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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

Email frank@healthstartup.eu

Twitter @fboermeester

Thanks!