Event recap: Increasing resilience by assuring trust in medicine, credentials, and supply chains – Atlantic Council

Mon, Jul 13, 2020

Event RecapbyHenry Westerman

Related Experts: David Bray, PhD,

On Thursday, June 18, 2020, the Atlantic CouncilsGeoTechCenter andNanotronicshosted YvesDaccord, Former Director General of the International Committee of the Red Cross, Philippe Gillet, Chief Scientific Officer of SIPCA, Toomas HendrikIlves, former President of the Republic of Estonia, IdrisGuessous, MD and PhD, Head of the Division of Primary Care Medicine at the University Hospitals of Geneva, PeterRashish, Senior Fellow and Director of theGeoeconomicsProgram at the American Institute for Contemporary German Studies, DanielleTavino, VP and Co-Founder of Code-X, andDr. DivyaChander, MD and PhD, CEO and Founder oflucidify.

The event wasmoderatedby David Bray, PhD,Director of theGeoTechCenter at the Atlantic Council.

The paneldiscussedthe potential for technological and policy innovationstoenable a greater degree of trust between medical organizations and supply chain providers by following the example of some of the worlds best practitioners.

Personal and public health,as well as the care and medicine required to maintainthem,have always been top priorities for individuals and societies around the world. Amidst the COVID-19pandemic, concernsoverhealth havebecome even more prevalent. Yet, as the panel responded, at the same timeas more people than ever are seeking reliable information andmeasures to protect themselves from the novel coronavirus,healthcare systemsin the UnitedStatesand other countriesareconfronting a crisis of trustemerging in three key ways.

Thepanel emphasizedthe way that, as withall issues of trust,the primary difficultiesareon a personal level.Individuals have found it increasingly difficult todetermine thetrustworthiness ofmedical advicefor dealing with COVID-19. With so muchdisinformationand somany false-but-enticing medical messages floating around themediasphere, ordinary citizensfindit harder than ever toknowwhether recommendationsfrom neighbors, medical professionals, or politicianswill actually protect their health.

Relatedly, medical practitioners themselves have increasingly struggled with trusting the information coming to them from researchers, policymakers, and administrators.The paneldecried that,whether it be a high-profile scandal at prestigiousmedical journals like the Lancet, or a smaller-scale policymix-upor data flaw, doctors struggle to find trustworthyguidelinesto inform theirmedical decisions.

On a systemic level, the medical supply chainrecentlyencounteredserious problemsasindustriesfound their complex, globalsupply chains disrupted by local and international crises. In the name of efficiency, hospitals have outsourced the productionofessential tools, ranging from personal protective equipment (PPE) or respirators topharmaceuticals. Unfortunately, with such adispersed supply chain, itisnearly impossible for hospitals and medical systems to accurately identify their real carrying capacity in times of crisis when many healthcare providers find themselves relying on the same limited suppliers, resulting inunexpectedshortages.

The panel explainedthat, due to the breakdown of trust in the medical system at all three of these levels, the world has failed to effectively respond to COVID-19. Individuals have found themselves unsure of who to trust for medical advice. Doctors are at a lossaboutwhere togetreliable information on the growing pandemic. And hospitals and medical systems have run into shortages andare unabletoutilize theirsurge capacity due to the complexity of theirsupply chains.

Fortunately, the panel advised, new technological tools can help to restore trust in the medical system ateachof these levels. Through the implementation of a data trust for medical and health related information, as envisioned by theGeoTechCenter, researchers couldaccesshard datawhilethe studied individualsremaincertainthat their privacy is notcompromised.Adata trust systemdeveloped by a coalition of public, private, and NGO partners and maintained bycitizen-juriesand transparent regulationscanrestore thesacred trust between medical researchers and practitioners and patients. This framework could store data beyond biometrics as well, including records of suppliers and their sources of devices and equipment, tostreamlinein the medical supply chain.

According to the panels vision, a data trustwouldalso enable individuals to take ownership of their data, deciding how and by whom it can be used. Consideringthetransferof data a transaction in which the individual has equal agency will help build trust in both the dataprovidedand the conclusions drawn from it, as individuals couldchoose to only provide their data to projects that would benefit the commongood.The unified framework of alarge-scaledata collection of this nature would also facilitate easy transfer of information and ideas across communities, states, and nations. In this way, the panel envisionedan economy of trust in health data that couldspread to the entire world, helping build networks of trusted partners within communities and globally. With every medical and data transaction made transparent through the use of technology, medical practitioners couldbridge the gap between patients, doctors, and researchers, restoring lost trust through virtually-enabled person-to-person interaction.

Some of the worlds most advanced medical systems have already begun to develope a system-level data trustor other frameworks for building trust in medicine.

One of the most frequently celebrated examples in recent years has been the country of Estonia, whose esteemed former President, Toomas HendrikIlves,outlined their medical technology innovations for the panel. In Estonia, all medical records and biometric informationarekept on a keyless signature blockchainthrough whichcitizens are granted individual ownership over their data, who accessesit, and for what reasons. The systems design also insulates against potential data manipulation and corruption, meaning doctors and researchers can trust the integrity of the data theyreceive. With high levels of protected data maintainedforevery citizen, Estonia can more effectively prepare for health crises and provide individualized care as needed.

Anotheroft-cited exampleofpervasivesocietaltrustis Switzerland, represented by IdrisGuessous, MD and PhD,of the University Hospitals of Geneva. Though Switzerland is respected around the world foritshighcitizen participation in government, as well asitslow levels of inequality, the UHG system has also begunrollingout technological tools for building trust between citizens, their doctors, and the researchers studying there. Dr.Guessousemphasized how, as the hospital rolled out digitized medical recordsthroughwhichpatientswereasked before their data could be studied, he was surprised by the number of patients who consented to their datas use,so long as their information could be leveragedfor the public good. The panel emphasizedthatmost individuals would be more than willing to provide their data to doctors and researchers,so long as theycouldtrust that the goalsofits use are transparent and worthwhile.

As these examples illustrate, it is technologically feasible even now to develop adata trustakin to the panels vision. Theobstacle, though, is whetherrelevant parties can cooperatetodevelopa system that empowers citizens and builds trust, rather than one that emphasizes individualism, surveillance, and one-sided transactions.

Henry Westerman is an intern with the Atlantic Councils GeoTech Center and a rising senior at Georgetown Universitys School of Foreign Service. His course of study is in Science, Technology, and International Affairs, with a concentration in Security, focusing on the intersection of science and geopolitics, particularly relating to advanced digital infrastructure and outer space development. Previously, Henry has interned at the Library of Congress and the Department of States Office of Science and Technology Cooperation. He also works at Georgetowns writing center, providing free editing and consultations and serves as the historian for Georgetowns student association.