>>Welcome to this IBM Watson health client conversation here. We're probing the dynamics of the relationship between IBM and its clients. And we're looking back, we're exploring the present situation and discussing the future state of healthcare. My name is Dave Volante from the cube and with me are Alex Dillard. Who's a senior director data analysis at blue choice, blue choice health plan, and Darryl decode, who is IBM with IBM Watson health. Of course. Welcome gentlemen. Good to see you. Thanks for coming on. >>Hey, >>So, you know, you think about lasting relationships. They're the foundation to any partnership and this past year, and it's tested all of us. We've had to rely on both personal and professional relationships to get us through the pandemic. So Alex, let me start with you. How has the partnership with IBM supported you in 2020? >>Well, uh, I've just a piece of a larger puzzle. Uh, the relationship that Darrell and I have had is confined to IBM Watson health, but blue cross blue shield, South Carolina, which food choice is a wholly owned subsidiary of has had a standing relationship with IBM on the it side. Uh, we are a mainframe shop, uh, about 70% of our it infrastructure is on a mainframe. And, uh, that puts us as a segment one client for IBM, we're in the top 300 of all of their clients in the Americans. And more specifically we're the fourth largest, um, uh, Linux on Z shop in the world. So, uh, we've got a lot of diversification at blue cross blue shield of South Carolina and the mainframe and the vastness of that. It infrastructure reflects that, uh, diversification. We are more than just a crossing the shield. Uh, that's typically what people think of is insurance when they think of crossing shield, but we also have a division that does a lot of subcontract work for government programs, uh, track air, which is the military healthcare, uh, claims processing and Medicare claims processing. >>We were a subcontractor of other folks that use our back office, it infrastructure to, to run their claims through. So that's, that's the larger, um, aspect of our relationship that, that blue cross blue shield of South Carolina house with IBM, uh, as it relates to Watson health, we have been a client since 1994 and obviously that predates the IBM proper. Uh, we were a client of med stat and then Truven, who then, uh, was bought by IBM. So we have used the products from Watson health throughout our system to support provider profiling, uh, count group reporting, um, and ad hoc analysis and to some extent to, uh, support our value-based products with, uh, ACO and PCMH, >>Uh, products. >>Awesome. Thank you for that. So Daryl is very long-term relationship. Obviously, if people forget sometimes that, uh, how IBM has modernized the Z Alex talked about, uh, Linux on the mainframe. That's pretty cool. I wonder if you could talk about specifically the things that, that you've done with Alex in his, in his, in his team, you know, thinking back last year, what were your accomplishments that you really stand out? >>Yeah, so, so one thing that jumps to mind is, uh, given the long standing relationship, I relied heavily on Alex to help us work through a multi-year renewal. And it was, it was a, um, a good adventure for us. We, we were able to laugh along the way. We certainly had some, some phone calls that, that were a little bit challenging, but the great thing about it was that the relationship that Alex and I had, he really views it as a partnership. And that was just so encouraging and uplifting. So to me, from my perspective, that was absolutely, uh, one of the highlights of my year and working through even through the pandemic and all that, we figured it out. >>So you guys, when you get together, go ahead, please. >>That's what I had as well. Um, you know, the, the unique thing about the Watson health contract is because it involves data. Uh, we take the stance that it's an it contract, so I'm on the business side. So I've got to just, as Daryl has to navigate it with me, we've got to navigate a large of your it bureaucracy. Um, and, uh, it, it was challenging. Um, you know, the business people kind of smooth the tracks and then you get the lawyers involved in, it just goes haywire. So, um, we were able to navigate that. Um, uh, so yeah, so it was a big accomplishment. So Alex, it's not real sexy to talk about, but we got it done >>Well. So Alex you're, you're in sales, so you're, you're used to role playing. So imagine you're, you're, you're sitting down, uh, sorry, Darryl. You're used to, role-playing out. Imagine you're sitting down with Alex and you're thinking about 20, 21 planning, so, you know, take it away. W what do you, what would you ask, what would you talk about or share with us? >>Yeah, yeah, absolutely. So, so I, I know that, you know, one of the key objectives is, uh, continued to ingest, engage with your members and you have key business strategies. I know you recently migrated over to a new PBM, and so there, there's some complexities that come with that. Um, but just, you know, Alex, if you don't mind, why don't you share a little bit about kind of your, your perspective on what 2020 would hold for you in your organization? Well, I think that due to the pandemic, we are, I personally kick the, can down the road on a couple of things, particularly >>Having a strategic roadmap discussion, um, you know, uh, I was going to get into this later, but I enjoy doing things face-to-face rather than, uh, over the phone or, or virtually. And so, uh, I guess I was a little too optimistic about maybe being able to get together late 2020 to have that strategic roadmap discussion. Um, I think, uh, given what has developed with, um, the pandemic and vaccines and stuff, I may, I may be able to get everybody on the same page later this year, hopefully. Uh, but certainly we want to have a strategic roadmap discussion. Um, we license, uh, Watson Hills, uh, cat group insights, uh, tool, which we use for employer group reporting. And we are currently in the beginning stages of rolling that out to our external clients, whether it's agents, brokers, um, those types of