Looking behind ?
Overlooking 2013 and a large ideas i had in late 2012 for it, wanted to write down some reflections on it. Doing this all yet i know that one customarily can bond the dots looking backward to see if i took a right path. But it also make me consider on a subsequent stairs and how a kick a outrageous hurdles medical is facing.
The approach of a dodo
“The internet has revolutionized a lives!” is an mostly listened exclamation. The Net combined a lot into a lives indeed, and also finished a few things disintegrate from a lives. Think of all a things that became archaic due to a internet, for instance minute writing, remoteness and many kinds of brokers and core men.
These developments make me consider about a dodo, a scandalous -one scale high pigeon-like flightless bird, that was final speckled by a Dutch sailor in 1662 circuitously Mauritius. Of all a class that became extinct, a dodo has turn arrange of a embellishment of extinction. To “go a approach of a dodo”means that something is headed to go out of existence. In this epoch of internet and technology, this goes not customarily for flora and fauna, yet also for things we use or things we do. Many futurists have already likely that things like post offices, cab drivers, primer labor and even genocide itself will go a approach of a dodo.
So what about healthcare? What will disappear in a margin of medicine? Will record and a Internet take over like they did in a song and transport industry? Will nurses be transposed by robots? Will a alloy be transposed by a intelligent phone app? Will we no longer go to a sanatorium or to a doctor’s office? Shift certainly ís function and some things in medical have already commenced their treads on a approach of a dodo. But, in my opinion, we will still need medical professionals. Real people, with genuine caring and giving good care.
The hurdles that medical faces are huge, that’s no violation news. Financial mismatches, doubling of medical direct and a necessity of learned crew (the Netherlands will miss 400.000 professionals by 2040) will expostulate medical systems to “reinvent themselves”. Moreover, there are dual developments accessible “at a gate” to interrupt many of a stream caring models: a noisy studious is here to stay and new technologies are building during exponential rates. The impact of new communication paradigms, such as amicable media and clarity of opening is customarily as underrated as a purpose of e-health is overrated. We should consider big, act small, brave to fail, stop talking… and start behaving NOW.
If we still wish be a applicable spoke in a medical complement in, let’s contend a subsequent 5 years, we should be concentrating on these 3 topics, for yourself, for your institution, and many of all for your patients:
- Patient engagement
- Exponential flourishing technology, including a internet
- Social media
Next, we will residence a preference of destiny medical dodos. With a energy of a 3 topics above, a Radboud REshape Innovation Center has instituted a operation of innovations. Among these some are (in pointless order):
- Hereismydata™ A use that include out of a Personal Health Record, a village partial and a eHealth connector
As of 2009 we a crowdsourcing a locations of AED’s in a Netherlands. With a largest database in a universe during benefaction with over 18500 units and roughly 300.000 downloads with a assistance of a public.
A videoconference complement we’ve grown to be means with customary record yet additional hardware to confrere with medical professionals in an easy and secure way.
A online village for immature cancer patients (18-35 years of age) to share in a secure approach insinuate sum about their life with cancer during immature age. Challenges like relationship, work, financial etc. At a impulse we are enroll nationally.
- TEDxMaastricht, TEDxNijmegen
Every year we light a high turn discussion twice in Maastricht (2011 2012) twice in Nijmegen (2012 2013) pity idea’s dreams and examples i.e. by a internet.
- And several projects that we’ve run on department-level that change from listening to a targeted groups compartment REdesigning a patients tour around a health-system.
By these projects we try to outmanoeuvre a dodo, and differently we will turn vital (or extinct) examples for other innovations in a circuitously destiny that breathe a same suggestion and aspiration of destiny explanation health.
