Building blocks

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Meet Angshuman Deb, an Executive Architect with IBM Watson Health from Maryland, USA. Angshuman is part of the IBM Health Corps team working with CARE India to build a proof of concept platform that integrates disparate data sets and provides actionable visualizations in order to assist public health decision makers more efficiently manage the essential drug supply chain.

What does an solution architect do?

A solution architect takes an idea that’s expressed in the form of a business question and turns that into something developers can write in code. I work to understand a problem, define the components to be built, the data to be captured, and how the front end talks to the back end. Like the architect of a building, I determine what the solution will look like. I choose the materials, but I’m not the expert who actually lays the tiles. I know what roof is needed, but I don’t put the shingles on.

What are we trying to do here in Bihar?

We’re trying to answer key questions that haven’t been possible to answer because of siloed data applications. Specifically, we’re looking at the drug supply chain, making sure there is the right medicine provisioned, at the right time, at the right cost. Here in Bihar, it’s a demand driven system. A single person – the civil surgeon of a district – raises a demand. But today, there is no data-driven forecasting occurring. It’s guesswork.

So the first key question we’re helping to answer is from the point of view of the civil surgeon, how do I better forecast my needs – to meet patients’ health needs and to make sure I’m not taking away resources from another district that might need them. We’re looking at what is the optimal point to just-in-time deliver drugs to patients. By leveraging consumption data, we can  help answer the question of forecasting.

The second key question is how do I measure performance across the state, as a principal secretary. Looking at consumption data alone doesn’t give us a true picture. We need to look at supply too.  We’re applying a data science approach to help decision makers find which districts are high and low performing around efficiency of the supply chain.

What data-related improvements do you think could make a difference improving analytics for drug supply chain in Bihar, India?

  1. Tracking drug consumption all the way to the last mile, to the ASHAs (Accredited Social Health Activists) and APHCs (Additional Primary Health Centers). This gives a fuller picture of where drugs are moving through the system.
  2. Having the person at the drug counter enter information on what has been prescribed, not just what has been distributed. One way to improve this is by having an e-prescription solution as well.
  3. Having master data for drug names and categories. If this permeates every application you build, every district, this will enable Bihar to do magnificent analytics projects on drug prescription, supply, and consumption patterns. So much of our effort was spent on data cleansing because of differences in drug names, dosage, etc.

What will you take back with you from this Health Corps experience?

Memories of a great team. We didn’t know each other before coming here. But the way we worked together in just three weeks – I feel like we’ve been working together for the last three years. We trust each other, we aren’t ashamed to admit when we make mistakes, and then we fix them. It’s a great team.

 

care IBM team photoIBM Health Corps and CARE team

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Practicality and impact

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Meet Kenney Ng, research staff member in the Center for Computational Health and manager of the Health Analytics Research Group at IBM Research in Cambridge, Massachusetts, USA. IBM Health Corps is working with CARE India to build a proof of concept platform that integrates disparate data sets and provides actionable visualizations in order to assist public health decision makers more efficiently manage the essential drug supply chain. Kenney is bringing his data science expertise to the project, looking at what questions can be answered by the data.

Tell us your impressions of the project so far.

This is very different from work that I’m used to. The work I do day-to-day is usually several steps removed from practical reality. Whereas here, we’re at the last mile, where the rubber meets the road. It’s good to get this exposure and clarity. It’s made me realize there are a lot of problems in the real world that can be solved without having to come up with overly complex methods or approaches. We try to be practical in research but really you have to come up with new methods and a lot of these methods are somewhat contrived and a bit removed from reality. So it’s good to have that reminder that there are lot of things we can do that are more straightforward and have a lot more impact.

What are you taking away from this experience?

It’s amazing how much the team has been able to do in such a short amount of time – in only two weeks so far.  The amount of information gathered and digested, and then we’ve analyzed and built upon that, and now we’re working on the process of restating and adding value. The amount of stuff that’s done with a seven-person team plus the CARE India folks has been amazing.

