Due to COVID-19, access to the operating theatres in hospitals is restricted, which means medical training must balance practical learning experiences while ensuring the safety of their students.
NUS have released how they are enabling their medical students from the NUS Yong Loo Lin School of Medicine to experience the process of patient safety and immersion in operating theatre procedures through virtual reality (VR).
The students have been able to learn about the entire flow of the peri-operative setting: from dental clearance to anaesthesia evaluation, to the handling of sharps during surgery and the safe conduct of operations in a simulated environment through VR headsets and hand-held controllers.
The system, called PAtient Safety aS Inter-Professional Training (PASS-IT), is a digital gamified environment that allows students to learn about hands-on techniques in the operating theatre.
“PASS-IT’s gamified style lets multiple learners be immersed in situations where they are given the opportunity to participate in what would usually be a highly restricted environment,” said Associate Professor Alfred Kow, a surgeon and Assistant Dean (Education) of NUS Medicine.
“With the COVID-19 situation, students have also been removed from these settings of practical learning due to the risk of exposing them to aerosol-generating procedures. This VR system is a good tool to help the students consolidate their learning despite increased clinical restrictions,” he added.
Operating in the virtual training world
Medical students use VR headsets and hand-held controllers to interact with each other in real-time. Their physical movements and actions are also tracked and displayed in real-time for visualisation and evaluation.
The tool allows students “to make mistakes, learn in a safe environment and ensure that they are competent before they enter actual clinical environment to care for patients”, according to Assoc Prof Kow.
The PASS-IT programme was piloted with a cohort of 36 third-year medical students who had just completed their clinical rotations in surgery, as well as 56 fourth-year medical students during their Phase IV Anaesthesia posting.
Students showed improved understanding of peri-operative patient safety after the training. Results also showed that the VR training had elevated the students’ appreciation for effective communication between healthcare workers, and the majority of students also spoke positively of the use of VR technology to enhance their knowledge of patient safety.
Assistant Professor Terry Pan from the Department of Anaesthesia at NUS Medicine said the introduction of the PASS-IT VR system has been timely as it gave the students “a unique opportunity to continue the operating theatre learning experience virtually in a safe and structured manner”.
“This innovative VR tool can certainly complement the operating theatre learning experience when the current restrictions are lifted,” he added.
Researchers at the Indian Institute of Technology in Bombay (IIT-Bombay) have created an AI model to diagnose two species of malaria parasites by studying the changing trends of proteins in human blood. The project has been funded by the Department of Biotechnology.
According to a news report, the researchers recently developed proteomics technologies and made an artificial intelligence (AI)-based model in collaboration with three different hospitals across India. The model differentiates between two malaria parasites – P falciparum and P vivax – for better malaria diagnosis.
The researchers, from the Department of Biosciences and Bioengineering, collected blood samples for strains of P falciparum, P vivax, and dengue from across the country. Including the Medical College Hospital in Kolkata, Sardar Patel Medical College in Bikaner, and Dr LH Hiranandani Hospital in Mumbai, along with blood samples of healthy people. Then, the team created a dataset to train the AI model.
The dataset was analysed, and the researchers studied the protein levels from blood plasma against the severity of malaria to create quantifiable data. The majority of malaria cases in India come from the malaria-vulnerable population, including workers at construction sites in malaria-endemic regions. These are regions without a proper drainage system, leaving standing water for days to facilitate mosquito breeding.
Other parts of the malaria-vulnerable population include people without awareness of the harmful effects of the standing water in their localities during the malaria season. The main issues at the time of the disease are quick diagnostic aids, which describe the causative agent of the disease, a researcher from the study explained.
Currently, the team is focused on creating a prototype of a diagnostic kit so that the technology is available for the mass-detection of the disease. The kit can be used to compile these panels of proteins for diagnostics and prognostic purposes. Once this prototype is ready, the team will compare the kit with the currently used RDT kits. The study involves a panel of proteins, which will help in the reduction of false-positive and false-negative results.
Since 2000, India cut malaria cases by more than half and the number of malaria deaths by more than two-thirds. Ending malaria remains a top government priority. In 2016, India introduced its first National Framework for Malaria Elimination (2016-2030). In 2019, the government increased funding by more than 25% for the National Vector Borne Disease Control Programme.
