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I’ve always been fascinated by how technology can improve healthcare, and over the years at my keynote talks audiences have asked me for my view of what’s next.

Finally, I managed to grab two leading figures on this subject: Dr Simon Wallace, Chief Clinical Information Officer at Nuance Communications, and Umang Patel, Chief Clinical Information Officer at Microsoft.

Simon is a GP and public health doctor providing consultancy services to healthcare organisations. He has 20 years of commercial experience modernising & improving the delivery of healthcare. 

Previously he was at Hutchison 3G, AXA, PPPhealthcare, Bupa, FIFA, GSK, Optima-life and Worldcare UK.

Umang has worked across commercial and public sectors in healthcare both from payor and provider perspectives and was an early employee at Babylon Health, commercial leader at Aviva, and a NHS Leadership Academy Fellow and practising clinician at Frimley Health.

On the back of the news that Microsoft has agreed to acquire Nuance Communications for $19.7 billion and the transaction is now approved and complete, I spoke to Simon and Umang about how significant this alliance is for the future of digital health.

They are both passionate clinicians and have a deep understanding of how healthcare will be improved with the use of the latest technologies.

I managed to ask many of my “What’s the future of healthcare” questions I’ve wanted to ask for a while, and also confirmed some of my futurist predictions.

In this wide-ranging chat, we covered:

  • The Nuance & Microsoft Alliance
  • How the acquisition came about
  • Nuance and conversational AI
  • Future health plans from Microsoft
  • Can technology restore the NHS to full health?
  • Open data vs patient privacy
  • The power of AI in transforming healthcare
  • What can we expect to see in terms of innovation?
  • What we’ve learned from the pandemic about driving innovation
  • The success of the NHS app
  • Fitness tracker data for my Doctor
  • Importing fitness data into health systems
  • The untapped power of speech & AI in healthcare
  • What does the Healthcare Professional of the future look like?
  • What does the Hospital of the future look like?
  • The promise of a “digital pill”
  • The clinician’s sixth sense
  • Using voice to establish patient wellbeing
  • Simon’s proudest project
  • Umang’s proudest project
  • Quickfire round
  • Three Actionable things to better understand the benefits of digital health solutions

Resources mentioned on the show
United Nation The Case for Integrating Ireland
Better Off Dead: (Jack Reacher 26)
Karen Jacobsen – “Aussie Karen” Siri voice

More on our guests
Simon on Linkedin
Umang on Linkedin

Nuance website
Microsoft Cloud for Healthcare Website

Episode Chapters

1:42 More on the Nuance & Microsoft Alliance

2:54 How the acquisition came about

3:40 Nuance and conversational AI

5:26 Future health plans from Microsoft

7:29 Can technology restore the NHS to full health?

8:43 Open data vs patient privacy

11:08 The power of AI in transforming healthcare

16:19 What can we expect to see in terms of innovation?

18:28 What we’ve learned from the pandemic about driving innovation

20:50 The success of the NHS app

22:34 Fitness tracker data for my Doctor

24:14 Importing fitness data into health systems

25:42 The untapped power of speech & AI in healthcare

30:02 What does the Healthcare Professional of the future look like?

32:00 What does the Hospital of the future look like?

34:19 The promise of a “digital pill”

36:14 The clinician’s sixth sense

36:30 Using voice to establish patient wellbeing

38:51 Simon’s proudest project

39:48 Umang’s proudest project

41:01 Quickfire round

42:35 Three Actionable things to better understand the benefits of digital health solutions

Episode Transcript

0:01
Welcome to The Actionable Futurist® Podcast, a show all about the near term future with practical and actionable advice from a range of global experts to help you stay ahead of the curve. Every episode answers the question what’s the future? with voices and opinions that need to be heard. Your host is international Keynote Speaker and The Actionable Futurist®, Andrew Grill.

0:30
Today’s guests are Dr. Simon Wallace, Chief Clinical Information Officer at Nuance Communications and Umang Patel, Chief Clinical Information Officer at Microsoft. Simon is a GP and public health doctor providing consultancy services to healthcare organisations. He has 20 years of commercial experience modernising and improving the delivery of health care. Previously he was at Hutchison 3g, AXA PPPhealthcare, Bupa, FIFA GSK, Optima-life and WellCare UK. Umang has worked across commercial and public sectors in health care, both from payor and provider perspectives, and was an early employee at Babylon health and an NHS Leadership Academy fellow and practising clinician at frimley health. Welcome both of you to the podcast.

1:12
Thank you. Andrew, great to be here.

1:13
Thank you very much, Andrew, delighted to be here.

1:15
Now I’ve known both companies for a long time. In fact, the Australian voice of Siri, Karen Jacobson, will be on the show soon. And she worked with Nuance many years ago, providing the voice samples for what ultimately became Siri. Now some very exciting news, Microsoft’s agreed to acquire Nuance Communications for $19.7 billion, and the transaction is now approved and complete. So could you explain to our audience how important this alliance is, and what it will mean for the healthcare industry going forward?