folks. And then it vanished we as our core product that we use for analysis, and that product is transitioning to what is called health insights. And so from an analytical standpoint, my staff and the staff of our cluster areas will need to sort of move to health insights since that's where it's going, uh, from an analytic standpoint. So we're going to work on that as well. Um, and then some more detailed things around database rebuilds and stuff like that. Those are all sort of on the roadmap for 2021. >>Yeah. So, you know, you talk about strategic planning and you think about the way planning used to be. I mean, sometimes you take a longer term horizon, maybe that's five years, you know, technology cycles, you know, even though they go very fast, but you see major technology shifts, they're like go through these seven year cycles, you see that in financial world. And then with the, with the pandemic, we're talking about seven day cycles, you know, how do I support people work from home? Do I open the store or not? You know, it's a day-to-day type of thing. So I wonder if you could each talk about personally and professionally w how, how is 2020, you know, changed you and maybe position you for, for what's ahead, maybe Alex, you could start, >>Well, you know, I'm an analyst, so I always fall back to the numbers. What are the numbers show us, um, you know, people can have four perceptions, but, uh, the numbers give us a reality. So the reality is that a year ago, pre pandemic, uh, just 13% of blue cross blue shield employees were working from home a hundred percent, uh fast-forward to today. And that number is now 87%. So think about, uh, just the lift from a it infrastructure to support that we almost, all of those people are using Citrix to get in to our network. Uh, we're using a remote desktop. So you've got this pipeline that probably had to go from, you know, this small, to huge, to get all this bandwidth, all this data and everything. So you've got that huge lift. Um, and then it affects different areas, um, differently. Uh, I don't have any first-line staff, any staff that are member facing, so I didn't really have to navigate, you know, how do these people talk to our member? >>How does staff talk to our members on the phone when they're at home, as opposed to in the office, and, you know, is there background noise, things like that. So I've got analysts, uh, they're just crunching numbers. Um, but my, my, my personal, uh, feeling was I like doing managing by walking around, you know, stopping and talking to other, working on. So that went away and I like face-to-face meetings, as I've mentioned, and that went away. So it was really a culture change for me personally, it was a culture change for our organization. Uh, and, and now we're having conversations with executive management that, you know, if you've got staff who have been doing a good job and they remain productive, you know, give me a reason they got to come back in, which is just, as you told me that I'm going to be the case a year ago, I would have been, you know, flabbergasted, but that's where we are right now. >>And so on a personal standpoint, you know, I went home for a little while and then came back. And so my wife also works for blue cross blue shield of South Carolina. Um, so, you know, she set up in the dining room working, uh, I have my own book in our living room working, and then we've got a great side, you know, the school is not in session, you know, in person. So he's doing virtual learning. So combine all those things, and you've got all kinds of crazy things that could happen. Uh, and then you've got staff who are in the same situation. Um, so it was a lot to handle. And the longer it goes on the novelty of working from home wears off, and you kind of realize, you know, I can't go do this. I can't go out to eat. I can't do all types of things that I used to do. And so that affects your mental health. So as, as a leader, um, of my small area, and then our executives really had to become more, uh, uh, in, in people's faces. So we've got, we've done a lot more video, uh, messages, a lot more emails. Um, I have been tasked with being very deliberate about checking on how everything is going at their house. Are they getting what they need? Um, you know, how are they feeling? Are they getting up and exercising, all those things that you took for granted, uh, beforehand. >>Yeah. So Daryl, anything you'd add to that in terms of specifically in terms of how you might, how you might change the way in which you interact with your clients generally, uh, an Alex specifically, Alex likes, face to face, you know, we can't wait. All right. >>Yeah, yeah. It's funny. We never quite got to do it Alex, but we were talking about doing a virtual happy hour at one point too, to just celebrate the success. Um, but for me, you know, typically I would travel and visit Alex face-to-face on maybe a monthly basis. And so it it's been really hard for me. I didn't realize how, how much I enjoyed that in-person interaction. And so that, that was something that I I've been, you know, working through and finding ways to, to still interact with people. And I'm certainly making, making the best of, of the video phone calls and, you know, that sort of thing. So, uh, just work working to maintain those relationships. >>I wonder if I could ask you when, when, when this thing, when we're through the pandemic, what do you expect the work from home percentage? I think I heard 13% prior to the pandemic, 87% today. What do you think is going to be post pandemic? >>That is a good question. Um, it, it may go back to maybe 60% at home. I think, I think there will be a simple majority, uh, working from home. Um, that's, that's from our planning, uh, space planning standpoint. That's, that's what we are, uh, what we're expecting, um, if, if production stays, um, at acceptable levels, um, >>Do you feel like productivity was negatively impacted positive? It will be impacted or it's kind of weird. >>Yeah. All the metrics that we track show that it was, it was sustained and in some areas even better. Uh, and if you really think