One of a vital shifts in medical is that plcae is removing reduction important. Due to new (mobile) record and cheaper contrast methods, things are a-changing already. On a other hand, rising costs in medical are forcing all stakeholders to turn many some-more fit concerning processes, staff and overhead. The series of mergers and takeovers is increasing. Whether or not that is a approach to go is still to be seen. We during a Radboud University Medical Center, consider there are other ways to turn some-more efficient. For instance by formulating a network formed on partnership instead. With opposite points of caring nearby, and with a assistance of new technology, many things can be achieved. We will be means to guard a patients during locations customarily around a corner, or even from their possess homes. More dilettante procedures will be achieved over away. Over a past decades we have tended to take medical divided from a people themselves. This started with bringing people into hospitals rather than caring for them in their homes. Healthcare has turn centralized in institutions, rather than in networks as it was in a aged days. But new record is enabling us to retreat that, while gripping a same high standards. So this means that trusted, good famous hospitals with doctors we are now so informed with, will disappear some-more and more. We will pierce behind health(care) into a homes of people.
Duration of a stay
A decade ago some procedures took adult to 15 days hospitalization. Now, they take 3 days. This is due to new technologies, innovations in medication, logistics, protocols and new insights on rehab. A median stay in US hospitals during benefaction is about 5 days. Long stays for unchanging procedures will turn nonessential and over-expensive. Monitoring during home is some-more and some-more holding an critical position in this field, enabled by a internet.
Individual confused medical professionals
Healthcare is apropos even some-more formidable than it already was. This is caused by augmenting legislation, and considerable bill cuts. There are many constraints on medical preparation and a overkill of information that has to be eaten creates it tough to keep up. Next to that a executive weight is increasingly distracting all medical personal from delivering tangible healthcare. The partial time ratio for medical workers is increasing. The series of womanlike professionals entering medical adds to this tendency. More and some-more tasks are substituted from doctors to helper practitioners and physician’s assistants and subsequent adult is ‘delegating’ to patients and their network. In sequence to contend peculiarity standards and to be means to keep collaborating on formidable issues, operative in groups or environment adult vital partnerships could advantage medical processes.
we trust that within one or dual decades, particular confused medical professionals will turn a minority.
Two-party investigate in a 3 celebration world
Up until now health investigate has especially been finished by a curative courtesy and researchers. Patients were merely a pacifist object. we mostly contend : “Doing (as in designing) medical investigate yet a team-work of patients is like racing a automobile backwards… blindfolded”. Now, we have a collection during palm to engage patients. New communication techniques democratized a media and even certain regimes were forced into revolution. Crucial in this was a purpose of a internet. These collection will also be used to get patients orderly around investigate on matters they caring about deeply, namely their possess health or a health of a tighten family member. Research with patients in co-control will interrupt normal investigate and emanate a pathway for (applied) investigate by new systems that will change a environment for ever. It will customarily be a matter of time before these kinds of collection will turn accessible to patients. We wish to minister to this idea with MedCrowdFund™, a amicable height (like a medical kind of Kickstarter) where patients can pattern and find appropriation for innovations and research. Let’s see how prolonged it takes for a dual celebration health investigate complement to get remade into a three-party one. Patients will barter roles from being a object, to being a theme to behaving as a partner in research. A unequivocally good instance is my crony Jack Andraka, innate in 1997 (!). After many rejections by normal institutions and after a lot of perseverance, Jack grown a pancreatic cancer exam “just by regulating Google and Wikipedia”. It is designed as an early showing test, to establish either or not a studious has early-stage pancreatic cancer. The exam is over 90% accurate, it is 168 times faster, 26,000 times reduction costly (costing around 3 dollar cents), over 400 times some-more supportive than a stream justification tests and customarily takes 5 mins to run. He says a exam is also effective for detecting ovarian and lung cancer, due to a same biomarker they have in common. Truly inspiring! So demeanour delicately during these new initiatives; do not decider them on what they are doing, yet on why and how they are doing this. Reach out, try and plea diseases together!
Being a good doc won’t be good adequate anymore
We have gotten used to submitting and anticipating patron opinions of roughly any kind of use online. Reviews and ratings of traveller prohibited spots, transport agencies, restaurants, financial products, and so on, and so on have left public. And of course, medical professionals are partial of this trend. A diagnosis has turn an experience, and a customer’s compensation with it in ubiquitous competence turn uniformly critical as a peculiarity of a medicine practiced. According to Pew Research, 50% of a smartphone users in a US use their device to demeanour adult health information, a new investigate in a Netherlands showed that this was 60%. . That means that they will substantially have researched their medicine online while they were sitting in a watchful room. And that they will examination him or her as shortly as they have left a building. “Hospital-ity” has regained a critical meaning.