1:42
Firstly, I think it’s really exciting. And one of the, one of the reasons I joined Microsoft was because I read about that potential acquisition of nuance AI bringing the companies together, that got me really excited. One of the big challenges we have with bringing technology into healthcare is a general cynicism that comes across from the frontline about what is this really going to help me? Is this going to save me time, so I can help my patients more? Or is there going to be another set of passwords after November, and another annoyance to my day, and when you look at what new ones have got, they absolutely were entirely designed to save you time. Rather than you tapping away at keys, we can use the conversational AI, you can use our speech recognition to make sure that you save, you know, minutes per patient that rolls up into hours per day. And when I look at what Microsoft has got, you can see this sort of underpinning enterprise scale technology that allows us to deliver that not only to people on the frontline in each department, but across integrated care systems and beyond. So bringing the two companies together, I think was a real step in the right direction for saying technology and healthcare is here to stay, it’s going to be increasingly usable, and we’re going to get better outcomes as a result.

2:51
So fascinating story. How did the acquisition actually come about? We

2:54
We weren’t necessary around when they first started. But from what I understand, it was just one of these partnerships that just blossomed, say, when I talk to people that have been in Microsoft longer than me, they say, well, we just love talking about nuance to our healthcare clients, because of the reasons I’ve just articulated. So as we sort of started talking more and more, it became increasingly apparent that we should form up and have a deeper relationship. So as a seller’s from a motor perspective, we’re talking to our clients. So they actually, you know, this is how we can help you and look at the great things that are coming downstream with companies and partners like nuance, it became clearer and clearer that deeper integrations were needed. And to one that one thing led to another I guess, and now we’re part of the same company.

3:35
So Samir, maybe you could outline how instrumental nuance has been in the emergence of conversational AI, it

3:40
Probably might be an idea just to explain what we mean by conversational AI. It’s, it’s the question no longer hunched over the keyboard typing, but instead, the desktop computer has gone out of the room. And there’s a purpose built healthcare device on the wall with a multi microphone, array, and senses. And voice biometrics play a role in being able to do two things, one, identify the clinician, so that he or she is not having to log on log in by voice is my password. This is used in banking and the HMRC today, but then those voice biometrics, then diarize, the whole conversation between the patient and the clinician. And then smart natural language processing in the background, is picking out the key clinical terms that have been talked about, and then putting those into a structured codified note. So at the end of the consultation, a note is produced using technology that allows the patient and the patient to have that direct interaction And without a clinician having to type it out over the keyboard.

5:03
It’s fascinating. I understand how much time it’s going to save. And I’ve always thought that voice is the next frontier. And of course, this is voice with permission. So you’re actively saying, I want to tell this machine something and I want them to make some sense of it. After LinkedIn, this is Microsoft’s largest deal ever at 19 Point 7 billion sequels. Microsoft is serious about health care. So what can we expect to see from Microsoft going forward in this area,

5:26
Hopefully lots more, you’re bang on, right? It was a huge acquisition, and really important to have that, that mark in the sand of intent. So one of the things that we’re doing at Microsoft, and really trying to help our partners go through is this, this move to be able to compute at levels that we’ve never been able to do before. So as we often talk about moving stuff to the cloud, I think sometimes that gets lost in there, okay, I get it, but like why, so I can store stuff somewhere different, okay, I get that that might be a bit more helpful. But the actual storage is somewhat irrelevant to the computing power that allows to happen. And so when I think about what that might end up, meaning for clinical practice, you know, way back when, in 1948, when the NHS was formed, we were all using information that was coming out of studies where we’re using a few 1000 people and measuring what we could, worse today, there’s been a billion fold increase in the amount of information that’s collected to understand what we need to do for healthcare. So medical research is just exponentially grown in the amount of data that’s used in it. One of the things we’re trying to get with Microsoft is how can we then start taking all of this extra data, your genomic profiling, precision medicine, the big data stuff that we’ve talked about for a while now? How can we start making that usable? And if we can start making it usable, and putting it onto the desks of doctors and nurses around the country, in fact, around the world that we think we can really shift healthcare on to the next frontier. And when you start a shirt, trying to show people what that can really look like, and how that can be touched and felt. That’s where nuance comes in as a real way of saying, look, it’s already here, this isn’t something that’s going to happen in the future. It’s something that we could do now,

7:04
For our global audience, we should probably explain the NHS as the National Health Service. It’s the jewel in the crown here. It’s a very unique health service. And of course, both of you have been involved in it for many, many years, it gets a fair share of criticism. I think it’s probably as an Australian living in the UK, we all envied it. And we all love it. And the other side of the pandemic, we all appreciate how much everyone strive to do so much. We’ve seen tech is transforming NHS and you just explain in some ways that that’s going to happen. But can tech restore it to full health?

