Care On Our Own Terms

As Kaveh Safavi of Accenture continues his annual look at our global healthcare, we look at the changes that healthcare providers have to face up to, and ask – what are they afraid of?

Fear manifests itself in a number of ways. The traditional route in surgeries and hospitals, is to stick to the status quo. Nobody gets fired for doing what they always did. or to put it more directly – burying one’s head in the sand. As said above, nobody gets fired for being myopic.

I “get” that fear of the unknown, is relevant. But fear of what we already have, and which the public are increasingly demanding – should be a wake up call. The question is, – is fear of progress created by simple lack of understanding.

People that know about these things in UK NHS Management, tell me that “the NHS will be fully digitalised within the next 20 years”. This is both 20 years too late, and also misunderstands what we mean by digitalisation, and what you and I increasingly demand from our healthcare providers.

For a start, just about all of us in possession of our Apple Watch, our Smart mobile – are already capable of managing our own health and scary symptoms, in real time, online, thanks very much, from the comfort of our armchair. When we call our Doctor, phone our hospital – we already have the data, personally and as consumers, of our own health situation. And moving on – as patients, we do not need the large corporate AI to automate the personal data that our hospital does not yet have. What we need, is the immediate link between our personal way of life, and people who know how to treat us at a place called a hospital, when we get sick.

So when Kaveh Safavi, Health spokesman at Accenture – says in his recent Seminar at HIMSS Europe – that patients are now increasingly moving away from traditional routes to health provision – he is sounding a warning bell. And he has the global numbers to prove it.

What he says is, – is that trad primary care is in decline. In the years 2013-2017, use of virtual access to healthcare, rose in the USA by some 200%. Already, in the UK, some 33% of the population go online to access our healthcare provider, at least once per year. In Finland, some 67% of the population would gladly get their healthcare access online – if only the infrastructure was there to do so.

But interestingly, – what Kaveh eloquently also says is – this is no cause for alarm. It is simply that, as patients and that dreaded word “consumers”, we are making lifestyle choices. It is not a case of “either/or”. Or “A or B”. It is a multiple choice of A-B-C-D-E, and these choices are based on what is the best availability of the healthcare that we need, that fits our lifestyle. So, if we prefer to drop in to a walk in clinic at our train station en route to the office – so be it,- as long as they have access to our data. Some regions are already recognising this Scénario. In Spain, some 33% of the population go online for virtual healthcare, and a further 83% prefer a retail environment to get primary care access.

This means two things; first – if we believe that prevention is better than cure, then investment and recognition needs to go into the provision of consumer based services. As said above, the growth of smart phone solutions means we are all doctors now. And that second, there is nothing to fear from a mix of healthcare provision at our local hospital. You could argue that the relevance for a hospital will increasingly be the provision of every level of walk in service, in the same way that supermarkets in Sweden offer walk in healthcare.

I’m sure Steve Jobs did not envisage the tangential App development in our personal lives, when Apple launched the iPhone all those years ago. But we live in a real world. And if you are reading this article on your ipad as you travel to work – well, that wasn’t too scary now, was it?

Managing Energy has never been more important.

We look at the upcoming Future of Utilities: Smart Metering Update 2019 conference on Smart Metering of Energy and ask – why has it taken so long?

In brief – this topic has been discussed and received focus – for the past five years even to our knowledge. But in those earlier halcyon days, small interruptions such as hacking and global warming were but twinkles in our eyes. Nowadays of course – things have changed. As my colleague at a Cyber Security company in Israel tells me – “there are two types of smart meter; those that have been hacked and nobody knows it; and those that are hacked and everybody knows it”. And for sure everybody knows about global warming.

So the upcoming Conference from Marketforcelive, in central London this June, is timely. This is the latest and important opportunity for leaders in the Energy space, to sit down and say – how are we controlling access to the flow of energy, both remotely and at source. Saving energy has been defined as the secret sauce of modern energy management, We are not as naive as before.

Whereas before, delegates that subscribed tended to come from the pure data and tech environments and talked in a language that you or I could not understand – nowadays, this Conference will attract the commercial leaders and all those on the peripherals. Energy control is essential big business in a world where such is the reach of media, we are all experts now.

With an impressive Speaker List – we expect “Future of Utilities: Smart Metering Update 2019”,to become a Forum for exchange of ideas that are proven and that work, a significant development from other Conferences in the past that were merely talking shops.

