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To Harry. Ok, thanks for the invite. Um I'll just load my slides here. So, um I thought I would just basically run through my career to date quickly. Um, talk about what my current roles are and then just a bit about the radiology landscape, um how things look in terms of applying for training. Um, and then also like life as a consultant. Um, so I went to Uni in Liverpool. I did my foundation years there. Then I did CST. Er, my ambition was always to go down the surgical route. I thought maybe I'd end up doing orthopedics. Um, and then when I was doing CST, I realized that I didn't really enjoy the majority of the job. Um, so it just so happened that one of my friends, um, was ST one radiology at the time. Um, and he said, you know, anatomy from orthopedics, et cetera, maybe, maybe that would be something to consider would be radiology. So I looked into it, did a taste a week, um, and I was completely sold. Um, so I actually resigned from CST once I got my, er, training number for radiology and just did a plastics locum for a few months before starting ST one, during my radiology training I started rast with two other registrars but I'll get onto that. Um, and then I took a consultant job and was doing that for probably about 18 months. Um, before then, er, making the decision to, to do something completely different and move to Dubai and start doing the telera full time. So, um, yeah, like, I guess I was a bit late to radiology. Um, there's more students now who are clued up to it as a career. Um, whereas for me it wasn't really something that I considered as a career. When I was, er, in medical school, radiology was trained kind of as a, as an adjunct to other things. So you'd learn about chest x rays when you were doing your respiratory rotation, um, or you know, ct abdomen when you're doing general surgery or whatever. So, um, it was all, it was all kind of extras to the other things. So no one ever presented it as, as a career opportunity. And I also think that in medical school, when you're looking for training opportunities, you want stuff that you find engaging, you want stuff that um, is perhaps practical or where you, where you feel like you're going to be useful. So, anything that was ward based or in theater, I was always drawn to doing those kinds of things. Whereas like sitting next to a radiologist reporting CT scans was not exactly what I was interested in when I was 2021 years old. So, um, yeah, I guess it, it wasn't something that I thought about as a career but I'm so pleased that I did and, um, there's more and more people now that are thinking that way. Er, the competition ratios now for radiology ST training have gone through the roof. So, to give you an idea when I applied in 2015, um, there were four applicants per training post across the country. Obviously, there's slight like regional variation within that, but nationally it was 4 to 1 nationally. Now, this time round it's 12 to 1. So the number of people wanting a post has, has tripled effectively. Um, the number of posts has gone up a little bit but the number of applicants has gone up massively, which kind of like books, the trend that people were expecting if, um, fears for A I were creeping in and all that sort of thing. Whereas, um, yeah, actually it's, it's, it's become more popular than ever. So, yeah. Um, what do I do now then? So I kind of have two things that are the two areas where I work. So, Hexad is the Teleradiology company that I, that I work for and I divide my time with them into three different things. So, first and foremost, I'm a consultant, radiologist. Um I subspecialise in musculoskeletal work and then I do acute CT as well. So on call type work. Um and then in addition to that, I'm the clinical lead for M SK. So that's the governance side of things, er, managing any feedback that comes in from customers, dealing with um arbitration disputes between differing opinion on reports, that kind of thing. Um And then also looking at how we can all learn from errors. So um making sure that if mistakes do happen, it's, it's inevitable that in radiology, there will be things that are misinterpreted. So how come everybody learn from those to minimize the chance of those happening again? So that's a huge part of the, the governor's role as well. And then um in moving out to Dubai, there was a, a plan to um have a, a hub out here, so to basically develop a community of radiologists out here. And that was driven by the fact that when Hexad looked at the distribution of all their ra radiologists throughout the world, the majority are in the UK. But then they also had quite a large concentration in the UAE. So they thought, how can we, how can we tap into that more? How can we um provide them with more opportunities? And then in the meantime, we have a lot of people who are interested in moving over here to, to work. So it's like, how can we kind of roll all of that into 11 project? Um So within that, I do some recruitment work. And then there's a lot of around how we retain radiologists here, how we make sure the radiologists are happy. Um What kind of things can we do for radiologists who have chosen this as a full time career? What can we provide for them that will um limit the drawbacks compared to working in a department? So for example, if you're a teleradiologist working independently from home, then you haven't got someone in the office next to you to ask for their help on a scan, you, you know that second opinion thing. Um So I've done some work around that again, around managing, around managing errors, er learning from errors. Um So having face to face meetings where we can go through cases, discuss things. Um Yeah, just, just trying to, to build a community out here to make sure that people feel as though um they're valued, make sure that they feel as though their needs are, are being met. They've got opportunity for career development, all that kind of thing. So a very, very sort of different role to um if I was doing NHS practice. Um And then in addition to that, I have rad CST. So this is something that I set up with uh two other registrars. Um And we've continued doing this through training. We started this as a podcast um around the time of starting it. There was a lot of anxiety amongst trainees about the threat of A I, so this is in like 2017, 2018. It wasn't really that much of a, you know, a AAA thing that was within departments. Um It was this thing that was on the horizon that people were scared of. And there's that quote of the guy who was saying that radiologists will be out of a job in 10 years and all that kind of thing. So, um yeah, there was quite a lot of anxiety around it. Um And we thought, how can we get to the horse's mouth as it were? So how can, how can we um get an insight from the people who um know what is actually happening and then how can we disseminate that