An Analysis on Scaling Digital Health in Developing Markets

GSMA Intelligence, in collaboration with the GSMA mHealth programme, has published its latest research on the digital healthcare landscape in developing countries. The report, Scaling Digital Health in Developing Markets: Opportunities and recommendations for mobile operators and other stakeholders, explains that "digital health is taking its first steps in some African, Asian and Latin American countries. The number of initiatives is growing, with a widespread opinion that digital health can help address key healthcare issues if it reaches scale." Furthermore, "This report provides an overview of the healthcare landscape in developing countries and assesses the role of digital health to help address key issues. It looks at technology enablers, challenges, use cases and evidence of the positive impact digital health can have on key health indicators. The report also assesses the role and opportunity for mobile operators and what needs to be done to scale digital health."

The report's Executive Summary presents the following four points:

1. Healthcare landscape – poor coverage and quality, and low digitization are key issues. "Developing countries continue to face poor healthcare funding, which affects access, quality, cost and key health outcomes," notes the report. In addition, "The healthcare sector is a late-comer to digitization, even in high-income countries. Implementation is phased over a period of decades. Priorities among low- and middle-income countries at an earlier stage of development are focused on addressing fundamental access and quality issues as well as cost inefficiencies. Advanced regions (US, Europe, parts of Asia) are exploring the use of artificial intelligence, Internet of Things, automation, cloud computing and big data for enhanced healthcare delivery and cost reduction."

2. Widescale digital health can help address key healthcare issues. "Early digital health solutions in some developing countries show encouraging results but greater scale is needed to drive longer-term benefits. Digital health needs to focus on three objectives over the next five to ten years – help to expand coverage (access), enhance services (quality) and optimize resources (cost). Some solutions can help achieve multiple objectives."

3. Scaling digital health – what needs to be done? "Digital health is still in its infancy. Many pilots are not followed by full-scale implementation due to a lack of sustainable financing, high risks for individual stakeholders and long time-to-market for commercial solutions."

The report further explains:

Greater and more stable government investment in digital health – as opposed to cyclical/individual initiatives – can help drive scale in developing countries, as venture-capital activity is limited and private sector healthcare provision is at a low scale. Digital health stakeholders need to stimulate government investment by demonstrating how digital health solutions help address national healthcare issues of poor access, quality and cost inefficiencies. Ministries of health also need to encourage and support the implementation of national digital health plans aligned with ICT and broadband agendas. Policy and regulations that promote investment and facilitate faster time-to-market of digital health solutions are a further enabler to adoption and scale.

Governments spend about $1 trillion per year on health in developing countries. If local governments allocate 0.5% of that to digital health initiatives over the next five years, a cumulative $25 billion will be available for digital health companies, including operators.

Ecosystem collaboration is needed to address current fragmentation and create a holistic digital health model. Individual companies do not own the full set of resources and capabilities required. Public-private partnerships (PPPs) serve to share resources, capabilities, opportunities and risks among stakeholders. Such collaboration brings the potential for greater social and economic value for all stakeholders in the ecosystem. In a holistic digital health platform model, new core and complementary services can be more easily integrated and packaged for B2B clients.

Industry collaboration is also needed to address current interoperability issues and drive healthcare data integration. EHRs, for example, need to include a complete and secure patient data history that can be shared in realtime across healthcare organisations. Data integration also improves healthcare worker and patient trust in the health system, and increases the overall value of data collected, dramatically increasing the potential for AI and other advanced technologies in the longer term. The mobile industry can help by advising on the application of standards and by working with healthcare industry partners to deliver services based on the principle of interoperability.

4. Mobile operators need to pursue a holistic approach to digital health and position as ICT and digital service partners. Encouragingly, "Mobile operators are engaged in digital health in developing countries. All the largest groups – Vodafone, Bharti Airtel, Telefónica, America Movil, Telenor, Orange, MTN – as well as a number of smaller operators provide a range of B2G, B2B and B2C services."

In addition, "The current size of digital health across developing countries is small but the factors discussed earlier can drive scale. For operators, health is a nascent revenue stream and a further platform for cross-sector partnerships. Digital health usually sits within a wider 'Business Services' unit. This allows a holistic approach to societal digitization and helps navigate the IoT learning curve."

"To be relevant in the digital health space," however, "operators need to adopt strategies that can strengthen their role as ICT and digital service partners for governments, health providers and health tech companies. A holistic approach that looks at digital health as an integrated – as opposed to fragmented – portfolio of services is crucial to drive partnerships and opportunities, both locally and regionally.

For those who work in the digital health sector in developing countries, I recommend reading the GSMA report. Do you agree with the report's findings?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

Mobile is Contributing to Jobs and Economic Growth in the MENA Region

"By mid-2017, there were 365 million unique subscribers across the Middle East and North Africa (MENA) region, accounting for 63% of the population," according to a report, The Mobile Economy: Middle East and North Africa 2017, produced by the GSMA. The report further says: "Global subscriber penetration overtook MENA during the course of 2015. As a result, MENA has fallen behind Asia Pacific to become the second least penetrated region in the world. There is, however, huge variation between countries in the region, from the advanced Gulf Cooperation Council (GCC) States where 76% of the population on average are mobile subscribers, to some of the other Arab States such as Comoros, Djibouti and Somalia where less than a third of the population subscribe to mobile services."

Regarding 5th generation mobile networks (5G), the report notes that "markets in MENA – particularly some of the GCC States – will be among the first countries globally to launch 5G networks, with commercial deployments planned in the UAE in 2019 and Qatar in 2020." Furthermore, "In the early years following these launches, operators in 12 other countries across MENA are expected to deploy 5G services, covering around 30% of the region’s population by 2025. By this time, regional 5G connections (excluding IoT) are forecast to surpass 50 million."

The mobile industry is contributing to the MENA's economic growth. "In 2016, mobile technologies and services generated 4.2% of GDP in the MENA region, a contribution that amounted to $165 billion of economic value. In the period to 2020 we expect this to increase to almost $200 billion (4.3% of GDP) as countries benefit from the improvements in productivity and efficiency brought about by increased take-up of mobile services."

