Singapore perspective about access and use of patient data & Artificial intelligence industry news
1.Patient data: Access, privacy & ownership
While patient data offers a trove of information that can be used for further research or population health studies from a government or policy perspective, a key concern still remains – do patients themselves know or approve of how of their health information is used?
At the HIMSS Australia Digital Health Summit on 21 November, a patient advocate from Australia and officials from the public health sector from Singapore and Australia sat down for an extended discussion on the complexities of the ownership, access and secondary use of patient data.
Who owns the data?
The reality is that providers, patients and HIT vendors all have some justifiable proprietorship over patient information/data to a certain extent but that reality can be quite complex. A/Prof Low Cheng Ooi, Chief Medical Informatics Officer (CMIO) of Ministry of Health (MOH), Singapore, explained that it is accurate that all the data belongs to the patient – things like vital signs, imaging and laboratory results all belong to the patient.
However, the part about who owns the patient information that can be controversial is the assessment and the professional opinion of the clinician. This is because the clinician makes a point of the assessment from the original patient data and he is held liable for it in a sense, professionally. Technology vendors have the least say about who owns the data as they are primarily intermediaries who host the data, but they have no ownership rights.
Rick Sondalini, Senior Policy Advisor, Australian Digital Health Agency, responded that beyond who owns the data, the more important question to ask would be the legal ownership of the data and the associated rights about access to the data. For the case of the My Health Record in Australia, there is legislation built into in the rules and IT system.
From a patient advocate’s perspective, Renza Scibilia, Manager of Type 1 Diabetes and Consumer Voice, Diabetes Australia, said that while the patients themselves own the data, it is far more complex than that. “In the diabetes world, there are so many platforms now that have bridged the gaps of what are doing. If I am using three or four different devices (to collect health data), I can’t in any way, aggregate anything but there are organizations and companies that are providing that information,” she said.
“My numbers are absolutely everywhere, but I will fight to the death to say that I still own them.”
Access and control of data – putting patients first
“The My Health Record was structured towards patient control, it is about patients being able to control and manage that access,” Sondalini said. A/Prof Low mentioned that in terms of clinical information sharing in the context of a centralized system that collects the health information in the future, the question that comes is, is it made known to the patient that his/her information is shared and for what propose?
He added that Singapore is working towards a vision of one patient, one record and the National Electronic Health Record is very similar to Australia’s My Health Record in that it is a summary record of a patient’s clinical encounters. That critical summary is whatever that is required for the next doctor or care professional to take care of the person/patient.
“When we digitize and start to share information, we’re doing it to facilitate the patient experience so that they not have to repeat the tests or explain their medical history. It also helps the clinicians to have more information but it can open up another can of worms, for instance if the clinician does not read enough or check the medical history,” A/Prof Low elaborated.
Scibilia suggested taking a step back to consider why some patients are not willing to share their health data/information. The main reason is because of the stigmatization of certain diseases and chronic conditions, as well as the fear of being judged. She emphasized that empowering people living with chronic conditions is really important, because they do not need to repeat the same conversation about their condition with every single doctor they need.
Secondary use of data and related concerns
John Daniels, Global Vice President, HIMSS Analytics cited the example of Ascension Health in the US entering into an agreement with Google to share the data from their EMR for specific purposes, which raised a lot of concerns. A question was raised about the secondary use of patients’ data and its implications.
“There’s actually a legislation being put in place (for the My Health Record) that is called secondary use and one of the principles is that there won’t be authorized use of information (for non-health or commercial purposes) from the My Health Record, even if it is de-identified,” Sondalini said.
A/Prof Low commented that when health data is collected centrally in Singapore, the purpose is primarily for continuity of care and direct patient care, which is similar to the principle of the My Health Record in Australia. In Singapore, work is still in progress around proposing a law for the secondary use of health data.
“Once the (health) information is collected, it’s a ‘honey pot’ of information as one of my colleagues described, everybody wants to have access to it. So you need to have very tight central control and a very clear definition of what is authorized and what is not authorized. On a system or government level, when you decide on something, you need to be able to defend it publicly that it is for the greater good,” concluded A/Prof Low.
2.Singapore’s national AI strategy to focus on chronic disease management and prevention
Deputy Prime Minister and Minister for Finance, Heng Swee Keat, today announced at the SFF X SWITCH (SingaporeFinTech Festival and Singapore Week of Innovation and TeCHnology) Conference, a national Artificial Intelligence (AI) strategy to transform Singapore’s economy and improve the lives of citizens.
The key approach of the strategy is to adopt a human-centric approach, and focus on delivering tangible benefits to citizens and businesses through AI. Five national AI projects have been identified for a start:
– Transport and Logistics: Intelligent Freight Planning
– Smart Cities and Estates: Seamless and Efficient Municipal Services
– Healthcare: Chronic Disease Prediction and Management
– Education: Personalized Education Through Adaptive Learning and Assessment
– Safety and Security: Border Clearance Operations
Drilling specifically into healthcare, the emphasis of the national AI strategy will be on chronic disease management and prevention. Below are some key timelines and targets:
By 2022, the Singapore Eye Lesion Analyzer, Selena+, a system which analyzes retinal photographs across the nation for diabetes screening will be deployed.
