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All You Need To Know About HR Management: An Exclusive Interview With Jairo Fernandez

Savita V. Jayaram

Jairo Fernandez, Senior Vice President of HR - Asia Pacific and Japan at SAPThrough an exclusive conversation with Jairo Fernandez, senior vice president of HR in Asia Pacific and Japan at SAP, HR in Asia unravels different facets of human resources (HR). We discuss the challenges of creating an innovation-friendly workplace and learning culture; setting new standards, processes, and systems; integrating IT and HR to simplify people management;  grooming talent into future leaders; promoting women leadership in Asia, and a lot more.

How does your team combat attrition effectively as the global war for talent reaches its peak?

First of all, we look at our corporate culture. We know what makes our employees tick, and we know what will maintain their interest in being a part of our team: a strong company culture and a collaborative work environment. To retain and recruit new talent, we create and maintain a working environment where employees can have fun while enjoying the nature of their work and seeing that their contributions are meaningful. Furthermore, our organisation depends on innovation for growth and high performance. This depends on employee initiative, risk taking, and trust – all qualities that are nurtured by the organisation’s culture.

Tell us more about your workplace culture.

We have a diverse and inclusive culture that is critical to making SAP both a great place to work and a successful company. At SAP, we believe in constant workforce cultivation. By subscribing to the learning culture philosophy, everyone is a teacher and everyone is a learner. We have a well-articulated culture that is built around our five key behaviours that form the foundation of our business conduct and success.

Which Asia-Pacific market offers women the most opportunities? Do you think women are well-represented in leadership roles?

Across Asia Pacific and Japan, we aim to nurture a diverse and inclusive environment. We believe that that diversity is essential for enabling a culture of innovation, productivity, and creativity. In turn, SAP has committed itself to increasing its global number of women in management to 25% in 2017 (up from 18% in 2010). To ensure that SAP continues to further this aspect of diversity as part of our innovation strategy, SAP promotes women in leadership through professional development and mentoring programs, active retention of women in leadership roles, executive sponsorship, and ensuring that the shortlist for leadership positions is diverse.

One example of a professional development initiative is LEAP – the Leadership Excellence Acceleration Program. LEAP is a year-long targeted development journey focused on women who have the potential and desire to succeed in people management positions or reach new heights of excellence in people leadership. So far, we have around 90 women who are a part of this group. In Singapore, our efforts have been met with great success: 42% of our employees and 26% of our leaders are women.

What recent initiatives are encouraging better employee engagement?

In Singapore, we have just started the FitSAP initiative. This initiative encourages SAP employees to wear a wearable fitness device that can be synced to the FitSAP application – an app supported by wearable devices from FitBit, Jawbone, Withings, and MiFit. Data from individual devices is presented on a dashboard that tracks cumulative steps of all employees, average steps per day, distance covered, and participation rate. In addition, individual employees can also see how many steps they have taken this quarter and their rankings. Employees who clock an average of 8,000 steps per day for a quarter will earn 100 points in their flexible spending account.

With this initiative, we have managed to encourage healthy living and, of course, nurture friendly competition among employees who are trying to rank highest for steps taken per quarter!

How is your organization influencing diversity in the workplace?

Diversity is about leveraging the unique experiences and perspectives of all employees to better understand and serve our customers, drive innovation, and create a work environment where all employees are fully and passionately engaged to achieve our corporate objectives. We actively promote an environment that values differences in culture, race, ethnicity, age, gender, sexual orientation, gender identity or expression, and physical ability.

One example of how SAP influences diversity at the workplace is through our Autism at Work initiative. This initiative employs people with autism because we believe their strengths allow them to perform better at certain jobs. The ultimate goal of the program is to have 1% of the company’s total workforce represent people on the autism spectrum by 2020.

How is your company bridging the gender gap in pay parity and structure in APJ?

SAP is an equal opportunity employer in every respect. We rigorously track gender pay parity every year. Managers receive a report on pay-parity analysis before and after the salary review cycle, empowering them to make more-informed decisions.

At SAP, pay and rewards are based solely on merit. Our philosophy is to reward and recognize the right talent at the right time and secure a lasting connection between reward and performance. We put in an enormous amount of effort to make the reward mechanism transparent and ensure employees are aware of the criteria. Furthermore, variable pay is closely linked to individual performance and company’s performance which helps drive a high-performance culture and behavior among employees.

Take us through the HR interview selection and candidate screening process.

Our hiring policy is simple: We want the best talent who demonstrates long-term potential – not just a candidate who has the right set of skills and competencies, but also someone who brings the right attitude, values, and aspirations.

We have stringent interview selection and candidate screening processes for different levels within the organization. Beyond the role competencies, skills, technical evaluation, and people-manager interviews, we place emphasis on recruiting talents whose values and aspirations align with those of SAP. We believe cultural fit is a crucial ingredient for success in an employee’s career over the long run. Candidates who demonstrate the right potential are carefully handpicked by hiring managers and assessed for cultural fit.