information to um trainees? And we thought, what, what would be the best medium? And then we just arrived at the idea of doing a podcast. So we ended up doing this monthly podcast um where we'd have a different guest on from a different field, whether it was from an A I company or someone from the media or whatever it might be. Um radiologists who have done slightly different things with their careers. Um And that was our way of sort of getting this message out to, to different people. And then as the podcast audience grew, um we thought, what else, what else can we do? Um So then we started to, to develop courses. Our first course was for um people who were applying for radiology ST training. So an online module of the course and then mock interview practice to go along with that. And then from there, we've just developed courses that go up each step of the chain. So getting people into radiology, um then consulting applications at the other side, um getting them started in F one and then something for um sort of F ones and final year medical students as well. So we've got a, a portfolio of courses that we, that we manage. We've got a, an international anatomy competition now that we've run for a couple of years and then um we're changing how we, how we do the podcast. So, yeah, there's um lots of things there to keep me busy. Um I think what you find with radiologists is that obviously it's, it's completely fine to go, you know, do a full time NHS job. Um It's very rewarding to do that. There's a lot of job satisfaction from that. There's a lot of career development opportunities within the hospital, but you do find that there's a lot of radiologists who have got other things going on outside of the NHS. Um Whether that's people who are um very big on the lecture circuits, you know, they're getting invited to conferences all over the world, whether it's people who are involved in tech. So do they um work for A I companies or med tech companies doing advisory work? Um Whether it's media related things. So there's, there's all sorts of opportunities that you can go into in addition to being a radiologist. Um So the career can be as varied as you want it to be, or it can be as straightforward as you want it to be the consultant who was my mentor in my final years of training. He was doing the same job plan for like 10 years. So he was doing the same thing, day in day out for like 10 years and he was perfectly fine with that. And that's, there's nothing wrong with that. That's ok. But then you have other people that want to want to do different things. And if you're that way inclined, then there are plenty of opportunities out there. Um You can either make enquiries with different companies or you, you know, you can go to linkedin and see what people are up to there. There's loads of, there's loads of different opportunities out there. Um But I would certainly say that if you doing something and you're not happy doing it, then it doesn't mean that you have to stay with that. So um I realized that I wasn't happy with CST. So I found an alternative thing to do. Um Then find what subspecialty are like initially, I thought maybe I want to do head and neck, but then um discovered that I had more of an affinity for musculoskeletal work. So decided to do that instead. Um And then when you progress and you get all your exams and you, you finish training, then the world is your oyster in that, in that sense. So you can um get your job in the NHS, do 10 sessions full time and that's absolutely fine. But if you want to go and live in another country, if you want to work remotely um doing teleporting, if you want to develop other projects on the side, then there's loads of opportunities out there. Thanks very much. Thank you so much, Doctor Harry. That was really, that was really insightful. Um Now I'd just like to hand over to Doctor Parker and we'll start his section session. Um I'll just get the slides up for you. Sorry. Uh let's see. Ok. Ok. Sorry. Mhm. That's well, Doctor Parker is just preparing his slides. Anyone please feel free to drop any questions that you have into the chat. Um We can take some time to answer them now and also later in the Q and A session, I can just tell you actually about what my, what a typical week is like for me now. Um So I work Monday to Friday. Um I do on call shifts, um which cover UK overnight hours on a Monday, a Thursday and a Friday. So I do those from 5 a.m. to 11 a.m. You do buy time. Um, and then er, on the Tuesday and the Wednesday, I just do M SK reporting. Um I do a little bit of that every day but the bulk of that is done on Tuesdays and Wednesdays. And then I have, um, a governance meeting weekly on a Thursday afternoon. I have a marketing meeting, alternate Tuesdays and then I have a catch up with the, er, the chief executive of the business, all alternate Fridays. So I'm, I'm set up so that I do all my clinical work in the morning because I know that I'm a morning person. I know that that's when I work the best. That's when I have the most focus, the least distraction. And that's one of the advantages of teleradiology, you can kind of, you can work to your strength. So, um, obviously the on call is slightly different in that you have to be covering certain hours. But with the routine work, there's a lot more flexibility with that. So the scans are allocated to me and then I can report them when I want. Um, they're always allocated the day before I was doing them. So then I've got the whole, you know, I've got 24 hours effectively to get them done. So if I want to do them early in the morning, I can do if I'm doing them and there's a few more complicated ones in there and then I get a bit tired and I want to take a break, then I can go off, um, go to the gym or whatever and then come back and, er, pick up some work a bit later on in the day. Um, if I want to do more, there's, I can always request, request more work. So, um, it's very, very flexible in terms of that, in terms of the routine work, the on call is the only thing where because you're covering a, a shift and they, they need to have enough people on the, you know, staffing the shift to turn around all the scans quick enough. Um That's the only real sort of time commitment, but that is in the, it's very early in the morning. So that plays to my strengths. If you're a night owl, then, you know, you can do it the other way round. There's someone who I work with who prefers to do their work like 11 pm to 3 a.m. So Dubai time. So they're covering like late evening UK. Ok. Fantastic. Sorry about that guys. Um OK. That uh should be ready for you now. Ok. You can see that there. Yeah, we can sorry about that guys. So, um, thanks everyone for coming along this afternoon. Um It's great to have you all here. Um, now I know this is a talk about careers in radiology. Uh So, uh for me, uh, considering I'm not actually a radiologist, I feel a little bit of an