The Conference takes place on the 18th June; go visit it at; http://bit.ly/2wGAiqZ. our longer report will follow shortly after.

Conception and Reality

We explore the magic at the Fertility Fusion Clinic in North West UK, and see how their Team create success for their patients.

The conversation is already ten minutes old – before the flood gates open.

The young lady, in her mid thirties, has been biting her tongue for some moments before there is the first visible welling in her eyes. The girls at Fertility Fusion are experienced in softly opening a dialogue but time is not on their side. They have to get to the point. Like so many couples, this elegant woman has travelled for more than three hours to attend this Conference, for her moment of discussion with people who can make a difference, because for her too – time is not on her side. The Fertility Fusion clinical manager, a younger lady – gently steers the woman away to somewhere quieter;
“Let’s have a chat”. She says.


For most people, the magic of conception is clouded and clothed in happy images, of intangibles, of Storks, or “twinkles in eyes”. This only serves to accentuate the feeling of disappointment when for so many women and men – it just doesn’t work out. Whole relationships crumble under this augmented pressure. Couples that attend a fertility conference are brave and are there for a reason.

Fertility is big business. At a time when CCGs are increasingly walking away from IVF financing, the “fertility” industry has been quietly growing and expanding, with a plethora of contradictory information, all aimed at couples who are emotionally ready to part with large sums of money to whichever expert reaches out to them.

The Fertility Fusion approach is noticeably different. First – there is no discussion of money – in fact the opposite. Once the opening scene-setting has been established – “where are you at the moment?” – the clinicians look at what NHS funding is indeed available. For some couples, this is an issue, and whilst Fertility Fusion might indeed be in the business of delivering dreams, we are now at the practical end of the discussion, almost in reverse from what people expect.

Couples need their hand held. The girls at Fertility Fusion patiently explore the clinical options – and are straight and to the point. Couples need to know factually their options, and if this involves bad news, there is no value in hiding that. Individuals need to be told the dangers of their lifestyle. For some patients – they would prefer to be in denial. The Team at Fusion are years experienced in this fine balancing act of how to deliver information.

And this translates into measurable success stories. Fusion Fertility is currently the most successful of regional clinics, and couples and individuals come form across the UK to be treated.

On the opening conference day when I was there – there is a steady trickle and then a flow, of couples, of same sex partners, of single women, of confused men. And I am a guy, a voyeur – a disinterested onlooker, from a distance. For these discussions at heart, are woman to woman.

The men shake my hand warmly at the end of their discussions with the Fertility Fusion team – even though I have done nothing and neither have they. They want to be involved but they do not know how to. Shaking my hand gives them a value.

I have to leave to get my train. My daughter calls me; “Can I borrow your Volvo?”. I love my Volvo – but this is not the time to get picky. “Yes of course dear; I filled it up last night”.

I am a lucky guy.

Fertility Fusion can be contacted at; fertilityfusion.co.uk

ENO CONJURES UP MORE MAGIC


We review the first night of the favourite Mozart’s “the Magic Flute” at the London Coliseum.

Ever since my days at University and falling in love with the Magic Flute even as a teenager – Mozart Opera has always held a special place in my heart. In the same way that “relationships” need constant adjustment and spark – so the magic of ENO is its re-interpretation, at every level, of the Operas that it performs.

This was my second viewing of this original production. But not for my two ladies who sat next to me. This was their first ever opera performance. They chose the right topic and evening.

This performance was sharp, very well constructed, the classic ENO minimalist approach of letting the performers take you by the hand on the journey, the mix and almost conversations of orchestra and protagonists, and particularly principal flautist Claire Wickes wandering into the stage in dialogue with Papegeno.

The sudden-ness of the orchestra kicking into life as we start with full lights on in the auditorium – to grab our attention, and the humour of the Chaplin-like screen writing, tells us everything we need to know. This is no classical Mozart. This is Mozart made modern.

You can only do this, of course, if you have the professional immaculate singing. ENO excels at the Chorus, the groups of singers. And yet this was the area that for me was the least convincing this time around. It took a while for the Three Ladies to get into gear – but this is to be picky. I loved Lucy Crowe as Pamina, and Rowan Pierce later on as Papagena is always funny and spot on – she gave a brief synopsis of the approach when she sang just a few months ago at the ENO Celebration Evening.

ENO is always very clever and relaxed when it does Mozart. This “Magic Flute” is up there in competition with its staging and performance of “Cosi Fan Tutte “ a couple of years ago.