How do you see emerging HR tech trends boosting the recruiting sphere and facilitating better payroll management?

We are helping businesses simplify the way they work to achieve business outcomes they never thought possible. With the use of technology for recruiting and payroll management, businesses have an opportunity to simplify their processes and increase their productivity. As for payroll, businesses can use solutions to streamline and centralize their payroll processes. Companies can realize the benefits and convenience of cloud delivery and the control of implementing and managing payroll in-house.

What people management practices in your region are motivating and empowering employees to be future leaders? 

To ensure a steady pipeline of senior leadership, we have established a robust talent and succession management process, where we identify potential successors to key positions early in their career and provide support, coaching, and opportunities to take on additional responsibility beyond their typical scope of work.We are also keen on developing its future leaders by providing a range of structured development programs to allow potential leaders to experience leadership positions.

For example, our Leadership Framework analyses the lifecycle of a leader at SAP. Developed in Asia Pacific Japan in 2014, the program increases the quality and standards of leadership practices. It serves as a useful resource for leaders across all levels to seek information on the topics around onboarding, leadership development, goal setting, talent acquisition, succession, promotion, and performance management.

With HR moving to the cloud, how do you envision the future in 2020 and beyond?

The exploding scale of computing, mobile, cloud, business networks, and connected technologies is rapidly changing the way we live and work. In just a few years, the Internet of Things is expected to have tens of billions of devices connected to one another as well as to cloud-based services. This change will provide opportunity and cause complexity.

HR teams that successfully navigate the complexity caused by the deluge of data will be the ones rewarded with a stronger bench of talent and a better-managed workforce. The key is to run simpler systems as they navigate through the changing dynamics of today’s workforce and embrace the future of work.

Tell us more about your employee leave policies and benefits offered in case of maternity/paternal leave?

Our employees go through several life milestones in their careers. So we want to make sure that the workplace is as family-oriented as possible. New mothers are entitled to 16 weeks of paid maternity leave and fathers are eligible for a week’s paid paternity leave. Beyond these fundamental pro-family policies, we also have a range of family-oriented initiatives. We host a Kids@Work day, where children are invited to the workplace during their school holidays to enjoy movie screenings, the arts, and sports competitions. This year, we also organised the SAP Beach Fiesta for our Singapore team that enabled the family and friends of SAP employees to join us for a fun-filled day at Sentosa Beach.

According to a recent news report, Japan’s talent mismatch ranks the most severe in Asia Pacific. What challenges are you encountering when hiring and retaining talent in Japan?

Japan is a tough talent market to crack, but hiring and talent retention is a key focus area across the world. Our mission is to identify and acquire the right talent who will help drive our company towards greater heights. To combat issues such as talent mismatch, we strongly believe in identifying the untapped potential of future managers and proactively groom them for future responsibilities. By grooming leaders in-house, we not only accelerate the development of our amazing talent and empower them to realize their full potentials, but we also ensure that these leaders are aligned with the company’s strategy.

We have also invested in our graduate hiring across many areas of our business in Japan to grow talent from within the company. This is proving to be a successful strategy for creating the internal bench strength needed to continue growing our business in Japan.

As one of the top 5 Great Places to Work in Singapore, what are your organization’s key strengths, challenges, and people management strategies that have helped your workforce upgrade their skills, making it to the top 5 spot?

A career at SAP is based on an interest in life-long learning, and we strive to provide a culture that nurtures it. It is our employees who fuel our innovation and ensure a sustainable future for the company, its customers, and society. This is precisely why we invest in and actively encourage talent development through challenging work assignments, collaboration with peers, and attending formalized programs geared at upgrading employees’ skill sets.

One example is the SAP Sales Academy program, which includes innovative classroom training at our world-class learning center in California; several months of on-the-job training and mentoring; and skills development in presentation delivery, teamwork, and knowledge of our offerings.

What is the future of HR in Asia Pacific and Japan?

Without a doubt, HR will move from being data-driven to being fact-driven. But at the core of it all, HR is essentially a people function. It is essential to balance business requirements with the need to engage your employees at the same time. Not only does HR need to be a trusted advisor and partner to the business function, but it should also serve as a promoter of talent across the company.

This article originally appeared on HR in Asia and was republished with the author’s permission.

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Savita V. Jayaram

About Savita V. Jayaram

Savita V. Jayaram has been working as a journalist and writer for many international publications of repute. You can connect with her at savita@hrinasia.com. Feel free to share your feedback.

How To Design Your Company’s Digital Transformation

Sam Yen

The September issue of the Harvard Business Review features a cover story on design thinking’s coming of age. We have been applying design thinking within SAP for the past 10 years, and I’ve witnessed the growth of this human-centered approach to innovation first hand.

