Quality Care Concern

17/09/2025

AI and the Future of Doctors: Three Possible Scenarios

Artificial Intelligence is transforming healthcare faster than ever. But what does it really mean for the role of doctors?
The truth is, the future could unfold in different ways:

🔹 Optimistic (Collaboration):
AI takes over routine, repetitive tasks—diagnostics, documentation, data crunching—while doctors focus on what truly matters: empathy, innovation, and complex decision-making.
👉 The result: “Super Doctors” empowered by AI.

🔹 Neutral (Slow Integration):
AI becomes a trusted decision-support tool, but adoption remains uneven due to regulation, cost, or trust issues.
👉 The result: incremental change, with pockets of excellence.

🔹 Pessimistic (Over-Reliance):
Healthcare systems push AI too far in pursuit of efficiency. Dehumanization, erosion of trust, and gaps in rare/unexpected cases emerge.
👉 The result: technology without humanity.

💡 The most likely future? A partnership between AI and doctors—where machines handle the predictable, and humans handle the profound.

The key question is not “Will AI replace doctors?” but rather:
➡️ “How do we design the future so that AI augments doctors, without losing the human side of care?”

What’s your view—are we heading towards collaboration, stagnation, or over-reliance?

16/09/2025

Strategic Purchasing: The Key to Quality Health Care, Starting with Primary Care:
Policy Dialogue held in Hotel Sarina, Organised by DGHS & ARK Foundation & technical assistance by Quality Care Concern :

When we talk about health system reforms, financing and procurement often sound like technical details. But in reality, they are the levers that shape the quality of care people receive—especially at the primary care level, where most health needs begin.

🔹 Why Strategic Purchasing matters
Traditional purchasing is often passive: funds flow without linking them to performance, quality, or outcomes. Strategic Purchasing (SP) changes this dynamic by making financing a tool for accountability. It asks:
• Are we paying for the right services?
• Are the most vulnerable being reached?
• Is money driving better quality, efficiency, and sustainability?

🔹 Primary Care at the center
Primary health care (PHC) is the frontline of any health system—managing maternal and child health, NCDs, immunization, emergencies, and health promotion. Yet PHC often suffers from underfunding, weak accountability, and fragmented service delivery.
• With SP, governments can ensure that funds are tied to quality standards and community needs, not just inputs.
• It allows for blended payment models—a mix of fixed base payments and performance-based incentives—to strengthen continuity and responsiveness.

🔹 Ensuring quality through SP
• Benefit packages can guarantee essential PHC services for everyone, especially the poor and urban slum populations.
• Contracts and tender documents can embed quality indicators, sustainability clauses, and grievance redress.
• Monitoring and audits ensure providers are accountable for the care they deliver.

The takeaway
Strategic Purchasing isn’t just about buying services—it’s about buying results. When applied to primary care, it becomes a driver of equity, efficiency, and quality, and a cornerstone for achieving Universal Health Coverage (UHC).

I believe it’s time we place Strategic Purchasing at the heart of our policy and financing reforms—because quality health care begins where people first seek care: Primary Health Care.

15/09/2025

Policy Dialogue Workshop on
“Aligning Outsourcing with Strategic Purchasing in Urban Health Care”
📍 Hotel Sarina, Dhaka | 🗓️ 15 September 2025
The session brought together diverse voices—government officials, development partners, academics, and health service providers—united by one goal: to make urban health care more accountable, efficient, and equitable through Strategic Purchasing (SP). The session moderated by Dr. Md Aminul Hasan, PhD, Health System & Quality of Care Expert.
Why it mattered
Under the Public Procurement Ordinance 2025, outsourcing can only be impactful if aligned with Strategic Purchasing.
The dialogue focused on how to translate this alignment into policy, practice, and accountability.
🔑 Highlights from the Dialogue
1️⃣ Payment Models
Endorsed blended approaches: a predictable base payment plus performance-based incentives tied to access, quality, and outcomes.
Built-in safeguards against cost escalation and underservice, ensuring fiscal sustainability
2️⃣ Benefit Package Design
Agreement on a basic vs. extended package model.
Commitment that all urban populations, especially slum dwellers and the poor, will have mandatory access to essential PHC services
3️⃣ Strategic Purchasing Principles
Five principles were reaffirmed: equity, efficiency, quality, sustainability, and accountability.
Emphasis on integrating SP into MOHFW procurement and budget systems, not treating it as a parallel mechanism
4️⃣ Monitoring, Evaluation & Accountability
Proposals for independent audits, patient satisfaction surveys, and grievance redress.
Support for digital monitoring dashboards and e-procurement tools for transparency and real-time data
Takeaway Message
Strategic Purchasing is not just a procurement reform—it is a pathway to Universal Health Coverage (UHC). The dialogue showed a clear road ahead: embed SP principles into MOHFW guidelines and Standard Tender Documents (STDs) to ensure both legal compliance and strategic alignment with national health goals.
🙏 Thanks to all the participants for their thoughtful contributions. Together, we are laying the foundation for a more sustainable, equitable, and people-centered urban health system.

