Seeing the Bigger Picture - Ana Cuteanu
Former Laidlaw Scholar from University College London, Ana, discusses her research into the use of the internet in medical patients, her social enterprise project aimed at alleviating youth unemployment, and the importance of experiencing other cultures.
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This week Nikol is joined by Ana Cuteanu - an Arts & Sciences student and former Laidlaw Scholar at University College London, to discuss Ana's research into the use of the internet in medical patients, her social enterprise project aimed at alleviating youth unemployment, and the importance of experiencing other cultures.
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NIKOL CHEN [V.O.]: Hi, I’m Nikol Chen and this is The Good Leader. A podcast where we talk to remarkable individuals in all sorts of fields to learn more about how to lead with integrity and explore what the next generation of leaders is doing to solve the world’s most intractable problems.
You’re listening to a Scholar Spotlight episode - a rubric in which we interview our current and former Laidlaw Scholars about their research and leadership journeys. This is actually the last episode before we go on a short hiatus, which marks the halfway point of the first season of The Good Leader. So, make sure you follow us on Twitter and LinkedIn to keep up to date with the podcast, and please send us any feedback you might have about the series! We would love to hear from you.
Today our guest is Ana Cuteanu - an Arts & Sciences student and former Laidlaw Scholar at University College London, who at the time of the recording - in the faraway pre-coronavirus time - was on her year abroad in Tokyo at Hitotsubashi University.
Ana is originally from Bucharest, lived in Strasbourg for the majority of her life, as well as Montreal, London, and Tokyo, and in this episode she will discuss her Laidlaw research into the use of the internet in medical patients, her social enterprise project aimed at alleviating youth unemployment, and the importance of experiencing other cultures.
You can find the references, further reading suggestions and the transcript of this episode on the Laidlaw Scholars Network.
Here is Ana.
NIKOL CHEN: Hi Ana, welcome to our podcast!
ANA CUTEANU: Hi Nikol, happy to be here. Thank you for having me.
NIKOL CHEN: So, could you start by telling me a bit about your Laidlaw research and its real world applications?
ANA CUTEANU: Sure, I spent the two summers of my undergrad doing research on essentially medical sociology, looking at the impact of technology in healthcare.
So, my first summer I worked with Dr Fiona Stevenson from UCL, she’s the associate director of the E-Health unit and a reader in medical sociology. And we looked at how the patients used the internet, how they bring that up during consultations or they don’t and why that is.
And in my second summer I reached out to Dr Sarah Shaw from University of Oxford, from the Nuffield Department. So, she’s an Associate Professor and she’s also a Fellow at the Green Templeton College, and we looked more at the policy side of things, trying to see if and how the government supports more use of technology in healthcare within the NHS and how they are working with private providers. So yeah, just generally I think my research focused on technology in healthcare.
I think the real world application of this research will be that once we know how patients interact with technology and how governments are supporting the use of technology in the realm of healthcare, then we can work on having better design because we understand our users, so to say - the patients. And then we can try to optimise the technology for people’s needs. So, if someone has a chronic illness and they need to manage it from home, it would be much easier for them to just use a piece of technology instead of going that extra mile to the hospital, back & forth everyday, and it’s also helpful for people with mobility issues and people who are geographically far away from healthcare providers. So, we were looking at a piece of research about that - that in Australia where people live far away in scattered communities and they don’t necessarily have a doctor around, so that’s when video consultations can really be extremely helpful.
There is this sort of stereotype in the medical field that stems from a couple years back when the internet wasn’t as prominent. The stereotype is that some patients will just go on the internet and Google their symptoms and then believe they have cancer or something when it’s not that. So, I think doctors would rather have their patients discuss it with them. But personally, for my research, I’ve seen that people are really very much aware of what the internet can and cannot do for them. And most people have common sense, they are very willing to find out more about their symptoms. So, yeah, I really see the potential for the internet to help us manage our health better because I think the more information we have about what’s actually healthy, what’s unhealthy, how to take care of our bodies and why our bodies do certain things, how they function, then the easier it will be for everyone to take care of their own health and thus the less pressure we will have on our healthcare systems because people will be more educated. The internet really democratises healthcare in a way because now we can all get access to information about our bodies and about illnesses, and it’s something that we couldn’t really do 50 years ago. We would have to go to our physician or to buy very specialised books. And that’s also a big passion of mine - I really want to see everyone get the education that they deserve and I don’t see how it would be positive in any way shape or form to keep people away from the information that could help them.
