy thinking focusing on AI stewardship. “From the citizen or consumer perspective, what we lack is both actionable definitions of purpose and practical safeguards. We need Augmented, not Artificial Intelligence. We need data privacy safeguards, we need ownership of data, we need trusted providers of technology where we can believe that they are serving our interests and our interests only. We need Public Interest AI - I think that’s the biggest point. 14

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“I’m a firm believer that beneficial AI, serving citizens and governments together, should be a goal and should be definitely something that we set our eyes for. With well-defined visions and a lot of hard steering work, AI also has the potential to augment our civilisation, even create some kind of utopia. The question is how to get to it and do we want to get there?” BetweenBrains concludes that AI will serve as the most important driver and instrument of power redistribution in the 21st century, and that ultimately, despite a fragmented approach up to now, we still have the opportunity to make clear choices on what kind of AI


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we want. The narrative of inevitability should be changed to that of purpose and stewardship. Hatamleh believes we’re on a journey not dissimilar to that of previous revolutions. “Look at the beginning of the 19th century and how the Industrial Revolution disrupted people and jobs but, eventually, it was an engine for creating incredible economies,” he says. Tilesch agrees that AI could potentially end up doing far more good than bad but only if we take the opportunity now to steer the ship with newly built, AI-fit frameworks, models and movements.

“AI pessimism or optimism right now would probably mean, at least to me, that we are powerless,” he concludes. “Currently we may think that the image AI takes in the end is out of our hands, but actually we should develop that capacity, coming together as society and sectors to define the actionable trajectories that take AI in a beneficial, humanistic direction. Then we will be in a much better position to be optimistic about it.” For more information on BetweenBrains and to buy the book in digital or print form, visit betweenbrains.ai

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FEED THE WORLD Agritech is revolutionising what we eat and the way we eat it. It needs to: the planet will suffer a critical food shortage unless it does. We spoke to Intel director turned agribusiness evangelist Fernando Martins to talk synthetic meats, IoT, deforestation, innovative ecosystems and the future of sustainable farming

AUTHOR: David Currie

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he first great human revolution was not a movement. Nor was it a military adventure or a dramatic cultural uprising. It was crops and cows, arable land, chickens and pigs. The first great transformation in human society was in agriculture; as soon as our loincloth-wearing ancestors realised they didn’t have to spend all day bounding after wild beasts in order to survive, but could instead settle in one place to grow crops and selectively breed animals, human culture was changed forever. When, over the last 200 years, advances in medicine began to untether human existence from the diseases that had hitherto kept its numbers in check, the world’s population exploded. It quadrupled in the 20th century alone, and a vast industrialisation of agriculture was required to make sure it didn’t starve. Today, however, agriculture’s capacity to keep pace is under severe threat. While 50% of the world’s habitable land is used for agriculture – 77% for livestock and the remaining 23% for crops – by the year 2050 it is estimated Earth’s population will have increased by another 2.5 billion to approach 10 billion. The World Economic Forum (WEF) has warned that food productivity will need to increase by 60% to meet the demand. How do you do that in the face of global warming, deforestation, and land sim18

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ply running out? The WEF states that “nearly 800 million people are undernourished while two billion are micronutrient deficient and two billion more people overweight or obese. At the same time, food production, transportation, processing and waste are putting unsustainable strain on environmental resources”. So once again agriculture is going through a revolution, born out of necessity to improve sustainability. While media, retail, transportation and automotive have embraced new tech, farming was the last of the large industries to adopt. But now it’s on board, the need for acceleration is clear – and it’s starting to happen.


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From impossible burgers using plantbased proteins that cook in the same way as meat, to using less space to produce more food through machine learning and big data, agritech is becoming big business. It’s the future of not just what we eat, but how we eat. One of the very smartest minds in agritech is Brazilian-born engineer Fernando Martins, who took the leap into the sector after recognising its seismic importance while still president of the Brazilian arm of Intel in 2011. A prodigious and varied career had preceded that moment, including as global director of strategic technology planning at Intel in the US.

Prior to that, as a young engineer he had helped fix the famously wayward guidance system of the US military’s Patriot missile system, before going on to play a role in the Moving Picture Experts Group (MPEG) and registering 27 patents in the early development of video encoding. “I think the shift to agribusiness was just a natural new interest,” he says. “I developed a new interest! That has often been the case in my career. I’ve been very curious since I was six years old.” At Intel, he developed the company’s Digital Agro strategy and launched the Center for Innovation in Agribiz. After leaving, he became CEO of AgroTools, ISSUE 01

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We have less and less deforestation in Brazil caused by the expansion of the agribusiness frontier” Fernando Martins

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a young Sao Paulo company that aimed to use satellites to monitor land in Brazil used to graze cattle. Around 70% of all meat produced by Brazil now passes through the company’s system, which issues social-environmental certifications to protect against Amazon deforestation. Martins is also a shareholder and former director of Solinftec, another fast-growing Brazilian agritech company that provides end-to-end IoT and data processing solutions to big agriculture. AgroTools and Solinftec are just two of a portfolio of interests Martins has accumulated in the burgeoning sector, and are just two among more than a thousand startups emerging from Brazil’s vibrant agritech scene. Martins’ impressive body of work means he has become globally recognised as an evangelist for the digital transformation of agribusiness. “The principal challenge is to feed the planet, right?” he says. “We need to do that with a concern for the environment, we need to increase productivity without increasing deforestation. We need to increase the productivity per square meter. To be able to do that we need to be cognisant of the challenges. There is global warming, the climate is changing, the soil is degraded to a great extent already.


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“We have issues with water – there’s not enough water in many regions of the world. China, for example, has a shortage; they’re a big desert surrounded by cities, so a lot of China’s imports are driven by a lack of water.” To tackle these issues, in 2009 the WEF launched its New Vision for Agriculture, which holds that “to meet the world’s needs, sustainable agriculture must simultaneously deliver food security, environmental sustainability and economic opportunity.” Martins explains: “[The WEF] postulates that there’s three things we need to get there. One is new technologies. In their 2018 report they singled out 12

technologies that are important, from things starting from all the science fiction – alternative protein synthesis, impossible meats and insect protein – all the way to best practices in precision agriculture, the use of microbiomes, and so on. “The second thing is really economic opportunities to the value chain. You have to have technologies and economic opportunities for everybody along the value chain. “The third thing is the existence of an innovation ecosystem. So an innovation ecosystem that will have start-ups working on the development of the technologies, that will have corporations and ISSUE 01

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channels of distribution such that those technologies get productised and distributed, and the government research funds applied all in the same vector. So this innovation ecosystem is very important.” Like with any digital transformation, changes in agriculture and the world’s food supply chain will be driven because there is an economic imperative to do it – not just because of a social need. As ever, money keeps the world turning – and fed. “The ecosystem that I’m very proud of being part of, that solved to a great extent that decoupling of deforestation

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from productivity, is an ecosystem that looks at the retailers and convinces them to become activists. The retailer will say, ‘I will not purchase meat that was produced on land that has been a recent target of deforestation’. Social environmental certificates allow for that visibility. “There’s a beautiful graph [below] that shows that before the use of digital environmental certificates the growth in meat production in Brazil was tied to deforestation. After the implementation of this policy, deforestation went down and meat production went up. Completely