7:31
There are two answers to that question. If one is absolutely eat, because but you’ve already got a biassed audience on here. And secondly, I don’t know what other choices we have, right? So healthcare is not like making biscuits, we can’t just stop, we’ve got to carry on. And, you know, throughout every industry and throughout history, we’ve seen technological advances be the answer to solving problems that seemed intractable. You know, there was a time when people couldn’t believe that there was anything other than a horse and cart, then came along the motorcar for all of the problems that we may have with it today. It’s all chief problems back then. So I’m really hopeful and actually entirely believe that we’re standing at that same juncture. So as you start moving things onto different computing models, greater computing power and better connectivity, I think we’re going to shift away from some of the challenges that we see in healthcare today as being insurmountable to being able to be more positive about the future. And think you know, what, we can solve this backlog crisis, it’s okay, if everybody’s living longer, because we’ve got solutions that will help us going forward to be more efficient and lead to better outcomes.

8:31
We talked about data. And when we talk about medical data, it’s a very sensitive topic and the importance of data privacy is very relevant when it comes to medical data. So how can we best balance the good that open data can do to save lives with the need to protect patient privacy? You’re exactly right.

8:45
So one of the biggest problems we’ve got with healthcare and data is being able to enable that trust. So healthcare has always been based on the trust that patients have with their clinicians. When we start translating that into new technological formats and different ways of delivering that care, we need to feed that story. I think this is an area that Microsoft’s really strong in, you know, we’ve worked with the NHS for 40 odd years now, being able to build on that already trusted relationship is key. And then also being able to show people that what we’re doing is safe and secure. And the best way of doing that is showing people through various case studies implementing it across hospitals, and winning the frontline over. So I we spent a long time thinking about how do we tell patients about data and what that might mean. And actually, I think for patients, the problem when they come to healthcare is that they’re scared already. And having another thought process to go through is too difficult. Whereas now as we’re seeing more and more clinicians get involved and start being able to talk to their patients about it. We’re seeing that that trust is being more easily earned. And of course, having anti it’s really important for us to make sure that we

9:48
keep it data privacy is really important. And I guess it needs to be balanced with the public understanding the importance of clinicians having data at left additives information at their fingertips. When they’re seeing patients, healthcare has just become so much more complex over the last 1520 years, and clinicians are needing to have that support of information about the patient. Also sort of guidelines, pathways, all those good sorts of things. And I think if the public understand that there’s a, you know, the information is really, really important that if it is sort of safe and secure, then that sort of psyche, if you like, that mindset, will become much more understandable. From the public’s point of view.

10:36
Yeah, I think it’s about trust. And once we know, we can trust the healthcare providers and that feedback loop, we know that by giving away a little bit of data, it provides me with better health care or faster healthcare, I think we’re going to warm to that and actually overtly want to give data we’ll talk a bit later on about data in the consumer sector, but I would happily give data to my clinician, my GP, if I knew that was gonna give me a better diagnosis. But assuming you were one of the early employees at Babylon, and perhaps for our global audience, you might explain where Babylon fits in the health tech space. But what did you learn about the power of AI and data when you were there when it comes to transforming healthcare?

11:09
So I joined Babylon way back when when there was at a company of about 10 people. And for context, it was a company and maybe if I tell this story, I met the founder, Ali Parsa, for a coffee, and he said, Look, rather than talking about technology, and healthcare, what about if we just take the best that we can do today, and really try and drive it through and see how far we can get with it. And that was generally the force that we had the fact that we could click a few buttons to book an appointment with a doctor, we created a telemedicine service that was empowered by some AI as well, to try and deliver some of the best tech into into patients hands. And we grew that company, from the 10 people from when I started around three and a half 1000 people and an IPO late last year. So in the global context, we became the largest primary care provider in the UK. Pretty quickly. We raised I think we IPA did about $4.2 billion. So we became quite big in a tech unicorn. And to answer your question, well, there were two things I really took from that experience, that that I think are important to share. The first is, as we start thinking about how we deal with patients, and we start talking about data and other things. We forget that actually, they’re consumers sometimes and we treat them too much like patients, and we we don’t treat them like citizens. And we sort of coined this phrase about consumer grade health care. What is it that people really want the need? And when we took a step back and tried to design, the seven star service, as it were for health care, we were like, what are the pain points? And back in the early days of Babylon, we were like, Okay, well, one of the hardest things was seeing a doctor was getting an appointment with a doctor because you had to find a receptionist. So we changed that to just three clicks, you know, can I click a button here, choose a time, book an appointment, and then see a doctor. And by delighting our users with that experience, we don’t know trust, then move on to being able to do the next part, which is NC their doctor, when they realised that they could see their doctor, they were then going, Oh, well, I’m not scared about having now that I’m not scared, because I can’t see my doctor, I’m gonna have to wait a long time for it. I started to trust them and the more techie elements of it. So I use some of the AI that we put in to answer questions through the chat bot, or into my information into it into a health assessment, digital twin type process to say, we learned that what you had to do was take the problem that was facing the patient or the person straightaway solve that problem in order to earn the trust. And then the second thing that we learned was that when you do start doing that, you suddenly scale a lot quicker than you might have anticipated. So like I mentioned, we became the largest GP practice in the country pretty quickly. And I remember when we launched, we reached the front page of the times with the headline, you know, the doctor will see you now or whatever it was a bit on your phone. And can you imagine today, that being like, even, it’s not even newsworthy, right, it’s taken for granted. In fact, today, we saw in the press in the UK, that we’re expecting the NHS app to have that functionality put into it relatively soon. What we learned was that because you’ve scaled so quickly, because you’ve actually solved a problem that matters to people, you’ve run out of some things pretty sharpish, one of those was the ability to have doctors to serve those patients. So it didn’t matter what we did, right, we didn’t have a magic Dr. Tree That meant we could grow more clinical, you know, bigger clinical workforce fast enough. And that’s where we started to try and use AI to lift some of that burden away to make sure we got the right patient to the right place at the right time. And we did that with varying degrees of success. Some of it worked really well, some of it, do you know what we did it and we thought it was going to be amazing. And it turned out that it just didn’t solve anybody’s problems. But through that process, we learn that it’s really important to iterate. And it’s really important to have scale at the heart of your thinking. Because whenever you set up a service again, it took us by surprise at how big we became really quickly and when The advantages of working at an organisation like Microsoft, for example is that you know, scale sort of baked into anything that you might do. So I’m really excited about how we 10 healthcare from what might have been more of a sort of isolated industry before into something that’s really enterprise ready. So how can we take healthcare and start applying some of these enterprise type factors into it in order to help make sure we see as many patients as possible, reap the benefits.