NIKOL CHEN: Can you recall a moment from your research period that stood out to you, that you found particularly impactful?
ANA CUTEANU: So, in my first summer I was mainly looking at interview data with patients...the specific study also had filmed consultations and I had the opportunity of looking at a couple of them. And I remember one of the consultations - I was very touched by the GP’s way of dealing with the patient. In this particular case it was an elderly woman who was complaining about being very stressed and all these memory complaints and I was very impressed by the way in which the GP figured out that there was something else going on, and she literally was able to talk to her patient like a human being and find out that the underlying cause was something to do with problems at home, and I was really touched by the human connection between the doctor and the patients and how they were...how the GP was able to look beyond what was told, what the patient was telling her. So, I thought that was really interesting because we don’t really get to see what happens behind closed doors in the medical environment. So, that kind of stuff but equally in terms of the research side, I’d say, during my second year I was really impressed by the level of attention of detail that my supervisor was putting into her work. Because she gave me some of her fieldnotes and I felt like I was reading a detective novel almost, because she was talking to all these influential people that were dealing with policy & healthcare, and I just found that really amazing - the lengths she would go to to get a specific person to sit down with her. I felt really inspired by the motivation that these researchers have and I think, overall, I’m really interested in how people communicate, and what drives them and what motivates them.
NIKOL CHEN: So, talk a bit about the future of tech in healthcare.
ANA CUTEANU: I think in the future we will have a lot more pieces of technology inside our hospitals and inside our consultation rooms that will help the doctors do their job. In a more streamlined way, an easier way, to make it easier for both the patient and the doctor. But I think, the most important thing to keep in mind is that we shouldn’t be afraid of technology being in the way, we should work with it to help us. But that being said, I think we’re sadly a long way away from seeing more technology in our hospitals just because of the way the NHS is set up and I think it’s sort of the case with many countries in the world where healthcare systems, be they centralised or decentralised, private or public, they will never really be very simple. There is always a certain degree of complexity that comes with technology and so, replacing one old system with a new one is always a really big struggle actually, there’s always a lot to do, to change. And there’s also the fact that people have to get accustomed to new technology and that’s not always easy for someone who just wants to do their job and especially doctors or nurses, everyone in the medical field - they are very busy people and they have a lot on their plate, so having to adjust to a new technological set up is a lot for them as well.
I think all over the world we’ve seen this growth in health apps. I was actually at a talk by the CEO of Babylon, Dr Ali Parsa. Babylon is this AI and digital health company and they’re pioneering an AI mobile application that will be able to essentially conduct a very quick consultation for patients wherever they are in the world, so I think this sort of technology will transcend borders and hopefully will do so for the benefit of the patients. But for now, these sort of apps, they’re not getting a very good reputation because doctors are still in the mindset that having an AI diagnose, or at least triage a patient, is not the most reliable thing to do for the patient. And I think these sort of things really need to pass the test of time and then they will be able to gain the public’s trust.
NIKOL CHEN [V.O.]: We recorded this interview with Ana before the coronavirus situation around the world grew to its current scale. What we are seeing at the moment is that actually healthcare systems have been pushed to embrace tech because of people’s need to access medical advice remotely during self-isolation. Some countries such as Australia are also developing new mobile apps to keep track of infected people to try to break off the chain of transmission. I will now read out a brief message from Ana regarding the situation:
“We are going through a really tough time right now, but it's very inspiring to see we have developed technologies that allow us to keep caring for those in need! I'm expecting that this pandemic will definitely fast-track the adoption of technology on many levels - it's already showing employers remote work is definitely possible more than they probably expected, so I am sure we will also witness a big push in digital health, epidemiology and beyond!”
If you would like to learn more, head to the Laidlaw Scholars Network and check out the further reading list.
NIKOL CHEN: And, in your experience, have you noticed any differences in healthcare tech in Japan compared to where you’ve lived before?