about, um, sort of your typical day when you work from home, I found, uh, that I was logged on an hour earlier. That's probably what's happening with other staff as well is they're, they're motivated to get up and, and get online, uh, earlier. >>Yeah. Mostly tech leaders that I talk to share that sentiment, that the productivity is actually improved. So Darryl, I presume you see the same thing in your observation space. Yeah. >>Yeah. I, I do. And, and I have other clients too, and, and, and they are definitely looking at ways to continue to work remotely. I know that for a lot of people who are in the office all the time, uh, having a little bit more flexibility when you work from home can be a good thing. And, and like you said, you, you have to make sure that the productivity is still there and the productivity is up. Um, but I, I could see that the trend continuing absolutely >>I'd love for you to, to look at Darryl and say, and tell him what the kinds of things that IBM can do to help you both today, immediately 20, 21, and in the future and a Darryl, how, how your, how you'll respond. >>Well, I'll tell you that. Um, so in 2020, what, what changed most dramatically for us as a health plan? Uh, and, and I, it echoes what we see across the country is the gigantic shift in telehealth. Um, you know, if, if, again, if you look at the numbers, uh, our telehealth visits per thousand, so that's the number of visits per thousand members in a given month, went up 1472%. And so, you know, the common response to that is, well, you know, your visits overall probably, you know, were flat because, uh, you know, they just weren't happening in that. And that's not necessarily true for us. So if you look at visits overall, they written down four and a half percent. Um, so there was a shift, but it, it was not a big enough shift to account for, uh, visits overall sustaining the level that they were pre pandemic. >>Um, so as we look into 2021, uh, we will be investigating how we can maintain, uh, the, uh, the accessibility of our healthcare providers via telehealth. Um, you know, one of the projects that we started in 2020, uh, was based upon the choosing wisely campaign. So if you're not familiar with choosing wisely, it's a very well thought out process. It involves many, many provider specialties and its sole target is to reduce low value care. Uh, so we took it upon ourselves to Institute sort of a mirror of that plan or that program at, at blue cross here in South Carolina. And so as we moved to 2021, obviously those low value services just because of the pandemic were reduced, uh, and some of the high-value care was reduced as well. And so what we are going to try to do is bring back habit, bring back that high value care, but not bring back that low value care and so low value care or things like vitamin D testing. Uh, it can be other things like, um, uh, CT for head headaches, um, imaging for low abdominal pain, things like that. So, uh, we want to focus on low, uh, eliminating what value care, bringing back high value care, >>Okay, Dale, you're up? How are you going to help Alex achieve that? So, so good news is, is that we've got the analytic warehouse and the database where all of the data is captured. And so we we've got the treasure trove of information and data. And so what we'll do is we'll come alongside Alex and his team will do the analytics, we'll provide the analytic methods measures, and we'll also help him uncover where perhaps those individuals may be, who had postponed care, um, because of the pandemic. And so we can put together strategies to help make sure that they get the care that they need. Uh, I also a hundred percent agree that tele-health hopefully is something that will continue because I do think that that is a good way and efficient way to get care for people. Um, and, you know, as a, as, as a way to, to address some of their needs and, and in, in a safe way too. >>So, um, I, I look forward to working with Alec and his team over this coming year. I think there is, uh, knowing Alex and, and the partnership and his readiness to be a client reference for us. You know, those are all great, um, recognition of how he partners with us. And we really value and appreciate, uh, the relationship that we have with blue cross blue shield, South Carolina and, and blue choice. Excellent. Daryl's right. The, the, the database we use already has some of that low value care measures baked into it. And so throughout 2020, I've worked with our analytic consulting team. Uh, it's under Daryl too, to talk about what's on the product product roadmap for adding to the cadre of live low value care measures inside advantage suite. Uh, so that's something that we'll actively be, um, uh, discussing because certainly, you know, we're, we're obviously not the only client only health plan clients. So there may be other plans that have priorities that very different made very differently than ours. Uh, so we want to give them what we're studying, what we're interested in, so they can just add it in to all their other client feedback, uh, for advantage suites, roadmap. Excellent. >>Look, my last question, Alex is how would you grade IBM, if you had to take a bundle of sort of attributes, you know, uh, delivery, uh, value for service relationship, uh, et cetera, how would you grade the job that IBM is doing? >>I, the thing that I enjoy most about working with IBM and Darryl specifically, is that they're always challenging us to look at different things. Um, things that sometimes we hadn't considered, because obviously it may be an issue for another health plan client or an employer client that they've got. Uh, they tell us, this is what we're seeing. You know, you should look at it. Uh, a lot of times they do some of the foundational work in producing a report to show us what they're seeing in our data that is similar to what is in some of their other clients data. So that's refreshing to be, uh, challenged by IBM to look at things that we may not be, uh, looking at, uh, or maybe missing, because we've got our eye on the ball on something else you >>Care to put a letter grade on