It is a performance to enjoy as an old friend. But it is also for newcomers. One of the key aims of ENO is to widen the approach to a wider audience. My ladies sitting next to me, were not disappointed.

Raising your Voice

The things that we already take for granted in our private lives, the “hey Siri” – the access to Alexa, – and untold information simply by asking a machine that sits by our bedside or we carry in our pocket – also can deliver big savings in time and costs when used in healthcare.

It’s been a while in coming; but now that clear uses have been developed that deliver benefits for the man in the street – now is the time for Community clinics and Hospital Outpatient areas, to take this seriously.

We focus on the latest, that is already clinically proven across the USA; this is what they say…

-Orbita, Inc., provider of the only HIPAA-compliant platform for voice and chatbot applications in healthcare, today announced through its collaboration with Mayo Clinic, the availability of Mayo Clinic’s award-winning first-aid voice application on two additional platforms:  Google Assistant and voice-powered web chat. This takes Mayo Clinic beyond its initial foray into voice with the Mayo First Aid skill for Amazon Alexa, and provides new capabilities to deliver first aid content via Google Assistant-enabled devices and a voice chatbot offered at www.mayoclinic.org.

“Expanding the delivery of Mayo Clinic content through more voice channels helps give consumers ready access to trusted health information where and when they need it,” said Sandhya Pruthi, M.D., general internal medicine physician and associate medical director of Mayo Clinic Global Business Solutions. “We’re pleased to continue innovating with voice and exploring its value to enhance patient and consumer engagement.”

Research shows consumer adoption of voice devices is exponentially faster than web and mobile predecessors. This bodes well for value-based health care where improved patient engagement aims to translate into quality improvements and cost reduction. 

“Mayo Clinic is sharing these new offerings just weeks after buzz at CES that the AI-powered virtual assistant, Google Assistant, would be on more than one billion devices by January 31, 2019,” said Orbita CEO Bill Rogers. “Clearly, voice is here to stay. Orbita is honored to collaborate with Mayo Clinic in exploring new voice opportunities for health care.”

At HIMSS, the health IT event bringing more than 45,000 attendees to Orlando, Fla. this week, Mayo Clinic and Orbita are highlighting:

  • Mayo First Aid for Google Assistant: Users of Google Assistant can tap “account”, then explore to access the “Mayo First Aid” action. After saying “Hey Google, Talk to Mayo First Aid,” they proceed with asking a question such as “How do I treat my baby’s fever?” 
  • Mayo First Aid Web-based Voice Chat : The same content and experience currently available through the Mayo First Aid Alexa skill and now Google Assistant, is also available via web-based voice and chat at  www.mayoclinic.org/voice/appswww.mayoclinic.org/symptoms, andwww.mayoclinic.org/diseases-conditions on web and mobile browsers that support voice input. Unlike most of today’s chatbots, which are only keyboard driven, this new Mayo First Aid Voice Chat experience offers an integrated voice and text-based interface.

These solutions join the Mayo First Aid Alexa Skill. Last month at the Chattanooga-based Alexa Conference, event organizers selected Mayo Clinic First Aid for the 2019 Alexa Skill of the Year for Healthcare Award. Orbita received the 2019 Best of Show Bronze Award and the 2019 Best Third Party Tool Award. 

The Future of Finance 2019

We look at changes that need to happen in 2019, if Financial Service providers can actually “provide” what you and I want.

The upcoming Future of Finance conference at Hurlingham London in a few weeks, is a landmark – a pointer in the sand if you will, a meeting place where key decision makers in the financial industry can meet to discuss well, where is their market going, and by implication, where are they themselves going?

There is a suspicion that actually, they are not going anywhere. This is reasonable or understandable. It is far easier to paper over the cracks, and this is seen in the way such organisations create “transformation teams”, but still retain the same people and attitudes;  change people’s job titles, play musical chairs with executives, or focus on costs savings – but still carrying the same methodology and still looking at costs instead of looking at efficiency. The two are not the same.

Yet there are two areas that can make a difference, and they simply require a cool look at how you and I behave. In particular; how do we prefer to access our financial info; and what sort of info do we want to have. 