At present, malaria diagnosis is undertaken by manually studying the blood samples for the parasites which still has difficulty in determining the progress of the disease. In the case of malaria, P falciparum, P vivax and other species are not differentiable through RDTs and ideally need an expert eye along with intensive work of looking at 100 fields of blood smear using microscopy, the gold standard for malaria diagnosis, the researcher noted.
During malaria season, the number of cases is high, resulting in an increased burden on clinicians for manual diagnosis. If the diagnosis, along with the timely progression prediction from non-severe malaria cases to severe, before the development of clinical manifestations is made for clinicians, then the treatment can be specific and efficient.
Malaysia and Sweden have come together to introduce the Digital Health Innovation Challenge. Launched 15 January 2021, the Innovation Challenge invites start-ups registered in Malaysia to identify solutions in solving healthcare challenges, especially related to non-communicable diseases (NCD).
The initiative is a collaboration between Team Sweden, comprising of the Embassy of Sweden, Business Sweden and a British-Swedish multinational pharmaceutical and biopharmaceutical company; and Malaysian partners Sunway iLabs, Malaysian Global Innovation & Creativity Centre (MaGIC) and Malaysia Digital Economy Corporation (MDEC).
The Innovation Challenge is aimed towards identifying solutions that can empower NCD patients and high-risk communities to proactively reduce the risk factors of these diseases by encouraging healthy living and increase accessibility, on top of introducing digital tools enabling self-care and monitoring.
Start-ups that are selected to participate will get access to incubation programmes, global innovation networks, mentorship and funding, as well as an opportunity to collaborate with the above partners to solve healthcare challenges in Malaysia.
The Swedish Trade Commissioner to Malaysia stated that the Digital Health Innovation Challenge is a great opportunity for start-ups to explore solutions from multiple angles and to work with partners to exchange knowledge and scale-up across borders.
Adding to this, the country president of the pharmaceutical and biopharmaceutical company noted that empowering patients with innovative digital health care solutions and technologies is a major part of the firm’s focus. They believe that digital health is a means of making our health systems even more patient-centric.
For this reason, they engage in various partnerships to deliver next-generation health solutions. The Digital Health Innovation Challenge will certainly galvanise digital start-ups to develop new technologies and health care solutions that would meaningfully support our health system development and public health.
The Chief Innovation Officer of the Malaysian conglomerate company and its Innovation Labs director stated that it is important that the public and private sectors come together to solve societal problems.
“I believe that this initiative is a great example of how we can accelerate market-driven healthcare innovations from talented entrepreneurs by leveraging corporate testbeds and international networks,” he remarked.
The CEO of MaGIC added that collective participation and engagement from the government is needed – by its policy and mobilisation of resources; the private sector, which carries with it a wealth of expertise and scale to make a difference; and finally, the start-ups that are built to create impact and resolve these challenges through technology and innovation.
start-ups should take the opportunity to showcase their advantageous capabilities which are agile by design, and pivot during crucial times, she added.
For MDEC, healthtech is one of the key areas that the agency is looking to grow within its tech ecosystem. The CEO od MDEC stated that the challenge plays “a crucial role” in highlighting the capabilities of Malaysian healthtech start-ups.
“It also empowers them to create technological impact within the health industry that the pandemic is accelerating. By supporting programs like the Digital Health Innovation Challenge, MDEC will further ramp up the development and improvement of Malaysia’s healthtech ecosystem as part of the ongoing efforts to realise the vision of Malaysia 5.0 and establish Malaysia as the heart of digital ASEAN,” she concluded.
Applications for the Digital Health Innovation Challenge will be open from 15 January 2021 and will continue until 15 February 2021. Applicants must register with the Digital health Innovation Challenge Application Form and submit their proposal in accordance with the terms and conditions specified.
A team led by Dr K.K.Y. Wong and Dr Y.K. Choi at the Department of Computer Science of the University of Hong Kong (HKU) has designed and developed a multi-purpose IoT (Internet of Things) device named Stay Alert Stay Healthy (SASH) box which can be applied in multiple scenarios, providing a one-stop service for the public eager to stay safe during the COVID-19 pandemic.
