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Hands but doctors and no longer just medical professionals theyre being forced to become doctor analysts as well they trading in their stethoscopes for Virtual Reality goggles it may not sound all that reassuring but it does give doctors a whole new skill set to do their jobs all that much better standing there buck naked in front of my g. P. Recently it was the p. C. Doing all the checks for skin cancer computers the faster and robots can be so much more precise so when it does it leave my doc lets take a look. To determine whether a mole is malignant doctors are now consulting Computers Artificial intelligence being used to detect skin cancer drawing on a database with over 100000 image samples. Train ai like you would a small child if we show the ai a benign mo then perhaps a black malignant melanoma eventually after viewing thousands of images would be ai recognizes the patterns behind the diagnoses and is able to generate answers. On what. Is himself a dermatologist so does this mean hes handing his job over to a computer. Doesnt its more a change of role the doctor takes a step back and becomes a management controller. Dermatology is at a relatively advanced stage of digitalisation. On the ground however hospitals can have a slow Internet Connection and still usually have hard copies of patient files but not for much longer digitalisation is changing the working world for doctors while also opening up a range of questions. When do patients need a human face to interact with them where can mistakes by Artificial Intelligence be in voided. When will we see x. Rays being evaluated by a oh i instead of humans. And our doctors themselves ready for the revolution. Is not. Currently in a transformation period we know what direction the vision is headed. But its still some way off so right now the next generation of doctors and especially the current one are not prepared for it. Hopes an introductory seminar on Digital Health care its the only course of its kind in germany which is part of the problem the aim is to familiarize budding doctors with the new options available to them and to look at which ones are useful. We have to consider whether using this technology will help the patient and how i can make it an integral part of routine procedure and we might find that no it isnt helpful so i wont make use of it or i will use it in this case. Technology is increasingly being used for other forms of training here young doctors hone their surgical skills with the help of the chill reality. In this room and youll surrounded by the liver is that were you can look into whatever detail you like zoom in marks something its a really new experience. And can you sustain crucially different people can view the same thing together even if theyre separated by continents so you can consult someone else where who has more experience of this procedure. Thats set up already in use by you run a just for example with some operations now being conducted by a robot called Davinci Young doctors get to grips with the davinci simulator part and parcel of training for the next generation as doctors by expect to see a lot of robotics or similar developments. The 1st step in training is a kind of driving lesson with a robotic assistant. Digitalisation means Major Investments in new technology and Training Programs even seasoned doctors need lots of practice where their expertise is also essential is knowing what procedure makes sense. When come which Digital Tools be of genuine assistance. And who used to define what beneficial even means. As a doctor i need to know which apps have which capabilities so that i can decide whether a tool has benefits for my patient. Does it do what its supposed to do other its an app that appears to have medical background knowledge it might do Something Different with that data and over 5 made up most of. The mole on dr holger handlers patient turns out to be harmless say both the dermatologist and the ai of course computers can make mistakes too just like us ai after all was created untrained by human beings. Sometimes we do grievous mistakes a lesion is classified as benign but is clearly anything but and sometimes very advanced forms of skin cancer fail to be identified on them i mean it would be good to be able to explain why this or that wasnt detected and right now we cant explain everything. And so its very difficult to iron out mistakes who does this authors religion is there are still plenty of pitfalls. To melt some. Fresh quick. There is indeed still plenty of work to be done from improving doc to Training Programs to laying down quality standards but meanwhile the very occupation of dr is changing as it always has done with the evolution of technology for the benefit of patients. Is another benefit for us personalized medicine the latest buzz word in the industry its not just about customizing medication to your needs to make sure they work against things like cancer a riveting but also checking the effects of the meds 247 this whole new way of doing health care is sparking a major rethink for the pharma giants. Now lies medicine instead of blockbuster drugs. Schmidt is saying shes been taking Blood Pressure medication for years to little effect. The drugs were developed by Big Pharmaceutical Companies and tested mainly on men that mass produced medicines are marketed to achieve maximum sales despite often only helping home for the patients in question. It typically costs 800000000. 