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This is a true Internet of Things system, where machines talk to machines and they make the decisions”

decoupled. When you have these kinds of policies and tools in place, economic forces push the farmers and ranchers to use different technologies. “It becomes economically viable to start confinement, to start better genomics, instead of just deforestation. So better practices increase productivity and you have an example here of a success story, where we have less and less deforestation in Brazil caused by the expansion of the agribusiness frontier.” Ten years ago, deforestation in Brazil was at 24,000 sq km a year; a year ago it had reduced to 8,000. The election of Jair Bolsorano as president of Brazil in January 2019 has caused problems, but the signs are still encouraging. “What has happened since the new president here in Brazil, is that he’s loosened up a little bit on the govern-

ment controls and that has created an uptick on deforestation,” Martins says. “So what was a trend of going down became a trend of going up again, but we’re still below 10,000, which is less than half of what it was ten years ago. But 8,000 sq km is a lot of forest; we’ve got to do much better than that.” A great example of tying sustainability to profit was early work carried out in Brazil by Solinftec. The company set about instrumenting all of the equipment used in the production of sugarcane - one of the country’s most important crops. It connected everything - harvesters and their attendant collection trucks, the larger trucks that move the sugarcane to mills, and finally the mill operations themselves. “All of these things entail complex queuing theory,” says Martins. “You ISSUE 01

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have different logistics every day: the number of trucks, the number of harvesters, the front lines that require change. The point is that you have a very expensive capital investment in the mill, so you can’t have that mill stop for a shortage of sugarcane. But on the other hand you don’t want big lines where you’re going to have your capital investment waiting in trucks just sitting there waiting for the mill to process, so you want to optimise that. “So every day a new equation for queuing is solved, the number of trucks is recalculated, and instead of having a couple of trucks, one behind the other following the harvester, you just have one. Sensors will tell me when that truck is full, and we call that the single line of transportation, which is where you have just one line of trucks for the whole operation. The trucks get dispatched on demand, and the demand is generated by the other machines. So you can see this is a true Internet of Things system, where machines talk to machines and they make the decisions. All of this dialogue is implemented by the machines.” Apply the same principle to all forms of harvesting, and suddenly you have a system that not only provides a better margin to the grower, but it’s also a more sustainable system because less fuel is used. 24

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You’re going to see economic forces pushing towards synthetic protein and people will most likely adopt that” Despite dire warnings of global food shortages over the next 30 years, Martins remains resolutely optimistic that the challenge will be met. “I’m actually very optimistic, because there’s nothing more primal than food,” he says. “We have never statistically had such long lives. We have never eaten as well as we are today. And it’s only going to get better. “If we look at the technologies that are still to be unleashed, we are going to see tremendous productivity. We’re going to have well-balanced diets with nutrigenomics, which is softer scaffolding to help people decide what to eat, and how people get visibility on what they’re eating.” He also predicts that we are at the advent of impossible meats – such as the Impossible Burger which made headlines around the world a few years ago. It uses a plant-based patty that cooks in the same way as meat, made


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using haem – a compound containing iron that’s abundant in animal muscle. Because it’s made from plants, the environmental footprint is much smaller than if it were made from beef. Meatless meat is becoming increasingly mainstream, and Martin believes this trend will accelerate. “If you look at the cold chain, and the logistics required to move beef from central Brazil to Novosibirsk in Russia where it will be ultimately consumed, it’s very complicated to keep containers frozen 26

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with the cold chain preserved all the way through to Europe. And it’s very, very expensive. You have to have electricity, you have to have diesel being spent to keep the container cold, and so on. There’s loss – meat has problems! It’s an animal, you have fecal matter in non-zero percentages. So it’s very complex. “Now if you compare that with the new technology, and you have a new factory that produces protein that tastes like it, with zero cholesterol, no fecal matter, no need for a complex cold chain because


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you can transport grain to the destination and have the factory there, there’s a lot of economic advantage. You’re going to see economic forces pushing towards synthetic protein and people will most likely adopt that.” Martins also sees big changes to farms over the next few decades. “We’re going to see farms that manage themselves,” he says. “We’re going to see what I call autonomic agriculture, so the farm will fix itself, it will look at the weather and decide to spray or not,

and the sprayers will go to the fields and spray without human interaction. That’s going to happen. “I can see that in 30 years we’ll have a lot more progress towards autonomic agriculture, with a lot more data being collected by those machines and data flowing through systems like blockchain to get to you with trust. We can dream a lot of things, but I definitely think a lot of those items will be a part of agriculture 30 years from now.” The world is counting on it. ISSUE 01

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KEEPING ‘ATLANTA STRONG’ IN EXTRAORDINARY TIMES Since Gary Brantley took on the role of CIO of the City of Atlanta in late 2018, he has battled against the fall-out of one of America’s largest cyberattacks and now the threat of a global pandemic. Speaking exclusively to Tech for Good, Brantley talks about how the two viruses have enabled opportunity for lasting change, why Atlanta is smashing public sector stereotypes and a burning desire to use technology to help the city’s under-served communities

AUTHOR: James Henderson

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or most technologists, the prospect of starting off a new job by tackling the after-effects of a truly cataclysmic cyberattack would make them think twice. Many, quite understandably, would run for the hills. But for Gary Brantley, it was one of the main reasons he accepted the offer to become the City of Atlanta’s CIO in late 2018. Many people, he readily admits, will consider him “crazy” for taking such a stance, but to Brantley it was a chance to oversee a rebuild that could genuinely transform a city, and have a truly positive impact on a community. “I don’t know of any other job in America that allows you to have an impact in such a broad range of areas,” he tells Tech For Good. The scale of the 2018 ransomware attack on Atlanta is considerable, and is considered to be the largest successful security breach ever suffered by an American city. The city’s computer network was targeted, affecting millions and sending many people back to a manual process. Hackers’ demands of $51,000 to be paid in Bitcoin were not met, with eventual costs associated with the attack estimated at $17 million. Brantley has gone on record in support of that decision, stating that it is better to spend millions of dollars on over30

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hauling a network, rather than paying cyber criminals. The attack allowed Brantley to set out aggressive plans to improve the city’s security infrastructure when he arrived, a plan that he says may not have been given the green light had the incident not have occurred. But key to the plan - above ambitious, costly or flashy initiatives - was stripping everything back to establish a foundation that the city could build upon. “When something like that happens, you have two areas in need of attention. You have the digital transformation element to it and then on the other side you have a humanistic transformation that


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We had to make sure we did the right things and we had the right people in the right places. If you don’t have the basic fundamentals down as it relates to IT, then you can’t do anything else” Gary Brantley needs to happen, a lot of which is embedded in changing your culture,” he says. “After I arrived, one of the things that I thought we needed to improve on were our basics. It became a key theme that we held onto to get back to our operational principles. I always use the analogy of sports or playing an instrument - before you can think about doing anything extra or special, you have to get your basic fundamentals down. “We had to make sure we did the right things and we had the right people in the right places. If you don’t have the basic fundamentals down as it relates to IT, then you can’t do anything else.” ISSUE 01

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As any technologist worth their salt will already know, people are just as important in implementing a successful technology transformation, if not more so. In trying to change behaviours in a public sector environment, Brantley said he was “laser focused” on winning hearts and minds in his efforts to change the culture. “We all know government entities have turnover at the top layers but underneath that you have employees who have grown up with the system. It’s really about trying to change cultural norms for the better, adopting the ones that need to stay, but changing the ones that need to go,” he explains. In his own words, that process took 32

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a “tonne of conversations” and hours of time to build trust and relationships, navigating through the politics of a governmental organisation to affect change, but also to listen to people and find out what makes them tick. “You have to sell it, that is a huge part,” Brantley adds, emphatically. “You have to sell the change, you have to sell the vision and have an ability to make people believe, all of which takes a little bit of time.” An experienced CIO, Brantley describes the overhaul that has taken place in Atlanta as the “fastest, most rapidly adopted transformation in the most complex environment,” which, it is fair to say, are not always qualities you’d associate with public sector organisations.