The SASH box is built on the low-cost Raspberry Pi 4 which provides the computation resources necessary for hosting a lightweight server application as well as analysing the incoming data from its attached sensors.
It can be used to detect people with abnormal body temperature, whether they are wearing a face mask or not. It can also crawl updated COVID-19 information (e.g., locations of confirmed cases and required self-isolation cases) from government open databases to provide timely references for the general public.
The SASH box is equipped with LEDs, a speaker, and a consumer-grade thermal camera, enabling it to alert people to potential risks in the environment. The research team developed application components to enable it to operate as a multi-function device and a low-cost and effective solution for corporate and individual use.
Unlike hybrid thermal camera devices commonly used in the market, the SASH box is equipped with a single thermal camera but not RGB cameras to avoid compromising privacy. The team had collected and analysed over ten thousand thermal images and trained high-performance machine learning models to detect human faces with and without face masks using the low-resolution (120×160) thermal images captured from the device.
AI algorithms have also been developed for modulating detected temperatures to cater to temperature fluctuations in the surrounding environment and the hardware itself.
The SASH box is capable of retrieving up-to-date information, for example, COVID-19 cases, from online databases. The team is now developing speech recognition and text-to-voice capabilities in the device to provide easy accessibility for elderly people and people who are visually impaired.
Apart from working as a standalone gadget, the SASH box can also serve as a server and host useful applications for connecting devices. Users can easily retrieve information and monitor the environment in which a SASH box is located (e.g., households, classrooms, elderly homes, clinics, bus/taxi cabinets) in real-time by connecting their mobile devices such as smartphones or tablets from a remote site.
The design of the SASH box also allows ready scalability so that multiple devices can be connected to form a satellite network to facilitate sharing and monitoring of environmental data.
About HKU Faculty of Engineering
The Faculty of Engineering is one of the founding Faculties of The University of Hong Kong established in 1912. Since its foundation, the Faculty has kept pace with developments in the engineering world and is always at the forefront of engineering research, evolving into one of the largest Faculties at the University with five departments providing undergraduate, postgraduate and research degrees in a wide range of important fields of modern engineering, technology and computer science.
The Faculty aims at providing an all-round education for students, equipping graduates not only with knowledge of cutting-edge technology but also excellent communication and social skills, an innovation mindset, a lifelong learning attitude, professional integrity and international exposure.
Rajavithi Hospital in Bangkok has introduced a high-tech surgical robot to assist medical teams with a promise of better accuracy, and a safer and shorter hospital stay for patients.
Under the name of da Vinci Xi, the US-made surgical robotic technology is designed to assist surgeons’ accuracy during urologic surgical procedures. Highly magnified 3D HD technology allows surgeons to see a surgical site with improved depth perception and clear vision.
Meanwhile, the instruments bend and rotate for beyond the abilities of the human hand. With high motion technologies, the robot allows surgeons to operate with a steadier motion than is humanly possible, the company says.
The head of the hospital’s committee overseeing the surgical robotic system said da Vinci Xi is the most advanced technology in the country and is providing satisfying results.
Patients are happy with the operation done by the robot due to less pronounced wounds after operations. The robot’s technique helps patients recover quickly, reducing their hospital stay. That, in turn, frees up beds for patients, he said.
It was noted that the robotic arms are developed to be close to people’s hands, in terms of movement. “But the good point is that they can go deeper to small points [of the body] that need operating on without any limitations,” he added.
The hospital has launched 11 new operating theatres, including one room for the surgical robot. A surgeon requires at least 30 hours to be trained on how to use the robot, before performing an operation on a patient.
Many patients with cancer and complex diseases have already been operated on by the robot. The hospital says 85% of operations by the robot are related to diseases found in the throat, ears and nose, 11% for gynaecology, and 2% for prostate and kidney cancer.
There are eight surgical robots in the country at King Chulalongkorn Memorial Hospital, Siriraj Hospital and Ramathibodi Hospital. It is estimated that 5,270 surgical robots are currently working around the world.
The Chief of the Department of Medical Services stated that the hospital has over 6,000 walk-in patients per day and the number is expected to increase. The robot will play a significant role in treating patients who need complicated operations.
Robots are not only time-saving but also provide safety to patients by reducing direct contact between patients and medical teams, he said.