Encouragingly, the report further explains that "the mobile ecosystem also supported more than 1 million jobs in 2016. This includes workers directly employed in the ecosystem and jobs that are indirectly supported by the economic activity generated by the sector. In addition to the mobile sector's impact on the economy and labor market, it makes a substantial contribution to the funding of the public sector, with $20 billion raised in 2016 in the form of taxation."

The report also discusses how mobile is driving engagement and innovation in the MENA region. "Mobile has emerged as the platform of choice for creating, distributing and consuming innovative digital solutions and services in MENA, and the region is playing a leading role in certain areas. For example, some countries, particularly in the Gulf region (Saudi Arabia and the UAE, for example), are looking to address challenges around urbanization, pollution and resource management by implementing smart city services, while others (such as Turkey) are spearheading initiatives to provide individuals and businesses with secure and robust access to online services via mobile-based solutions."

In addition, "Mobile operators in the region are also increasingly collaborating with tech start-ups to help scale innovative and sustainable mobile services. By supporting these new and innovative digital players to secure the funding, resources and direction they require to bring their products and services to scale, mobile operators are helping to deliver the most impactful mobile solutions to those that need them most, and generating the greatest socioeconomic impact."

On the topic mobile helping address social challenges, the report's Executive Summary says:

The large-scale societal adoption and use of digital technologies is a key driver of measurable economic, social and cultural value, including increased productivity, a rise in employment rates, improved security, and greater capacity to tackle social and environmental issues. Mobile internet penetration in MENA has doubled over the last six years, reaching just under 40% of the population by mid-2017.

Despite the steady progress, a vast digital divide remains in many parts of MENA, particularly in the developing countries: across the region, there are 350 million people without access to the mobile internet. As challenges around infrastructure, affordability, consumer readiness and content are addressed, an additional 67 million people are expected to gain access to the mobile internet across the region by the end of the decade, bringing the total to just under 300 million, or 48% of the population.

Given its reach of 5 billion people across the globe, mobile is also playing a key role in tackling various social and economic challenges as outlined by the UN’s Sustainable Development Goals (SDGs), including poverty, education, employment and sanitation. Mobile technology provides access to tools and applications that help address these issues, and enables new technologies and innovations to build more efficient and environmentally sustainable societies.

In a post about GSMA's 2016 report, I wrote that my colleagues and I recognize the successful creation and deployment of localized mobile software solutions in the MENA region will be based on establishing strong collaborative relationships with local developers, marketers, and channel partners. This statement is more true today as the mobile industry matures.

How are you engaging in the MENA region's mobile industry?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

Changes in China's Governmental Policies and the Impact on the Country's Medtech Sector

"China's medical technology (medtech) market is still an alluring prospect for companies, as it is expected to continue its double-digit annual growth rate over the next five years," says a report, Medtech in China: Growth amid policy uncertainty, published by The Economist Intelligence Unit (The EIU). The report analyzes the major policies affecting the medtech sector, looks at how they will play out in medtech's various segments and highlights areas in which the right strategy can help medtech companies to capture new opportunities in the market.

"The medtech market reached Rmb370bn (US$53.6bn) in 2016, marking a 20% increase compared with 2015," The EIU notes. "However, a series of policies rolled out by the government in recent years to reform medical services in China are having an enormous impact on the country's medtech market landscape, leaving some multinational companies uncertain about how to interpret these policies and navigate new dynamics across the medtech market."

The report correctly notes that "China is a large country with an agglomeration of cities with disparate healthcare infrastructures and market characteristics." Moreover, "As life expectancy increases and the proportion of elderly people in the population grows, demand for healthcare in China is likely to rise, as the elderly are more likely to consume health services and demand higher-quality services to cater to more complex medical needs."

New Realities in Domestic Innovation-Based Medtech Competition

"Recently announced policies demonstrate the Chinese government's commitment to encouraging innovation in medical device development and adoption of innovative medical devices," the report . "However, this commitment favors domestic companies, meaning that the competition faced by multinationals in China will intensify, especially in certain segments."

• The special approval procedure for innovative medical devices: In 2014 the China Food and Drug Administration (CFDA) announced that it would fast-track regulatory approvals for innovative medical devices that meet certain requirements. To qualify for this special approval pathway, the device’s working mechanism must not be present in any other device available in China, and its technology must be of an internationally leading standard and must be patented in China. Significant advances in the device’s performance and safety relative to other devices in the same category, and significant clinical benefits offered by the device, are other necessary conditions to qualify for expedited approval.
• Made in China 2025: In 2015 the State Council (China's cabinet) announced the Made in China 2025 initiative, which aims to boost local development of high-performance medical devices. Imaging instruments, medical robots, high-value medical consumables (for example, degradable vascular stents) and remote medical products (such as wearables and remote diagnosis and treatment devices) were listed as areas of focus.

The report importantly points out:

The policies have so far played out in favor of Chinese companies. Since 2014, the number of medical devices approved under the fast-track scheme has totaled 117; of these, domestic brands have accounted for over 90%, while leading medtech multinationals have accounted for fewer than 10%. Moreover, of the devices that have benefited under the fast-track scheme, domestic products have entered the market earlier than foreign ones: approval of the first foreign product under the scheme lagged behind the first fast-tracked approval for a domestic product by about a year. 

Given the success of the policy in supporting domestic innovation—particularly in coastal provinces of eastern China, Beijing, Shanghai, Guangdong, Jiangsu and Zhejiang, which are home to companies behind 80% of all fast-tracked local medical devices—multinationals will face tougher competition from domestic companies, which are expected to drive high growth in the market for innovative devices.
Competition is expected to intensify across all segments of China's medtech market. Innovative medical devices that have been approved under the fast-track program cover the spectrum from low- to high-value devices in a number of different market segments including (among others) in-vitro diagnostics (IVD), medical imaging and interventional cardiology.

