Continuation of the PaJR Workflow ProJR from the previous link given below 👇
BODH: Benchmarking Open Data Platform for India Health AI - A Review of Architecture, Evaluation Methodology, and Implementation Framework for Clinical AI Validation in India
Prasanna Kumar C S
Vol. 15 No. 2 (2026): Volume XV Issue II February 2026 / Articles
GITAM University, Novotech Health Holdings, Bengaluru
DOI: https://doi.org/10.51583/IJLTEMAS.2026.15020000117 (https://doi.org/10.51583/
IJLTEMAS.2026.15020000117)
Published: Mar 21, 2026
Abstract How to Cite Metrics References License
Background: India's healthcare AI landscape is rapidly evolving, yet a critical
infrastructure gap persists: the absence of a sovereign, interoperable benchmarking
platform for systematic validation of AI models against clinically representative
datasets. This paper introduces BODH (Benchmarking Open Data Platform for Health AI),
a pioneering digital ecosystem unveiled at the India AI Impact Summit 2026, designed to
address this de�cit.
Objective: To present the technical architecture, evaluation methodology, governance
framework, and anticipated clinical impact of BODH as India's �rst federated AI
benchmarking infrastructure for healthcare, conforming to international standards
including HL7 FHIR R4, SNOMED CT, and OMOP CDM.
Methods: BODH employs a multi-layer microservices architecture incorporating
federated data ingestion, a secure model evaluation sandbox, and a cryptographically
audited leaderboard. Evaluation dimensions span diagnostic accuracy, fairness across
demographic strata, model explainability (SHAP, LIME, integrated gradients), clinical
safety, and regulatory alignment. Benchmark datasets cover radiology (chest X-ray, CT,
MRI), pathology, genomics, clinical NLP (EHR), and wearable biosignals
Results: Preliminary validation with 12 pilot AI models across 5 Indian hospital networks
demonstrates that BODH's multi-dimensional scoring reduces overestimation of model
accuracy by 18-34% compared to single-metric evaluation. Fairness gap indices reveal
statistically signi�cant performance disparities (p < 0.01) across gender and
socioeconomic strata in 7 of 12 models, previously unreported in vendor evaluations.
Conclusions: BODH represents a transformational step in responsible AI adoption in
Indian healthcare. By institutionalising open, reproducible, and regulation-aligned
benchmarking, it creates a veri�able trust layer that bridges the gap between AI
development and clinical deployment, serving as a model for low- and middle- income
country (LMIC) AI governance frameworks.
How to Cite
BODH: Benchmarking Open Data Platform for India Health AI — A Review of Architecture,
Evaluation Methodology, and Implementation Framework for Clinical AI Validation in India.
(2026). International Journal of Latest Technology in Engineering Management & Applied Science,
Full Text HTM (https://www.ijltemas.in/submission/online/article/
view/4224/5701)
[6:11 pm, 24/03/2026] hu5: No actually, missed them there.. looks interesting
[6:11 pm, 24/03/2026] hu1: Let's have a look. Thanks for sharing.
[6:11 pm, 24/03/2026] hu1: Yeah agreed. Any more potential additions? It's actually quite a hassle to set these up 😅
[6:11 pm, 24/03/2026] hu2: The two below can be removed?👇
Name of Consent Taker
(People need not be giving consent to any individual and also for those who are directly engaging online without any intermediary this would be redundant)
PaJR Health ID
(No point showing this option when it's not yet made and once made the system would inform them automatically?)
[6:11 pm, 24/03/2026] hu1: Alright. So backend stuff can be taken off. Yes I guess this was carried over from the paper form
[11:44 pm, 24/03/2026] hu28: hu5, can you access the full text of this. And more so, are you able to actually access the portal for BODH? I am unable to see that from USA.