14/09/2025

Policy Dialogue Workshop on
" Aligning Outsourcing with Strategic Purchasing in Urban Health Care"
Today, 14th September 2025, we successfully completed Day 1 of the two-day Policy Dialogue Workshop organized by DGHS in collaboration with ARK Foundation, with technical assistance from Quality Care Concern.
Venue: Jalsha Hall, Level 3, Hotel Sarina, Banani, Dhaka
Day 1 focused on critically reviewing the 2025 guideline for outsourcing PHC/GP services and exploring how outsourcing can be aligned with Strategic Purchasing to strengthen urban health systems
Presentation Point Day 1
Key discussion themes today included:
• Service Scope & Benefit Package – clarity of services, prioritization of essential PHC, and ensuring equity for the urban poor.
• Quality Standards & Accountability – enforcement of patient safety, accreditation, and accountability mechanisms.
• Payment Mechanisms – designing fair and performance-linked payment models.
• Monitoring & Evaluation – building robust data, audit, and feedback systems
The Ordinance passed in May 2025, revising PPA 2006, provides a procurement backbone—transparency, digital tools, sustainability, and market integrity. The workshop emphasized that while the Ordinance sets the rules for procurement, the forthcoming MoHFW guideline must set the rules for health purchasing.
Looking ahead: Tomorrow, 15th September 2025 (Day 2), the dialogue will continue with panel presentations and recommendations to shape MoHFW’s path forward in operationalizing Strategic Purchasing for PHC.

12/09/2025

05/09/2025

আমরা AI–কে স্বাস্থ্য ও পরিবেশ সমস্যার সমাধানকারী হিসেবে দেখি, কিন্তু এর উন্নয়ন প্রক্রিয়া নিজেই পরিবেশের জন্য টেকসই নয়।

Lancet Global Health–এ প্রকাশিত একটি নিবন্ধে বলা হয়েছে যে কৃত্রিম বুদ্ধিমত্তা (AI)–এর নৈতিক আলোচনায় আমাদের অবশ্যই পানি-নির্ভর ও কার্বন-নিবিড় ডেটা ইনফ্রাস্ট্রাকচারের প্রভাব বিবেচনা করতে হবে। এবং সবচেয়ে বড় কথাটা হলো—এই বিশাল পরিমাণ নির্গমনের পেছনে সবচেয়ে বড় প্রতিষ্ঠানের স্বীকৃতি আমরা সাধারণত বাদ দিয়ে দিই: মার্কিন প্রতিরক্ষা বিভাগ (US Department of Defense)। 

পোস্টে শেয়ার করতে যেগুলো উল্লেখ করবো:

🔹 বড় AI মডেল প্রশিক্ষণের জন্য প্রচুর সামর্থ্যসম্পন্ন মেশিনের দরকার হয়—যা কোমায় অত্যাধিক বিদ্যুৎ এবং বিশুদ্ধ পানি খরচ করে। উদাহরণস্বরূপ, GPT-3–এর প্রশিক্ষণে প্রায় ৭ লাখ লিটার পানি ব্যবহার হয়েছে—যা কয়েকশো পরিবারের এক বছরের পানির চাহিদার সমান।

🔹 এছাড়া, অনেক বড় টেক কোম্পানি (যেমন গুগল, মাইক্রোসফট, অ্যামাজন) তাদের প্রকৃত কার্বন নির্গমন কম দেখায়; তদন্তগুলো বলছে নির্গমন আসলে প্রায় ৬ গুণ বেশি।

🔹 Lancet নিবন্ধটি প্রাসঙ্গিকভাবে তুলে ধরেছে—যখন AI–এর পরিবেশগত খরচ এত বেশি, তখন কি এর স্বাস্থ্য বা জলবায়ু উন্নয়ন দেখা সত্যিই টেকসই? না, বরং এ প্রশ্নের উত্তর স্পষ্ট—এর বর্তমান উন্নয়ন প্রক্রিয়া আমাদের পরিবেশের জন্য একটি বোঝা। 

