Dissecting Digital Health — with Manuel Schneider
Manuel Schneider was having an existential crisis (just a small one) when we met. What should a theoretical physicist focus on when there is so much opportunity in healthcare to preserve the ‘human’ in our technological development?
This is the full transcript of the podcast Dissecting Digital Health with Dr Louise Schaper, interview with Manuel Schneider.
Guest: Manuel Schneider
Host: Dr Louise Schaper, HISA
Tweet Louise @louise_schaper
Production: This podcast is produced by Ivan Juric
Show Notes
[01:26] Louise begins the conversation with Manuel by having him give his brief bio and interests. Manuel touches on what led him to his interest in theoretical physics, and tells Louise about his desire from an early age to understand, in depth, the way things work, and why they work.
[03:47] Manuel talks about how his need to understand formulas took him from mechanical engineering to theoretical physics in a matter of weeks. Manuel reveals a side of physics that deals with the philosophy of life and the interconnectedness of the universe.
[09:52] After a deep conversation about the existential questions of being through the lens of physics theories, Louise shifts the conversation back to Manuel’s educational journey. Manuel reveals how he was intrigued by how programs work, and was eventually led to software development.
[11:36] Manuel shares the story of his first freelance gig to develop a mobile app for a company to sell houses. He talks as to how this sparked his interest in developing mobile apps.
[14:05] Manuel shares how the concept of developing apps as a company was a relatively new idea in Switzerland. His interest and the opportunity at the time led him to begin a start-up linking product information to products placed in television shows in real-time.
[15:46] We developed quite some good stuff around that, using all kinds of artificial intelligence, machine learning, big data analysis, stuff like that. It was very exciting. We went out to market with the product, but in the end, the market wasn’t there for such a thing.
[17:29] With failure comes success. While Manuel’s app was not successful, a chain of events it triggered led him to medical and health informatics
[20:16] Louise asks Manuel to share what it is about the field of healthcare that excites him the most. Manuel tells Louise about his desire to change the way people manage their data, and technology’s potential to bridge that gap between patients and better care.
[23:06] Louise and Manuel discuss university educational opportunities in health informatics in Switzerland and the multidisciplinary and collaborative nature of the field of as a necessity for dealing with complex systems.
[26:07] Louise asks Manuel to share more about the healthcare system in Switzerland in terms of health informatics and digital health. Manuel talks about how digital health is a new concept and the lack of electronic health records.
[29:15] Louise and Manuel discuss the Swiss government’s move towards more digitised healthcare. The two reflect on the accessibility of information and Manuel reveals his belief in the potential for technology to step in and automate solutions to data accessibility issues.
[33:35] Louise wraps up the conversation by asking Manuel to reflect on what a successful life and contribution means for him. Manuel concludes with his goal to ensure technological development does not neglect human-centred thinking.
[35:21] Closing Remarks
Full Transcript
Opening remarks by host Dr Louise Schaper
[01:13] Louise: So, ladies and gentlemen, boys and girls, welcome to Dissecting Digital Health. I’m your host, Louise Schaper, and sitting next to me is…well, I’m going to let him introduce himself. Guest, who are you?
Louise begins the conversation with Manuel by having him give his brief bio and interests. Manuel touches on what led him to his interest in theoretical physics, and tells Louise about his desire from an early age to understand, in depth, the way things work, and why they work.
[01:26] Manuel: Thank you for having me. I’m Manuel Schneider. I’m from Switzerland, I’m 29 years old, and I just happen to be at Salzburg, where we could meet.
[01:37] Louise: Yeah, it’s great, isn’t it? And, when I gave you the heads up that I was going to get you to introduce yourself, you said, “Oh jeez, that’s a deep question.” So, who are you, aside from being 29 years old and hanging out in Salzburg?
[01:53] Manuel: Yeah, who am I? Well, I just came back from travelling for eight months, so it’s kind of a question I’m trying to figure out right now, but I grew up in Switzerland, so I’m Swiss, and I studied theoretical physics at ETH in Zurich. So, I’m kind of a science guy. But, yeah, I have many interests, and I’m not just interested in physics or analytical stuff, but I’m also interested in a variety of things.
[02:37] Louise: Well, how did you get started…
[02:38] Manuel: Can we start again?
