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I am excited to introduce you to the PARMA project that’s been brewing. A revolutionary healthcare application designed to streamline patient record management for healthcare institutions. I built it with the goal of empowering providers to efficiently manage their processes while maintaining details, accurate, and secure profiles. 😀 : With a deep understanding of both front-end and back-end technologies, James is the driving force behind our app's technical architecture. His passion for delivering a seamless user experience across web and mobile platforms is infectious. James Koduah Full-stack Developer : That's me! I bring to the table a versatile skill set that allows me to tackle various aspects of this project. From crafting elegant front-end interfaces to optimizing back-end functionalities, I'm here to ensure our app shines on all fronts. Farai Ushe: Full-stack Developer Why this project? It all began when I was testing datasets for a school management system, a job that seemed worlds away from healthcare and disease prevention. Zimbabwe, particularly in the southern region, faces its fair share of health challenges. Diseases like cholera and malaria often rear their ugly heads, causing suffering and loss. The local healthcare system, while valiantly striving, is undeniably stretched thin. It was against this backdrop that the spark for our project was kindled. My thoughts often drifted to how technology could make a difference in the realm of healthcare, especially in a place like Zimbabwe. I couldn't help but wonder if we could harness the power of data and machine learning to predict and prevent disease outbreaks before they spiral out of control. While the Zimbabwean healthcare system may have its challenges, it's also filled with dedicated individuals working tirelessly to make a difference. Diseases like cholera and malaria can be curbed if we have the right tools and insights at our disposal. This project isn't just about coding; it's about making a meaningful impact on the health and well-being of my community and beyond. It's about taking the skills I've learned and using them to address real-world challenges. It's a reminder that sometimes, the most unexpected journeys lead to the most rewarding destinations. Together with my amazing teammates, James, and our shared vision, we're determined to make a difference, one line of code at a time. Accomplishments with the HealthCare App Project One of the key achievements of our project is the successful implementation of robust authentication and authorization mechanisms. I've ensured that only authorized users can access patient records and other sensitive data within the application, enhancing security and privacy. Authentication and Authorization: I've developed a set of APIs that enable crucial functionalities within the HealthCare App. These APIs allow for booking patients, registering new patients with Medical IDs, and providing doctors with a dedicated dashboard to view booked patients, queued patients, and the next patient in line. This feature streamlines the workflow of healthcare professionals, making patient management more efficient. API Development: Our application's database architecture is designed for both performance and data integrity. I've employed a primary database for write operations, ensuring data consistency and durability. Additionally, I've implemented a replica database to distribute read traffic, improving overall system performance and providing data redundancy for failover scenarios. Database Architecture: To ensure optimal utilization and responsiveness, I've integrated a load balancer into our architecture. This load balancer evenly distributes user requests across multiple identical servers, enhancing the application's scalability and reliability. Load Balancing: Technologies and Technology Choices: For the front end, I opted to use HTML5, CSS3, and JavaScript without additional frameworks. This choice allowed us to focus on solidifying our understanding of JavaScript and create a responsive and user-friendly interface. HTML, CSS, JavaScript (Vanilla): For the backend, we chose Flask Python due to its simplicity, flexibility, and efficiency. Flask's lightweight nature made it an ideal choice for rapid development and scaling as our project expanded. Flask Python: As our primary database management system, MySQL provides the data consistency and durability required for our healthcare application. Its relational database structure suits the nature of patient records and medical data. MySQL: Notable features: I've implemented a secure and user-friendly authentication system, ensuring that only authorized personnel can access sensitive patient data. Authentication and Authorization: Our system allows healthcare providers to efficiently book patients, streamlining the scheduling process and improving patient care. Booking Patients: Doctors have access to a dedicated dashboard that provides essential information about booked patients, queued patients, and the next patient in line, enhancing their ability to manage patient appointments effectively. Doctor's Dashboard: Challenges I faced In our HealthCare App project, I grappled with the task of dynamically selecting available doctors for patient appointments. However, the API consistently threw a "Doctor not defined" error, hindering our ability to recognize the values being passed. Our challenge was clear: enable nurses to efficiently select doctors actively logged into the system for patient appointments. This necessitated real-time availability tracking and a seamless user experience. To conquer this obstacle. Firstly, I introduced real-time doctor availability tracking, monitoring login and logout activities. This updated doctors' statuses to "Available" upon login and "Unavailable" upon logout, supported by an extended data model. Secondly, I adapted API calls for nurses' interfaces, enabling them to filter doctors based on their up-to-the-minute availability status. Nurses received clear, real-time feedback on each doctor's availability status, empowering informed scheduling decisions. Our solution succeeded. Nurses could now effortlessly select from a list of actively logged-in doctors, streamlining patient appointment scheduling. Technical takeaways Implementing real-time doctor availability tracking was a significant technical challenge. It taught me the importance of data synchronization in real-time applications and how to design systems that can handle constant data updates efficiently. Extending the data model to accommodate real-time status updates for doctors was a valuable lesson in database design. It showed me how a well-thought-out data model can simplify complex application features. This project is reinforcing my belief in the power of collaboration and teamwork. Working closely with my teammates, each with their unique skills and perspectives is instrumental in overcoming technical challenges. Being open to trying different technologies and approaches, as we did with real-time tracking, can lead to innovative solutions. Questioned Beliefs While I held the belief that planning is essential, this project reaffirmed that adaptability and agility are equally crucial in the fast-paced world of software development. It's essential to strike a balance between planning and the ability to pivot when needed. LINKS My LinkedIn: www.linkedin.com/in/farai-ushe-b29368109 Landing page: http://parma.jaskin.tech/ Github: https://github.com/James-koduah/parma