that. >>Oh, definitely. Definitely. Thank you. >>Well, Darryl, congratulations, that says a lot and, uh, we have to leave it there and one at a time, but, but Daryl, anything that I didn't ask Alex, that you, you wanted me to, >>So, um, Alex re able to keep your tennis game up during the pandemic? Uh, I, yes, I tried as, as often as my wife would let me good. I would play every time I was asked, but, uh, yeah, so I, I did have to temper it a little bit, although when you spend all day with her and, and my son, you know, she may be a little more, uh, lenient on letting me leave the house. Well, maybe she's >>Yeah. The tribute to the late great comedian Mitch Hedberg, who says, uh, you know, when I, I played tennis, I played against the wall walls. Really good, hard to beat if it's pandemic appropriate. >>Oh, that's good. That's a true statement. And there was a lot of that going on, a lot of that play and playing against the wall. >>Hey, thanks so much, stay safe and really appreciate the time. Thank you. >>Thank you. Thank you. You're >>Really welcome. It was a great conversation and thank you for watching and spending some time with client conversations with IBM Watson health.

>> Narrator: From around the globe it's theCUBE, covering HPE Discover Virtual Experience brought to you by HPE. >> Hi everybody. Welcome back. This is Dave Vellante for theCUBE, and this is our coverage of discover 2020, the virtual experience of HPE discover. We've done many, many discoveries, as usually we're on the show floor, theCUBE has been virtualized and we talk a lot at HPE discovers, a lot of storage and server and infrastructure and networking which is great. But the conversation we're going to have now is really, we're going to be talking about helping the world solve some big problems. And I'm very excited to welcome back to theCUBE Dr. Eng Lim Goh. He's a senior vice president of and CTO for AI, at HPE. Hello, Dr. Goh. Great to see you again. >> Hello. Thank you for having us, Dave. >> You're welcome. And then our next guest is Professor Joachim Schultze, who is the Professor for Genomics, and Immunoregulation at the university of Bonn amongst other things Professor, welcome. >> Thank you all. Welcome. >> And then Prasad Shastry, is the Chief Technologist for the India Advanced Development Center at HPE. Welcome, Prasad. Great to see you. >> Thank you. Thanks for having me. >> So guys, we have a CUBE first. I don't believe we've ever had of three guests in three separate times zones. I'm in a fourth time zone. (guests chuckling) So I'm in Boston. Dr. Goh, you're in Singapore, Professor Schultze, you're in Germany and Prasad, you're in India. So, we've got four different time zones. Plus our studio in Palo Alto. Who's running this program. So we've got actually got five times zones, a CUBE first. >> Amazing. >> Very good. (Prasad chuckles) >> Such as the world we live in. So we're going to talk about some of the big problems. I mean, here's the thing we're obviously in the middle of this pandemic, we're thinking about the post isolation economy, et cetera. People compare obviously no surprise to the Spanish flu early part of last century. They talk about the great depression, but the big difference this time is technology. Technology has completely changed the way in which we've approached this pandemic. And we're going to talk about that. Dr. Goh, I want to start with you. You've done a lot of work on this topic of swarm learning. If we could, (mumbles) my limited knowledge of this is we're kind of borrowing from nature. You think about, bees looking for a hive as sort of independent agents, but somehow they come together and communicate, but tell us what do we need to know about swarm learning and how it relates to artificial intelligence and we'll get into it. >> Oh, Dave, that's a great analogy using swarm of bees. That's exactly what we do at HPE. So let's use the of here. When deploying artificial intelligence, a hospital does machine learning of the outpatient data that could be biased, due to demographics and the types of cases they see more also. Sharing patient data across different hospitals to remove this bias is limited, given privacy or even sovereignty the restrictions, right? Like for example, across countries in the EU. HPE, so I'm learning fixers this by allowing each hospital, let's still continue learning locally, but at each cycle we collect the lumped weights of the neural networks, average them and sending it back down to older hospitals. And after a few cycles of doing this, all the hospitals would have learned from each other, removing biases without having to share any private patient data. That's the key. So, the ability to allow you to learn from everybody without having to share your private patients. That's swarm learning, >> And part of the key to that privacy is blockchain, correct? I mean, you you've been too involved in blockchain and invented some things in blockchain and that's part of the privacy angle, is it not? >> Yes, yes, absolutely. There are different ways of doing this kind of distributed learning, which swarm learning is over many of the other distributed learning methods. Require you to have some central control. Right? So, Prasad, and the team and us came up together. We have a method where you would, instead of central control, use blockchain to do this coordination. So, there is no more a central control or coordinator, especially important if you want to have a truly distributed swamp type learning system. >> Yeah, no need for so-called trusted third party or adjudicator. Okay. Professor Schultze, let's go to you. You're essentially the use case of this swarm learning application. Tell us a little bit more about what you do and how you're applying this concept. >> I'm actually by training a physician, although I haven't seen patients for a very long time. I'm interested in bringing new technologies to what we call precision medicine. So, new technologies both from the laboratories, but also from computational sciences, married them. And then I basically allow precision medicine, which is a medicine that is built on new measurements, many