Category Archives: Health Tech

Education, Health Tech, Healthcare, Healthcare News, Wales News

Educ8 launches first Welsh Healthcare Science Apprenticeship Programme

Wales based training provider Educ8, are the first in Wales to launch the new Level 4 Health Care Science Associate Apprenticeship qualification, working in partnership with NHS Wales Health Boards.

Leading private training provider Educ8 are supporting the National Health Service (NHS) to address skill shortages and develop key skills within the health sector, where capacity is directly related to the number of skilled staff.

A year that has seen unprecedented demand on the NHS, in the wake of the COVID-19 pandemic, has also seen rising levels of appreciation for health care workers and front-line services. In January this year, the Health Foundation reported that there had been a substantial increase in the number of people wanting to work for the NHS.

In recent months it has been highlighted that apprentices working for the NHS have been of significant help during the most challenging times of the Coronavirus pandemic, with Ken Skates, Minister for Economy, Transport and North Wales, acknowledging that there is a need to ensure the next generation of NHS workers are skilled, adaptable and work-ready in order to support our economic recovery.

Liz Hargest, Education Development Manager with Health Education and Improvement Wales (HEIW) said: “This Framework is an exciting development that will be part of a suite of resources available to support the development of staff and build on the high-quality services already delivered. Offering transferable knowledge and skills in over 50 disciplines, the accredited scheme will not only upskill individuals but will provide a sustainable solution that will benefit everyone.”

The apprenticeship programme is a hybrid process enabling NHS staff to learn while they work, with much of the course being processed online.  A significant advantage of the programme being delivered in this format is the benefit of being able to ‘earn while you learn’ while also being able to remain in the areas that they live, through working with their local health boards.

Sarah Kent, a RTT Co-Ordinator in the ECG Department for the Cwm Taf Morgannwg University Health Board, shared her experience of the qualification: “I have worked in the Cardio-Respiratory department for a long time and always found my interests and heart belong here. Having this qualification will mean that I can achieve my dream and develop my skills and knowledge in the cardiac diagnostic testing and be able to assist my colleagues in a more competent manner. This means the department will benefit from more experienced members of staff relieving them of a very heavy workload thus using my transferrable to the best of my ability.”

The Level 4 qualification will support learners into assistant audiology, blood science and clinical engineering roles to name but a few, with learners being able to enrol from NHS organisations right across Wales.   While the programme is running across the whole of Wales, the project has been led by Cwm Taf Morgannwg University Health Board (CTM UHB).

Rhian Lewis, Assistant Learning & Development Manager at CTM UHB said: “It is great to see recognition for the staff who are already working hard and developing their skills.  The qualification will create further development opportunities and make them available to staff where they live, in their local area and through their local Health Board. This is a hugely exciting development. ”

Educ8 are the first training provider in Wales to deliver the innovative Level 4 Apprenticeship Framework, combining the vocational learning expertise at Educ8 with subject experts in the health service.

Speaking on the launch of the qualification, Ann Nicholas, Customer Account Director at Educ8 added: “We are delighted to be the first provider to bring this much needed Apprenticeship Programme to Wales.  We are committed to supporting the Welsh Government’s aim of increasing the number of apprentices employed in Wales and preventing a future skills shortage in the NHS. This year has been challenging for us all, but not least our incredible healthcare and frontline workers.”

Applying for the qualification starts with registering online, with more information available on the Educ8 website.

Health Tech, Healthcare, News

The Royal Marsden partners with Agilisys to innovate data systems as part of digital transformation goal

Working with Agilisys, The Royal Marsden NHS Foundation Trust sets its sights on cloud-provisioned services to deliver transformational informatics for its clinical, research and operational communities

The Royal Marsden NHS Foundation Trust has selected a consortium led by Agilisys to help deliver a new, innovative informatics environment for its clinical, operational and research analytics over the next five years.

This initiative is an integral part of the Trust’s wider digital transformation objective which will help to improve ways of working through providing a more updated, innovative storage system for patient and clinical data that can be used in a better way to provide insights and help inform decisions for patients. It replaces a system that was first developed by The Royal Marsden nearly four decades ago and was, at the time, one of the first clinical databases and fully integrated electronic patient record (EPR) solutions.