Multinational corporations (MNCs) can win market share in China in three ways:

1. Acquire an emerging Chinese company: Domestic companies usually have a narrower scope of business, with strong customer pools in lower-tier cities and lower classes of hospitals. By acquiring the right companies, MNCs can expand their product portfolios and strengthen their product distribution networks;
2. Collaborate with local companies: To take advantage of policies designed to boost domestic innovation, MNCs can develop new products in collaboration with local companies and apply for product licences through the fast-track approval pathway. This reduces the levels of investment needed for product development and shortens time to market; and
3. Gain exclusive marketing authority for Chinese brands: This is one of the strategies employed by Abbott to increase its market presence in the clinical chemistry market. Abbott gained exclusive marketing authority for a clinical chemistry reagent kit made by a prominent local clinical chemistry reagent manufacturer, BSBE, and also for a clinical chemistry reagent kit from Leadman – a Chinese IVD company, to expand its product portfolio, providing more comprehensive test panels to customers.

The Two-Invoice Policy Restructures the Distribution System

The report provides an overview of how China's two-invoice policy restructures the distribution system: "Following pharmaceutical companies operating in China, medtech companies will soon have to prepare themselves for the implementation of the two-invoice policy. Under the policy, no more than two invoices can be issued between supplier and hospital. This means that only one distributor can be involved in the procurement process: one invoice is issued by the manufacturer to the distributor, and the second is issued by the distributor to the hospital.

MNCs can win market share under the two-invoice policy via:

1. Channel management: Tailor distribution models to regional differences in the two-invoice system in order to increase control over distribution channels;
2. Focused client management: Companies can develop targeted promotion strategies to engage different customer groups. For example, using hospital sales data, hospital customers can be ranked by level of purchases. Building a tiered system based on customer revenue, the top 20% of customers can be categorized as key accounts for a company, the next 60% as "regular" accounts and the remaining 20% as weak accounts. Three different sales and promotion strategies—one for each customer tier—can then be developed. For key accounts, companies can use their internal sales force to track user behavior and try to develop new products to address unmet needs. Distributors will be deployed for regular accounts to expand product penetration rates and increase sales volumes to existing clients. For weak accounts, companies can consider outsourcing sales-related work—such as pre- and post-sales support and technical support—to contractors in order to ensure stable income; and
3. Pricing strategy: Companies need to ensure tighter control of ex-manufacturer prices in different regions. After collecting data on hospital purchase prices across China, companies can identify the price mark-up in regions applying the two-invoice policy in order to set new ex-manufacturer prices in these regions.

Pursuing Growth Amid Uncertainty: What Medtech Companies Need to Know

The report concludes with a list of questions on what medtech companies should be asking to enable better decision-making amid uncertainty:

• Environmental analysis: What macro-, socio-economic, regulatory, reimbursement, technological, healthcare and industry trends are shaping the medtech market? How will these changes play out in the market, and how will this impact your business?
• Market intelligence analysis: What is the competitive landscape in the market? What is the outlook for market potential and dynamics in the future?
• Market and customer segmentation: How can your business target the right markets and customer segments to gain greater market share?
• Developing distribution models to expand access: How can your business build an effective distribution network to reach the grass-roots market and also maintain premium market penetration?
• Regional-level user and customer insights for differentiated market strategies: Companies' ability to increase market share and maintain high growth requires an understanding of factors in the highly heterogeneous Chinese market that influence the penetration of medical devices:
• How does use of medical devices differ between provinces?
• How do consumption and purchasing patterns vary between hospitals?
• How do physicians prescribe diagnoses and procedures; how do surgeons conduct surgical procedures and use related products?
• What do patient pathways to obtain diagnosis look like, and how will they evolve?

Do you agree with the findings of the report?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

Helping International Students in the U.S. Prepare for a Successful Career

Having business interests with an international focus has provided me with the opportunity to work with international students attending college or university in the United States. I learned that international students desiring to work in the U.S. after completing their academic program must navigate various challenges U.S.-born or naturalized students may not necessarily encounter. Such challenges include understanding the American work culture that may be drastically different than their home country's work culture or questions an employer in the U.S. may and may not ask during the hiring process.

Therefore, when Yan Tang, a business professional with years of experience working with American companies in China, shared her idea with me of creating a business that will provide customized career training for international students to help them prepare for a successful career, I agreed to help her form such a company. CareerLight, LLC was duly formed in the State of Washington on July 13, 2017.

Mohand Alturky, Ms. Tang, and I decided CareerLight's first program would be a workshop to help international students attending higher education institutions throughout the greater Seattle area to navigate the job search process, understand the recruiting timeline, receive advice on becoming a high-quality candidate, and learn from experienced business professionals.

Photo: Mohand Alturky

Moderated by Marjalena Santos, Director of Human Resources & Compliance at TRInternational, Inc., a Seattle, Wash.-based chemical trading company, I served on a distinguished panel that included Randy Massengale, an adjunct professor and chairman of the leadership certification program at the Albers School of Business and Economics at Seattle University, and Matthew Bateman, a data and design specialist with several years of supporting startups and community initiatives around the world.

Noting that most international students perform a vast amount of research when deciding which American higher educational institution to attend, Mr. Massengale recommended that these students perform the same amount of research in the companies they may want to work for upon graduation (or as an intern during their academic program). Such research includes visiting the company's website and searching online for news articles. Job candidates should ask themselves: why that company and why that position?

Mr. Bateman spoke about the importance for international students to tell their stories to hiring managers. He also recommended to the workshop's attendees explore Remote.com, which promotes itself "the leading community for remote and freelance work." In addition, Mr. Bateman correctly emphasized the importance for job candidates to follow-up after communicating with employers and hiring managers.

Mr. Bateman also noted that career advisors are available through Seattle University Career Services to discuss career exploration, job/internship searches, resume and cover letters and to conduct mock interviews.