inferiority complex we've had, uh, Jamie there. Um, but I hope that my journey of medicine and now sort of into the world of health tech uh with Hexad, can provide you guys with a bit of insight into the alternative career paths available within medicine, especially sort of within digital health uh that you don't tend to hear about in med school. And I know that's certainly something that sort of Jamie talked about in terms of not knowing exactly what you're gonna wanna do or having certain plans and certain ideas about what you think you're gonna do and then maybe heading in a different direction. Uh And I'll also focus a little bit on digital health and radiology and how they're linked um some exciting developments in the field. Um And what Hexad is doing in the telehealth space and teleradiology space. So, um I suppose my Jamie uh family, Jamie. So I started with the university and as I'm sure you can t to tell from my accent, I'm Australian. So my story story starts back there. Um I did a Bachelor of Science and medical degree at the University of Queensland with a little bit of rugby thrown in. Um And so I probably fell into somewhat of a stereotype for rugby playing medic, uh that I was more surgically inclined. Um and finished up uh with uh honors focusing on orthopedics and sort of just the radius fractures. Uh You know, I probably got a bit more of an exposure to radiology at this stage than, than a lot of people we with my supervisor, we did a lot of analysis of the, the fractures themselves, which was quite interesting and sort of first developed a bit of my interest in radiology as well. Uh I then moved to the Sunshine Coast which is sort of a beach town uh north of Brisbane uh for my internship in junior doctor years. Uh And I continued along this path that sort of gained my first exposure to, to digital health and a new interest there because during my second year as a doctor, um the hospital I was working out underwent a digital transformation uh from paper based um medical records uh to electronic medical records. Um And so that was a big thing. Now, I just wanted to check in here um whether I'll do a little poll uh just to check in to see how many, how many of you have worked uh at hospitals with paper based charts just to get a bit of an interactive. Uh Yes. Right. Ok. I think we've got one and one so far, but basically, um I'll sort of head on while that, that goes along in the, in the background. Um But I was at nights at the time and so I was a bit apprehensive about the whole ordeal, but quickly re recognized the benefit of sort of the transformation there. Um There's no more racing around looking for missing charts. Uh No trying for ages to decipher, sort of impossible to read doctor's handwriting. Uh, you could remotely review patients observations and check what else had been going on with them. Uh, you could do automatic drug dosing and check for interactions with other medications. Uh, but there are also some unintended consequences. So, racing around for the ward looking for a computer now, uh, needing to change battery packs, endless logins and slow loading times. I think that's sort of, um, an important point to make about digital health and for health tech and that's about unintended consequences. Um User centered design and interoperability. Um So I suppose it's extremely important for us to consider uh the people working with technology um in terms of user centered design. Um And I think this is one of the areas where we've sort of been let down uh by health tech so far, especially in the hospital realm. Um These systems are often designed purely for people uh from a tech background and without the consideration of uh of sort of doctors and clinicians who are really important and what they want and what they need. Um And I think in the case of electronic medical records and electronic pa pa patient records, um it's the fact that these are sort of signed on long multiyear contracts worth millions and millions of pounds and thus, they're sort of very hard to change and really to incentivize uh the hospitals to change as well. Um And then interoperability. So that's a, a matter of um of being able to, uh to improve basically um and interact between systems. So between sort of radiology systems, between electronic medical records, stopping all of those endless logins. Um And because I had to change to PDF, I'll just share a different screen with you guys quickly, uh to highlight a little video which I think, uh really captures this quite well. Ok. Has Missus Jones had her CT scan yet? Uh Yeah. Let me see what the radiologist said. No, no, no. We always look at the scans ourselves first. Yeah. Ok. Let me pull it up. Just give me a sec. It's, you know, it's epic. II think you, you go to Encounters. No, II tried that. It's, it's, it's not on that tab. Oh, is it episode or media media tab? Uh I don't see it listed there. I don't know. Uh II think you wanna look in chart review. Oh, it's a chart review. Oh, and I think you just go to imaging and, and try to find the link. OK. Where's the link? II? Don't see the link. You just scroll down. Sometimes it's hard to find the link, you know, let's just take a peek at the radiology report. And, and so I think, um that sort of really highlights a few of those, a few of those issues that we see in medicine. Um And that's about users that are design. So it, it capturing what, what needs to be designed in terms of the clinicians, um they couldn't find how to get the scan. It's not very usable, it's not user friendly. Um Basically, they gave up. So obviously, that's, that's poor user centered design and, and radiology centric and doctor centric and then interoperability. The the ps the imaging system uh was was not able to communicate easily with the electronic medical records. So they were not able to easily switch between the two and then unintended consequences. So the ward doctors did not view the images, they decreased their own exposure to scans, decrease skills, sort of creates hyper specialization within medicine and siloed medical care, which really is not ideal for the patient and not ideal for for you as doctors um really undergoing sort of medical training and improving and creating more holistic care. Um So I suppose going forward, that's something to consider when you guys are thinking of your next big med tech or digital health idea, please keep sort of those three things in the back of your mind. Um And then, uh well, we've got about 18 responses and most people are, have still used sort of paper based charts and paper based medical records. So it's probably far too many uh in 2024. Um But that's something that, that I think is really uh something we need to move forward with and improve in terms of, of digital health and in terms of medicine. Um So yeah, after I sort of experienced that digital transformation. I was still surgically inclined and moved into an ent