The Royal Marsden is a world-leading cancer centre specialising in cancer diagnosis, treatment, research, and education. As the largest comprehensive cancer centre in Europe, The Royal Marsden sees nearly 60,000 patients every year. Together with the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), working closely with its academic partner, The Institute of Cancer Research (ICR), its ground-breaking research influences how cancer patients are treated and cared for across the UK and around the world.

The Royal Marsden is now investing in a solution, delivered in partnership with ClikHealth Solutions and Aridhia, that will enhance its ability to undertake transformational clinical informatics. Once fully operational, the system will provide staff with advanced data and analytics that will support the continued delivery of the highest standards of patient care. Clinical researchers and scientists will have rapid access to both the data and the tools that will enable radical new approaches into cancer research. In addition, hospital staff across all disciplines will benefit from access to their own suite of analytical tools and visualisations all driven from the same patient-centric cancer data model.

Steven Francis, Director of Performance & Information at The Royal Marsden NHS Foundation Trust said: “The new solution we are designing with Agilisys will enable us to make a significant step-change in the way the organisation interacts with data in all aspects of research, planning, and delivery of care. Our clinical and operational data is such a rich, asset, and we must ensure it can be securely and appropriately leveraged by clinicians, staff and our academic partners to provide insights, inform decisions, and facilitate discovery.”

“Through the Agilisys-led solution we will be able to redefine how stakeholders interact with data, whether on their mobile phone, tablet or laptop. They will have the right information, at the right time to make the right decisions.”

This ambitious goal requires the re-engineering of The Royal Marsden’s cancer data model, built for the future, optimised to deliver rapid insights and to exploit all the benefits of a robust and secure cloud platform provided through Microsoft Azure technologies. The solution will provide a high-performance database which will be capable of processing large volumes of structured and unstructured data with proprietary machine learning algorithms.

Agilisys is one of the UK’s fastest growing and innovative cloud and digital transformation specialists across the public sector, enabling organisations to adopt technologies, platforms and processes that promote new ways of working.

The Royal Marsden currently has an active portfolio of over 450 research trials and recruits over 4,000 trial patients each year. Upgrading the data environment will provide new ways for teams to rapidly identify patients who will benefit from specific clinical trials, supporting data driven research by being able to supply up-to-date data at volume.

Paul Williams, BRC Informatics Programme Manager at The Royal Marsden said:

“The Royal Marsden and ICR together operate the only Biomedical Research Centre (BRC) dedicated to cancer. We are one of 20 BRCs in England, each funded by the National Institute for Health Research, and our goal is to undertake translational research that rapidly accelerates clinical discoveries from the research environment to direct patient care – a ‘bench to bedside’ approach. This initiative represents a paradigm shift in our informatics capability, laying the foundation for the development of AI technologies in imaging and clinical decision-support informatics that will have a radical impact on patient care.”

Max Jones, Managing Partner – Health at Agilisys added: “The Royal Marsden wanted to do a complete data refresh from top to bottom so that it could improve the way stakeholders interacted with the data. To glean as much potentially life-saving information from the data as possible, it was imperative that complex algorithms could be run atop the data.

“The proposed solution offers a cost-effective means for Royal Marsden to store, process and access several terabytes of sensitive data in seconds. The project supports The Royal Marsden in maintaining its position as a digital trailblazer in healthcare.”

Agilisys is an established partner for the public sector. For over two decades the customer and outcomes focused organisation has earned a strong reputation and holds deep domain expertise to deliver change and innovation.

About The Royal Marsden NHS Foundation Trust

The Royal Marsden opened its doors in 1851 as the world’s first hospital dedicated to cancer diagnosis, treatment, research and education.

Today, together with its academic partner, The Institute of Cancer Research (ICR), it is the largest and most comprehensive cancer centre in Europe seeing and treating over 59,000 NHS and private patients every year. It is a centre of excellence with an international reputation for groundbreaking research and pioneering the very latest in cancer treatments and technologies.
The Royal Marsden, with the ICR, is the only National Institute for Health Research Biomedical Research Centre for Cancer. This supports pioneering research work carried out over several different cancer themes.

The Royal Marsden Cancer Charity raises money solely to support The Royal Marsden, a world-leading cancer centre. It ensures Royal Marsden nurses, doctors and research teams can provide the very best care and develop life-saving treatments, which are used across the UK and around the world.

