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.

Can We Celebrate 70 Years of the NHS?


As increasing numbers of ordinary people move away from this cherished institution – we ask the question – why do they do so?

This is not about private medicine and public services. The UK NHS and its principle guardian of healthcare – free to all – at the point of delivery – is the cornerstone of just about every UK and European belief that healthcare is a public right – not something that you only get if you can afford it.

Fair enough.

The problem is when you put that into practice for the ordinary lives of people like you and I. The principle might be ok but – well, if other places are offering something better, and its within our price range, we are going to choose whatever that something else is.

And so they do.

At the recent Employee Benefit Fair in London just a couple of weeks ago, of the 115 Exhibitors, some 30% were all offering private walk in Doctors facilities.  And the services they were offering were better, than their NHS counterparts, particularly in areas that can be monitored remotely by smart technology on the wrist of all of us. As the provision of healthcare moves away from hospitals into a more community based environment, if for just a few bucks a  month, say you can have your diabetes monitored every day, in real time – or your heart and blood pressure similarly managed – does it matter that you never get to see a real Nurse?  All you want is the Nurse to call you when things look wrong – and for you to be able to drop by as you pass thru the local train station en route to work.

So why do so few NHS Hospitals and CCGs want to adopt similar practices?

The problem is twofold; if we can  solve a specific problem, with  technology, using half the nurses – then we can schedule the remaining nurses somewhere else where there is a greater need. Except that clinical grass roots staff have a fear of change and a fear of losing their job. And Managers have a fear of losing their nurses – and their silo based budgets.  As long as they have lots of people coming through those hospital doors – the money will keep rolling in.

And second – we regularly get emails and responses from NHS senior Managers saying;  “Sure, come by for a conversation, but not for a conversation that means we have to do something”. There is this misplaced belief among so many NHS Managers that as things have always been done this way – then life will continue to be done this way.

Not any more.  

We are seeing already that the public is voting with its feet. Sure, its a small beginning – but its a beginning none the less. As a senior more enlightened NHS Director told me – “we cannot keep trying to squeeze 100 appointments into the time reserved for only 40”.

There will become a time, sooner rather than later, when the public itself will start to wonder why they are paying any money for public healthcare at all. By then of course, it will be too late.

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IS DIGITAL TRANSFORMATION MISSING THE POINT?

We focus on the upcoming IP Expo Europe Conference at Excel London  and ask the question – are consumers being left behind? 

If so, this would be a pity. It is no coincidence that IP Expo Europe is just a few days before the Chinese IRC Retail Conference also in London, whose view is;  With the challenge of slowing retail sales, international expansion is key to maintaining double-digit growth.

The emergence of the Chinese eCommerce market, in a country whose GDP is constantly growing, is a clear opportunity to Re:Generate retail. Today’s QiXi day – the Chinese equivalent to Valentine’s day – is poised to generate record growth in international eCommerce sales. In other words, ECOMMERCE can drive retail.

The problem is, that’s not how ordinary people are viewing this. It’s not just Consumers, although there is  a dawn of realisation in the minds of the general public that the great benefit of online retail might also be killing the social high street that binds society together.  Maybe going shopping wasn’t so bad after all?  When one third of all the things that people buy online, are routinely returned to their sender – and there are more charity shops than thriving retailers – perhaps we are missing something in the way we describe and market “digital transformation”. Transformation might not necessarily be for the better.

The same feeling is also spreading into our public sectors; increasingly we are seeing new “digital transformation” labelled projects, that are little more than typing our patient records into someone’s Windows 7 desktop.  The NHS has “ringfenced” (oh please, don’t be naive) – money for “digital transformation” that will simply throw money at projects its hospitals were going to do anyway.  Digital Transformation is great PR.

At a time when emails no longer carry the same immediacy as they originally did – and it is now better to communicate sending something called a Letter in the mail – are we missing the point in thinking that everybody of course knows what blockchain is? Or are we blinded by selling technology to ourselves, when we are forgetting that what people want are the benefits of said technology? What that  technology is  – is irrelevant.

And that’s the point. IP Expo Europe  is not addressing consumers. It is a platform for the vendors of said technology, to show us the best ways of delivering business benefit.  We as “consumers” of technology should know how to translate that into something our own customers will understand. But to get there – we need the face to face, the casual conversation, the in depth presentation – with our peers – that will show us better ways to get where we ourselves need to go.

This may in turn reflect back into our struggling retail market, as long as it is a catalyst for methodology change, marketing people to get together. In short, the key to overall success, is a mix of the two -ECOMMERCE drives face to face retail.

We expect the greater awareness of vendors and delegates at IP Expo Europe will bear fruit in the change in the way vendors market what they do, and organisations handle their consumer data, in particular, becoming more open to international business – which will in turn drive the very retail sectors that are under pressure. 