Speaking about her experience as an HR manager, Ms. Santos emphasized said the importance of being culturally fit for the team. International students can provide a unique advantage to American companies operating in markets abroad. From her perspective, Ms. Santos said international students must understand the randomness of candidates. Giving a strong first impression to a hiring manager is a necessary to standout from other candidates. This can be done through a variety of ways including showing up on time, dressing appropriately, and making sure the job candidate listens throughout the interview and taking a moment to respond as necessary.

My advice to the workshop attendees focused on the need to understand the employer's perspective that they are trying to find talented people to help solve a problem (or take advantage of an opportunity). This may include developing a product or service, creating a strategic plan to enter a new geographic market, or identifying and mitigating a number of risks a business will encounter. In addition to having a well-constructed resume that clearly lists their qualifications and relevant skills, international students should utilize online platforms such as LinkedIn.

In addition, I informed the international students attending the workshop that they should not assume employers or hiring managers are familiar with rules governing nonimmigrant visas (F-1 or M-1) including the Curricular Practical Training (CPT) or Optional Practical Training (OPT). According to the USCIS website, the OPT "is temporary employment that is directly related to an F-1 student's major area of study. Eligible students can apply to receive up to 12 months of OPT employment authorization before completing their academic studies (pre-completion) and/or after completing their academic studies (post-completion). However, all periods of pre-completion OPT will be deducted from the available period of post-completion OPT." International students may need to educate hiring managers about their ability to work as part of the OPT.

The USCIS also provides a STEM OPT Extension for a period of 24 months to students who have earned degrees in certain science, technology, engineering and math (STEM) fields.

Carol Lwali with Seattle University's Career Services attended the workshop. She noted that the office recently restructured to provide better value to domestic and international students alike including the launch of the Redhawk Network, a career services platform powered by Handshake that connects students and employers to democratize the job finding experience in college and beyond.

The workshop was generously supported by the following sponsors:

• Center for Global Business at Seattle University Albers School of Business and Economics
• Chinese Business Club at Seattle University
• Innovation and Entrepreneurship Center (IEC) at Seattle University
• International Student Center (ISC) at Seattle University
• Koba Ethiopian, LLC
• ROI3, Inc.
• Seattle University Chinese Students and Scholars Association (SUCSSA)
• Seattle University International Alumni Chapter
• Technology and Business Association at the University of Washington (TBAUW)
• TRInternational, Inc.
• Yeeko Inc.

Photo: Mohand Alturky

Attendees said they found the workshop informative. According to a survey, attendees commented that they felt empowered as they navigate the confusing and challenging job search process in a culture that is different than their own. Through CareerLight's future training sessions, workshops, and other career support initiatives, I hope international students will be prepared to start a successful career in the U.S.

I invite all international students to regular visit CareerLight's website and follow us on Facebook and Twitter. In addition, I manage a CareerLight group on LinkedIn, which serves as a venue for sharing ideas and experiences of pursuing a career in the U.S.

What advice do you have for international students who are seeking a job in the U.S.?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies.He also serves as the editor of Solutions for a Sustainable World.

Simple Steps to Keep Your Online Information Secure

Cybersecurity is an important subject this blog has covered through a number of posts. Most recently, I published a post summarizing my experience of attending a mobile security forum Microsoft hosted on Oct. 11, 2017 in Bellevue, Wash. I posed the following question in my post dated Oct. 17, 2017: What methods are you using to secure your data?

In answering the question above for myself, I send the following email message on the first day of each quarter to my colleagues at all of the businesses where I am a member of the executive team or serve on the board of directors:

Dear Colleagues:

In order to keep our company's online information secure, it is strongly recommended that you:

1. Keep your operating system updated by repairing the security holes that hackers love to exploit with the newest critical updates for your personal computer AND mobile devices. Make sure you are using the most updated version of your web browser. Also, make sure you are using the latest version of the apps downloaded or pre-installed on your mobile device (whether or not you actively use the app);
2. Use proactive software protection. Anti-malware software is a basic requirement for initial protection on all computers as viruses and spyware can creep into your computer and easily degrade performance and corrupt or even destroy data;
3. Use a firewall. Firewalls assist in blocking dangerous programs, viruses or spyware before they infiltrate your system. Various software companies offer firewall protection, but hardware-based firewalls, like those frequently built into network routers, provide a better level of security;
4. Use a strong password, which is your first line of defense to keep your financial data safe. Complexity is best, so aim for double digits – an eight-character password can potentially be hacked in hours; 14 characters are infinitely less likely to be cracked. The best passwords use a combination of upper and lower case letters, numbers and symbols, and do not use words, names or birthdays. And never write them down.
5. Use multi-factor authorization (MFA) to protect you and your data by making it more difficult for someone else to sign in to your account. (MFA is also known as two-step authentication.) MFA uses two different forms of identity: (1) your password and (2) a contact method such as an authenticator app, phone number or email address. Even if someone else finds your password, they will be stopped if they do not have access to your other devices or accounts. I encourage the use of MFA for all the services you use for personal purposes (e.g., Facebook, Gmail, LinkedIn, and Twitter);
6. Remain cautious of suspicious emails and text messages from unknown sources. Do not open emails with attachments if you do not know the sender. Similarly, do not click on links sent via text, WhatsApp or WeChat messages if you do not know the sender; and
7. Steer clear of websites of ill repute. These are havens for malicious and annoying intruders like spyware. When surfing online, look carefully at URLs (web addresses) and make sure they match your expectation. Especially sites that should be secure – secure sites start with https.

While companies such as Microsoft, Google, and Amazon are investing millions of dollars in securing their cloud computing platforms, users must also take certain precautions to secure their devices. Accordingly, I cannot overemphasize the importance of using multi-factor authentication. Should a hacker learn your password, I take comfort knowing that a second method of identification verification is required to access my accounts.

I often hear it is when, not if, your system will be hacked. If so, why make is easy for the hackers when a few simple steps may prevent your confidential or sensitive information from being stolen?

