1. Impact van Zorg 2.0 op
onze samenleving
Frank Boermeester
MIConnect - 12 november 2013 – MIC Kortrijk
Contacteer ons!
Mail: info@micvlaanderen.be Etienne Sabbelaan 51, 8500 Kortrijk
Twitter: @MICVlaanderen Jaarbeurslaan 25, 3600 Genk
LinkedIn group: Microsoft Innovation Center - Vlaanderen
Newsletter: http://www.micvlaanderen.be

2. Digital Health
&
Health 2.0
Impact of digital technologies on healthcare?

3. Frank Bart Leo
@fboermeester @bart @leoexter

4. What is Digital Health / Health 2.0?
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

5. eHealth versus 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

6. Intense & focused programme
1 theme
high-potential
7
startups
70 hand-picked
investors &
decision
makers

7. I Brussels BE – Supply chain & Admin
II Antwerp BE – At-home care
III Nijmegen NL – Big Data
IV London UK – Health data integration

8. Coming up:
Heidelberg/Warsaw/Tallinn/Berlin

9. First, consider this...

10. (Whites Only) Class of ‘86, Kloof High School

11. This is how we
communicated

12. For information we relied on each other or
this...

13. ... it led to this wonderful story.

14. ...but also probably prolonged Apartheid

15. Instant worldwide communication

16. Instant answers

17. Always on

18. Access to everything there is in the world

19. Instant decision support

20. Always with me

21. It is amazing!

22. But does it apply to healthcare?
Instant communication
Instant answers
Always on
Access to everything
Instant decision support
Always with me

23. No. In some way’s we’re still in 1985

24. 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)

25. Will the healthcare system cross its Rubicon?

26. Fortunately something is brewing

27. Digital
Health is
HOT !
The startup
factories
have
arrived

28. 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

29. But will it help?

30. Because the reality is, the future of healthcare is not
looking so good...
•Staffing shortages
•Budgetting crises
•R&D becoming more costly

31. What will be the impact of digital health?
•On quality & outcomes?
•On productivity & cost-efficiency?
•On access to healthcare?

32. Change begins with imagining a better future

33. A Digital Health Manifesto
The future of healthcare, possible today

34. A digital health manifesto
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)

35. Which hospital?
Ask your GP...
Ratings on ***** scale:
•Outcome:
•Quality:
•Price:
•Experience:

36. Which GP?
Ask your pharmacist...

37. Compare
ratings & pick
your
appointment

38. Ask a
question,
check out
reputations,
then book

39. From symptom to
clinician

40. One to
watch...
$100 million
D round
funding

41. Why it matters.

42. A digital health manifesto
2. I want access to remote/mobile
health services
- Avoid travel & waiting rooms
- ‘Always on’ monitoring (the doctor
calls you)

43. Patient adjective. bearing provocation,
annoyance, misfortune, delay, hardship, pain,
etc., with fortitude and calm and without
complaint, anger, or the like.

44. One to watch..
Patient-Doctor
collaborationpl
atform & EHR

45. Instant
consult

46. What’s that
rash?

47. Otoscope
add-on for
smartphone

48. Eye exam
add-on for
smartphone

49. Diabetes
telemonitoring
All-in-One:
-insulan pump
-activity monitor
-glucose monitor
-diet monitoring
-secure communication

50. Telemonitoring
packages for:
Hypertension
Chronic heart failure
Diabetes
Obesity
COPD
Asthma

51. On the
couch

52. A digital health manifesto
3. I want access to (and I want my
clinician to have access to)
updated/complete medical
records, medical knowledge &
decision support tools

53. 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)

54. 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

55. 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

56. EHR in the cloud

57. Free EHR in
the cloud

58. EHR going
mobile

59. Collaborative
EHR

60. Big Data &
Analytics.
Making
sense of it
all

61. Finding information outside the
Journals pipeline

62. 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

63. Ask your patient
community what works...

64. Something
for every
condition

65. Doctors have
communities too

66. Medical Search – publishers fighting
back

67. Using information to make
decisions and control quality

68. I don’t trust opinion –
I expect data-driven decisions

69. Show me
how

70. A digital health manifesto
4. Empower me with technology to
take control over my health
- Doctor, take this seriously

71. Genomics “Cheap genotyping...

72. ...& real-time sequencing”
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

73. Heart rhythm,
activity & sleep
is covered…

74. The race for
‘invisible’ &
‘always on’

75. Going beyond heart rate &
activity monitoring

76. Battle for the Starfleet ‘Tricorder’ (X-
Prize)
SCANADU
Heart rate
Blood pressure
Saliva testing
(Strep throat, etc)
Urine testing
(pregnancy,
dehydration, etc)

77. The Vault

78. Records &
communities

79. Digital coaching
&
wellness/fitness
programs

80. Chronic
illness self-
management

81. A digital health manifesto
5. All my anonymous health data
available to researchers

82. 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

83. Portable
legal consent
& the health
data
commons

84. Releasing
mobile data

85. Every heart
beat

86. Let’s look at the Belgian context...

87. A digital health manifesto
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)

88. Barriers
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

89. A digital health manifesto
2. I want access to remote/mobile
health services
- Avoid travel & waiting rooms
- ‘Always on’ monitoring (the doctor
calls you)

90. Barriers
Barriers:
• Reimbursement models
• Professional liability
Driver:
• International competition?

91. A digital health manifesto
3. I want access to (and I want my
clinician to have access to)
updated/complete medical
records, medical knowledge &
decision support tools

92. Barriers
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)

93. A digital health manifesto
4. Empower me with technology to
take control over my health
- Doctor, take this seriously

94. Barriers
Cultural?
Drivers will be networks effects and
development of Apple-like
products

95. A digital health manifesto
5. All my anonymous health data
available to researchers

96. Barriers
Research benefit is too indirect…
hence informed consent needs to
be integrated in clinical process

97. Bringing it all together...
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)

98. So what?
Consumers/patients - Start today

99. So what?
Clinicians – don’t resist, use the
technologies to improve
care/service, differentiate

100. So what?
Hospitals – differentiate on data and
accessibility

101. So what?
Policy/government – enable new
business models by adapting
reimbursement & liability
legislation; and set common
standards for interoperability and
security

102. So what?
Entrepreneurs – there’s a huge
ecosystem out there, keen on
supporting you

103. Further reading

104. Thanks!
Email frank@healthstartup.eu
Twitter @fboermeester