Design thinking is, as the HBR piece points out, “the best tool we have for … developing a responsive, flexible organizational culture.”

This means businesses are doing more to learn about their customers by interacting directly with them. We’re seeing this change in our work on d.forum — a community of design thinking champions and “disruptors” from across industries.

Meanwhile, technology is making it possible to know exponentially more about a customer. Businesses can now make increasingly accurate predictions about customers’ needs well into the future. The businesses best able to access and pull insights from this growing volume of data will win. That requires a fundamental change for our own industry; it necessitates a digital transformation.

So, how do we design this digital transformation?

It starts with the customer and an application of design thinking throughout an organization – blending business, technology and human values to generate innovation. Business is already incorporating design thinking, as the HBR cover story shows. We in technology need to do the same.

Design thinking plays an important role because it helps articulate what the end customer’s experience is going to be like. It helps focus all aspects of the business on understanding and articulating that future experience.

Once an organization is able to do that, the insights from that consumer experience need to be drawn down into the business, with the central question becoming: What does this future customer experience mean for us as an organization? What barriers do we need to remove? Do we need to organize ourselves differently? Does our process need to change – if it does, how? What kind of new technology do we need?

Then an organization must look carefully at roles within itself. What does this knowledge of the end customer’s future experience mean for an individual in human resources, for example, or finance? Those roles can then be viewed as end experiences unto themselves, with organizations applying design thinking to learn about the needs inherent to those roles. They can then change roles to better meet the end customer’s future needs. This end customer-centered approach is what drives change.

This also means design thinking is more important than ever for IT organizations.

We, in the IT industry, have been charged with being responsive to business, using technology to solve the problems business presents. Unfortunately, business sometimes views IT as the organization keeping the lights on. If we make the analogy of a store: business is responsible for the front office, focused on growing the business where consumers directly interact with products and marketing; while the perception is that IT focuses on the back office, keeping servers running and the distribution system humming. The key is to have business and IT align to meet the needs of the front office together.

Remember what I said about the growing availability of consumer data? The business best able to access and learn from that data will win. Those of us in IT organizations have the technology to make that win possible, but the way we are seen and our very nature needs to change if we want to remain relevant to business and participate in crafting the winning strategy.

We need to become more front office and less back office, proving to business that we are innovation partners in technology.

This means, in order to communicate with businesses today, we need to take a design thinking approach. We in IT need to show we have an understanding of the end consumer’s needs and experience, and we must align that knowledge and understanding with technological solutions. When this works — when the front office and back office come together in this way — it can lead to solutions that a company could otherwise never have realized.

There’s different qualities, of course, between front office and back office requirements. The back office is the foundation of a company and requires robustness, stability, and reliability. The front office, on the other hand, moves much more quickly. It is always changing with new product offerings and marketing campaigns. Technology must also show agility, flexibility, and speed. The business needs both functions to survive. This is a challenge for IT organizations, but it is not an impossible shift for us to make.

Here’s the breakdown of our challenge.

1. We need to better understand the real needs of the business.

This means learning more about the experience and needs of the end customer and then translating that information into technological solutions.

2. We need to be involved in more of the strategic discussions of the business.

Use the regular invitations to meetings with business as an opportunity to surface the deeper learning about the end consumer and the technology solutions that business may otherwise not know to ask for or how to implement.

The IT industry overall may not have a track record of operating in this way, but if we are not involved in the strategic direction of companies and shedding light on the future path, we risk not being considered innovation partners for the business.

We must collaborate with business, understand the strategic direction and highlight the technical challenges and opportunities. When we do, IT will become a hybrid organization – able to maintain the back office while capitalizing on the front office’s growing technical needs. We will highlight solutions that business could otherwise have missed, ushering in a digital transformation.

Digital transformation goes beyond just technology; it requires a mindset. See What It Really Means To Be A Digital Organization.

This story originally appeared on SAP Business Trends.

Top image via Shutterstock

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Sam Yen

About Sam Yen

Sam Yen is the Chief Design Officer for SAP and the Managing Director of SAP Labs Silicon Valley. He is focused on driving a renewed commitment to design and user experience at SAP. Under his leadership, SAP further strengthens its mission of listening to customers´ needs leading to tangible results, including SAP Fiori, SAP Screen Personas and SAP´s UX design services.

How Productive Could You Be With 45 Minutes More Per Day?

Michael Rander

Chances are that you are already feeling your fair share of organizational complexity when navigating your current company, but have you ever considered just how much time is spent across all companies on managing complexity? According to a recent study by the Economist Intelligence Unit (EIU), the global impact of complexity is mind-blowing – and not in a good way.

The study revealed that 38% of respondents spent 16%-25% of their time just dealing with organizational complexity, and 17% spent a staggering 26%-50% of their time doing so. To put that into more concrete numbers, in the US alone, if executives could cut their time spent managing complexity in half, an estimated 8.6 million hours could be saved a week. That corresponds to 45 minutes per executive per day.