According to recent research, the market for surgical robots is expected to grow from US$6.7 billion in 2020 to US$11.8 billion by 2025, at a CAGR of 12.1% during the forecast period. Growth in the surgical robots’ market can be attributed to factors such as technological advancements, advantages of robotic-assisted surgery, increasing adoption of surgical robots by hospitals & ambulatory surgery centres and increased funding for medical robot research.
Based on product and service, the global market is segmented into robotic systems, instruments, and accessories and services. The instruments and accessories segment commanded the largest share of the market in 2019. The large share and high growth rate of this segment are mainly driven by the recurrent purchase of instruments & accessories as opposed to robotic systems, which are a one-time investment.
Based on the application, the market is segmented into general surgery, urological surgery, gynaecological surgery, orthopaedic surgery, neurosurgery, and other applications. The general surgery segment is expected to grow at the highest rate during the forecast period.
Growth in this market segment can be attributed to the increased use of surgical robots in general procedures such as bariatric surgery, Heller myotomy, gastrectomy, hernia repair, cholecystectomy, transoral surgery, and pancreatectomy.
Based on end-user, the market is segmented into hospitals and ambulatory surgery centres. The demand for surgical robots in hospitals is primarily driven by the increasing focus on carrying out surgeries with better precision and ensuring more comfort for surgeons.
Taking forward the learnings from a recent cyber attack impacting organisations all across the world, the Monetary Authority of Singapore (MAS) has rolled out a set of central banking rules to mitigate the technology risks in the financial sector.
The Monetary Authority of Singapore (MAS) now requires all financial institutions to assess the suppliers of their technology vendors. The updated guidelines apply to all banks, payment services firms such as GrabPay and Singtel Dash, as well as brokerage and insurance firms.
In a typical assessment, suppliers may be asked to prove that their software source code is rigorously tested and they do not use unsafe programming practices. Suppliers may also be asked to reveal their security measures and how often they monitor cyber risks.
Mr Vincent Loy, assistant managing director of technology at MAS, shared that using an external vendor which may, in turn, procure third-party tools brings significant risks to banking systems. “Unknown third-party suppliers are what MAS is most worried about… Financial institutions that do not allocate sufficient financial resources may be more open to unknown third-party suppliers,” he said.
The hacking of Texas-based SolarWinds, a leading provider of IT management software, had subjected hundreds of thousands of firms and government entities around the world to risks. SolarWinds’ IT management tools are common components in the products of many large vendors including Microsoft, FireEye and Cisco Systems.
Mr Tan Yeow Seng, the MAS chief cybersecurity officer, said financial institutions are increasingly reliant on third-party service providers as they adopt new technologies. “The revised guidelines set out MAS’ higher expectations in the areas of technology risk governance and security controls in financial institutions,” he added.
Straits Times reported that an assessment of third-party suppliers was previously not required under the MAS Technology Risk Management (TRM) guidelines, although due diligence on technology vendors was a must. The screening of component suppliers is now clearly spelt out in the revised TRM guidelines, which cover a wide range of topics to help firms fob off and recover from cyber-attacks and system failures.
Risks through the use of open application programming interface (API), a code that lets different applications talk to one another, are also addressed in the newly updated TRM rules. Banks have used APIs to automatically share foreign exchange rates, for example. This has allowed many external developers to build currency conversion apps using the data. Under the revised TRM rules, financial services firms must vet entities that access their APIs by looking at the nature of their business, cybersecurity posture, industry reputation and track record. They must also secure the development of the APIs and encrypt sensitive data transmitted to prevent leaks or hackers injecting malicious codes in the APIs.
In another key change to the TRM guidelines, the board of directors and senior management in financial institutions must vet and approve key technology and cyber-security appointments. “Organisations that do not have a good cyber-security posture usually do not have a board and senior management oversight for IT functions and key appointments,” said Mr Loy, citing findings of the central bank’s own audits.
Last revised in 2013, the TRM guidelines have been updated at a time of increased data sharing that underpins the sector’s digital transformation. The revision took in feedback from a public consultation in 2019 and other expert engagements. The guidelines elaborate on the mandatory requirements set out in the MAS TRM notice, first issued in 2013 and which carries a fine of up to $100,000 for non-compliance under the Banking Act. In the case of a continuing offence, a further fine of up to $10,000 daily may be levied.
