NEW LAWYERS. TRANSFORMATION OF A PROFESSION

The subtle movement and shift of emphasis from today’s lawyers into Business Partners and strategic advisers – has changed the view that we have of them – and them of us. The question is; is this a difficult sell?

Nora Teuwsen is looking at me across the screen. She is dressed in Swiss minimalist chic, dark grey modern clothes, long auburn hair. As former General Counsel for Swiss Railways, and surrounded by the financial areas of Zurich, she is well placed to make a perceptive judgement.

“It used to be”, she says. “But now, Corporates are waking up to the fact that their in-house Lawyer is also a modern facilitator”.

Like so many young lawyers starting out, Nora had little clue of what a legal profession entailed. Her motivation had been more a belief in justice, integrity, that she still regards as valuable of all skills to have. What she was not prepared for in those early days – was the lack of client contact, and to work out and discover an understanding, that her preferred role was one of explanation, to explain the “why” things need to be so.

She is calm but animated in her delivery, you can see the entrepreneurial spirit that is driving her responsibility to take her client on a journey. The legal background has no longer become the prime reason for being retained, it is the structure of thought that can open other commercial discussions.

It is no surprise that after 15 years with Swiss Railways, it was obvious that the next step was to create a vehicle that could embrace all of these attributes and competences, into one, that could be offered as a package so to say.

What she says is; “companies are underestimating the value of their legal department”, and in many ways that department needs to be courageous in pushing for creative and pragmatic solutions which are taking into account the company’s strategy and focussing on longterm value.

Nora continues: “The role of the legal department is expanding. Areas of sustainability, social responsibility, are becoming the go to areas of importance for corporates of all sizes, and the legal department can assist in handling that interest.”

It is also a focus on use of Data. Surprisingly, Nora is not convinced by use cases in Artificial Intelligence in the legal industry. There is a great transformation going on, but so far, results are limited. So far, it has not come up on her radar as a priority.

The “BeyondLegal” Boutique Firm, Nora’s brainchild – from a single Zurich base – is already international clients. “What we are trying to do, is build a network of like-minded legal professionals. We live in an international world”.

I turn off my screen and take a moment of reflection. In a technology driven marketplace, human values are still the bedrock of our corporate growth, which we always had but somehow had been forgotten. Some things remain the same.

Is AI finally getting traction in Healthcare?

Ahead of Rare Disease Day (Feb 29), Ashley Yum has written to us,  to offer us the opportunity to speak with Steve Costalas, CEO, HVH Precision Analytics, about how AI and machine learning are being used to help diagnose rare diseases faster and more accurately.

HVH Precision Analytics is a joint venture between the world’s largest health and wellness network Havas Health & You , and Vencore,  and specializes in AI and machine learning data analytics.

At a time when take up of AI in healthcare is surprisingly low, this collaboration is looking at  how AI/big data can identify symptoms of disease 3-5 years before diagnosis, – and using RWD and RWE to find undiagnosed patients in healthcare databases – and finally, – · leveraging data to support the rare disease community beyond diagnosis.

And they have some interesting side announcements, if you will…

95% of rare diseases do not have an FDA-approved treatment, significantly limiting treatment options for the 400 million people living with a rare disease.

7,000 rare diseases have been identified, but only 5% have FDA-approved treatments.

The total number of Americans living with a rare disease is estimated at between 25-30 million.

The average time it takes for rare disease patients to receive an accurate diagnosis is 4.8 years.

However, they are  excited about the progress that’s been made in recent years thanks to AI, and  they would love to share  what they  think is in store for the future.

Ashley can be contacted at; ashley.yum@HVHprecision.com

DOES AI WORK IN HEALTHCARE?

 

We take a look at a recent Study from across the Pond by the guys at Black Book Research, and ask – why are we not having the same results in Europe?

If there is ever a case for not believing what you hear, or putting your finger to your face and pulling your eyelid down – “you’re kidding, right?” – it is in the happy figures that are quoted by Hospitals about their impending use of AI.

There are two reasons for this. Firstly, AI is frequently confused with “let’s do a bit more work on our EHR”, or more simply – “AI is a technical solution so we give it to the CIO to solve.”

When handled correctly, AI is none of those things; rather, it is a clinical evaluation of what we need in clinical management, and work backwards from that.

We see frequently, in the Uk as our base, hospitals having little or no plans or concept as to what actual benefit can be achieved – and in some cases, actually throwing out the AI project they had started in the first place. One Consultant told us he had moved back to pencil and paper.

And yet, the concrete figures from across the Atlantic from colleague Doug Brown at Black Book Research, are compelling and convincing. What they say is; some “44% of healthcare organizations already report using AI in one form or another, and 88% of surveyed C Suite officers expect widespread implementation in next 5 years.”

Practical benefits include, in the USA at least, significant reductions in payments claims being refused, because there is a faster, more accurate process for matching data from all relevant parties.

