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Healthy Conversations brings together leaders and innovators in health care to talk about the biggest issues facing patients and providers today. Every month, we explore new topics to help uncover the clinical insights and emerging technologies transforming health care in real time.
DR. TONY YOUNG:
Doctors, we operate in our silos too often, don't we? And there's lots of other people in our society, and if you work together, I think amazing things can happen.
DR. DANIEL KRAFT:
Welcome to Healthy Conversations, an original podcast from CVS Health. I'm your host, DR. DANIEL KRAFT. Today we're presenting the second in a two-part conversation with DR. TONY YOUNG, national clinical director for innovation for the National Health Service England and founder of the NHS Clinical Entrepreneurs Program. The United States is often a culture of healthcare, the way it's done in the operating room or the clinic, and sometimes that culture can really hinder even the best innovation. It doesn't integrate into the workflow and align with the care or the mindset. Are there any lessons in the shifting of culture and the ability to take a new innovation and really bring it to impact?
DR. TONY YOUNG:
So yes, I recall I had to go in front of a parliamentary committee in the House of Lords and give evidence on what we were doing around innovation. And I was trying to persuade the Noble Lordships. It's about winning hearts and minds. I was struggling to win hearts and minds of the panel that were questioning me. And I said, there was an author about 150 years ago who was given the option of doing something very technical, which was writing a pamphlet about childhood poverty and the real problems this country was facing in the Victorian period. And instead of doing that, he decided he needed to win hearts of mind. So he wrote a story and a novel, and of course the author was Charles Dickens, and the story was A Christmas Carol. And so if you can tell a really great story like telling surgeons in an operating room, don't do it that way, do it this way.
My experience of that is they're just going to push back and they're not going to welcome your intervention in their space. Whereas if you can maybe see it from their perspective, what they're trying to achieve and win them over. I recall having dinner with the senior microbiologist for the Welsh government just as I was starting at NHS England. And he said to me, Tony, do you expect to last in that job? Do you know how difficult that is? You want to go and read this book and it's called a General Theory of Love. And I said, why do I need to know about the psychiatry of love? And the key kind of message from the book was be authentic. So really be who you are. That book taught me that actually you win people's hearts and minds and then when you've done that, then they tend to want to come with you on the journey.
DR. DANIEL KRAFT:
I love that sort of synthesis because it's really not always about the technology, it's about blending it with the human spirit and the art of the possible and the incentives and the workflow and collaborating to win a really clinical end goal. It makes a big difference. Many of our listeners are not in the NHS, many of them are clinicians of all types and see challenges and pain points every day. And maybe don't have the support of a NHS clinical entrepreneurship program or a Stanford by design. Any kind of simple takeaways for maybe busy clinician who might see a challenge, maybe even has an idea, maybe even a patent.
DR. TONY YOUNG:
I think you've got to surround yourself by like-minded people. Is ideas the 10 or penny? Now, if you need someone in machine learning, it's going to be going to the machine learning events and conferences or to a university that's got a really great center. Be true to yourself. And if you really have a dream and you really want to make a difference, don't give it up. But on the other hand, I would say don't fall in love with your solution. Too many people go, oh, I've got just the perfect answer for this. But it's not actually. Fall in love with the problem and really work that through and then bring people on board that share that problem and really want it solved. And there's lots of online great resources, but there's no real solution I think for networking with other people. If you're a seed and you're not in a fertile environment, you're not going to grow. And sometimes you have to move from that environment to somewhere that's going to encourage you to grow.
DR. DANIEL KRAFT:
Yeah, move out of your pot. Some things are physical, right? So you also have co-founded the Anglia Ruskin MedTech campus. That's set to be one of the world's largest health innovation physical spaces. Maybe tell me about that space.
