And here we go. So welcome everybody, see good attendance to you today. And it's my pleasure to introduce you to Mr. Hussain Shakir from the Arabic Emirates. And this is good one, I leave the stage to you Hussain to display what you are doing on that end of the world. So we're pretty curious to know more into your universe to get acquainted to you. So it's now for us to have you today with us and leave the stage to you to start presenting your company, what you're doing with the current project and for the future ones. Thank you Andrea, first of all, for a very, very warm welcome. And I mean, we have a great crowd here and I wanna make it worth the next 30, 35, 40 minutes to give you a glimpse into what we are doing here in the Arab Emirates in the blockchain world or to be more specific in the hyper ledger blockchain world, the private permission blockchain world. And then UA trade connects as the name suggests it's turning into the national trade finance platform for the region. We do have the first use case already live for about 13 months and has some interesting stats. And the main purpose of this first use case and how this lays a foundation for where we think very soon we are progressing towards. A lot is happening as we speak. I'll give you a glimpse of how the journey came about, how the platform operates, the power of blockchain which is very subtle, but indeed doing a fabulous job behind the scenes and how this translates into an exciting future for us. So in terms of agenda again, let's understand how the first use came together and in strength for any blockchain play, I strongly personally believe it's all about co-creation. It's how you put a consortium together. It's how you have a steering committee of your consortium members that drive it forward. And that's the key element of success for any blockchain, at least private permission blockchain output. Then I want to have a quick video about 1995 second that will take you through how the system operates in layman's words. I mean, for the technologists on the forum, they would be mapping it in their head onto which node and which smart contract are invoking. Success of the system in terms of numbers. And then I want to just give a glimpse of how we see this as one potential roadmap for ourselves going forward. Okay, so what I'm going to start with is talking about the first use case. UTC, which we use as an abbreviation for UAE Trade Connect. The idea was to address the fraud risks in the trade finance space, but this use case was identified by the banks. And in terms of risks in the present environment, so we all know that when it comes to trade finance, whether it's about invoice discounting, factoring, reverse factoring, trust receipts, so many flavors are the same thing. We know that a customer walks into bank A, says, hey, I did a million dollar business. My cash is going to be realized about a few months down the road, but I'm looking for quick working capital. The banks will do the due diligence, make sure the KYC is good, make sure the transaction is decent, and they will go ahead and finance. But that doesn't stop the company from walking into bank B with the same document, right? And this is what is an industry-wide blind spot. And we picked it up as the first use case because to de-risk the trade finance environment, to have the banks build the confidence of lending and eventually propagating the economy, we had to address this as the beginning of our journey. And it's not just that a company takes an invoice to do it, they could take it to multiple banks. And we do know that the underlying risk of over-invoicing, under-invoicing, just paper-based trade, they all exist. And this is the journey that we embarked on. And this is where I said earlier that the power of blockchain, I think is very synonymous to consortium. It's all for consortium play. And this is how our journey started. Back in 2018, one of the leading banks of UAE came to the telecom company in the region, the largest telecom company at the Salat, which is now known as the EN group there. They came, they said, this is an industry-wide problem. What can we do to solve it? Well, if it's an industry-wide problem, what we do need is we need to have all the banks in it. So we invited all the banks, seven of the more agile, more, I would say, rarely to tackle a problem kind of banks said, let's form a consortium. So seven banks at the Salat, the anchor telecom provider in the country and a technology partner, they got together. And in all these banks on the top were the ones that started the journey with us. And these are all household names in the region from First Abu Dhabi Bank to its NBD to RAC Bank, National Bank of Fujairah, CBI, Mushrik and Commercial Bank of Dubai. So what we did was created a consortium that said, we need to co-create. We need to work together to solve this industry-wide problem. And we are lucky because back in August, 2020, the central bank of UAE joined the stating committee of the program in an observation capacity, right? But I mean, as being the regulator, all the guidelines started flowing from them in terms of what we should, more than what we should do, what we should not do. How to ensure integrity, how to ensure data privacy and data protection, how to establish communication channels and how to basically establish a working relationship for banks. And I understand back in 18, 19, 20, this is still a new concept, at a very high level, it was an exploration concept, but that turned into a reality when we turned it around in a few months to a pilot program. And we allowed our banks to basically not just test it, but simulate a real-life culture of how it worked, gave ourselves six to eight months to test the platform out. And last year in April, I believe the date was 19th April, is when we launched the platform with the first use case of invoice deduplication. And it was, I would not say it was a run of a success. Like all platforms had its challenges of adoption, but it's a very different picture today. When I present the stats in a few slides, you'll see that, that growth, that marketing, that trust of the banks got us to a position where we were, the platform was looked as one of the key enablers and was proposed to be part of the National Financial Infrastructure Initiative of the country. And the 2022, this year started with the bank because we onboarded not only the largest Islamic bank in the country, the Biaslamic Bank, but we also onboarded one of the very active bank in the retail segment of the B commercial bank. And just like all the learnings that were passed on from our founding members, they all go into the, into a very structured onboarding program that enables and that allows incoming banks to onboard themselves in a very small period of time. And what looks like here is the nine logos, very powerful logos, well, then it's going and you know, because we are under NDA of so many other prospects right now and I can't put those logos, but it's a very thick pipeline if I were to use that word. And it's not only just the banks, but you know, the alternate lending environment has also taken a notice and because it's a blind spot, we all need to work towards it to ensure that we minimize the blind spot. With that, I mean, now that I've given the background of how things have come about the power of co-creation, the power of the consortium, let me take you through a 90 odd second video which will give you a glimpse into how the system works. It's in layman's words, but still tries to explain how blockchain to people who don't come from a technology background. And probably at the end of the video, if there are any queries, it would be a good time to maybe address them. And with that, I will play the video. UAE Trade Connect is an award-winning consortium where the first of its kind is a digital national trade finance platform featuring cutting edge technology based on blockchain, artificial intelligence, and machine learning technologies. The first use case offered on the platform is the fraud detection and identification of two picketing voices financed by banks as part of their trade finance offering. Here is how UTC adds value through five simple steps. One, a bank submits invoice information into our private commission for through the platform through their node. Two, the selected information required for fraud detection is replicated to the UTC node using smart contracts. Three, this information is then pushed into the fraud investigation engine, which performs G-look at checks and a risk assessment. Four, based on the fraud checks, the bank will be notified as follows. A, pass, clean invoice, which may be financed, or B, failure, major issues identified or a duplicate invoice, do not proceed, or C, inspect. Banks further investigation is required since a high risk score has been determined. Five, final action taken by the bank with respect to financing the invoice is securely saved onto the blockchain. The selected invoice data, risk assessment outcome, and the final action taken by the bank is chronologically stamped onto the blockchain network, and that combined with the immutability of data ensures tamper proof and distributed storage of sensitive information. Atisalat Cloud Services hosts a solution within the United Arab Emirates, ensuring compliance with central banks regulations. The central bank has also endorsed UTC's unique proposition as well as due to sharing architecture among banks. UAE Trade Connect benefits both banks and their clients by reducing fraud, enabling the banks to share knowledge of duplicate invoices without sharing any sensitive information, enhancing finance for corporates and SMEs. UAE Trade Connect. Built by the banks for the banks. And I think we do live by the tagline that this is built by the banks for the banks. And I think this is, again, a very important pillar in our storyline. This is, I would say, the most important element of our journey so far. And now, what the video was trying to explain, let me articulate that in a step-by-step real scenario that happened with us back in December of last year. This is a real case, no names. But more importantly, it will help you, the audience understand what is actually happening. So Ace Seller, which was a manpower company servicing large entities, government, semi-government level entities, had a pack of two invoices. And they approached their bank A, the ones they banked with and said, you know, we are looking for some receivable