“Embracing digital will be the key skill of any healthcare enterprise”
If you look at the digital transformation throughout all sectors, what is specific for healthcare?
After the shipping industry, healthcare is the second slowest to adopt digital technology because it is a complex network with interdependencies: sick patients consult a doctor, maybe a hospital or pharmacy involving a payer among others, all of which save their patient data in analogue silos. A digital revolution however will link these digital files into one platform. That is the biggest challenge for healthcare in the pipeline. Interestingly, companies like Amazon and Apple will showcase how to build such a platform from the scratch. I am convinced that only by connecting the silos will the health sector receive the benefits of digital.
What is essential for today’s healthcare leadership to successfully manage the digital change?
They have to look into what is next. Consumers nowadays are used to having smooth and frictionless interaction with an increasing number of services. Why should anyone make an appointment with a doctor, go there in person and wait? Digital change is not just about technology deployment. We need the leadership to change service after service, providing less friction to the system and offering patients something they did not expect their hospital could offer them. Leadership will have to convince their employees that they should embrace technology and understand that all the digital tools around will enrich their jobs, just as computers in general made us more creative as human beings.
Switzerland has recently adopted the ePD. Is that the way forward?
The ePD implies that patients are sick in a system – but truly, 99% of my life is not playing in the healthcare system but happening in the real word. Compare it to logistics: if you send a package from Bern to Tokyo you can trace it on the website of the package delivery service every five minutes. You know exactly where it is. The average diabetic or cancer patient though spends 8750 hours each year by themselves not linked to the healthcare system – so a common parcel is better off than me as a patient. Healthcare needs so-called real-world data. If I start to combine data out of my life with my healthcare experience, care providers will start to understand why I am getting sick and since they know immediately or even in advance, they can interfere in time.
Real-world data also provides the foundation for artificial intelligence (AI), right?
Indeed. We all know people suffering from headaches. If they start using an application that asks them to indicate via smartphone when they get pain and keeps track of their eating, sleeping and exercises, then after a few weeks this artificial intelligence can provide an insight like: “My headache always starts on Monday when I come back from London on Friday, sleep for longer than usual on Saturday, drink several coffees on Sunday and hardly exercise on Tuesday.” That is a delight which we, so far, never received from healthcare but AI-technology can provide us with.
In your book ‘Sick no more’ you claim that digital technologies can lead us to an ultimately preventive and personalised healthcare. Can you expand on this please?
Yes, there is so much to gain from embracing digital to the point where we can even predict what will happen and prevent events from happening. We can just look at the great example of an allergic person who is alerted about location-specific allergens like pollen in the air and is advised not to go somewhere. We should not underestimate patient empowerment in this regard.
A few years ago, blood cancer was only one disease but it is almost 100 diseases now. Based on our biological profile we can get diseases more personalised and individually create unique treatments with the help of testing populations and even develop ways to prevent sickness. That is the future of healthcare from my point of view. Data provides information, information provides knowledge, knowledge provides freedom, but freedom provides anticipation.
What role does genetic sequencing play in this regard?
A major one. Since I did my first speech on genome sequencing in 2011 people frequently ask me where and how to access their genome. Having access to our genome brings a significant challenge to healthcare because if my hospital is not ready to start adopting these new insights, I might go to another institution who can give me better care in return. The impact of the genomic revolution will be huge. It facilitates personalised and predictive medicine, and it will enable us to cure diseases.
You are an expert in the fields of cancer and genomic analysis, right now teaching as guest professor of Molecular Oncology in Ghent. Why are personally tailored cancer treatments only the beginning?
The genomic revolution started with the breakthrough in cancer medicine because cancer is a genetic disease. Genomes helped us to understand that the lung cancers of lifelong smokers and non-smokers are completely different diseases. Genomic insight is the first step into personalisation. We start to see that the same is happening for diabetes and other diseases. Soon there will be diabetes type 3, 4 and more. For Parkinson’s, we might anticipate the onset early by observing changes in laryngeal muscle tension by listening to how vocals are pronounced, and combine these incidental findings with genome data. This way, we can anticipate happenings and manifold diseases through predictive sensor measurements, be it eyesight, voice changes or tiny temperature differences in the breast in the case of breast cancer.
I cannot emphasise enough that collecting real-world data gives healthcare providers completely new ways to offer delight. In reality though, doctors often see patients with data from a device they do not trust. They should ask themselves what devices they can trust. In Belgium two hospitals already offer heart activity surveillance with an FDA approved iPhone application for ECG measurement – it is clear that patients will prefer these hospitals, so doctors should take the lead.
Is that the link to your keynote at the Swiss eHealth Summit 2018?
Indeed. Digital technologies will enable us to provide preventive and personalised healthcare. Belgium recently lost two famous athletes because their heart stopped beating at the age of 17 and 21. Even though genome analysis cannot predict when and where this might happen, simply implanting a small atrial defibrillator tackles the risk issue. On that background, quantified self-measurement devices, measuring frequently can provide better insight than the accurate single medical measurements once a year because they describe a trend. Hospitals will have to adopt this real-world data by not keeping their data in silos any longer and thus be able to anticipate illness.
You often envision “a perspective of delight” in the digital revolution in healthcare. Can you explain this in more detail please?
Delight is created if you give more than expected, the best experience so to speak. In this sense, I believe that healthcare management has to switch its mindset to: what can I offer in terms of service to make my hospital better than others and help patients to recover faster? Leaders will succeed if they start using AI tools based on real-world patient data given to them based on a trust-factor. Then they might even provide preventive care. My future vision is the idea of a personal digital twin: a virtual model of ourselves deployed to test medication or certain lifestyle changes before implementing them in our real life – just as it is common practice in the machine building industry. A virtual alter ego as personal coach.
Thank you for your insights, Koen! Look forward to hearing you in Bern.
About Koen Kas
Koen Kas is known for his stunning keynotes on the future of healthcare showing the transformative and disruptive impact of new technologies and the latest breakthroughs in medicine. His aim to make healthcare delightful, personalised and preventive is developed throughout his book ‘Sick no more’ in which he describes how to move from reactive care of the sick to proactive healthcare. The “perspective of delight” is his approach to showcase to any healthcare stakeholder how to delight his customer.
To learn more about the Swiss eHealth Summit 2018 visit www.ehealthsummit.ch