The potential productivity impact of every executive having 45 minutes more to work every single day is clearly significant, and considering that 55% say that their organization is either very or extremely complex, why are we then not making the reduction of complexity one or our top of mind issues?

The problem is that identifying the sources of complexity is complex in of itself. Key sources of complexity include organizational size, executive priorities, pace of innovation, decision-making processes, vastly increasing amounts of data to manage, organizational structures, and the pure culture of the company. As a consequence, answers are not universal by any means.

That being said, the negative productivity impact of complexity, regardless of the specific source, is felt similarly across a very large segment of the respondents, with 55% stating that complexity has taken a direct toll on profitability over the past three years.  This is such a serious problem that 8% of respondents actually slowed down their company growth in order to deal with complexity.

So, if complexity oftentimes impacts productivity and subsequently profitability, what are some of the more successful initiatives that companies are taking to combat these effects? Among the answers from the EIU survey, the following were highlighted among the most likely initiatives to reduce complexity and ultimately increase productivity:

  • Making it a company-wide goal to reduce complexity means that the executive level has to live and breathe simplification in order for the rest of the organization to get behind it. Changing behaviors across the organization requires strong leadership, commitment, and change management, and these initiatives ultimately lead to improved decision-making processes, which was reported by respondents as the top benefit of reducing complexity. From a leadership perspective this also requires setting appropriate metrics for measuring outcomes, and for metrics, productivity and efficiency were by far the most popular choices amongst respondents though strangely collaboration related metrics where not ranking high in spite of collaboration being a high level priority.
  • Promoting a culture of collaboration means enabling employees and management alike to collaborate not only within their teams but also across the organization, with partners, and with customers. Creating cross-functional roles to facilitate collaboration was cited by 56% as the most helpful strategy in achieving this goal.
  • More than half (54%) of respondents found the implementation of new technology and tools to be a successful step towards reducing complexity and improving productivity. Enabling collaboration, reducing information overload, building scenarios and prognoses, and enabling real-time decision-making are all key issues that technology can help to reduce complexity at all levels of the organization.

While these initiatives won’t help everyone, it is interesting to see that more than half of companies believe that if they could cut complexity in half they could be at least 11%-25% more productive. That nearly one in five respondents indicated that they could be 26%-50% more productive is a massive improvement.

The question then becomes whether we can make complexity and its impact on productivity not only more visible as a key issue for companies to address, but (even more importantly) also something that every company and every employee should be actively working to reduce. The potential productivity gains listed by respondents certainly provide food for thought, and few other corporate activities are likely to gain that level of ROI.

Just imagine having 45 minutes each and every day for actively pursuing new projects, getting innovative, collaborating, mentoring, learning, reducing stress, etc. What would you do? The vision is certainly compelling, and the question is are we as companies, leaders, and employees going to do something about it?

To read more about the EIU study, please see:

Feel free to follow me on Twitter: @michaelrander

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Michael Rander

About Michael Rander

Michael Rander is the Global Research Director for Future Of Work at SAP. He is an experienced project manager, strategic and competitive market researcher, operations manager as well as an avid photographer, athlete, traveler and entrepreneur. Share your thoughts with Michael on Twitter @michaelrander.

Heroes in the Race to Save Antibiotics

Dr. David Delaney, Joseph Miles, Walt Ellenberger, Saravana Chandran, and Stephanie Overby

Last August, a woman arrived at a Reno, Nevada, hospital and told the attending doctors that she had recently returned from an extended trip to India, where she had broken her right thighbone two years ago. The woman, who was in her 70s, had subsequently developed an infection in her thigh and hip for which she was hospitalized in India several times. The Reno doctors recognized that the infection was serious—and the visit to India, where antibiotic-resistant bacteria runs rampant, raised red flags.

When none of the 14 antibiotics the physicians used to treat the woman worked, they sent a sample of the bacterium to the U.S. Centers for Disease Control (CDC) for testing. The CDC confirmed the doctors’ worst fears: the woman had a class of microbe called carbapenem-resistant Enterobacteriaceae (CRE). Carbapenems are a powerful class of antibiotics used as last-resort treatment for multidrug-resistant infections. The CDC further found that, in this patient’s case, the pathogen was impervious to all 26 antibiotics approved by the U.S. Food and Drug Administration (FDA).

In other words, there was no cure.

This is just the latest alarming development signaling the end of the road for antibiotics as we know them. In September, the woman died from septic shock, in which an infection takes over and shuts down the body’s systems, according to the CDC’s Morbidity and Mortality Weekly Report.

Other antibiotic options, had they been available, might have saved the Nevada woman. But the solution to the larger problem won’t be a new drug. It will have to be an entirely new approach to the diagnosis of infectious disease, to the use of antibiotics, and to the monitoring of antimicrobial resistance (AMR)—all enabled by new technology.