measurements of molecular phenotypes, how we call them. So, basically that process on different levels, for example, the genome or genes that are transcribed from the genome. We have thousands of such data and we have to make sense out of this. This can only be done by computation. And as we discussed already one of the hope for the future is that the new wave of developments in artificial intelligence and machine learning. We can make more sense out of this huge data that we generate right now in medicine. And that's what we're interesting in to find out how can we leverage these new technologies to build a new diagnostics, new therapy outcome predictors. So, to know the patient benefits from a disease, from a diagnostics or a therapy or not, and that's what we are doing for the last 10 years. The most exciting thing I have been  through in the last three, four, five years is really when HPE introduced us to swarm learning. >> Okay and Prasad, you've been helping Professor Schultze, actually implements swarm learning for specific use cases that we're going to talk about COVID, but maybe describe a little bit about what you've been or your participation in this whole equation. >> Yep, thank. As Dr Eng Lim Goh, mentioned. So, we have used blockchain as a backbone to implement the decentralized network. And through that we're enabling a privacy preserved these centralized network without having any control points, as Professor explained in terms of depression medicines. So, one of the use case we are looking at he's looking at the blood transcriptomes, think of it, different hospitals having a different set of transcriptome data, which they cannot share due to the privacy regulations. And now each of those hospitals, will clean the model depending upon their local data, which is available in that hospital. And shared the learnings coming out of that training with the other hospitals. And we played to over several cycles to merge all these learnings and then finally get into a global model. So, through that we are able to kind of get into a model which provides the performance is equal of collecting all the data into a central repository and trying to do it. And we could really think of when we are doing it, them, could be multiple kinds of challenges. So, it's good to do decentralized learning. But what about if you have a non ID type of data, what about if there is a dropout in the network connections? What about if there are some of the compute nodes we just practice or probably they're not seeing sufficient amount of data. So, that's something we tried to build into the swarm learning framework. You'll handle the scenarios of having non ID data. All in a simple word we could call it as seeing having the biases. An example, one of the hospital might see EPR trying to, look at, in terms of let's say the tumors, how many number of cases and whereas the other hospital might have very less number of cases. So, if you have kind of implemented some techniques in terms of doing the merging or providing the way that different kind of weights or the tuneable parameters to overcome these set of challenges in the swarm learning. >> And Professor Schultze, you you've applied this to really try to better understand and attack the COVID pandemic, can you describe in more detail your goals there and what you've actually done and accomplished? >> Yeah. So, we have actually really done it for COVID. The reason why we really were trying to do this already now is that we have to generate it to these transcriptomes from COVID-19 patients ourselves. And we realized that the scene of the disease is so strong and so unique compared to other infectious diseases, which we looked at in some detail that we felt that the blood transcriptome would be good starting point actually to identify patients. But maybe even more important to identify those with severe diseases. So, if you can identify them early enough that'd be basically could care for those more and find particular for those treatments and therapies. And the reason why we could do that is because we also had some other test cases done before. So, we used the time wisely with large data sets that we had collected beforehand. So, use cases learned how to apply swarm learning, and we are now basically ready to test directly with COVID-19. So, this is really a step wise process, although it was extremely fast, it was still a step wise probably we're guided by data where we had much more knowledge of which was with the black leukemia. So, we had worked on that for years. We had collected many data. So, we could really simulate a Swarm learning very nicely. And based on all the experience we get and gain together with Prasad, and his team, we could quickly then also apply that knowledge to the data that are coming now from COVID-19 patients. >> So, Dr. Goh, it really comes back to how we apply machine intelligence to the data, and this is such an interesting use case. I mean, the United States, we have 50 different States with 50 different policies, different counties. We certainly have differences around the world in terms of how people are approaching this pandemic. And so the data is very rich and varied. Let's talk about that dynamic. >> Yeah. If you, for the listeners who are or viewers who are new to this, right? The workflow could be a patient comes in, you take the blood, and you send it through an analysis? DNA is made up of genes and our genes express, right? They express in two steps the first they transcribe, then they translate. But what we are analyzing is the middle step, the transcription stage. And tens of thousands of these Transcripts that are produced after the analysis of the blood. The thing is, can we find in the tens of thousands of items, right? Or biomarkers a signature that tells us, this is COVID-19 and how serious it is for this patient, right? Now, the data is enormous, right? For every patient. And then you have a collection of patients in each hospitals that have a certain demographic. And then you have also a number of hospitals around. The point is how'd you get to share all that data in order to