KEEPING ‘ATLANTA STRONG’ IN EXTRAORDINARY TIMES

“I’m not just saying this for the sake of saying this, but I really believe the change has been rapid and it has been extremely successful. To come into a very challenging environment and to really be able to focus on the right things when you have so many areas that people want you to focus on is a win in itself. The city was ready for change after the cyberattack. “Rapid acceleration, innovation and adoption have taken place during both of the viruses.” Which brings us to the giant elephant in the room; having fought against a computer virus, Atlanta and the wider world is now fighting against a human one - COVID-19. Brantley, understandably, is careful to preface everything he says with an acknowledgement of the heavy human toll the virus has had, but is insistent that - as with the cyberattack - Atlanta must use the experience to come out stronger on the other side. “We are in a time of crisis, but we have to think about how we can take advantage of the situation that we’re in, because it is here,” he says, matter-of-factly. “This virus today allows us to focus on innovation and it really puts IT in a different arena. It has made us think about how we move from a city that was focused on security - and rightfully so - to

Government was viewed as a slow part of that process as it relates to technological changes but we now know that we can move just as fast as anyone else and the biggest lesson learned is - man, look at how great we can be if we get out of our own way” now being able to bridge that gap to learn those security lessons and move on to operational efficiencies and new ways of doing business and serving customers across the city using technology.” It is undeniable that Brantley’s time as the City of Atlanta’s CIO to date has been a tale of two viruses. But if there is a silver lining, it is that the lessons learned and culture change driven by the computer virus has made the city better equipped to deal with the pandemic, which has been the catalyst for an increasing number of phishing attacks worldwide. “Because of the work we did to imISSUE 01

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We want to address gaps in proficiency, which will enable many citizens in our under-served communities to enhance their skill sets and be ready to work in technology, which is ever-changing and a quick environment” prove the basics and fundamentals after the 2018 attack, we are a lot more agile and flexible around different security practices, whether in a confined environment or in an unconfined environment,” he says. “We obviously didn’t know this was going to happen but what we did notice was that we were focusing on the right things and building up a lot of muscle memory through repetition, through intentional focus. Now we have different challenges, so sometimes they are the same problem, but posed in a different environment. “Yes, the phishing attacks are happening a lot more because of the ability to use the pandemic to take advantage of the situation, but it is still a phishing attack, it’s just being done in a different environment than we’re used to having it done, and neither is the patching of our equipment.” Brantley is clearly proud of the work he and his team have carried out and, in his own words, considers Atlanta to 34

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be the “leader of the pack,” showcasing the true potential of public sector technology teams. “Government was viewed as a slow part of that process as it relates to technological changes but we now know that we can move just as fast as anyone else and the biggest lesson learned is man, look at how great we can be if we get out of our own way,” he says. While it can be difficult to imagine a post-COVID world, that is exactly what public organisations must do, with Brantley and his team of technologists working fastidiously to ensure momentum built up before the coronavirus struck is maintained. Key to his longer-term mission as Atlanta’s CIO is to extend valuable initiatives and programmes to communities that have previously been under-served when it comes to the benefits of technology. “Our focus is on learning those security lessons and moving on to operational efficiencies and new ways of doing busi-


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ness and serving customers across the city using technology,” Brantley comments. “It has really allowed us to put our attention back on to where it needs to be, which is dealing with inequalities across the city in our under-served communities - how can technology be a big part of that solution? “We want to address gaps in proficiency, which will enable many citizens in our under-served communities to enhance their skill sets and be ready to work in technology, which is ever-changing and a quick environment. “That doesn’t mean you have to be a technologist, that means you really need to be able to understand services we’re providing that use technology. I think a lot of times we jump ahead,

and we want to change the government to be this high-tech environment, but at the end of the day, you want to be able to meet your constituents and residents where they are.” To that end, Brantley and his team are working with several large Fortune 500 companies and local universities as part of its smart city initiative, with the focus changing from just integrating devices and technologies into communities to ensuring citizens can access initiatives and programmes to give them the skills they need to work in today’s technology economy. “It’s not just about turning a computer on and off; we want to drive real value. We want to see residents come out with cloud architecture qualifica-

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When you lose a fight, you should come back better and we see that everywhere. The only way to get better sometimes is to take defeat and learn from defeat and Atlanta is a good example of that�

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KEEPING ‘ATLANTA STRONG’ IN EXTRAORDINARY TIMES

tions, so they can work for the likes of Salesforce, AWS and Microsoft. So, we are partnering with a lot of those large organisations to implement those impactful programmes.” The Smart Atlanta programme is also built on data protection, privacy protection, policy protection and making an open data portal that allows for streamlined communication and interoperability to ensure residents can access online services. The City IQ programme is another that is close to Brantley’s heart, taking the combined benefits of technologies such as artificial intelligence (AI), machine learning (ML) and the Internet of Things (IoT) to address key challenges faced by Atlanta’s urban population, such as traffic management, healthcare and energy. “When you talk about AI and ML, you’re talking about making sure we have a digital infrastructure that is living within our streetlamp posts and also in the cloud,” he says. “Those are areas we’ve been working on. And like many other cities, our camera readers that have been installed on our public roads are capturing traffic optimisation and vehicle metadata. Those are some of the areas we are really focussing on.” Utilising emergent technologies to further these smart city efforts, while ensuring the vital technology infrastruc-

ture that is relied upon by its almost half a million residents is running smoothly, would be enough to keep any technology team busy. But combined with the double whammy of a large-scale cyberattack and a once-in-a-century pandemic, Brantley and Atlanta’s technology experts have found their backs against the wall. However, its CIO is adamant that the city will ultimately win the battle, thanks in large part to his team, for which he reserves special praise. “When you lose a fight, you should come back better and we see that everywhere. The only way to get better sometimes is to take defeat and learn from defeat and Atlanta is a good example of that,” he concludes as the conversation draws to a close. “My team has been great. When you have been through the events they have been through, you can tell a lot about them. They are people who will go to war with you and that’s how I look at it, they have been outstanding. They have been pushed and challenged in a lot of areas both personally and technologically and they have really risen to the challenge in order to get that done. “Atlanta is known as being a resilient city and my team has adopted that and we believe in ‘Atlanta Strong’, they exemplify ‘Atlanta Strong’.” ISSUE 01