I think a big part of it is the focus. A lot of time was spent organizing ahead of time, so we don’t have to wait. The silly blockers were removed.

I’m thinking about how to apply this as a general practice for me and my team. I have a policy where people work on no more than two projects. But I need a better assessment of how many distractions are actually happening and then working with the team to reduce them. Focus is the key and how do we realistically make that sustainable.

This is your first time in India. What’s stood out to you so far?

The sensory overload in terms of the number of people, the noise, the variety of transportation you see on the roads (cars, motorcycles, cycle rickshaws, bicycles, pedestrians, horses, even cows). Everyone seems to be doing their own thing. Like with the traffic… even though there are lights and cross walks, and a police directing traffic, people disregard this. It was an interesting preview into the health system here. Even with a structure, mandates and directives from on high, things happen bottom up, more organically. There’s inconsistent adherence to those mandates. That’s interesting for us to consider how culture plays a role in our project.

I’ve enjoyed getting out and seeing things. Our trip to Nalanda was really interesting – to see how extensive the facilities and grounds were for a free university that long ago was very impressive. We see examples of ancient civilizations that seem to be so far ahead, in terms of their approach and thought, as compared to where we are now. It’s interesting to see how certain areas of human knowledge have advanced a lot in a short time, but there are other areas that have hardly changed at all.

Exploring Nalanda, founded in the 5th century AD, an ancient seat of learning in India

So, all in all… how do you feel about our project?
There are three things that motivate me:
1) Working on and contributing to a challenging problem
2) Working with smart, motivated people
3) Learning something new
This project is satisfying all three. It has been a great experience and I am grateful for the opportunity to be a part of the team.

 

Making data science accessible

Meet Bibo Hao, an IBM research scientist from Beijing, China. Bibo and IBM Health Corps team are working with CARE India to build a proof of concept platform that integrates disparate data sets and provides actionable visualizations in order to assist decision makers like civil surgeons and state bureaucrats in more efficiently managing the essential drug supply chain.

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Tell us a little about yourself and how you came to work in health.

I grew up in a very small town in the middle part of China and when I was 5 or 6 years old, I caught a cold and couldn’t stop coughing. So I went to the local hospital and at that time I was misdiagnosed with tuberculosis. I was in the hospital for several weeks, following the treatment plan. But my parents still were worried about my condition. They took me to a hospital in a bigger city, and the doctors at the hospital said I had pneumonia, not tuberculosis.

So when I think of that experience, I feel that health is important. I didn’t realized what it meant to my parents when their son was diagnosed with TB. At that time in China, health care quality was poor. A tuberculosis diagnosis could have meant losing their son. That experience inspired me to work on healthcare.

So after finishing my education in computer science, when I was seeking a job, the healthcare team’s work at IBM Research China really attracted me. At IBM, I’m working to apply data science and a data-driven approach to healthcare decision-making, especially for primary care. For example, predicting which patients are more likely to have a heart attack or stroke, so that we can help doctors provide proper care as early as possible.

How are you approaching this project for Health Corps, and what are your hopes for how this work goes forward?

Hopefully many people can use this data science platform we’re creating in Bihar. For example, first it’s for the data scientists. We can provide them with documents and tools to use the algorithms and proper program components to analyze the data and derive insights. And second I’m making the platform easier to use by non-data scientists. I’m building a wizard view, so the user does not need to program. They just select some parameters and click buttons, and derive insights from the data. With this, data science will become more accessible to many users. This will give more people a whole picture of what’s happening. They will see things they had never seen or thought about before.

What can we do to help have adoption of the platform?

There’s a gap between technology development and technology adoption. “Data science” has been a buzz world in the tech world, and now data science is something that is used mostly by data scientists or geeks. So we’re building a software as a service platform and creating 1) a user interface that is easy to use, so you don’t have to write code to access the algorithms, and 2) we are articulating best practices and framework so we can tell users (like doctors and business analysts) what we are doing, why we are doing this, why it’s a scientific and rational approach.