Not customarily calm formed web content, yet also informational videos will turn increasingly important. Healthcare could advantage from adopting a use of video as well. It offers good opportunities for providers to benefaction themselves and their services.
Caveat! Medical peculiarity will no longer be a customarily indicator people review to select medical providers.
The studious is not in a middle
Many pivoting medical providers are putting a studious in a middle. we consider that is one of a many paternalistic approaches a studious could humour from. The studious is not an intent around that we perform your duty. The studious should be(come) a partner. He is an equal in a group that collaborates to means or grasp his optimal health. If patients wish to take control of their health, yet they aren’t means to, we contingency learn them. If they wish to yet they can’t since there is no complement or technology, we contingency build it fór and with them. And if they don’t wish to we contingency broach medical in a unchanging way.
In a core however, is something else: it is an ear. A unequivocally critical organ (that’s since we have two, right?). A conference clarity that many medical systems have stopped using. As they know what’s best for patients – during slightest that’s what they consider – they make choices on interest of instead of with the studious and their families.
Often we squeeze “innovation” as a large resolution for everything. We start innovating yet carrying looked closely into existent procedures and how optimizing these existent systems could pierce good advantage and improvement. That (at slightest in my opinion) starts with unequivocally listening to what is unequivocally needed. Stop assuming, quit meditative that we “know” what patients need, or from a courtesy viewpoint what medical professionals need. Listening is asking. we rarely suggest appointing a CLO into your team, we combined and allocated this position behind in 2009: a Chief Listening Officer. Start seeking patients offline-online, “how can we assistance we ?”
Do not blink a energy of collaboration. At a Medical Center, we adore to group adult with other parties, nationally as good as internationally. It is indispensable that we do not humour from a not-invented-here-syndrome. So open up, clear a gates surrounding your domains. It is tough to find likeminded, yet they’re out there! In a Netherlands we mostly come opposite a common suspects; hence we broadened a environment and contacted many general innovators. In other countries are mostly other cultures and mentalities. We are tender by a gait we are means to keep in a general teams, and a bit ashamed that it apparently is unfit to rise and exercise quick in a possess country. The significance of a internet in that aspect as good is crucial. Connections are being finished by amicable media, formed on slip decks that we have put online, people reflecting on photographs that we published. Entrepreneurship, leadership, wilful actions and speed are critical resources in sequence to exercise your innovations successfully. Without it, we can't evolve. And a predestine of a dodo is one step closer.
Rules and regulations
The thing with exponential developments is that is takes small time to develop, yet some-more time for laws and ethics to locate up. How should a Inspectorates ready for an ever changing universe where record is exponential flourishing and changing a arena? In a “old“ days, it took large companies years of creation before they could launch a new medical device. Nowadays, new inclination strike a marketplace on a daily basis, time to marketplace has decreased dramatically. Does this indeed change a approach how inspectorates should act? In a Netherlands, regulatory mandate for digital medical innovations are prohibited during a moment. It is in a core of courtesy of a Dutch Healthcare Inspectorate. And that’s a good thing. Certification of medical applications will supplement to some-more quality. we consider that that’s not adequate though. we strongly trust that a apparatus of open technical standards for instance for information sell and a reuse of existent and proven applications should be finished imperative by slight makers. The program courtesy has absolute interests. They work defensively and are distant from fervent to open adult their systems and thereby practically extenuation entrance to competition.
Furthermore, a financial complement contingency be improved. If financial compensations do not finish adult in a money registers of a developers and producers of (digital) medical innovations, a dodo will shortly be accompanied by many gifted peers.