Is happiness quantifiable? This is an age-old question that ancient philosophers have tried to answer. Even the meaning of happiness and motivation eludes an exact definition. For utilitarians, happiness is, in its rudimentary sense, the absence of pain and the existence of pleasure. For Aristotle, happiness is the highest good and is closely equated with virtue and purpose, a concept which he referred to as eudaimonia or an activity expressing virtue.
There is still no single meaning of happiness, more so now that the global economy is struggling to adapt to changes brought by the COVID-19 pandemic. In the realm of business, most companies are sustaining their momentum in digital transformation. They are scaling up their operational blueprints and adapting to the new normal of implementing remote workstations.
They visualise investments in technology and infrastructure to level up their game. However, many of these organisations delay investing in one key area of the workforce – the mental wellness of their employees, their level of happiness.
An Oxford study shows that a happy worker is 13% more productive. This increased productivity does not just benefit employees; it spills over to company profits and return of investments. Hence, the well-being of employees is equally important as other areas in business operations.
This is the same sentiment that Joye Founder and CEO Sanjeev Magotra lays on the table. Leveraging this perception, he found an innovative method to use artificial intelligence in tapping into the mental well-being of employees.
During an exclusive interview with OpenGov Asia, Sanjeev discussed that they have launched an AI-powered digital service to help map out employees’ level of satisfaction, as well as their emotional and mental state.
Joye was created alongside the company’s vision to attain what Sanjeev referred to as the “10,000-step mental health habit” which is equivalent to taking care of one’s self physically. Joye’s AI is trained to recognise users’ unique situations with extreme privacy, and it will guide you to the right care at the right time.
These suggestions include mood analytics and contextual behaviour tips, podcasts and mindfulness audios. This service tries to understand employees’ feelings through contextual nudges and uses data gathered from these interactions to formulate a plan that would help employees address their life stresses. It also allows them to keep track of their emotional and mental well-being on a daily or weekly basis.
Sanjeev further explained, “Our vision is that when you finish your video conference, and there’s a lot of stress in that video conference, we’ll pop up the Joye button to help you as opposed to staying stressed and becoming unproductive. We’ll help you immediately express yourself, self-reassess yourself and we will give you behavioural nudges to help you immediately turn positive.”
The idea behind the Joye application is not new. Sanjeev said that employers have long realised the importance of investing in employees. Employees have also formulated their routines in keeping themselves emotionally predisposed to life and workplace stresses by hanging onto their support systems and social networks.
What sets apart the Joye application is three-fold. At the outset, Joye is the first company to integrate a voice-enabled interface where individuals can express their feelings. This is in contrast to other apps that rely heavily on chatbots and not on systems that use voice responses.
It is also the first firm to insert this type of programme into a company’s existing mental health and employee engagement apps. Sanjeev said that they are looking at enhancing this feature of the Joye app by embedding it in enterprises’ video conferencing programmes especially during the new normal.
The more important distinction is that while most health platforms bank on mindfulness content or digital therapy and counselling, the Joye app employs a contextual behavioural nudge approach. Sanjeev stressed that “you say what is happening to you and we will tell you what you should do. We try to find out what is happening in your mind and what you should do at that point in time.”
He was quick to add that the Joye application puts a premium on privacy. Although it uses digital methods to gather and analyse employee data, there is still a cloak of anonymity that keeps these data private.
Sanjeev added, “Privacy is an important element of our design. We anonymise the data of the employee immediately after the session is finished, but we will keep the analytics so that the employee can see these data from time to time and that is a good way for the employee to manage their fitness over a period of time.”
Additional challenges during the new normal
The new normal is shaping the way many enterprises work, including looking for innovative ways to run their business workstations. Sanjeev emphasised that remote work opens up additional challenges that piles on top of existing stresses an individual is experiencing. This is where the magic of Joye comes in.
He also mentioned that the mind is the trigger of all actions and behaviour. The scenario is more amplified when working in a remote environment, as there are lots of new stresses and isolation working in the minds of the employees. This, he said, becomes an additional challenge to address.
The Joye application tries to nip future issues in the bud by addressing them at a time when they are small and inconsequential before they balloon into bigger problems that are harder to address.