We need to demonstrate the value of the technology and how it can help people. If we can show how with this platform and investment, you can save lives and relieve people’s pain, people will realize it’s worthwhile to invest in this.

So can I (interviewer Natalie, a non-technical person) use the platform?

Sure! Imagine data science is like the DOS system built by Bill Gates. What Bill Gates did was build the operating system of Microsoft Windows, and Windows had an easy to use interface so you can operate your computer easily with those windows and buttons. So I’m bridging that gap too so many users can use the data science. It’s not just some theory. It can be used by anyone.

What did you know about the Indian health system before coming here?

I didn’t know what it was like before coming here. Chinese people believe that in India, the drugs are cheap because they have a different patent system than us. But I found it’s another landscape. People in some areas can’t even have basic level of health care and medical treatment. Some of them can’t even get their drugs in time. They suffer because they can’t have the proper drugs.

What are you taking away from this project?

Passion. When I am working in China, most of the time I’m not faced with people in poor conditions. Now in Bihar, when I’m doing field visits in district hospitals I find that there is a lot of room for improvement. I see that, I feel that. There are a lot of people in desperate need for improvement in healthcare. So when I go back to China, I hope that my work can help many people in this world.

The Indian government has an ambition is to provide free basic care to people in India. I think this is a great ambition. It’s my honor to contribute my experience and expertise to this initiative.

“Data integration” with a purpose

Meet Somasundaram Raman, a Healthcare subject matter expert from Bangalore, India. Soma and IBM Health Corps team are working with CARE India to examine how data integration can bring insights into improving the supply chain for essential medicines.

CARE state unitWhat are some of the challenges we are experiencing in integrating the datasets for this project?
Because of the siloed applications — e-Aushadhi (which is a drug distribution application) and Sanjivani (which is a drug consumption application) — there is no consistent language, vocabulary, or data dictionary in terms of drug dosage form or drug strength. This is because of different people handling the applications; the common language has not been adopted. EDL (Essential Drug List) designations need to be adopted across all systems and all people – it brings a common standard.

One way to solve this problem in the long run is to create a machine learning mapping algorithm based on drug name, dosage form, and strength so that it can be automatically captured in master mapping and with a data stewardship module. This may reduce a lot of manual mapping that would take place across different systems.

Also, going forward, we want to see e-Aushadhi and Sanjivani rolled out at all levels of the health system and to both outpatient and inpatient care. Critical will be how to ensure adoption by users – that helps improve the completeness and quality of the data.

What are you taking away from this Health Corps experience?
I’m thinking if the model of Health Corps can be applied to our day-to-day work in IBM key account and projects. The way we’ve brought different experts in various fields as one unit for three weeks, it’s really a great experience. If this approach can be extended for some key accounts, that would be good. It gives a different experience to our partners like CARE and the Gates Foundation here. They can see the power of what we can achieve.

This is the “One IBM” approach. Bringing different expertise into one group can create a lot of value. I’m going to encourage my teams to work that way on projects when I return home.

What does it mean to you to be part of Health Corps, especially as someone who lives in India?

Health Corps really is living “Our Purpose” of being essential (as our IBM CEO Ginni Rometty put it). I hope the result of this small use case can expand to a greater project that improves the health of people living in Bihar and help reduce their out of pocket expenses (a major priority mentioned by the Principal Secretary of Health). This means a lot to me and I’m thrilled to be part of this journey.

 

 

The Best of Bihar

By Mihaela Miches, Front-end developer with IBM Watson Health in Ireland, Proud IBM Health Corps team member working with CARE India

My top experiences so far:

  • This is my first time being outside of Europe!
  • Meeting so many top government officials in Bihar, from the Gates Foundation, and from CARE USA
  • Visiting a Sikh temple, a Buddhist temple, and attending a Hindu ceremony next to the Ganges river. This feeling of multiculturalism has been amazing to see.
  • Our trip to the big bazaar – darting through the traffic and hearing the constant honking
  • Everything we’ve eaten pretty much has been my first time trying it.
  • The friendliness and hospitality of everyone we’ve met
  • Being so hands-on with the design thinking activities and field research. I’ve enjoyed filling out the “AEIOU” worksheets when we’re in the field (A=activities, E=environment, I=interactions, O=objects, U=users). I don’t do this in my day-to-day job as a developer.
  • Being written up in a newspaper for the first time

