Special bonus episode. This is a shortened version of the episode with Jess Morley, focusing on ethical approaches and takeaways relevant for digital health companies. How do you move from  having ethical approaches as 'nice to haves' to actually getting prioritised. It can be tough when good intentions rub up against business realities. Jess shows how you can avoid getting your initiative or feature getting kicked down the roadmap. People who will find this useful:Product managers and product leadersDesign/UX folkSoftware engineersClinical safety officersClinicians working at digital health companiesQuality assurance and regulatory professionalsFoundersOperations leads

Jess Morley, a postdoctoral research associate at Yale's Digital Ethics Center, shares her expertise on integrating ethics into digital health. She discusses the ethical dilemmas faced by health tech leaders and the challenges of reconciling good intentions with business pressures. Morley critiques the UK's AI action plan and emphasizes the importance of inclusive data practices. She advocates for embedding ethics in procurement processes and product development, urging stakeholders to prioritize social responsibility amid a growing focus on economic growth.

🎙️ New Episode: Connecting Global & Local Perspectives in Digital Health ImplementationIn this special episode, we close out the year with two fantastic guests: Rigveda Kadam, Digital and AI Lead at FIND, and Andrew Muhire, Chief Digital Officer at Rwanda's Ministry of Health.Building on the innovator insights in Rwanda from our previous episode with Dr. Jana Alagarajah, this discussion dives into the critical connection between product development partners and ministries of health to create conditions for successful digital health implementation.From Rwanda’s patient-centered approach to FIND’s global perspective across LMICs, we explore:✔️ How Rwanda balances top-down mandates with frontline adoption to foster trust.✔️ Tackling antimicrobial resistance with clinician decision support as a case study.✔️ Using systems thinking to measure success in evolving interventions—Andrew’s "contribution lines" approach is a must-hear!✔️ Rigveda’s wishlist for the ecosystem: from WHO priority areas to better alignment on patient journeys.Tune in for an inspiring conversation on infrastructure, policy, and trust—key elements for making impactful digital health innovations stick.FIND: https://www.finddx.org/ Some resources mentioned: Rwanda MoH 7 priorities: https://newmoh.staging.risa.rw/1/strategic-plans-prioritiesThe value of diagnostic imaging for enhancing primary care in low- and middle-income countries: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00478-4/fulltextASSESSMENT OF DIAGNOSTIC GAPS AND RELEVANT DIGITAL HEALTH SOLUTIONS SUMMARY FINDINGS FROM PERU, INDIA, NIGERIA AND UGANDA: https://www.finddx.org/wp-content/uploads/2022/12/20201515_rep_assessment_dx_digital_health_FV_EN.pdfPrinciples for Digital Development: https://digitalprinciples.org/Overview of the validation platform: AI validation platformAbout the guests: Riveda Kadam: Experienced global health strategist with expertise in digital health, AI, and public health programs, driving impactful innovations and policy alignment.Andrew Muhire : Chief Digital Officer at the Rwanda Ministry of Health

