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Newsletter #15: May 2019

Contents: 

Introducing the Hope Initiative 
SE Health, CFHI & AMS Host the Empowered Home Care Summit
Demystifying AI in Healthcare
SE Futures 1st Anniversary Video
SE Futures attends Rotman's 1st Bi-Annual Artificial Intelligence Conference

They Are Old and Bold. Meet the "Wellderly"  
Welcome to SE Futures Student Fellow Alicia! 
SE Futures Quarterly Open Book Club - June 5th @ 8:00am 
Ecosystem Events 
Connect with us 

Introducing the Hope Initiative

We are excited to introduce an exciting new project to our pipeline! SE Health has joined forces with AMS Healthcare to collaborate on a four- year project to implement an innovative model of home and community care.  The Hope Initiative will create a Living Lab where the H.O.P.E. Model® and emerging technologies will be tested with approximately 1,000 clients and their families, neighbourhoods, and a team of nurses across Ontario. Inspired by the Dutch Buurtzorg neighbourhood care model, the H.O.P.E. Model® is aligned with a global movement that is transforming community nursing from a transactional model, to a more empowered, efficient and person/family centered model.

The H.O.P.E. Model® leverages small self-empowered teams of nurses to take care of the full set of needs of clients in a neighbourhood; supporting patients across the continuum of care. The incorporation of care-provider continuity and relationship-based practices into H.O.P.E. moves us away from narrow definitions of health, to allow teams to have a comprehensive view of the contributors of health and wellbeing that matter to patients. H.O.P.E teams will be responsible for determining a patient's care plan and helping patients and caregivers connect to both informal and formal supports. Moreover, as part of the model, nurses will be empowered to work to their full scope of practice and seek creative solutions to support people to live at home.

A number of innovations and digital tools will be tested in the Living Labs across Ontario to create seamless communications and coordination across the circle of care for clients and their families, and allow home care professionals to be more productive and efficient.  In addition to the creation of living labs, part of the project will be to further evaluate and refine the H.O.P.E Model® and position it for spread and scale in Ontario and beyond. If you are interested in joining a community of interest focused on innovation in home and community care to learn more and stay up to date, click HERE to sign up.   

The Buurtzorg Team Visits SE Health

As the futures team launches the Hope Initiative, we were fortunate enough to host team of individuals from Buurtzorg to share their story of transforming home care in the Netherlands, as well as their subsequent expansion to Sweden, Britain and Ireland. Buurtzorg started in the Netherlands in 2007, when Jos de Blok (CEO & Founder) decided to do something about the challenges he was experiencing in the home care system as a nurse; fragmentation, low satisfaction from patients and providers, lower quality and higher costs. Many of the these issues are the same we are seeing here in Ontario. The organization has grown to over 10,000 nurses all operating in self-steering independent teams.  A central tenet of the organization is humanity over bureaucracy. They focus on giving authority and responsibility to the front-line nurses who are supported without tiers of management. (Read more about Buurtzorg here.)

We started the Buurtzorg visit off with ride alongs with our SE Health front-line providers; to allow the Buurtzorg team to experience firsthand what home care is like in Ontario. The following days were spent discussing a number of topics relevant to designing and operating in a neighborhood care model. The visit was timed for our guests to participate and share their stories with a larger group of Canadian health system leaders at our Empowered Home Care Summit on May 8th (Details below). We look forward to using the lessons learned to support the successful design, implementation and spread of the H.O.P.E Model. 

On May 8, 2019, SE Health, The Canadian Foundation for Healthcare Improvement (CFHI) and AMS Healthcare hosted 100 healthcare leaders from around the globe for our inaugural Empowered Home Care Summit. The purpose of the summit was to discuss innovative and empowering home care models and learn from each other at an international scale. 
 
The day started off exploring the critical challenges and implications homecare has on patient outcomes within the community. Learning from the lived-experiences of patients, caregivers and front line nurses and how they have been empowered or faced challenges being empowered really set the tone for the rest of the event.  
 
During the keynote speech, summit attendees learned from Jos Do Blok, Founder and CEO of Buurtzorg who shared his experience of creating and implementing the innovative home care model, Buurtzorg. Following the keynote, guests explored 6 empowered home care models being practiced around the world and exchanged knowledge with one another. Afterwards, CFHI shared levers for healthcare improvement and discussed their lessons learned from spreading and scaling the INSPIRED project in Alberta. Lastly, we discussed the critical policy levers that can be used to unlock empowered home care models at scale. 
 