Do you use additional methods not listed above to keep your online information secure?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

Microsoft Security Forum: Security in a Cloud-First, Mobile First World

Whether it was the convenience of accessing documents through any internet connection, easing the budgetary pressure of maintaining a private server or appreciating new technology, I was an early-adopter of Microsoft's cloud computing platform that debuted over ten years ago. As mobile applications have evolved and become readily available, I find myself using a smartphone to access my documents stored in the cloud more frequently. While conveniently accessing documents stored or apps hosted in the cloud is important, keeping the information secure is always paramount. Therefore, I did not hesitate to register for a mobile security forum, "Security in a Cloud-First, Mobile First World," Microsoft hosted on Oct. 10, 2017 in Bellevue, Wash.

Security for Your Digital Transformation

In his presentation, "Security for your digital transformation," Javier Dominguez, a Technical Solutions Professional at Microsoft, highlighted the four-step process Microsoft utilizes to secure its cloud computing platform: (1) identity and access management (protect users' identities & control access to valuable resources based on user risk level), (2) threat protection (protect against advanced threats and recover quickly when attacked), (3) information protection (ensure documents and emails are seen only by authorized people), and (4) security management (gain visibility and control over security tools).

He also noted that two billion records were compromised in 2016, which led to an average cost to a business of $15 million per breach (not including the reputation impact a business may experience when its data is compromised).

Identity & Access Management

Speaking during the second session, "Identity & Access Management," Mr. Dominguez said 81 percent of breaches are caused by credential theft, 73 percent of passwords are duplicates, and 80 percent of employees use non-approved apps. In securing its cloud platform, Microsoft asks the following questions about access control:

• Who is accessing? What is their role? Is the account compromised?
• Where is the user based? From where is the user signing in? Is the IP anonymous?
• Which app is being accessed? What is the business impact?
• Is the device healthy? Is it managed? Has it been in a botnet?
• What data is being accessed? Is it classified? Is it allowed off premises?

Mr. Dominguez also highlighted a new service called Windows Hello for Business, which replaces passwords with strong two-factor authentication on PCs and mobile devices. This authentication consists of a new type of user credential that is tied to a device and uses a biometric or PIN. In addition, Windows Hello for Business lets user authenticate to an Active Directory or Azure Active Directory account.

Protecting Against Modern Attacks

Speaking on protecting against modern attacks, Ken Malcolmson, an Executive Security Advisor at Microsoft, emphasized to the audience that cyber threats are a material risk to their business. He noted how Microsoft is detecting malicious activity in organization including (1) detecting compromised user credentials, (2) detecting malicious apps and data, (3) detecting advanced threats and abnormal behavior, and (4) detecting advance threats to hybrid workloads.

The objective with implementing multiple detecting mechanisms, Mr. Malcolmson said, is to "raise the cost of attack." In other words, increasing the time and financial resources required to compromise a cloud system will diminish a hacker's incentive.

Mr. Malcolmson then outlined five methods for responding to threats quickly:

1. Respond to Compromised Identities. Get recommendations and remediation actions in case of a suspicious activity on-premises or in the cloud; review next steps on a simple, actionable attack timeline; and identify threats before the attackers access critical data and resources.
2. Respond to Malicious Email Files. Remove emails found to be malicious after they land in user inbox; intelligent filters which update based on evolving cyber threat landscape; and ability to remediate for real-time malicious emails.
3. Respond to Compromised Data. Identify high-risk and anomalous usage in cross cloud apps - including Office 365 and get recommendations and remediation actions for next steps.
4. Respond to Compromised Devices. Remediate potential threats and prevent reoccurrence using built in technologies; receive mitigation guidance for remediation for threats and future risks; and assess organizational security score including trends over time.
5. Respond to Compromised Workloads Across Hybrid Infrastructure. Prioritized security alerts that help you respond quickly with azure security center; recommendations to mitigate threats and vulnerabilities; and threat intelligence reports for deeper insights into attack.

Information Protection

Mr. Dominguez then made a presentation on protecting and managing your data throughout its lifecycle noting that the "new world of work is driving change." Elaborating on this point, he provided some statistical data:

• 41 percent of of employees say mobile business apps change how they work;
• 85 percent of enterprise organizations keep sensitive information in the cloud;
• 88 percent of organizations no longer have confidence to detect and prevent loss of sensitive data; and
• 58 percent have accidentally sent sensitive information to the wrong person.

Mr. Dominguez discussed the lifecycle of a sensitive data including how data is created, imported, and modified across various locations:

• Data is detected across devices, cloud services, on-premises environments;
• Sensitive data is classified and labeled based on sensitivity, used for either protection policies or retention policies;
• Data is protected based on policy. Protection may in the form of encryption, permissions, visual markings, retention, deletion, or a DLP (data loss prevention) action such as blocking sharing;
• Data travels across various locations, shared protection is persistent, travels with the data;
• Data is monitored. Reporting on data sharing, usage, potential abuse; take action and remediate; and
• Retain, expire, delete data via data governance policies.

Microsoft Security Management

Making the forum's final presentation, Mr. Dominguez noted the different ways chief information security officers can secure their company's data including:

• Use Azure Active Directory to secure identities in your environment;
• Enable threat management for your devices through Windows Defender Security Center;
• Manage and control apps and data for your SaaS apps with Office 365 Security and Compliance Center as well as Microsoft Cloud App Security; and
• Consolidate security management for your infrastructure in cloud and on-premises with Azure Security Center.

I found value in the information presented during the security forum. As a customer of Microsoft's cloud computing platform, I appreciated getting a better understanding on how the company is protecting their customer's data against unauthorized access, detect attacks and breaches, and help with responding and adapting to prevent it from happening again.

While I am not a IT director/manager or security officer, per se, as an active user of cloud computing platforms for personal and business purposes, I understand the importance of cybersecurity and the financial and reputational impact a data breach can have to myself or my business.