Reflections from Mihaela Miches, IBM Health Corps in India

Meet Mihaela Miches, a front-end developer with Watson Health from Ireland, serving on the IBM Health Corps team in Bihar, India 

JPEG image-3CC795488EB7-1You grew up in Romania, and live in Ireland now. What are some of the similarities and differences you’ve seen among those health care systems and the one we’re working in here in India?

One of the similarities is that health care systems are not perfect anywhere. They all have their big problem, and that’s why we’re here. We’re doing everything we can to make it better. In Ireland if you wanted to get your drug prescription, what’s similar to this [to India] is there are a lot of queues as well. You’ll have to wait to see a doctor, and generally just wait until they prescribe you something. And many times, in Ireland, you’re better off going to a private hospital. In Romania, there’s not so much queuing, but the quality of health services offered… there’s a lot to improve. Everywhere around the world – every system has their problems.

How are you approaching this project with CARE India and the creation of the user interface?

I’m bringing my day to day experience to this work. It’s not just about “hype driven development.” First, I’m making sure the system is responsive – that it can be viewed on a mobile device – because today, everyone’s using them as their first experience. I’m thinking of the district civil surgeon who may not be at a computer every day, but has a smartphone in his pocket.

Second, I’m paying attention to the accessibility issues (learn more at https://www.ibm.com/able/). Third, for the overall ecosystem, we’re using github and using open source technologies, and leveraging the culture of DevOps.  I think this will accelerate CARE to take this work forward more easily.

What does it mean to you to be part of Health Corps?

It’s an honor. I’m very grateful to be here. My job right now at IBM is the job I’ve been dreaming of since I was 14, thinking about what do I want to do when I grow up. I wanted to be part of something big, like a big company that has influence and access everywhere around the world. I wanted to work with AI. And I wanted to solve the hard problems for society, and healthcare is hard and burning and very important to solve. It’s a dream come true to be here and be on the ground and actually hands on to help the people of India.

HC team with CARE district level staff

IBM Health Corps meets with the Vaishali district civil surgeon and the CARE District Resource Unit

Interview with Anne Stevens, IBM Health Corps in India

Meet Anne Stevens, a user experience and data visualization designer from Toronto, Canada, serving on the IBM Health Corps team in Bihar, India working with CARE India

IMG_6294What is IBM Health Corps bringing to the project with CARE India that’s different from the current-day approach?

I’m an advocate for IBM’s design thinking practices, and I’m hoping to bring that to the IBM team and other stakeholders, such as CARE and the Government of Bihar. We like to think that IBM isn’t a high-tech company, but it’s a design thinking company. That means we always put the end-user front and center, understand their real problems. We don’t create technology just because we can, but because it’s useful for a real end-user. We actually make something better for them.

To do that, it’s important to get out and see end-users in their situation, in their context, and understand what they’re trying to do, not just hypothetically. We need to see the tools they’re using. So field visits have been really critical. We’ve been meeting and interviewing stakeholders at different levels of the supply chain in the health system. We did a design thinking session in order articulate need statements. And this afternoon, we’re going to do a design sketching session. I don’t want to be the only designer in the room.  Everyone on the team is bursting with ideas, so we want to be inclusive in the process.

What do you hope will change because of our engagement?

Our short-term goal is to demonstrate the value of integrating data and providing more useful, interactive, valuable visualizations that can help people make decisions.  I’m hoping that what we do sticks; we’re only here for a short time. And long-term – we want this to go toward better health delivery to that last mile.

What has been the most striking experience for you so far?

outpatient department india

Going out to visit the district hospital and primary health center was pretty striking. We saw the sheer volume of patients they process – even in the outpatient department, they had more than 1,100 patients in one day. We saw the crowds lining up just to register, and then lining up with their prescription, and crowding around the pharmacy dispensing window in the heat. It was intense. We witnessed a whole range of situations, from what might have been a routine pregnancy check to some really tragic events as well. It really brings it home — what’s at stake here.