15:25
Two things I love about what you just said. One is that you want to see people as customers. And I think when we think about customers, we think about customer care and a great experience. And I think that will be a fundamental shift when everyone in the whole ecosystem is thinking about well, we have to think about our net promoter score, we care when we go into a John Lewis or we interface with an Amazon or Netflix. So we have a great experience. And we want to have that great experience when we’re being treated when we’re not feeling well. And the other thing that I think we’ll see a lot of as digital twins, those on the podcast will have heard me talk a lot about IoT and the fact that you can actually have a digital twin for an aeroplane or building but I think the human digital twin, and this comes back to data privacy, if I could actually have my own digital twin, and it would actually be living, breathing, looking at how I’m performing. When I’m feed real time data back to it or clinician data. I think that’s probably something that is a quantum leap in using technology to save lives. We might talk about that a bit later on. But But Simon, what can we expect to see when it comes to innovation, now the two companies are joined forces,

16:20
Innovation is key, I think a couple of things that will come to come to the fore, is we’ll move faster into into the cloud. One of the key things about speech recognition, is being able to for clinicians to be able to use this as a cloud based service. It gives them more flexibility. It gives it makes them more nimble to be able to use it. And we certainly saw that during COVID when clinicians were able to use speech from from home. So I think the the ability of both of our organisations coming together the whole direction of cloud based speech recognition that is only going to accelerate further. I think the other area is around tele teleconsultations. That obviously, again, came to the fore during COVID. And we’re going through this pivot at the moment aren’t we have of sort of getting a balance between the appropriate face to face consultation versus what can be done more remotely? And what’s interesting, we talked about customers and consumers, what do they really want? Well, we did a survey last year. And we found that just under half out about 47% of UK patients would choose to rely solely on a face to face appointment. And that was down by about a fifth from 64% pre pre pandemic. But innovation is around making sure that we get that balance, right, that we get that sort of doctor patient relationship balance so that too much technology doesn’t dampen. If you like, the often the sensitivities of that quite unique interaction between two individuals, we’ve come

18:15
out the other side of the pandemic, let’s hope so I’m interested for maybe both of you what we’ve learned from pandemic in terms of how to drive innovation and process development that the NHS and broader healthcare providers may not have been exposed to had we not had the experience of the last two years,

18:29
building on the digital twin thing, something really exciting happened during the pandemic, but aside from all of the devastation that it caused, and that was just our absolute necessity. And whatever that quote is, you know about necessity being the mother of invention, which allowed us to look outside of sort of the way that we were doing things and, and just by way of story, trying to build in the digital twin component as well. I remember our CTO at Babylon, for example, saying he joined us from McCarran being like, well, if I if I have a race car, I run it around almost every track in the world 100 times to see how it might perform in a in its digital twin format before I even pick up you know, or let the team pick up a single spanner to start putting it together. And when you think about for healthcare, we do the exact opposite. We wait for the body to go wrong. And then we look at what that is. And we go okay, well now that it’s gone wrong, let’s see what chemical processes we can change or manipulate or physiology we can change in order to try and stick a plaster over it and get the patient back to full health. So that mind shift I think is has is really needed and I think now has enabled us to go there. And looking at other industries has been one of the key benefits for innovation, I think post pandemic. You know, we saw people really coming through we saw engineering companies, building ventilators as an example and everybody pulling towards that, you know, is there anything more important than our healthcare? I’m not sure. And with that in mind, how can we all pull together to in order in order to sort of learn from each other? Really try and pump prime the innovation is needed in healthcare, get it to that scalable enterprise level. And I think some of the things that we’ve been talking about here and some of the things that we’ve put in the pipeline between nuance and Microsoft, for example, sort of capture that. And we’re really excited to take that forward, show people what the future can look like. And also point out that when we talk about the future, we’re not talking about things that are 10 years away, we’re talking about things that we think we can do, you know, in the next one to three years, the