If so, then Digital Transformation can start to create social good in the very areas that have been left behind. 

LIVING WITH GDPR; HAS LIFE MOVED ON?

We look at the upcoming Chief Data Officer conference in London and ask; are we getting bored by all this?

Yes, indeed we are. And that’s the problem. And it makes us immune to the real issues of handling our corporate data, because, frankly – if we ever see yet another request from a company we have never heard of, to “opt in and remain on their mailing list”, – when we never knew we were even ON their mailing list – then we would be forgiven for jumping out of the nearest window.

Depressions were never as bad as this!

The answer, is to take a balanced view. I absolutely “get” that there are still some serious issues as to how we handle our personal or restricted data and that these aspects have not been universally solved.

But let’s not miss the real opportunity – which is; there are new and better ways to handle our data. Wake up calls are great if we do what the name suggests, ie – we actually “wake up”!

Looking at the Agenda of governance, emerging technology, and conceptual avenues of strategy – the upcoming CDO conference promises to move us along, in the directions that we now need to be heading.

If the profile of delegates attending, is as expected – then this is a forum that our decision makers in business need to attend. Decisions are based on looking forward as much as the experience of looking back – but let’s not dwell just on those experiences.

The key thing about the CDO is as always the interim networking, the casual conversation, and our guess is that this will always be the same. But the blurb from the good people at IQPC is that things have moved on, and that this is the discussion platform that will take us there. Pillows and blankets will not be provided.

Our longer Report will follow shortly.

CARE ON OUR OWN TERMS.

We look at how patients are becoming consumers and are driving the growth of virtual technology in healthcare.

One of the most relevant discussions for the future of UK healthcare, was not taken in any formal setting. My colleague was not visible on my Skype screen, and I was some 500 miles distant, sitting on my sofa, drinking tea.

It is an irony that is not lost on either of us. At a time when the key assumption of the benefit of the HIMSS  2018 Conference, is face to face interaction, my counterpart Kaveh Safavi of Accenture is eloquently discussing the essential benefits of his Presentation on virtual healthcare, that he made just a few hours earlier sitting in Barcelona; and I am nowhere to be found.

“Virtual healthcare” has taken over as the buzzword from the more difficult term “A.I”, which nobody could understand. And it is not before time. If the WHO is saying that by the year 2030, we will have a shortage of some 15 million healthcare professionals – the one thing we don’t need is to carry on putting in place more and more clinics, with longer and longer waiting times, for an ever increasing number of patients, with nursing staff that we do not have. Better option is first enabling our existing resources to work optimally.

We have reached a critical moment where the population (that’s you and I) – are increasingly comfortable using our smartphones, our Apple Watches, our connected meters, etc – to deliver our our health data to responsible health people who can manage this. But our health service providers are standing still in their acceptance that things have to change. And so, if this remote interaction works – and the technology exists to bring health data remotely into the distant screens – why is the rate of traction in Europe and certainly the UK – so slow?

The answer is many and varied, and it comes from not communicating the benefits – and also a myopic fear on the part of our providers, of losing their jobs or reducing their salaries. From experience of automation in the commercial sector, neither of those latter scenarios actually would take place.

So far, virtual healthcare has been limited in its explanation, to automatically registering a patient appointment – to go to a clinic, let’s say. But this misses the point. The real benefit is far deeper than that. If we associate virtual healthcare with long standing conditions, let’s say Diabetes for example – (where remote tech is now starting to get traction) – patients and providers will get the immediate benefit of more rapid diagnosis, more motivated and engaged patients, far less cost per patient in monitoring. And they need never visit a clinic at all. In some clinics, holograms have taken over from even seeing a real person.

In short – virtual healthcare is convenient. It also increases the “quality” of the service provided; Because sure if things are wrong and your data is untoward – only then do you go to your clinic, and your Nurse will have far more time to see you, and your discussion will already be personalised and entirely based on the health data you have already sent, in real time, through the very technology you are already wearing on your wrist. You will not be rushed out of the door.

I take a pause in my dialogue with Kaveh and glance at my Apple Health app on my watch – my heart is beating a bit quicker, apparently. I think I’ll take another cup of tea.

COCIR launch new Healthcare Roadmap in Brussels.

There is a great deal of benefit from being connected with our nearest neighbours and being aware of and part of their healthcare initiatives on a broader scale.  We are pleased to publish the latest announcement.

The Integrated Care Alliance (ICA), of which COCIR is a founding member, has launched today its ‘Multi-Stakeholder Digital Health Roadmap’ in support of Integrated Care. The Roadmap is being launched at the 18th International Conference on Integrated Care in Utrecht hosted by the International Foundation for Integrated Care (IFIC).