What does it mean to you to be part of Health Corps?

I love my job but there can be an element of a day-to-day grind. So it’s good to get out of that for a bit of time. To flex your brain muscles in a different way. To be able to focus and block out the day-to-day noise. It’s refreshing.

And to be with new people, be exposed to different skillsets — it’s a great learning opportunity. For example, seeing my teammates exploring the data…  I sort of do that, but I don’t do it the way they do it. I want to understand that more.

India’s a country I love. I’ve been here before, part of my childhood was here. So it means a lot to come back.

Registration at district hospital - India

Rich Strangers

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United we stand. Alexandria, Virginia, May 2017

By Lynne Driscoll, Director – Intellectual Property, IBM

Bringing together several people from 5 different countries and cultures has certainly been an experiment worthy of a ‘Big Brother’ like television show environment. Myself along with others from the U.S., South Africa, Singapore, Mexico and Cameroon have been living in a shared rental house for the last three weeks in the beautiful and convenient ‘burb of Alexandria, Virginia area, just 10 miles south of Washington, DC.  A few of my housemates had never left their country before.

All of us were strangers, for the most part. Some prep phone calls and web conferences occurred prior to the start of the project, people jockeying to understand their role on the team, the project, and to simply understand the accents & to connect the voices we heard to the pictures we saw of our colleagues online and on the messaging application called WHATSAPP.  If you don’t know what is WHATSAPP, it’s more popular than a standard texting application worldwide because it uses internet and not cell data for message transmission therefore much more cost effective than what we blindly expect from our gluttonous US-based mobile data plans.  And it’s more fun.

Speaking of gluttony. While we were together in DC, one of our global team members wanted to get a ‘chalupa’ at Taco Bell. I groaned in agony over his request. Another wanted to visit this store they heard of called ‘Walmart’. I grimaced in disbelief. The rental house itself, where we were domiciled, was nearly 11,000 square feet with 8 bedrooms and 3 kitchens (crazy, I know, but good story to share in person over a margarita).  Is this what we want to share about America with our global colleagues? The infamous American excesses?

At the end of our three weeks together, what we really shared was an excess, or a plethora you would say, of true team work. We each brought our own wealth of skills and experience to take a loosely defined project, create a roadmap and turn it into a working system in record time.  We created (along with our NGO Partners) a working cancer treatment advisor tool, based upon IBM’s kick-ass Watson technology, that can rapidly help oncologists in select Sub-Saharan African countries find the right treatment based upon what is available in that country. Staying up late on most nights, we laughed, we coded, we negotiated, we argued, we ate, we drank and we focused. We used our riches to enrich each other…and more importantly… enrich the health and lives of those we will never meet.

At the start of this journey we were sequestered together as strangers to work on an IBM Health Corps community service project. It seemed like the start of a bad joke. 4 Americans, 1 Cameroonian, 2 South Africans, 1 Mexican and 1 Indian walk into a house….

We walk out tomorrow as rich friends. God bless everyone and my deepest appreciation to our employer IBM who exhibits support and leadership in making the world a better place.

 

The War & the Moon

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Iwo Jima Memorial Washington, DC – Memorial Weekend 2017

By Lynne Driscoll, Director – Intellectual Property, IBM

As an American, there is not much more moving than visiting our Nation’s Capitol on Memorial weekend.  This U.S. holiday is informally known as the ‘start of summer’, however it is formally known to honor those who have served in both life & death in the protection of our country, values and freedom.  The energy of the visiting crowds, food trucks, street vendors along with the monuments and their stories reminds us how fortunate we are as a society.  Speaking of fortune, we were provided a delightful, local private guide for an evening, moon-lit tour of the Capitol complete with historical insights unknown to many and sights unseen by our IBM Health Corps team.