[02:39] Louise: No, this is all good. It’s fine. So, how did you get interested in theoretical physics? When I read your bio, we hadn’t met each other, just for the listeners at home, or on the tram, or the trains of Melbourne, wherever they may be — but, I read everyone’s bios, (your standard, couple hundred word bios), and when I saw yours and was like, “He’s a theoretical physicist, he’s doing start-up stuff, and he’s a health informatician. Wow, I’ve got to meet this guy”. So, let’s start with theoretical physics. How did you get interested in that?
[03:09] Manuel: Well, I think I was always interested in how things work. So, I mean, if you’re out there sitting at the lake, and you see the waves in the lake, or listening to music, so this is all about finding a pattern. So, that was what was driving me, also as a child. So, I always tried to figure out how stuff works, tried to find the common grounds, tried to find the formula behind how things work, and I think that’s why I ended up studying theoretical physics. Actually, I started firstly studying mechanical engineering.
Manuel talks about how his need to understand formulas took him from mechanical engineering to theoretical physics in a matter of weeks. Manuel reveals a side of physics that deals with the philosophy of life and the interconnectedness of the universe.
[03:47] Louise: Oh, so robots and stuff?
[03:50] Manuel: Yeah, exactly [Light laughter], because I like to construct things. I also always liked electronics as well, so kind of real world stuff. Theoretical physics is very different, but when I had the lectures in the beginning, they were always saying for example, “Well, that’s the formula. It works like that, so we can calculate the force,” and stuff like that. But, I found myself thinking ‘how?’ ‘why is it like that?’. Those answers come from the physicists. So I realised, I don’t only just want to calculate the forces or apply the formula. I want to know how it works, why it works, and I’m much more interested in finding that formula than applying it. So, I switched after two weeks.
[04:42] Louise: Oh, just two weeks? I was going to say, “How long did you do mechanical engineering?” So, two weeks?
[04:47] Manuel: Just for two weeks.
[04:48] Louise: So, when you make up your mind, you make up your mind, then.
[04:51] Manuel: Yes. I think I consider things and then I make a decision, and after that, it’s done [Light laughter].
[04:58] Louise: What’s studying theoretical physics like at university? Like, a lot of other science geeky guys and gals?
[05:07] Manuel: Well, they are…
[05:08] Louise: Super-smart. You’re not sitting around talking about the Kardashians, I imagine.
[05:11] Manuel: No, not at all. We’re talking about the “Big Bang Theory,” for example.
[05:14] Louise: Oh, Big Bang, of course. We love The Big Bang.
[05:16] Manuel: No, but I mean there are a lot of ideas on how physicists are, and some of them are true [Light laughter], but a lot aren’t.
[05:25] Louise: I mean, stereotypes do exist for a reason.
[05:27] Manuel: Exactly.
[05:28] Louise: We don’t like to admit it.
[05:29] Manuel: Exactly. But, I always felt we had some people during our studies that were really interested in physics. And, I mean, after lectures, they went home and continued studying, they had physics journals at home, they were reading until early in the morning. So, I always thought that these are the guys that should actually be the physicists, and make physics. So, I think that’s also why I left physics.
[06:00] Louise: But you finished your undergraduate degree?
[06:03] Manuel: I have a Masters in theoretical physics.
[05:54] Manuel: I totally loved the subject. I still love theoretical physics.
[06:13] Louise: Yeah, I can see the light in your eyes when you’re talking. It’s like “Someone wants to talk to me about physics!”
[06:20] Manuel: Yeah, definitely, definitely.
[06:20] Louise: I wish I knew more and could go into depth, but I’m afraid you would leave me for dead in that conversation.
[06:27] Manuel: That’s no problem. Actually, there’s a lot of stuff that you can talk about in theoretical physics, even without knowing much, because it does actually affect our lives. Many people have difficulties seeing that, but actually, it’s not that hard of a subject. I mean, if you get into depth, it’s quite hard.
[06:48] Louise: What’s one of your favourite things, then? Educate me.
[06:51] Manuel: In physics?
[06:52] Louise: Yeah.
[06:53] Manuel: Well, there are quite philosophical questions in physics. For example, how was the world built? What’s the underlying structure? A conversation that’s been going on for years is about string theory and quantum theory, so like the very fundamentals of our universe and of our being, and trying to connect all the different areas into one big formula, or into one big truth…- maybe.