From funding state-of-the-art equipment and ground-breaking research, to creating the very best patient environments, The Royal Marsden Cancer Charity will never stop looking for ways to improve the lives of people affected by cancer.

About Agilisys

Agilisys is the technology and transformation partner for the public sector. For over 20 years we’ve partnered with healthcare, local government and organisations throughout the public sector. Working together to unlock the potential of technology and transform the services that improve lives. To find out more visit www.agilisys.co.uk

Health Tech, News

How Touchscreens Are Transforming Our Approach to Healthcare

The healthcare sector is constantly changing – and there is no time this has been truer than now.

Touchscreens are a key part of how this change is occurring in the healthcare sector; we’ve looked at some of the major ways touchscreens are impacting healthcare and discovered the following:

• Self-service information point touchscreens improve check-in times in hospitals for 3 in 4 patients and improve wayfinding within hospitals
• New processes for quickly categorising and diagnosing patients are now possible with touchscreen “reception” desks which improve the efficiency of seeing patients
• Applications such as touchscreen-enabled bedside terminals and psychiatric care screens are now integral parts of the care systems of many clinics
• Hospitals are also beginning to use touchscreens to improve accessibility, including “dimpled” touchscreens for visually-impaired users
• Touchscreens can considerably improve hygiene when compared to traditional buttons in medical devices and technologies

Quickly Identifying Health Needs

Touchscreens can also provide a valuable way of asking quick screening questions for patients entering the hospital. This can allow key information to be ascertained immediately upon arrival; for example, if a patient selects the option that they are experiencing flu symptoms, the screen can ask the follow-up question “have you received a flu vaccine in the past 12 months?”. LifeHub, a Hong Kong-based clinic offering specialist, bespoke treatments, recently installed such a system to help identify health needs quickly and efficiently upon entering the building. Ms Candice Chan, Executive Director at LifeHub, said that the new system allowed patients to “identify their health needs in a way they can understand and afford” and described the new technology as “a new personalised consumer health experience” which was transforming the way they approached healthcare.

Information Screens

The implementation of informational touchscreens in hospitals, doctor’s surgeries and other healthcare centres can significantly improve check-in times and help manage the flow of patients in busy hospitals. However, this technology is still not widely implemented in the sector despite its proven efficiency; this study from the California Healthcare Foundation discovered that although 75% of patients felt that checking in via a kiosk was faster than checking in through a receptionist, only 5% of hospitals provided touchscreen check-ins.
The use of touchscreens can also help patients to find their way around massive hospitals. A study at Emory University Hospital discovered that wayfinding challenges cost the hospital more than $220,000 per year; however, touchscreen solutions have been proven to assist in this regard. After Boston Children’s Hospital introduced a smartphone app to help visitors with wayfinding, 65% of users said it improved their experience, whilst a study of the 3rd largest UK hospital discovered that over 86% of users who interacted with a touch screen wayfinding monitor found their desired destination without requiring further support.

Easy to Use and Accessible

One of the major challenges in healthcare today is making services accessible and user-friendly. One of the solutions the medical sector is currently using to solve this is touchscreens; a touchscreen is something intuitive and simple to use which most users can understand with minimal learning required. With no fixed user interface, these screens can also be continually updated with new user improvements as required.

New adaptations to touchscreens in hospitals are even allowing these technologies to aid those with visual impairments. Ian Crosby, sales and marketing director at Zytronic, commented:

“Touchscreens are becoming available which can have dimples and grooves machined into their surface. Together with touch force-sensing technology and audio feedback, these alterations make the screens usable by patients and visitors with sight impairments and accessible to all”

Bedside Terminals

In the busy environment of a hospital or medical centre, information needs to be accessed and recorded as quickly and efficiently as possible by nurses, doctors and other medical professionals.
Touchscreen bedside terminals are an easy way for these people to gain access to critical information about a patient as required, especially if a patient is asleep or incapacitated and unable to provide information to a passing member of staff about their state. These bedside terminals have been successfully implemented in many hospitals around the world, allowing for a standard of healthcare not previously possible.

In addition, certain touchscreen technologies have been developed to allow interaction whilst wearing latex gloves and other protective gear; these touchscreens are allowing medical professionals to safely access critical information at a speed not previously possible, offering dramatic improvements to patient care especially when time is a critical factor.