Infused in our friendly banter among ourselves and our guide, we wandered through the monuments and through the topics of the political parties differences between our respective countries, the puzzling (to even us Americans) electoral college and just exactly how much could you pay for a home in the trendy Georgetown section of D.C.? (according to realtor.com….a LOT is what I would say).

And yet in this celebration of those who lost their lives and loved ones due to wars on soils near & far –  on behalf of the United States and our allies – it hit home. It’s clear that our small team, 7 of us from IBM, is fighting a war in itself.  The war called Cancer.  With many in support, we are building a tool that oncologists on the ‘front-lines’ in low-resource countries in Sub-Saharan African (far away soils from America) can use to effectively treat and battle one of nature’s most destructive forces in the human body that is more insidious than bombs, more prevalent than AK-47s, more underhanded than an IED.

As an example, cervical cancer is one of the leading causes of death of African women.  Preventable with a vaccine, treatable if caught in time. And too many women are senselessly losing the struggle in this part of the world. Let’s stop the advancement of this cancer and the others we are working on.

This team is part of the Moonshot that our CEO declared on this disease. A century-old technology company, that has survived through 8+(?) times-of-war over our existence, seeking to eradicate an enemy.  This team will never get a monument raised in our honor. We aren’t seeking one. But it’s been my honor and pleasure, however small a contribution, to serve my country and my fellow human beings.  I am proud to be an IBMer.

To pursue the mission, add the humans

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Health Corps team at the American Cancer Society Hope Lodge, Baltimore, Maryland

By Lynne Driscoll, Director – Intellectual Property, IBM

We get distracted and buried in our own problems of traffic jams when running low on gas, missing an important email from your boss, batteries dying on our mobile devices at the inopportune time, frantically running kids to soccer/band/scouts, or Amazon not getting your order to your door in the two days PROMISED under Prime.  Sacre bleu!

And then…

And then…

…you get your internal compass reset.

While doing some out-bound community service as part of our IBM Health Corps special project to build a cancer care tool to help the oncologists in low resource Sub-Saharan African countries, my internal needle was spun around this week.

Hope Lodge is a place that cancer patients and their families, who may travel from far away to get treatment at local Baltimore medical facilities, can stay for free of charge.  Beautiful facility, well organized, well staffed, and… as well…emotionally moving. The IBM Health Corps team provided and served dinner to over 40+ people who were using the facility.

Following the strict instructions of the events organizer Jacki (seen above), we donned our hairnets, put on the sterile gloves, avoided the bone marrow transplant tables, made note of the disinfectant location and served dinner.  Then when our guests were sufficiently served and fed, we joined them.  My dinner companions included a man who is a 10-yr survivor of prostate cancer and traveled around the country ‘volunteering’ for the experimental treatments; a young, pretty mother of  8yr old and 10 yr old children getting a newer proton treatment for her breast cancer (who’s husband could only come up 1x a week because of the child care strain); a lovely gentleman with esophageal cancer who was not fairing well with his treatment (and interestingly, his wife worked at IBM in the 1960’s as an admin).  And finally, a young man, not much older than 30, who traveled from Japan for his second occurrence of brain cancer.

Our dinner conversations were insightful at times, uncomfortable at other times, and surprisingly cheerful with some laughs.  They were so so keen on what we were doing.  They all told me that they had to be their biggest advocate to find their treatments (not the physicians), and could this tool be made available to people like them who have to sort through volumes of internet research to push for the latest and strong hope for the best available treatments? I took all their comments and stories to heart.  I was in awe of their strength.

I left the event emotionally drained yet intellectually uplifted.  While this specific project for IBM Health Corps is focused on Africa and what are ‘Third World’ problems with the lack or resources or consistent drug availability, its time for all of us to properly gauge the importance of our ‘First World’ problems because we are all humans just trying to survive.  Be it in Baltimore at the Hope Lodge, be it in Ghana at a doctor’s office.

Remember these people I will.  To think about the impact of what we are doing on this project —  and  —  remind myself of what is really important when my specially packaged southern corn grits are shipped ‘late’ from a warehouse.