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ONLINE LEARNING, REDEFINED As top-tier university lecturers and startup innovators, David Shrier and Beth Porter are highly regarded in the edtech world. Their present ambition is to reinvent online learning by combining cognitive science with sophisticated technologies, as Tech For Good found out AUTHOR: Ben Mouncer

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n the field of learning, one of the 21st century’s major advancements has been the shift to online. Technology has helped offer opportunities to a far broader demographic of students and professionals, with new online platforms attracting millions of users and many traditional centres of education pivoting to facilitate remote learning at scale. The coronavirus pandemic has accelerated this trend. Most of us, confined to our homes, have grown reliant on technology to complete our work or studies. In education, distance learning 38

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has become the new normal - and, for many institutions, it will be the preferred method of teaching for the foreseeable future. Cambridge University, ranked the third best in the world, made headlines in May when it committed to a full academic year of exclusively-online learning. Remote education is here to stay, that’s for certain. But for those charged with delivering these online classes and training programmes, a significant challenge still exists: exactly how do you create truly effective remote learning


ONLINE LEARNING, REDEFINED

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As I’ve gone through my career and created new and more evolved softwareengineered solutions for learning, what I’ve found is that people really make poor use of technology” Beth Porter

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alternatives which get somewhere near to the face-to-face experience? David Shrier and Beth Porter - both lecturers at the prestigious Massachusetts Institute of Technology (MIT) - have combined their professional and academic endeavours to try and solve this problem, utilising some of the most advanced technologies of our age. “As I’ve gone through my career and created new and more evolved software-engineered solutions for learning, what I’ve found is that people really make poor use of technology. We felt inspired by the problem of how we make an online learning programme that is really excellent in all dimensions,” says Porter. Porter has dedicated her professional life to transforming learning experiences. Along with her commitments to MIT and Boston University (BU), she is also CEO of Riff Analytics, a software company with a social learning platform for people and companies. Previously she held senior product roles at the likes of Pearson Education and edX. Shrier acts as Chairman of Riff Analytics but is also a highly-regarded author, lecturer and advisor to public bodies and private companies on technology-powered growth and disruption. The pair’s vehicle for driving change in education is Esme Learning. Co-founded as a means to synthesise their knowl-


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edge in teaching and technology, Esme is working with some of the world’s foremost universities to reinvent remote learning classes using the tools available through the Riff Analytics platform. The Esme mission is one borne out of many years of frustration at the conventional online learning approach, as Shrier explains. “Around five years ago, a professor at MIT - Alex “Sandy” Pentland - and I came across an opportunity to really reinvent what online learning looked like. So at the time, in 2015, a lot of online learning was really bad television. Someone would say, ‘let’s just take a camera, and stick it in the back of a classroom, and film someone give an hour-long lec-

ture, stick that up on the internet and that will be online learning’. “And then for these Massive Online Open Courses (MOOCs) that you read about, where they say they have 50,000 students signed up, the completion rate - meaning the number of people who actually finish the class - was at 3.13%. So out of the 50,000 people who start, only about 1,500 finish. We looked at that and said, ‘maybe if we take a lot of lessons from cognitive science and neuroscience, and we take some new technology and new approaches, we could really make online learning better’. “Sandy and I put together a handful of classes and they reached into 140 counISSUE 01

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tries and successfully engaged more than 15,000 innovators across topics like fintech, blockchain and data science. That was a really interesting experience for us but we felt there was still more to be done, and that there was an opportunity to take next-gen research and nextgen platforms and put them to work. That led to the birth of Esme Learning.” Shrier asked Porter to lead on the side of academic research and Esme went about building courses based on a disciplined methodology founded in science. One of the key outcomes from research in this area is that individuals learn better in teams - and that is where the technology from Riff Analytics per42

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fectly complements Esme’s peer learning approach. A collaborative tool underpinned by artificial intelligence (AI), Riff’s platform helps create meaningful group interactions online by providing real-time feedback on metrics such as speaking time, influences, interruptions and affirmations. It is designed to help businesses better communicate and collaborate remotely. For Esme, it is all about “re-architecting” group collaboration in a learning context and generating more satisfying results. “In small teams, when you’re trying to accomplish complex tasks, you need everybody’s voices to be heard and you need there to be relative balance in the


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There was an opportunity to take next-gen research and next-gen platforms and put them to work. That led to the birth of Esme Learning” David Shrier conversation,” Porter adds. “There can’t be a rush to close down the conversation or cut off the discussion; you need to make sure that there is lots of dynamic speaking time going back and forth, because that high exchange rate is highly indicative of whether a team can be successful working on a non-routine problem together.” Early examples have achieved completion rates above 90%, while the courses have been delivering up to a 1,800% improvement on student satisfaction when compared to other digital offerings. Now Esme is doubling down on its efforts in industry and exploring how it could quickly upskill executives and workers. ISSUE 01

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You have a lot of measurable events that happen in an online course that you can really not easily do in an in-person course. So where you might lose some of the body language stuff that happens when you’re in-person, and the social dynamic, you do gain an enormous amount of measurability of the environment” Beth Porter The company, which launched a year ago, recently announced its involvement in the Oxford Cyber Futures project. A joint enterprise between Oxford University’s Saïd Business School - where Shrier is a programme director - and Mastercard, Oxford Cyber Futures is a six-week, all-digital programme aimed at educating cybersecurity professionals on critical topics in AI, cybersecurity, threat analytics, data privacy and digital ethics. Oxford Cyber Futures, which launches this summer, is underpinned by Esme’s course methodology and technology with the ultimate aim to show that if you practice good cybersecurity, you actually can create new business opportunities. The idea was first discussed when Shrier met with Paul Trueman, Mastercard’s SVP of Global Enterprise Risk and Security, in a pub two years ago. “We had a conversation about how we could create a really engaging educa44

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tional programme from a top-tier university and deliver it in such a way that would help not the CISO (Chief Information Security Officer), but everybody else who talks to the CISO - so everybody else in the business. That was the birth of Cyber Futures,” Shrier reveals. “For decades, people have been selling cybersecurity solutions based on fear. If you’re in ecommerce, there’s more than $300 billion a year of lost revenues for companies who have bad security and fraud management. If you improve that, you can dramatically improve business performance from growing revenue. Then on top of that, there are a couple of trillion dollars of expected business losses due to hacks coming within the next couple of years. So we’ve got a big multi-trillion dollar problem that we need to solve.” The programme’s approach to remote learning is pioneering. After lessons on a range of cyber topics, participants


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will be thrown into a cyber-attack simulation to assume the roles of senior executives at a fictional company. The simulation then responds to the action taken by the participants. While this may sound unusual on the face of it, the underlying methodology is rooted firmly in cognitive science - and both Porter and Shrier are convinced it will result in improved learning outcomes and ergo a greater degree of knowledge around the basics of cybersecurity. “The main thing is that the experience is immediate,” explains Porter. “People do still read a lot of content and learn from it, they watch a lot of content and learn from it, but the immediacy of the moment of testing whether they’ve learned something is what we capitalise on with these online courses. That quick reinforcement is just part of how cognitive science works, which is that if you

don’t give people a chance to test that knowledge right away, they’ll lose it.” Shrier adds: “Part of how our classes operate is that they’re designed to drive immediate applicability to work. With Cyber Futures, you will walk out of that six-week experience with a new cyber opportunity idea that you could apply at work tomorrow. And along the way, every single week, you’ll be getting tools and frameworks that you could apply at work the next day. People tell me when they take our classes that it’s the immediate applicability to work that makes them extraordinary and different.” Porter and Shrier exude passion about online education and its power to create better outcomes through tech-enabled, experiential learning. In fact, the pair are convinced that - certainly in some aspects - the quality of the learning matches or even exceeds that delivered