20:24
crisis, it gave everyone permission, when they forced them and gave permission to be innovative, because we had to there was there was just that need in a crisis that people really did not know how it was all going to go to actually lock horns, and really get on and do things that are not be held back by bureaucracy and process. There was just a need of it had to be done. I mean, one example that came out was the the NHS app, people started using the NHS app simply because it was the way that their COVID vaccination sort of evidence could be could be used. And it brought an app that was doing okay, ish, but it brought it centre stage. And going forward, we need to sort of be building on that so that all the benefits of that type of technology can be realised.

21:24
Yeah, you’re right. Probably everyone I know has the NHS app on their phone because they had to the other interesting byproduct, I had been a huge QR code sceptic years ago, thinking how we’re going to use these, I don’t know anyone that doesn’t know what a QR code is, and have having scan one to either get their NHS passport or check into a venue. So the rise of QR codes has been one interesting byproduct from the pandemic. Yeah, and

21:44
also just using our phones for past interactions, that that that whole dynamic at the tool has completely changed a lot of around the sort of the hygiene side of things. Very interesting how that quickly, you know, probably accelerated far more than it would have done, I was amazed

22:01
with acceleration. So I talked to all my corporate audiences about how things have accelerated so quickly, I famously stood on stage in January 2020, and talked about the things that might happen in two or three or four years. And all these things we’ve talked about have been accelerated. So if anything good has come out of the pandemic, it is the realisation that technology can be used for good and things like QR codes and paying at the tail. And those sort of things are here and now and everyone’s used to it. Just on the technology angle there. I’m one of the millions of people’s that has a fitness tracker to how far away are we from my GP being able to leverage that data in a regular or predictive way?

22:33
Not very far at all. I mean, I had a patient the other day. So my, my proper job, if you like is being a paediatrician, I had this family come in. And their child had a temperature to come in with this reoccurring temperature, and it was obviously wearing them. And the dad just pulled out and said, I don’t know if there’s a health doctor. But I’ve been recording it, I had been recording it in an Excel spreadsheet. And, and then just showed me the graph of the temperature was incredibly helpful to be able to see it. So now, that was just somebody doing something off their own back. But it really struck me about how people are going well, just but this is how I do stuff. Now why wouldn’t I just capture it in this way, and bring it along with me. So I don’t think we’re very far away at all from being able to see that in life consultations. And as we start putting more EP ours in, as we start having that better data integration, I think as a clinician, I’d be sat there fully expecting to be able to see what my patient’s blood pressure was, or the temperature were at home, being read by their device. And that’s another really exciting innovation. And I’d expect us just sort of nail myself to a master on this. I think within the next two years, that’ll be relatively commonplace, especially for people with chronic conditions,

23:42
we will be happy now that I am a bit of a geek and have a bunch of IoT device I weigh myself every morning with my we think scale, I have a we things watch that measures all my vitals and also have little temperature device that is Wi Fi connected. So I could actually download all that data to my physician, I suppose the issue is the friction between it’s in one device, it’s in Apple healthcare. Other GP is ready to have this data downloaded. It’s all very well to show them the screen, I suppose my question is two part question is, is there a way for me to actually import that data into some system and make sense of it?

24:12
I think there will be it goes back to that enterprise scale. So I think you’re right today, we don’t think about healthcare as being enterprise ready. So you know, if it was an organisation, imagine if that was you submitting, you know, Acme report into your company or going through a purchasing order or whatever else it might be in the corporate world. And if we take that type of thinking and and apply that to healthcare, we’ll get that right. So, okay, well, I’ve got this information, I need to upload it or get it into a system, we’ll be able to find a way for that. And, you know, again, I don’t think that’s very far away. And then the second part in this, as I was talking about how we need to use a cloud and transition into that new way of interacting and that new ability to compete. As a clinician, I can’t possibly have all of the data points, assess them and then be useful to you. So going back to my example, wonderfully, this family had been recording that Charge temperature every half an hour, for two days. So the actual spreadsheet that I saw was way too detailed. And, you know, really what I needed to see was the insights that were caught out of that I wanted to know what the peak temperature was, and how often it went above a certain line. And so by moving to cloud by changing processes, and using the latest AI and clinical systems to be able to do that, I think we’re better to take this data and make it usable, so that when I am looking at the dashboard or talking to my patient, I’ll be able to see the pertinent bits of information that will help me make the right assessment, rather than just having all of the data there for the having the data’s for sort of having the data there for data sake.

