Background:
Healthcare is an industry that generates trillions of data points daily with vast potential applications from the discovery of new disease treatments to optimisation of individual treatment through personalised care. However, a large proportion of data are never utilised for clinical and/or commercial applications due to conflicts of stakeholder interest and complexed privacy requirements. These are constraints I first encountered in my early years practicing as a clinician in public sector hospitals.

Since 2011, my team and I sought to help improve the treatment of a poorly-understood condition called ocular tuberculosis (TB), for which diagnosis and treatment varied widely due to a lack of data and disproportionate disease burden among low income populations. We found ourselves navigating the constraints of healthcare data management at a global level in our project involving hospitals across 10 countries to better understand clinical phenotypes of this disease. Although this data was eventually published and utilised to develop new international guidelines, 1,2 it took us years to obtain the necessary approvals to access and utilise this data. Subsequently in 2017 I was tasked to support our national EHR development and operationalization for the military as a clinical advisor, and in 2019 was brought into the team at Raffles Medical (over 50 clinics in SEA and 3 hospitals between Singapore/China), where I practice medicine while helping to lead regional telemedicine commercial, clinical and technical projects with EHR integration.

Ultimately, across these various healthcare settings, I observed that the need for sufficiently granular data to conduct meaningful analyses is often at odds with privacy and commercial interests that require multiple levels of abstraction. These exposures to the research, military, public, and private healthcare settings in the region have each given me the different lenses to healthcare data management and potential approaches to address these challenges. My motivation is to develop a leaner approach to health data management with a permissionless, trusted custodian to enable rapid access for clinical and/or commercial applications. This is with an aim to enable researchers, administrators, and industry to conduct cutting edge research and identify potentially life-saving discoveries rapidly through a streamlined approach to privacy-preserving, healthcare data management.

Relevant bio:

• MBBS (practicing doctor) with >10 years experience in healthcare data management
• 1 prior digital health start-up, Doctorbell (acquired 2018 by MaNaDr)
• Invented method to enhance eye care services using VR and AR (patent-pending) featured in 2018 Forbes 30 under 30 Asia

References:

1. Agrawal R, Gunasekeran DV, Grant R, et al. JAMA Ophthalmol. 2017;135(12): 1318-1327.
2. Agrawal R, et al. Ophthalmology. Feb 2021;128(2):277-287.

Researchgate: https://www.researchgate.net/profile/Dinesh-Gunasekeran