financing on this. So the bank said, okay, great. Let us do the due diligence on you. KYC comes out good. And they said, well, we now have a new system called UAE Trade Connect. Let's submit the invoices as a final check against the system. Because the system had not seen those invoices, marked them as clean, the banks decided to finance those invoices. And they stamped it onto the blockchain network that they have financed them. About three weeks later, the same seller approached Bank B with the same set of invoices and said, we'd like to apply for some quick financing. The bank said, well, let's do our due diligence and the last mile check against the UTC system. And the UTC system this time identified the invoice as a duplicate, flagged it as a failed instance. And more importantly, notified Bank A that the invoices that were presented to you three weeks back have shown up somewhere else. Now the beauty of the system is this fraud was running in about four million or about a million euro, a little over a million dollars right now, given the conversion rate, a little over a million euro as well right now. And Bank A was notified that the invoices they had seen a few weeks back had been presented to Bank B. Bank B was informed correctly at the time of transaction that these invoices have appeared on the network. The beauty is Bank A doesn't know Bank B, Bank B doesn't know Bank A, yet all the parties involved in this potential, what could have been a fraud were informed correctly and on time. And the banks took their corrective action, whatever they did post their investigation but had a system like this not existed, this would have easily passed through and there would be no policing around it. Now when I move into... Huzain, is it okay to interrupt? Yes, yes please, yes. Sure, sure. Huzain, in this case, if Bank B hasn't been a part of your UAE trade connect, would they able to identify this issue? No, no, of course no, because that's the blind spot. I mean, if the banks are in the network and we are working towards having all the banks that deal in this trade finance product to be on the network, once everybody is, maybe 100% with the logos you saw earlier, there's a very significant percentage of the market that we already covered and given the fact that I can't share, we are getting very close to... Sorry Huzain, yeah, you proceed, please, sorry, yeah. Yeah, yeah, we expected to grow to about 85 to 90% coverage early next year. Okay, okay, okay. And one more quick query Huzain. So is this invoice fraud? I know that this, whichever, it's a beautiful concept within the trade finance because this is the first step of, between the exporter and importer, the things will happen. And what I just want to check it out is, is it for all the, like invoicing, like even letter of credits and bill of lading that has also been checked by your system or only a general invoicing? No, that's in fact a very good question. So our consortium, which is again run by the banks have decided that as far as the borrower is in the UA originating, the borrowing is originating in UAE, irrespective of the counterparty where they belong to and irrespective of what kind of transaction it is open account, LC or any other arrangements. But if a trade invoice is involved, then they should run it against the system as a last mile check before they are okay to go ahead and finance it. So we're getting the whole nine yards in all possible currencies that our respective banks are dealing in and irrespective of the product, factoring, discounting, LC oriented because what could be an LC for bank A could be an open account transaction for bank B.  Hence, they're putting in all the volumes that they have come across. Okay, thank you. It was a fantastic achievement by your team. As in like, we are just started to explore this from India. As in like, RBA has just given a go-ahead for, to start this particular project as such, to explore with the trade finance. But I think view people are a bit advanced on that and really nice to see this coming in. And I think blockchain is one of the things, which is going to disrupt this trade finance world. And I seriously believe that, once blockchain is getting explored, I think, shift is something, which is going to get a huge change. And I believe on CBDC and central bank digital country once it gets implemented, right? I think only buyer seller and the one intermediary. Satya. Satya, thank you. Let's go ahead with the presentation that we can recap. See during the question and time at the end of the speech. Yeah, yeah, definitely. Definitely, sorry, sorry, sorry. I think, you know, I don't have any worries. Yeah, yeah, I got it, I got it. Yeah, go ahead. We started our journey, probably mirroring some of the other achievements across the globe, but our success story has been our own. And I'm sure your journey has started and if there's anything that we can help be beginning age, we'll be very happy to share our experiences with you. In terms of the success of the system. So if I were to put this in plain numbers, and I would say this is about 43 billion dirhams in local currency, we're looking at what about 13 or 14 or billion euro or dollars today. That's the value of invoices that has already been validated inspected on the platform by eight out of nine our banks because the ninth bank is still just coming in. But I would say the volumes from eight banks have already started hitting. This is what we have as a number. And this is pretty latest, but I mean, this is from yesterday or day before and I'm sure it's jumped a few millions here or there. And the average ticket size, what we are looking at is about $50,000 to $60,000 or euro. It's a significant ticket size, even an average value. Some tickets are really, really high. And on a monthly basis, I mean, the volume has started now going upwards of 30,000 invoices with about 1.3 billion USD or euro per month. And if you look at the curve, it's just going upwards. And the system is working as designed, right? The system is working as designed. Why I say this? Because so far, we have already found 20 interbank duplicates. Now, the value may not look very high, but it's a 2.5, 3 million USD euro. But the beauty is that the system has picked up exact matches to a little bit of fuzzy matches. But more importantly, seven out of our eight network banks have seen a duplicate. And it's consistent now. Every month, we've seen five to six duplicates with decent value, decent ticket sizes. And on the record, we have that the customers, I mean, the investigation within the banks have led to blacklisting the customers when it was a fraudulent intent to actually understanding why the banks looking at their own processes and improving them as they go along. Because it was very important that somewhere within their system, also within their process also, they have to tackle this. We had one very interesting case a few months back and it deserves a mention here. So there's a pack of seven invoices by a huge automobile supplier based out of a free zone. And then they had a counterparty which was the distributor of their automobile brand. It was what about 15 to 17 million USD euro when it was presented. So the first party that presented was a supplier. Was looking for supply side of financing. Few weeks later, the counterparty which was looking for buyer side of financing presented the invoice. The system picked it up as a counterparty. It was a legit transaction. The supplier was getting the finance first for the right reason and then the buyer getting the financing paying the supplier. But had a system like this not existed, this kind of a pattern, this kind of a trade, this kind of an arrangement would not have been picked. Apart from that, I mean, there are the intra bank duplicates. And again, I highlighted it could be because there's partial financing happening or there is duplication within the bank because it's coming through two different channels or through different items. Or it could be that within the bank, the processes are not in line and they end up uploading the same invoice twice. I mean, that number is growing significantly. And on the right side, what I have is apart from checking the duplicates, what we also do is we have a risk core engine on the invoices. And if you look at it about 3 fourth of the invoices are absolutely clean. And about 1 fifth of the invoices have low risk. What are low risk indicators? And this has been decided by the consortium. So an invoice which has more than five zeros as a total in an economy which is VAT oriented, why do we have a round off? So those kinds of triggers and it's an alert. If an invoice is more than 120 days old, why are we financing that old invoice? Things like that, checks like that, something very meaningful. An invoice number, nomenclature, is it in line with the last time the same supplier presented it? Is it really off? Does it mean there's something fishy going on? So those kind of elements are also flagged as the invoices go through our screening system. Now, I mean it's blockchain. So it's inherently protected, it's inherently secure. But on top of that, I mean, what we have today is a banking grade software used by the leading banks of UAE and it required that we had the highest level of security standards, what we call banking grade standards, what put around it. So apart from the system going through the VAPTs on a very regular schedule to the entire system being CSL to compliant, the connectivity is through very secure tunnel. It's not like in public domain, it's available for our hackers to go in. It's not, it's pretty secure. And the most important element is that apart from the leading banks certifying the technology and the security architecture of the platform, the central bank, we had an opportunity to present and get them to review and get them to endorse a blockchain-based knowledge sharing model, which didn't exist before we got in. So allowing the banks to share the data without sharing the data. And more importantly, as banks are used to, we have a 24 by 7 SOC in place, SIM solutions like Splunk are in place. So it's heavily guarded. It has to be because it's sensitive data. And again, data protection security is actually at the very heart of the platform. And I think this probably is coming towards the end. And I hope I'm in time. Where do we go from here? I mean, we have a beautiful journey so far. We expect that many, many banks are going to join us between now and early