focused job uh with six months of ent and six months of intensive care at emergency. Uh But the digital health bar sort of started to take hold for me. Uh at this point COVID hit. Um And although we were quite lucky in Australia with the case, numbers saw the massive impact on the healthcare system. Uh but also the rise of telehealth. So telehealth existed prior to that for many years. Uh worldwide with little use, Australia did have a little bit of um implementation of telehealth for managing remote patients basically away from capital cities who are thousands of kilometers or 100s of kilometers away from capital cities. Um But COVID really represented the first widespread use of telehealth. And alongside this came some, some major investment in digital health. Um And I was part of a hybrid ent service where we basically converted most of our appointments to telehealth to decrease the risk of transmission. And this was exciting and interesting. But once again, I really felt as though uh there was room for improvement and we were at times let down by the technology. Um COVID was also a time of sort of increased strain on healthcare workers and that was a tough training pathway for ent where basically a number of my senior colleagues um who despite years of experience and strong commitment, maybe read limited life outside of medicine were struggling to get onto the training program. So decided to change cha and slow down by doing some locum um in emergency and medical specialties. Um loing across Australia it's seeing amazing places. Um and really interesting things. So went out to Broken Hill which is in far west, uh New South Wales in the Outback, went up to the surf coast, Grafton, lots of surfing near sort of an ri um and Yamba and then up to Cairns in Far North Queensland where I got to see the Great Barrier Reef and some really interesting tropical medicine. I'm probably selling the uh the Aussie dream to a few of your medical students as well along the way, the way, I know there's lots of movement over uh to Australia. Um But I think it's sort of important for us to, to think about um try to improve, you know, NHS and digital and health systems so that people do want to stay in their local health system. Um But that's something I noticed and there was dis disconnected health systems limited by technology. And because I've always had a dream to study overseas. Um and now that I wanted to be sort of on that cutting edge of healthcare and technology, um I sort of decided to apply for a new masters um at Oxford uh which basically um was in a, a master's of applied digital Health. So I was lucky enough to um to get on to that course. Uh And we started that at the end of 2022. And so the master's basically was pretty amazing, was uh surrounded by an inspiring cohort of other clinicians, public health uh people, uh consultants, scientists, technologists from around the globe, they all had interesting and unique uh insights and experiences within health care. Uh And we were taught by sort of professors who are world leaders in their fields. Um And often some of the nicest people you have ever met. So I was here, I was really introduced to those concepts uh of magen unintended consequences, user centered design interoperability alongside many more. So we learned the full life cycle of digital health uh from sociology and the interaction between technology and society to a grounding epidemiology and uh developing skills and programming and statistics uh from big data to machine learning and A I more generally, alongside behavior change theory, health economics is your experience of design. So really um broad education and what digital health is um and really what good health tech looks like and could achieve. Uh but also gave me a bit of context as to why digital health systems and interventions were a bit averaged throughout the healthcare system. Um And then my sort of final portion of the master's culminated in a dissertation project. Uh and this is where my sort of link to radiology um becomes a bit clearer and aligns with the second part of my talk. So my dissertation basically was a scoping review on um the use of A I to detect intracranial hemorrhages on CT scans. And was basically examining the current literature on A I mediated detect of, of brain bleeds. I intracranial hemorrhages with non contrast CT scans and focused on sort of performance metrics, patient outcomes and healthcare system outcomes. Um So I won't spend too much time into the background of intracranial hemorrhages. Um You all sort of know what you know what they are being medical students. Um But basically, they are, are very serious spur disease and have sort of for functional uh outcomes after they've uh after they've had the had the episode. Uh that reason for a case is that intracranial hemorrhage is rapidly diagnosed by noncontrast CT scans and their diagnosis prompts management. And when you get faster management, you can improve your prognosis and outcomes for these patients, which is really important when they have such poor outcomes to begin with. Um And so basically, more generally in radiology, there's high workloads, not enough radiologists to deal with the number of scans, which again brings us on to basically the hexad proposition of teleradiology companies. Uh and there's increased wait times, radiology cases. And A I was proposed to increase accuracy and speed of diagnosis, decrease those radiology workloads and potentially create positive outcomes for patients. And so looked at a whole uh number of studies. Um but basically, uh there was about 64 studies that I examined in the end. Um and they came from countries all over the world, 31 different countries leading with USA India and China. Um And then more interestingly, um we looked at the types of studies, they were so 57 studies focused on performance outcomes, 20 studies focused on healthcare system outcomes and four studies focused on patient outcomes. Um So the next thing we can see here is the performance metrics. So the sensitivity and specificity across all of these studies was actually quite high. So 95 and 94% respectively, uh and that's sort of approaching radiology, uh radiologist levels of performance. Now, as sort of Jamie alluded to, there was lots of fear around sort of A I as replacing radiologists. But really, there's been little evidence to suggest that that's going to happen anytime soon. Um But there is some quite interesting evidence where radiology um can be assisted and augmented A I to improve efficiency uh and improve sort of outcomes as well. So some of the interesting healthcare system outcomes I found were that in, in a majority of uh cases. So four out of seven cases which examined radiology workflow, the use of A I improved the speed of workflow for radiologists. Uh more importantly, um this occurred when A I was used to automatically triage um scans in the workflow. So uh