have good training of your machine? The ACO is of course a know privacy of data, right? And as such, how do you then share that information if privacy restricts you from sharing the data? So in this case, swarm learning only shares the learnings, not the private patient data. So we hope this approach would allow all the different hospitals to come together and unite sharing the learnings removing biases so that we have high accuracy in our prediction as well at the same time, maintaining privacy. >> It's really well explained. And I would like to add at least for the European union, that this is extremely important because the lawmakers have clearly stated, and the governments that even non of these crisis conditions, they will not minimize the rules of privacy laws, their compliance to privacy laws has to stay as high as outside of the pandemic. And I think there's good reasons for that, because if you lower the bond, now, why shouldn't you lower the bar in other times as well? And I think that was a wise decision, yes. If you would see in the medical field, how difficult it is to discuss, how do we share the data fast enough? I think swarm learning is really an amazing solution to that. Yeah, because this discussion is gone basically. Now we can discuss about how we do learning together. I'd rather than discussing what would be a lengthy procedure to go towards sharing. Which is very difficult under the current privacy laws. So, I think that's why I was so excited when I learned about it, the first place with faster, we can do things that otherwise are either not possible or would take forever. And for a crisis that's key. That's absolutely key. >> And is the byproduct. It's also the fact that all the data stay where they are at the different hospitals with no movement. >> Yeah. Yeah. >> Learn locally but only shared the learnings. >> Right. Very important in the EU of course, even in the United States, People are debating. What about contact tracing and using technology and cell phones, and smartphones to do that. Beside, I don't know what the situation is like in India, but nonetheless, that Dr. Goh's point about just sharing the learnings, bubbling it up, trickling just kind of metadata. If you will, back down, protects us. But at the same time, it allows us to iterate and improve the models. And so, that's a key part of this, the starting point and the conclusions that we draw from the models they're going to, and we've seen this with the pandemic, it changes daily, certainly weekly, but even daily. We continuously improve the conclusions and the models don't we. >> Absolutely, as Dr. Goh explained well. So, we could look at like they have the clinics or the testing centers, which are done in the remote places or wherever. So, we could collect those data at the time. And then if we could run it to the transcripting kind of a sequencing. And then as in, when we learn to these new samples and the new pieces all of them put kind of, how is that in the local data participate in the kind of use swarm learning, not just within the state or in a country could participate into an swarm learning globally to share all this data, which is coming up in a new way, and then also implement some kind of continuous learning to pick up the new signals or the new insight. It comes a bit new set of data and also help to immediately deploy it back into the inference or into the practice of identification. To do these, I think one of the key things which we have realized is to making it very simple. It's making it simple, to convert the machine learning models into the swarm learning, because we know that our subject matter experts who are going to develop these models on their choice of platforms and also making it simple to integrate into that complete machine learning workflow from the time of collecting a data pre processing and then doing the model training and then putting it onto inferencing and looking performance. So, we have kept that in the mind from the beginning while developing it. So, we kind of developed it as a plug able microservices kind of packed data with containers. So the whole library could be given it as a container with a kind of a decentralized management command controls, which would help to manage the whole swarm network and to start and initiate and children enrollment of new hospitals or the new nodes into the swarm network. At the same time, we also looked into the task of the data scientists and then try to make it very, very easy for them to take their existing models and convert that into the swarm learning frameworks so that they can convert or enabled they're models to participate in a decentralized learning. So, we have made it to a set callable rest APIs. And I could say that the example, which we are working with the Professor either in the case of leukemia or in the COVID kind of things. The noodle network model. So we're kind of using the 10 layer neural network things. We could convert that into the swarm model with less than 10 lines of code changes. So, that's kind of a simply three we are looking at so that it helps to make it quicker, faster and loaded the benefits. >> So, that's an exciting thing here Dr. Goh is, this is not an R and D project. This is something that you're actually, implementing in a real world, even though it's a narrow example, but there are so many other examples that I'd love to talk about, but please, you had a comment. >> Yes. The key thing here is that in addition to allowing privacy to be kept at each hospital, you also have the issue of different hospitals having day to day skewed differently. Right? For example, a demographics could be that this hospital is seeing a lot more younger patients, and other hospitals seeing a lot more older patients. Right? And then if you are doing machine learning in isolation then your machine might be better at recognizing the condition in the younger population, but not older and vice versa by using this approach of swarm learning, we then have the biases removed so that both hospitals can detect for younger and older population. All right. So, this is an important