next year and probably in a span of few months, we would be at a point that we would have covered the blind spot in the industry between 90% to 95%. And the 5% will follow eventually, will fall in place. But as a roadmap, we believe that we have a responsibility being at a national level, at a nation level, to ensure that the platform continues adding value to the defrauding and de-risking of trade. And UAE is heavily, was one of the leading trade hubs of the world. So bringing this into the environment just makes it far more friendly for the businesses to propel. And we believe that adding TBML checks, sanction screening, dual usage goods checks, verifying the trade documents to looking at a more nationwide robust KYC KYB as a given on the platform and probably working with the leading shipping lines of the world. And there are so many platforms today available for us to collaborate with. But if a bank had a visibility on the LC down to where the vessel was in the high seas, down to tracking their container, there will be a lot more confidence when it comes to financing the traded hands. Aiding and collaborating with customs, we could kill another, or we could tackle one of the bigger problems of under invoicing when it comes through the customs gates. So these are all eventual road maps. Most of them we have embarked upon. There's quite a lot of work done. We just had a major release a week back where we enhanced the rule engine to look at far more permutations and combinations of potential duplicates. And in subsequent months, this road map will start taking shape. And with that, I think I will open the floor for questions. I know that in the chat box, I do see a few questions. There is already one from my friend, Tham Sanga. By the way, welcome back, Pam. It's great to have you here. Pam basically is asking, what did the business gates look like? But would I create this service and then to offer it as a compelling service? Of course, Pam, feel free to say the word and ask at the next one. Yeah, happy to. First of all, thank you very much for sharing. Really good, really good project and update. But hopefully, does the question make sense? Because obviously, it's designed by the bank, the full bank, keen to understand how they made the business case to invest to create the service, number one, and then obviously to consume it. So are you are you asking what was in it for the banks to come up with this service or how did you consult him? No, I think you explained it very well as to where the value is in as far as the avoidance of double finance. And that's value there. How did you quantify the value and determine how much money to invest in the creation of the platform, how the banks funded it, and then how much do you charge for the platform to survive for the banks to then continue to use it? That's a great question. I mean, in one question you have me talking for the next 30 minutes again. But to cut it short, I think when we started the journey, it started as a proof of concept. Technology was new to the region. Banks were getting into a model of this sharing of data they had not done before. So all this was very new to them. So Etesalat, the telecom company, and now the enterprise wing of it, which is now known as the EN Enterprise, said we shall put the whole program together and find a way for releasing as a subscription model for the banks to pay for it. So instead of the banks investing, banks who are helping steer the use case and potential solution, whereas Etesalat EN took the responsibility of developing the platform, investing in it, and then finding a model to charge back. Now, when you ask for the pricing, it's a little sensitive topic, but let me explain how it works. So we have a subscription fee on an annual basis, which is paid by all the banks and also has an X number of invoices which are covered as part of the upload. Now, anything beyond that we charge per invoice and then there is a ceiling price at which the charges stop and you could have N number of invoices beyond that. This model helps the largest banks to have been capped, they get capped at a sustainable price. And for the smaller banks to have a very low end subscription fee, and if the business is good and invoices are more, then they are charged very incrementally per invoice. So that this model, again, the pricing model was decided by the consortium. And this is how the platform is now growing with that pricing model. Lovely. Yeah, no, it is a complex one because you've got to manage the three business cases. One, two, as you said, create the platform. And obviously the local operator took care of that. Then how does it actually become self-funding? So it's not continuously absorbing more capital to keep it running. And then how do you then get that pricing, right? As you said, complex. But your model sounds very much in the right place. So congratulations, congratulations. Thank you, thank you. It was a lot of hard work for the people involved. Some very smart people like my boss, I wish I was on the call. And in coming up with this pricing, in having the Stereco and the consortium running hands in hands is the bigger success. And then that everything starts falling in place. Our question, say, why hyper ledger? Yeah, I was going to have a more provocative one. But that's a good one. What did you choose to go for hyper ledger? So a couple of reasons that led us to hyper ledger. Of course, the private permission blockchain, the kind of security and the mindset we had in mind, especially catering to banks, the benefits of hyper ledger made sense. Our partner in journey, one of the known names in the hyper ledger world, Vanzi Innovations is an expert at hyper ledger, their product Cypher, which is the underlying platform, the underlying framework of the platform as one of the highest rated suite of products in the hyper ledger world. So it was just putting all of that together. We didn't think that this was a public blockchain play. It had to be managed. And it was a privileged entry to the club, as opposed to keeping it open. So that's how the hyper ledger story came about. Thanks for saying it. The reason I'm the question for my friend, I am from Turkey, is that solution for local trade transactions? Yes, yes. So local trade, as I said, as far as the borrower or the borrowing is in the country, then irrespective of if the transaction is domestic or foreign, banks have decided to put their invoices as a last mile check through the platform. So it could be an invoice, which is a parcel of an LC transaction. They still check it against our platform because somebody else or the same company could present it elsewhere as an open account transaction. So we still cover the blind spot. It just makes a lot of sense to have that. Clayton says, will hyper ledger EBLs be interoperable with DDoCs, EBLs? I think this is a question. It was going on in space as well. Yeah, I think that that's a question for you. I think so. Hi, can I ask a question? How many banks are operating nodes? Every bank has a peer node. So right now, nine banks, all nine of them have peer nodes. You were just telling about your advisor from Cypher. Can you please repeat his name, please? His name, please. Avanza Innovations. Okay, E-Vanza. Avanza, A-V-A-N-Z-A, Avanza Innovations. Okay. Dubai based company. Got it. I can share the link to the video. I can also, I think, yeah, Andrea, when I give the presentation to you, that time I can share the link as well. Yeah, I'll share it on the LinkedIn side of the happy ledger satellite chain and trade funds. Sick. And also we will share the record on today's meeting where you can visualize, you can watch the video shared by Hussain. There's another question from Gigo Joseph.  This is a technical question, basically. So we are blessed to be part of a telecom operator that also has their own data centers and cloud services. So what we have today is we run the nodes on their behalf, but they're all network segmented and virtually separate and all of that good stuff is done, right? So as if it's in there, they are in their own private cloud, every node. But there are some banks who have expressed the interest. And again, this is a technological evolution across the globe where banks are saying, we would like to take ownership of our nodes and make it... But again, given the time given the readiness, it made sense to also be the infra provider at that point in time. So we could make sure that the use case sees the day of light. Are we looking to partner with other blockchain consortiums? Yeah. 100%, 100%. Good question by Abhishek. Yeah, we are continuously evaluating and we have been invited by, and we are inviting consortiums that it makes sense to collaborate. There are quite a few within the country. There are quite a few around the region. And then of course, the larger global players as well. Hussain, just a question for Mayan. You've basically focused the presentation on, you see double spending, antifraud, stuff like this. From a technological perspective, you know you have blockchain, you have other related technology that works in this place. How do you see the interaction in the future between these technologies? And how do you see them collaborating and solve the problem related to fraud and to double spending? Are you talking about related technologies like artificial intelligence, for example? Yeah, exactly. Machine learning, natural language processing. You see, the only way the document requires not only open accounts, but also invoice authenticity and stuff like this. So this is, I mean, it goes without saying the platform has all the capabilities built in when it comes to artificial intelligence and machine learning. And I mean, as you know, the journey is about 14, 15 months old. So some of the AI is still in the learning mode. But what we do have is, we have put together a few AI based rule sets around the supply line of business, around the product price check. And it's curating its own database. And it's coming to a point where we have started seeing some of the early results. And this is AI, right? It needs to have a lot more data. It needs to ingest so much more data for it to become smarter. So we're creating our own models. We are continuously analyzing the data output. The data scientist side of things is heavily involved in looking at different angles. And we're continuously evolving our AI models. We believe that, you know, we would come to a point where depending on the trends and