Europe's biggest health start-up..

"Do not look at me, but see me. Do not hear me, but listen to me" Reflecting a bit on 2015, i highlighted this quote of Rene Tabak because we should start building healthcare based on the needs of patients! In this essay i am addressing the ongoing digital health(care) transformation we are facing right now, and how this could help to incorporate the real patients needs.

One of the main reasons for existing business to fail is often neglect, in all kinds of variations. Neglect to (re)act on the change they see surrounding their branches or company. Neglect because they want to keep things as they are, not accepting there is a 'new order' coming up. History has some strong examples like Kodak who, by neglecting the fact that the market was ready for digital photography (actually invented by themselves) but their business model wasn't yet, put themselves out of business. Meanwhile this example is commonly referred to a "a Kodak Moment" based on their own marketing tagline, to photograph life event, as this was their own 'life-event’.

Today there is a lot of ‘neglect’ in general for healthcare branche, in a way i described as a “pre-gap” phase.

We tend to think technology and societal change affects only óther ‘man’s jobs and professions and healthcare is ‘to complicated’ for this. Or the -always present- argument of ‘people will not go online for healthcare’. My friend Jeroen Tas (now CEO Philips Health informatics) 15 years ago has lead the transformation into electronic banking for Citibank.  He recently said to me that people called them ‘nuts’ and using the same arguments in healthcare now as they did back then to think people would go online to do their banking.

If we take the spectrum of medical grade devices at one end and low-cost consumerlevel at the other end, we will see the emergence of the pro-sumer device. They will be validated into ‘serious devices’ as Prof Bart de Moor KU Leuven coined it. Low-cost devices that will hit the market, giving consumers access to devices with features that in the past were only available to professionals.

With the help of wearables, insideables etc patients will be able to create data 24/7, allowing professionals a subscription to their data. Also they will create more data than all healthcare professionals all together. 

We’re in the midst of the Fourth Industrial Revolution where everything will be connected to everything. As Swaab pointed out at the WEF, innovations now will come as a tsunami in stead of small waves, they will accumulate and and we’ll go from product innovation into system innovation. Entrepreneurship and agility will become key-factors of success and survival in a world where the fast fish will eat the slow ones, as opposed to the big fish that will eat the small ones.

We have to innovate our way into a sustainable future in all three pillars: consumer, technology, and business model. From a medical standpoint of view Academic Medical Centers are the experts on the medical aspects of it, from a business perspective however we should partner with leading business schools like Nyenrode, Tuck School of Business or Harvard and on the patients side they are the expert in having the condition or disease. 

Meanwhile in healthcare we keep trying to become better, cheaper and faster. I honestly don’t think this is the way to go. Sure, we will have to continue to get better, but our mindset has to change. We have to take bigger leaps.

Over the past months i have been working on a model to speed up things in Radboudumc and our network. And at Exponential Medicine last November in San Diego I presented our approach that comes down to 3 main points.

• ”Digital first, physical next”
• “Become obsolete”,
• “if we won’t, others will!”

Trivial in this vision is the aim to become obsolete, with the help of digital technology, for that PART of our served population that ARE empowered enough to use technology. We would free up time, resources and energy to serve those who are NOT able to or can’t or are in need of ‘in real life’ visits. This also helps in the doubling of the healthcare demand we’re facing.

Also, i expect Health(care) to become a software ‘business’ within the next decade, so we will face a huge digital Health(care) transformation on a global level.

By creating an onset for the ambition to run everything ‘digital first, physical next’ we could serve a group ‘tomorrow’ that is already out there, that can’t wait to get healthcare the same way as their other daily ‘business’ like booking hotels, airtravel, banking and music. So we will not create a digital-only healthcare, but will flip the coin from adding 'some' digital options into a two-sides approach by default encouraging people to start digital whenever possible.

Also with that attitude we’ll create the needed ‘artificial’ sense of urgency take (bigger) and additional steps than the current process improvement, we have to leapfrog some of these processes: i.e. the rationale for my “we have to become obsolete” as a strategic heading. With that encouraging our thinking beyond 'doing the same a bit differently'.

The tagline “if we won’t, others will” referring to new players in the market, or other healthcare players that wíll pivot their process, I wanted to point out the stop delaying the moment to really start, as opposed to only talk about it, there is to much talking going on. And on the other hand in the ‘outside world’ startups will find their way at lightning speed, including funding at levels we can only dream of. Healthcare lacks a true start-up culture, although we are trying to get some skin in the game with i.e. our Rockstart Digital Accelerator Nijmegen.

As a matter of fact i envision us to act as a actual startup (a huge one thought with 1B$ revenue and 11.000 people;-) reinventing every step, asking questions from scratch, and trying to create our own competitor. And that is exactly what we will start doing as of January first in our REshape Center. 

This all will not only affect our delivery model, but also will strongly impact our research models and even the needed business models i.e. crowd funding for research by patients unions and open access publishing. Clear step are being made i.e. by the Netherlands Organization for Scientific Research (NWO) by issuing that non-public-access research might even face refunding in the future.

Subsequently we have to safeguard these (new) processes in the educational models i.e. curricula for freshmen in medical and nursing school (we kicked off a new curriculum at Radboudumc this September including the above), but also have to serve the ’sitting crew’ in CME programs.

Next we have to train our current ánd new leaders into an era that will be characterized as what I coined “the era of never-ending change”.

For this 5 years ago we created our REshape Center to explore, understand and test new options for health(care)

In all of this we have to incorporate the targeted group right from the very first beginning : patients. So #patientsincluded should be the default, what else ? ;-) . Just like we did with the (Dutch) ICT & Health magazine i'm guest editor-in-chief 2015-2016 for, where patients will add a review of every article in it. Or like the BMJ started in 2014. 

Let me stop by circling Rene Tabak, one of the patient advocates that has been within our REshape Center’s network for years. At one of our TEDx’s early 2012 after sharing a lot of his own experiences facing a heart disease he addressed the professionals in the audience : "Do not look at me, but see me. Do not hear me, but listen to me" referring to the mismatch he faced between medical needs, and real patient needs.

Adapting that line to ask my fellow professionals to not only listen to what is ‘out there’, but really adapt and translate that into your own daily practice. Go out and stop attending only your own ‘possy-conferences’ as I coined them, organized by your peers and step out of your comfort-zone to visit others too, i.e. on the digitization of healthcare.

Take a step back and analyse your own behavior in society, how digital has your journey of life became and how does that relate to your own professionals practice.

Wishing you great holidays and a healthy 2016!@lucienengelen