Future of Telemedicine: Lessons I've Learnt From Building my  HealthCare App MVP

An explanation of benefits (EOB) details a patient’s coverage, the treatment they have received, what the payer covered and did not cover, as well as other pertinent details. While it is not a bill, it is similar to an itemized invoice. With different patients utilizing different insurance companies, larger dental practices, in particular, can become quickly consumed in wrangling data. Traditionally, specialists manually gather and compile this information from each individual insurance portal. It must be done daily and requires managing multiple secure log-ins in addition to the data being downloaded. After each piece of the EOB puzzle is gathered, it then must be read and sorted, and formats converted where necessary – this may include scanning and uploading digital versions of hard copy documents. The specialist then needs to account for full and partial payments, and appropriately credit patient accounts - all manually. The process then begins again for the next patient.** ** AI can provide an automated solution to this time-consuming and inefficient process. It would parse EOB continuously and securely, accessing individual insurance portals, pulling EOBs, and recreating them in one, standard, user-friendly format. Specialists could then access it at any time via a dashboard. ** ** Full payments, partial payments, and denials could be clearly delineated with the sum of total daily reports available to specialists for tracking. When access to practice management software is provided, AI that parses EOB might even automatically write-back payment postings to patient accounts. For high-volume organizations, EOB data could also be provided in JSON and CSV formats, expanding automation possibilities.** ** The key is in utilizing artificial intelligence to identify the appropriate data from the top 25 insurance payor EOBs with a suitably high degree of confidence. Offering documents in multiple format options would also speed optimization.** ** The benefits of AI replacing manual work include reducing the associated effort, handling time, and cost while increasing work quality ** ** (Pragya Jain, American University, February 18, 2021, AI and the Future of Work in the United States). Additionally, exposure of confidential patient information would be significantly reduced, making it easier for a practice to maintain compliance with The Health Insurance Portability and Accountability Act of 1996 (HIPAA). Streamlining complex administrative tasks has profound implications for patient care. Technologies like AI, RPA (Robotic Process Automation) could parse EOB for dental practices and reduce the time spent on clerical tasks, freeing practice staff from an endless cycle of paperwork. By Ato Kasymov, CEO of Zentist ** **

AI-Driven EOB (Explanation of Benefits) in Healthcare To Declutter Clerical Work: An Introduction