understanding, the AI would help us predict some of these potential frauds and some of these potential trends that we miss out otherwise. So we'll get there very soon. No, can we use only e-invoice on our platform? Do you mean if, I mean, there are multi-mode or multi, there's multi-modes of interacting with the platform. So that isn't, just like you have a paper invoice, we have exactly the same UI. And you can go in and punch in your fields, right? Let's say if you're typing it for the smaller units who are just having a couple of invoices a day or so, they may prefer to do it. There's a lot of fancy front-end client-based checks available. It's a browser-based application, becomes very interactive. That's model one. Model two is when you have a list of invoice CSV and mass upload them for mass tracking. The third model is where you put in a PDF or a JPEG and the system does OCR. You confirm the OCR and it goes through the same drill. And the fourth one, which is being used by the larger banks, in fact, most of our banks are converting to having their systems integrated via API. Our platform is microservices oriented. So everything is available through an API call. So they are integrating to send heaps of data into our platform and then get real-time output and feed their operators real-time information for instant decision-making. So the platform has quite a bit of... Okay, Sarth noted. Sorry, Ozan, can I input for a minute? Yes, please, Sarth. Yeah, sorry. Ozan, just have one query. With respect to hyperledger, we will be using Ethereum. How do you find the transactions per second as such? Like, how it impacts the trade finance transactions as such? Like, with respect to the current infrastructure, are we able to sustain that with the volumes keeps increasing? So far, we have not hit any roadblock in terms of performance. But again, I mean, at the end of the day, it's tables and it's rows and columns and it also depends on how smartly you have designed them. But from a hyperledger perspective and the underlying blockchain perspective, so far, we have not hit any performance issues and we don't anticipate. It has been so far very smooth and we believe as we continue scaling the way we have designed our architecture, we don't seem to be getting there anytime soon with a performance issue. This is very... Oh, sorry. Go ahead. Hello? Yep. Yeah, go ahead. You can go ahead. Yeah. Sorry, a one query. I'm sorry. Yeah, just one final thing is like, how we are convincing the banks to adapt to this new technology? That's such a very, very good question. So the founding banks was easy. Beyond the founding banks, it was the power of the consortium. See, I think the banks are convinced on two sides of things. One, the plunge was taken by the founding banks, right? They created sort of a precedence for the others to follow. The dynamics are changing. All banks are going through digital transformation and adopting a platform like ours is a step in that direction. So that's another reason that they get convinced. And the third is that the value. You know, even if you catch one invoice and there are banks, I mean, one invoice is just getting themselves saved from that one fraud is far more value than the subscription they pay. Yep. So we don't have a challenge with banks or the price point. The challenge is the readiness with the bank because you understand when you introduce a process like that, like this, the banks have to alter their existing processes. And that takes some time. That adoption is the challenge. That cultural shift is a challenge. But it's not, we don't see the challenge with the dimes and the dollars. Okay. Awesome. Lovely. There's a question, Hussain, from Gigo again. Are you planning to open to investors at side banks to come in and be this well? So banks come in and invest money in the platform? Is that the question? Gigo, you can take the word if you want an answer directly. I think what he's asking is that are you open for investments besides the banks investment as well? I think there is no stopping of incoming dollars. And this is a fintech startup, great ambitions. And I think the right stakeholders can make the decision but I would not shy away from saying that we are close to investors, I would not say that. Got it. Got it. There's a question from Tom that says different classes and groups of members who get different decision rights and involvement. How was that decided? So this is a great question. So the number of banks we have today, we have a steering committee. Steering committee, all banks are equally represented. Everybody has the same say at the table. Within under the steering committee, there are three subcommittees. One is the trade finance working group that focuses on the product side of things. We also have a compliance working group that is very important because they help us with the regulatory guidelines to be in line with the other requirements in the region. And third is the infosec, which is represented by banks infosec experts. So these are the three subcommittees. And subcommittees are open to any banks that want to play a role in it. And I believe most of the subcommittees are fully presented by all the participating banks on the network. And on the steer code, the only thing that we did a little different, I mean, to drive it to really put it in the fast lane, we had an election, very simple election process and we elected coaches. So two people were elected as the chair of the steering committee from different banks. This was again on a voting system by the represented banks in the network. And it's working out really well. Great, thank you. Thanks for saying, any follow-up question on that here? In terms of the dollars or the U-80 dollars that were needed to be ponied up at the beginning, how was that decided? Not so much what the dollars were, just, you know, did somebody say, hey, I'm gonna put it, the founding members we each have to put in 100,000 and then we'll get that back later on or was it, you know, we'll figure out a different way to do that? I don't think there's a straight answer to that, but I would say that Etisalat or EN is known as, is a pioneer when it comes to this country. Okay. From running the copper lines in the 60s and 70s to running the highest grade fiber in the world today. It was all about innovation. It was all about emerging technologies. But the thing was, it was not about just saying, oh, it's blockchain, you know, let's rally behind it. It's AI, let's rally behind it. No, what is the real problem we are going to solve? Does it have a value? Is it tangible? And is it gonna aid the community and the nation at large? There's always this idea about, you know, how it will help at the national level, how it will help the nation. And I think that was the noble thinking behind investing in such a project. Because I mean, this could take any shape. This could have died six months back or, you know, would have no future, but just getting the results out, being patient with it and now seeing the platform in going in so many different directions, helping connect, you know, all the loose ends, I think is the real value that I'm sure, you know, the country and the leadership is so visionary. So people at the high positions saw this as a vision and allowed, you know, our team to come up with a platform that could someday, and it's already becoming, you know, a nationwide success. Got it, thanks. There's something like the key here. There was a champion that really drove this one and helped it so that it would really grow and then others could come on board. Yes. I mean, I have a question from the attendance. Sorry, there is an echo today that I don't manage to eliminate. I don't know what's going on in the Zoom room. I guess that's it for today. Right, Andrea, no more questions coming in. Yes, no more questions from the attendance. It was a very good meeting, by the way, Zainan. I thank you for this. Thank you for being with us today and sharing city updates. That was great to come to know your experience and evaluate it, can wait to witness, see what would go on in the future. And let's keep in contact, by the way. Thank you so much for being with us. And I'll see you in the next meeting. No, really appreciate the opportunity and, you know, present our... It's no more a case study. It's a successful... Yeah, successful study. It's a great learning. Yeah, thank you so much, Josain. It was really great. It was really nice to have the presentation. Thanks for all the patiently answered questions. Yeah, thank you, Andrea. Andrea, can we have a little background about you? My background, yeah. I'm a trade finance professional. I spend most of my time working time with multinational companies, I was deeply based in the Manning region at Frikel, of course, the Middle East, because of the business I work with. Process food technology. And it was always a great time. I got a great passion about that.  No, no banks. I've always been working with companies. Okay. And you are also well versed in the hyperledger solutions? What's your name? I'm saying you are also well versed in the hyperledger solutions? I'm a volunteer. One of the chairs, you see, of the hyperledger supply chain, trade finance, we all volunteer. Please share your contact. I would love to get in touch with you. We are building something unique in India for the global markets, and I would be requiring help from our community in the hyperledger and, again, in the financial service. I just share my own mail so you can contact me anytime you like. You'll see here in the chat. That's great. Wonderful. So thank you so much for being with us today and see you in a couple of weeks time. Next meeting is going to happen on the 26th. We're going to go deeper into the URGTC. We're going to have David Maynell of ICCUK. So this is going to be insightful and I advise you to attend. Thanks again for saying it was a great pleasure. We're never pleased to provide slides that will upload on to our wiki page and to our LinkedIn page. So everybody can access them and enjoy it. We'll do that. Andrea, once again, thank you very much to you, hyperledger foundation for this great opportunity. Wonderful. See you soon again, guys. See you. Bye-bye. Thank you very much. Bye, everybody. Bye. Thank you, Andrea. Thank you, everyone. Bye-bye, Andrea. Thank you so much, Andrea. This is Ihan. Bye-bye. Bye, Ihan. Bye. Thank you. Thank you, Andrea. Thank you, Zane. Thank you so much. Thank you. Thank you, Zane. Bye-bye.