Psychiatric Care

The varied uses of touchscreens have even found effective applications in the care of psychiatric patients in acute or long-term care facilities. Recornect, a Dutch mental disability care solutions company, used large, robust touch screens to allow patients to control aspects of their living space such as the ambient lighting, choosing entertainment or making calls to family or members of the medical team. They also allow psychiatric professionals to administer visual rehabilitative treatments safely from another room in a non-confrontational manner. The flush nature of the design means that the system was free from projecting parts, switches, bezels and buttons which could be damaged by aggression or used to self-harm.

Hygiene

Although hygiene has always been a significant consideration in healthcare facilities, it has never been more vital than now. With the onset of COVID-19, it is now imperative that all aspects of healthcare are as hygienic as possible to help prevent the spread of the virus.

Whilst traditional buttons and keyboards still form a large part of hospital infrastructure, for example in reception desks, lift controls and more, these can provide potential hotspots for spreading microbes and harbouring dirt. With the moving parts, nooks and crannies of mechanical buttons, thorough cleaning and disinfection is challenging. However, a suitably designed touchscreen provides a single unbroken interface which can be disinfected quickly and efficiently multiple times a day.

Ian Crosby of Zytronic Displays commented: “Touchscreens are now available made from antimicrobial glass or which have specialist coatings applied. These can impair and, over time, kill microbes on the surface; together with a regular disinfection regime for the screens, these can help reduce the spread of bacteria and viruses within medical centres”.

Zytronic is a UK-based touchscreen manufacturer who has developed award-winning touchscreens for leading companies in the medical sector for more than 15 years.

Health Tech, News

Thomson Screening completes successful pilot study for new Covid-19 screening management software

Thomson Screening Solutions Ltd has successfully completed a pilot project testing its Covid-19 screening management software.

With Covid-19 testing an important part of controlling the spread of the virus, finding an effective software system to manage the testing process and collate the results, on a national level and individually within businesses, hospitals, care-homes and schools etc., is essential

Thomson Screening developed SchoolScreener Imms in order to manage health testing within schools, but with the outbreak of the coronavirus pandemic, the company received a grant from Innovate UK Funding to adapt its existing software to deliver automated, audible and scalable administration of large scale Covid-19 testing including patient feedback and outcome analytics.

The C19 Screener software, which manages (not administers) the tests, has now been successfully trialled through a pilot project. This pilot finished on time, on budget and achieved all its goals of demonstrating the capabilities of the test manager. It is now ready for integration into the Government’s testing plans.

“Testing is a key part of controlling the spread of the virus, especially as we return to school and work. However, testing is only useful when it is properly managed and tracked. If you miss people, or record the wrong results, or don’t test frequently enough, it loses its efficacy. C19 Screener helps to manage this process and allows the user to integrate and analyse the data.” Says Thomson Screening co-founder Michael Ter-Berg.

Thomson Covid-19 Test Manager is a software platform that enables testing providers to scale irrespective of where, how and what test is carried out. Functions include automated reporting at local and national level for bodies including Public Health, Community Health and Employers with data reporting into other systems, as required.

A separate module using questionnaire and risk assessment methodology enables local residents to self-report Covid-19 symptoms with automated reporting to local (or national) Public Health and the ability to automatically push out messaging specific to the individual with symptoms.

The same software system can also be used to manage a vaccination programme when appropriate.

“The pilot was a success and clearly demonstrated the capabilities of our Covid-19 Test Manager software. Now we are just waiting for the Government to decide on the best testing process and mechanism. Once that is confirmed we can start to integrate C19 Screener into nationwide testing as well as helping individual businesses, schools and hospitals manage their testing, which in turn will help us tackle the virus and slow its spread.” Explained Marta Kalas, co-founder of Thomson Screening Solutions Ltd.

For more information see: https://workscreener.com/covid-19-test-manager/

Thomson Covid-19 Test Manager is a software platform that enables testing providers to scale irrespective of where, how and what test is carried out. Functions include automated reporting at local and national level for bodies including Public Health, Community Health and Employers with data reporting into other systems, as required.

A separate module using questionnaire and risk assessment methodology enables local residents to self-report Covid-19 symptoms with automated reporting to local (or national) Public Health and the ability to automatically push out messaging specific to the individual with symptoms.