ANA CUTEANU: So, fortunately I haven’t been to a doctor yet, or haven’t been to a doctor’s office. So, I can’t really comment on the use of technology in healthcare. But I think just in the way the public transport works, you can see they actually rely on technology more than we do in Europe or in the UK. Over here, it is much more reliable in a way as well because I feel that in the UK at least we just expect the technology to break down on us, we don’t necessarily trust it to do its job, so we’re always almost ready, waiting for something to fail, waiting for a Skype call, for a piece of machinery to not work. But here they really rely on technology a lot more, so even something as simple as choosing what sort of meal to order at a restaurant, a lot of restaurants here have some sort of like machine that will allow you to get the ticket that you want to. So, for example, you’d pick your meal and then you’d get a ticket and then you’d give the waiter a ticket and that’s something that’s very normal here and in Europe that wouldn’t happen --
NIKOL CHEN: Oh my god, that would have made my life as a waitress at uni so much easier [laughs]
ANA CUTEANU: [laughs] Yeah, also, there are so many ways in which technology can make our lives easier, just honestly. They have a lot of apps here as well, which are very useful for navigating or for dealing with everyday tasks like having to print something if you don’t have a printer, just use an app and go to a convenience store or a supermarket. So, yeah, I think they really know that technology can be trusted here, as opposed to back home.
NIKOL CHEN: And what are some of the ethical implications you can think of when it comes to tech in healthcare?
ANA CUTEANU: Yeah, that’s a very good question. I think there are a lot of ethical implications, especially in terms of making sure that people don’t sort of propagate false pieces of information on the internet, so they don’t use it to scam people. That’s a big concern. Another big concern is to the use of personal data because the more we implement technology in our healthcare systems, obviously the more vulnerable we make our patients and ourselves because we really need to protect the confidential data that we have, so I think, yeah, breeches of information - those would be very concerning.
I was recently reading about a cyber attack that took place in Singapore, think a couple of years back. And they released the list that they have of people who have HIV in Singapore, because they are mandated to keep a list of everyone who’s been infected, and being HIV-positive in Singapore still comes with a very big social stigma. And when that happened, a lot of people were very afraid of losing their jobs, of severing personal relationships because of that being exposed. So, I think, if we’re going to go the digital way, we really need to make sure that we have the cyber security tools in place to make that very secure because that will become very controversial and certainly a topic of debate.
NIKOL CHEN: And now, could you tell me more about the social enterprise project you started with your friends?
ANA CUTEANU: So, we started working on this side project in my second year at University because we got a call to action from the Hult Prize Foundation. So, there is this big social entrepreneurship competition and they set up a goal every year and then a bunch of students around the world try to solve the challenge. And last year the challenge was to create 10k new jobs to specifically help youth unemployment. And I met my other co-founders, I met them through social media and one of them was a neuroscience undergraduate, the other one was doing the same degree as me. One of them really had a passion for the service industry, so she worked as a nanny and she realised that there are a bunch of nanny startups in London and she also realised that we don’t have anything similar for the adult social care sector because that’s a place where we have a lot of shortage of employment - not enough people take care of the elderly.
But at the same time, there are a lot of young people that are unemployed who have the right social skills, who have the right motivation, but they are not getting into those jobs. We were trying to look at why that is and if we could bridge the gap between the employment-seeking youth and the sector that is in need of people coming in to help out. So, we’re trying to find ways in which to streamline recruitment and also ways in which to make the job itself more attractive to young people and hopefully follow the same approach that programmes like TeachFirst use or Unlocked Graduates, not sure if you’ve heard of them but basically they put graduates into...so, for TeachFirst it’s teaching, for Unlocked Graduates they do that for prison officers. So, they take graduates, they put them in these places that are underserved for a limited amount of years and then they help them either stay in the sector or go out of it, and that’s the way they try to help get more people interested in doing those jobs and make the sector more attractive.
So, what we’re doing is essentially trying to make that happen for the social care sector because it’s really horrifying - the way in which our populations are ageing and we really don’t have a system in place for better social care. So, we’re thinking if we can make it more attractive to young people, if we can screen for people in an easier fashion and really pick out the people who are motivated, then maybe help them set up their own ventures in the social care field, maybe that would offer a solution. We got to the international stage of the Hult Prize competition but we didn’t really make it past that, but that was enough for us to get started and for us to dip our toes into entrepreneurship.
NIKOL CHEN: And what did you take away from that experience?
ANA CUTEANU: I think from that experience I took away the fact that we can all start something and really push for it, and be taken seriously. Because as students we oftentimes don’t realise that we are in the best place to start something because we don’t have the constraints of a 9 to 5 job, we don’t have a very demanding personal life yet, most of us I want to say. So, it’s sort of the easiest time to get funding for a new idea. And people are way kinder to students - I was talking to an executive in a startup and I was trying to find out more about how to get this thing off the ground, and he was telling me that had I not been a student, he would have never answered my email. I was asking him to talk to me about how he did it, so he was telling me that we are in a very fortunate position because CEOs or other executives, they will stop and listen and talk to us because we are students and we’re not seen as aggressive competition just yet. And a lot of people do empathise with being a student and wanting to change the world and they really want to provide as much mentorship as they can.