[07:32] Louise: Do you think that’s possible?
[07:33] Manuel: Well, yes. I hope so [Light laughter]. Yes.
I love the idea of breaking it down to a common ground to realise that at the end, everything is connected.
That’s what this quest is kind of about, to not have like…general relativity, that deals with the very big, and then quantum physics, that deals with the very little, but to really see how these interact, how they coexist. This raises a lot of questions about what is time? Why can’t we go back in time? Is it actually like that? What is reality? How do you perceive things? Is there really an us, a me? So, stuff like that.
[08:31] Louise: How do you balance? When you’re taught to think that way, which is what happens to us all when we go through our education, when we’re passionate. So, how do you balance those massive big questions, like are we really having this conversation right now? Is there a different you and me, a different time plane — that sort of thing. How do you balance that with just the pragmatics of everyday life and the trivial details that we all have to do every day?
[09:00] Manuel: Well, I think that’s exactly how. In the end, we are here, or at least I feel that I’m here. I have some information about being. I don’t know if it’s real or not, but it doesn’t matter in the end, because, I mean, it’s the everyday stuff that we have to deal with. So, it’s exactly about being pragmatic.
It’s interesting to think about if the universe is really there and, what makes it up, but at the end, it doesn’t matter. I am here, or I feel being here, if I am or not, so I can just enjoy that feeling of being here.
[09:40] Louise: Okay, so you do try to avoid having an existential crisis on a daily basis?
[09:47] Manuel: Yes, totally.
[09:48] Louise: Well, that’s good then. You’re doing well.
[09:50] Manuel: But, I have that once in a while.
After a deep conversation about the existential questions of being through the lens of physics theories, Louise shifts the conversation back to Manuel’s educational journey. Manuel reveals how he was intrigued by how programs work, and was eventually led to software development.
[09:52] Louise: Well, we all do, really. Okay, well then, so you’re doing mechanical engineering for a grand total of two weeks, and then you move to theoretical physics. You do it so well that you continue to a Masters level. What happens next for you, after that?
[10:07] Manuel: Well, I’ve always liked IT. I always liked programming, and I starting programming when I was eight years old.
[10:17] Louise: What language did you use?
[10:18] Manuel: It was something like Hyperstack, I think.
[10:24] Louise: Okay.
[10:25] Manuel: It was a software development kit for Apple computers called Hypercard, and it was kind of a mixture between object-oriented language and just regular script language, but I started this because, again, of my idea of analysing things. So, I saw a program on the computer, and I asked my dad how this works. How can you do such a thing, because I mean, I cannot touch it. So, he explained me a little bit — he’s not a software developer or anything. But, it was enough for me to get interested. So, he bought me that development program, and I just tried to analyse existing codes.
[11:17] Louise: When you were eight?
[11:18] Manuel: Yeah. I had no idea about English, so I didn’t read any book about programming. I just analysed the patterns of programs, and I modified little things to see what happens, and that’s how I got started programming.
[11:35] Louise: Brilliant.
Manuel shares the story of his first freelance gig to develop a mobile app for a company to sell houses. He talks as to how this sparked his interest in developing mobile apps.
[11:36] Manuel: So, IT was always part of my life, and during college, high school, it was just easy to develop software a little bit as a freelancer to earn some money. So, that’s when I kind of started to get into software development. During my Masters thesis, a friend asked if I knew someone who could develop a mobile app for a company to sell houses.
[12:12] Louise: Oh, okay.
[12:14] Manuel: So, I said, “Yes, I can do that.” So, he brought me together with his father, who was the architect for that house they wanted to sell.
[12:27] Louise: So, they were just wanting to sell that one house?
[12:28] Manuel: Yes.
[12:29] Louise: It wasn’t real estate.
[12:30] Manuel: It was the idea of then applying the concept to other houses, but at this point, it was just one house they wanted to sell. In the end, they sold it before we could even start developing an app, but it got us thinking, and we thought that well, this could be a thing, developing mobile apps.
[12:53] Louise: What year was this, roughly?
[12:54] Manuel: It was roughly 2011.
[12:59] Louise: Okay.