[11:44 pm, 24/03/2026] hu28: It should be available somewhere on ABDM
[9:56 am, 25/03/2026] hu2: There's a full text link in that PDF
[9:57 am, 25/03/2026] hu2: PaJR bot driven global CPC
Today's CPC rephrased:
This is a celebration of medicine learning by alumni from an urban hospital in India who are currently spread out globally in various urban and remote locations in the world and at one such rural location there is a current admitted patient being compared in parallel with the patient who died months ago in the same urban hospital as both appear to have overlapping data points. This comparison is happening asynchronously across a global web based platform even as the urban hospital patient's autopsy findings are being discussed offline synchronously around the same time on a Wednesday morning.
The integration of an AI bot into the discussion serves to structure and elevate the human reasoning process. By organizing clinical thoughts into an IMRAD format and posing Socratic questions, the AI acts as an ambient analytical partner. It bridges the temporal gap between the 1.5-year illness narrative of the deceased patient and the acute presentation of the current patient, synthesizing disparate data points to warn against diagnostic pitfalls (e.g., misinterpreting an autoimmune storm as chronic infection like TB).
PaJR Health - Informed Patient
Consent and Authorization Form
(English Consent Form)
1. Purpose of Sharing
[✓] I understand that healthcare professionals may share my anonymized clinical details,
including relevant history, examination findings, radiology or laboratory images, and treatment
details, for the purpose of education, discussion, and professional collaboration.
2. Nature of Information and Anonymization
[✓] My identifiable personal information (such as name, contact details, address, identification
numbers, or facially recognizable images) will not be shared. Only de-identified or anonymized
data necessary for the stated purpose will be shared. The health professionals handling my data
will comply with the Digital Personal Data Protection Act, 2023, and relevant medical ethics and
privacy standards.
3. Risk of Re-identification
[✓] I understand that complete anonymity cannot be absolutely guaranteed and that there
remains a small possibility that I or my relative may be identified by someone familiar with the
case.
4. Scope and Medium of Publication
I understand that my de-identified case report may be immediately shared or published in:
[✓] • Online academic or professional discussion groups (e.g., PaJR Health Publications,
WhatsApp, Facebook, Blogs, Forums etc.).
[✓] • Printed or online medical journals, educational websites, or institutional repositories and I
shall be informed whenever they are published in medical journals.
[✓] • Other educational or research platforms, subject to compliance with applicable data
protection and professional standards.
5. Rights of the Data Principal (as per DPDP Act, 2023)
I have been informed that:
[✓] • I have the right to withdraw this consent at any time before publication, by contacting the
consent taker in writing or electronically.
[✓] • I have the right to access, correct, or restrict further sharing of my personal data, if any
personal identifiers are inadvertently included.
[✓] • I can contact the designated Data Protection Officer / Grievance Officer of the institution
for any concerns or grievances related to the use of my information.
6. Role of Treating Physician
[✓] • I understand that the E-log of online discussion on the team-based learning platform
(https://pajr.in/) is meant solely for patient and health professional educational collaboration in
good faith and not as a substitute for medical advice or treatment from my primary physician,
who remains responsible for my clinical care.
[✓] • I also consent to my data being discussed and used on the platform to identify similar past
cases for my benefit and to support future patients with comparable conditions. I understand
that the goal of PaJR Health is to create awareness and collaboration between patients and all
other stakeholders in healthcare.
7. Language and Understanding
[✓] The purpose and implications of this consent have been explained to me in a language I
understand. I have been given an opportunity to ask questions, and all my queries have been
satisfactorily answered.
PATIENT DETAILS & SIGNATURE
Name of the Patient: hu1
Age (Years): 32
Gender: Male
WhatsApp Phone Number: xxxxxxxxxx
Email Address: xxxxxxx@gmail.com
Address of the Patient: Hyderabad, India
Name and Relation of the Patient Advocate:hu1 - Twin brother
Patient Illness Summary: 32/M Unwell with stress of setting up PaJR Health Pvt. Ltd.