So, I think from this experience I figured out that anyone can be a leader if they really have something to care about and I think most of us do have something we care about, we just don’t really give ourselves the space and the time to think about it, and think about how we want to pursue our goal.
NIKOL CHEN: And what was your favourite part of the Laidlaw Scholarship and what did you find the most challenging?
ANA CUTEANU: I think my favourite part if I’m being super super honest about it was the community that I was thrown into. So, not only my fellow colleagues - scholars - but also the mentors that we had access to, the people that were in charge of the programme. I’ve never felt so supported before in a community and I really got to know a lot of the people, well, everyone really, in my cohort and I’ve made some really great friends. I’ve met very interesting people and we had a lot of workshops about team building, working in teams, and I just remember finding a lot of the challenges or the tasks really sort of ridiculous in the beginning but then as we worked through them, I realised I really just had to trust that a group of people will find a solution to a seemingly impossible task. So, yeah, I think the community, at least for me, it was my favourite part of it. But, of course, I got to meet really ambitious and passionate researchers and that was a really cool experience because you don’t get to talk to them one on one, and to be taken seriously by them as an undergraduate student.
I think one of the most challenging parts was sort of having to really work on my own for the first time. And being trusted with a lot of responsibility and that’s something that doesn’t really happen to a lot of undergraduate students, especially in the UK - we don’t really get a lot of personal projects. So, I remember my first year project - I was essentially working alongside PhD students and being treated almost the same, and I didn’t have the experience that came with being a PhD student, I didn’t really know how to manage my time very well or how to go about, you know, mapping out a whole project and getting it done by the end of 6 weeks that we had. So, I had to learn that and I also had to learn to reach out to my supervisor when things were not going the way they should be going. So, that was very challenging but it was also a very good growth experience because it allowed me to see what I could and couldn’t do and to seek help and really learn to work on my own, and set my own goals and self discipline. I think self-discipline is something that I really learnt doing that project. And as much as it was challenging, it was also a great growth experience.
NIKOL CHEN: And I know that you’ve moved quite a bit in your life - you were born in Bucharest but lived for a long time in Strasbourg, then Montreal, as well as London and now Tokyo. So, how do you think experiencing all these different cultures impacted your development as a leader?
ANA CUTEANU: I think, as you said, I’ve had to move quite a bit during my lifetime and it wasn’t always very easy or very pleasant but I’m very grateful that I got to do that because it really opened my mind to other cultures and I think it played a big role to my ability to be more empathetic and more compassionate and really understand other people’s points of view. So, for example, when I moved to France, I couldn’t really speak a word of French, a word of English, and I just felt very alienated from everyone. But that really made me appreciate the effort that goes into learning a language and, for example, now if I see someone struggle with English or with French or any other language, I will completely understand them. And I think this sort of experience really humbles you down and makes you understand what really matters in being human. I think there’s something about seeing beyond these nationalities or languages when you can really understand that the person you have in front of you may not speak the same language, may not look the same as you, but they are still human. And at the end of the day they are probably just doing their best to survive and have a healthy life, so I think the benefits of having a more cosmopolitan society or access to a more diverse community are very many, I think. Once you figure out that there are a lot of people with very different experiences from you in the world, you’re open to different issues, you’re being exposed really to different issues and to different points of view, and that’s when you start to see the bigger picture, I want to say.
So, for example, if you’re a straight white male in the West, you might not be aware of the privilege that you have because it’s not everyday that we think of the things that we have, you know. If you don’t know that other people don’t have the same things as you, then it wouldn’t cross your mind to question that. So, I think that’s something that is very helpful when we get to communicate with other people from other cultures and other sexual orientations, other backgrounds, we can see that their stories are not the same as ours and we really get a bigger appreciation for the human experience and what the real issues are in this world.
So, yeah, I’m really grateful that I’ve had this experience of moving around because had I not moved around, had I just lived in Romania my whole life, I think I would have just never really been able to empathise with other people’s struggles, so I would have never really learnt other languages and that’s really great because now I can communicate with other people, I can have this conversation with you and I can learn more about your experience as well and I think that’s really great.
NIKOL CHEN: And what sort of advice would you give to incoming Laidlaw Scholars around the world?