Key vertical market in this, is the rise of the self-service private client – the guy who has savings but where the return on investment is nothing when compared to actual portfolio investment. Surely there are now sophisticated tools that can algorithm all this stuff for the man in the street? Indeed there are. The Tetralog company in Munich (as an example) focus on this sort of Robo Advisory that still retains the use of the face to face Advisor – but gives the client the info in a way he can understand and monitor, automatically. There is nothing worse than seeing graphically how your savings otherwise  are gradually deteriorating over time.

Equally important, is the tangential thinking that wakes up to the fact that, with mobile technology, we are all different now. The irony is that this is not a tech discussion, but a business discussion, by people who may not necessarily be financial – but who can spot how people want to work in the future. Richard Copland, formerly CGI Logica and now Partner at The Futureshapers told me; “ executives no longer have time to take a pause or have the courage to throw out legacy solutions, or legacy ideas”.

But throw things out, they must. And this includes being very open to new ways of doing things. 

We expect the winners in 2019 to be those organisations who are prepared to back their hunches, and the losers? Well, they will be the ones who carry on as before.

Have a Happy and Healthy New Year!

And Let’s Help Set The Nation on Course For a Healthy 2030! We publish a great Post from the NEHI team (Network for Excellence inHealth Innovation) because it links innovation to achievable you and me health aims for the year. Based in Boston, USA- this is something we all can aspire gto. Great idea; this is what they say:

Every decade, the federal government’s Healthy People initiative develops a new set of science-based, 10-year national objectives with the goal of improving the health of all Americans.

The U.S. Department of Health and Human Services (HHS) is now soliciting written comments regarding the Healthy People 2030 objectives. The public comment period is now open through January 17, 2019.

Members of the public can comment on the proposed HP2030 objectives, and can also propose their own objectives. You can get more information on Healthy People 2030 and this public comment period by clicking here;

Previous public comments on the proposed Healthy People 2030 framework helped shape the vision, mission, foundational principles, plan of action, and overarching goals for Healthy People 2030. In this public comment period, HHS would like input on the proposed Core, Developmental, and Research objectives.

Please don’t miss this important chance to have input into this once-a-decade process to help shape the nation’s health goals!

In response to stakeholder input, Healthy People 2030 will be a streamlined set of national health objectives guiding the Nation in efforts to improve health. Heathy People 2030 will continue to represent critical public health priorities by addressing the leading causes of morbidity and mortality and driving action at the national, state, and local levels.

Again, Happy 2019!
The NEHI Team

Financials are changing. Is 2019 the Year of Wake Up?

As more and more high street stores close, what does it take for us to realise that our entire financial landscape is changing?

The man sits opposite me in one of Edinburgh’s posh hotels. He is CDO of one of Scotland’s. main finance tech  companies,  and says; “You know, Richard – young people – our Millenials – won’t go to brokers any more, as you and I might have done. Their app on their phone will do their search and recommending for them – and it will be more intuitive and better informed, than any independent adviser that you care to meet”

I am in Geneva and my colleague leans across; he is CEO of one of Switzerland’s main Consulting houses – and  almost conspiratorially he says; “Our Generation Z have no material aspirations or rather, do not see value in actually acquiring the objects of desire that has driven consumer manufacturing for so long.  Aspirational values will be what their peers think of what they do or how they do it – rather than the expensive object that their parents could have chosen.”

These two statements are either damaging – or opportunistic. It depends on how you want to see them. One of the reasons for the decline in our retail environment, is that said retailers have not woken up to the fact that their market has changed.  People are still spending money. They just don’t spend it on the same things as before, or rather, they do – but in a different way. 

But it goes deeper than that. It is a change in how our future generations see life, where you do not have to own a car to be able to “enjoy” driving  a car; where simply being able to “be” at a cool place, wherever that might be – is more important than your ability to fly biz class or your upgraded loyalty points.

Current forecasts are that we will all be eating out more, but what that means is that we will order in our food, and eat at home rather than actually “go” to a restaurant. dinner will be prepared on some industrial estate and wizzed to us by a guy on a bike.  I can’t think of anything more horrifying, but here I am at family dinner when my son wants to eat Italian and my daughter wants to have vegan and I want Chinese. 

Maybe it is time to stop crying over the demise of the High Street – and start to welcome the changes that can revolutionise our high street experience.  Because the one thing that is staying the same, is social contact. People are once again appreciating that actually getting together, is far better than purely relying on our social media giants for proper communication.  So maybe life is now a compromise of all  things hybrid. Because,  after all – even if we eat different food – we have to eat it somewhere, and we will get our mortgage and buy our shares etc, from the nice lady hologram  on our mobile phone as we eat.