Date of Consent: 2026-03-25
Signature:
Grievance / Data Protection Contact:
xxxxx@gmail.com
RS1, Lawyer and patient advocate, PaJR volunteer, xxxxxx@gmail.com
Professor hu2, PaJR volunteer,xxxxxx@gmail.com
Professor hu31 Epidemiologist and Public health specialist, WA: xxxxxxxxxx
[6.02 am, 26/03/2026] hu5: Stress of setting up, twin brother 😂😂
DPDP Inputs and reviews/comments please
GPT 5.4 review -
Here is a legally strict, DPDP Act, 2023–focused assessment of your consent form. I will evaluate it against core statutory requirements: lawful basis, notice, consent validity, purpose limitation, data minimization, rights, grievance redressal, and cross-platform sharing risk.
---
Executive Verdict
Not fully DPDP-compliant.
It is directionally good but legally fragile in multiple critical areas, especially around:
valid consent design
purpose specificity
withdrawal mechanics
data fiduciary obligations
platform risk exposure
---
1. Consent Validity (Section 6) — Weak / Potentially Invalid
Problem:
Your consent is bundled, vague, and partially coercive by design.
You combine:
education
publication
WhatsApp/social sharing
research reuse
into a single checkbox-based consent
DPDP requires:
> Consent must be free, specific, informed, unconditional, and unambiguous
Why this fails:
“Online discussion groups (WhatsApp, Facebook…)” is not a specific purpose, it is a distribution channel
No granular consent options
No separate opt-ins for:
publication vs internal discussion
social media vs academic journals
Consequence:
A regulator can argue:
> Consent is not specific → therefore invalid → entire processing unlawful
---
2. Purpose Limitation — Overbroad and Non-compliant
From your document:
> “education, discussion, and professional collaboration”
Problem:
This is too broad under DPDP
Also:
> “Other educational or research platforms”
This is effectively:
> future unspecified use
Why this fails:
DPDP requires:
clear, narrow, explicit purpose
no open-ended reuse
Risk:
This clause allows:
secondary use
indefinite reuse
uncontrolled propagation
Which makes consent:
> legally challengeable
---
3. “Anonymization” Claim — Legally Misleading
From your form:
> “Only de-identified or anonymized data will be shared”
But also:
> “small possibility that I may be identified”
Problem:
You are mixing:
anonymized data (not regulated)
personal data (regulated)
Legal reality:
If re-identification is possible, it is NOT anonymized under DPDP
→ It is still personal data
Consequence:
You cannot rely on anonymization exemption
All DPDP obligations still apply
---
4. High-Risk Platforms (WhatsApp, Facebook) — Major Compliance Exposure
You explicitly allow:
> WhatsApp, Facebook, blogs
Problems:
1. Cross-border data transfer risk
2. No control over downstream processing
3. No enforceable safeguards
4. These platforms are independent data fiduciaries
Missing:
No mention of international transfer compliance
No mention of platform-specific risks
No downstream liability disclaimer
Legal impact:
This is one of the biggest weaknesses
---
5. Withdrawal of Consent — Non-compliant Implementation
From your form:
> “withdraw at any time before publication”
Problem:
DPDP requires:
> Withdrawal must be as easy as giving consent
Issues:
No mechanism defined
No timeline for action
No clarity on:
already shared data
cached or redistributed data
Critical flaw:
You restrict withdrawal:
> “before publication”
This is not compliant
User must be able to withdraw:
any time
not conditionally
---
6. Notice Requirements — Incomplete
DPDP requires notice to include:
data collected
purpose
grievance officer
method of withdrawal
complaint escalation (Data Protection Board)
You have:
partial rights
contact persons
Missing:
clear identity of Data Fiduciary (legal entity responsibility unclear)
processing duration / retention
complaint escalation to Data Protection Board
automated decision-making disclosure (if any future use)
---
7. Data Fiduciary Ambiguity — Serious Structural Issue
You list individuals:
doctors
volunteers
Problem:
Who is the Data Fiduciary?
Individual doctors?
PaJR Health Pvt Ltd?
Platform operator?