The Roadmap follows up on the ICA’s successful Call to Action ‘United Towards Integrated Care’ launched in the European Parliament in June 2016. The ICA partners have worked through the points identified in the Call, recommending measures in four key areas; health policy, new care models, skills and training as well the use of digital care technologies. It also identified the need to build capacity to execute these measures at all levels – European, national and regional. The partners are also inviting those other stakeholder organisations that play critical roles in the integrated care value chain to become part of the initiative.

The publication emphasises the vital role that integrated care will play in reorienting healthcare delivery, creating systems designed to meet the needs and demands posed by an ageing population. At a time when budgetary and human resources are becoming increasingly scarce, an integrated care approach directs resources to where they have the greatest impact. Using the principles of integrated care systems engages citizens, makes provisions for patient education and allows primary and secondary prevention along with early diagnosis and intervention. Digital technologies and services can help ensure appropriate care is readily accessible outside the hospital setting.

Nicole Denjoy, COCIR Secretary General, said; “This Alliance will be key to accelerating the successful transition and scaling-up towards an integrated care mode. The multi-stakeholder approach brings the variety of approaches and insights that we need. It also provides the partners with an ideal platform of communication to share best practice and adds to the existing momentum provided by the ICA’s 2016 Call to Action. As one of the founding members of the ICA, COCIR is committed to making the work of this Alliance successful.”

The ICA is committed to strengthening and expanding integrated, sustainable health and care services across the EU Member States. The Alliance is made up of multi-stakeholder experts dedicated to sharing their experience and expertise while providing direction, advice and guidance for establishing and consolidating integrated care schemes.

By 2021, the Alliance aims to make innovative and interoperable digital care technologies central to healthcare delivery and to harmonise sharing of data plans routine in daily practice. The Alliance’s future work is fully aligned with the objectives of the Digital Single Market and Digital Transformation of Health Care in Europe.

For more information, contact:

Nicole Denjoy
COCIR Secretary General
Tel: +32 (0)2 706 8961
Opens window for sending emaildenjoy@cocir.org

Is South America now worth going after?

When it comes to healthcare, it would certainly seem so. We have been monitoring where Israeli health vendors are now choosing to market their solutions.  Having seen a focus on cyber security in 2017 and 2018 at the HIMSS platform in the USA – their attention is now moving south.

This is interesting because it says what we have always suspected, that the lead time in getting traction in the UK and Europe, is just too long. Put it down to myopia or simple monotonous decision making times – other parts of the world are moving ahead of our own so called advanced healthcare, and South America is one of them, because of a faster uptake.

We publish a current editorial from Mobile and e-Health company G Medical Innovations Holdings Ltd (ASX: GMV), who have announced they will  be demonstrating its medical monitoring solutions for the first time in South America at Hospitalar 2018, commencing tomorrow in Brazil. Such a presence will enable the company to present its medical monitoring systems to a growing and dynamic region. What they say is this:

Hospitalar has been a leading trade fair in South America for the past 25 years, and is one of the most important shows in the healthcare sector for local and foreign markets.

The company will showcase the Prizma Medical Smartphone Case and Vital Sign Monitoring System with G Medical Patch (VSMS with GMP), including a demonstration of its Prizma’s User Portal and Doctor Portal and GMP’s nurse multiple and single patients view station. The Prizma has received approvals from regulatory authorities including the FDA, CE and TGA.

The Prizma enables consumers to easily transform their smartphone into a highly-reliable mobile medical device for independently managing their own health. Currently the Prizma measurements include a 1-lead ECG, heart rate, stress levels, temperature and oxygen saturation. Consumers can continuously measure, monitor and share these biometrics with caregivers and loved ones. In addition to providing immediate access to personal health indicators, the medical data can be sent to the consumers’ personal Portal where it is stored, and can be easily viewed and shared with those involved in their medical care.

 The Vital Sign Monitoring System with G Medical Patch   is a modular, easy-to-use, clinical grade solution for monitoring patients, the VSMS with GMP utilizes patented wireless technologies, proprietary information technology and service platforms. This innovative solution is ideal for monitoring patients in most healthcare settings including clinics, assisted living residences, hospitals and out-patient locations. It can be used to monitor patients at all stages of the healthcare lifecycle, and takes the burden off medical and healthcare personnel, while still enhancing patient care.

G Medical will be exhibiting at Hospitalar 2018 from May 22-25, 2018, held in Sao Paolo, Brazil, as part of the broader Israeli E-Commerce Group presence at the show. Attendees at Hospitalar 2018 are welcome to visit G Medical, located at Hall 15, Stand #178 in the International Pavilion.