25:37
So Simon, back to what nuance do, what’s the untapped power of speech and AI in a healthcare setting,

25:43
I always go back to this wonderful quote from Professor Cyril chantler, where he said medicine used to be simple, ineffective and safe. But today, it’s complex, effective, but dangerous. And it all sort of hovers around the importance of having clinical documentation. But the trouble is, with clinical documentation, it’s a real chore and a real pain for clinicians. They spend something like 11 to 12 hours per week, creating their documentation. So where speech comes along, is trying to take out that burden. When we first started our podcast, I painted this vision of conversational AI, and what’s coming down the track. But today, just using speech recognition, by creating your notes, using a microphone to get your consultation into the admission notes into a discharge summary into an outpatient letter that has real opportunity to speed up that the time taken to do that chore. We speak three times faster than we actually type. And certainly our experience in different areas show that that’s been a real benefit. I think the other really important thing about speech, and there may be some listeners who’ve tried it maybe 10 years ago and was slightly put that put off because of a need for correction is that the word recognition now today is is really very, very good. And the reason it is is because the speech engines have changed in the way they are built and operate. It’s based on AI deep learning and sophisticated algorithms, supported by a comprehensive medical dictionary. And what that’s done is me it has meant that clinicians can now speak their notes, actually see the words come out on page where the cursor is and not have to be doing any correction. So there’s that area of supporting them with their clinical notes. But they can also use it for their email. They can also use it in Word if they’re getting a presentation or a proposal together for a conference. And other areas we’ve seen it useful is users that may have dyslexia or have some repetitive strain injury from the keyboard. So there’s been a whole host of areas where it’s taken off. And I think just in summary, we’re making this cultural shift from the keyboard to our voice. And that’s going to make a huge difference going forward in trying to reduce the burden of clinical documentation, which in itself, going back to Cicero’s quote is so important to maintain.

28:55
You’re right about the improvement in voice recognition or speech recognition. I remember years ago trying to train these systems and being frustrated. It’s interesting, the anecdote that you talk three times faster the type, I probably talk about five times faster than I type. I use speech recognition every day, I’d love to try your system. I try another system, the moment to transcribe the podcast gets in about 80 or 90%. Right? It always gets my name and the name of the podcast wrong. And I’m thinking Why don’t you learn that I do it every week, that it’d be interesting to see if I could use that to transcribe podcasts.

29:23
I think that’s interesting. I mean, that that type of recognition is not great engines of today. And certainly they need to do have that clinical robustness, and 99% plus accurate. And I think the thing about the engines today is they’re always learning from every time you speak. So I will have my individual profile, there’ll be in the cloud. And every time I’m using it, it’s learning. It’s improving. It’s getting even better at the recognition.

29:56
So a two part question, maybe one for each of you. What’s the healthcare professional? The future look like and what’s the hospital the future look like?

30:03
The healthcare professional the future. Let me let me start with that. I gotta get back to some basics Umang and myself both being coalition’s that they must all have listening skills and compassion that health professionals have always had. That’s, that that’s absolutely key. Because as I stated just a moment ago, because healthcare has become so much more complex, they need to have quality information at their fingertips to make often, you know, life critical decisions. And I think the healthcare professional of the future will be dependent on having that type of resource when he or she is consulting. And I guess it goes back to what I was just saying, that type of confidence and having access to that source will only come about if there’s been good clinical documentation along along the way. So the healthcare, the professional will be hopefully much less bogged down and burdened by admin and excessive admin chores. And having that much sort of healthier, face to face. interaction with the patient,

31:29
healthcare, freshman future will probably look pretty that younger, because you know, doctors always look younger to me nowadays, but they can probably look younger, and will just look less stressed and be more present. I mean, that’s what I’d love to see is us being able to sit there and be I’m with you as a patient, because you’re here now, and a lot of the preamble and the bits that have needed to be done or been done. And I can concentrate on what we need to get done in this interaction. Because I’m not, you know, bombarded by having to write my notes or do other bits and pieces which are distracting me from doing what I really love doing, which is treating you and to pick up on what I think the hospital of the future looks like. I think it looks like a really exciting place, I think it looks like a sort of place where you know, you get dropped off. Rather than having to battle for parking for two hours and worrying about how much that’s going to cost, you’re able to then get in be automatically booked in. We talked about QR codes. And I love that, you know, some of this technology that is relatively simple and very simple in its deployment, if maybe not in its set up means that it’s now accessible to you know, my grandmother as well as you know, any 25 year old. So we can bring these things in allow us to be able to use technology. So as you walk through your bed to check in, be automatically routed through to the next part of the process, the right information being put there, I’d love us to be able to start having things like HoloLens involved to say when you go in and see the doctor, there’s not just the doctor or the nurse that’s in front of you that’s limiting their ability to care for you, the whole of the multidisciplinary team might be able to join remotely or in a hybrid way, that will mean that as you come in, we can maximise the time that you’re spending in the hospital to make sure that it’s a an experience that is as good as it can be. I don’t think anybody goes to hospital thinking it’s going to be Disneyland. But when you’re there feeling that the patient as a patient, knowing that your clinicians know everything they need to know about you in order to inform the next step of your care, and leave in an efficient way that will mean that you feel confident that you’re going to get what you need, and you know, hopefully get better and thrive.