when the A I detected that there was a um intracranial hemorrhage, it reprioritized it to the top of the patient list and it was reported quicker and improved that workflow. Um Another interesting uh outcome was the use of A I assistance for performance. So four out of five studies that examined this found an improved uh performance uh for radiologists when they had the advent of A of an A I tool. The most interesting um version of this was when they compared doctors of different training levels. So they compared uh radiology trainees, they compare to general radiologists and to subspecialist neuroradiologist. And when the A I tool was utilized, you could improve the performance of radiology trainees to the level of a general radiologist for detecting intracranial hemorrhages. And you could improve the level of a general radiologist up to the level performance of a neuroradiologist. So this has really important um uh sort of implications for overnight reporting where maybe the radiology trainees on by themselves and the former reports aren't checked by a consultant radiologist to the next day. It's also got important implications for resource poor settings. So in third world countries where they might not be a, you're a radiologist, they might not even be a radiologist. There's just a, a resident who's on for the eeg or an emergency clinician. And if these tools can be utilized to improve their performance, they can improve the outcomes for patients sort of over the world. So uh that's sort of some of the key outcomes that uh I found with that study there. Um So more generally, basically the substantial volume of literature uh demonstrated that the performance of A I media detection, there was higher levels of diagnostic performance, positive impacts on the healthcare system. Um But there's an imperative for ongoing research. Uh really uh this all these points can can apply to uh A I and medicine more generally, but especially in radiology. And that's a movement towards sort of prospective methodologies uh studies focusing on clinical effectiveness and applicability, uh which can increase the strength of evidence in this field. So basically, um for A I and radiology uh in in medicine, there's really just so far, there's been a use of small datasets which increase the risk of bias. There's generally non randomized and retrospective evidence, which again is not a level of evidence. We want, we want prospective evidence with large randomized trials, large datasets because that's going to decrease the risk of bias. It's going to increase the evidence and it's going to increase sort of the level of adoption as well within healthcare. Um Now, interestingly, uh scoping review of uh randomized controlled trials for A I tools found that 81 of 86 trials had a positive endpoint and that shows back to the risk of publication bias. Um There's a whole lot of trials out there. I think it's only 1 to 3% of all trials for that have been registered for A I tools have actually been P published. Uh Most of these RCT S were single center, single country RCT S and only 19% reported citing reporting guidelines. So um there is a lot of work to do with the methodology of these uh of these reports. Uh So I think the next next place to go is where is radiology and A I heading. Um And so I suppose if you're all young and keen and uh interested in research, I would suggest sort of following up on those points and, and creating projects ah um sort of where we're looking for prospective studies that focus on clinical effectiveness, adoption, usability and cost effectiveness. Um But radiology is basically at the forefront of digital health and especially in the use of A I. And I think that sort of makes sense given the technology is such an important part of the specialty. Um And so, so far 75% of FDA. So American approved uh F DAA I tools of radiology specific uh which really speaks to how far ahead radiology is in the medical A I field. Uh But some more interesting tools when it comes to radiology that uh II think would be worthwhile highlighting um is the use of uh detection software. So similar to what I was talking about um with my, my uh my uh research looking at intracranial hemorrhages. So brain omics, uh they have an E stroke A I algorithm uh which helps detect large vessel occlusion and strokes. Um And basically, it's a decision aid for clinicians that runs in the background when the scans done and lets them know um if a large vessel obstruction has been detected in the stroke. Uh And after this was implemented, um in UK hospitals, there was improved door to door referral time for these stroke patients for endovascular thrombectomy. Um But more importantly, there was significantly improved functional outcomes for these patients. So that independence increased from 16% to 48% at three months post stroke. So this basically highlights how A I can be utilized in radiology to um improve outcomes and really improve efficiency within healthcare. Now, um the sort of next frontier I think for uh A I and radiology is the use of multimodal models. Uh for example, Harrison A is Harrison rad one. Basically this is a multimodal large language model where you can input images. So it'll take a a chest X ray and then you're able to use a chatbot style function like chat GPT to give you further input on that image. So it can describe an image, it can tell you what sort of findings you you can ask it. OK. Is there a um a pneumothorax on this, on this chest X ray? And it will reply in sort of real language, easy, easy to understand ah language. And it's, it's really something that could be utilized um in regained resource poor settings where there's no radiologists on call, but also sort of overnight when there's no uh no radiologist available and say in an emergency department, if they're worried about a scan, they can type this in um to Harrison rad one and get a bit of an indication. Now, before I get too far ahead of myself, this has not actually been uh sort of approved for, for use in clinical settings as of yet. It's a, a trial tool at the moment, but it is showing some really positive results um which is quite exciting and I suppose that leads me on to, to my next step steps uh where I am now with Hexad. Um So, Hex Rad is a Teleradiology company, a Radiology tech company that provides uh teleradiology and a software platform to healthcare organizations. And their mission is to provide fast and accurate diagnosis for everyone everywhere. Um And that's a big statement. Uh but one that I really buy into and I'm sure Jamie does as well. Uh My personal ambition moving into health tech um was, was really about helping decrease in efficiencies and inequalities within healthcare systems, uh improve patient outcomes and advance the healthcare experience for both patients and clinicians alike. Um And that sort of harks back to user center design. Um And that really aligns with what