How are you or your business using cloud computing? What methods are you using to secure your data?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

The Changing World of Digital Health

Organized through its Kirkland, Wash. office, Nan Hai, a Millbrae, Calif-based company that produces tech and business conferences to facilitate cross-border collaboration between companies in the U.S. and China, held its annual Seattle Biz-Tech Summit in Bellevue, Wash. on Sept. 30, 2017. The theme for this year's summit was "Innovation meets Connection," which continues the summit's focus on technology innovation and business exchanges between the Pacific Northwest and Asia. This post focuses on the presentation, "The Changing World of Digital Health," I gave in a breakout session titled "Technology & Innovation in Healthcare." The content of my presentation is primarily derived from three articles published by The Economist.

What Role Will Technology Play in the Delivery of Primary Care in China?

Starting with an article, "Shod, but still shoddy," published on May 11, 2017, I focused my discussion on the assertion that "many people who seek medical help in China bypass general practitioners and go straight to hospital-based specialists. In a country once famed for its readily accessible 'barefoot doctors,' primary care is in tatters."

In presenting the current conditions in China, the article explains:

It is not just long waiting-times at hospitals that necessitate more clinics. People are living far longer now than they did when the Communists took over in 1949: life expectancy at birth is 76 today, compared with 36 then. People from Shanghai live as long as the average person in Japan and Switzerland. Since 1991, maternal mortality has fallen by over 70%. A growing share of medical cases involve chronic conditions rather than acute illnesses or injuries. GPs are often better able to provide basic and regular treatment for chronic ailments. The country is also ageing rapidly. By 2030 nearly a quarter of the population will be aged 60 or over, compared with less than one-seventh today. More family doctors will be needed to manage their routine needs and visit the housebound.

Whether it is through wearables, telemedicine or other technological hardware or software platforms, what role will technology play in the delivery of primary care of China?

How Hospitals Could Be Rebuilt, Better Than Before

Referencing an article, "Prescription for the future," published on Apr. 8, 2017, I highlighted The Economist's observation that:

Today, hospitals are where patients go for consultations with specialists, and where specialists, with the help of medical technicians and pricey machinery, diagnose their ills. They are also the main setting for surgery and medical interventions such as chemotherapy; and where sick people go for monitoring and care.​ But high-speed internet, remote-monitoring technology and the crunching of vast amounts of data are about to change all that. In the coming years a big chunk of those activities—and nearly all the monitoring and care— could move elsewhere.​

I also explained that "technology firms are already playing a bigger part in health care as phones become more powerful and patients take control of their own diagnosis and treatment." Furthermore, "the more far-sighted hospitals are hoping to remain at the center of the health-care ecosystem, even as their role changes.​"

The following text from the article provided the central thesis of my presentation:

Picturing what hospitals could be, if the various obstacles are overcome, means abandoning long-held assumptions about the delivery of care, the role of the patient and what makes a good doctor . . . . Just as online banking made life more convenient for consumers and freed up branch staff for complex queries, online health care could mean fewer people need to come to hospitals to be cared for by them. Last year half of consultations ordered by Kaiser Permanente, an integrated American health-care firm that runs many hospitals, were virtual, with medical professionals communicating with patients by phone, email or videoconference.​

Mark Wen and Aaron Rose
at the 2017 Seattle Biz-Tech
Summit

What is more, as "more sophisticated diagnostics, including blood tests and virtual imaging, become available remotely, more patients could receive hospital-quality care without leaving home . . . . And with better remote monitoring some chronically ill patients who now need to be in hospitals will be able to stay at home, only coming in when their conditions deteriorate. Moving care outside institutions will both save money and raise standards, by making patients more comfortable and reducing infection rates."

The article is correct to forewarn that "for all this to happen, primary care and home support will need to improve." Technology will play a significant role in such improvements.

In the future, the article suggests, "rather than checking patients' vital signs only at intervals, or parking ICU-nurses next to beds, live data-streams from medical machines and wearable devices could ow straight to such command centers, where supercomputers could screen them for anything worth bringing to the attention of medical stations. Doctors in the command center, or even in their own homes, could be at patients' bedsides virtually with a swipe of a touchscreen. All this would not only make the hospital safer and more efficient; it would also give medical staff a more complete record of patients' progress."

Moreover, "A command center could watch over patients not only in hospitals, but also at home. Wearable devices that track vital signs, contact lenses that monitor blood-sugar levels and smart-stitches that measure the pH level of fluid in wounds would all mean fewer patients in hospital for monitoring."

On the topic of robotics, "The surgeon's job, too, could be transformed. Today, the use of robots in the operating room is limited because they must be steered manually with a joystick. In future robots might be able to carry out some standard procedures such as hip replacements autonomously, with a surgeon getting things started and the robot doing the rest."

In addition, more complex operations via "a supercomputer linked to a real- time virtual-reality (VR) machine could help walk surgeons through their operations. It could, for example, highlight where a tumor sits in the liver and warn a surgeon about impinging on an artery, just as a satnav warns of traffic jams ahead."

The article accurately the discusses the world's growing need for healthcare workers. "The World Bank," notes The Economist, "estimates that by 2030 the number of health-care workers will need to double, compared with 2013—an extra 40m workers globally." Additionally, "High rates of stress and burnout are already a problem in health care; if workloads continue to increase they will only rise further. But if medical staff are made more productive with the help of computers, monitoring devices and robots, they can be freed up to do the work that only humans can do, and helped to do it better and more happily."

China's Audacious and Inventive New Generation of Entrepreneurs

My presentation then focused on the wave on new Chinese companies that are transforming the digital economy domestically and abroad. According to an article, "The next wave," by The Economist, "China's nimble new innovators are using world-class technologies from supercomputing to gene editing. Having established themselves in the cutthroat mainland market, many are heading abroad."

China's health industry "is antiquated and dysfunctional," the article claims. "Long queues are common at state hospitals and access to drugs is complicated by an opaque system of dispensation." This, however, has provided an opportunity for entrepreneurs and well-established Chinese companies alike. "AliHealth, an arm of Alibaba, is now a leading online pill-peddler. WeDoctor helps patients book medical appointments using smartphones. Venus Medtech has invented a retrievable heart valve intended for patients with high calcification in their arteries."