Whilst the Study spends a lot of time talking about Coding and IT issues – it also goes on to pick out those vendors who have best succeeded in giving a practical advantage to all sides. Doug goes on to say; “Overall, 89% of all hospitals surveyed report cutting transcription costs in half or more while improving the transparency of dictation and transcription processes within one year of implementing end-to-end coding, CDI and transcription software tools. 94 % of providers realized operational efficiencies without impacting clinician workflows. “

What is becoming apparent is that in healthcare, despite the need for enhanced platforms and IT speak etc – the key driver is the identification of what actual benefits you are trying to achieve – and then let the tech do the rest.

Do Lawyers need AI? Good question…

We look back at the recent IQPC Conference on the need for AI, within the legal profession, and ask – who needs this anyway?

It’s a stupid and naive question. Lawyers are the byword for heavy and voluminous documents and the search for precedence.  You can argue  that if anybody needs some sort of automated way to find the data that will  get you  out of jail – it is your lawyer.  And whether this is criminal or private or commercial – the economics are clear; understanding  and devising new ways to handle a legal process – and then automating it – can save billable hours.

And that is the question, and why this intriguing and intensive and experience lead two day event,  was so critical – and explains why of all industries, the legal profession is the last to seriously take a peek under the hood, of the benefits of an AI process.  In a market that so depends on its billable hours – why would you want to reduce your billable hours anyway?

It took a day of separate speeches and discussions and coffee networking – before on Day One, we reached this nadir. It was worth waiting for.

Key speakers and delegates from some of Europe’s leading brands, had flown in from across Europe and taken the DLR  from across the road, to meet at Canary Wharf, and listen and contribute. A key strategy and benefit of an IQPC event is the informal inclusion. Nobody is afraid to say what they mean, and everybody understands that the more they contribute, the more they benefit, from everybody else.

In many ways, the informality belies it’s importance as a means of sharing important best practice. And this allows the delegates to ask the difficult questions. Day One, where we were present, allowed all parties to go beyond their earlier preconceptions that billable hours are the key essential, set that aside, and say :”well, there are other ways of doing this now”. 

What is clear is that – unlike say financial services or Chief Data environments, the legal profession does not come to the table with a problem  that it has to fix. People don’t use lawyers because they want to – it is because they have to. This has allowed the profession to do its own thing, in its own way. Up to a point.

Sure, this Conference was friendly, supportive.  Key corporate legal decision makers rubbed shoulders with public sector movers and shakers. Networking around the water cooler on steroids if you will.

But what is clear, now, is that internal competition from one lawyer to the next – and also the growth and competence of Inside Counsel, has woken up the need to be more commercial. The need indeed for survival, in a real world, has finally kicked in. 

CAN A.I. HELP THE LEGAL PROFESSION AND CAN IT INDEED HELP YOU?

We take an advance peek at the upcoming AI Legal Forum from the experts at IQPC, in London this week, and ask – where does AI fit into this very personal relationship-based industry?

The AI Legal Forum is rocking up at what should be already the centre of UK artificial intelligence. With its base for two days this week at the Hilton London Canary Wharf, the venue is surrounded by the movers and shakers in the banking and financial industries. If anybody depends on accurate use of data – it is them.

So we are in good company. The Forum already has some of the UK’s leading Legal Firms as Speakers, including a couple of large Media companies and PDA vendors. It is a broad church. And it needs to be,.

Reading through the nice announcements, what the Forum is there to do, is ask questions of its delegates rather than deliver information. Sure, there will be experience lead discussion – but as much can be gained from the feedback as the initial presentations from each leader or speaker.

A key element will be the redefining of how legal firms calculate their revenues, from what source. A major bugbear from customers who require legal advice is the constant focus on billable hours, and this is a key topic under discussion, as we move in to new ways of assessing client value.

It’s about time. But then, in the legal profession, you could say it has always been that way.

Clever People. Important Discussions.

We engage with the very clever people on both sides of the table at the Millenium Hotel London and ask – why do I not understand this?.


The answer is, of course – that I am not meant to understand it. The whole point of working with people who talk in languages and have skillsets that I do not understand – is that on my side – I have competences that are completely unknown and confusing, for them too.

Business depends on the communication of competences across the divide, and this is why every year as ritual, the IQPC Conference on AI, and on Intelligent Automation – has become a must see event, de rigeur. At whatever level of vertical corporate you are – Data and its automated future, are the way things will go for your industry and you need to be ready.

And it’s not that I am stupid. Mark Whitehorn’s discussion on where automated data can take us, was powerful but as a mere marketeer, was deliberately over my head.

But not over everybody’s head; the questions from the floor were equally intellectual and important, and there was a meeting of minds among a whole section of delegates and the speaker of this initial presentation.

As if recognising this small imbalance – Alasdair Anderson stepped up into the Panel and gave the more business focussed view. And this is the secret so to say, of the IQPC Conference; the balance of many views, and the opportunity to meet with one’s peers, from whatever provenance.

If there were two fundamental questions raised and answered, they were; what does it take to implement this stuff? It is ok having the technology, but here has to be a willingness and an understanding to do so.