Hexad is trying to do. And basically, we've got two key services and that's tech enabled teleradiology where we've got our own internal tech team, uh who've built a whole number of solutions and technical products uh to improve uh our our offering there. So teleradiology is I'm sure, you know, but basically it's about um delivering scans that hospitals are un un otherwise unable to report on themselves. That might be because they don't have enough radiologists to cope with the scan, the overall scan demand. It might be because they can't have radiologists or radiology trainees on overnight. And so any emergency scans that are sent uh need to be sent to an outsourcing or telera service. Um And what hex ad's been able to do, we've developed our integration engine called edge which enables rapid image transfer automatically pulling prior imaging. So it makes reporting a lot easier, easier for radiologists like Jamie, when they've got all the previous information to compare to and also the appropriate clinical information. And in the case of sort of rapid image transfer, they can place to our sort of integration engine. We can transfer CT trauma scans which previously can take up to sort of 30 40 minutes to transfer and they can be transferred to our radiologist in four minutes, uh which is obviously gonna dramatically improve uh time to diagnosis and time to management in the case of say a big car accident. Uh And the second part is sort of business intelligence and workflow management software. Uh that's a tool called opti rad, um which it's probably a bit beyond what we're, what, what we're talking about now with um in, with, in terms of getting radiology students. But uh it's basically designed to help improve productivity within radiology departments and it improves sort of the number of reporting sessions for, for multiple departments. It's improved consultant productivity. So they report more scans per session um and been able to save uh NHS departments um up to up sort of 100 and 6200 lbs uh per year, which is quite a dramatic saving uh and the sort of third and final uh aspects which is quite interesting um for Hexad is we've got a partnership with Newtons Tree, which uh is an A I platform founded by uh other NHS clinicians which provides a platform to select, implement and monitor the performance of A I tools within radiology, but also across the hospital. Um So this is, is something that again, it has been an issue for A I implementation across the healthcare space. So uh like most tools uh the performance uh of A I can vary over time. Uh But also due to issues that I discussed earlier small data sets, uh retrospective trials so often uh the performance that was seen in those trials may not match what's seen in the clinical setting. So it's important to uh provide um the platform to test A I tools within your own hospital and within your own clinical setting and New Tree, Newton's tree. Um And the partnership with Hexad allow integration with hospitals and the ability to select relevant A I tools. So uh say you've, you've, your ed has had an issue with poor rates of fracture detection. So there's a, a multiple tools out there on the market which can uh automatically detect fractures. So you might want to select one of those tools, implement it in your hospital and then check the performance levels and check that they reach the levels seen in those previous studies. And Hexad um and industry allow a platform to do that and ongoing monitoring of, of basically those A I tools. Um So that sort of comes to, to the end of, of what I was talking about with hex around uh I suppose sort of key points for me and key takeaways. Um as Jamie said, is that A I is sort of not gonna replace doctors. Um But doctors that know how to use A I know how to use digital health tools are going to displace the doctors that don't. So A I and Digital health, it's gonna be a really powerful tool to augment our work. Technology is gonna create new roles. Um And there's gonna be a significant uh inter interplay between human and machine co collaboration as we go go forward. Um So, from my end, um I suppose a few takeaways um uh that's just if you're looking about at Digital health and, and alternative careers within medicine. Um There's some really good resources out there. So the B MJ Future Health platform uh they provide free seminars and lots of really useful information. Uh Health tech pigeon. Uh It's a sort of uh a, a newsletter that sends out some, some great updates on what's going on in the digital health world. And there's also the health Tech podcast uh which keeps you up to date with that. The Royal Society of Medicine, Digital Health podcast is another uh really great resource. And then there's a number of great, great people to follow on linkedin if if you're looking to get involved and really research that area. Um But otherwise, that brings me to the end of end of my part. If there's any questions, thank you so much, both of you that was really interesting and really insightful and for the sake of time, we'll move straight into the Q and A. Then um first question, we have a question from Alex. Alex was asking that right now in the UK, there are massive barriers to sharing good quality and clean data to train algorithms. How does this differ in Dubai? So? Well, I suppose, yeah, patient, patient data is always um protected, let's say more so than, than normal data. And the, the same is true over here. Um There's very, very strict policies around data sharing. Um even having discussions with hospitals around implementation of tele rad. Um because that's not something that they're really familiar with over here. The concept of, of where the data is going is um is, is very, very important to them. So, er, yeah, I think that although there's um massive interest here around sort of start up culture developing algorithms, um again, the issue of getting the data to test those is, is still the, the main barrier. Thank you for your answer. I hope that answered your question, Alex. Um Another question for you, Doctor Howie um is if you work as a teleradiologist in Dubai hospitals as well and if that's different to in the NHS. So yeah, so like I just briefly mentioned, teleradiology isn't really a thing over here. So the healthcare system is, is sort of divided in two. So you have government hospitals and then you have private hospitals. Um and every er, every expat here, er, everyone who moves over here for work is reli I is required to have health insurance as part of um their visa. So um that immediately puts you in the private hospital sector and the private hospitals are all very well staffed. There's a lot of competition between different centers in the market. So, er, I guess the, the demand for teleradiology isn't the same. It's not like hospitals in the UK where they're overrun with, with work. Um the hospitals can, can for the most part, can manage uh