In the 20th century, appeared. the school as a factory metaphor The specifications for manufacturing come from the demands of twentieth-century civilization, and it is the business of the school to build its pupils according to the specifications laid down. Our schools are, in a sense, factories, in which the raw products (children) are to be shaped and fashioned into products to meet the various demands of life. Ellwood Patterson Cubberley The school as a factory metaphor was working for the past century as education was mostly linear: get an education, get a job, retire. Information was at a premium and scarce. It was perfectly logical for schools to cram information into children’s brains with notions about mathematics, literature, geography, history, biology, etc. In the 21st century, we are drowning under the crashing waves of information, disinformation or misinformation. Wikipedia, MOOCs, Ted talks, podcasts, videos, we have access to information for a few lifetimes. Access to information is much easier now, but getting an education doesn’t guarantee a job. The global automation trend has already started. Any job that is rule-based or process-based can and will be automated. Think of ATMs, self-checkout machines, automatic car park payments, vending machines. As John Oliver remarks in , What will not be automated then? this video “series of non-routine tasks that require social intelligence, complex, critical thinking, creative problem-solving.” In his book , Satya Nadella, the Microsoft CEO, identifies a few skills that “future generations must prioritize and cultivate. To stay relevant, our kids and their kids will need”: Hit Refresh The ability to understand and share the feelings of another, allowing us to build nourishing social connections and regulate our emotions. Empathy is an exceedingly difficult skill to replicate by writing code, and thus “empathy will be invaluable in the human-AI world.” EMPATHY: As our life spans will increase and birth rates will decline, some might say that investing in education might decrease as well. Nevertheless, people from my generation switch careers at least once. Skills that were in high demand just a decade ago are considered obsolete today. Our children’s generation will only see a further increase in career switching. To adapt and survive the harsh economic competition and volatile job markets, we will have no choice but to become effective life-long learners. EDUCATION: As Satya Nadella writes, “machines will enrich and augment our creativity, but the human drive to create will remain central.” For example, when the COVID-19 pandemic stroke, medical systems were brought to their knees by the delays in COVID-19 testing: take somebody to the hospital with an ambulance, disinfect the ambulance afterwards, then go to the next patient. South Korea had the genius idea with their drive-through testing that other countries implemented as well. In Romania as well. CREATIVITY: , they started to have drive-through vaccination centres Even if we accept computer-generated medical diagnoses or legal decisions, we still expect humans to be accountable. This can be difficult when we as a species still seem to struggle with our own biases. JUDGEMENT AND ACCOUNTABILITY: There is the dreadful danger that companies produce algorithms that contain the companies’ biases embedded into code: bias against women in , discrimination based on gender and race stereotypes in , , search result algorithm, where algorithms reduced the number of black patients identified for extra care by more than half, etc. One of the most vocal people to highlight the gender data gap is Caroline Criado Perez. I highly recommend subscribing to or reading her book, . Amazon’s AI recruiting tool Facebook’s ad delivery Google’s terrible facial recognition disaster Google’s unprofessional hair racial bias in healthcare algorithms her weekly newsletter Invisible Women Children starting school this year will have their first jobs in mid-2030. These children will retire, if current laws still apply, in early 2080. As the COVID-19 pandemic showed, we can’t precisely predict what can happen one year from now. And yet, schools and parents are preparing children for jobs that will either become obsolete, automated or are not yet invented. The unpredictability of education in the 21st century is quite extraordinary. We need a new metaphor for the school in the 21st century as the factory metaphor is no longer relevant in this new era of information and automation. It will not be the strongest or the smartest who will withstand, but like Darwin said, the fittest. We will need to reinvent ourselves every few years if we want to remain relevant. The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn and relearn. Alvin Toffler