Implementing a digital mental health solution in Rwanda. What does real, meaningful co-design look like?What does it mean to truly engage with a community to develop a solution they actually use and that addresses their problems? What incentives and mindsets allow us to, instead of 'driving' a certain technology into a context, stop and listen, and go in with no pre-conceived notion of what would be built?How do we get procurement and policy to really value and elevate equitable solutions?These are some of the great questions we covered in the latest podcast episode with Dr Jana Alagarajah. His wide experience, and work implementing a digital mental health tool with young people in Rwanda gives us some great talking points. Jana shares what he learned working with people and community leaders, as well as carers, and how they approached co-design and evaluation. We also talked about his insights from working in partnership with UNICEF, USAID, the King's Fund and Health Foundation.  Dr Jana Alagarajah (MD MPH): Digital mental health specialist, UK-trained public health doctor, and psychiatrist co-designing equitable and impactful digital health innovation in Africa with young people as Technical Lead at YLabs. Partnering with UNICEF, USAID, and Gates Foundation, he leverages digital tools to strengthen health systems.Linkedin: https://www.linkedin.com/in/janaganalagarajah/YLabs: https://www.ylabsglobal.org/Grand Challenges Canada: https://www.grandchallenges.ca/Key Resources: Design:Co-design: YLabs’ Youth-driven approach to digital health focussing on co-designing with youth. Designing for diversity: Importance of co-creating culturally adapted tech to address health inequalities in diverse populations - report from NHS Race and Health Observatory. Regulation: Co-developed Africa’s first evidence-based digital mental health regulation (‘HealthTech Hub Africa Digital Health Policy Blueprint 1.0’) with the Rwandan Ministry of Heath, Africa CDC, Jhpiego, Novartis Foundation covering key design elements such as interoperability, data privacy and UX approaches to meet the needs of diverse populations. Implementation:Digital stigma reduction tool: ‘Prepare for a Better Tomorrow’ (Rwanda, 2021): Rwanda’s first youth-driven, holistic digital learning and peer support platform to increase mental health literacy and psychosocial support for Rwandan youth aged 10-19 years old. Funded by Grand Challenges Canada. Digital tools for mental healthcare workers: ‘USAID Kijana Nahodha’ (Tanzania, 2023): digital mental health education and referral tool for community health workers in Tanzania as part of a $5.4M USAID grant, impacting 140,000 youth and 250 community health workers. Evaluation: Evidence generation: A systematic literature review evaluating the efficacy of digital mental health technologies for youth in low and middle-income countries: Alagarajah J, Ceccolini D, Butler S. Digital mental health interventions for treating mental disorders in young people based in low-and middle-income countries: A systematic review of the literature. Cambridge Prisms: Global Mental Health. 2024;11:e74. doi:10.1017/gmh.2024.71Innovative approaches to digital evaluation: At YLabs, we have utilized traditional evaluation methodologies such as cluster RCTs to evaluate our digital interventions. However, given the challenges in evaluating digital health solutions, novel methodologies, such as cyclical evaluation, can be used to maximize usability, and support integration into health systems. 

OverviewWe are joined in this episode by Ruchit Nagar, the CEO and Co-Founder of Khushi Baby. For his efforts to deliver scalable public health impact, Ruchit has been recognized as a Forbes 30 under 30 leader in Health Care, a World Innovation Summit in Health Young Innovator, and a Distinguished Young Alumnus by by the Yale School of Public HealthThis episode covers into the role of India's Community health workers, or Accredited Social Health Activists (ASHAs). We hear from Ruchit's experience implementing with Khushi baby the challenges of integrating technology to support health workers. Ruchit also gives us a lowdown on India's digital public health approach and shares his key learnings and insights for people looking to implement tech in rural areas. We get into the challenges in policy, the data infrastructure layer and the importance of funding for sustainable health initiatives. Ruchit also emphasizes the need for better support and resources for ASHAs, the impact of technology on healthcare delivery, and the necessity of aligning incentives to improve health outcomes.Chapters00:00 Intro03:53 Khushi baby origins05:10 Challenges in Community Health Delivery07:18 The Role of ASHAs in Healthcare12:28 The Need for Integrated Solutions14:14 India public health digital ecosystem 10119:51 When "too much digital" gets in the way of good care22:28 Pitfalls in funding and investment approaches23:20 The 3 I's that drive implementation success31:56 Leveraging Data for Health System Strengthening35:53 Challenges in Health System Integration41:35 Measuring Impact and Effectiveness47:44 Aligning Incentives with Ground Realities53:56 Navigating Quality, Evaluation and Regulatory Challenges56:48 Future Directions for Khushi Baby01:02:02 Ruchit's top takeaway for developersReferencesKhushi baby websiteBook reference: Poor Economics by Abhijit V. Banerjee and Esther DufloTB free India 2025Like what you hear? Follow us. I'd love your feedback on what you found valuable, and what you want to see. Comment on youtube, and follow the page on linkedin. Want to share your story? Get in touch.

