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Mail: [email protected]
Twitter: @MICVlaanderen
LinkedIn group: Microsoft Innovation Center - Vlaanderen
Newsletter: http://www.micvlaanderen.be
Etienne Sabbelaan 51, 8500 Kortrijk
Jaarbeurslaan 25, 3600 Genk
Impact van Zorg 2.0 op
onze samenleving
Frank Boermeester
MIConnect - 12 november 2013 – MIC Kortrijk
Contacteer ons!
Digital Health
&
Health 2.0
Impact of digital technologies on healthcare?
Frank Bart Leo
@fboermeester @bart @leoexter
8 converging elements:
– Wireless Sensors and Devices
– Genomics (A, C, G, T = digital)
– Social Networking
– Mobile Connectivity and Bandwidth
– Imaging
– Health Information Systems
– The Internet
– Computing Power and the Data Universe
What is Digital Health / Health 2.0?
1. Heavy duty ERP & EHR vs light consumer
technologies (web & mobile) and web 2.0 services
(social networks)
2. Technology & data for providers versus technology
& data for consumers-patients as active
participants in care
3. Automating existing healthcare processes versus
disrupting healthcare models
4. Large technology companies vs lean startups
eHealth versus Digital Health / Health
2.0?
theme
high-potential
startups
hand-picked
investors &
decision
makers
Intense & focused programme
1
7
70
Brussels BE – Supply chain & Admin I
II Antwerp BE – At-home care
Nijmegen NL – Big Data III
IV London UK – Health data integration
Coming up:
Heidelberg/Warsaw/Tallinn/Berlin
First, consider this...
(Whites Only) Class of ‘86, Kloof High School
This is how we
communicated
For information we relied on each other or
this...
... it led to this wonderful story.
...but also probably prolonged Apartheid
Instant worldwide communication
Instant answers
Always on
Access to everything there is in the world
Instant decision support
Always with me
It is amazing!
But does it apply to healthcare?
Instant communication
Instant answers
Always on
Access to everything
Instant decision support
Always with me
No. In some way’s we’re still in 1985
Why the resistance?
Reimbursement models
Liability legislation
Legacy investments
Cultural – healthcare shouldn’t be
commercial
Cultural/vested interests – doctors don’t
want to lose control/authority (and patients
aren’t assertive)
Will the healthcare system cross its Rubicon?
Fortunately something is brewing
Digital
Health is
HOT !
The startup
factories
have
arrived
In just two years, 15+ health startup accelerators &
incubators were established...
& 9 major digital health conferences
& numerous hackathons, competitions and investor
matchmaking events
http://healthstartup.eu/the-ultimate-health-
startup-resources-guide/
Spawning hundreds of new devices and apps
touching all aspects of healthcare
But will it help?
Because the reality is, the future of healthcare is not
looking so good...
•Staffing shortages
•Budgetting crises
•R&D becoming more costly
What will be the impact of digital health?
•On quality & outcomes?
•On productivity & cost-efficiency?
•On access to healthcare?
Change begins with imagining a better future
A Digital Health Manifesto
The future of healthcare, possible today
1. I want access to a transparent
market for healthcare services,
based on cost, outcomes and
reputations
- I have a right to choose the best
(and know who the best are)
A digital health manifesto
Which hospital?
Ask your GP...
Ratings on ***** scale:
•Outcome:
•Quality:
•Price:
•Experience:
Which GP?
Ask your pharmacist...
Compare
ratings & pick
your
appointment
Ask a
question,
check out
reputations,
then book
From symptom to
clinician
One to
watch...
$100 million
D round
funding
Why it matters.
2. I want access to remote/mobile
health services
- Avoid travel & waiting rooms
- ‘Always on’ monitoring (the doctor
calls you)
A digital health manifesto
Patient adjective. bearing provocation,
annoyance, misfortune, delay, hardship, pain,
etc., with fortitude and calm and without
complaint, anger, or the like.
One to watch..
Patient-Doctor
collaborationpl
atform & EHR
Instant
consult
What’s that
rash?
Otoscope
add-on for
smartphone
Eye exam
add-on for
smartphone
Diabetes
telemonitoring
All-in-One:
-insulan pump
-activity monitor
-glucose monitor
-diet monitoring
-secure communication
Telemonitoring
packages for:
Hypertension
Chronic heart failure
Diabetes
Obesity
COPD
Asthma
On the
couch
3. I want access to (and I want my
clinician to have access to)
updated/complete medical
records, medical knowledge &
decision support tools
A digital health manifesto
This is troubling
In the age of DROPBOX....
My (family’s) medical records are scattered at numerous
institutions and clinicians in Belgium, South Africa, New Zealand
and the U.K.