Just shy of the one-hour mark, howling seven hits its crescendo. Ted cooks up a mean batch of chili and uncomfortably looks at one of the customers as he enjoys it. The customer starts to walk away and wipe out. Ted absolutely loses it. I did not alter these fart sounds. These are what you get in the film.  Utter perfection. And now I know why this is called the howling. It's not for the werewolf killing, it's for the non-stop belly aching comedy. Oh man, I'm howling. I'm laughing so hard. Sounds like the Pillsbury Doughboy. Nothing says loving like chili from the howling.


Thank you, Shizu, for making possible this book. It's a beautiful piece of art. And thank you, all of you, for coming here. Also, it's a pleasure to have the presence of one of my favorite artists here, like Yolanda López and Rene Yáñez and Río Yáñez. Río? Yeah. Yeah, thank you. I will read first in Spanish, and later in English is a short poem. Ofrenda del tiempo. Nuestras infinitas manos, delicadas y fuertes, tocando algo ahora, olvidándolo después. La memoria es una cosa extraña que dice su verdad y se esfuma. El calor de la belleza nos mantiene vivos. Acariciamos su luz como una delicada pluma. Con su aroma hacemos poesía. Con su textura podemos transformarnos en lo que sea. Memoria sin miedo. La vida está más allá de la memoria. La vida es un baile. Bailas conmigo. This is in the page 263. My name is Adrián Arias. I forget to say something like that. Our infinite hands, delicate and strong, touching something now, forgetting it later. Memory is a strange thing that says its truth and vanishes. The heart of beauty keeps us alive. We caress its light like a delicate feather with its aroma we make poetry. With its texture we can transform into whatever it is. Memory without fear. Life is beyond memory. Life is a dance. Do you like to dance with me?


soldiers of the press this week on zeo diary this is robert vermillion united press correspondent in italy it's my job to tell you people at home what's going on here on the beachhead at on zeo it may sound funny to start telling you what things are like with something as on war like as a wedding but it was a part of the ludicrous hodgepodge of war to those of us at the beachhead it was a very touching event if you've ever hitchhiked on a foggy highway back in the states seen a pair of headlights approaching through the darkness you get what I mean it's a mighty black business on those few square miles in italy the boy and a girl getting married in the midst of it was like seeing a couple of hundred dreams come true every one of the boys carries around a favorite dream in his pocket maybe it's a snapshot maybe a letter all those pictures and letters were rolled up into one when the wheezy old organ they managed to dig up started playing the old familiar strains just playing getting married with a battle going on has no easy business you couldn't be sure the German bombers wouldn't be over any minute you know when I was a little girl I always thought that I'd be married when the mcnolleyer came out in our backyard mother used to tell me what she'd do to grandma's wedding dress to make it do you'll be a beautiful bride honey even without the magnolia what do you mean I wouldn't trade all the magnolia an old race in the world for this why second lieutenant Jane Samson had her last assignment today in one hour it'll be second lieutenant Jane Clark the magnolias can wait what's borrowed Jane this handkerchief it's Mary's what's blue blue I've forgotten that I should have something blue shouldn't I of course you sure well I didn't do it wouldn't be right without it and don't forget it's all right come on there were two surprise raids while the bride was getting ready for the ceremony everybody dived for foxholes and then when the bombers disappeared went on with things as if nothing had happened one of the girls red cross worker had seen to everything she persuaded the boys to collect old ammunition cases where the 300 nurses and soldiers were to sit she'd even arranged for the wedding to be at 830 so the pair could be married with the minute hand on the down sweet all around us big guns were coughing and exploding keeping up their deadly chorus as our small organ began to play as the bride approached the crew daughter she looked as glowing and hopeful as if she'd been in the church at home the officers and men stood with the worn looking ammunition cases when they sat down there was a low clatter as they put their helmets at their feet I heard something about their romance they'd met two years before it can't pick it Virginia but the bride told me it wasn't love at first sight then in Sicily they met again there's a gentleman waiting to see you oh did he give his name he said he was lieutenant Clark lieutenant Clark really I'll be right now hello Jack well it certainly is a surprise to find you here I guess it is I just found out your hospital unit was shipped here well I thought I'd make another stab at sweeping you off your feet well I wish you better luck this time oh you don't understand these are orders I talked the case I was my commanding officer and he agreed it was a matter of extreme importance oh you are now a military objective well in that case maybe we better take a walk and talk they had a lot of long walks and talks and finally they applied for permission to get married when the permit came through they were both in Italy but lieutenant Clark said we're not waiting another day beachhead or no beachhead that's how the first military wedding in Italy came about that's how it happened that we were all standing there while the guns boomed all around the boy and a girl who had fallen in love in the middle of war got married dearly beloved we are gathered together here in the sight of God and in the face of this company to join together this man and this woman in holy matrimony which is an honorable estate instituted of God in the time of man's innocence signifying unto us it was a small isolated event in a vast battlefield but it had a lot of strength and reality in a way it was close to everyone there because there were plenty of other things at the Anzio beachhead to make your heart get sick and twist with fury there was death and destruction all around us this little beachhead wedding was life not dead it was lifting warming almost a defiant gesture in the cruel face of war we had our fill of cruelty to two nights after the wedding the Germans bombed two American hospitals on the beachhead around 10 o'clock hurling incendiary bombs on the fragile hospital tents where our wounded were being cared for when I reached the spot where the bombs had been dropped fragments were still exploding scattering burning steel through the frail canvas structure I'd hit the dirt a couple of times to keep clear of those flying bits of fire the whole hospital area was a weird hash of sound color and action bright flashes from the burning fragments below barely audible groans and sobs from hurt men the calls for litter bearers the brisk efficient handling of the wounded I made my way to the nearest tent the front had been ripped open by the explosion was dark inside I could hear the firm even voice of a nurse quieting the men the raid is over you don't have to worry everything is all right now I stepped inside and the nurse brushed past me get me some stretches and get them quick inside wounded men had jerked themselves from beds onto the floor regardless of how badly hurt they were cuts were tipped over men lay sprawled under the bedding and in the middle of the aisle some were struggling to get on their feet the nurse tried to reassure them make them comfortable until the warden and arrived one by one the men stopped moaning then the only sound came from one boy I couldn't even see it's all right everything is all right you'll be better soon the litter bearers came took out the men who were alive first the boy calling for his mother was one of the first to be picked up he was still crying out as they carried him from the tent I couldn't help asking myself one question over and over did the Germans mark the hospital as a specific target was it deliberate who knows may have been after all doesn't the first time yes no major deliberate or not done plenty of damage how bad is it well so far one wounded soldier and one ward man have been killed at least 56 others are badly injured but the death toll may be higher I don't know how many of the injured are going to live that brought the total casualties from German bombing and shelling of American hospitals on the Anzio beachhead to 37 killed 185 wounded it's hard to believe that scene was taking place where there'd been a wedding two days before but there are other things probably even harder for you back home to believe but despite the bombings there was a kind of normal community life on the Anzio beachhead commonplace things going on under fire the backdrop of war making them seem strange and unbelievable like the movie the fifth army puts on every night I've gone to a couple of them once I happened to the projection have a million hi John sounds like the boys are lapping it up yeah it's pretty good flicker lots of laughs well I can use them you're not kidding cigarette Joe no you can't smoke up yeah that's right was that sounded like a shell exploding somewhere near this building shell explodes and the guy start laughing I don't get it well because he can't see the screen right after the shell goes boom the gallon of picture turns around and says so what I'd like to tell you about one other thing that happened at Anzio I heard about it the afternoon it happened and I took down with a bunch of doughboys to watch there and the rolling surf of the Taranian sea one of our men was getting baptized dearly beloved for as much as all men are conceived and born in sin that which is born of the flesh is flesh they were in the flesh cannot please God but live in sin committing many actual transgressions our savior Christ says in battle never stopped raging all around us but there was time for a wedding and a baptism simple things that seem tremendous under fire that's what it was like at the Anzio beachhead a bizarre kaleidoscope that shifted from scenes of sordid horror to scenes of ordinary fun from scenes of pain and endurance to scenes of life and hope


