Data Driven Doc: As Easy As ‘Tak, tak, tak’

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Early on in creating Navya- Gitika and I met with the CEO of a private hospital in Mumbai exploring interest in Navya’s expert opinion services. He dismissed us offhand- saying he could email his friends ‘tak, tak, tak’ (Indian/Desi colloquialism for ‘instantly’) and get a response from them on any questions he had. Funnily enough – he was a radiologist who didn’t see the power of asynchronous and instantaneous collaboration on medical information. Today teleradiology is one of the largest medical services online.

A few years later, I’m impressed with how many ‘tak, tak, tak’ connections Navya has created for our patients across the world. We had 20 requests for consultations today, and we were able to get instantaneous reviews of many of the cases by international experts.  Where one expert’s response wasn’t confident enough, we got two or three to confirm! Back to the patient in a day!

A well-connected CEO of a hospital may get his medical questions answered by specialists in a jiffy, but the true value of Navya on democratizing expert information across the world, instantaneously, is beautiful. It’s truly as easy as ‘tak, tak, tak’.

-Dr. Naresh Ramarajan

Online Expert Opinion: navyanetwork.com/tmh
Tata Trusts: tatatrusts.org
Tata Memorial Center: tmc.gov.in
Navya: navyanetwork.com

Quality vs. Quantity

umbrellas-205386_1280There are a lot of technologies out there.   How many of these are touching a patient?  A doctor?  An expert?  A family member?

Technology is the basis for results.  Without data, decisions cannot be made.  Without intuition and learning, a decision cannot be perfected.  There are a lot of technologies:  cognitive computing, artificial intelligence, natural language processing, machine learning, but that will not save a life.  Don’t let anyone fool you into believing that a system can save a life.  I’ve been a patient, a family member, a technologist committed to cancer care, and I can tell you that technology is insufficient and far from application-ready.

There is data everywhere.  I’ve written about this before.  But just as one does not need to know all the books written in this world to add two numbers, or be successful as an expert, there is a critical mass of knowledge that can be obtained and utilized effectively.  So don’t be fooled with vastness of data that one might possess.  Your grandma told you, it’s quality not quantity that matters.  So one need not know all the medical textbooks and clinical trials in the world to be a cancer expert, but one must certainly know all the relevant practice changing trials and have experience being an expert.

Your grandma told you, it’s quality not quantity that matters.

Ultimately, it is intent.  Why is a company building a technology.  Why is a doctor providing online opinions. How credible is it.   Does it matter that there is data on every single patient ever treated in my type of cancer, if my cancer is common or unique.  Think hard. Think wise.

Intent matters.  The use of technology with experts who want to enable patients – through a service that is only focused on patients and nothing else, requires very little buzzword technology, very focused data, a small number of true experts, a family of clinical analysts and patient advocates willing to serve patients as their own, and a large number of patients in a population that is struggling to get its basic needs met in cancer care.

Navya and Tata Memorial Centre in the Indian subcontinent, in 34 developing countries in Asia and Africa.

The patented Navya Expert System, the pioneering technology in evidence and experience-based treatment decision making and the one of a kind experts at Tata Memorial Centre.

Navya is committed to holding the hand of every cancer patient and lifting them to the same pedestal as everyone else in the world:  expert cancer care for all.

Navya is the only clinically validated end-to-end decision system in cancer treatment decision making.  The Navya system is patented and the first innovator in this field.  Use Navya at navyanetwork.com/tmh

You, your family, your friend, will always have us no matter the cancer to conquer or access to technology and data.  Access is always enabled through us, and our system, service, and experts empower for real, in a format that you can consume from home!

tmc.gov.in

tatatrusts.org 

 

Decision Making

flowers-164754_1280Decision making is about pros and cons.    I was on my way to Boston Logan, to catch my flight to Bangalore.  My cofounder called me, and said “it’s a Navya moment.”    There was a personal, family, decision that he was helping coordinate, while he was at the Maui airport to fly across the country to get to his family in New York City.   Between our flight schedules and travel times, we had about an hour or so to chat before certain important decision had to be made.   The clock was literally ticking, and we started our process.   He had looked up the papers that discussed clinical trials and retrospective analysis of individuals in similar circumstances as his kin.  (He will write about these experiences in a blog post, soon.)  The advantage of waiting versus proceeding with a surgery was about five days at most.   That, was the known.  The evidence.  That we could likely delay surgery by five days and gain the benefit that would bring.  However, the disadvantage, the unknown, the risk of any complication while waiting, far outweighed the known disadvantage (mandatory stay in a well-managed, top of the line, intensive care unit).   Then, the experts.    Experts known to us pointed to their experience of being able to manage any complexity of surgery at the time.   They were comfortable, confident, yet let us (the patient and the family) decide.  What did the patient want?  There was anxiety.  There was anxiety about the known and the unknown – what was worse?  What did she prefer?  Patient preference.  And then, the much talked about guidelines – the international guidelines that indicated that both, surgery and non-surgery were acceptable options at this time.  Brilliant!  Not helpful.   It was a Navya moment.  We had to reconcile, hold each other’s hands, and decide from the patient’s perspective.

There are many elements to decision making.  Evidence, experience, experts, and patient preference being the most measurable, computable, elements.  Guidelines of course are the most general and are the weakest link.   At the center though, is the process of utilizing and combining all of the above.  The Navya process, which is extendable from oncology to obstetrics decision making.   The gentle consideration, the conversations, the repeated conversations on the various considerations, the data, the people, the process.  Always results in a decision that is well thought out, bringing clarity, and rooted in the best evidence and experience of experts.   The Navya process that we followed in an hour long conversation lead to two beautiful outcomes, a pair of healthy baby twins, born at the right time to a mother who felt relieved with confidence in her decision. 

An Expert Opinion makes the difference – not another 2nd opinion. Cancer patients know that difference.

11143552_1657596077813277_6232528969219220839_nWhen Naresh and I first started Navya, many asked us why we were setting-up an organization to offer second opinions. First, who would like to second guess their doctors, especially an oncologist (after all, cancer is a dreaded mystery for most); and second, it sounded like a basic service – what’s the value. We struggled hard to explain because our vocabulary was so new. Navya was an evidence and experience-based expert decision system. First, we were focused on empowering patients with all the relevant information, from every credible source, so there is no mystery, except the destiny of the Almighty. And second, we never proposed to enable an Nth confusing second opinion for any patient. We were focused on an expert opinion, a single consensus opinion that combined relevant and applicable knowledge from clinical trials, international guidelines, outcomes of similar patients, and true experts from only the handful of true expert centers. That reconciled opinion – the expert opinion – would remove all complexity of what treatment to undertake (preventive surgery or just sit tight… surgery first or chemotherapy… benefits of radiation versus risk of incontinence or infertility… chemotherapy or new targeted therapy or both… reinduction protocol or maintenance protocol or wait and watch…)

Navya and Tata Memorial Centre, one of the world’s largest tertiary care expert cancer centers, have empowered patients from over 34 countries, and most contently from developing countries and in remote towns in India, who would have otherwise not had the privilege of an expert opinion. Every cancer patient has the right to an expert opinion. Know, and let your friends know. Expert Opinion Online at navyanetwork.com/tmh is powered by the visionary support of Tata Trusts. Together, we are working to ensure that every cancer patient is comforted and strengthened with expertise to fight.

I am one of the founders of Navya, and it is a true privilege to have this opportunity.

– Gitika Srivastava

Navya: navyanetwork.com