with the, the in house staffing that they've got. So the need for outsourcing isn't really there. The other thing is the, the population here is a lot smaller and also the demographic is completely different. So the majority of the population here is, er, healthy working age. Um, you don't really have much of a, an elderly population burden. Um, not the same level of chronic disease burden. So, um, yeah, just all of those things coming together to, I mean, the, the demand isn't, isn't really there for teleradiology at the moment. Thank you. Um We have another question from Zacharia um directed to either of you um how competitive is it to get into Hexad or teleradiology? And if there was anything that you did to stand out and what would you recommend to someone aiming for that? You wanna go home? Yeah, I suppose. Um I suppose that's a bit different. So my role at the moment is um actually in the commercial team. So um that's in, I'm a business development manager here. So it's not a clinical role. It's about interacting with NHS and other healthcare organizations um working on sales to them, of our platform, of our um teleradiology services and of our sort of software as well. Um And that's not something that I had any direct experience in previously. Um I think um my knowledge from my medical background and then from um from doing my masters in digital health uh really helped um and sort of aligned, as I said with, with what he Hexad is trying to do within the teleradiology space and create sort of a clinician centric um and patient centric platform um that improves outcomes but is also sort of really usable for radiologists who are reporting with us and then also for the doctors at the hospital um that are getting our reports. So I think sort of um basically that sort of is how I ended up getting the job, but also a little bit of luck and networking as well. So, talking to people who um working within the field that you're interested in, I went to sort of well presented by research at a few radiology conferences and was networking with people there, which is how I got into Hexad in the first place. Thank you. I hope that answers your questions. Zacharia. Um We have another question from Alex. Um It's slightly on the longer side. So I'll let you guys read that. Um Generally though it's about A I MEDITECH regulation. Thanks again though, Alex for engaging. So, well, it's really helpful and I'm sure the other students really appreciate it. So OK, I can start with maybe the first part um in terms of regulation. Um This is uh quite an interesting uh field I suppose. Um because uh it depends, uh and again, it depends what sort of a I you're talking about if you're talking about clinical facing. Um A I, so diagnostic software, uh decision aids, um things that are basically gonna impact diagnosis or management. Um There's a real imperative to um have a strong standard of regulation and a high level of evidence required for these tools. Um But that creates ah further issues for sort of reimbursement um and funding of these so running trials that prove clinical efficacy um are quite difficult um and very expensive. Um So trying to balance that and it's a discussion, I know I was at the B the B and J sort of future health conference just last week. And it was something that they were discussing there is about how do we well in the UK setting, but also sort of worldwide, how do we ensure there's adequate funding so that there's going to be investment and innovation? Um And then letting that translate into um appropriately reregulate tools. Um But I think further down you were talking about um what's the next big step in nondiagnostic med tech world? And I suppose from my end, um I think that's more about improving workflows and efficiencies within the healthcare system. Um So as I talked about with Hexad, improving the, the image transfer time and the accessibility um to prior information, prior scans, which makes uh improves clinical quality of the scans being um produced by our radiologists um but also improves efficiency and then potentially patient outcomes as well. Um And so I think it's more about improving those efficiency based systems, interoperability, making sure everyone in all the different systems can interact. Um For example, sort of medical records, having them accessible for a patient who comes into Ed, but might be from a different part of the country. Um And so their records are localized within their GP and you can't actually tell uh what's been their medical history. So it's about improving those factors that I think is gonna be more, make more of an impact on the healthcare system than sort of new diagnostic tools in A I, to be honest, thank you so much, Doctor Parker again, Alex, I hope that's answered your question. Feel free to drop any more questions in the chat room in our last few minutes. Um We have another question from, was it um I know Doctor Parker, you mentioned some uh resources already, but he's asking if there's any more um resources or mentorship opportunities or experiences that you'd recommend to medical students so that they can gain a deeper insight into the various specialities that they can choose from. I think um for gaining a deeper insight. I mean, in med school, you'll obviously have rotations with, with various specialties and they tend to cover the major ones, surgery, medicine, um critical care, and then you might have electives in your final few years. Um I think that is, is dependent and then when you come into to working as a junior doctor, it's dependent as to what your sort of health system is like as to whether you get access to those various opportunities um in different specialties. So it is something that is quite difficult. Um, if you're not lucky enough to, to get access to those specialties. Um, but I have found personally that most, uh most consultants or um, are often quite, quite open if you were to go in, in a bit of your spare time. I know there's not a lot as a medical student or as a junior doctor. Um and to, to reach out to them, it's often better maybe in the hospital setting in person. I know there can be limited interaction with emails sometimes um from, from medical consultants in hospitals. Um And then I suppose in terms of resources, um that's gonna tend to be country specific, but having a look at sort of training program requirements is, is often a really good thing to give you insight as to what's required to get onto a training program. Um So that can, that can assist you into uh when you think about what sort of stuff you have to do to get there. Um And then relevant CPD courses that will often give you uh a really good insight into the specialty and really shows off what those specialty specialties do have to offer. Um Jamie, did you have anything sort of, I suppose? Radiology just specific there? Sorry. Yeah, I think um again, it just comes, it comes down to putting