But that new technology is not being implemented fast enough to prevent what former CDC director Tom Frieden has nicknamed nightmare bacteria. And the nightmare is becoming scarier by the year. A 2014 British study calculated that 700,000 people die globally each year because of AMR. By 2050, the global cost of antibiotic resistance could grow to 10 million deaths and US$100 trillion a year, according to a 2014 estimate. And the rate of AMR is growing exponentially, thanks to the speed with which humans serving as hosts for these nasty bugs can move among healthcare facilities—or countries. In the United States, for example, CRE had been seen only in North Carolina in 2000; today it’s nationwide.

Abuse and overuse of antibiotics in healthcare and livestock production have enabled bacteria to both mutate and acquire resistant genes from other organisms, resulting in truly pan-drug resistant organisms. As ever-more powerful superbugs continue to proliferate, we are potentially facing the deadliest and most costly human-made catastrophe in modern times.

“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” said Dr. Keiji Fukuda, assistant director-general for health security for the World Health Organization (WHO).

Even if new antibiotics could solve the problem, there are obstacles to their development. For one thing, antibiotics have complex molecular structures, which slows the discovery process. Further, they aren’t terribly lucrative for pharmaceutical manufacturers: public health concerns call for new antimicrobials to be financially accessible to patients and used conservatively precisely because of the AMR issue, which reduces the financial incentives to create new compounds. The last entirely new class of antibiotic was introduced 30 year ago. Finally, bacteria will develop resistance to new antibiotics as well if we don’t adopt new approaches to using them.

Technology can play the lead role in heading off this disaster. Vast amounts of data from multiple sources are required for better decision making at all points in the process, from tracking or predicting antibiotic-resistant disease outbreaks to speeding the potential discovery of new antibiotic compounds. However, microbes will quickly adapt and resist new medications, too, if we don’t also employ systems that help doctors diagnose and treat infection in a more targeted and judicious way.

Indeed, digital tools can help in all four actions that the CDC recommends for combating AMR: preventing infections and their spread, tracking resistance patterns, improving antibiotic use, and developing new diagnostics and treatment.

Meanwhile, individuals who understand both the complexities of AMR and the value of technologies like machine learning, human-computer interaction (HCI), and mobile applications are working to develop and advocate for solutions that could save millions of lives.

Keeping an Eye Out for Outbreaks

Like others who are leading the fight against AMR, Dr. Steven Solomon has no illusions about the difficulty of the challenge. “It is the single most complex problem in all of medicine and public health—far outpacing the complexity and the difficulty of any other problem that we face,” says Solomon, who is a global health consultant and former director of the CDC’s Office of Antimicrobial Resistance.

Solomon wants to take the battle against AMR beyond the laboratory. In his view, surveillance—tracking and analyzing various data on AMR—is critical, particularly given how quickly and widely it spreads. But surveillance efforts are currently fraught with shortcomings. The available data is fragmented and often not comparable. Hospitals fail to collect the representative samples necessary for surveillance analytics, collecting data only on those patients who experience resistance and not on those who get better. Laboratories use a wide variety of testing methods, and reporting is not always consistent or complete.

Surveillance can serve as an early warning system. But weaknesses in these systems have caused public health officials to consistently underestimate the impact of AMR in loss of lives and financial costs. That’s why improving surveillance must be a top priority, says Solomon, who previously served as chair of the U.S. Federal Interagency Task Force on AMR and has been tracking the advance of AMR since he joined the U.S. Public Health Service in 1981.

A Collaborative Diagnosis

Ineffective surveillance has also contributed to huge growth in the use of antibiotics when they aren’t warranted. Strong patient demand and financial incentives for prescribing physicians are blamed for antibiotics abuse in China. India has become the largest consumer of antibiotics on the planet, in part because they are prescribed or sold for diarrheal diseases and upper respiratory infections for which they have limited value. And many countries allow individuals to purchase antibiotics over the counter, exacerbating misuse and overuse.

In the United States, antibiotics are improperly prescribed 50% of the time, according to CDC estimates. One study of adult patients visiting U.S. doctors to treat respiratory problems found that more than two-thirds of antibiotics were prescribed for conditions that were not infections at all or for infections caused by viruses—for which an antibiotic would do nothing. That’s 27 million courses of antibiotics wasted a year—just for respiratory problems—in the United States alone.

And even in countries where there are national guidelines for prescribing antibiotics, those guidelines aren’t always followed. A study published in medical journal Family Practice showed that Swedish doctors, both those trained in Sweden and those trained abroad, inconsistently followed rules for prescribing antibiotics.

Solomon strongly believes that, worldwide, doctors need to expand their use of technology in their offices or at the bedside to guide them through a more rational approach to antibiotic use. Doctors have traditionally been reluctant to adopt digital technologies, but Solomon thinks that the AMR crisis could change that. New digital tools could help doctors and hospitals integrate guidelines for optimal antibiotic prescribing into their everyday treatment routines.