Echo Vanderwal, Executive Director of The Luke Commission, leads transformative healthcare for underserved communities in Eswatini. She discusses innovative telehealth hubs using shipping containers for better access to care. Drones are employed to deliver vital medications like antivenom quickly and efficiently. Vanderwal emphasizes the importance of community involvement and building compassion in healthcare staff. She also shares insights on developing local capacity for drone operations and navigating funding challenges in digital health initiatives.

Episode 5: What is the right approach for regulation and evaluation of digital health technologies?In this conversation, Shubs Upadhyay interviews Stephen Gilbert, a professor of medical device regulatory science, about the challenges and successes of digital health regulation and implementation. They discuss the need for flexibility in regulation, the importance of feedback from clinicians and patients, and the evaluation of digital health technologies. They also explore the concept of suites or groupings of digital devices and the need for regulatory approaches that acknowledge their flexibility. Gilbert emphasizes the need for regulation to adapt to the changing landscape of digital health and to ensure that it is fit for purpose. Stephen also talks about what health system leaders, policy makers and developers can learn from the challenges of the DiGA fast track reimbursement framework in Germany, the PECAN framework in France and what is coming in the UK. As well as calling out the stark differences in approach from the FDA and the EU, Stephen helps understand the deeper reasons for the different approaches.On evaluation of effectivenss, Stephen emphasizes the importance of integrating different technologies into a cohesive system rather than treating them as isolated tools. The discussion also highlights the role of regulation in facilitating interoperability and promoting the use of digital technologies in healthcare. A great section on the need for long-term thinking on exactly how we want to transform healthcare delivery, setting clear goals, and continuous feedback loops is emphasized, along with the recognition that digital transformation in healthcare requires investment, embedding and time to get back the ROI. TakeawaysFlexibility is crucial in digital health regulation to adapt to the rapidly changing landscape of technology and healthcare.Feedback from clinicians and patients should be actively encouraged and integrated into the regulatory process.The evaluation of digital health technologies should consider their unique characteristics and the need for holistic assessment.Regulatory approaches should acknowledge the flexibility and groupings of digital devices, such as suites, to ensure they are fit for purpose.Digital healthcare involves the integration of various technologies, such as teleconsultation and remote monitoring, into a cohesive system.Regulation plays a crucial role in promoting interoperability and facilitating the use of digital technologies in healthcare.Long-term thinking and clear goals are necessary for effective digital transformation in healthcare.Continuous feedback loops and monitoring are essential for evaluating the effectiveness of digital health tools.Investment is required for digital transformation in healthcare, and initial costs may be higher before yielding dividends.Links to papers mentioned:Paper on regulation, reimbursement approach: flexible groupingsPaper on regulation, reimbursement approach: flexible suites of technologiesA/B testing framework mentioned hereStephen Gilbert, Professor at the Faculty of Medicine, Dresden University of Technology (Else Kröner Fresenius Center for Digital Health), leads a multidisciplinary team specializing in regulatory science for medical devices and in vitro diagnostic devices. With over 15 years of expertise in clinical research, computational biology, and regulatory science, he is committed to advancing digital health innovation and governance.

Episode 4: Creating real impact with AI in isolated communitiesIn this episode, Dino, a pioneer in the digital health landscape, shares his insights on how digital solutions and AI are revolutionizing the healthcare industry. He discusses the critical challenges such as overcrowded healthcare facilities and the urgent need for support for healthcare professionals. Dino’s extensive work at Audere focuses on utilizing digital tools to improve healthcare delivery and outcomes, particularly in underserved communities.Key Topics:Digital Solutions for Overcrowded Healthcare Facilities: Dino explores how digital health can alleviate pressure on healthcare systems.AI Tools in Healthcare: The role of AI and language models in enhancing diagnostic and conversational capabilities in healthcare settings.Building Trust and Reliability: The importance of trust in technology, especially large language models, and how it's achieved through rigorous data handling and prompt engineering.Partnerships and Local Collaboration: How forming strong local partnerships contributes to the successful implementation of technology solutions in healthcare.Regulatory Support and Technology Verification: The necessity of regulatory backing in ensuring the safety and efficacy of new technologies.Impactful Insights:Improving access to rapid diagnostic testing through digital tools and AI.Enhancing patient-provider conversations with advanced language models to make healthcare more accessible and efficient.The significance of trust, reliability, and local partnerships in implementing successful digital health solutions.Utilization of specific data sets and prompt engineering to enhance the accuracy and relevance of responses from large language models.The role of specialization and niche focus in addressing particular healthcare and technology challenges.LinksAudere