Why this matters:
Under DPDP:
> A clearly identified Data Fiduciary is mandatory
Without this:
liability is unclear
compliance enforcement fails
---
8. Data Minimization — Violated
You collect:
phone number
email
address
illness summary
Problem:
Not all are necessary for:
> “educational sharing”
Risk:
Over-collection = violation
especially sensitive health data
---
9. Sensitive Personal Data (Health Data) — Under-protected
Health data is high-risk
Missing safeguards:
no encryption mention
no access control description
no retention limits
no breach notification clause
---
10. Audit Trail — Good but Not Sufficient
You include:
> submission ID, IP, timestamp
This is good for:
traceability
But:
does not compensate for invalid consent
---
Bottom Line (Brutal Summary)
Area Status
Consent validity Weak
Purpose limitation Non-compliant
Anonymization claim Legally incorrect
Social media sharing High risk
Withdrawal rights Non-compliant
Notice completeness Partial
Data fiduciary clarity Missing
Sensitive data safeguards Weak
---
If This Is Challenged
A regulator could reasonably conclude:
Consent is invalid
Processing is unlawful
You are exposing sensitive personal data improperly
This is not a minor gap — it is structural non-compliance
---
What You Must Fix (Priority Order)
1. Split consent into granular options
2. Define precise purposes (no catch-all clauses)
3. Remove or tightly regulate WhatsApp/Facebook sharing
4. Clarify Data Fiduciary (PaJR Health Pvt Ltd explicitly)
5. Allow unconditional withdrawal anytime
6. Add retention period + deletion policy
7. Fix anonymization language (call it “pseudonymized” instead)
8. Add cross-border data disclosure
9. Add DPB complaint mechanism
10. Minimize collected identifiers
GPT 5.4 review -
Here is a legally strict, DPDP Act, 2023–focused assessment of your consent form. I will evaluate it against core statutory requirements: lawful basis, notice, consent validity, purpose limitation, data minimization, rights, grievance redressal, and cross-platform sharing risk.
---
Executive Verdict
Not fully DPDP-compliant.
It is directionally good but legally fragile in multiple critical areas, especially around:
valid consent design
purpose specificity
withdrawal mechanics
data fiduciary obligations
platform risk exposure
---
Consent Validity (Section 6) — Weak / Potentially Invalid
Problem:
Your consent is bundled, vague, and partially coercive by design.
You combine:
education
publication
WhatsApp/social sharing
re
GPT corrected version
PaJR Health Pvt Ltd
Informed Consent and Authorization for Use of Health Data
(Compliant with Digital Personal Data Protection Act, 2023)
---
1. Identity of the Data Fiduciary
PaJR Health Pvt Ltd ("PaJR Health") is the Data Fiduciary responsible for processing your personal data under this consent.
Contact:
Email: support@pajr.in
---
2. Nature of Personal Data Collected
With your consent, the following categories of data may be collected and processed:
- Clinical information (medical history, diagnosis, treatment details)
- Diagnostic data (laboratory results, radiology images)
- Limited identifiers (age, gender, non-specific location)
Explicitly excluded from sharing unless separately consented:
- Name
- Phone number
- Email address
- Exact address
- Government identifiers
- Facial images or identifiable photographs
---
3. Purpose of Processing (Granular Consent Required)
Please select your preferences:
3.1 Educational Case Discussion (Required for Platform Use)
[ ] I consent to my pseudonymized clinical data being used for discussion among registered healthcare professionals within controlled platforms operated by PaJR Health.
---
3.2 Academic Publication
[ ] I consent to my pseudonymized clinical data being used in medical journals, case reports, or academic publications.
---
3.3 Internal Research and Case Matching
[ ] I consent to my data being used to identify similar cases for clinical learning and improving patient outcomes within PaJR Health systems.
---
3.4 External Platform Sharing (High Risk – Optional)
[ ] I consent to my pseudonymized data being shared on external platforms such as:
- Messaging platforms (e.g., WhatsApp)
- Social media platforms
- Open-access forums
I understand that:
- These platforms operate independently of PaJR Health
- Data shared may be stored outside India
- Complete control over further distribution cannot be guaranteed
---
4. Nature of Data Protection
- Your data will be pseudonymized, meaning direct identifiers will be removed
- However, complete anonymization cannot be guaranteed, and re-identification risk may exist in rare cases
- Appropriate administrative and technical safeguards will be implemented
---
5. Lawful Basis of Processing
Your data is processed solely based on your explicit consent under the Digital Personal Data Protection Act, 2023.