My new GP has no data. I have no data (except Kind & Gezin
booklets buried deep in a drawer)
But this is an OUTRAGE
In the age of Google, where the world’s information should be
universally and instantly available...
The world’s scientific community produces 1,5 new articles a
year. These are published by a small number of publishing
companies, in journals which cost universities up to
€20,000/year
Long peer review process, causes delay of 2-5 years before
publication of results
Small wonder:
13,300 researchers have signed up to a boycott of Elsevier
UK Welcome Trust & Bill & Melinda Gates Foundation want
research results to be freely available within 6 months
And here’s another OUTRAGE
In an age where “zero tolerance for error” is possible (as in
nuclear power stations, airliners, etc) using decision support
systems and quality control systems...
Death due to medical error is a top ten cause of death
EHR in the cloud
Free EHR in
the cloud
EHR going
mobile
Collaborative
EHR
Big Data &
Analytics.
Making
sense of it
all
Finding information outside the
Journals pipeline
The story of
e-Patient Dave
2007 diagnosed stage IV renal
cancer, 24 weeks to live
Via his kidney patient community
he found information outside the
‘clinical information pipeline’ about
a promising experimental drug
Took part in clinical trial,
successful treatment..
Today he’s a patient engagement
advocate
Ask your patient
community what works...
Something
for every
condition
Doctors have
communities too
Medical Search – publishers fighting
back
Using information to make
decisions and control quality
I don’t trust opinion –
I expect data-driven decisions
Show me
how
4. Empower me with technology to
take control over my health
- Doctor, take this seriously
A digital health manifesto
Genomics “Cheap genotyping...
Oxford Nanopore developed
a disposable DNA
sequencing device the size
of a USB memory stick
whose low cost, portability
and ease of use are
designed to make DNA
sequencing universally
accessible. A single
MinION is expected to retail
at less than $900
...& real-time sequencing”
Heart rhythm,
activity & sleep
is covered…
The race for
‘invisible’ &
‘always on’
Going beyond heart rate &
activity monitoring
Battle for the Starfleet ‘Tricorder’ (X-
Prize)
SCANADU
Heart rate
Blood pressure
Saliva testing
(Strep throat, etc)
Urine testing
(pregnancy,
dehydration, etc)
The Vault
Records &
communities
Digital coaching
&
wellness/fitness
programs
Chronic
illness self-
management
5. All my anonymous health data
available to researchers
A digital health manifesto
I’ve experienced thousands of
symptoms, been diagnosed
with numerous medical
conditions, taken hundreds of
medications, undergone many
scans and had many many
blood tests...
Yet, I haven’t contributed one
bit of data to medical research
Portable
legal consent
& the health
data
commons
Releasing
mobile data
Every heart
beat
Let’s look at the Belgian context...
1. I want access to a transparent
market for healthcare services,
based on cost, outcomes and
reputations
- I have a right to choose the best
(and know who the best are)
A digital health manifesto
Cultural barrier? (is competition in healthcare acceptable?)
The data is out there, simply needs to
be made available If institutions & doctors don’t release it,
patients-consumers will gather it themselves… the writing is on the wall
Barriers
2. I want access to remote/mobile
health services
- Avoid travel & waiting rooms
- ‘Always on’ monitoring (the doctor
calls you)
A digital health manifesto
Barriers:
• Reimbursement models
• Professional liability
Driver:
• International competition?
Barriers
3. I want access to (and I want my
clinician to have access to)
updated/complete medical
records, medical knowledge &
decision support tools
A digital health manifesto
Medical records: a matter of time Personal records: cultural? (driver will
be communities, collaborative EHR, or coaching)
Medical knowledge: IP, clinical trials, peer review process
Decision support: cultural? (driver will be outcomes-based competition)
Barriers
4. Empower me with technology to
take control over my health
- Doctor, take this seriously
A digital health manifesto
Cultural?
Drivers will be networks effects and
development of Apple-like
products
Barriers
5. All my anonymous health data
available to researchers
A digital health manifesto
Research benefit is too indirect…
hence informed consent needs to
be integrated in clinical process
Barriers
Use your imagination… At birth – genome, PHR, tailored lifestyle
programs kick in Adult – continuous monitoring of risk indicators,
setting personal goals, more coaching programs, choosing providers in transparent market, sharing data with patient communities and researchers
Elderly – at-home monitoring, DIY emergency care (devices, instruction kits)
Bringing it all together...
Consumers/patients - Start today
So what?
Clinicians – don’t resist, use the
technologies to improve
care/service, differentiate
So what?
Hospitals – differentiate on data and
accessibility
So what?
Policy/government – enable new
business models by adapting
reimbursement & liability
legislation; and set common
standards for interoperability and
security
So what?
Entrepreneurs – there’s a huge
ecosystem out there, keen on
supporting you
So what?
Further reading
