UCL: AI in Medicine 2020 Conference

I attended the MedTech UCL  AI in Medicine Conference: a bespoke, one-day conference bringing together some of the greatest minds in digital health. With speakers from Google DeepMind, BenevolentAI, NHS X and others. The day  consisted of talks, discussions on the greater implications of AI in healthcare, exciting workshops. 

BenevolentAI integrates AI technologies at every step of the drug discovery process from early discovery to late stage clinical development.It has a platform of computational and experimental technologies and processes using vast quantities of mined and inferred biomedical data 

 AI uses already generated medical data for research into areas like biomedical sciences. AI research also explains the difference in the prevalence of certain diseases amongst different races for example diabetes affects Asians more than Africans. 

BenevolentAI collaborates with international organisations such as the African genome variation project.
Genetic studies of human diseases are more challenging to perform in sub-saharan Africa because genetic diversity is greater than in other populations.This pilot will increase our understanding of African genome variation and enable the design of large scale genetic association studies in the region.

The African genome variation project aims to collect essential information about the structure of African genmes to provide basic framework for genetic disease studies in Africa.

Clinical trials are relatively absent in most parts of Africa and there is an opportunity to bridge the gap ad provide data for AI needs

Demo for an electronic health record system( Africa Safety Data)

Integrated Paediatric Service

Integrated Paediatric Service (IPS) is a new care model was set up to deliver specialise health care services for children in acute and community settings to receive specialist care by appropriately qualified staff in their own home or primary care settings. The target patient groups include 0-16 years (19 special needs).

The service model include

• Children with chronic illness being seen by the same team of professionals in both hospital and community
• Facilitate direct access and admission to hospital
• Multi-disciplinary team (MDT) which is clinically lead that will interface with primary care clinicians to provide the highest quality of individual holistic care to the child and family  
• Working with consultants in clinics located in hospitals, homes and schools

To facilitate this the level of interface between primary and secondary care services should be seamless between the various clinical system example, EMIS interface with e-referral (ERS). As at the time of writing this, integration between both systems doesn’t exist so GPs at primary care level may not be able to refer patients directly to secondary care without the use of a clinical assessment service to triage referrals between primary and secondary care.  

The advantage of IPS include

Paediatric Referral Triage

• Reduced numbers of inappropriate outpatient referrals due to the Consultants ability to defer back to

primary care with advice and guidance.

• Patients being seen in the right place first time reducing duplication of care

Integrated Clinics

• Reduced need for outpatient follow-up due to improved handover to primary care

• Cost savings due to redirection of outpatient activity into clinics at a lower tariff

MDTs

• Reducing the need to refer to secondary care for specialist advice saving outpatient referrals

• Providing a platform for proactively managing patients and best utilising early help and community service

reducing the reliance on secondary care

Teaching and engagement

• Upskilling GPs and increasing their confidence to treat children in secondary care

• Removing barriers to GPs seeking advice and guidance from secondary care, reducing the need for

outpatient referrals to secondary care

Interoperability: Health Information Exchange

When time is of the essence, every moment that you wait for a patient’s information could have life altering repercussions for the individual and their family. The ability to cut out this waiting time won’t just help you respond to the needs of a single patient quicker, you’ll also be able to maintain a continuous flow of patients through your health system

By supporting the exchange of data across organisational, geographical and technological boundaries, caregivers can access clinical information from any venue of care. That means that medications, pre-existing conditions, test results, allergies and more can all easily be considered when clinicians are creating health plans for patients, with safer and more timely decisions reached at the point of care.

The health information exchange (HIE) provides integration services via a one-way HL7 API and two-way REST API to integrate all sources of health and social care information across a region. It uniquely solves the consent to share and access patient information by allowing the patient to manage the permissions of each organisation, team or individual via the user interface of the patient portal. It provides granular consent to segment the record and allow permission to be granted by the individual for secondary uses of data (such as population analytics). The consent API provides all other connected systems with details of what information can be shared with each organisation, with a medico-legally audited ‘break glass’ functionality for overriding patient consent in cases of emergency or lack of capacity, where it in the person’s best interest. The HIE is managed by a publish-subscribe architecture and connects to integration engines and to most major systems in primary, secondary and tertiary care to deliver fully coded medical data in a view only or read/write approach. It is a fully hosted service with zero infrastructure requirements.

How to help children develop problem-solving skills

For children to learn how to resolve conflict, they must first learn problem-solving skills. Children should be encouraged to think of solutions and alternatives to problems, which will help them be more confident when they’re faced with difficult situations. Children who learn problem-solving skills will develop and use them throughout their life.

Here are some general steps to teach children problem-solving skills:
 

• Get the facts and identify feelings. When children are fighting, angry, frustrated or upset, identify the problem. When asking children to tell you their problems, you need to be calm and nonjudgmental. Children see things from their own perspectives and may be completely unaware of how their actions affect other children. Helping children identify their own feelings and recognize the feelings of others is an important step.
• Help children set the conflict-resolution goal and define what they want to happen in the situation. When children have clear goals, it’s easier to think of solutions.
• Generate alternatives. Help children stay focused on their problems and ask what they can do to reach their goals. When children offer alternatives, repeat their ideas and ask them what else could be done. Don’t criticize their ideas. Instead, prompt more solutions by asking the children questions. If they cannot think of alternatives, ask them to imagine how someone else might handle the situation.
• After children have generated their ideas and alternatives, help them evaluate the consequences. For instance, “What might happen if . . .? Would it be safe? Would it be fair? How would everyone feel?” Adults should encourage children to evaluate their ideas and see why they are acceptable or unacceptable.
• Ask for a decision. After children evaluate their ideas, adults should restate the problem, summarize their ideas and let children decide which actions they would like to try. If children choose an idea that you think will not work, make sure they know what their alternatives are and what they should try next.