Our team is excited to take what we have learned and apply it to all of our future work #EmpoweredHomecare19

Demystifying AI in Healthcare 

In February, Martijn van der Meulen joined the  SE Futures team as a student fellow. A recent MD graduate and software developer from Radboud University Medical Center and REshape Innovation Center in The Netherlands, he teaches eHealth and works on implementing AI in healthcare. He is also the founder of Plexuz - a startup that helps Dutch med students uncover their knowledge gaps. Below is a blog post sharing some of his insights and findings researching the implementation AI in Healthcare while here in Canada. 
Advances in the field of Artificial Intelligence (AI) are moving at an unprecedented pace. The accuracy and speed at which Machine Learning and Deep Learning algorithms can process language, images and big data are changing industries across the board. Comparable to our seemingly sudden dependency on smartphones – daily tasks such as navigation (Maps), ordering services (Uber, Foodora) and e-commerce (Amazon) rely heavily on these new forms of AI, and influence many aspects of our day-to-day life. Even though these applications are still in its infancy, their vision is comparable to putting someone on the Moon in the 1960’s: driverless cars, smart buildings and deep medicine all have the potential to disrupt our society in the fourth industrial revolution where everything is connected and continuously gathers data.

However, even though healthcare is such a data-focused industry, AI is still in a phase of such infancy that real post-pilot implementation is very sparse. Inherent to healthcare’s extremely complicated ecosystem, culture and regulation, healthcare lags behind other industries due to a number of reasons. To gain a better understanding of these challenges and review the current state-of-the-art, I joined Zayna Khayat and the SE Futures team at SE Health to interview AI pioneers pushing the algorithmic envelope in the world’s AI hotspot: Toronto. Toronto, arguably a global AI hot spot, offers a unique mix of research, private and public sectors working together in institutions such as Vector, the MaRS Discovery District and the Government of Canada & Ontario to facilitate research and adoption of AI.

Here are some of my preliminary insights; summarized in three categories:

 
1. Data
2. Ecosystem & Regulation
3. Culture & Ethics
 
1. Data
Inherent to training machine learning models - you need a lot of good quality data, especially for deep learning purposes. As EMRs are still the main modality of healthcare data, there is little structured healthcare data of high quality to come by. There are also many caveats around training for healthcare, such as unforeseen biases and under-representation. The field of maintaining data and ensuring quality is called Data Governance. Unfortunately, data governance is not a priority for many healthcare institutions.

2. Ecosystem & Regulation
As many startups enter the AI in healthcare playing field, the potential for training AI in a broad context of data sources decreases. This is inherent to the startups' business models: their data and algorithms are often the mainstay of their revenue models. There is no regulation that mandates open access, and the European privacy law such as GDPR seems to be a double-edged sword: it forces companies to allow their users to get any data the company has stored about them at their discretion. This might impede innovation, but could also stimulate the creation of APIs that users can opt-in to, to exchange their data and allow third parties or government institutions to train models on their data.

3. Culture & Ethics
Healthcare is by nature a risk-averse industry: we want to make sure we help patients using best practices, not experiment and innovate on them. A balance is needed between these opposing forces to allow for safe development and implementation of machine learning algorithms that improve patient care. Ethics also comes into play, where there are many questions that lack unambiguous answers. Can we start trusting inexplicable algorithms, or do we need subject-matter experts to be able to verify every result? If an algorithm can analyze CT scans with less radiation, but with the consequence that we can't determine if it's correct - should we do it? And who's accountable for mistakes?

Some of these challenges are inherent to healthcare, but require elegant solutions nonetheless. Strong leadership is key to mitigate these challenges - bravery, confidence and perseverance displayed by pioneering decision makers and stakeholder champions are the first leaps towards unlocking the true potential of AI in healthcare.

SE Futures wants to thank Martijn for being a part of the team over the last 3 months and for sharing his knowledge, expertise and passion for combining medicine & AI.

SE Futures 1st Anniversary Video

The SE Futures team recently celebrated our first anniversary and created this video to provide a fun update at a recent all-staff event at SE Health. We hope you enjoy this fun video highlighting some of the things we are working on! 

SE Futures attends Rotman's 1st Bi-Annual Artificial Intelligence Conference 

On May 24th Rotman held their 1st biannual “AI, Digital, and the Creative Destruction of Careers in Healthcare” conference. The day was full of talks not only about AI and it’s uses but how leaders can lead the transformation within their organizations. Speakers included Avi Goldfarb a Rotman chair of AI and healthcare and one of the authors of “Prediction Machines." He talked about the economics of supply and demand of AI. Tom Lawry, Director of Worldwide Health at Microsoft gave us the 5 rules for AI leadership. One of these rules is “AI requires leaders to think and act differently”. With the quote “I’m all for change … you go first” he called out leaders who want to use AI but may scared to make the first move. The Futures team is aiming to be one of the first to find and test AI in the home care setting. 

They Are Old and Bold. Meet the "Wellderly"  

SE Futures Leader, Zayna Khayat, published a blog in the Future of Good discussing the Future of Aging.