---
6. Data Retention
Your data will be retained:
- For educational and research purposes: up to 10 years
- Or until consent is withdrawn, whichever is earlier
After this, data will be deleted or irreversibly anonymized.
---
7. Your Rights as a Data Principal
You have the right to:
- Access your personal data
- Correct inaccurate data
- Withdraw consent at any time
- Request erasure of your data
- Nominate another person to exercise your rights
---
8. Withdrawal of Consent
You may withdraw your consent at any time, by:
- Email: support@pajr.in
- Platform request (if applicable)
Upon withdrawal:
- No further processing will occur
- Reasonable efforts will be made to delete previously shared data
- Data already published or shared externally may not be fully retractable
---
9. Grievance Redressal
Grievance Officer:
Email: grievance@pajr.in
If unresolved, you may escalate to the Data Protection Board of India under applicable law.
---
10. International Data Transfer
If you consent to external sharing:
- Your data may be transferred and stored outside India
- Such transfers will comply with applicable legal requirements
---
11. Declaration
- I confirm that I have read and understood this document
- I have had the opportunity to ask questions
- I provide my consent voluntarily and without coercion
---
12. Patient Details
Name: _________
Age: ________
Gender: _______
---
13. Consent Record
Date: _________
Signature: ______
---
14. Audit Trail (System Generated)
Submission ID: ____
Timestamp: ____
IP Address: ____
---
Overall I think it's good but some nitpicks above courtesy AI.
[9.12 am, 26/03/2026] hu2: Excellent inputs 👏👏
I have a few Inputs on it before @hu1 can incorporate these in the online form.
[9.34 am, 26/03/2026] hu5: AI is getting better at feedback :-)
[10.11 am, 26/03/2026] hu2: My feedback on it's feedback:
Instead of
3.3 Internal Research and Case Matching
[ ] I consent to my data being used to identify similar cases for clinical learning and improving patient outcomes within PaJR Health systems.
Let's change the heading and just call it
[10.11 am, 26/03/2026] hu2: Instead of:
3.2 Academic Publication
[ ] I consent to my pseudonymized clinical data being used in medical journals, case reports, or academic publications.
Let's say:
3.2 Academic Publication
[10.23 am, 26/03/2026] hu2: Instead of:
3.4 External Platform Sharing (High Risk – Optional)
[ ] I consent to my pseudonymized data being shared on external platforms such as:
- Messaging platforms (e.g., WhatsApp)
- Social media platforms
- Open-access forums
We can say:
3.4 External Platform Sharing
Once your patient's deidentified data is available open access online, it can be shared by online users over any open access forum such as WhatsApp, Facebook and similar social media but the chances of anyone identifying your patient is low
[10.25 am, 26/03/2026] hu2: Instead of:
6. Data Retention
Your data will be retained:
- For educational and research purposes: up to 10 years
- Or until consent is withdrawn, whichever is earlier
After this, data will be deleted or irreversibly anonymized.
Let's say:
6. Data Retention
Your data will be retained:
- For educational and research purposes for life
[3.35 pm, 26/03/2026] hu1: Please can I give you edit access to the forms directly and you can make the finer edits sir? I'm drowned in a bit of information overload tbh
[4:02 pm, 26/03/2026] hu1: Great inputs here and most valid but my takeaway from this is that the vocal minority always wins, while the silent majority generally does not care. A great example for this is McDonalds chicken is now completely halal because a few people were vocal about it and while the silent majority did not care, McDonalds felt it is better to make all chicken halal and be done with it. In the same way, the design of our consent form is to handle the worst of the worst - either advocate or legal counsel - who can bring down the whole pack of cards and fall our business! While we are protecting ourselves against black swan events, the incentive structure is heavily pivoted in favor of the ruckus creators rather than the normal but silent majority!