00 to develop a new drug. Fetlock buster drug needs to earn over 1000000000 to make it worthwhile but the days of standardized medication are numbered personalized medicine is starting to take off. Lisas personal genetic profile can now be decoded in 25. 00 hours for a few 1000. 00 in the u. S. Companies are using the data to forecast future ailments with 1000000 signing up i medical tech firms use x. Rays tissue samples blood cells and pathogens to develop an individual Health Profile including if the micro biome the hope is that will allow them to identify the drugs and therapies that are more likely to work. Those firms are also looking into the benefits of Artificial Intelligence a digital plaster in lisas arm could in future trigger an alarm if her drugs are no longer having an effect around the clock monitoring costing just a few 100. 00. Lisa schmidt is hoping that personalized medicine could finally provide her with a cure but who has access to all the data that shes giving away. The doctor obviously but now a growing number of companies are also offering these services. Established pharmaceutical firms are also having to rethink instead of just producing tablets for the masses they now need to think in smaller numbers bringing together diagnoses research and Treatment Options to become Service Providers for patients like lisa. Is Something Else you can thank modern healthcare for because of prenatal diagnoses fewer people being born with disabilities sounds like great news but this next guy has mixed feelings. Was born with spina bifida he wants to see inclusion rather than selection lets hear what he has to say. When im with a model i want to ask my mother what would have happened had she known about my disability and whether she might have had an abortion she started crying. Soon after i was born it was clear that i had a neural tube defect was called spinal bifida. All that meant i had various difficulties especially when it came to walking on by debate on points another common symptom with spinal bifida is hydrocephalus which is a condition where cerebral spinal fluid can drain properly from the brain and shortly after i was born i had a shunt implanted it drains that fluid through a catheter into my abdomen and. Soon after that doctors told my mother that i probably wouldnt survive to adulthood today we know that those kinds of predictions were completely off base of course the doctors were wrong and it caused us a great deal of fear and stress. On what i felt. Because that is from a stance on the whole i dont want to demonize prenatal diagnostics it can be helpful for example it can help couples who are having a baby and know what to expect whats a button but i dont believe it should result in what i would consider hasty or unnecessary abortions. Up time and. This had to feel because that fewer people with disabilities would have all sorts of consequences for our Health Care System that. Insurance providers would say they could save lots of money a fewer people have special needs. But medical care is always Getting Better which will also lessen the impact of a disability. The idea of a society full of designer babies is something that does concern me that i do find disturbing. I dont believe it would be good for society if all of the differences among us were racist. For me that also means that people with disabilities are an important part of our society theyre part of the diversity of our Society Depends on it. Well these ethical questions become even more important as the digitalisation of medicine Gains Traction as we mentioned the Big Internet Companies also want to play ball like amazon but whether or not theyre in for healthy profits what digitisation is doing is helping put patients in charge of their own health care heres how its democratizing medicine 0. Siraj india is one of 7000000 users that ada an app he consults whenever he feels. Thirsty type symptoms on his phone then the program ask them a series of questions similar to a doctor. When did the symptoms 1st emerged for example a couple of minutes later hes presented with what the system considers to be the most likely diagnosis. Data uses a lot of technical terms when describing the symptoms of medical language is often difficult to understand language or. Every 3 seconds the app generates a possible diagnosis for a patient somewhere in the world its especially popular in countries where seeing a doctor is expensive or where Health Care Services are poor. Is the c. E. O. Of the Company Behind a startup based in berlin. Firstly we never claim that ada provides the right diagnosis theres always the doctors for objective we make that very clear in the op. We never tell the patient that were providing a 100 percent diagnosis based on 20 questions. 