DR. TONY YOUNG:
We kind of founded a vision, I think about 13, 14 years ago now when I started at Anglia Ruskin University of how could we create all the translational infrastructure that you needed if you were a clinician or a scientist and you wanted to take your idea and actually build it. Where was the place that brought together all that, not just physical infrastructure, but all the services you would need, all the technical capabilities and know how. And it didn't really exist in Essex. We didn't have any science parks at all, but we had a great healthcare need. We had lots of great clinicians. So we set this vision of securing just 120 acres of land, three 40 acre sites across our county. And I visited the Dell Medical School in Texas recently, and they've got a big new, huge new incubator building going up there. And that's the kind of thing we started doing here about 10, 12 years ago now.
So I had no money, and I set this task of going to raise half a billion pounds. Everyone laughed. They said, you'll never going to do it. And they would just say, well, when is anyone, who's the surgeon from Essex ever changed the world? Well, 150 years ago, there was a surgeon from Essex who went to the same medical school as me. His name was Joseph Lister. And of course, Lister's discovery of antisepsis, I would argue, changed everyone's healthcare everywhere. So why couldn't I have a dream and said, it doesn't matter who I am or where I'm from, why can't we do this? And now we have the enterprise zone in Harlow, so about a 50 acre site, Public Health England relocated there. We have about five million pound innovation center, and we're working with Southend Unitary Authority to help develop their science part capability here where I'm based at the moment.
And the economic growth and development that comes from that means other people in your society benefit. And let's put it this way, I've helped facilitate 5% of the UK life science industry in the last six years off a program that gets almost no funding. So I learned an enormous amount about how do you make a case relevant to local government and regional and national government leaders? How do you bring on investors and developers and industry and other stakeholders around to make that happen? So yeah, you do need the physical space, but it works. Doctors, we operate in our silos too often, don't we? And there's lots of other people in our society, and if you work together, I think amazing things can happen.
DR. DANIEL KRAFT:
Your work reminds me of that famous Margaret Mead quote, "Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it's the only thing that ever has." And once you start changing the world, others catch on and expands. And,
DR. TONY YOUNG:
I love that.
DR. DANIEL KRAFT:
We all have so many global healthcare challenges to solve for it. It can really help raise the boats and the art of the possible from others, which raises the kind of question, I think it's catalyzed by the pandemic as well, health inequities, the disparities that were highlighted by the fact that not everyone had equal access to care. Maybe touch on how your clinical entrepreneurship community's been addressing health inequities and access.
DR. TONY YOUNG:
Rightly, as you said, Daniel, the pandemic lay bare inequalities in the system. You only have to look at oxygen saturation probes. If you have non pigmented skin, we can tell you what your oxygen saturation's going to be, but if it's pigmented, then I'm sorry. But the technology that's been developed may not be accurate in you. How did we allow that to happen? Then we're at the moment just getting to the final stages of our health inequalities tool that allows anyone who's got an innovation in healthcare and life sciences to understand, am I bringing in unconscious bias? Is this going to make health equity worse? And a great example of something that it shouldn't exist and this wonderful innovation that's called Written Medicine. And I love this innovation so much. So it was a pharmacist called Ghalib Khan and drug labels in the United Kingdom can only be printed in English, and they're stuck on your medication box.
So if you spoke Urdu or Mandarin or Punjabi, that doesn't matter. And medication errors were occurring as a result. And so what Ghalib's done now, he's been on our entrepreneur program. If you don't read English and that's not your first language, we can now print the drug label so you can understand how to take your medication in a language you do actually understand. How did we allow a system where you could pay your taxes in this country, you could work all your life, but if you don't read English, oh, sorry, we can't help you with your medication. Crazy. Another one, Rachael Grimaldi from CardMedic. So in the pandemic, of course, patients could be ventilated, they'd have an [inaudible 00:09:10] tube in, but they couldn't speak because of course they were being ventilated. And so Rachael realized that patients wanted to communicate. So she would have a number of pre-written phrases saying, how are you?
And the patient could pick from a selection of options of how they were feeling. And she realized that actually we could do this in any language. And then CardMedic was born, which translates common medical phrases. We now have a system of integrated care systems. There're called 42 of them across the nation bringing primary and secondary care together in the United Kingdom. So now we've commissioned CardMedic across our whole integrated care system. I can go on to CardMedic and we can have a conversation about your medical condition or what's going on in any language before we can get hold of an interpreter. Another health inequality addressed through technology. And that one has come out of the pandemic. How amazing is that?