Thomson Covid-19 Test Manager is designed to adapt rapidly to fast changing requirements and is fully scalable. The Innovate UK grant enables Thomson Screening to utilise investments made in the core functionality of the company’s products used in the NHS, especially its SchoolScreener Imms product, to rapidly repurpose and deploy the software.

To learn more visit https://workscreener.com/covid-19-test-manager/

Case Studies and Partnerships, Health Tech, News

Royal Cornwall NHS Trust chooses Navenio’s location tech as part of e-transformation project

Navenio, the UK healthcare scale-up, has announced that the Royal Cornwall NHS Trust has selected its location-based AI platform to support Clinical Imaging Assistants (CIAs) (radiology portering and service support ) as part of a programme of efficiency improvements within the Diagnostic Imaging department.

The partnership involves supporting the trust in two key ways; firstly, it covers the indoor location-enabling of the Royal Cornwall NHS Trust site, with a view of it being integrated with existing staff and patient facing applications. Secondly, The Trust will adopt Navenio’s AI-powered Intelligent Workforce Solution (IWS) for use by radiology CIAs and operational staff, across its 500-bed site at Truro. This will increase the efficiency of teams and improve patient experience by linking them with an appropriate staff member based on where they are in the hospital.

Navenio’s location technology will be made available on-site, so that the Trust’s e-transformation team can assess its impact and potential application in other use cases such as patient wayfinding. The scale-up will provide a SaaS licence to the site for a period of three years supported by professional services. Its infrastructure-free technology provides ‘right person, right time, right place’ localisation service for the indoor environment, where GPS doesn’t work.

“Navenio will give us the agility we need to evolve our portering systems”, commented Ian Nicholls, eHealth Transformation Manager at the Trust. “I’m delighted to be working with Navenio to implement its infrastructure-free technology, which will optimise facilities across the Trust and improve the level of care patients receive at this critical time.”

Tim Weil, CEO of Navenio, added: “It’s great to see our platform helping NHS trusts navigate complex workflows to ensure more agility within patient services. I’m looking forward to working with the Royal Cornwall NHS Trust team to deliver efficiency benefits so they can become a flagship for indoor technology adoption in the NHS.”

The project kicked off in July.

 

Health Tech, Healthcare Tech, News

IAM in the Healthcare Industry for Improved Consumer Experiences and Efficient, Secure Access Management

By Johann Nallathamby, Associate Director – Solutions Architect at WSO2 and Sherene Mahanama, Senior Technical Writer at WSO2

The ongoing COVID-19 pandemic has placed healthcare systems and their efficiency (both operational and technological) under greater scrutiny. The healthcare industry has some of the most valuable, high-priced information sold on the dark web. Since they are a prime target for cybercriminals, it is vital for healthcare organisations to use a strong and secure Identity and Access Management (IAM) system to protect this information, while also ensuring that this extra security does not hinder the time-sensitive nature of healthcare work.

Regions across the UK with good centralised healthcare management systems share patient information and medical records across hospitals, to ensure quick access to patients’ medical history. Sharing information this way requires a solid IAM platform as the central backbone such as NHS Identity to connect, authenticate, and provide quick but secure access to healthcare professionals and patients across multiple systems. Local/ regional systems require a way of mediating with NHS Identity and this can be done using an IAM product such as WSO2 Identity Server.

Let’s take a look at how this can be done easily, saving valuable time for hospital staff.

Adaptive Authentication

Health data requires a high level of security, however, it is tedious for healthcare professionals to constantly go through 2–3 levels of proving their identity when they barely have the time to do it once.

Adaptive authentication can be configured to only prompt extra steps of authentication when the authentication is abnormal in some way (e.g., authorising a high risk medicine, logging in from a different location/device etc.)

Login analytics can be used to gain insights into potential security risks and configure risk-based adaptive authentication. For example, if a doctor logs in from within the hospital network, this might require only one factor of authentication whereas a doctor logging in from home might require two-factor authentication.

Identity Federation and Just-in-Time Provisioning

The NHS identity federation service supports OpenId Connect, SAML or WS-Federation Federated Identity. Using one of these standards, WSO2 Identity Server can federate user accounts of patients/doctors over to the local system, saving countless hours that administrators would spend creating user accounts for hospital employees.