yourself out there. So, um opportunities aren't going to come to you. You have to go out and find them and the first place to go is gonna be the radiology department. And I know that historically, the perception of radiology is that the radiologist is this grumpy guy that wants to sit in a dark room and be left alone all day. But actually, you'll find that most radiologists, if you approach them and say I'm interested in your career, then they'll become really animated and they'll want to guide you. They'll want to provide you with opportunities, they'll want to learn more about you. So, um yeah, I mean, if we're talking about radiology specifically, then that's what I would suggest. Go to the department, like find a consultant and tell them that you're a medical student that you're interested in radiology as a career or that you want to learn more, you know, is there any time where you could shadow them or, you know, just, just start from there, take it from there. And then um similarly, if you're wanting to do some CV building, then um go to the department and ask, are there any any projects that you have ongoing at the moment or that you want to do that you could help with data collection or something like that? So, um yeah, fir first port of call is, is go down to the department? Definitely. Thank you. I'm sure that the students are really, really appreciating the time that you're taking to answer their questions so thoroughly. Um As I'm conscious that we're running over, we'll just finish off with the last question, a question from Zacharia. Um He's asking about if there's anything you would recommend for clinical roles to people interested in Hexad and a few more general in general details about your work as a hex radiologist doctor. How, um regarding kind of how much? Ok, so I guess there's sort of 22 sides to it. So, um there's my roles and then there's working as a radiologist in teleradiology. So, um Hexad, they um will look at anybody who approaches them basically. So if you're, if you're a consultant radiologist um on the GMC specialist register, you've got F RCR. Um and you send your CV in, then they will be interested in, in whether you can work with them or not. So, um what it comes down to initially is what you want and what is available. So if you come along and say I want to do all, you know, a full night shift every day of the week, then they'll probably say we don't have enough capacity to be able to bring you in to do that because obviously it's already a fully staffed ROTA. Um or you might say, um I want to do cone BMC T um And I want to do 300 cone BMC T cases a week and they'll say, well, we don't have that much work coming into us to be able to, you know, provide you with all of that. So, um, it's a bit of, it's a, it's a discussion around like what, what you report, what is it, what is it that you're looking for and then what's available at the time. So as it stands, we have a lot of people that want to do the on call. So the rotor is fully staffed, but then as the volumes go up and we have to bring more people in, then there's people that, that kind of come off the waiting list to, to join that. Um And then with the routine work, the musculoskeletal radiology is probably the field that has the largest pool of work in teleradiology. Um primarily because there's more people that can request it. So, um you have stuff coming in from GPS, physios, et cetera, as well as orthopedics and um you know, triage services and stuff. So, yeah, the M SK is probably the, the subspecialty of radiology that has the largest pool of work within tele rad. Um in terms of me specifically, um Harry mentioned earlier, look, look and networking. Um So, yeah, I interviewed, er, Amy and Farzana um from Hex, the two of the founders um on the podcast. We had them on the podcast twice actually. Um So I already knew them through that and then, er, I was speaking to them at a conference actually over in Dubai a couple of years ago and we were talking about their ambitions for, over here, I was looking at moving. Um So then we just kind of progressed to discussions about how I would be able to fit into the company and, and what the role would look like. So, um yeah, it wasn't as though there was a, a job advert and I applied for it. Um I, you know, it was just the right place at the right time and, and, and knowing the people already. So, um yeah, I think that one thing that doctors are used to is being on this path. So, you know, that you have to get into medical school, you know, that you have what a levels you have to do, you know that when you're in medical school, you have your exams at this time of year. So everyone starts revising at the same time of year. You know, you've got these other portfolio requirements that you need to meet then that's the same basically for your whole career. So, you know, when F one starts, you know, when you're moving to F two, you know, when you're applying for specialty training, you know, when you're doing your exams, um it's all there out in front of you, which is not how it works in the real world in, you know, outside of, outside of the health service. So, um there's much more emphasis on networking, on creating opportunities um on making something for yourself as opposed to just following a, a prescribed path. So I think that um it can be quite daunting because you, it's something that feels very unnatural. Um It's something that you, you don't have a defined endpoint for. Um It's, it's something that's quite alien to, to what you're used to. So, um all I would say is you have to go out there and look for the opportunities and you might get rejected from stuff, you might be accepted for something and then it turns out to be not what you, what you were looking for in the first place, but you have to put yourself out there and try. Um And I think one of the great things about Hexad is that um getting involved in a company that is growing in such a way and being able to be part of that growth is really, really, really exciting. And the um the founders, they all have a radiology background, they're all, they're all radiologists. Um They're all still pra practicing as radiologists as well. So, um they have this insight into the world that we're all working in and they're always looking for ways in which things can be improved and then they're in a position to be able to make those changes. So, um it's really inspiring to see how they want to do things, how they want to develop things um and how quickly they can make stuff happen. Thank you so much, Doctor. How are you Dr Parker for sharing your insights with us today? Um It's been a super inspiring and informative session. We really appreciate your time and expertise. Thank to the students. Thank you all for attending. We hope you found the talk helpful. Um If that's the end of the questions, I hope you all have a great rest of your evening. And thank you again.