DR. DANIEL KRAFT:
Yeah. There are definitely some silver linings for the pandemic, and I can imagine the new sort of generative AI gpt three and soon GPT four. You can ask it to write a note for your patient who only speaks Swahili with an eighth grade education about how to take their medications and manage their hypertension.
DR. TONY YOUNG:
So I work a lot with many of the tech companies, and I know there's a lot of excitement in this space, but we have to proceed with really great care in medical translation. And to give you an example, in Somali, there is no word for dementia. The only Somali word is madness. So no one wants to recognize that dementia is an illness or acknowledge it because the word is the same. And that carries a lot of stigma in that society. And so I think we need to proceed with great care. I mean, over the years, how many things have you seen that people have said this is going to be transformative in the next two or three years? Everything will change.
DR. DANIEL KRAFT:
I would argue there's that famous quote, "Your doctor or nurse or pharmacist won't be replaced by the AI, but those doctors, nurses, healthcare systems using AI will replace those who don't." So lots of possibilities, but also definitely we need to be careful and not move fast and break things.
DR. TONY YOUNG:
At the moment, I haven't seen anything that's convinced me that that's going to be the latest, greatest thing instead of the doctor. But have I seen lots of companies raise hundreds of millions and some of them even sell for billions of dollars, incorporating artificial intelligence and machine learning to help with the operational efficiencies in the delivery of healthcare? Absolutely.
DR. DANIEL KRAFT:
Which then gives us hopefully more time back to be doing the human touch part of healthcare, not typing our EMR notes. And,
DR. TONY YOUNG:
Wouldn't that be wonderful? Wouldn't that be wonderful?
DR. DANIEL KRAFT:
Exactly. How are you seeing the ability to evaluate new technologies and then get them proven and into use and impact?
DR. TONY YOUNG:
We've come up with something new. It's actually one of those mutation that works. So we've developed a program called Insights, short for Innovation sites. So 10 NHS organizations across the country from North [inaudible 00:12:22] and Newcastle down into Leeds and Bradford and Birmingham and the east of England and London and the southwest of our country. Much like in the startup world, we created a data room. But in this data room, we put the data sharing agreement, your research and ethics processes, your outline business case approval, your dynamic procurement framework that we use, your health economic evaluation, one set of paperwork approved by all 10 organizations. Just imagine one set of paperwork and for a population of what, 68 million, you could have the largest testing, trialing, adopting, and scaling healthcare system anywhere on the planet. And we did it in genomics in our country about 10 years ago.
We have 26 genomic medicine centers across the United Kingdom, and each one had a different ethics approval process for taking that genetic sample from a patient. But because each one was different, no one would use anyone else's samples or their data. And they formed something called the Musketeers Memorandum, which was one for all and all for one. Now we have the biggest combined genetic research pool as far as I'm aware, anywhere in the world because we agreed the standardized paperwork. And my challenge for me is I want to be better and faster than colleagues in the United States. I hear it all the time, the NHS, you don't take the latest things up. We have to go to America or Europe or Australia. And I want to change that paradigm because I want our patients in this nation to get the firsthand benefit of those innovations.
DR. DANIEL KRAFT:
Well, of course, that can be a global collaboration.
DR. TONY YOUNG:
And that's what I love so much about the relationship I've developed with you and forming a global community around these healthcare challenges that we face has never been more important than now. So I welcome that collaboration. If you're committed and driven and true to yourself and your values and go for your dreams, then I think you won't go far wrong.
DR. DANIEL KRAFT:
Let's all live our dream. Thank you so much, DR. TONY YOUNG. You're a real gem and a national treasure, not just the National Clinical Director for Innovation at NHS England, but a real catalyst, inspiration and change maker. So thanks for joining us on Healthy Conversations.
This transcript was exported on Mar 03, 2023 - view latest version here.
HC_Dr_Tony_Young_Part_2_HI_REZ (Completed 03/03/23)
Transcript by Rev.com
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