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We very much would like to change the world, but we’re not arrogant enough to think we can do it just by ourselves. What we know we can do by ourselves, in our startups, is come up with cutting-edge ideas and then validate that they work at scale” David Shrier

in lecture halls and training centres. For Shrier right now, this isn’t about one method being better than the other - it’s about a service that is “differently good” to the other. Though he doesn’t hide his ambition to take online learning even further. “Our goal over time is to actually transcend, to actually create something that is better than in-person,” he reveals. “That’s really difficult, and Beth and I both keep ourselves close to the veracity of that statement by actually teaching in person. But we have had success in cre46

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ating a ‘differently good’ experience - it’s not the same as being in the classroom, but it has other benefits that outweigh the drawbacks, so it works out at a net even. But we want to go beyond that.” The capability to measure the efficacy of teaching methods is one of the main benefits of Esme’s model. Porter says this is one facet where online beats face-to-face, with in-person teaching being historically difficult to appraise. “I have, on average, 50 people in my IT strategies class that I teach at BU,”


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she adds. “In that class, we break out into small groups, we have very deep discussion topics that I want our small groups to engage in, and then we have a period of sharing. Yet I can only visit so many groups, I am only one person and I can’t measure much at all about those groups and their dynamics. “You have a lot of measurable events that happen in an online course that you can really not easily do in an in-person course. So where you might lose some of the body language stuff that happens when you’re in-person, and the social dynamic, you do gain an enormous amount of measurability of the environment.” It’s difficult not to buy into the ideas of two individuals who are working at the frontier of developments in learning and technology. Supported by leading research and world-class universities like MIT and the University of Oxford, Porter and Shrier are offering enterprise a radically different approach to online education, and one that could be even more appealing as organisations reel from the effects of a pandemic. But what about the bigger picture? When asked if they could change the world, Shrier’s response is measured. He knows it will require a far broader collaboration to take their learning methodology to different communities and people - but he isn’t ruling it out.

“The answer is yes, but it’s going to take a lot of help,” he concludes. “We very much would like to change the world, but we’re not arrogant enough to think we can do it just by ourselves. What we know we can do by ourselves, in our startups, is come up with cutting-edge ideas and then validate that they work at scale. Then once we’ve done that, it becomes a lot easier to convince other people to adopt them. “The principles that we’re deriving from Esme Learning classes and from working with Riff could certainly help with shaping the practice of education more broadly. Because in addition to being a platform to deliver a really fantastic learning experience, we’ve also built in a research capability. We plan to do more of that under the supervision of a major university and with the appropriate consent and human subjects’ approval. “A lot of our students enjoy being part of research studies. When we did one on group collaboration and predicting future events, 85% of our students signed up to be in the study because they were really curious to be part of this adventure and advancing the frontiers of learning knowledge. We expect that to be a significant part of our company going forward.”

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HEALTHCARE

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WILL CORONAVIRUS TRANSFORM DIGITAL HEALTHCARE?

WILL CORONAVIRUS TRANSFORM DIGITAL HEALTHCARE? The rapid onset of a global pandemic has led to swift and often remarkable deployments of new technologies in healthcare. We ask four leading voices whether an industry historically resistant to transformation might now be able to find its digital feet AUTHOR: Romily Broad

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E

ight years ago, emergency-room physician Dr Michael Brooks became so disturbed by the dangerous anachronisms of the hospital in which he worked that he decided to do something about it. “I saw some pretty shocking things, mistakes being made, largely because people had lost bits of information or data wasn’t available. Most of my life as a doctor has been spent collaborating on paper, and that is still the case in the majority of hospitals in the world today,” he tells Tech For Good. Dr Brooks began spending just one week a month in the emergency room, using the rest of his time to champi-

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There’s a real cost to not innovating” Dr Michael Brooks on a cause he felt was critical to the welfare of the patients he served. He founded PatientSource – a novel electronic medical record (EMR) system – and set about creating a tool he says doctors and nurses desperately needed: A digital patient records solution designed by them, for them. It was an effort, along with repeated high-profile attempts at all levels of government over the last decade, to wrestle a recalcitrant and hugely complicated NHS system into the 21st century. However, while technical progress has been made in some areas - especially on a regional level by astute and collaborative trust CIOs - truly holistic digital transformation remains a more distant ambition. Eight years later, PatientSource counts most of its clients in countries outside of the UK. “It culminated, for me, when a patient had a stroke because of a lost piece of paper,” recalls Dr Brooks, underlining the mission-critical importance of dig-


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©️PatientSource italisation. He’s keen to stress that the risks to patients of a stubbornly analogue system remain prevalent today. As recently as two years ago, an emergency department in which he worked still relied on fax machines to process patients in need of time-critical interventions. It could take 20 minutes to transmit ECG results to a regional cardiologist in order to blue-light a heart-attack patient onwards for life-saving treatment. “I could have scanned it and emailed it within a minute. That’s 19 minutes of heart muscle that’s dying in that patient because of our technology.” The hospital no longer relies on fax machines, he says, but even achieving that milestone was a struggle. “They’re not

doing that now because I put a flatbed scanner in the department. It took me nine bloody months to get the organisation to agree to it, and they only did it because I threatened to go to Argos, buy one, and hack the computer to make it happen. They knew I had the skills for that. “There’s a real cost to not innovating.” Dr Brooks’ frontline experiences illustrate well the challenges faced at all levels of healthcare governance in terms of digitalisation, and not just in the UK. National and even regional healthcare systems are necessarily enormous bureaucracies, populated by huge numbers of long-standing staff using intractably entrenched tools and work practices. They are overwhelmingly concerned with the ISSUE 01

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sanctity of patient data and are fearful of the disruptive impact of change against their duty of care to patients. Moreover, they are almost always making investment decisions from the wrong end of a negative balance sheet. But the devastating sweep of the COVID-19 pandemic around the world, while applying unprecedented levels of stress to these systems, has perhaps revealed an adaptability and openness to technological change that was hitherto hard to see. “There’s probably three areas where we’ve seen pretty dramatic progress,” says Dr Brooks. “Number one, above everything else, is videoconferencing. Another area that we’ve seen progress is the tracking of cases. And then there’s VPNs.” All three factors have been enhancements forced by necessity. Similar to

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organisations of all types, healthcare systems have needed to rapidly transform their infrastructures to allow very large numbers of people, including patients, to interact with institutions remotely. In the short-term, doing so has meant a crisis hasn’t become a calamity. In the longerterm, it could finally mark the beginning of something transformative. NEW BEGINNINGS Andrew Raynes is CIO of The Royal Papworth Hospital in Cambridge, the UK’s leading heart and lung hospital and the country’s largest cardiothoracic transplant centre. It is home to some of the world’s most renowned surgeons and already boasts a history of innovation; it was the site of the world’s first triple transplant in 1986. It was where Professor Stephen Hawking received his care (his family donated his ventilator