The Sept 23, 2017 article further says: "The best example of a local health-care disrupter with global potential, however, is iCarbonX, a health-data analytics firm from Shenzhen, a metropolis near Hong Kong. It is the brainchild of Wang Jun, who is a picture of the active health he wants to encourage with his startup. He formerly ran BGI, one of the world’s leading genomics-research firms. The Chinese company was involved in the global race to decode the first human genome and at one time owned half the world's gene-sequencing equipment."

ROI3's English Language Learning for Medical Terminology​

I concluded my presentation with a discussion about a mobile app my colleagues and I at ROI3 developed to help medical doctors and healthcare professional in China to learn English language medical terminology. Not only does our app correspond to the growing international presence Chinese companies are experiencing, but many studies suggest that over 90 percent of global medical research is published in English. Chinese medical universities and research institutions have recently made significant investments in building their research and development programs with the aim to share their innovation with partners and customers worldwide.

I want to express my appreciation to the panel's moderator, Dr. Mark Wen, Vice President & Director for Seattle Children's Hospital Global Business Development and International Medical Services, for inviting me to speak at this year's summit. In addition, a special "thank you" to my colleague, Jingyan Zhang, for her help with creating the PowerPoint presentation, which may be downloaded via SlideShare.

What are your predictions on how technology will change the global healthcare industry?

The Changing World of Digital Health from Aaron Rose (罗安伦)

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

Export 101: Choosing Your Export Market

The article below was originally published by The Center of Excellence for Global Trade & Supply Chain Management, a partnership with Highline College in Des Moines, Wash.

"The World is Flat" is not just the title of a book by Thomas Friedman, but it is a concept in conducting business in the 21st Century. Given today's ease of sharing information worldwide, it has become easier than ever to export to markets on the same continent or land thousands of miles away. However, the variety of markets that exist means not all countries provide ideal conditions for your product or service. A business must choose its export market(s) carefully by gathering relevant and accurate information, speaking with trade experts, and performing a country-level risk assessment.

Lots of Market Choices, Make an Informed Decision

There are approximately 196 countries in the world (depending how the word "country" is defined). From Afghanistan to Zimbabwe, each country possesses its own set of risks and opportunities. Developed markets like the United States, Canada, Japan, the United Kingdom or the euro area, the monetary union of 19 of the 28 European Union (EU) member states which have adopted the euro as their common currency and sole legal tender, offer stable conditions with low political and security risks, as well as a strong rule of law for enforcement of contracts and protection of intellectual property to safeguard your investment. While stable, these markets may lack the economic growth that allow for rising consumer or enterprise spending necessary for an exporter to implement a successful international growth strategy.

Emerging or developing markets in Asia, Latin America, Middle East and North Africa, and sub-Saharan Africa may offer a rapidly growing middle class who will purchase your products or services, but also present significant geopolitical and socioeconomic risks. Selecting the right export market involves doing your homework about the specific nuances involved with exporting, learning about the country's political and economic environment, trade regulations and understanding risks associated with each market.

Successful business leaders often say that you worry less about making good decisions if you make informed decisions. And making informed decisions about your business strategy often involves performing a significant amount of research. Choosing the wrong export market for your business is easy when you do not perform the proper due diligence. Identifying the right resources to learn about the nuances of exporting is the first step to developing a viable international growth strategy.

Export.gov Can Get You Started

Export.gov is managed by the U.S. Department of Commerce and International Trade Administration to assist U.S. businesses plan their international sales strategies and succeed in today's global marketplace. The "How to Export" page contains a video collection to help small businesses become better equipped to enter the exciting exporting world. And the report, "A Basic Guide to Exporting," provides an overview of the fundamentals in exporting, designed for small to medium-sized companies who are considering finding new market segments overseas.

Through Export.gov, the Top Market Series contains reports prepared by economists and trade experts who analyze and rank industry opportunities in key overseas markets. Export.gov also provides export information by industry, which is updated regularly by commercial specialists around the world.

Exporters Utilize Country Commercial Guides

Country Commercial Guides, prepared by trade and industry experts at U.S. embassies worldwide, contain information regarding market conditions, opportunities, regulations, and business customs for over 125 countries. These guides are an excellent starting point to find everything you need to know about doing business in an overseas market, detailing eight important factors to help you decide if a market is right for your product or service:

1. Doing Business in …: Provides a broad overview of the market and the top reasons why U.S. companies should consider exporting here. Recommends strategies for entering the market and summarizes challenges or barriers for U.S. companies;
2. Political and Economic Environment: Links to the State Department's website for background information on the country's political environment, its bilateral relationship with the U.S. and the country's membership in international organizations;
3. Selling U.S. Products and Services: Provides guidance and best practices for selling U.S. products and services in the market, includes typical use of agents and selling to the government. Provides steps for establishing an office or joint-venture/licensing partner, and conducting due diligence. Discusses the state of e-commerce, franchising, and direct marketing;
4. Leading Sectors for U.S. Exports and Investment: Identifies the top industry sectors that have potential in the market. Provides a general overview of each sector, including trade data, challenges, sub-sector best prospects, and a list of relevant websites and trade shows;
5. Trade Regulations, Customs and Standards: Describes trade regulations, customs and standards in the market. Provides information on import tariffs and documentation U.S firms should be aware of when exporting, including any prohibited items or temporary entry procedures;
6. Investment Climate Statement: Describes the country's openness to foreign investments and provides information on the country's investment policies, the labor market, political violence and levels of corruption. Describes foreign trade zones and laws for protecting property rights;
7. Trade and Project Financing: Describes the country's financial system and how U.S. firms typically get paid. Describes the banking system and provides information on foreign exchange controls in the market. Describes important sources of funding for project financing; and
8. Business Travel: Describes relevant business travel information and business customs, includes any special visa or entry requirements, potential health risks, travel advisories and information on travelling around the country.