ANA CUTEANU: I don’t know if I have that much wisdom about it but I guess having gone through it, maybe some things I wish I had known are that you should always just go for it and take a risk, ask someone a question you are dying to find the answer to. Especially when dealing with supervisors or other people in research departments, I think it’s quite intimidating being one of the only undergraduate students but I think for a lot of them, they are aware that our experiences are different. They have also been in our shoes at some point and they do empathise with our struggles, so it’s good to reach out and ask for help and ask to check in with your supervisor if something goes wrong or if you want to make sure that you’re on track. I think that’s really helpful. And also, yeah, just reach out to anyone in the research community - I found through this scholarship that in academia people are very collaborative and they are very interested in talking about what they do. So, definitely grab a coffee with someone who is from the same department or someone else from the university and ask them about their journey, like how they go to where they are and see if they are interested in that, and I think that’s really helpful.
I think people miss out on opportunities because they’re too shy or they’re not brave enough to ask someone for a coffee chat and I think that’s a shame because we’re all human at the end of the day and if we can share experiences and help each other, that’s great.
I guess one last thing I’d like to say is I’m super grateful to the Laidlaw Foundation for this opportunity and I think they should really keep promoting this programme. I’m super grateful that I pushed myself to apply even though I wasn’t sure that I was going to get it or just thought that it was really out of reach for me. And yeah, I think this experience really taught me that we should always go for it and be brave about what we really want. So, I’m very grateful to everyone, like thank you Nikol for this interview, this was really fun for me as well and it’s really helping me reflect back on everything. So, yeah, I hope this can help other scholars and it can prove to everyone and people working at the Foundation that the work that they’re doing is really great and it’s really helping impact lives and helping to empower people, so yeah, I’m very grateful.
NIKOL CHEN: Alright, thank you so much Anna for coming on the podcast and sharing your experiences with us!
ANA CUTEANU: No, thank you for reaching out and for choosing me for this episode, honestly. It’s been really fun.
NIKOL CHEN [V.O.]: You can connect with Ana and find out more about her research on the Laidlaw Scholars Network. As I mentioned at the beginning - this is our last episode before we take a break. So, follow the Laidlaw Foundation on Twitter and LinkedIn to find out when we release our new podcasts episodes and email us at firstname.lastname@example.org if you have any feedback or suggestion - we would love to hear from you. If you would like to find out more about our programmes visit www.laidlawfoundation.com.
Once again, you can find all the references, further reading suggestions and the transcript of this episode on the Laidlaw Scholars Network.
Our music is by Broke For Free and Tours.
Thanks for listening.
References & Further Reading
Data Breaches Dent Singapore’s Image as a Tech Innovator https://www.nytimes.com/2019/01/29/world/asia/singapore-data-breach-hiv.html
Digital Health & Medicine Related Academic Journals: https://www.digital.health/journals
FOUCAULT, M. 1975. The Birth Of The Clinic: An Archaeology Of Medical Perception. New York: Vintage Books.
HAMILTON, F., MCDONAGH, L., & STEVENSON, F. (n.d.). The unexpected consequences of digital health: Lessons from a stakeholder workshop. Presented at: Society for Academic Primary Care Annual Scientific Meeting.
LABRIQUE, A., VASUDEVAN, L., MEHL, G., ROSSKAM, E., HYDERA, A. A. 2018. Digital Health and Health Systems of the Future. Global Health: Science and Practice, 6(S1). https://www.ghspjournal.org/content/6/Supplement_1/S1
New digital service ‘to allow every UK GP surgery to offer remote consults’ https://www.digitalhealth.net/2020/04/new-digital-service-to-allow-every-uk-gp-surgery-to-offer-remote-consults/
ROSS, J., STEVENSON, F., LAU, R., MURRAY, E. 2016. Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update). Implementation Science, 11(146). https://implementationscience.biomedcentral.com/articles/10.1186/s13012-016-0510-7
STEVENSON, F. A., HALL, L., SEGUIN, M., ATHERTON, H., BARNES, R., LEYDON, G., POPE, C., MURRAY, E., ZIEBLAND, S. 2019. General Practitioner use of online resources during medical visits: Managing the boundary between inside and outside the clinic. Sociology of Health and Illness, 41(S1). https://onlinelibrary.wiley.com/doi/abs/10.1111/1467-9566.12833
The Helix Centre - an innovation lab in healthcare made up of an interdisciplinary group of designers, technologists, clinicians and researchers; a joint initiative between Imperial College London & The Royal College of Art, based at St Mary's Hospital in London.