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to the hospital at the beginning of the coronavirus outbreak), and it is also one of the country’s newest, having been rebuilt on a new site just over a year ago. Raynes’ speaks to Tech For Good in the midst of the UK’s coronavirus outbreak, in between appointments to oversee the installation of handheld and ceiling-mounted RFID scanners intended to track vital hospital assets around the estate in real time. His hospital, like all others, is responding to the sudden demands of COVID-19. “The virus has given organisations a stark realisation on the value of communications in particular, and a focus on how important technology is in helping with that,” he says. “We have accelerated our digital strategy at least three to six months in that sense. That’s in terms of infrastructure, equipping and mobilising.” Raynes outlines how the hospital quickly expanded its bandwidth to accommodate a suddenly connected and distributed workforce. It upgraded from a 100Mb line to a 500Mb “five-lane motorway”, while simultaneously splitting out its WiFi provision to enable both staff and patients much faster access to its network. Some of that was separated out for VPN, too. But perhaps the greatest challenge was the need to physically equip a newly dispersed workforce with the devices they needed.

Things will never be the same. A bar has been set that has accelerated the adoption of new technology” Andrew Raynes

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“Every organisation in the country was after the same thing. Quite honestly, it was just trying to find a seller that hadn’t already sold out. Some organisations were queuing up outside shops trying to buy stock – and that smacks of crisis. So all your infrastructure was strained, all at once, with the rest of the country.” Once the workforce was connected and equipped, the next challenge became upskilling staff to use unfamiliar tools. Centrally, the NHS provided licences wholesale for software such as Microsoft Teams and Cisco Webex, which Raynes says has been “fantastic”, albeit representing a looming cost burden for the future. “For us, technology is about making people as efficient and safe in the hospital as they can be. Now everyone in the hospital has got a bigger picture of what is needed to help them function as efficiently as they can in a crisis situation. “Things will never be the same. A bar has been set that has accelerated the adoption of new technology.” One opportunity Raynes spies is the ability for a world-leading surgical institution such as The Royal Papworth to leverage its enhanced connectivity to broadcast its expertise to the rest of the world. “Exporting the capabilities of that highend surgery into other countries… that’s quite an exciting opportunity. Covid has 54

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accelerated that capability through the very nature of virtual consultation – the Microsoft Teams and Webex type scenarios which provide a platform to do that.” BARRIERS While a newly connected and enabled healthcare workforce has been key to meeting the immediate challenge of a global pandemic, maintaining and building on that digital progress is another thing altogether. That may be particularly true in the event of seemingly inevitable post-pandemic budgetary pressures. Dr Brooks, for one, is cautious: “We’ve had rapid digitalisation because we’ve been forced to. Adversity has allowed us to innovate. But I think we will largely revert to form. “A lot of the processes, procedures and regulations that have stood in the way have been given a temporary bypass. But those barriers are still there. As the force of change of the covid pandemic passes, the licence to bypass those barriers is going to disappear.” Among the systemic barriers Dr Brooks cites are rigid hierarchies of decision making, exclusionary tendering processes that bar entry to smaller innovators, and burdensome, often overlapping regulatory processes. Another long-time healthcare innovator, Dr Bernard Algayres, agrees. His


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Healthcare is very conservative – it is still struggling with some of the basics that other segments resolved a long time ago” Dr Bernard Algayres

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perspective is informed by providing technology solutions to healthcare institutions for the last 20 years, including in leadership roles at Carestream and as general manager of GE Healthcare’s enterprise imaging division. Dr Algayres is now Managing Director at Smart Reporting, a fast-growing German software company aiming to revolutionise the efficiency and sophistication of medical reporting in radiology and pathology contexts. Today, up to 99% of formal reporting in those areas remains free text – inefficient, error-prone and difficult to store, analyse and reproduce. “Healthcare is very conservative – it is still struggling with some of the basics that other segments resolved a long time ago, such as simply transferring patient data over the internet. Your bank started transferring your account through the network 30 years ago,” he says. “Being able to work remotely, virtually and digitally, in healthcare will require that patient data is more easily accessible from different locations, and that does not exist today.” He is, however, optimistic that green shoots are beginning to appear. He refers to examples in the NHS where regional trusts are forming data-sharing consortia to tackle the problem. Similarly, at The Royal Papworth, Raynes led a successful pre-covid effort to build


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©️PatientSource a bi-directional interface between the EMR systems of The Royal Papworth and neighbouring Cambridge University Hospitals. It made headlines since it was the first time in the UK that anyone had managed to integrate systems from giant American platform providers DXC and Epic, otherwise fierce competitors in the EMR space. And the world is not without examples of healthcare systems that have largely overcome the data sharing roadblock and provide impressive role models to which others can aspire. “Finland,” says Dr Brooks, without hesitation. “Finland, Estonia and the Nordic countries,” says Dr Algayres. “I have always been told: look at what those Nordic countries do, because sooner or later it will come down to the rest of Europe. They were the first ones to really digitalise primary care, digitalise imaging, to create

regional networks. They’re more open and less conservative than other countries.” While methods for comparing the relative quality of countries’ healthcare systems vary, Finland and its neighbours are used to holding all the top spots in most world rankings. Kari Klossner heads up Business Finland’s Smart Life programme, which represents the country’s dynamic healthcare industry on behalf of his government’s trade and investment arm. “Close to 80% of healthcare in Finland is provided publicly, while the rest is operated and funded by private healthcare providers and insurers. For both public and private players, COVID-19 has meant it has become even more important to secure access to healthcare systems remotely. We have seen up to a tenfold increase in use of remote appointments and other telehealth services during this COVID spring.” Finland is already well ahead of the curve in providing a portfolio of digital ISSUE 01

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New Children’s Hospital, Helsinki health services, collectively called Kanta Services. The country systematically introduced electronic prescriptions 10 years ago, and that will soon be supplemented by a national medications list to provide patients with key information about their treatments. A national patient data repository, accessible by both clinicians and patients, went live seven years ago. That has more recently been complemented by infrastructure to share imaging, a similar repository for social care data, and a system through which patients can add their own data to the record via a range of different apps. This holistic investment in digital healthcare has led to a return in the form of a vibrant healthcare technology ecosystem in Finland, which Klossner is proud to represent internationally. 58

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“With the increase in demand, and by being already well positioned in these markets, many Finnish companies have been able to develop a leading position internationally. We fully expect time- and place-independent access to health services to become the ‘new normal’ in the post-COVID world for many applications in the health and wellbeing services space. “I think now we will see a real focus on wearable devices, such as intelligent rings and bracelets. While their main function has traditionally been monitoring health and wellbeing, they can now also assist in self-diagnosis, measuring weak signals that can be an indication of infection. “Moreover, the use of machine learning algorithms provides additional insight into the data logged by wearable devices. Finland is also a leader in this field


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We fully expect time- and placeindependent access to health services to become the ‘new normal’ in the post-COVID world” Kari Klossner

with a number of companies developing advanced AI algorithms. The use of wearables is not limited to temperature measurements. Several Finnish companies are world leaders in monitoring heart rates to deliver real insight, too.” Examples of the export of Finnish healthcare expertise include Oura, a smart, connected ring, alongside wearable offerings from the likes of Suunto and Polar. Meanwhile, Ninchat and VideoVisit are secure communications platforms that facilitate remote consultations. The latter was recently awarded funding by the UK’s NHSX innovation arm as it sought ways to support vulnerable people during the coronavirus lockdown. So despite problematic barriers, countries like Finland prove what is possible with clear-eyed policy and consistent, long-term effort. “The things that I’ve seen that have come across my desk in terms of innovation over the last eight years. I’ve seen some amazing things,” say Dr Brooks. “However, I’ve also seen the vast majority never see the light day because of these systemic barriers. Priority one – knock these barriers down. Suddenly you’ll see a rate of innovation similar to when you’ve got a global pandemic shifting stuff. “We now know we can do it.”