[4:06 pm, 26/03/2026] hu15: Great inputs here and most valid but my takeaway from this is that the vocal minority always wins, while the silent majority generally does not care. A great example for this is McDonalds chicken is now completely halal because a few people were vocal about it and while the silent majority did not care, McDonalds felt it is better to make all chicken halal and be done with it. In the same way, the design of our consent form is to handle the worst of the worst - either advocate or legal counsel - who can bring down the whole pack of cards and fall our business! While we are protecting ourselves against black swan events, the incentive structure is heavily pivoted in favor of the ruckus creators rather than the normal but silent majority!
Very well said. Same with the practice of defensive medicine in today's world.
[4:07 pm, 26/03/2026] hu1: From my reading - there are several countries where even if someone does file a case, only their records are redacted but the whole business wont be taken down - However, By default I expect Indian judiciary to be bottom of the barrel and thus not only kill our business but anu potential future ideas! Perhaps this is all stemming from the current political climate in the UK, where the 'bottom of the barrel' (I am quoting Theodore Dalrymple here) dictate political and governance outcomes and thus we have such perverse incentives!
[4:07 pm, 26/03/2026] hu15: The system is pivoted towards preventing trouble from the minority of ruckus creators
[4:09 pm, 26/03/2026] hu15: I remember (and am paraphrasing) a popular quote attributed to someone in a senior management position at a tech major. When you are building don't worry much about regulations, if you don't scale, it won't matter anyways, because u will wrap up. And if u do scale, u will have a bevy of lawyers on retainer to deal with the paperwork
[4:09 pm, 26/03/2026] hu15: The quote was later taken down due to heavy criticism 😃
[4:13 pm, 26/03/2026] hu1: A great regret I have is I moved from one bureaucratic hellhole to another one in the UK! I did not realise that i was very subtly becoming zero-sum in my ways and how people's mindset and worldviews are shaped from a long history of working here/in the NHS! It is a colossal failure of human capital. Clinical medicine has died more than a decade ago in the UK but the administrative side is an absolute cancer (I have no qualms in saying this) - I cant believe how much most other countries have caught up and the UK still refuses to open its eyes. Like Taleb says the designers of these laws and systems are those with no skin in the game - they have never built a business in their life, never setup a shop or worked a factory and thus are truly unaware of the downstream effects of the laws they create. I'm just bored of this world, if not anything else!
[4:15 pm, 26/03/2026] hu1: British law once upon a time used to be against such vocal good for nothings causing any harm, the entire structure has now flipped on its head.
[4:19 pm, 26/03/2026] hu1: Leadership within the NHS is to be 'vocal' and loud. By loud I literally mean loud. A senior registrar was reported to his supervisor because he was 'too unusually calm' during cardiac arrests! By an ACP - Again a vocal minority overarching on a silent majority. The senior registrar was asked to be more vocal and loud and was told off. He had 17 years experience as a doctor, the ACP was an MSc in Physics and did a 2 year course to bypass medicine but work almost like a doctor. @hu28 this is a huge political issue here in the UK on ACPs and PAs working at doctor level without any formal training whatsoever. What is it like there? I know that the UK borrowed this model from the USA?
[4:19 pm, 26/03/2026] hu1: Perhaps retire and take a road trip from Zimbabwe to South Africa every 9 months? Apparently it is too beautiful to ignore!
[4:24 pm, 26/03/2026] hu2: Can be done once every 9 months without retiring as well?
My first five years as asst professor was spent here:
https://en.wikipedia.org/wiki/Machapuchare and this was close to what I woke upto eveyday. The problems at that time in 1999 were very similar overall. Humans don't change much but we need to find out own Shangri-Las in the midst of all the din
[4:24 pm, 26/03/2026] hu15: Soon, I wish😊
[4:46 pm, 26/03/2026] hu1: Lovely! Final dream is to drive from Hyderabad to London. Someday!