150 people work for a to Health Including 40 doctors. The company also works with Health Insurance companies. They can make considerable savings if the app diagnose is one of 7000 Rare Diseases for example. Is that. This is an area where the advantage of technology over doctors who work alone is particularly apparent. Depending on the study you look at it takes on average between 5 and 8 and a half years to get the right diagnosis for someone unlucky enough to contract a rare disease. But jar is worried that the app may cause some people to not see a doctor at all to try to save money. Limited 3 point one problem is that poor illiterate people might take the diagnosis provided by the software as definitive and they might start using medication it recommends sometimes this could be harmful. Medicines. So doesnt want to take any chances and as recommended by the app he goes to see a doctor but is permanently blocked knows. As you know that most of the indians in our country they are quite ignored or they are going to. Just parties in one to. Buy i think that this. Rules of the software. Immediately. Immediately come up with this that he must concerned. About. Both the doctor and the app diagnosed inflammation of the mucous membranes nothing urgent and easy enough to treat cirrhotic or jar says the app does come up with reliable results use of the app looks set to increase. Google is for General Information we want to be for people seeking medical information. Will eventually be helping 1000000000 people to have a better understanding of the state of their health thats of. Siraj gorge i says hes happy to consult the app for himself. But when it comes to his young daughter do he would definitely go straight to see a doctor in person. Out official intelligence as another diagnostic tool in fact today google can identify a flu outbreak faster than the health of aris just by analyzing the search terms that you use but a form of Data Protection official has told made that Data Protection has not been a priority in digital medicine thats a huge worry in a business that relies 100 percent on doctor patient confidentiality the risks of a new industry thats moving ahead at light speed. To patient confidentiality Means Nothing to them they just want to make as much money as possible with the data. That advises the European Parliament and other organisations about data privacy in Digital Health care. Didnt tell you zation has a lot of potential so why not just ignore Data Protection so that we can make that big step forward. You can do a lot of useful things with data of course data can also be used in harmful ways. For example you can bring people into disrepute leaving them stripped and exposed. Health data is especially Sensitive Data privacy activists insist it should only be sent to 3rd parties will be expressed agreement of the patient is that realistic because were now seeing Internet Companies entering the Health Care Sector especially in the us. That does concern me they have no concept of doctor patient confidentiality so they have one goal to use the data to make as much money as possible. The inevitable result is that weve been reduced to 4 to what you might call data objects. In germany regulators cant always money toward doctors or lawyers for Data Protection compliance that increases the risk that data might be passed on illegally for financial gain. Doctor or a lawyer my claim patient confidentiality or client confidentiality then regulators cant ensure that data privacy protections are upheld this is completely illegal under both e. U. Law and the german constitution but thanks to lobbyists this is now been incorporated into law this has an impact on digitalisation in health care. The Digital Health care. Making increase use of genetic data this could lead to breakthroughs in the treatment of cancer and dementia but it also poses risks. The worst scenario i can imagine is if it became mandatory to assemble a comprehensive record of everyones genetic data. Our genetic disposition has a massive impact on our health we might see our Society Making decisions about people on the basis of their genetic disposition then you see things like we dont want them they get no money they get no insurance certain people will be seen as a threat and people with good genes would get preferential treatment before so. Despite these the risks is convinced that we have the capacity to protect the data privacy of citizens but whats missing is the political will. Germans are wary about anything involving data privacy but israel has been collecting patient data for decades Tech Startups use the medical records to develop algorithms and their businesses so far theres been little pushback on the contrary israel wants to become a world leader in digital medicine its already reputed to be one of the most innovative countries in this sector lets take a look. Israeli companies are usually. Bringing in fresh angle to an existing problem in health care thats where we expect. With a population of around 9000000. 