Sunday, 29 November 2020

Shri Indu Bhushan has a dream

No doubt, this is a distant dream

Here is why :

It is facing obstacles of ,

Ø Hardware ( every piece of medical device to be internet connected and standardized ? ) and

Ø Software ( common central database + collaboration between millions of separate / stand-alone / unstructured / non-standardized databases held on different servers of doctors / hospitals / nursing homes / labs / health centers etc )

Ø Concerns about private / personal health data of an individual getting leaked to others

Ø A massive exercise of training millions of health workers to scrupulously follow SOP ( Standard Operating Procedures ) in each and every interaction with a sick person and record their findings / observations / recommendations etc in STANDARDIZED FORMS , across entire country

It will take time for our National Health Vault / National Health Stack , to get universally “ accepted “ and “practiced “, by the patients / health workers / health institutions

But that process can accelerate if the Government (with the cooperation of country-wide health workers ) undertake a campaign to CONVINCE the citizen, the long-term benefits of this exercise , viz :

PREDICTION and PREVENTION of ILLNESSES to each citizen

By citing following – and similar – examples :

AI Model Could Help Patients Predict Disease Risk With Electronic Health Records / 06 Nov 2020

Extract :

Ø Electronic health records use a two-level hierarchical structure to capture the medical journey of a patient using International Classification of Diseases (ICD) codes. The hierarchy begins with the patient, followed by the chronological sequence of visits. Then within each visit, ICD codes are stored with the recorded symptoms for that visit.

Ø He added, ““The model can output the probability of whether the patient will suffer some disease. For some patients, they may not have clear symptoms at the current time, but the model can make a prediction.”

Ø The researchers conducted experiments on three real-world electronic health record datasets of patients with heart failure, kidney disease and dementia, and found that LSAN outperformed existing state-of-the-art shallow methods and deep learning models.

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It is indeed heartening that , Shri Indu Bhushan ( CEO – Ayushman Bharat / i.bhushan@gov.in ) has come up with “ NDHM Sandbox “ , which will enable “ controlled experimentations “, as explained below :

Accelerating Digital Health Innovation / Eco Times – 26 Nov 2020

Extract :

# NDHM has created a “sandbox “that enables technologies or products to be tested in a contained environment

and duration – subject to NDHM standards and oversight – and judge the consumer and market reactions to the

same

# The sandbox will facilitate integration of current systems and IT platforms in healthcare with NDHM building

blocks namely , Health ID, Doctors’ and Health Facility Registries, and Patient Health Records

# At its core, the sandbox has been created with the objective to foster RESPONSIBLE INNOVATION in Health

Tech Services, promote efficiency and bring benefit to consumers

# The sandbox brings together healthcare and health tech service providers, centrally and state run public health

programmes , software providers, healthcare aggregators, tech companies to TEST and INTEGRATE their

products and services with NDHM

# The NDHM sandbox is founded on the idea that the government, private sector and citizen need to work

together as partner to solve the problem of healthcare. It will enable “ learning by doing “ on all sides

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Following is a brief list of those “ RESPONSIBLE INNOVATIONS “, which , I think Shri Bhushan would want to experiment with, in NDHM sandbox :

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Source : Modicare : A Game Changer ………………….[ 01 Feb 2018 ]

Extract :

Each eligible family member to be issued a “ Ayushman Card “ ( linked to Aadhar ID )

Ayushman card will have inbuilt memory capacity to store that person’s health data from “ Cradle to Grave “ ( Privacy advocate need not worry ! )

All the Health Data of all 50 crore beneficiaries to be stored on a Central Server for BIG DATA analysis , in order to “ Predict “ WHO might become susceptible to WHICH ailment and WHEN

As an alternative , a GPS enabled / NFC capable Smart Phone pre-loaded with AYUSHMAN MOBILE APP , could be considered to replace the card

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Ayushman Bharat : Think Big ……………………………………[ 23 Sept 2018 ]

Extract :

Tomorrow, each medical device will be embedded with sensors / transmitters and be Internet connected ( IoT ) to relay their readings to the Central Health Server of Ayushman Bharat

Government will make it mandatory for the device manufacturers to embed such sensors

And, day after tomorrow, these devices will become nano-size and get printed as electronic tattoos on our skins or become integral parts of our bodies, like contact lenses or stents

What is in it for Ayushman Bharat ?