[5:41 pm, 26/03/2026] hu28: Re: vocal minority
"squeaky wheel gets the grease"
Re: PA / NPs
Politically charged topic in the USA as well. My belief is that the practice of medicine is not one homogeneous set of skills that can or cannot be practiced by ACPs. More than ever before we need a team to care for patients and populations, and ACPs can be helpful in the team. Physician supervision should be available to PA /NP as guardrails and experts. There should be hierarchy in decision making , not necessarily in ideas.
[5:44 pm, 26/03/2026] hu28: Physicians and nurses are teams. They have different roles and have better knowledge about different aspects of care. Often nurse has more info about the organism level and physicians the organ level. Problem is not in division of role and responsibility but when we lose sight of collaboration and communication.
[5:45 pm, 26/03/2026] hu28: Having PA and NP on surgery and procedural teams is good for productivity an access for patients to procedures. But can be a problem in access to assurance and education by the expert who worked on their body.
[5:46 pm, 26/03/2026] hu32: I would just be mindful that if you have any American patients in here, you open your self up to legal liability when sharing any identifying legal information publicly.
It could also cause patients to not feel safe to share their data.
[5:47 pm, 26/03/2026] hu1: Physicians and nurses are teams. They have different roles and have better knowledge about different aspects of care. Often nurse has more info about the organism level and physicians the organ level. Problem is not in division of role and responsibility but when we lose sight of collaboration and communication.
Law of unintended consequences - that was the intent but it just turned out to be something else, at least here in the UK!
[5:47 pm, 26/03/2026] hu28: APP / Nurse / Surgeon can be more clearly separated in role differentiation.
APP / general practice is where it starts getting blurred and most of the friction is felt (hospitalist or PCP both)
[5:49 pm, 26/03/2026] hu32: Also as someone who works in the AI field- it is not anywhere near reliable enough to summarize medical context without a human in the loop.
[5:49 pm, 26/03/2026] hu1: We serve globally and all global patients will be protected with maximum legalese.
[5:52 pm, 26/03/2026] hu1: Step 3 done sir. Step 4 can only be done if they respond in the appropriate manner to the questions in step 3
[6:04 pm, 26/03/2026] hu28: Another lens is that the physician profession is centuries old and has accumulated a prestige and aura, most of all in the minds of physicians who see old photographs and paintings of medical history thru the ages. All displaying heroism and focus on the physician and their act with the patient.
Modern medicine picture is a building and machines and teams and tables and graphs. The human is not seen.
We still exert a lot of influence in the medical ecosystem even as this space is populated by other partners such as nurses, social workers, therapists over time all of who are important roles in the patients recovery journey. Why are physicians still the top authority? They understand pathologic basis of disease well and had a license to intervene on the human body -- is that particular action of manipulating another humans biology that gives us a special status?
APPs are also being permitted to prescribe. With external guidelines and intelligence we are relying more on external knowledge to make such decisions. Then what is it that general internists draw their superior authority from?
[6:12 pm, 26/03/2026] hu1: Great points. I wonder how many ACPs and PAs hold the same view? It should be a two way street.
In any case, I'm sure initially the intent was the same in the UK but I've come to realise a (very) flattened hierarchy will drown out expertise and wisdom with vocal and loud. As much as we do not intend for these, unfortunately these are the outcomes.
I wonder how the academic flatlands of PaJR will evolve.
[6:16 pm, 26/03/2026] hu1: Great points. I wonder how many ACPs and PAs hold the same view? It should be a two way street.
In any case, I'm sure initially the intent was the same in the UK but I've come to realise a (very) flattened hierarchy will drown out expertise and wisdom with vocal and loud. As much as we do not intend for these, unfortunately these are the outcomes.
I wonder how the academic flatlands of PaJR will evolve.
I'm an Endocrinologist and the irony is that the absolute confidence with which I thought I could diagnose type 1 diabetes 2 years ago, has paled and waned and I am even more in dilemma now.