The Future of Education in the 21st Century

effect If you are not sure what a Doorknob is, you probably want to keep reading. Either you’ve seen it before and didn’t act properly, or worse you just missed it. “Doctor, I forgot to tell you” In Clinical practices, this phenomenon occurs when patients wait until the last moment — usually when the physician is grasping the doorknob walking out of the examination room — to provide crucial information about their condition. “Sorry, I forgot to tell you, but I got a weird chest pain a couple of times last week”. Physicians tight schedules can create a rushed atmosphere. Patients then feel uncomfortable to reveal frightening or embarrassing symptoms. So they wait. When the doctor is at the door they can’t delay the announcement anymore. This can be explained in 3 words: Patients are scared! From Physicians to Managers As a manager, I have 8 one-on-one meetings per week. Those are dedicated moments to know if team members are feeling good or if they struggle. My main goal is to identify where I can help. But I face the same type of problem as physicians. Some team members tend to wait the last minute to tell me difficult things like or . “I think I am stuck on this project”, “I lost my motivation”, “It’s hard working with my teammates” Even if the context is different, the same reasons apply. Nobody wants to look weak at work. Why would you say to your manager, that you are struggling? After all, he is the one who decides about promotions or underperforming behaviour, if you should stay or if you should leave. That's a lot of reason to be nervous. They are scared! 5 tips to fix the Doorknob effect The solution is counter-intuitive. My sister works as a pulmonologist at the ICU in a French hospital. During one of the worse sanitary crisis, where cases are growing exponentially, it’s easy to start rushing from one patient to another. You will actually lose time in the long term. Ten extra minutes during a consultation can allow you to detect a problem before it gets worse and to save days of treatments. But you need to make sure a patient will tell you what's wrong at the beginning, so you can see more of them. 🐢 Slowdown Last quarter, I was constantly 5 to 10min late for all my meetings. People started to tell me “We can postpone and talk when you have time”, “It can wait I know you are really busy”. I realised that I created an environment where my colleagues thought I didn't have time for them anymore. So I started to slow down. I cancelled meetings to free my calendar, I put a time buffer between meetings. I also spent time organising team building and took more time for lunch. The idea was to show everyone that I had plenty of time. 🙊 Stop talking, listen. I plead guilty; I speak too much. I always want me to tell people what to do, I need to listen more. So, I start most of my 1:1 by “Do you have anything specific you want to talk about today?” I make sure I give enough room for the person in front of me. Then I stop talking, I literally shut up, I enjoy a long silence. If they don't have anything to say, it's suspicious to me. On the other hand, if they talk a lot, without going to the point, you know they are hiding something. Because they are uncomfortable, they fill the silence, but they don't tell you exactly what's wrong. They expect you to pick up the clues. Take time to dive deep, ask follow-up questions and listen to the answers! 🦈 Don’t be a predator It’s really hard to admit when we are wrong. Have you ever been scared to be fired? You may want to hide something or try to fix a mistake before anyone noticed. I want people to tell me when they screw up. But they won’t if they fear me. Seven years ago, I went to my manager because I messed up. I told him “I think I run the wrong script on the production database.” It was a massive problem, but because I told him immediately the team managed to fix it without any consequences. I remember my manager saying He was right, I never did that again. "Why would I fire the only person that will never do this mistake again". 🐙 Postpone Unfortunately, you don’t have height arms. You can’t deal with everything at once. . Every extra minute your doctor spends with you makes him late for his next patient. As delay accumulates, patients feel rushed, they may feel angry for the waiting time. So the doorknob effect becomes more likely, making it worse. The doorknob effect is a vicious cycle If you have back to back 1:1 and you are late, just cancel. Everyone can understand that there was an emergency. If a sensitive point is raised just before the end, if the discussion requires more time, schedule a follow-up. It will give you time to prepare. You will have a clear goal and dedicated time to talk about a sensitive topic, without the pressure of being late. 🕸 Don’t get trapped Some people resort to Doorknob questions for non-constructive reasons. In the medical review about Doorknob phenomenon you can read: “Reasons for prolonging the appointment may include primary gain (e.g., the gratification from assuming the sick role), loneliness (e.g., going to the doctor may be the highlight of the patient’s day, week, or month), or anger (e.g., wanting to punish the doctor for a too-brief encounter).” As a manager, you can also face people who want your attention. They want you to notice them, they want to feel important. Learn to see patterns of doorknob effect, when they appear to often, it’s a sign it’s not working. Stop the discussion when you are getting stuck. Conclusion As for medical consultation, a one on one is useless if your employee leaves without telling you what's wrong. The only way to make a proper decision is to have all the relevant information. As a manager, it's your role to make sure you have all the data before moving to another meeting. If you are a manager slow down and listen. If you are talking to your manager next time, start by the difficult part, you will both save a lot of time. Sources: The Doorknob Phenomenon in Clinical Practice Curing 'The Doorknob Phenomenon' (Disclaimer): I am not a physician, this is not a clinical blog post. I just saw an analogy between two types of behaviour, with common solutions. However, I'd like to thanks my sister for her inspiring insights and her hard work at the hospital.

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