By 2025, a retina-based risk score for high glucose, high blood pressure and high cholesterol (3H) related cardiovascular diseases will be developed.
By 2030, there will be collaboration with industry players to develop AI models for 3H patients.
Other than the development of a personalized risk score for chronic diseases, other objectives under the national AI strategy for healthcare include clinical decision support for primary care doctors and empowering patients to better manage their own diseases.
Prior to the announcement of the national AI strategy, there have been AI-related developments at SingHealth, one of Singapore’s largest public healthcare groups and the National University Health System (NUHS). Since April this year, SingHealth has been working with Ping An Smart Healthcare (PASH), a subsidiary of the Ping An Group (Ping An) in China, to trial the use of its clinical decision support systems (CDSS) named AskBob, to provide doctors with personalized treatment recommendations for Type 2 diabetes patients at the point of care.
NUHS is also working with PASH to trial AskBob with clinicians for smart literature search and medical research trend analysis.
1. Huawei opens new AI lab in Singapore to train 1,000 AI developers
Chinese tech giant Huawei has opened a new artificial intelligence (AI) lab here promising to train up to 100 AI architects and 1,000 AI developers over the next three years.
At the launch of the lab at Changi Business Park on Friday (Nov 22), Huawei International chief executive Nicholas Ma said the firm hopes to address the AI tech talent crunch here as the move is beneficial to all parties.
“Whenever I attend a tech summit in Singapore, people are asking me about getting more talent here. There is a need for more tech talents across every industry, and we want to help fill that gap. Hopefully, by doing so, these talents will help us in the long run and make contributions to our business,” he said.
Other than the talent programme, Huawei signed a memorandum of understanding with Nanyang Polytechnic on the same day to explore various talent cultivation programmes in the fields of AI as well as 5G and cloud technology.
Earlier this week, in Guangzhou, Huawei also inked a collaboration with Singapore’s CapitaLand and Business China to implement an intern exchange programme that will offer Singapore university students the opportunity to take up internships in China.
Mr Ma said: “In the past, we’ve organised some training workshops and courses with local universities and polytechnics, but this year we wanted to do something different. We want to speed up the whole tech ecosystem.”
The new lab, which cost the Chinese tech giant more than US$10 million (S$13.6 million) to build, is said to be the first AI lab in Singapore to boast 5G capabilities. That means that users can use the space to test-bed a wide range of 5G applications and scenarios, on top of AI research and development projects.
The lab is open to government agencies, institutes of higher learning as well as small and medium-sized enterprises to use.
The lab opening comes a week after Deputy Prime Minister Heng Swee Keat unveiled Singapore’s national AI strategy, which is its plan to harness artificial intelligence technologies for social and economic benefits.
Mr Ma said: “We hope that this lab can help to nurture a flourishing local AI ecosystem here and boost Singapore’s AI capabilities towards its smart future.”
Huawei’s new lab adds to the list of high-profile openings of several other AI centres here, including the Nanyang Technological University-Alibaba Research Lab, Singapore Management University’s Centre for AI and Data Governance, and Salesforce’s AI centre in Suntec City.
2.Singapore approves medical AI software for automated analysis of vascular ultrasound
SEE-Mode Technologies, a medtech startup based in Singapore and Australia, on Dec 10 announced regulatory approval for its debut product, an AI-based software for automated analysis and reporting of vascular ultrasound scans, one of the most common scans used for patients with cardiovascular diseases.
See-Mode’s first product, AVA (Augmented Vascular Analysis), has been approved as a Class B medical device by Singapore’s Health Sciences Authority (HSA). With the HSA approval in hand, See-Mode is now pursuing regulatory approval for AVA in other regions, including TGA, CE and FDA.
See-Mode’s AVA uses deep learning, text recognition, and signal processing technologies and is intended to be used as an assistant to the clinician interpreting and reporting vascular ultrasound studies, which are commonly reported through a manual, time-consuming, and error-prone process.
To report a vascular ultrasound scan, a clinician, usually a sonographer or radiologist, has to manually review and analyse 50-150 individual images for each patient, consisting of various types of ultrasound images and doppler waveforms.
The end result is a hand-written, paper-based template filled with drawings, numbers, and measurements, which can take as long as 20 minutes per patient for severe cases.
“During our collaboration with different hospitals, we have observed cases where the mistakes in hand-written ultrasound worksheets could potentially result in the wrong treatment plan for a patient, for example, surgery on a wrong vessel.
See-Mode announced its seed funding round of US$1 million in early 2019, with participation from SGInnovate and Cocoon Capital in Singapore, and Blackbird Ventures in Australia.
“As people around the world grow older and live longer, there is an increasing need for new healthcare solutions. Globally, rising demands for greater healthcare infrastructure and resourcing are exceeding the ability of public and private systems to meet them.” said SGInnovate founding chief executive officer Steve Leonard.