And if I speak to a nurse and he/she hears my cognitive dilemma, they would be aghast and reflexively label me incompetent. But my own skepticism and years of practice tell me I'm on the right (and yes, admittedly incompetent). The Dunning Kruger effect makes them the 'vocal and loud' phenotype while the experienced experts are looking at the stars and suffering in silence! This asymmetry can lead to very bad outcomes
[6:17 pm, 26/03/2026] hu28: Dunning Kruger 👍
[6:19 pm, 26/03/2026] hu1: Which is probably why India possibly has such perverse laws about data privacy and protection but data breaches happen at scale that is hitherto unknown to mankind yet.
AIIMS and Aadhar data breach and Airtel numbers being distributed publicly!
[6:24 pm, 26/03/2026] hu1: What we are doing here is attempt full deidentification right at the off and then run them through 2 cycles of deidentification and then publish a pseudonymised version publicly.
The problem also is that medicine has been always obsessed with privacy and law (rather than the patient and the actual medicine bit @hu2 Sir @hu28?) that it has now become culture to be privacy obsessed. Can we invent a new culture where markets emerge and two consenting parties (PaJR Health and a patient advocate) agree to share patient's data and discuss on it, in the process also training students on it and also teaching medicine directly to the patient, while also acknowledging that invariably, as with anything human, there will be a data leak, and if spotted can be redacted straightaway.
[6:25 pm, 26/03/2026] hu1: And then somebody invented 'governments'
[7:25 pm, 26/03/2026] hu15: Brilliantly expressed
[7:27 pm, 26/03/2026] hu15: Two consenting parties can agree to mutually acceptable terms under any legal system, unless those terms are blatantly criminal, which our terms aren't (I hope).😊
[11:36 pm, 26/03/2026] hu1: Spot on. Maybe we have to bake that in to our consent form
[2:10 am, 27/03/2026] hu1: Just a quick query @hu5 @hu2 Sir - should our privacy policy address the DPDP issues or the consent form? I think consent form is voluntary and fluid while the privacy policy is DPDP rigid?
[6:43 am, 27/03/2026] hu8: Voluntary consent refers to a patient’s or participant’s freely given agreement to undergo a medical procedure, participate in a clinical study, or share personal health data—without any form of coercion, pressure, deception, or undue influence. Voluntary consent is essential for the ethical and legal validity of any consent process.
In other words, taking consent is NOT voluntary - rather legally mandatory, while the process of giving consent MUST be voluntary.
[7:51 am, 27/03/2026] hu2: We have even more legal liability in India if we share their identifying information
[7:53 am, 27/03/2026] hu2: Yes logically nothing without humans can be reliable for humans ever!
However if we look at the microscopic automated world of cells that is not subject to human cognition and control, cells just do their own thing either in in inflammation or repair
[7:54 am, 27/03/2026] hu2: We serve globally and all global patients will be protected with maximum legalese.
Unfortunately the gap between legal and ethical keeps widening where legal currently stands for "might is right" and ethical is "open to interpretation!"
[8:06 am, 27/03/2026] hu2: Great points. I wonder how many ACPs and PAs hold the same view? It should be a two way street.
In any case, I'm sure initially the intent was the same in the UK but I've come to realise a (very) flattened hierarchy will drown out expertise and wisdom with vocal and loud. As much as we do not intend for these, unfortunately these are the outcomes.
I wonder how the academic flatlands of PaJR will evolve.
This is a very interesting point @~Priyank Jain @~Rahul Kulkarni @~Tamoghna @~Z
In the academic flat lands of PaJR (PaJR as in un-copyrighted "patient journeys shared in two dimensional x-y axis" that makes up most of the global academic flat land territory, more here: https://userdrivenhealthcare.blogspot.com/2025/08/udlco-crh-reducing-multidimensional.html?m=1), essentially wherever and whenever patient users share their deidentified stories globally for decision making inputs, there is very less hierarchy and no one classifies team members in terms of their designation and salary and eventually only their content matters as long as it appears to go a long way to impress upon other team members that the content can improve decision …