⸻

Bottom line :
AI যদি সত্যিই মানুষ ও পৃথিবী রক্ষায় ব্যবহার করতে চাই, তাহলে দরকার শক্তিশালী “সবুজ কম্পিউটিং”, স্বচ্ছতা এবং একটি নৈতিক কাঠামো—যাতে এই প্রযুক্তির পরিবেশগত খরচকে প্রাধান্য দেওয়া হয়।

05/09/2025

🚨 অনেকেই জানেন না এই চমকপ্রদ সত্যঃ

AI বা কৃত্রিম বুদ্ধিমত্তাকে আমরা প্রায়ই স্বাস্থ্য ও জলবায়ু সমস্যার সমাধানকারী প্রযুক্তি হিসেবে দেখি। কিন্তু এর উন্নয়ন প্রক্রিয়াই পরিবেশের জন্য টেকসই নয়।

🔹 বড় AI মডেল প্রশিক্ষণে বিপুল কম্পিউটার শক্তি লাগে, যা প্রচুর বিদ্যুৎ খরচ করে। এর বেশিরভাগই আসে জীবাশ্ম জ্বালানি থেকে, ফলে বিপুল কার্বন নির্গমন ঘটে। একটি বড় মডেলের প্রশিক্ষণেই ৫টি গাড়ির পুরো জীবদ্দশার সমান কার্বন বের হয়।

🔹 ডেটা সেন্টার ঠান্ডা রাখতে ব্যবহৃত হয় লাখ লাখ লিটার বিশুদ্ধ পানি। শুধু GPT-3 মডেল প্রশিক্ষণেই খরচ হয়েছে প্রায় ৭ লাখ লিটার পানি—যা কয়েকশ পরিবারের এক বছরের পানির ব্যবহার সমান।

🔹 বড় টেক কোম্পানিগুলো তাদের আসল কার্বন নির্গমন কম দেখায়। গবেষণা বলছে প্রকৃত নির্গমন আসলের তুলনায় প্রায় ৬ গুণ বেশি।

⚠️ তাই প্রশ্ন হলো—AI যখন জলবায়ু ও স্বাস্থ্য সমস্যা সমাধানের কথা বলছে, তখন কি সে একই সাথে পৃথিবীর ক্ষতিও করছে না?

👉 সত্যিকারের পরিবর্তন আনতে হলে আমাদের দরকার সবুজ প্রযুক্তি, স্বচ্ছতা ও নৈতিক কাঠামো, যাতে AI টেকসইভাবে উন্নত হতে পারে।

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(25)00301-8/fulltext

04/09/2025

The Role of Private Sector in Achieving Universal Health Coverage (UHC)

Achieving Universal Health Coverage (UHC) is not solely a government responsibility—it requires a strategic partnership with the private sector. Private health providers, insurance companies, and NGOs play a critical role in expanding access, improving quality, and ensuring financial protection for populations.

Key contributions of the private sector include:
• Increasing service availability in underserved areas
• Innovating care delivery through technology and new models
• Complementing public financing through partnerships and co-investment
• Strengthening capacity for specialized services and diagnostics

💡 Takeaway: To reach UHC goals, governments must create a supportive regulatory environment and foster effective public-private collaboration, ensuring that private sector engagement aligns with national health priorities and equity objectives.

02/09/2025

The future of generative AI in healthcare holds enormous promise—transforming how we deliver care, support patients, and empower clinicians.

⚠️ But with opportunity comes responsibility. Safe adoption of AI cannot be achieved without:
🔹 Strong clinical governance
🔹 Robust ethical safeguards
🔹 Clear accountability frameworks

Technology firms, policymakers, and healthcare leaders must work hand-in-hand to guide this transition. AI should be embraced as a supportive tool—but never as a replacement for the values that define quality care: human judgment, empathy, and responsible leadership.

💡 The question is not whether AI will shape healthcare—it already is. The question is whether we will shape it wisely, ensuring patient safety and trust remain our north star.

👉 How is your organization preparing governance frameworks to balance innovation with patient safety?

31/08/2025

🔹 Model Context Protocols: A Cornerstone for Quality Clinical Care 🔹

In today’s complex healthcare environment, ensuring quality and consistency in clinical services is not just desirable—it is essential. One of the most effective tools to achieve this is the adoption of Model Context Protocols (MCPs).