Trade Events, Webinars and Experts

In addition to the aforementioned reports and online resources, Export.gov provides access to information on global trade events and webinars. These include seminars and workshops on export licensing and regulations, and the U.S. Department of State's Direct Line Program that connects you with over 270 embassies and consulates who provide market overviews as well as sector-specific commercial opportunities.

Beyond the valuable resources provided by Export.gov, the U.S. Commercial Service is the lead trade promotion agency of the U.S. government. U.S. Commercial Service trade professionals in over 100 U.S. cities and more than 75 countries help U.S. companies get started in exporting or increase sales to new global markets.

Chambers of Commerce and Export-Import Bank

Under the auspices of the U.S. Chamber of Commerce, the American Chamber of Commerce (AmCham) may be found in many countries worldwide (e.g., AmCham Cameroon, AmCham Canada, AmCham China or AmCham Colombia). This link leads to the American Chamber of Commerce Directory. While the U.S. Chamber of Commerce and American Chamber of Commerce groups located worldwide are membership organizations where dues are required to join, many make their reports or events available to the general public.

The Export-Import Bank of the United States (EXIM), an independent, self-sustaining Executive Branch agency with a mission of supporting American jobs by facilitating the export of U.S. goods and services, is a useful source of information. Specifically, EXIM's "Learning Resources" page contains articles, white papers, and publications focused on exporting globally. It should be noted that EXIM provides valuable services for exporting businesses including working capital loan guarantee, export credit insurance, project and structured financing, transportation financing, and financing for foreign buyers.

How to Analyze Risks in a Market

Once you have identified which of a short list of countries that may be suitable for your business to export to, your next step is to perform some due diligence on the risks that exist in each country. (Businesses should be in the practice of identifying, evaluating, and mitigating risks.) The Economist Intelligence Unit (The EIU), which provides country, risk and industry analysis, across 200 countries worldwide, is a resource many business owners find valuable when it comes to gathering information on a variety of geopolitical or socioeconomic issues. When considering which country your business should expand to, The EIU recommends asking the following questions:

1. Security: How safe is the physical environment?
2. Political Stability: How stable are political institutions?
3. Government Effectiveness: Does political culture foster strong business environment?
4. Legal and Regulatory: Will the legal system safeguard investment?
5. Macroeconomic Risks: Is the economy stable and predictable?
6. Foreign Trade and Payments: How easy is it to get inputs/money in and out?
7. Financial Risks: How healthy is the local financial system?
8. Tax Policy: Are taxes low, predictable and transparent?
9. Labor Market: Could labor market factors disrupt operations?
10. Local Infrastructure: Will infrastructure deficiencies negatively affect operations?

Given today's globalized economy, there are many options to choose when it comes to developing your company's export strategy. However, not all markets are the same and it is important to investigate the pros and cons of each market you are considering. By doing your homework and asking the right questions, you should be able to make the right decision on choosing the best market to export your product or service. Now you need just one more important item for business success: Luck!! And I wish you plenty of it.

About the Author

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He serves as Founder, President and CEO of ROI3, Inc., a Seattle, Wash.-based company whose mission is to empower people in emerging economies through innovative, technology-based solutions. He also co-founded Yeeko Inc., a digital media platform that produces content on culture and literature for Chinese readers worldwide. Most recently, Aaron co-founded CareerLight, LLC, a company that provides customized career training for international students to help them prepare for a successful career. As a business advisor, he provides expertise to Fortune 500 and small businesses alike on global strategic planning and business development, international growth management, and knowledge management. In the public sector, Aaron advises governments to promote comparative national advantages to attract foreign direct investment to stimulate private sector development.

Big Data Is a Driver of Growth and Change, but Don't Assume Its Value Is Automatic

Image: http://ow.ly/rWA930fIvq8

When my colleagues and I at ROI3 were developing our initial mobile apps for English language learners to learn English terminology for special purposes, people asked about what data we were planning to collect. In trying to answer the question, I learned that we should not collect for the sake of doing so, but identify the type of data that is available to collect and then prioritize how this data will allow us to improve our service to provide the best experience for our customer.

In a blog post, Alex Brooks, founder and CEO of AE Brooks, LLC (d/b/a Entreprov), a Seattle-based firm advising clients on machine learning and business strategy, wrote: "Companies that continue to succeed in today's market will have an effective strategy for collecting relevant data about their customers." Without a proper understanding, however, big data may confuse business executives and become an impediment in growing their business into a successful venture.

SAS Institute, a North Carolina-based analytics firm, explains that big data as a term describing "the large volume of data – both structured and unstructured – that inundates a business on a day-to-day basis. But it's not the amount of data that's important. It's what organizations do with the data that matters. Big data can be analyzed for insights that lead to better decisions and strategic business moves."

In an article, "Data is giving rise to the new economy," The Economist asserts: "Data are to this century what oil was to the last one: a driver of growth and change. Flows of data have created new infrastructure, new businesses, new monopolies, new politics and—crucially—new economics. Digital information is unlike any previous resource; it is extracted, refined, valued, bought and sold in different ways." Furthermore, data "changes the rules for markets and it demands new approaches from regulators. Many a battle will be fought over who should own, and benefit from, data."

Image: The Economist

The article also explains that "the quality of data has changed, too. They are no longer mainly stocks of digital information—databases of names and other well-defined personal data, such as age, sex and income. The new economy is more about analyzing rapid real-time flows of often unstructured data: the streams of photos and videos generated by users of social networks, the reams of information produced by commuters on their way to work, the flood of data from hundreds of sensors in a jet engine."

While big data is becoming ubiquitous in today's global economy, risks remain in properly determining its value. In an article for TechCrunch, Jon Evans writes:

I'm not saying data is valueless. I'm not saying analytics are completely unimportant. But I am saying that before you obsess about them — and believe me, with far too many of the clients I've had, 'obsess' is the right word — ask yourself what questions you will ask of your analytics data, and what value you expect to receive. Don't assume that its value is automatic, and just needs to be mined, when all too often it is fool's gold at best. Don't collect data for its own sake, collect it to answer specific questions — and know what those questions are well before you launch.

How is your company collecting and using big data?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.