[13:00] Manuel: So, the iPad, iPhone, was already introduced to Switzerland, but it was still somehow new. We had smartphones, but developing an app as a company for different kinds of reasons, that was still quite new in Switzerland. So, yeah, we started that business, and we thought that it would be much easier when we have some kind of legal structure around it, so we founded a company. We didn’t do any marketing, but we ended up having people asking us to develop stuff for them. So, we kept it running [Light laughter].
[13:41] Louise: Okay, and what happened to your original real estate app?
[13:43] Manuel: Oh.
[13:44] Louise: Did you ever finish that?
[13:45] Manuel: No, not at all.
[13:47] Louise: Oh, that’s a shame. That would have made you a lot of money.
[13:49] Manuel: Yeah [Light laughter], maybe, but I think we would have sold it way too cheap [Light laughter]. So, no, not at all. We drew some wire frames, but that was it.
[14:00] Louise: That was it. So, and you’re still doing that now, that company?
[14:02] Manuel: No, not at all.
[14:03] Louise: Oh, how long did you do that for, then?
Manuel shares how the concept of developing apps as a company was a relatively new idea in Switzerland. His interest and the opportunity at the time led him to begin a start-up linking product information to products placed in television shows in real-time.
[14:05] Manuel: I did this for two years — one and a half years, actually, and then a client of ours asked us if we could develop something for him. He described the project, and it was pretty big. It was clear that this was not a regular project, he could never fund that because it’s not just an app that you develop and run your normal business. So, we started another start-up together, and it was all about second screen, that hype around having your smartphone or tablet during watching TV, having all kinds of interaction between the programs. So, we developed algorithms to try to deliver in real time additional information on what you would see in the first screen.
[14:59] Louise: Okay.
[15:00] Manuel: So, imagine James Bond comes in to the scene, and you see his watch, and your smartphone tells you where you could buy that watch.
[15:06] Louise: I so need that app. Not for the James Bond thing, but I’m such a loser when it comes to dressing, and I see outfits on shows like Madam Secretary and I think, “Ah, I want to dress like that!” So, does that app exist? Did you make that?
[15:20] Manuel: Well, that app exists. We made it [Light laughter].
We developed quite some good stuff around that, using all kinds of artificial intelligence, machine learning, big data analysis, stuff like that. It was very exciting. We went out to market with the product, but in the end, the market wasn’t there for such a thing.
[15:46] Louise: Really?
[15:47] Manuel: Yeah.
[15:48] Louise: See, I would have thought — I don’t know, like the James Bond, that’s like Rolex or whatever James Bond wears, and as I said, people like me, I just want the entire outfit. I’d be like, “Yep, the top, the skirt, the shoes, just deliver it to my house please.” I would think there would be a huge market for advertisers.
[16:05] Manuel: Yeah, we thought so as well, and we talked to a lot of TV stations in Germany, also in the UK, and they were all very interested in this kind of project. I think the problem was they already had specific apps for some specific shows, and they worked more or less well. But in the end, we didn’t get the users, and the whole hype, actually, it collapsed, so nobody’s talking about second screen anymore. So, even in the United States, you couldn’t engage people really by using Twitter for a TV show. You couldn’t get people to download the app that covers everything over a specific show. So, there are still apps out there that do some kind of that stuff, like tailored for a show, for example, but the total hype…yeah, turned out not to be…
[17:12] Louise: Well, that’s a shame. I’ll have to keep an eye out for that, because I could use that app. Alright, well, hey…
[17:17] Manuel: And maybe Switzerland was also not kind of the place…
[17:19] Louise: Yeah, you were just ahead of your time, that’s your problem.
[17:21] Manuel: To market such an app, yeah.
[17:22] Louise: You’d think especially in the States with such a consumer-centric society, it would work there.
With failure comes success. While Manuel’s app was not successful, a chain of events it triggered led him to medical and health informatics.
[17:29] Louise: How did you get interested and involved in healthcare, then?
[17:32] Manuel: Yeah, so, well, after that start-up didn’t turn out the be the project I’m going to do for the next ten years, I got another job at the Think Tank in Zurich.
[17:45] Louise: Is it a private Think Tank?
[17:46] Manuel: Yeah, it was a private Think Tank, and, well,
we thought about technology development in general and how it’s going to influence society and vice versa, and we developed some interesting concepts on how you could use technology to disrupt markets.