So, let me thank the co-members of our little panel, and Bob Wilden will talk a little bit more about the ISCC after I present a few items, and Wendy Rubenstein has graciously allowed to take some notes, and thanks to Julie also for her input. So, I think one interesting thing, and this is like shamelessly sucking up to Eric Green, but here it goes. I really liked some of these comments that he and Greg made in a piece in JAMA a couple years ago, because I think it makes us think about what is the goal of education and just a few lines from this. Clinicians need not become geneticists to make use of genomic advances any more than they need to become radiologists, to make use of imaging, and that the genomics community has to align our educational priorities with those of the health profession groups we wish to educate, and really act considering the discussion that we just had, all clinicians are going to need informatic support to interpret and act on genomic information relative to patient care, and ensuring that high-quality software tools are available will be more important than forcing them to understand the intricacies of how these tools work. And I put this up here partly to just get discussion going and get us thinking about whether we're all going at this the right way. I am part of this group, which includes many people in this room, that this was a work that was done through one of the ISCC's committees to try to put together a framework for developing physician competencies in genomics, and this is a, I don't know, a six or seven page document with tens and tens of these bullet points of elements of a competency tasks that would need to take place, which I think includes an incredible expectation of expertise on the part of clinicians. So knowing the indications for genomic testing, explaining all the implications of putting the results in the chart, how incidental findings are going to be handled, on and on and on, I do think that it's actually quite a detailed list of tasks that we would expect general clinicians to know in order to be competent in genomics and wonder whether that's realistic. So related to GM8, we've done a great job of putting together how all of the GM-funded focus programs and related programs deal with educational issues and also issues of genomic interpretation, and I've highlighted some of these here in red. And I won't belabor it, but just to say that there are many of the groups that are represented in this room that have taken on different aspects of education and of how to translate and interpret genetic information to try to make it usable by clinicians. And likewise, a lot of barriers have been identified to doing this. From different groups, these include things like harnessing social media and crowdsourcing methods, having concise, comprehensive and interoperable lab reports, which we've just been talking about in panel seven, having use cases for CDS development, and the fact that there's differing education needs across different professional levels. So just a little bit of detail about some of the existing efforts on education of clinicians, and I've just summarized from Cesar's documents some of the items that they have listed, which include high visibility interactions with different scientific and professional exportations, eMERGE has a working group on consent education regulation and consultation, IGNITE has a working group, and then as we'll hear about from a moment, Bob has been very involved. The ISCC is completely devoted to clinician education, and the group that I'm most closely involved with, CPIC, creates these gene drug guidelines and we are trying to get these out widely to the community and get feedback from the community so that they're as useful as possible for those who are actually implementing pharmacogenetic guidelines in the clinic. So at first, I had a little bit of trouble thinking why is reporting results so closely linked to education, but again I think about as we just heard in the last hour and as we heard about a lot yesterday, we all seem to be thinking that by doing a better job of concisely and effectively reporting genetic results to clinicians will obviate the need for didactic education or will at least minimize the need for very specific educational programs, and it also will put the emphasis on the most important elements of genomics that really are going to require clinicians to understand so that they're able to practice in this era of increasing genomic results. But even in this task, I think there's some controversy in the field about whether we're really trying to interpret results so that they can, or report results so that they can be easily interpreted directly by the primary care clinician, or if the assumption is that still these results will need help from experts that needs to be asked for by the primary clinician in order to actually implement those results in their clinical practice. And again, I mean this problem has been recognized by many of our groups, so for example, Emerge has programs to develop, implement, and evaluate the process of clinician patient education from results. There's an app or a website, MyResults.org, that has patient information about genetic results, and my understanding is they're developing a genomic clinical decision support artifact repository, and they can clarify, the Emerge people can clarify as we go along what's really happening with that. And again, I think we've heard several times during this meeting about what kinds of repositories, what kinds of commons can be created by the genomics community, what kinds already exist so that we don't reinvent the wheel too many hundreds of times in order to share information among all of us who are doing clinical implementation of genomics. We've also heard a lot about the IOM Roundtable group working on genomics, and this subgroup it has called Digitize, which many of us are involved in. And this is really highly relevant, again, to the discussion we just had, trying to enable standardized genetic information in the EHR to ensure interoperability and usability of the data in the clinic and for research applications. And so I guess I think that this is where we bring it back a bit to NHGRI, who's in the business of funding research, that to do the kinds of EHR-based research, to do the kind of deep phenotyping we've been talking about, and even to use the clinical genomic information that's in the EHR, we've got to have a way to dig it out of the EHR, and we currently don't have interoperability or standardized terms. In the pharmacogenetic space, CPIC has taken on this problem of standardized terms because it's directly related to our ability to provide advice that can be directly utilized in the EHR by clinicians. And so we've gotten very, very specific about helping to standardize some terms that will result in being able to share information and build CDS to act on the genetic test results. If the CDS that's based on the genetic test results is really the way that we're going to, quote, educate clinicians, then we have to build the terms that can drive the CDS. And right now the EHR vendors are telling us you don't have terms that can drive the CDS. Would your community please get their act together and decide on what terms we can use? So that's part of what we're doing in digitize. Challenges have been identified by, again, by several of the groups. So CSER has identified that these lab reports need to be developed and integrated and optimize interpretation of these given inherent time constraints in the clinic, especially for diseases that may have a poor prognosis and a short window for action. And they're trying to assess and report on common themes across the CSER sites. IGNITE has identified the differing education and training needs for different groups of professionals and identified the issue that there's frequently rotating staff and, again, different kinds of modules for different kinds of clinicians. And CPIC has identified that there's this limited set of use cases for genomic CDS. We are now adding these into every existing CPIC guideline as it is updated and adding this into every new CPIC guideline that's created. And I'll show you some examples of some of the CDS that we provide. So just a little bit of background for those of you who don't know, CPIC was started in 2009. We have members all over the world. The goal is definitely to make each guideline be applicable internationally, not just in this country. And I won't go over in detail, but every guideline, thanks to the Informatics Working Group that Mark and Bob Freimuth are both important parts of, has an algorithm, a clinical implementation workflow that's an example of how it can work in the EHR. As we just mentioned, we recognize that every institution has different clinical workflows, but this is something that somebody can start with about how do you go from the result to the action ability. And it includes very specific example language, interpretive language based on the genetic test result that could be taken verbatim for interpreting that HLA-B test result, in this case, in the EHR of the individuals implementing that gene. And it includes very specific, possible to copy and paste interpretive language or suggested language for the CDS point of care alerts that would fire either pre-test if an individual is ordered a high-risk drug and there's no high-risk gene on file, or post-test if they have a high-risk gene test result that's existing in the medical record, what would be an example of the kind of alert that you would fire, in this case, if the high-risk drugs, Simvastatin, were prescribed to a patient with a high-risk phenotype for SLCO1B1. So this is an example of why the test alert is going to fire off of some kind of trigger or condition based on the gene test result. And this is why CPC and the digitized group have identified that coming up with specific terms to describe the high-risk phenotypes based on the genotypes is a critical aspect of making genetic test results go from the medical record into real clinical action ability is that something has to drive that high-risk status of the patient and it's going to be better if those terms are standardized. So we started back in November or so, this project, the CPC term standardization project with a lot of help from people involved in ClinGen and many other groups as I'll show you. And the goal is very focused, very simple, and it is achievable. We will finish this in the next couple of months. We're trying to come up with standardized terms for allele functional status. And this would be an example of characterizing the allele as low, absent, high or intermediate. So whether you call it a star 2, a G to A at position 233, an amino acid substitution at position 88, you will need an interpretation of the allele's function and you will need to have an interpretation of the diplotype of the patient which is really turned into the phenotype. And in pharmacogenetics those would include terms like ultra-rapid metabolizer, extensive metabolizer, etc. So what we've been doing through this Delphi process that started back in December is to have different phases of evaluating the landscape, clinical labs, literature, preferences, doing multiple surveys of experts, requiring those experts to participate in every survey and coming to a consensus on what sets of terms can be used to describe a allele function and to describe phenotype. And we're close to the end of this process of at least being able to do that. And this is just a screenshot from one of the surveys that we did, which I know is difficult to read, but this asked people to identify the groups with which they're associated, which again includes CPIC, ClinVar, the PGRN, the IOM, Digitized Group, ClinGen's Working Group, etc., etc., CDC, ACMG and many others listed down here, the HL7 Clinical Genomics Working Group, eMERGE, etc., etc. So we really tried to get as many groups as possible to buy into this process and to participate in the survey so that we'll get as wide a buy-in as possible at the end of this for adoption of these two sets of terms. And I will turn it over to Bob just to say that the Inner