Consider this :

# Doctor takes the readings of the patient using these internet connected devices

# Devices transmit these data to the smart phones of both, the doctor and the patient

# These phones transmit these data to the Central Health Care Server of Ayushman Bharat and update the LIFE

TIME MEDICAL HISTORY of that person

# This history can be accessed only by the “ Authorized “ health centers / hospitals / nursing homes , which are

official partners of the Ayushman Bharat scheme

Imagine all the Medical Devices ( including ECG / EEG / PET Scan, located in private clinics / health centers / hospitals / nursing homes / Path labs / Diagnostic centers etc ), transmitting to a Central Server ,

# Medical diagnosis

# Treatment

# Administered drugs

# Surgical procedures

- for all 50 crore citizens covered by this scheme

And imagine such petabytes of health data being subjected to BIG DATA analysis using AI !

Ayushman Bharat has the potential to usher this Health-care Revolution

When that happens , expect the AI to do the following :

# Offer Customized healthcare / Medical treatment / Supplementary diet

# Guide your family doctor to prescribe the best-suited medicine for each member of your family

# Recommend some “ preventive “ medicines before a disease manifests itself !

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2024 ! – V 2.0 of Orwellian 1984 ? ……………………………….[ 07 July 2017 ]

Extract :

There are 7,000 million people on the earth

It is possible that , at any given time , some 7 million of these are lying in ICU , connected with :

* Electroencephalogram ( Brain Monitor )

* Electrocardiogram ( Heart Monitor )

* Pulse Rate Meter

* Oxygen Level Meter

* Glucose Level Meter........etc

As soon as these instruments get embedded with Internet of Things ( IoT ), a central server could collect all of these " measurements / readings " on 24*7 basis , for all 7 million persons

Then it will combine these readings with following data about each of those 7 million persons :

* Country / Region / City / Language

* Race / Religion / Gender / Age

* Height / Weight / Colour / Biometrics

* Blood Group / DNA / Past Medical History.....etc

It will also record , who died / when !

Using such massive data base, can BIG DATA / Artificial Intelligence / Machine Learning, figure out what “Customized healthcare / Medical treatment / Supplementary diet " should be " prescribed " for each human on this earth ?

Shall we support such " Invasion of Individual Privacy " , in the larger interest / benefit of entire mankind ?

I think, we should

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Dear Shri Indu Bhushanji,

I suppose, much like Martin Luther King, you too are saying : I have a dream !

May God fulfill your dream

With regards,

Hemen Parekh / hcp@recruitGuru.com / 30 Nov 2020

Saturday, 28 November 2020

Thank You, Shri Tomarji

Context :

BJP plans to step up outreach on new laws / Hindustan Times – 28 Nov 2020

Extract :

Ø The Bharatiya Janata Party (BJP) has decided to step up its drive to reach out to farmers across the country in a bid to dispel concerns about the newly enacted farm laws even as protests against the legislations reached the Capital on Friday, a person familiar with the matter said.

Ø The party carried out a 15-day campaign wherein senior leaders, ministers, MPs and party functionaries reached out to farmers explaining the intricacies of the new laws in September, following Prime Minister, Narendra Modi’s instructions to BJP cadres to spread awareness.

Ø “The Prime Minister urged BJP workers to reach out to farmers on the ground and explain the importance of the laws.

This exercise was carried out across the country...and farmers were explained the benefits they stand to get from the new laws

However, given the Opposition’s attempt to mislead the farmers, this exercise will be renewed,” said another party functionary aware of the details

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Dear Shri Tomarji ,

[ nstomaroffice@gmail.com / ns.tomar@sansad.nic.in ],

Thank you for inviting farmers for frank discussions, almost 2 months ago

Source :

We are ready to talk to farmers : Agriculture Minister Narendra Singh Tomar / Business Line – 24 Sept 2020

Quotes :

Ø “ If anyone has any doubts, and I want to appeal to all farmer organizations, they are welcome to have a frank discussion with us any time of the day. We are ready even at midnight to address the farmers’ concerns “, said Tomar

The farmer was forced to sell in the mandis…..He had to bring his produce to

the mandi where the cropwas auctioned and he was forced to sell for fear of

transporting the produce back in case he is not able to dispose of it in the

mandi “

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I wish you all success in your discussions ( scheduled for 03 Dec ) with the farmers and for reaching an amicable COMPROMISE SOLUTION, in the spirit of “ Give and Take “