So, that’s when I got back in touch with the initiator of MIDATA, and we started that collaboration between the Think Tank and MIDATA, and that’s actually when I got first in contact with medical informatics, health informatics. I then…yeah, I helped them roll out and produce m-health solutions. I also worked with them on e-health policy, stuff like that. I mean, the whole MIDATA project is around changing the way people interact with data, especially in healthcare.
[18:50] Louise: And people meaning …patients, clinicians, is there a particular focus?
[18:56] Manuel: Anyone — citizens, because
the mission of the project is much bigger than just healthcare, so what we want to facilitate is that people are again in control of their own data. But, you don’t have to be sick to be in control of your own data. You don’t have to be a patient, you don’t have to have any kind of conditions, but this should be something that concerns us all.
But, we needed a starting point, and health data is interesting for different kinds of reasons. We are coming from a research background, so we also wanted to support research. Yeah, that’s why we started in the area of health care, medical informatics. That’s how I got introduced to medical informatics.
[19:45] Louise: Yeah, and do you call it medical informatics or health informatics in Switzerland?
[19:50] Manuel: In general, we have at the University for Applied Sciences in Bern, we have an institute for medical informatics, so we call it medical informatics in Switzerland. But in a more international context, it’s much more about health informatics, because it’s not just limited to medic care or whatever. But, the institute is called the Institute for Medical Informatics.
Louise asks Manuel to share what it is about the field of healthcare that excites him the most. Manuel tells Louise about his desire to change the way people manage their data, and technology’s potential to bridge that gap between patients and better care.
[20:16] Louise: And what are you working on now that excites you the most in the healthcare field?
[20:21] Manuel: Well, I’m still involved with that MIDATA project, and since this is at the moment very deep into healthcare, I think…I mean, we’d like to change the way people manage their data in the end, but I’ve seen a big impact in the field of healthcare, where we can really apply technology to make things better, because what I miss from when I was studying theoretical physics is the kind of direct impact you can make. Actually, during my Masters,
I worked one semester for a group in the biomedical engineering department of ETH, and there I started to feel again that I wished to be involved in something that’s more tangible.
[21:26] Louise: And more immediate, I guess, than theoretical physics, necessarily.
[21:31] Manuel: Exactly, yeah. So, what I really like about my work right now is that we can use technology to actually change the way we approach things and make processes better. That can be a very simple thing. We have lots of good ideas from students, they develop every semester tons of health solutions. Sometimes we build a product where we have the app or whatever. Sometimes, just the concept, but you see how even very small things can make a difference. For example, an app where you put in a smiley emoticon every day of how you feel and it’s sent to your physician, and that did make an impact. It was just a small pilot project for a platform, but we got the feedback that people liked it. So, we don’t know if this is true in general, but with very little effort, you can actually do something very concrete that has an effect on people, that can help people. But, you can also work on applying technology to change the way we experience healthcare. It’s not just having a better way of communication. It’s really about developing the healthcare system further to make it better.
[23:01] Louise: There’s a lot of scope there. Yeah.
[23:04] Manuel: That’s exciting about all of this, yeah.
Louise and Manuel discuss university educational opportunities in health informatics in Switzerland and the multidisciplinary and collaborative nature of the field of as a necessity for dealing with complex systems.
[23:06] Louise: That’s cool. So, what types of other professionals do you have on your team. Do you work with clinicians, with patients?
[23:12] Manuel: We have a lot of different people on our team. The initiator of the project, he’s a professor for genetics at ETH, so we have the biologist, from a pure biomedical interest. We have people that worked for years in healthcare on the policy side, we have people from big companies as project leaders, we have clinicians, we work with the University Hospital in Bern and Zurich, so we have different departments there that are involved. We are in contact with a physiotherapist practice.
[24:01] Louise: Yay for the allied health representation!
[24:05] Manuel: Yeah. We have a professor for ethics on board. We have a professor for big data on the team. So, it’s quite a diverse team.
[24:15] Louise: That sounds like you get to work with really interesting people every day, as well.
[24:18] Manuel: Yeah, totally. It’s really an enriching environment, and I think also that it’s kind of typical for health informatics, because being able to study medical informatics, health informatics, in Switzerland is quite new.