00 israel is a small country but its looking for a large piece of what set to be a large part of the Digital Health market. For 20 years the Israeli Health system has been gathering the medical data of more or less the whole population a database like this exist only in israel and serves as an ideal basis for the development of deep learning algorithms that could potentially save lives. Among the pioneers of this development he cofounded Zebra Medical Vision in 2014 the company was granted access to the take care of israels main Health Organization to optimize patient care. Its introverted care providers they dont meaning we know the outcome and what happened with all those patients and they state can create many many different tools to alter mate and help rhodiola just doors much of their day to day quickly and more efficiently. Zebras analytics tools are already in use. And his head of ai are overseeing their introduction in hospitals the Technology Reduces the time it takes radiologists to recognize acute symptoms by 80 percent with a brain hemorrhage for example that could make a crucial difference because the bridge is also collaborating with google scans can be uploaded to the google cloud and analyzed many hospitals still hesitate to upload Sensitive Data to the cloud. Gura says its safer there than on a hospital server and that the data zebra works with is all completely anonymous. He worries that pretty concerns about dealing progress. Millions of patients will be saved in china. Before they are being saved in europe and the us there is quite of a balance nations and citizens need to consider around impact on patients live perceived privacy with. Israels government is now having a range of Data Collected on what will be one digital platform it will be the Worlds Largest database of medical data will eventually be made accessible to start ups in terms of Digital Health the country is dreaming big. Shindle invests mainly in health Tech Startups part of what we need to do as investors is to connect. Bridges between the israeli are proper north and the world. The market here is tiny this bridge building between israel and the world is what really grounds the israeli entrepreneurs as fears of a Health Care Data breach this investor says such concerns are typically european. The population here is a little bit less risk averse were used to living in vironment when risk is part of the equation and we constantly balance between risk and reward lisa goal is cofounder of the start of day 2 and is identified Personalized Nutrition as a major trend the Company Provides customers with Personalized Health Solutions Based on the micro biome its methodology could revolutionize diabetes treatment. So how come israel has become such a hope of visionary ideas. Because were in survival mode all the time we need to be able to find Creative Solutions to move forward were not about. Getting mold he you know 1000000000. 00 companies up and running. But we do know how to innovate. Another factor is that in israeli Business Culture failure is seen as healthy if an idea doesnt work out its always worth trying again. I see you again here on made and make sure you keep up on the leaps of balance being made in the business of digital medicine its all about your health at the end of the day to see you again soon. Good luck. To. Enter the conflict zone the fronting the powerful. The trial of countless separatist leaders of the failed independence field has laid off divisions in Spanish Society my guest this week here in madrid is sprains foreign minister knows it from our congress here on civil charge that the trial scaf fundamentally unfair. Complicates the food smuggling. Standing up to order. A small town mayor a hungry. Beast for a progressive society. Welcoming minorities and fighting corruption. Mean a man whos proud to call himself what you are appear. 90 minutes w. D. To know that 77 percent. Are younger than 6 oclock. Thats me and me. And you know what time of voices i watch all the 77 of the sense to talk about the issue stuff my view from the toilet seat to flash from housing boom boom town this is where. Welcome to the 77 percent. This weekend g. W. Read the real power resides. When i come from there are lots of people in fact not in a 1000000000 if you 2 blood finances democracy maybe thats one reason why im passionate about people and aspirations and they can sense. The television the book is Fried Chicken blood and after the 4th of the fun in one i remember thinking at the time if the blur in vulcan for what could happen if people come together and unite critical. And i do the news i often confronted difficult situations for conflicts being discussed else i see despite my job to confront goodspeed as one policies and development to put the spotlight on issues that matter most. To security question much in isolation. And not has been achieved so much more needs to be john and i think people have to be at the heart of solutions money. I mean shes not you know working together. In. The u. S. State of alabama has a knack to the countrys toughest abortion law the state senate voted to outlaw abortion at any stage of pregnancy even if it results from incest or rape the law would also send doctors who perform abortions to prison for life. Protesters clashed with police in Rio De Janeiro after a day of demonstrations against large budget cuts in brazils Public Education the administration a fine

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