point, right? The ability to remove biases here. And you can see biases in the different hospitals because of the type of cases they see and the demographics. Now, the other point that's very important to reemphasize is what precise Professor Schultze mentioned, right? It's how we made it very easy to implement this.Right? This started out being so, for example, each hospital has their own neural network and they training their own. All you do is we come in, as Pasad mentioned, change a few lines of code in the original, machine learning model. And now you're part of the collective swarm. This is how we want to easy to implement so that we can get again, as I like to call, hospitals of the world to uniting. >> Yeah. >> Without sharing private patient data. So, let's double click on that Professor. So, tell us about sort of your team, how you're taking advantage of this Dr. Goh, just describe, sort of the simplicity, but what are the skills that you need to take advantage of this? What's your team look like? >> Yeah. So, we actually have a team that's comes from physicians to biologists, from medical experts up to computational scientists. So, we have early on invested in having these interdisciplinary research teams so that we can actually spend the whole spectrum. So, people know about the medicine they know about them the biological basics, but they also know how to implement such new technology. So, they are probably a little bit spearheading that, but this is the way to go in the future. And I see that with many institutions going this way many other groups are going into this direction because finally medicine understands that without computational sciences, without artificial intelligence and machine learning, we will not answer those questions with this large data that we're using. So, I'm here fine. But I also realize that when we entered this project, we had basically our model, we had our machine learning model from the leukemia's, and it really took almost no efforts to get this into the swarm. So, we were really ready to go in very short time, but I also would like to say, and then it goes towards the bias that is existing in medicine between different places. Dr. Goh said this very nicely. It's one aspect is the patient and so on, but also the techniques, how we do clinical essays, we're using different robots a bit. Using different automates to do the analysis. And we actually try to find out what the Swan learning is doing if we actually provide such a bias by prep itself. So, I did the following thing. We know that there's different ways of measuring these transcriptomes. And we actually simulated that two hospitals had an older technology and a third hospital had a much newer technology, which is good for understanding the biology and the diseases. But it is the new technology is prone for not being able anymore to generate data that can be used to learn and then predicting the old technology. So, there was basically, it's deteriorating, if you do take the new one and you'll make a classifier model and you try old data, it doesn't work anymore. So, that's a very hard challenge. We knew it didn't work anymore in the old way. So, we've pushed it into swarm learning and to swarm recognize that, and it didn't take care of it. It didn't care anymore because the results were even better by bringing everything together. I was astonished. I mean, it's absolutely amazing. That's although we knew about this limitations on that one hospital data, this form basically could deal with it. I think there's more to learn about these advantages. Yeah. And I'm very excited. It's not only a transcriptome that people do. I hope we can very soon do it with imaging or the DCNE has 10 sites in Germany connected to 10 university hospitals. There's a lot of imaging data, CT scans and MRIs, Rachel Grimes. And this is the next next domain in medicine that we would like to apply as well as running. Absolutely. >> Well, it's very exciting being able to bring this to the clinical world And make it in sort of an ongoing learnings. I mean, you think about, again, coming back to the pandemic, initially, we thought putting people on ventilators was the right thing to do. We learned, okay. Maybe, maybe not so much the efficacy of vaccines and other therapeutics. It's going to be really interesting to see how those play out. My understanding is that the vaccines coming out of China, or built to for speed, get to market fast, be interested in U.S. Maybe, try to build vaccines that are maybe more longterm effective. Let's see if that actually occurs some of those other biases and tests that we can do. That is a very exciting, continuous use case. Isn't it? >> Yeah, I think so. Go ahead. >> Yes. I, in fact, we have another project ongoing to use a transcriptome data and other data like metabolic and cytokines that data, all these biomarkers from the blood, right? Volunteers during a clinical trial. But the whole idea of looking at all those biomarkers, we talking tens of thousands of them, the same thing again, and then see if we can streamline it clinical trials by looking at it data and training with that data. So again, here you go. Right? We have very good that we have many vaccines on. In candidates out there right now, the next long pole in the tenth is the clinical trial. And we are working on that also by applying the same concept. Yeah. But for clinical trials. >> Right. And then Prasad, it seems to me that this is a good, an example of sort of an edge use case. Right? You've got a lot of distributed data. And I know you've spoken in the past about the edge generally, where data lives bringing moving data back to sort of the centralized model. But of course you don't want to move data if you don't have to real time AI inferencing at the edge. So, what are you thinking in terms of other other edge use cases that were there swarm learning can be applied. >> Yeah, that's a great point. We could kind of look at this both in the medical and also in the other fields, as we talked about Professor just mentioned about this radiographs and then probably, Using this with a medical image data, think