[24:40] Louise: So, you can study it at undergraduate level, can you?
[24:43] Manuel: Yes, you can do a Bachelor at the University for Applied Sciences.
[24:46] Louise: That’s fantastic.
[24:48] Manuel: Yeah, but it’s still quite new. They didn’t have it until about four years ago.
[24:53] Louise: Okay, you’ll have your new first graduates coming up.
[24:58] Manuel: It has to be four years. I think last year they had the first ones, yeah. I think there’s a lot of potential. But, already, at the University of Applied Sciences where they have this course, it’s not that you come there and you start studying health informatics from scratch. Usually you have an IT background or a health background.
So, already there are people coming together from different fields, and I think that’s how it should be, actually. In such a complex system, you should have different fields coming together.
[25:41] Louise: Yes, we have wicked problems to solve, so you need that multidisciplinary approach.
[25:45] Manuel: Exactly. What we try to do now is to also really involve the patients — that’s something we’re not so good at yet. Yeah, in Switzerland, it’s not…I think we’re quite happy with our healthcare system [Light laughter].
Louise asks Manuel to share more about the healthcare system in Switzerland in terms of health informatics and digital health. Manuel talks about how digital health is a new concept and the lack of electronic health records.
[26:07] Louise: Can I ask you about the healthcare system in Switzerland?
[26:08] Manuel: Yeah, sure.
[26:09] Louise: Tell us, because this podcast that we’re part of, I don’t imagine we’re going to get a huge international audience, although maybe that will grow, but it will probably be mostly Australian who like me have never had the opportunity to visit Switzerland. So, tell me a bit about your healthcare system in terms of the health informatics component and digital health.
[26:37] Manuel: [Light laughter] Well, digital health in Switzerland is I think quite a new concept [Light laughter]. Maybe you wouldn’t imagine that, but I think there are a lot of countries, like Australia, that are far ahead of Switzerland in that respect. So, for example, we don’t have a national solution for an electronic health record.
[26:57] Louise: Okay, so each man to his own? Each facility does their own thing?
[27:02] Manuel: Yes, and usually you would…well, it really depends on yeah, on the clinic, on the GP you have, but usually it’s just their computer and they have a system and they put it in there. So, you cannot really talk about an EHR.
[27:20] Louise: No. So, do most GPs have a computer system with clinical notes?
[27:24] Manuel: Yeah. A lot of them have nowadays, yes, but it’s only been four or five years.
[27:30] Louise: Okay, so still quite new.
[27:30] Manuel: Yeah, there are still a lot of GPs that put their notes just in writing. I mean, Switzerland is quite a federalist system, so every one has its own solution, even on that level of just having a clinic information system, you have tons of solutions out there.
[27:53] Louise: Do you have many home-grown ones, like…do you have many of the software products that they use, were they built in Switzerland, or do you have an international, sort of European feel to them?
[28:04] Manuel: Well, I think…well, we have all of that.
[28:07] Louise: It’s a big mix, right?
[28:09] Manuel: Custom built in Switzerland, we have others brought from other countries, international companies. Yeah. That’s…so, again, we have a long way to go until we have…
[28:22] Louise: And what about tertiary care there, what’s it like in hospitals in terms of clinical notes?
[28:15] Manuel: Well, usually
when you’re referred from one department to another in the hospital, usually it’s quite hard for them to get your information.
I mean, they get what they need, they know you’re here for a CT or whatever, but it’s not like they get your full medical record. So, usually its by passing through, by walking there which will get the information flowing. So, again, I think in general, we have a good system.
[29:02] Louise: Good, high-quality healthcare?
[29:04] Manuel: Exactly. High-quality. We have a high-quality system, so I think people don’t mind the inefficiencies so much, because it works. There’s not much to complain about. I mean, there’s a lot of room for improvement, but still, it’s on a very high level.
Louise and Manuel discuss the Swiss government’s move towards more digitised healthcare. The two reflect on the accessibility of information and Manuel reveals his belief in the potential for technology to step in and automate solutions to data accessibility issues.
[29:15] Louise: Okay, so people are generally happy and there’s not necessarily a call for going digital and starting to record things digitally, but that sort of contrasts with what you were saying a few minutes ago about how you’re excited about the aspects of getting patients more involved. So, when do you see that developing if there isn’t a cry or a call or any sort of momentum towards going more digital?