Society Coordinating Committee was started in February 2013 after GM4, and it's specifically devoted to educational issues for clinicians, and we'll hear more about that from Bob. Thanks. So I'm going to move on to my... This is from the ISCC website, which is being updated. And I guess I need to do space bar. Okay. All right. So the ISCC is the Inter Society Coordinating Committee for Practitioner Education in Genomics. That's why we call it ISCC. And I want to stay at the output that the ISCC was founded and driven by Terry Monoglio, Mike Murray, as the originating co-chairs until around January when I took over and then Ann Cardi came on as my co-chair. So they deserve a lot of credit for all of the things that were going on. And then G2C2, which I'm also going to talk about, has been driven principally by Jane Jenkins in my branch. So the ISCC was indeed... Grew out of the Genomic Medicine 4 meeting in 2013, and the main goals are to gather and facilitate... I guess there's a mouse here... Facilitate dissemination of best practices and resources in genomics education, promote their translation into evidence-based clinical care. And then there's a part about competencies here, which we'll talk a little bit more about. Okay. So education... This is just my statement. Education is the science and process of disseminating evidence and methods of use. So there are a lot of words and verifying effects. There are a lot of words that are overlapping with what Genomic Medicine does, science, process, disseminating evidence generation and methods of use as well. So just the concept isn't really that foreign when you break it down. All right. So the status summary for ISCC is in your e-book, so I'm not going to describe ISCC in all the different working groups and so forth. I was asked to discuss the gaps, overlaps, and opportunities relating to the Genomic Medicine working groups. And so I'm going to break it down into these three categories for the gaps. So materials are those things that we teach, and they are essential for educators. The Genetics and Genomics Competency Center, easily known as G2C2, is a searchable web-based clearinghouse for peer-reviewed educational materials. It's a product of NHGRI with a lot of help from ISCC members. It has similar goals to the younger MedEd portal, which we do not control. That's a product of the American Association of Medical Colleges. There's some convergence going on there. But G2C2 is Genomic Medicine Specific. G2C2 also uniquely maps submitted and cleared resources to provider discipline-specified competencies. So that's a set of things that allow educators and practitioners a systematic reference by which to judge completeness of their educational program. And these are like specific aims to researchers in a way. The rate of educational resource creation lags behind the emerging translational science. And so there may be a need for incentivizing creation of educational resources. On the consumer side, practitioners and their educators need to recognize the need for such resources and their availability. So marketing could help with that and we're investigating that as well. An interesting educational material is how to communicate genetic and genomic concepts. So there's a lack of consistent widely understood common language to use when communication occurs around genetic and genomic issues in the clinic. Whether it be between the patient and the provider, between one type of provider and another type of provider or between the provider in the laboratory, for example. And there are lots of examples you all know about problems in communication. So we'd like to know if there should be a preferred language or communication mode, including images and if so, how to teach it. So we, Mary already touched on the competency issue and this is just the competencies map link page in G2C2. And establishing those competencies for genomic education is a method and the process of linking up those competencies with the resources. And so each resource gets assigned a handful of competencies that it speaks to and that's an arduous manual process for the site's curators. So that's one of the challenges to using this kind of a setup. So moving on to methods, how do we do it? How and when to make education happen? We can break it into several axes. And I was struck again with some illiteration. So at what stage of a career is the training best done? Is it for done at the academic training when you're in medical school? After that in residency, continuing medical education or during board certification or the maintenance of certifications? There are multiple levels and probably the answer is all of them. On NPR radio this morning driving in, I heard that we should be doing this on Sesame Street in early age. So the next question is who are the targets? Physicians don't operate in a vacuum. Non-physician providers also need to understand something and we need to understand what they need to understand. And there's a mode of education which is gaining some traction called interprofessional education which tends to mimic the kinds of team efforts that happen in the real clinical world. Who are the teachers? Are they all genetic geneticists, genetic counselors? How do you make more teachers who have street cred in their specialty? And how do you know that the test, the educational process that you're going through is working? How do we share our materials, methods and effectiveness measures across medical specialties and other disciplines? And there are questions, these are all questions that have limited scientific answers. So this is just an example of something that gained some exposure at the November 2014 ISCC in person meeting. And that's a promising teaching approach that was developed for training pathology residents and it was presented by Rich Haspel and involves using flip classrooms, problem solving in groups and real time use of online databases. So from that presentation, a new innovative approaches working group was founded with NISCC to explore how to make this approach apply to training other residents and other types of providers. And several training events including a training session have or will happen this year as a result of that. So point of care education is a large subject. It's another innovative approach that EHRs and the electronic world has begun to make possible. And it's kind of embolized by the info button which has a much richer possibility space and has some real science behind it, which is great. A persistent problem with clinical decision support is as people have mentioned alert fatigue, a phrase which conjures strange looks from people who don't understand the background, alert fatigue, you know. So we really need to solve the alert fatigue problem because well, I have alert fatigue, alert fatigue. So I'm sick and tired of having it brought to my attention so you need to solve it. All right, so one of the big problems is motivation and relevance. And I think this has been spoken to a couple of times excuse me, already. So what motivates practitioners to learn about genomic medicine? Is it that they have to do it to continue practicing? They have to do it for their board certification or maintenance certification. Right now, they don't really have to do it except for geneticists. Does it bring value to them? Does it bring coverage and reimbursement for what they wanna do? There are providers who really are involved in the patient outcomes. Does it improve patient outcomes? What's the evidence for that? Is it in the peer reviewed literature? Is it supported by professional practice guidelines? And are there system priorities? Are there healthcare system administrators saying this is something that they need to do? So I'm bearing all here. ISCC has some challenges. It's made up of diverse members of professional societies kind of the guilds in a way as well as representatives from several NIH institutes and centers as well and a few health systems. And some of the challenges are inherent but can also be strengths and others are addressable. So members are varied. There are differences in governance, especially for focus of what they're trying to do. There are differences in roles and responsibilities as part of the team. The mission, each member society has its own mission and they don't necessarily overlap but in general they're abstractly aligned on the same goals. The mission interestingly is not a research mission. The money is an issue. It's a volunteer organization, no dues, no purse. It's not a research organization so really doesn't pursue research grants. We are trying to get approval to seek donor funding through the foundation for NIH. Just for perspective, last week of year at the ClinGen meeting you heard that in the UK, the National Health Service is planning on spending 20 million pounds on provider education for genomic medicine. Then the additional problem is metrics. How do we know if we're having any effect and when a specific, when do we know when specific education and genomics is no longer needed? So I'll close with an opportunity slide. So in the context of this meeting, there are a few opportunities that are intertwined with the ISCC, G2C2 resource and this group. And the grid provided by Terry and reviewed by Mary shows significant overlap and Mary went over those. And I think we should consider exploring having some joint activities around those shared areas. One strength for ISCC is the opportunity to become the leader in facilitating provider education across discipline and specialty boundaries, not just through resource serving, but also by helping advance the motivators that I talked about. For this group, one of the greatest opportunities potentially is connecting researchers with organizations whose members can facilitate research activities, particularly with respect to education, communication and implementation. And I added a little note here and utility utilization of the learning healthcare system. Yesterday there was also a discussion about the emerging need for learning to do re-phenotyping and could that be a skill that's disseminated through the most multiple specialties by ISCC? And it's kind of a two-way street too. Can there be a crowdsourcing effort for finding out what are the needs in the community? And the societies are often populated by people who are the local champions for their specialty. And so if you want to try to reach those local champions, that may be a way to do it. And I'll stop there. So obviously there's lots of groups working on education, so some discussion points, I think are to go back to do we know what we want when we say education of clinicians? And are there, given that, are all the gaps and barriers that exist being addressed and is the coordination of educational endeavors across projects adequate? And likewise, there are lots of groups working on how to report genetic results to clinicians. So again, I think I left off, but I think one important thing is what's the goal of reporting the results? Is there a need or desire to catalog approaches, to harmonize approaches, and also maybe to evaluate how are all of these approaches to reporting results being shared? And I'd like to open up the floor for discussion.