Helping children recognise pattern

Patterns are all around. They help children see how things work together and help in predicting what happens next. Patterns help children become our future problem solvers. When children learn to recognize, copy and extend patterns they are taking a giant step into the world of math. However, repetition is needed for children to become proficient at this. A five or six year old may be able to recognize and recreate patterns but this will take time and practice. The use of a variety of manipulatives during the lesson is needed.

1.Divide the classroom into 3 stations. Place the strips of construction paper at the first station along with a drawing of an A-B pattern. Instruct the children to create a paper chain in the A-B pattern in front of them. Ask them how they could extend this pattern. This will test whether the child is able to reproduce and extend a given pattern.


2.Set up the second station with different color crayons. Instruct the children to sort the crayons in whatever way they desire. The children may think of grouping colors by darkness or lightness of the color, by different shades of the same color, etc. There is no wrong way to sort them. Ask the children to explain why the crayons are sorted in this way. This helps to reinforce reasoning skills.

3.Set up the third station with colored candies. This station can help the children recognize that there are patterns everywhere, even in the food we eat. Instruct the children to take a handful of the candies. Tell them to count how many are in their hand. Instruct the children to create groups from what they have. Then have them count how many are in each group. This introduces them to simple mathematics. Ask the children why they grouped the candies like this and how many are in each group. Then ask them how many they had all together.

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How to deal with challenging behaviour.

Hopefully, you will not encounter behaviour like this in your classroom. However, you can sometimes feel like you've done ten rounds in the ring when you get home at the end of a busy day.

There are going to be some classes where, as a group, or because of the behaviour of specific individuals, you are likely to encounter challenging behaviour. Challenging behaviour is a label which sounds politically correct but describes less than perfect behaviour.

As a classroom teacher, you will need to deal effectively with this behaviour to avoid losing the class. I have seen this happen to a couple of teachers and it is not a happy thing. The teachers ended up feeling like they had failed, lost credibility and face.

This can be a real knock to self-confidence and it takes courage to get back up in front of a class again. If this ever happens to you, try and put it in a good perspective and be philosophical. The whole thing could be a learning experience, even if you learn that you never want to lose control of a class again!

The following are a number of interventions and approaches to managing challenging behaviour:

1 Planning

Much of the success in behaviour management comes from prevention rather than cure. If you carefully research and plan your approach to each class and the individuals that present challenging behaviour, you are much more likely to reduce the probability of disruptive behavior in the first place. At the least, thorough planning should help you to reduce the impact of any behaviour if it occurs.

For example, before I actually teach a class I will carefully look at the Special Needs Register and make note of any issues that the children may have. Often the SEN Department will have an action plan in place for that child. The action plan or IEP (Individual Education Plan) should have details of strategies that work or don't work for the child. It will be tailored to help with the child's problems . If you are teaching lower ability classes, definitely check out their IEP's. Another example of planning might be to look at the Schemes of Work and talk to SEN classroom assistants who know the kids well. You can then provide resources that are at the right level for the pupils and so avoid unnecessary frustrations.

This type of planning will help you get routines in place to help your classroom run smoothly.

2 Have your own sets of rules and communicate your expectations of the class.

3 Follow the School's Behaviour Policy.

If all the teachers in a school stick together and follow the policy, it has a much better chance of working. If you are new to a school, make sure you are familiar with the Behaviour Policy so that you can enforce it if necessary.

4 Keep things light and sidestep minor disruption with humour.

A certain amount of minor behaviour can be dealt with by the teacher making light of the behaviour but addressing it if it continues. Humour can be a great way to disarm a provocateur in a non-confrontational manner. As an example, I taught this boy called Tom, who had developed this attention grabber - by letting go gigantic farts just when I got to an important point in my lesson, or when I had just settled the rest of the class. The first time he did his trick in my class, the fart immediately caused mayhem. Kids moved because of the stench and some started to gag. I made a humorous comment about him eating beans for dinner and "beans, beans good for your heart, the more you eat the more you fart". This got the class laughing and gave me enough time to open the windows and door to let the gas escape. I quickly moved back to the point I was about to make and the lesson went on without a major disruption. Fifteen minutes later, Tom had built up enough gas to trump again. At this point, I asked him to take his gas outside and stay there until he was sure he could come back in without farting. After a cool off period, Tom realised I wasn't going to take any more disrupting from his overactive bottom and rejoined the class - fart free - for the rest of the lesson. As a footnote to the story, I heard that Tom had soiled himself while trying to disrupt his English lesson. What goes around, comes around!

If kids do not respond to your actions start to use the School Behaviour Policy.

If effective, warn and use detentions, a threat of parking or removal to 'time out'.