✅ What are MCPs?
They are structured, evidence-based clinical pathways that guide healthcare providers in making safe, timely, and patient-centered decisions—adapted to the local context.

✅ Why are they important?
• Standardization of care: Reduces variability and ensures every patient receives the right treatment, at the right time.
• Patient safety: Minimizes errors by providing clear, step-by-step guidance.
• Efficiency: Streamlines workflows, reduces duplication, and optimizes use of resources.
• Training & capacity building: Serves as a reference for new staff and a tool for continuous learning.
• Accountability: Creates a transparent framework for monitoring, supervision, and quality improvement.

✅ Applications in Bangladesh and beyond
• Managing common conditions (e.g., hypertension, diabetes, maternal care) with consistent protocols.
• Guiding referral systems in both urban and rural health facilities.
• Supporting integration of digital health and AI decision-support tools, ensuring technology aligns with safe clinical practice.

🌍 Global experiences show that where MCPs are applied—whether in Europe’s universal systems or in low-resource settings—patients experience better outcomes, reduced costs, and stronger trust in health services.

As Bangladesh and similar countries move toward Universal Health Coverage (UHC), adopting Model Context Protocols will be a game changer. It is not just about protocols—it is about building a culture of quality and safety in every clinical encounter.

🔖 Would love to hear how others have implemented MCPs in their settings—what worked, what didn’t, and what we can learn together.

24/08/2025

“Privacy, respect, and family-centered spaces — not extras, but essentials. 🚑 ”

On 9th August 2025, at the Bangladesh Quality Improvement Convention 2025, we witnessed a powerful discussion in Panel 6: “Family-Centered & Respectful Physical Environment of Health Care Space.”

The session reminded us that quality is more than clinical excellence — it is also about the environment, respect, and family-centered experience.

💡 Key reflections from the panel:

Respect & Dignity: As highlighted by Sayeda Mahfuja Aktar, care must honor patients and families — privacy, emotional support, and space design directly influence healing.

Human-Centered Design: Toslim Uddin Khan emphasized simple yet impactful design improvements: natural light, ventilation, signage, comfortable waiting areas, and inclusive spaces.

Practical Innovations: Dr. Md Akramul Islam shared examples from Bangladesh — ALO clinics, respectful maternity corners, and facility-level improvements through 5S-CQI-TQM approaches.

Policy & Accountability: Brig Gen Mir Sarwar Hossain Chowdhury stressed the urgent need for national guidelines and standards for respectful healthcare spaces, reinforced by patient feedback and audits.

✨ The session reaffirmed that a family-centered and respectful environment is not a luxury but a necessity for safe, equitable, and trustworthy healthcare.

This dialogue is only the beginning — translating these insights into policy, design, and action will ensure that every patient in Bangladesh receives care in a space that respects their dignity and strengthens healing.

23/08/2025

"Healthcare Quality in Bangladesh: Beyond Public, Towards Collaboration"

The Future of Healthcare Quality in Bangladesh: A Collaborative Journey
On 9th August 2025, the Bangladesh Quality Improvement Convention 2025 successfully hosted Panel 5, jointly organised by DGHS & IHI , focusing on one of the most critical frontiers in our health system:

"Private Sector & Public-Private Partnership (PPP) in Quality Improvement."
With over 60% of outpatient and diagnostic services provided by the private sector, it is clear that Bangladesh cannot achieve its national health goals without their active involvement. This session brought together leaders from both public and private domains to discuss how we can harness innovation while ensuring safety, equity, and accountability.

Moderated by the esteemed Dr. Md Aminul Hasan, the panel explored:

WHY private sector engagement is essential in our QI journey.
HOW PPP models can embed quality standards from the very beginning.
WHAT challenges remain—from regulation gaps to building trust—and strategies to overcome them.
WHAT’S NEXT—a practical framework for quality-focused PPPs that place patients at the center.

Our distinguished panelists included:
Md. Hafizur Rahman (Former CEO, PPP Authority)
Dr. Arefin Islam (Co-Country Director, Noora Health)
Dr. Supriyo Sarkar (PM, HSM, DGHS)
Dr. Manish Mishra (CEO, Lab Aid Diagnostics)

This discussion went far beyond theory—it laid down a pathway to extend quality improvement beyond public facilities and to build a unified, high-standard healthcare ecosystem for all Bangladeshis.

The insights from this panel reinforce a simple truth: the future of healthcare quality in Bangladesh isn’t just public—it’s collaborative.