Episode 3: How do we meaningfully bridge policy and real impact at the last mile of healthcare. Shubs Upadhyay interviews Bilal Mateen, Executive Director of Digital Square at PATH about digital health challenges and successes in underserved communities. They explore the importance of safety, regulatory considerations, and the need for inclusive data sets and data infrastructure. The discussion also covers the role of community health workers and the impact of AI and large language models in healthcare.Addendum : [As of October 2024 Bilal is now Chief AI Officer at PATH]Key Topics:Digital Public Goods: Exploring how digital solutions can be accessible public goods.Health Data Poverty: Discussing how this issue affects global health equity.The importance of strong data infrastructureRegulatory challenges : Bilal explores some of the work that still needs to be doneAI in Healthcare: Insights on the use of AI and large language models to improve healthcare outcomes.Chapters:00:00 Introduction and Background05:06 Digital Public Goods07:04 How Health Data Poverty Plays Out08:59 Reaching the Last Mile of Healthcare15:47 AI and Large Language Models in Healthcare29:00 Investing in Data Science Ecosystems and Regulatory Frameworks32:59 More Global Representation in Regulation37:03 Considering Local Nuances in AI Deployment39:12 Divergent Approaches to Regulating LLMs45:28 Regulation of LLMs as Medical Devices48:40 Recommendations to Innovators about Healthcare RegulationLinks:AMIE paper by Alan Karthikesalingam et alDigitalsquare.orgAudere WebsiteViamo Canada Call CentreSiontis et al Paper on Diagnostic test comparisons

Episode 2: Practical Solutions to Health Data PovertyIn this episode, we continue our exploration of health data poverty, showcasing a team that's making a real difference based on the issues discussed in Part 1 with Dr. Xiao Liu.We're thrilled to have spoken with Prof. Alexandre Filho, a Professor of Machine Learning in Sao Paulo, Brazil. He shared insights on how his team has been maximizing the impact of data-driven technology in Brazil. Prof. Filho's remark, "The world is becoming more like Brazil," sets the stage for a discussion on what the global community can learn from Brazil's approach to data diversity, especially in serving underserved communities.Key Topics:Global Lessons from Local Successes: How Brazil's high-quality, diverse data sets serve as a model for the world.Overcoming Data Challenges: Tackling issues with data availability and the performance limitations of algorithms developed in affluent settings when deployed in rural areas.Leveraging Local Data: Details on the team's work, including a paper on neonatal mortality prediction using routinely collected data.Direct Benefits to Data Providers: Ensuring that those from whom data is collected see benefits from its use.Balancing Impact and Scalability: The trade-offs between highly tuned, local solutions and the need for scalable models that perform well across broader contexts.Benchmarking for Better Health: Extended efforts in the ITU/WHO focus group on AI for health, evaluating the performance of models across different LMIC settings.Advancing Local Impact: The use of transfer learning to enhance model performance and impact locally.Prof. Filho’s Recommendations: Key advice for innovators and implementers in the EU, US, and UK.Guest Bio:Alexandre Chiavegatto Filho is an Associate Professor of Machine Learning in Healthcare at the Department of Epidemiology, School of Public Health, University of São Paulo. He directs the Laboratory of Big Data and Predictive Analysis in Health (Labdaps), which includes a team of 30 researchers focused on developing AI algorithms to improve healthcare decisions.Find the team's work on Google Scholar