When we factor in the increasingly fluid staff that includes visiting surgeons, residents, part-time doctors etc., who require limited privileges and access to the hospital’s data in real time, access control becomes an even bigger nightmare. Fortunately this can be handled with Just-in-Time (JIT) provisioning where visiting specialists can be authenticated into the system in real time, using their existing NHS credentials, and can gain limited access to resources.

Furthermore, approval workflows can be set up for provisioning or granting access to certain applications for trainee or part-time doctors. NHS Identity supports six deployment patterns as detailed in NHS Identity: Authentication and Authorisation Deployment Patterns. WSO2 Identity Server can represent the local/regional AuthN or AuthZ server in any of the six patterns to support the local system to authenticate and authorise with NHS Identity.

Fine-grained Entitlements

One of the primary reasons for healthcare vendors and hospitals to require a good, stable IAM solution is to authorise users securely according to the different levels of access they require. A pure role-based access control (RBAC) model will usually not be scalable in a health institution considering the different types of roles and specialisations in each of those roles.

Instead, we could use permissions-based-access control to assign permissions to roles on a more granular level by defining exactly which actions are allowed for a particular resource depending on the role.

However, most practical real world scenarios in the health industry would have more complex requirements and may require authorising access to certain resources based on attributes such as time of access, assigned patient ID, location, etc., in addition to the roles/permissions.

Therefore, usually the most appropriate form of access control would be to use a fine-grained, attribute-based authorization policy language like XACML to define these complex and detailed authorisation rules. WSO2 Identity Server can be used as a XACML engine to securely handle authorisation rules and access control.

API Security

APIs and microservices are used to collect and update patient data efficiently and securely. Healthcare APIs are an essential part of centralised healthcare management. Using APIs, hospitals and medical offices can share data within local systems in the UK to gain quick access to patient information, reduce errors, and improve overall efficiency.

The WSO2 Healthcare Integration Platform is a solution built on top of our industry-leading, open-source integration platform which allows you to quickly transform your data and expose secure APIs to meet interoperability requirements mandated by governments.

In NHS Identity deployment patterns 5 and 6, the user identity is sent from the NHS system to the local service provider to authenticate the user but the authorisation rules are handled by the local system. WSO2 Identity Server uses OAuth2 and can support the token exchange from NHS services to the local system and from the local system to NHS. Using WSO2 as the authorisation server for the local system, enables complex authorisation rules/policies, application of security to verify the API calls, and throttling to regulate the number of authentication calls.

Furthermore, all six of the NHS Identity deployment patterns highlight token exchange with a local/regional authorization server. WSO2 Identity Server can also play the role of the local/regional server to accept incoming token requests in an API Manager ecosystem.

Progressive Profiling For Better Patient Profiling

Treating the healthcare platform as a CIAM project (Customer Identity and Access Management) can be a good approach to gain insights and a 360 view of a patient’s activities.

APIs can help towards providing better patient care by capturing every part of the patient’s journey in that hospital. A patient may enter the hospital for a simple appointment that later escalates into multiple tests and scans, medications, surgery, post-care appointments, etc. With standardisation of APIs across all these services, the medical industry or at least hospitals in the UK, can avoid all this data being isolated among different, disconnected data silos and instead, use all of it to get a full and detailed collection of the patient’s healthcare story.

A unified view of a collection of patient information that is this big can be used to help profile or categorise patients. This is helpful in order to improve patient service in a variety of ways including alerting them when a doctor they were trying to channel is available or to do targeted marketing and promotions for patients depending on their interests.

User Managed Access

Patients increasingly wish to share sensitive health data extracted from Internet of Things (IoT) devices and wearables such as smart watches but struggle to do this in a secure and controlled manner. Enabling patients to do this would contribute towards improving health outcomes and providing quality patient care and patient satisfaction.

IAM solutions can provide ‘user managed access’ mechanisms to enable this level of controlled data sharing between patients and healthcare providers.

These are just a few ways that an IAM solution can help healthcare organisations protect the sensitive nature of the information they are dealing with on a daily basis without introducing a burden of bureaucracy that could get in the way of delivering a quick and seamless healthcare service to patients.

If you would be interested to find out more about WSO2’s services or your organisation is considering integrating open-source APIs into your business practices, please visit:

www.WSO2.com/?utm_source=external&utm_medium=media&utm_campaign=wso2ishealthcare_jul20