OK. Number one. What's number one, Dad? College building. Question. Ah. Anybody else got another answer? You can't do that. You can't do that. It says here, look, spoke. Number one. Number one, don't smoke in the college building. So what? Don't smoke. Can't. Ah, I see. You can't smoke in the college building. That's it. So number one. Number one. Good. Number two. Have a number two. Anybody? Number two. You can't. You can. You can? Can. OK. You can smoke in the college building. Three. For three, yeah? We're running out of time. Anybody? I think... Don't bring food into the classroom. Number three. That's right. Number three is good. Number three, correct. Four. What's four then, anybody? Number four? That's number five. I think we're on number four now. You can? Five. Five. Sorry, I don't know your name. You didn't put a name out. You could have... Have to, don't have to, can, can't. You have to show an identity card in the... That's it, fine. Have to show an identity card. That's fine. Six. Six, bang. Can't, that's it. You can't. You can't. Seven then. Seven. Todd, you got seven? Yeah. Computers in the library, possibly. Seven is right. Eight. It isn't necessary is... Don't you have to... It means isn't necessary, that means. Eight isn't... That's right, don't have to. Pay to use the computers. Nine. Nwch. Anyone? You have to... Bring a pen and some paper to lessons. Number nine, that's correct. Ten. Ten. You don't have to bring a dictionary, that's exactly right. Good, so they're all correct. There's the correct answers there. Lovely.


from theCUBE Studios in Palo Alto and Boston. It's theCUBE, covering IBM Think, brought to you by IBM. Hi everybody, welcome back. This is Dave Vellante, and you're watching theCUBE's coverage of IBM Think 2020, the digital version of IBM Think, and theCUBE is pleased to be providing the wall-to-wall coverage, as we have physically for so many years at big IBM events. Jesus Mentos is here. He's the managing partner for global strategy, for IBM and the global business services. Jesus, great to see you. Thanks for coming on. Great to be here, Dave. So every guest that we've talked to this week really, we've talked about COVID, but just briefly. Here we're going to do a bigger drill down and really try to get Jesus, your perspectives and IBM's point of view on what's going on here. So let me start with, we've never seen anything like this before, obviously. I mean, there are some examples. You got to go back to 1918 to try to get some similarities, but in 1918, it was a long, long time ago. So what's different about this? What are the similarities? Yeah, it's, you know what Mark was saying, that history doesn't repeat, but it often rhymes. I think there are similarities of what we are experiencing right now in this pandemic with other pandemics like Spanish flu. I think the situation is unique in terms of the impact and the synchronicity of that impact, right? So we can go back to other, if you want, economic crisis or a society crisis where you have either one country or one aspect being disrupted, but this is really a society being disrupted at a global scale. So its impact is unprecedented in that, in that perspective in modern time. And I think all of us are adjusting to it. I want to ask you about digital transformation because I've made the point that, you know, while a lot of people talk digital transformation, there's been a lot of complacency. People say, eh, not in my lifetime, eh, we're a bank, we're making a lot of money, we're doing okay. How do you think COVID-19 will sort of change that complacency and really accelerate digital transformation as a mindset and actually turn it into action? Yeah, I think the best way to put it is digital transformation five months ago was about obtaining a competitive advantage and digital transformation today in many industries is about survival. That is, that is how big of a change it is. The need for efficiency and cost savings, the need for resiliency that we have talked about, they need to be able to drive agility, to be able to switch and adapt. They need to make hyper-local decisions, right? To use data, none of that can be done unless you have fully digitized processes, you are consuming local data and you have trained the people to really operate in those new, more intelligent processes. So it has gone from optionality is okay, you can do okay, but if you digitize, you're going to do better to, unless you digitize, your business may not exist next year. I think that's the change. The change is, I think now is widely understood that the majority of our digitization processes have to be accelerated. And I would say that is a great statistic that when we go back in history, and there has been many as I mentioned of this crisis, you can look back at the two behaviors that businesses have.  And the other one is, okay, you defense, but you immediately switched to offense and then what happens two years later? Those companies that use this time to just defend and hand her down, history said in a couple of years later, 21% of them outperform, but those businesses that they shift from defense to offense and actually accelerate in these cases, programs like digitalization, 37% outperform. So very sub-premium for businesses that right now actually immediately switched to offense, focus on this set of digitalization and empowering cloud, managing data, and shooting the skills of the people, they're more likely not only to survive but thrive in the next few years, that those that just use this time to defend. To your point, it's about survival. It's not about not getting disrupted because you're going to get disrupted. It's almost a certainty. And so in order to survive, you've got to digitally transform. Your final thoughts on digital transformation, then I want to ask you if there's a silver lining in all this. I think what we do, we can change the context, but we cannot let the context define who we are either as individuals or as company. What we can do is to choose how do we act on that context. I would say those organizations and those individuals that take advantage of this situation to understand that some of these behaviors are going to change, understand that the more that we shift technology to the cloud, the more that we should work close to the cloud, the more that we use technologies like artificial intelligence and drive non-linear decisions that massively optimize everything we do from the way that we deliver healthcare to the way that we manage supply chains to the way that we secure food, frankly, to the way that we protect the environment. There is a silver lining that technology, it is one of those solutions that can help in all of these areas. And the silver lining of this is, hopefully let's use this time to get better prepared for the next pandemic, to get better prepared for the next crisis, to implement technologies that drive efficiency faster, that create new jobs, that protect the environment. And while we cannot change the fact that we have COVID-19, we can change what happens after COVID-19. So what we return to is something better than what we entered before COVID-19. Very thoughtful commentary, Jesus. Thank you so much for coming on theCUBE. Blessings to your family and yourself. I appreciate it, Dave. Thank you and thank you for everything you do to keep everybody informed.  And thank you for watching everybody. This is Dave Vellante. You're watching theCUBE's coverage of IBM Think 2020, the digital event, we'll be right back right after this short break.