As the world continues to trudge on during the new normal, some enterprises are adamant in investing in employee support technology like Joye, as they put more value on digital tools that can help streamline their operations. Sanjeev dispelled this notion by saying that investing in employee productivity does wonders to improve profits.
The Founder of Joye explained that: “if we invest in something like this, first of all, it’s a necessity in the remote working environment. Second, this investment has a very good return on investment in terms of improved productivity for the enterprise.”
Sanjeev concluded the discussion by leaving food for thought to employers. He reiterated that ultimately, employees’ mental health and well-being are crucial, more now as enterprises embrace a new remote working environment. To ensure that employees’ well-being is prioritised, Joye offers a quality solution. What differentiates it from other apps is that it helps the whole employee population and not just a small number of employees who are in most need of support. Their tool, he added, is for all 100% of employees who experience stress and anxiety daily and this can be overcome by engaging the workforce through a platform like Joye.
A Hong Kong Baptist University-led (HKBU) research team has launched an online cognitive behavioural therapy (CBT) programme called “EASE Online” to help people with a social anxiety disorder (SAD). It incorporates virtual reality (VR) scenarios that are common triggers for social anxiety, allowing participants to respond as they would to real-life situations and receive counselling services from mental health professionals.
The programme is recruiting 600 participants aged 18 to 70 with a social anxiety disorder. It will also provide training to around 100 local mental health professionals on how to operate the programme, to serve more people in need in the long run.
Blended mode of counselling to treat social anxiety disorder
People with social anxiety disorder are characterised by excessive fear and anxiety which are disproportionate to the social situations they encounter, such as meeting someone new, eating or even making phone calls in public. This overwhelming fear can keep them away from social contact and prevent them from seeking counselling services.
Dr Pan Jiayan, Associate Professor of the Department of Social Work at HKBU, who led a team comprising investigators from the Department of Social Work and the Department of Computer Science at HKBU, has developed a 13-week programme called “EASE Online” to help them cope with social anxiety and improve their quality of life with CBT. CBT is goal-oriented psychotherapy that helps people cope with life challenges by adjusting their patterns of thinking or behaviour.
Having started in 2020, the four-year EASE Online programme will run until 2023. It adopts a blended mode of service delivery including both online and offline counselling. The online service comprises nine weekly online modules delivered on the programme website or mobile app. The online modules include a briefing on CBT skills, case demonstration videos, exercises and feedback, a forum and self-assessment.
Integration of VR exposure therapy
The counsellor will provide three face-to-face sessions plus two telephone follow-ups to supplement the online service and review the service progress. VR exposure therapy will be adopted in two out of the three face-to-face sessions. The research team designed five VR environments that reflect real-life scenarios, such as giving a presentation and attending a job interview, for participants to experience the anxiety and fear associated with such settings.
These scenarios are designed by the research team and delivered in Cantonese. They are adapted and produced from local cases to fit the language and cultural context of Hong Kong.
Therapist-guided VR exposure therapy is an intermediate treatment step for SAD clients that exposes them to real-life social situations. A trained counsellor will guide participants in person throughout the exposure process and provide a debriefing for them on a variety of strategies as well as advice on how to tackle social anxiety.
To evaluate the effectiveness of the programme, participants need to fill in an online questionnaire upon completion of the programme, and at three- and six-month follow-ups, respectively.
Novel alternative tackles social anxiety
“Social anxiety disorder sufferers feel more than just shy or nervous in certain social circumstances. Their difficulty in building up good social and interpersonal relationships brings them unspeakable pain,” said Dr Pan.
Online counselling and VR exposure therapy create a safe and non-threatening environment for people with social anxiety to learn how to cope with fearful social situations. It is especially suitable for those who do not want to be stigmatised by society or cannot afford traditional face-to-face counselling services. The team hopes that the EASE Online programme will bring SAD sufferers’ social life back on track, Dr Pan added.
The programme is supported by a grant of more than HK$6 million from the Research Impact Fund of the University Grants Committee and HKBU. Besides investigators from HKBU, the EASE Online programme team also includes researchers from the Department of Psychology at Stockholm University, and the programme has also partnered with the Richmond Fellowship of Hong Kong and the Caritas Wellness Link – Tsuen Wan.