33:27
I just gotta say, just building on that, I think the hospitals will also need to have that much stronger, seamless link with community and social care. And I hope technology will be able to play a role so that that transition back into the community having had the experience for whatever reason in hospital is much more seamless. And works much better for that that that communication link is, is much improved.

33:58
You so right friends of mine that have had operations, they’ve come out of the hospital, that safe environment and back in the community as friends and carers we’re not quite sure how to look after them. Another Futurist question as a future. So I’m always asked about the future of healthcare, and I’ve got two experts in front of me. So I’m going to ask you, I often offered we’re not far away from being able to swallow a digital pill that can diagnosis in a more dynamic way. Is this just a Futurist dream? Or do you think it’ll become a reality?

34:21
I think it’d be a reality, I predict that we’ll have an artificial pancreas before we have that pill. As an example, I don’t think we’re that far away from being able to solve diabetes. For example, I think I think we’re close to that. I think we’re years and years and years away from being able to solve some of the mental health challenges that we find and I say this quite a lot. But I often say that I think mental health is our generations diabetes. But I’m I’m optimistic that we’ll find a solution to diabetes and therefore I’m hopeful with some of the things we’ve talked about today, big data, batch analysis, etc. We’ll be able to start working on the same solutions for mental health. I think the pill you describe, I do wonder if what you describe as a Futurist doesn’t quite match what We think about it as clinicians, because having a pill that will diagnose things is only a small part of the challenge. But I definitely do see us having smaller things that we can swallow, having extra wearables and other bits that will give us a much greater picture. So it’s not just about diagnosis, it’s about, you know, being able to optimise the onward care as well.

35:17
As a Futurist, we have an asterisk next to everything we say all the time, because we’d like to have it happen, I have these crazy ideas, and then I actually get grounded, and I test them on my guests like your soul. So I learned more from my guests than you’ll ever learn from me. And back to what I think Simon said before is that doctor and the clinician, they have to have empathy. And that’s something you can’t teach through AI. Because I know from people I’ve involved if that a carers and clinicians, they do the job you do, because they have an overriding desire to make people better. And that is a drive that is not in everyone, and not something you can replicate in AI. So never want to take the humans out of that. In fact, when I done some research on what jobs can never be replaced by AI, top of the list is clinicians, because you have to have that level of empathy and knowing how to diagnose something that’s in front of you, rather than just relying on some technology. So glad to hear clinicians and humans are still involved. As a Futurist, I want humans to be involved when you’re looking at what’s wrong with me,

36:12
it’s a very important point. And we will always talk about the sixth sense and the art of practising medicine. It’s one of the it’s one of those components that when someone comes in, you just have a hunch, and you need to follow that through. And often there’s something there that you hadn’t anticipated. In fact, with with voice, there’s there’s been some work done, where the voice, the waves, the sound waves from the voice can be analysed and give some indication on the well being of that individual. Is that person slightly more anxious is there sort of a depressive sort of component, and certainly when, you know, as GPS, and hospital clinicians having 10 or 15 minutes with with patients, we’re rushing, we’re trying to get the thing that they came in for the main reason they came in for a dressed, but there might be something subtle going on, that’s actually being portrayed in the tone of their voice, which we may miss, because we’re just simply rushing. And so that technology there is of interest, and it’d be, I’m watching that keenly see how that evolves over the next few years?

37:28
Well, actually, I talk about that, and the notion of ambient voice in the future of voice that having permission to record what’s going on. So you might say, you know, have someone present and say, Look, I’d like to use this newfangled technology, we’re going to record what we’re saying. But as you say, it then picks up on the nuances. And if I’m not having a good day that knows how I normally talk, I think that can be incredibly powerful, not just in a clinical environment, but actually in the workplace that it detects that today. I’m just not myself. And maybe it triggers someone to say my buddy, hey, can you just check in on Andrew, I think you’re right about mental health being our diabetes of our lifetime. And if voice can help that, but again, with permission, we can trust that technology is being used for good. And that’s a big ask in some places, then maybe voice can be used to see how we’re feeling. I think that’s a huge area, you’d be happy to know that I talk about that with my audiences. That’s one of the good positive forward uses of voice.

38:18
Agree. I mean, it’s like when I found my mum, regardless of what’s going on, she will always know if you know, I’ve had a good day or a bad day. But you know, even if we’re, you know, just in the way that we say hello and stuff, no, I would love to see us bringing that more to the fore in healthcare. And healthcare is a very verbal industry, right? We’re not like finance, we’re not sat behind spreadsheets, and other bits and pieces that healthcare is based on communication. So vital that we start utilising it in the best ways possible,

38:47
almost out of time. So I might just ask both of you, what’s the one project you’ve worked on that you’re most proud of,