“Human-computer interactions are critical, as the amount of information available on antibiotic resistance far exceeds the ability of humans to process it,” says Solomon. “It offers the possibility of greatly enhancing the utility of computer-assisted physician order entry (CPOE), combined with clinical decision support.” Healthcare facilities could embed relevant information and protocols at the point of care, guiding the physician through diagnosis and prescription and, as a byproduct, facilitating the collection and reporting of antibiotic use.

Cincinnati Children’s Hospital’s antibiotic stewardship division has deployed a software program that gathers information from electronic medical records, order entries, computerized laboratory and pathology reports, and more. The system measures baseline antimicrobial use, dosing, duration, costs, and use patterns. It also analyzes bacteria and trends in their susceptibilities and helps with clinical decision making and prescription choices. The goal, says Dr. David Haslam, who heads the program, is to decrease the use of “big gun” super antibiotics in favor of more targeted treatment.

While this approach is not yet widespread, there is consensus that incorporating such clinical-decision support into electronic health records will help improve quality of care, contain costs, and reduce overtreatment in healthcare overall—not just in AMR. A 2013 randomized clinical trial finds that doctors who used decision-support tools were significantly less likely to order antibiotics than those in the control group and prescribed 50% fewer broad-spectrum antibiotics.

Putting mobile devices into doctors’ hands could also help them accept decision support, believes Solomon. Last summer, Scotland’s National Health Service developed an antimicrobial companion app to give practitioners nationwide mobile access to clinical guidance, as well as an audit tool to support boards in gathering data for local and national use.

“The immediacy and the consistency of the input to physicians at the time of ordering antibiotics may significantly help address the problem of overprescribing in ways that less-immediate interventions have failed to do,” Solomon says. In addition, handheld devices with so-called lab-on-a-chip  technology could be used to test clinical specimens at the bedside and transmit the data across cellular or satellite networks in areas where infrastructure is more limited.

Artificial intelligence (AI) and machine learning can also become invaluable technology collaborators to help doctors more precisely diagnose and treat infection. In such a system, “the physician and the AI program are really ‘co-prescribing,’” says Solomon. “The AI can handle so much more information than the physician and make recommendations that can incorporate more input on the type of infection, the patient’s physiologic status and history, and resistance patterns of recent isolates in that ward, in that hospital, and in the community.”

Speed Is Everything

Growing bacteria in a dish has never appealed to Dr. James Davis, a computational biologist with joint appointments at Argonne National Laboratory and the University of Chicago Computation Institute. The first of a growing breed of computational biologists, Davis chose a PhD advisor in 2004 who was steeped in bioinformatics technology “because you could see that things were starting to change,” he says. He was one of the first in his microbiology department to submit a completely “dry” dissertation—that is, one that was all digital with nothing grown in a lab.

Upon graduation, Davis wanted to see if it was possible to predict whether an organism would be susceptible or resistant to a given antibiotic, leading him to explore the potential of machine learning to predict AMR.

As the availability of cheap computing power has gone up and the cost of genome sequencing has gone down, it has become possible to sequence a pathogen sample in order to detect its AMR resistance mechanisms. This could allow doctors to identify the nature of an infection in minutes instead of hours or days, says Davis.

Davis is part of a team creating a giant database of bacterial genomes with AMR metadata for the Pathosystems Resource Integration Center (PATRIC), funded by the U.S. National Institute of Allergy and Infectious Diseases to collect data on priority pathogens, such as tuberculosis and gonorrhea.

Because the current inability to identify microbes quickly is one of the biggest roadblocks to making an accurate diagnosis, the team’s work is critically important. The standard method for identifying drug resistance is to take a sample from a wound, blood, or urine and expose the resident bacteria to various antibiotics. If the bacterial colony continues to divide and thrive despite the presence of a normally effective drug, it indicates resistance. The process typically takes between 16 and 20 hours, itself an inordinate amount of time in matters of life and death. For certain strains of antibiotic-resistant tuberculosis, though, such testing can take a week. While physicians are waiting for test results, they often prescribe broad-spectrum antibiotics or make a best guess about what drug will work based on their knowledge of what’s happening in their hospital, “and in the meantime, you either get better,” says Davis, “or you don’t.”

At PATRIC, researchers are using machine-learning classifiers to identify regions of the genome involved in antibiotic resistance that could form the foundation for a “laboratory free” process for predicting resistance. Being able to identify the genetic mechanisms of AMR and predict the behavior of bacterial pathogens without petri dishes could inform clinical decision making and improve reaction time. Thus far, the researchers have developed machine-learning classifiers for identifying antibiotic resistance in Acinetobacter baumannii (a big player in hospital-acquired infection), methicillin-resistant Staphylococcus aureus (a.k.a. MRSA, a worldwide problem), and Streptococcus pneumoniae (a leading cause of bacterial meningitis), with accuracies ranging from 88% to 99%.