Lucia Di Lammermoor. A Story for Our Times


We review the English National Opera first night of this dramatic Donizetti masterpiece and say that – in the “MeToo” current world,  this is a production you have to see.

There are academic articles and opinions of the role of women and heroines and Prima Donnas in Opera, into which the creation of “Lucia” as an Opera, is designed to play a part.  This comment is not one of those. If you “get” that the fusion of music, and drama, is the key entry into deeper areas of  our soul – then the standout performance of Sarah Tynan as “Lucia” is one of the most phenomenal performances I have ever seen in all my years of watching opera.  This is a performance that you have to see, and you must say to your grandchildren that “you were there”.

How so?

Because Sarah’s interpretation rises above the protagonists around her, the wall of never decreasing orchestral and chorus support. It is a tour de force because right from the start, there was never any gentle introduction. There is angst even from the first scene. There was never going to be a happy ending.

This feeling of tragic helplessness, is enhanced by the oversized dimensions of the staging, with Lucia deliberately petite, vulnerable.

This “Lucia di Lamermoor” is drama supported by music. In many ways, the music never reaches the heights of melody of Mozart – or better insight into human nature of say Puccini, or Berlioz – and at times I just wished there was a melody that I could remember on the tube train back to my hotel. The music frequently pauses and moves into one aria after another, but it is not until the last Act does Lucia’s aria steal the show, so to say.

But this misses the point.

This production, particularly with Eleazar Rodriguez complementing Sarah with visible chemistry, is about drama and human emotion. It is riveting. At no point does the intensity ever stop, and at no time does audience appreciation ever waver. 

If you asked random people in the street, who would be their favourite composer – the name of Donizetti would hardly figure. And this is a pity. “Lucia” portrays humanity and the female situation, in a way that has hardly changed even now. I am going back to see this again – and so should you.

ENO; OPERA FOR ALL. It has always been thus…


We look with pleasure and amazement at the past 50 years of English National Opera  at their Gala Performance earlier this week.


I am fifteen years old. My cousin – who is at least five years older and a real Student – calls me. “Hey – I have two tickets for The Mastersingers. Wanna come?”


I don’t know what a Mastersinger is – and I say so. “It’s an Opera”, he says. I don’t know what one of those is either, but now is not the time for that discussion. “Sure” – I say: – “I’ll come straight from school”. The performance starts at 5pm apparently. It means catching the suburban bus, the local train into london, the tube to Islington. The place is somewhere called Sadlers Wells.


I hadn’t given much thought to this. Only when I got to the opera venue did I realise that The Mastersingers is some five hours long. It means hitching a ride back home through London. A local taxi picked me up somewhere in the street as I started walking. I’m sure there are laws about this sort of thing nowadays. I told my Mum the next morning I had a wonderful time.


I didn’t have a wonderful time. I had a change of life experience. I saw people singing and creating a life ambience – from nothing. I felt emotions I never knew existed. I discovered I could go to the pub on the corner and buy a shandy, no questions-asked. I could wear my jeans at somewhere posh. I could visualise a new musical dimension.


My cousin called me some 50 years later. “Did you get those tickets for the new production of The Mastersingers?.” This time, we are the ENO Coliseum, the grandeur, the sense of a journey as the orchestra starts to play – has not lost any of its ability to stir up excitement.


And that is the secret of ENO Opera for All. Once you walk through that door – there is no turning back.


The idea espoused by the current ENO Management that this is some new concept – is beautiful in its outreach, but it misses the point that ENO was always this. The only difference is not concept but one of scale.


The ENO Gala Performance brought together established Artists, but also showcased the upcoming Harewood Performers, who are every bit as exhilarating, – and finally focussing on the latest ENO prodigy who is still at School just finishing GCSEs. The future of ENO belongs to the new people, who are young enough to have completely new ideas and ambitions, better and newer communication skills.


Key at ENO is to be the Family. The Drop Off point at whatever stop you have reached on your opera journey. This is not a London based chic concept for SW1 – this is for pan -UK.


I sat next to two people at the Gala, who by total chance are the neighbours to my Music Professor when I was at Uni. We had never met before, but it was like a meeting of old friends, the strands of common ground, across different generations.


I took a moment of thought; if only my new neighbours in the Stalls had been there all those fifty years ago – perhaps they could have given me a ride home?
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