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Taking Tech for Good to the mainstrea UK charity m

Sopra Steria’s new Digital Ethics & Tech for Good practice is taking previously fringe issues to the heart of company transformations. Jen Rodvold, who heads the practice, speaks exclusively to Tech For Good AUTHOR: James Henderson

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f you were asked to think about the companies around the world leading the charge when it comes to utilising technology for good, you’d be forgiven for not instantly thinking of a multi-billion dollar technology consultancy with north of 40,000 employees. But Sopra Steria - which provides digital consultancy to some of the world’s largest private and public sector organisations - can lay claim to being one of the first to properly grasp the nettle when it comes to making both a busi60

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ness and societal case for technology as a positive force. Having long-housed CSR (Corporate Social Responsibility), sustainability and social value business units within the company, Sopra Steria went one step further last year when it established its Digital Ethics & Tech for Good practice. The woman tasked with leading the practice is Jen Rodvold, who joined the business in 2010 and has spent the bulk of her time spearheading Sopra Steria’s sustainability services. In her newly-created


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role, Rodvold is responsible for defining and bringing to market new services that address societal concerns, including the company’s Digital Ethics services, and help clients meet their business and sustainability objectives. Through Tech for Good, she also leads the Sopra Steria Community Impact programme, working with charities, social enterprises, small businesses and community organisations to build a better future using digital technology, innovation and entrepreneurship. It is a role that is tailor-made for Rodvold, who has been helping organisations use business and technology as forces for good for the last 15 years, after experiencing what she refers to as a “Road to Damascus moment” in her 20s. “I’ve always been interested in helping people and being part of the solution, ever since I was young,” Rodvold says. “I got exposed for the first time to the concept of CSR and had a chance to work on a microfinance opportunity in South America and I really saw how business, finance and opening opportunities to those without them can make a tremendous difference in the world. “I decided to pursue an MBA recognising that business was a force for change and did it in Sustainability and Corporate Responsibility. My first job out of the MBA was with a technology com62

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pany and that is when I started putting together business and technology as forces for good.” Rodvold says the decision to reframe the conversation around digital ethics and the use of technology for positive change was partly driven by the changing nature of conversations with clients over the last few years, reflecting a shift in thinking from shareholders and in the boardroom. “There has been a huge movement on the shareholder side to put pressure on companies to demonstrate good corporate citizenship when it comes to social and environmental issues, and


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Participants of Sopra Steria’s Micro-Tyco: Innovate for Good initiative that has led to increased investment in sustainability, so there has been a lot of change.” she comments. “All of our clients have sustainability and CSR targets and we find it an interesting and engaging way to start a conversation with them. Our clients get excited when they speak to us because they know we are not just adding these topics on as an annexe of a bid. They realise that Sopra Steria recognises what they are trying to achieve, whether that’s cutting emissions, understanding the ethical implications of a technology or how AI can change the make-up of a workforce.

“We have made this a part of how we want to work with companies and we see nothing but positives with that approach.” Rodvold believes the message that sustainable businesses are more likely to be successful businesses is one that is landing. It is an evolution of the conversation around CSR - a term she says she has instinctively moved away from - where the focus has changed from responsibility to opportunity. “Our sustainability work encompasses economic and environmental concerns, and some organisations might still see that as being CSR, but for me there is a subtle difference,” Rodvold explains. ISSUE 01

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Across almost all metrics, companies that think and act in an ethical and sustainable way outperform those that don’t” Jen Rodvold

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“When you start thinking about it as sustainability you switch the thinking from something that is reactive and an obligation to something that is good for everybody, it is a win-win-win for all stakeholder groups. “Organisations that get this right are really going to reap the benefits. We know the companies that excel in sustainability and ethics are better equipped to attract more diverse talent and keep their people engaged and performing, which leads to better innovations. “Across almost all metrics, companies that think and act in an ethical and sustainable way outperform those that don’t. It is about what makes for a sustainable business internally, but recognising that businesses are part of a wider ecosystem and rely on things like better education, a healthy and inclusive economy and strong social institutions. When we are all building for these shared benefits they help us all.” A key component of the Tech for Good side of the practice is community programmes, with Sopra Steria having recently won a £250,000 grant from innovation foundation NESTA to work with ELATT, a digital skills charity helping under-served and under-represented groups in London get the training and qualifications they need to get into gainful employment.


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Working with school children to improve digital skills With technology changing the nature of work and the workforce, Rodvold says there is no time to waste when it comes to reskilling people for the future of work. “There are six million people in the UK who are in jobs that are either going to be massively transformed or entirely disappearing because of demographic changes, but also technology changes especially in AI [artificial intelligence] and automation,” she comments. “There is a massive skills gap and, at least before COVID-19, there was pretty low unemployment which translates into a lot

of people who are in jobs who won’t be soon, a gap now that will only increase in terms of people to fill the jobs. “The hypothesis we are testing out in the NESTA project is that technology has a role to help people better understand what their core and transferable skills are and help their employing organisations understand that too. “We are moving beyond traditional CVs and assessment centres, although there is still a place for them. But now we’re looking at how technologies like AI can help organisations and individuals get a better grip on capabilities and ISSUE 01

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skills that might make people more capable of transferring into different types of roles and helping with that learning and change.” Sopra Steria is also working with the Ben Kinsella Trust, a UK charity that was founded by the parents of Ben Kinsella, who was killed at just 16 years of age in a knife crime incident in 2008. Sopra Steria has got involved with the Trust to help them scale their programmes and initiatives to educate young people on the dangers and consequences of knife crime. “They are trying to show young people what it is like to be a victim or perpetrator of knife crime,” Rodvold says. “What we are trying to do is help them scale

their programme to use tech to reach more young people around the country to prevent knife crime through education and immersion. We’ve developed a VR solution that is being trialled and tested right now, and that is a perfect example of ‘Tech for Good’.” The Tech for Good sector was previously one that was building notable momentum, with a report by Tech Nation last year valuing the scene in the UK alone at $2.3 billion. But there can be no doubt that the COVID-19 pandemic is fuelling its growth, with companies great and small working collaboratively to help in the fight against the disease. We have seen rival hypermajors like Google, Amazon, Apple and Microsoft