Houston Methodist Hospital, which uses the PATRIC database, is researching multidrug-resistant bacteria, specifically MRSA. Not only does resistance increase the cost of care, but people with MRSA are 64% more likely to die than people with a nonresistant form of the infection, according to WHO. Houston Methodist is investigating the molecular genetic causes of drug resistance in MRSA in order to identify new treatment approaches and help develop novel antimicrobial agents.

The Hunt for a New Class of Antibiotics

There are antibiotic-resistant bacteria, and then there’s Clostridium difficile—a.k.a. C. difficile—a bacterium that attacks the intestines even in young and healthy patients in hospitals after the use of antibiotics.

It is because of C. difficile that Dr. L. Clifford McDonald jumped into the AMR fight. The epidemiologist was finishing his work analyzing the spread of SARS in Toronto hospitals in 2004 when he turned his attention to C. difficile, convinced that the bacteria would become more common and more deadly. He was right, and today he’s at the forefront of treating the infection and preventing the spread of AMR as senior advisor for science and integrity in the CDC’s Division of Healthcare Quality Promotion. “[AMR] is an area that we’re funding heavily…insofar as the CDC budget can fund anything heavily,” says McDonald, whose group has awarded $14 million in contracts for innovative anti-AMR approaches.

Developing new antibiotics is a major part of the AMR battle. The majority of new antibiotics developed in recent years have been variations of existing drug classes. It’s been three decades since the last new class of antibiotics was introduced. Less than 5% of venture capital in pharmaceutical R&D is focused on antimicrobial development. A 2008 study found that less than 10% of the 167 antibiotics in development at the time had a new “mechanism of action” to deal with multidrug resistance. “The low-hanging fruit [of antibiotic development] has been picked,” noted a WHO report.

Researchers will have to dig much deeper to develop novel medicines. Machine learning could help drug developers sort through much larger data sets and go about the capital-intensive drug development process in a more prescriptive fashion, synthesizing those molecules most likely to have an impact.

McDonald believes that it will become easier to find new antibiotics if we gain a better understanding of the communities of bacteria living in each of us—as many as 1,000 different types of microbes live in our intestines, for example. Disruption to those microbial communities—our “microbiome”—can herald AMR. McDonald says that Big Data and machine learning will be needed to unlock our microbiomes, and that’s where much of the medical community’s investment is going.

He predicts that within five years, hospitals will take fecal samples or skin swabs and sequence the microorganisms in them as a kind of pulse check on antibiotic resistance. “Just doing the bioinformatics to sort out what’s there and the types of antibiotic resistance that might be in that microbiome is a Big Data challenge,” McDonald says. “The only way to make sense of it, going forward, will be advanced analytic techniques, which will no doubt include machine learning.”

Reducing Resistance on the Farm

Bringing information closer to where it’s needed could also help reduce agriculture’s contribution to the antibiotic resistance problem. Antibiotics are widely given to livestock to promote growth or prevent disease. In the United States, more kilograms of antibiotics are administered to animals than to people, according to data from the FDA.

One company has developed a rapid, on-farm diagnostics tool to provide livestock producers with more accurate disease detection to make more informed management and treatment decisions, which it says has demonstrated a 47% to 59% reduction in antibiotic usage. Such systems, combined with pressure or regulations to reduce antibiotic use in meat production, could also help turn the AMR tide.

Breaking Down Data Silos Is the First Step

Adding to the complexity of the fight against AMR is the structure and culture of the global healthcare system itself. Historically, healthcare has been a siloed industry, notorious for its scattered approach focused on transactions rather than healthy outcomes or the true value of treatment. There’s no definitive data on the impact of AMR worldwide; the best we can do is infer estimates from the information that does exist.

The biggest issue is the availability of good data to share through mobile solutions, to drive HCI clinical-decision support tools, and to feed supercomputers and machine-learning platforms. “We have a fragmented healthcare delivery system and therefore we have fragmented information. Getting these sources of data all into one place and then enabling them all to talk to each other has been problematic,” McDonald says.

Collecting, integrating, and sharing AMR-related data on a national and ultimately global scale will be necessary to better understand the issue. HCI and mobile tools can help doctors, hospitals, and public health authorities collect more information while advanced analytics, machine learning, and in-memory computing can enable them to analyze that data in close to real time. As a result, we’ll better understand patterns of resistance from the bedside to the community and up to national and international levels, says Solomon. The good news is that new technology capabilities like AI and new potential streams of data are coming online as an era of data sharing in healthcare is beginning to dawn, adds McDonald.

The ideal goal is a digitally enabled virtuous cycle of information and treatment that could save millions of dollars, lives, and perhaps even civilization if we can get there. D!

Read more thought provoking articles in the latest issue of the Digitalist Magazine, Executive Quarterly.