The Future of Good is a digital community who's content is focused on illuminating the innovations, perspectives and emerging trends shaping social impact in Canada. Below we have included an excerpt of Zayna's blog. Read the full article HERE at the Future of Good. 
The "Silver Economy" is coming. Are you prepared? 
The Canadian population is aging rapidly. In the next decade, the proportion of our population aged 65 and older will exceed twenty percent. The number of adults over 85 will quadruple, and the number of centenarians will triple.

It’s clear that we’re all living longer and if many continue to retire around the age of 65, there can be decades of post-retirement living. It’s a new “fourth stage” of life that we have not designed for with regards to our institutions, services, products, policies, or models of healthcare.

CHALLENGES TO AGING WELL IN THE 21ST CENTURY
In order for older adults to age well—which I believe means to age on their terms—a few fundamental, systemic challenges will need to be cracked:

SUSTAINABILITY OF OUR HEALTH SYSTEMS
Patients aged 65 and older account for nearly half of Canada’s healthcare resources. We simply will not be able to match supply of healthcare resources to demand.

DEMENTIA
There will be increased numbers of people suffering from some form of dementia, a condition which has devastating consequences for the individual and their families.

CAREGIVING
Some 70 percent of older adults will need assistance to care for themselves at some point. This creates a huge burden on family caregivers. Further, we are not in any position to train and hire the needed formal health and social care workforce to support the complex physical and social needs of the elderly.

HOUSING AND LONG-TERM CARE MODELS
Almost all—93 percent—of aging adults live at home and prefer to live in place. Yet, we have a dominantly institutional model of relocating our seniors to hospitals and nursing homes when they inevitably become too frail. We simply will not be able to build enough buildings or beds to absorb the demand—and few seniors want to be in these facilities anyway. Further, at the end of life, some 75 percent of Canadians prefer to die at home, but only 15 percent actually do. The majority die in hospitals, spending their final days on busy hospital wards, occupying a hospital bed that could be used by someone with an acute illness, which is what hospitals were actually built for.

Continue reading about other challenges and opportunity to help people age on their own terms here: https://futureofgood.co/the-silver-economy-is-coming-are-you-prepared/

Welcome to SE Futures Student Fellow Alicia! 

Alicia is joining us from the University of Alberta where she is entering her second year of medical school. Alicia completed her MSc in Nutritional Sciences at the University of Toronto which has shaped her interest in public health and desire to create a health system that better addresses patients’ social determinants of health. Alicia is excited to join the SE Futures team on the Hope Initiative, where she will be developing a methodology for leveraging community social assets, as well as, facilitating the development of a technological infrastructure that streamlines their integration into clinical practice.

SE Futures Quarterly Open Book Club - June 5th @ 8:00am 

When it comes to complex challenges, it’s not the problem you’re solving – it’s how you’re solving the problem. At our next Open Book, June 5th, David Benjamin and David Komlos from Syntegrity will join SE Health to discuss their book,Cracking ComplexityThe Breakthrough Formula for Solving Just About Anything Fast”. They will share their cutting-edge, highly engaging step-by-step formula for cracking incredibly knotty and important challenges in mere days, while mobilizing those who must execute.
 
We hope to see you there in person (SPACES @ 180 John Street, 7th floor), or virtually through periscope!

Register here: https://sefuturesopenbook.eventbrite.ca
Live Stream Link: https://www.pscp.tv/SEFutures/follow

Book for purchase is available at: https://amzn.to/2XECSt7

Ecosystem Events

Join us at the next HealthTO June 2019 event taking place June 5th from 6:00 - 9:00pm.  Our own Joe Au-yeung will be talking about the SE Futures Ring of Support project along other innovators from Memotext, Medchart, Evenset Inc. & Medexa. Find out more information and register to attend HERE
On June 6th from 12:00 - 1:00pm is the Design Thinking Speaker Series at Rotman “Sketching the Organization: Using Design to Develop a Whole View." The event features Patrick Whitney, Professor in Residence in the Harvard School of Public Health. Learn more and register HERE. 
Join us for an upcoming SE Futures Breakfast!
The SE Futures Breakfast Club is an opportunity to meet with the SE Futures team and like-minded individuals to share ideas about how to build the future of aging with dignity, health and vitality. These are informal sessions and all are welcome to attend. They are held biweekly at our downtown space (180 John Street, Toronto - 7th floor) on the 1st Friday of the month or our head office (90 Allstate Parkway, Markham - 8th floor) on the 3rd Friday of the month from 8:00-9:00 am.

We do ask if it is your first time attending, please use the link below to sign up! If you are interested, you can also sign up to do a 5-minute pitch on a topic, project or idea at one of the breakfasts. 

We look forward to hosting you, eating some great bagels and discussing all things ageing, health, and innovation!

Click HERE to sign up
Contact Us!
Mailing Address: 90 Allstate Parkway, Suite 300
Markham, Ontario Canada L3R 6H3
Email: sefutures@sehc.com 
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