As one delegate said; “what does it take in terms of incentive, to open the doors of the people who implement and deliver the benefit of, AI?” And from another colleague – a simple question: “Will this technology make the boat go faster?”

As always, the benefit of the IQPC Conference is as much in its casual networking between episodes.

I have to dash for an evening engagement but by mid afternoon delegates are already in deep discussion. There will be more hopeful of the same, next year.


IQPC schedule of similar conferences can be viewed at; http://www.iqpc.co.uk

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?

Healthcare. How to make AI work for You.

We look at the constant hype surrounding this overblown topic and ask; can it deliver for you?

On the basis of what we have seen – probably not. Although according to multiple independent reports “When it comes to healthcare AI, the UK is the powerhouse of Europe” – there are conflicting statements by  UK Government saying that “dealing with the NHS remains challenging”. And looking at a recent statements from others,  the evidence from startups and those tech companies who are at the forefront of developing new AI based solutions, take up is small, and there is  “little benefit to the value proposition”, from using AI per se. So there is a conflict between commercial take up – and perception of relevance.

What is worse, is that we are already seeing one hospital terminate their digitalisation journey, because – as one clinical Consultant told me – “it just doesn’t work”. 

The reasons  it “doesn’t work”  are many and varied, but largely fall into two camps,  first of which  is because the introduction of AI or Digitalisation, is not an IT or Tech discussion. It is a business process discussion. It is an HR and best use of people, discussion. If it remains easier to flip the paper pages of a file to see someone’s latest notes – then that is what it is.  But also – the announcement of a single IT decision point of the new NHSX quango, is itself a misnomer. At the upcoming Digital Health Conference, focussing on the new NHSX facility – there are no less than six Decision Makers all involved in the decision making process

So… what are the practical steps that you need to take, to get the best out ofAI based new technology?

1. Understand and create a Roadmap, of what you want to get out of this process? If it is simply to shore up your existing practices, then forget it.

2. Know which areas you  wish to include – both from a data access point of view, and also groups of people.  The more groups involved, the worse it will be.

3. Understand that what works for one hospital, may probably not work for you. Make clear choices about solutions that can deliver a specific benefit.

4. Do not engage in Trials.  AI data management is not a clinical discussion, and the algorithms used are already proven. You are already good to go.

5. Have milestones of progress. 

6. And only when you have all of the above written on a piece of paper – then involve your IT people.

You may well now find that the money you had previously allocated for something nebulous, will indeed deliver when broken down into manageable practical specifics.

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IF A.I. IS SO IMPORTANT… CAN SOMEBODY PLEASE EXPLAIN WHAT IT WILL ACTUALLY DO?

We look at some examples of the  new focus in healthcare and ask; really?

The recent announcement of the upcoming HIMSS Impact 2018| Leading Digital Transformation and Big Data in Medicine – conference in Berlin later this year, coincides with an announcement in the uk from the Government, that it is now investing zillions into “AI”, to combat various troublesome diseases.

In theory,  and indeed in reality, a new focus on a different way of  handling patient information, will save time, not necessarily save money, but enable our services to do lots more. And it comes about because there are just too many people, needing too many services. And as one clinical director told me; ‘we can hardly put a new clinic in the hospital car park..”

But  at a time when most Hospitals are still coming to terms about moving from Windows XP, there are three major stumbling blocks, and it is important to spell these out before we all get too excited.

First – if the UK Gov attempts to roll out this Finance in the same way as it has done for previous bjg deals, let’s say such as COGDE or Scan 4 Safety, etc.. then nothing much new will happen at all. Those hospitals that did take up either of the above, have largely  spent money on things they were already doing – so it just became a way of getting finance but not improvement; or they embark on a lengthy process of milestones that alas could have been done cheaper and faster with existing tech in the private sector. 

The result is that those Hospitals that did not make the cut, so to say, have become confused, and do nothing, as opposed to at least try to do “something”. What we have found is that if the management of a hospital wants to advance its healthcare performance, it will do so, regardless of Gov announcements.

Second – AI is not a Hospital process, but a Community process. This means that the data from a patient does not require said patient to come to a clinic or be seen by anybody in a place called a hospital. The data is patient driven and comes from his/her smartphone, his Apple Watch, her Fitbit, etc – without anybody doing anything much. In other words, AI in health is consumer driven,   and there are already plenty of Apps that harness very specialist health data from each and everyone of us, that can already be viewed by our GP or Hospital. The secret to AI health is by increasing patient engagement.

But finally – we need to understand what all this will do to our actual lives. What AI means, is that our diabetes, our heart, our fitness, can be monitored remotely – and we ourselves will take greater ownership of our lifestyle. 

This means that conventional financial models of where money comes from and for what – have to change. The focus will be empowering the community, and paying hospitals to monitor that – rather than get paid only when we physically make a visit.

Because if this does not happen, then health provision will move to pharmacies, etc, who will provide this monitoring for us – and we will pay them money to do so, because it will be immediate and in real time – instead of waiting to see our local GP or clinic appointment.

Which in turn will distance us from the very organisations we already pay money to, to look after us.

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