38:53
I guess mine was being involved with a primary care clinic. In the Gambia, we had no money, we had to raise some money from various sources. And one of the one of the key things was being able to get 700 malaria nets into this small remote village. Because just by doing that, we knew how much malaria would go through the village each year by having the nets there that that actually reduced that to almost zero. The other thing that we did was with some funding was trained three villages to become sort of midwives really, there was a lot of mortality from births not being managed as well as they could do. So completely non techie in my answer to that question, but I think that yeah, that that that has really left a mark of a sense of real achievement with me over the over the years,

39:49
as I think about that, the top of my mind comes to some of the work we did with Babylon, in in Wolverhampton and for me one of these I’m so proud of it was because we started This, you know, bringing technology into healthcare. And you know, we had our critics and people would say, you know, you’re you’re deliberately being disruptive and you know, are you doing the right thing. And we then we then went, and we took it to Wolverhampton, we broke out of London and we went to Wolverhampton, we put it within the NHS services, we have some, some great local GPS, that we’re already aligned to the hospital trust, to break down that these barriers between primary care and secondary care and deliver better patient care. And all along that way, we were told, you know, you can’t do this, it’s never been done before the type of contracting doesn’t exist, but we managed to get it through. So I was really proud of for me, that was a watershed moment when I just knew we jumped the chasm from people saying, Oh, this is something that I need this for people that have got iPhones in London, and have enough money to be able to use them, etcetera, etcetera, to being something that I could just see being the exact requirement and future of healthcare that we’re going to be delivering. And so I’m very proud of that.

40:54
Both great stories. Now we’re at the favourite part of podcast, want to run you both through a quick fire round. Now with both of you what I’m going to do is ask you alternately. So maybe you start with you make iphone or android android window I’ll window online or in the room in the room, your biggest hope for 2022

41:10
that everybody starts thinking about healthcare as being something that can be done at scale with technology now,

41:16
rather than in 10 years, Simon, the app you use most on your phone, WhatsApp or BBC News. What’s the one thing you won’t be doing? Again, post pandemic drinking so much laughter. I asked both of you the next three quick questions. What are you reading at the moment?

41:29
I’m reading united nation by Frank Connolly. And it’s about the opportunities and challenges of a united Ireland.

41:36
I’m reading the latest Jack Reacher book, because I just can’t get enough of that.

41:39
I’ll put the links to those in the podcast because people like to know what I guess reading. Next question for both of you who should I invite next on to the podcast,

41:46
I was going to say either Chris Whitty or Patrick Vallance to try and get some real insight into what happened during COVID. Failing that Roy Lilley, he’ll give you the real nuts and bolts about what’s going on in the NHS,

41:59
I would say Sajid Javid or Amanda picture of having heard them recently, at NHS confit Expo, talk really passionately about how powerful the NHS is and leading the world forward. As we get to more digital and more transformation.

42:12
No, no pressure then to get those high profile guests actually heard. So Patrick present at London Tech Week, a few weeks ago, he was very impressive, even though he spoke five minutes. Final question for both of you. How do you want to be remembered?

42:23
as an optimist?

42:24
For me, having been a good egg.

42:26
Two great answers. Now, as this is the actionable futures podcast, I want to ask you what three actionable things should our audience do today, when it comes to better understanding the benefits of digital health solutions?

42:37
First, go and have a look at what other people are doing. So you can convince yourself that it’s real intangible, and you can do it. The second is, ask them how they did it rather than having to reinvent it in your own way. And the third is, again, go back going back to asking, like just ask anybody you can how they can help you get to where you want to be. So start with a conversation. Because I think people will be surprised at what is available and how willing people are to help them get to where they want to go.

43:06
I’d build on that. My first one would be to give it a go. I’m certainly from my experience in the speech side of things, there is some hesitancy there. But I’m really surprised and pleased that when they give it a go, they become complete converts, I think, give it give it a go. And if whatever technology you’ve found is of benefit, then shout about it spread, spread, spread the news, I think that’s really important, as well. And I suppose just to finish off, that that sort of giving something a go, rather than saying no, just say what, why not?

43:49
I love that. Why not? Yes, I’m going to say that more often. But But why not? We’ve always done it this way. But why don’t we do it differently. For those listening today? How can people find out more about you and your work?

43:58
The Ewoks website is full of really good useful information. Or you can contact me directly my email address which is simon.wallace@nuance.com.

44:11
And for me, first port of call will be LinkedIn. Find me on LinkedIn, look forward to any old conversation.

44:16
Fantastic discussion today, gentlemen, I really enjoy that I’ve learned a lot. It’s changed my perception about a number of things and going forward, I will be singing the praises of Microsoft and Nuance. So thank you so much for your time today.

44:27
Thank You Andrew.

44:27
Thank you very much.

44:28
Thank you for listening to The Actionable Futurist® Podcast. You can find all of our previous shows at actionablefuturist.com, and if you like what you’ve heard on the show, please consider subscribing via your favourite podcast app, so you never miss an episode. You can find out more about Andrew and how he helps corporates navigate a disruptive digital world with keynote speeches and C-suite workshops delivered in person or virtually at actionablefuturist.com. Until next time this has been The Actionable Futurist® Podcast.