Huge amounts of information are being generated during a impulse by a lot of information systems, medical records, tracking devices, lab results, design resources, etc. What we need is a ability to cave these opposite kinds of information and to be means to know a meaning, family and interactions. We need a executive repository where anyone (not customarily patients, yet any civilian) can entrance his possess information in a extensive way. Health data, yet also other kinds of data, e.g. financial data. He and customarily he contingency be means to confirm whom to share it with. He could share it with his medicine or with his siblings, so they could use in on applicable occasions. The existence is that roughly all medical information systems are focused on a medical professional. It is not an open system, yet closed, with information stored in dark silos. It is customarily unequivocally homely and a user knowledge is poor. we call this eGo systems. Egoistic, hierarchical systems that do not line adult with contemporary demands. They somehow still conduct to distinction from business models that have already unsuccessful in other markets. These systems should have left a dodo approach a prolonged time ago, yet still conduct to survive.
We have to work on open, transparent, user friendly, mild systems, formed on open record standards and that foster interoperability actively. We have to pierce on from eGo systems to eCo systems. This is a time for an eCo complement that sees and treats a studious as a joining pin. A complement that is a consistent cause in any health associated movement and involvement concerning him. A pure complement that services patients and their networks independently. Putting people in assign of their possess personal health information also creates co-responsibility of course. we consider (and see it too) a lot of people are means to and wish to be in that position. Giving patients control over their possess information is an critical step in creation patients as partners.
Here is your data!
This is accurately a reason since we during a Radboud REshape Innovation Center motionless to light a non-commercial service to boost a slight of formulating these eCo systems, environment them up, validating them by systematic investigate and make them widely available. Just like a other collection like FaceTalk™, MedCrowdFund™, a AYA4-communityand AED4US we infrequently set adult services or products ourselves if we consider a marketplace acts to delayed or during too high prizes. Recently we announced is eCo system, and it is called: Here is my data™ .
Herismydata™ consists of:
- a Personal Health Record
- a village complement that gives patients, caregivers and families a event to speak about a specific disease;
- connectivity collection for many kinds of personal health inclination like Withings, Fitbit, Jawbone-Up, Scout etc, and good information visualization tools. Of march we’ll bond a FaceTalk™ and MedCrowdFund™ to it.
So it’s not a platform, it’s some-more like a use by a multiple of a best of 3 worlds. This use will give people a energy to mix a lot of their personal health (measurement) information into one place. If this information is indispensable health(care), it also can be used in one’s possess Personal Health Record (PHR). The disproportion with a lot of platforms and systems is that in Here is my Data™ people confirm for themselves who is postulated entrance and subscription to their data. In further to that, it is probable for a user to allow to connected services. For instance of hospitals measurements like blood values, or clinical notes. Next they can extend medical professionals like their GP entrance to their personal data, like for instance their weight history. This plan is a categorical spearhead during this impulse and we entice we to participate.
So now a creation flywheel is incessant in motion. For instance, we detected that during this impulse (summer 2013) a observation angle of Google Glass prevents surgeons from regulating it optimally. We yield a Google Glass group with profitable feedback and during a same time prop ourselves for impact. Because now we accept so many ideas from desirous medical professionals on how to urge their work by regulating Google Glass. This gives us a event to keep innovating.
In roughly all of my keynote presentations we stress “stop talking, start doing.” And by vital adult to this mantra we have been means to comprehend many innovative projects. Inevitably, not all of them were successful, yet we always ran a series of projects simultaneously. So utterly a few managed tarry expansion (so far). We incubated these projects in a Radboud REshape Innovation Center. And when they reached adulthood, we let them go. Back home, to a Radboud University Nijmegen Medical Center where they could be implemented into unchanging slight flows. Of march we stay in touch, to perform upkeep and to evaluate. And it is unequivocally good to see how these projects have found their approach to a daily slight of nurses, physicians, managers and house members. We collect justification by researching a efficacy scientifically and we incorporate a vision, knowledge and innovations into a curriculum.
Thinking of a subsequent stairs to take in 2014 again, since we will ‘beat’ a dodo!
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This post was published progressing as an letter in a BBVA Book Change : how a internet has altered a lives. (will be online shortly as good around OpenMind, with elements of former postings of me here on Linkedin Today.
The design is a print i took during my holiday recently in The Hague during a beach, and mutated it a ‘bit’ .