What you can hope to get by way of “ Take “ is for the farmers to peacefully return to their farms – and give you a solemn / documented promise to stop stubble burning

As far as the “ Give “ part is concerned , I urge you to refer to my following earlier e mail :

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Selling Farm Laws before selling Farm Crops ……………..[ 24 Sept 2020 ]

Extract :

Ø It is high time, the Central Government, Agro-processing Companies and Agro-business Start-ups,

# Launch a massive campaign to EDUCATE the farmers by sharing with

them the following examples of how TECHNOLOGICAL

INPUTS are revolutionizing farms in the developed countries and

# Raising the farmer’s income

Ø I am sure those farmer organizations would send their delegates to meet

you. When they do, I request you to consider telling them following :

# We will incentivize our 75 Agriculture Universities and 700 + Agriculture

Colleges , to set up on their premises,

-TECH INNOVATION CENTRES,

which will offer subjects on “NEW AGRI-TECH“, collaborate with Agri- Tech Companies / Universities around the World and train our farmers

# We will incentivize these foreign AGRI-TECH companies to set up

“ PROTOTYPE “ operations in India for DEMO purposes only

We will offer them free land/electricity + expenses incurred in training

Indian Farmers

There will be one such demo-center in each of our 718 districts

# We will urge companies entering into CONTRACT FARMING agreements

with a farmer, to construct on the farm premises of that farmer

GRAIN STORAGE SILOS / COLD STORAGE ROOMS ,

to enable a farmer to store his produce for a longer period, without

perishing under our harsh climate.

We will allow the concerned companies to set off expenses incurred in

constructing these facilities towards their CSR obligations

Alternatively, we will consider use of already announced Agri Fund of Rs1

LakhxCrore , for this purpose

We have also provided Rs 700 crore for setting up COLD CHAIN across

the country

# As it is, farm income is already exempt from Income Tax.

To enable rapid adoption of CONTRACT FARMING, we will exempt the

“Profit “ that a Company will make by “ Value Added through

Processing “ ,of farm produce purchased by entering into CONTRACT

FARMING

This provision will be for 5 years and will encourage thousands of

Companies to enter into CONTRACT FARMING agreements with farmers

This will expand the market and bring in COMPETITION among these

Corporate Buyers, leading to higher prices for the farmers

# On the existing Govt portal ( e-NAM ) , we will introduce a section called

CONTRACT FARMING ,

where the farmers desirous of entering into contract farming agreements,

will submit their full details

( Name / Farm Size / Location of farm / main crops / past yields per acre

/ no of workers / family members engaged / existing loan liabilities /

water availability etc )

Companies on look out for CONTRACT FARMING can search this database

( of course , after due registration with full details of the Company ) and

shortlist / select potential farmers and send them their “ Purchase

Proposal “ ( by filling in an Online Standard Form ).

Central Government would have full access to these contracts entered

Online between the parties and ensure that no contract is entered

into below the MSP for the concerned crop

No one else can see these contracts but the parties concerned would

have a provision to EDIT these

This will enable the Govt to know the INPUT COST for the “ Contracting

Company “ , and link it with the

" Profit made through Processing Value addition “,

in order to grant tax exemption described earlier

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Dear Shri Tomarji,

Various Farmers Unions have expressed following fears in respect of the FARM LAWS just passed :

Ø The Contract Farming law will make them vulnerable to exploitation by Corporations

Ø If Contract Farming picks up in a BIG WAY, Govt may stop buying at MSP – might even scrap MSP

Now, if the CONTRACT FARMING Act carries a clause that no contract can be valid / legal ( not even allowed to be registered on e-NAM portal ) if it is below the MSP ( relevant to the contracted crop ), then the farmers fears will get satisfactorily addressed

On top of this, you may want to give assurance following assurance to the farmers :

Ø For the crops which are currently not covered by MSP, we will, in consultation with the Farmers’ Unions , come up with MSPs in each case ( for CONTRACT FARMING only ) , over the next 5 years. Such MSPs will be 100 % above the COST of PRODUCTION

Ø The INPUT COSTS ( for each such crop ) will get determined by AI technology as described at :