About the Authors:

Dr. David Delaney is Chief Medical Officer for SAP.

Joseph Miles is Global Vice President, Life Sciences, for SAP.

Walt Ellenberger is Senior Director Business Development, Healthcare Transformation and Innovation, for SAP.

Saravana Chandran is Senior Director, Advanced Analytics, for SAP.

Stephanie Overby is an independent writer and editor focused on the intersection of business and technology.

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Small And Midsize Businesses Have The Capacity To Drive Europe’s Future As A Digital Superpower

Katja Mehl

Part 10 of the “Road to Digital Transformation” series

Representing 99.8% of all companies throughout Europe, small and midsize businesses have tremendous power when it comes to impacting the region’s economy. One innovation at a time, they’re transforming entire industries, propelling emerging industries forward with adjacent offerings, and even supersizing a favorite childhood toy to make living conditions better for the poor and homeless. But perhaps the greatest evolution is found in the growing adoption of technology among firms.

According to the IDC InfoBrief “The Next Steps in Digital Transformation: How Small and Midsize Companies Are Applying Technology to Meet Key Business Goals with Insights for Europe,” sponsored by SAP, 35.4% of all European firms feel that their adoption of digital technology is either advanced or well underway. Germany and France are great examples of countries that are embracing advanced business networks and automation technology – such as the Internet of Things – to boost productivity and computerize or consolidate roles left empty due to long-term labor shortages.

Despite the progress made in some countries, I am also aware of others that are still resistant to digitizing their economy and automating operations. What’s the difference between firms that are digital leaders and those that are slow to mature? From my perspective in working with a variety of businesses throughout Europe, it’s a combination of diversity and technology availability.

digital transformation self-assessment

Source: “The Next Steps in Digital Transformation: How Small and Midsize Companies Are Applying Technology to Meet Key Business Goals with Insights for Europe,” IDC InfoBrief, sponsored by SAP, 2017. 

Opportunities abound with digital transformation

European companies are hardly homogenous. Comprising 47 countries across the continent, they serve communities that speak any of 225 spoken languages. Each one is experiencing various stages of digital development, economic stability, and workforce needs.

Nevertheless, as a whole, European firms do prioritize customer acquisition as well as improving efficiency and reducing costs. Over one-third of small and midsize companies are investing in collaboration software, customer relationship management solutions, e-commerce platforms, analytics, and talent management applications. Steadily, business leaders are finding better ways to go beyond data collection by applying predictive analytics to gain real-time insight from predictive analytics and machine learning to automate processes where possible.

Small and midsize businesses have a distinct advantage in this area over their larger rivals because they can, by nature, adopt new technology and practices quickly and act on decisions with greater agility. Nearly two-thirds (64%) of European firms are embracing the early stages of digitalization and planning to mature over time. Yet, the level of adoption depends solely on the leadership team’s commitment.

For many small and midsize companies across this region, the path to digital maturity resides in the cloud, more so than on-premise software deployment. For example, the flexibility associated with cloud deployment is viewed as a top attribute, especially among U.K. firms. This brings us back to the diversity of our region. Some countries prioritize personal data security while others may be more concerned with the ability to access the information they need in even the most remote of areas.

Technology alone does not deliver digital transformation

Digital transformation is certainly worth the effort for European firms. Between 60%–90% of small and midsize European businesses say their technology investments have met or exceeded their expectations – indicative of the steady, powerhouse transitions enabled by cloud computing. Companies are now getting the same access to the latest technology, data storage, and IT resources.

However, it is also important to note that a cloud platform is only as effective as the long-term digital strategy that it enables. To invigorate transformative changes, leadership needs to go beyond technology and adopt a mindset that embraces new ideas, tests the fitness of business models and processes continuously, and allows the flexibility to evolve the company as quickly as market dynamics change. By taking a step back and integrating digital objectives throughout the business strategy, leadership can pull together the elements needed to turn technology investments into differentiating, sustainable change. For example, the best talent with the right skills is hired. Plus, partners and suppliers with a complementary or shared digital vision and capability are onboarded.

The IDC Infobrief confirms what I have known all along: Small and midsize businesses are beginning to digitally mature and maintain a strategy that is relevant to their end-to-end processes. And furthering their digital transformation go hand in hand with the firms’ ability to ignite a transformational force that will likely progress Europe’s culture, social structure, and economy. 

To learn how small and midsize businesses across Europe are digitally transforming themselves to advance their future success, check out the IDC InfoBrief “The Next Steps in Digital Transformation: How Small and Midsize Companies Are Applying Technology to Meet Key Business Goals with Insights for Europe,” sponsored by SAP. For more region-specific perspectives on digital transformation, be sure to check every Tuesday for new installments to our blog series “The Road to Digital Transformation.”

 

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Katja Mehl

About Katja Mehl

Katja Mehl is Head of Marketing for Europe, Middle East, and Africa at SAP.