[29:39] Manuel: Well, one thing is that we have now the process in place to implement an EHR on a national level. We are about to introduce an EHR and it should be implemented probably in the next seven years or so, but still, it’s a long time [Light laughter], and it will not be mandatory at the beginning to use it. Both the physicians and the patients can choose to use it, but they don’t have to. At some point, everyone will have to use it. So, there is now the ground for that, legislation is about to be finished around that, but it’s still a very on-going process. So, there is kind of this governmental driven movement, but where I really see — also my excitement coming from is actually an initiative like ours is starting to do that already, and that we can initiate that change — everyone can initiate that change. Sometimes it’s just that…last week, I talked to someone who had an injury three years ago and she felt terrible, and there were a lot of issues she had, and she just decided let’s produce an app that solves a problem for me, and that’s kind of the idea behind health informatics, that everyone can initiate the change, that
a project like ours can actually start to push an electronic health record faster than the government can. So, I don’t think we have to wait until they serve us something, but we can already initiate the change.
[31:37] Louise: Yes, and what about the interoperability piece? So, if we’ve got people like yourselves doing great things, how do we connect that information easily?
[31:46] Manuel: I think that’s one of the biggest issues that we’re going to face: how do we get that information flowing?
[31:54] Louise: Yeah, and you’d be interested in big data and the analysis, because that’s the other exciting thing about informatics, is that actually, it’s about access and use, that’s great, but come on, can’t we just get there? Our profession deals so much with deriving value from the data — value for patients, for clinicians, for researchers, for public health.
[32:17] Manuel: Totally. I think one thing is that, at least what’s very beneficial from national electronic health records, is the standard, and I really hope that we manage internationally to create that standard. I don’t know if it’s going to be FHIR, probably not.
[32:36] Louise: Oh, don’t tell Grahame Grieve that, he’s working really hard.
[32:41] Manuel: Yeah, I bet, I like it a lot, but usually, it’s not…I mean, we always try to come up with a solution, and usually it’s not the first or the second or the third, but at one point, we might get there. So, I haven’t lost faith in that, but
I also think that in the future, it will be more and more possible to kind of…through maybe artificial intelligence or big data analysis to make it…to automatically match data into patterns so that we don’t need the standard for data exchange, but that we can decide automatically how this information is going to fit into that structure.
So, that’s kind of the thing I’m very excited about.
Louise wraps up the conversation by asking Manuel to reflect on what a successful life and contribution means for him. Manuel concludes with his goal to ensure technological development does not neglect human-centred thinking.
[33:35] Louise: Okay, well, my last question for you then, because I think we have to get over for our last session of the day — it’s been a long week. So, you know, I see your face light up when you talk about these things, and back to the start of our interview where we were talking about your not-too-bad existential crisis, so when you think about yourself as an old man, you know, looking back at your life and your professional career, what would you see as success that you would feel you contributed to. You’ve got varied interests, you’re very passionate about a lot of things, but you’re also wanting to build things and look at the foundations of building those things, but really make things tangible and change the world. So, have you got a particular thing that might stand out that you’d feel proud if you could contribute to?
[34:25] Manuel: No, I don’t think I have one thing in particular.
[34:29] Louise: You can list ten, that’s also okay.
[34:30] Manuel:
I would love to somehow contribute to kind of understanding that technology shouldn’t be at the centre, technology should enable, and that this actually brings people closer together and helps us interact as humans.
So, I think that’s kind of a very big challenge, and I think there are so many good people working good things, and we tend to forget what this is all about, and so
I would love to contribute somehow to preserve the human in all of that technological development.
Closing Remarks
[35:21] Louise: Oh, that’s quite a beautiful sentiment and a great place to end. It’s a bold goal, but completely doable, I have no doubt you’ll be able to pull that off, and there’ll be people in health informatics all throughout the world helping you achieve that. Well, thanks so much for the chat today. It’s been really nice talking with you, and yeah, we’ll see you out in Australia, I think.
[35:38] Manuel: Yeah, we will.
[35:39] Louise: Great, thank you.
[35:41] Manuel: Thank you very much.
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