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I think every organisation wants to be a part of the solution [to COVID-19] and some days I’ve felt quite redundant because Tech for Good when it is done right should be distributive with everyone tinkering and exploring these issues” working together to develop technology to track COVID-19, while manufacturers and even breweries have pivoted their operations to produce ventilators, PPE and hand sanitiser. The startup and SME sector has also stepped up, and Sopra Steria is now using its considerable clout to pinpoint Europe’s best 50 projects, which will then be whittled down to a handful that the company will invest in and take forward. “I think every organisation wants to be a part of the solution [to COVID-19] and some days I’ve felt quite redundant because Tech for Good when it is done right should be distributive with everyone tinkering and exploring these issues,” Rodvold says. “The challenge will be to sustain some of that in the longer-term. It has been

a great reminder of the ingenuity and capacity for human compassion, but how we sustain it is a question. There are also ethical questions that are coming to the fore because of the crisis which are really important, such as privacy of apps and what we as a society have signed up for. “It is really important that organisations and individuals working in technology take this opportunity to think about the ethics of technology. The pandmeic has presented a challenge because we are having to work at pace but it also offers the opportunity to explore ethical issues to harness the enthusiasm and passion for using technology and business for good. Now is the perfect time for us to be having these debates and taking action on ethics and Tech for Good.” ISSUE 01

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WEARABLES AND THE MODERN PATIENT EXPERIENCE IN CLINICAL TRIALS Medidata’s Paul O’Donohoe writes on how wearable technology will completely transform clinical trials, benefiting both patients and professionals

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here is no doubt that technology has significantly improved the way clinical trials have been run over the last few years. To date, these improvements have mostly been focused on the trial process - including electronic databases, computerised trial management and collecting data from patients using smartphones and tablets. This has brought great benefits and efficiencies around study conduct, analysis and data management, and formed the framework of modern trials designed to understand the safety and efficacy of new treatments. We are still in the very early stages of determining to what extent wearable

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PAUL O’DONOHOE

technology and sensors will transform drug development and what the true potential might be, but they are already offering the promise of allowing us to do completely novel assessments, both through improved insight into the patient experience and providing a vast set of new observations and learnings. Fully understanding the patient experience in a trial is vital, and wearables are able to monitor both the physiological impact of a treatment and track the progression of a patient’s symptoms to a level we’ve never previously been able to get to. Wearables are offering a new stream of data alongside traditional questionnaires that attempt to measure outcomes. However, there are a number of considerations to take into account when it comes to incorporating wearables and sensors into clinical research. Data, context and measurements Measurement of physiological variables has always been central to the assessment of the safety and efficacy of new treatments. Wearable technologies have drawn greater focus to the potential of the individual patient-level physiological data within trials, expanding our attention away from the conventional assessments. Batteries of questionnaires that ask patients to provide information on their subjective experience raise difficult

Wearables open up new and potentially very fruitful avenues for us to explore, supported by the more traditional subjective assessments” questions about what it is we’re actually measuring. Attempting to measure vague concepts, such as asking a patient to rate their pain, is fraught with complications as there is no widely accepted objective measure of an individual’s experience of pain, for example. The intense interest in wearables and sensors in clinical trials has to a large extent been driven by the idea that we can standardise and offer a more “objective”, round-the-clock measure of the range of patient experiences. Despite not yet being able to record and standardise pain, it is this passively sourced data that provides us with alternative levels of insight into their experience and medical condition without the patient needing to divert from their normal day-to-day life. Clinicians widely recognise that questionnaires are only a snapshot in time of ISSUE 01

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the patient’s condition. However, at present, these same clinicians are also still trying to determine what the data from wearables actually means in context of the modern clinical trial. For example, Fitbits and Apple watches seemingly provide simple measures in step count from a patient, yet these devices are not measuring actual steps but producing calculations based on their movement through space. All of these devices have their own algorithms for converting the physical feedback the devices are receiving into a measurement of steps. So, it raises the question: can a clinician be confident such wearables are consistently giving accurate measurements, and more fundamentally, what

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does this data actually tell us in understanding the effect of a treatment? Regulation and changing roles There is ongoing discussion as to whether wearables offer the correct measurements and insights into what is meaningful for the patient. Just because, for example, a patient’s step count has increased 20% over the course of the study, does that actually matter to the patient? Regulators and clinicians do recognise the significant potential of the use of wearables, but regulatory bodies in particular have been very clear in advising that trials need to start by determining what will be measured before implementing the


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With the impact of COVID-19, tech corporations are likely to accelerate their move into healthcare in general” use of a wearable device. Just because we have the technology, it does not mean it’s necessarily the right tool for a given job - simply asking a patient how they feel often remains the best way to gain an insight into their experience. But wearables open up new and potentially very fruitful avenues for us to explore, supported by the more traditional subjective assessments. However, wearables also create additional logistical variables. What was originally a couple of data points recorded in a daily diary has now evolved to a wearable product that can produce gigabytes of data in a single day. From a technical and logistical point of view, handling and analysing this data in a regulatory compliant way is a whole new challenge for the sector. Huge responsibilities are now imposed on vendors and sponsors by the inflow of potentially very sensitive data now produced by patient wearables. Patients’ familiarity with similar technologies in their daily lives has definite-

ly brought a willingness on the patient side to adopt wearables in relation to medical treatment, which holds significant promise for the healthcare industry. Electronic clinical assessments are going to continue their upward trend and adoption, and advance conversations around decentralising and virtualising trials. Wearables even hold the possibility of conducting remote performance outcome assessments, allowing us to shift more tasks out of the clinic. The role of the modern trial clinician and the patient is set to be transformed as pharmaceutical organisations become braver in utilising and integrating these technologies into clinical research. The future shift There are a number of ongoing industry projects involving sponsors, vendors and regulators, to try and understand how best to leverage wearables and sensors in clinical trials. Amid the excitement of using new technologies, a key theme that keeps emerging is the importance of ISSUE 01

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not losing the human connection during a clinical trial - if the impact of a disease or treatment is particularly difficult, the face-to-face interaction with physicians may be really meaningful and important for patients. Regulators are actively requesting sponsors to come up with useful and experimental approaches to using wearables, and encouraging open discussions on planned uses of these devices. As we continue along this 72

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upward trajectory, we’ll likely see more of an open landscape for big tech companies like Amazon, Google and Apple to get involved in this space. With the impact of COVID-19, tech corporations are likely to accelerate their move into healthcare in general, particularly as Amazon shifts from being a consumer marketplace to an essential logistics distributor. This is positive as it means an influx of investment and innovation into the sector, and important


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lessons can be learned from their more consumer-focused work on developing solutions that are easy and a pleasure to use. However, these companies are used to rapid timelines that are drastically different from the longer timelines in healthcare and drug development that often span the course of years rather than months. As the capabilities of wearables progress, we are set to see the continued involvement of consumer technology in

the healthcare space. Wearables hold the potential to both improve patient experiences and our understanding of that experience, but the sector must appropriately determine and navigate how best these vast data sources can inform clinical decisions. More so, the pharmaceutical sector and regulators must continue to actively collaborate and foster discussions on best practices as these innovations are only set to continue.

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