of it as a scenario in the future. So, if we could have an edge note sitting next to these medical imaging systems, very close to that. And then as in when this the systems producers, the medical immediate speed could be an X-ray or a CT scan or MRI scan types of thing. The system next to that, sitting on the attached to that. From the modernity is already built with the swarm lending. It can do the inferencing. And also with the new setup data, if it looks some kind of an outlier sees the new or images are probably a new signals. It could use that new data to initiate another round up as form learning with all the involved or the other medical images across the globe. So, all this can happen without really sharing any of the raw data outside of the systems but just getting the inferencing and then trying to make all of these systems to come together and try to build a better model. >> So, the last question. Yeah. >> If I may, we got to wrap, but I mean, I first, I think we've heard about swarm learning, maybe read about it probably 30 years ago and then just ignored it and forgot about it. And now here we are today, blockchain of course, first heard about with Bitcoin and you're seeing all kinds of really interesting examples, but Dr. Goh, start with you. This is really an exciting area, and we're just getting started. Where do you see swarm learning, by let's say the end of the decade, what are the possibilities? >> Yeah. You could see this being applied in many other industries, right? So, we've spoken about life sciences, to the healthcare industry or you can't imagine the scenario of manufacturing where a decade from now you have intelligent robots that can learn from looking at across men building a product and then to replicate it, right? By just looking, listening, learning and imagine now you have multiple of these robots, all sharing their learnings across boundaries, right? Across state boundaries, across country boundaries provided you allow that without having to share what they are seeing. Right? They can share, what they have lunch learnt You see, that's the difference without having to need to share what they see and hear, they can share what they have learned across all the different robots around the world. Right? All in the community that you allow, you mentioned that time, right? That will even in manufacturing, you get intelligent robots learning from each other. >> Professor, I wonder if as a practitioner, if you could sort of lay out your vision for where you see something like this going in the future, >> I'll stay with the medical field at the moment being, although I agree, it will be in many other areas, medicine has two traditions for sure. One is learning from each other. So, that's an old tradition in medicine for thousands of years, but what's interesting and that's even more in the modern times, we have no traditional sharing data. It's just not really inherent to medicine. So, that's the mindset. So yes, learning from each other is fine, but sharing data is not so fine, but swarm learning deals with that, we can still learn from each other. We can, help each other by learning and this time by machine learning. We don't have to actually dealing with the data sharing anymore because that's that's us. So for me, it's a really perfect situation. Medicine could benefit dramatically from that because it goes along the traditions and that's very often very important to get adopted. And on top of that, what also is not seen very well in medicine is that there's a hierarchy in the sense of serious certain institutions rule others and swarm learning is exactly helping us there because it democratizes, onboarding everybody. And even if you're not sort of a small entity or a small institutional or small hospital, you could become remembering the swarm and you will become as a member important. And there is no no central institution that actually rules everything. But this democratization, I really laugh, I have to say, >> Pasad, we'll give you the final word. I mean, your job is very helping to apply these technologies to solve problems. what's your vision or for this. >> Yeah. I think Professor mentioned about one of the very key points to use saying that democratization of BI I'd like to just expand a little bit. So, it has a very profound application. So, Dr. Goh, mentioned about, the manufacturing. So, if you look at any field, it could be health science, manufacturing, autonomous vehicles and those to the democratization, and also using that a blockchain, we are kind of building a framework also to incentivize the people who own certain set of data and then bring the insight from the data into the table for doing and swarm learning. So, we could build some kind of alternative monetization framework or an incentivization framework on top of the existing fund learning stuff, which we are working on to enable the participants to bring their data or insight and then get rewarded accordingly kind of a thing. So, if you look at eventually, we could completely make dais a democratized AI, with having the complete monitorization incentivization system which is built into that. You may call the parties to seamlessly work together. >> So, I think this is just a fabulous example of we hear a lot in the media about, the tech backlash breaking up big tech but how tech has disrupted our lives. But this is a great example of tech for good and responsible tech for good. And if you think about this pandemic, if there's one thing that it's taught us is that disruptions outside of technology, pandemics or natural disasters or climate change, et cetera, are probably going to be the bigger disruptions then technology yet technology is going to help us solve those problems and address those disruptions. Gentlemen, I really appreciate you coming on theCUBE and sharing this great example and wish you best of luck in your endeavors. >> Thank you. >> Thank you. >> Thank you for having me. >> And thank you everybody for watching. This is theCUBE's coverage of HPE discover 2020, the virtual experience. We'll be right back right after this short break. (upbeat music)