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The Way of the Dodo
The dodo bird has become a metaphor for extinction. A one-meter-tall, pigeonlike, flightless bird native to the island of Mauritius, the dodo died out in the late 1600s because Dutch settlers relied on them for food and brought in alien species that killed the ground-laying bird’s young. In healthcare, what will “go the way of the dodo”?
Will technology and the Internet decimate the healthcare industry as they have done to the music and travel industries? Will nurses be replaced by robots? Will doctors be replaced by smartphone apps? A shift is surely occurring, but we still need medical professionals, real people with real compassion giving great care.
Three trends threaten to make much of today’s healthcare obsolete: the Internet has made patients more engaged in their own care, technology is advancing exponentially, and social media is a dominant force in daily life. Responding to these trends, the Radboud REshape & Innovation Center has initiated a range of innovations: HereIsMyData, a service that consists of a personal health record, a community aspect, and an eHealth connector; AED4US, a crowdsourced database of locations of automatic electronic defibrillators; FaceTalk, a videoconference system that allows healthcare professionals to consult securely with patients and colleagues; AYA4, an online community for young adult cancer patients; and webcasted conferences — TEDxMaastricht, TEDxNijmegen, and 360andabove — to share ideas, dreams, and examples.
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With these projects, the Radboud REshape & Innovation Center is trying to “outsmart the dodo” and avoid extinction by creating “futureproof” healthcare.
Location and duration of stay
Location is becoming less important in healthcare. Mobile technology and cheaper testing methods are enabling us to monitor patients in their own homes. And procedures that required up to 15 days of hospitalization a decade ago only require three days today. In the last century, technology brought healthcare out of people’s homes and into centralized hospitals, but now technology is doing the opposite, bringing healthcare back into people’s homes.
Two-party research in a three-party world
Until now, health research has mainly been done by the pharmaceutical industry and researchers. Now, patients are doing their own medical research. MedCrowdFund, for example, is a social platform where patients can design and find funding for innovation and research.
Being a good doctor won’t be good enough anymore
People are no longer choosing healthcare providers based only on the quality of medical care they or their personal acquaintances have received. Patients now routinely research their physicians online and post reviews of their healthcare experiences. Fifty percent of U.S. smartphone users use their device to look up health information. Doctors can gain a competitive edge by providing both text-based and video web content.
Healthcare providers need to stop assuming they know what patients need, or, from an industry perspective, what healthcare professionals need. Listening is asking. The Radboud REshape & Innovation Center appointed a chief listening officer in 2009 to interview patients, family members, and caregivers about how the Center could help them. Feedback from these target groups has significantly benefited the Center’s healthcare projects. The Center also teams with innovators nationally and internationally, finding these likeminded collaborators through the Internet and particularly through social media.
Rules and regulations
Time-to-market for medical devices is much shorter today than it used to be, and many more devices are being released, leaving regulatory agencies to play catch-up. In addition to implementing regulatory requirements for digital healthcare innovations, policymakers should make open technical standards mandatory for information exchange and the reuse of existing and proven applications. And the financial system must be improved to ensure that the talented developers and producers of digital healthcare innovations are well compensated for their contributions.
Huge amounts of data are being generated by information systems, medical records, tracking devices, lab results, and imaging resources. But all of this data currently resides in inaccessible silos where patients can’t make use of it. We need a central repository where individuals can access their own data in a comprehensive way, mine all of the different types of data, and understand their meanings, interrelationships, and interactions. We need open, transparent, user-friendly, and cooperative systems based on open technology standards that actively promote interoperability.
To speed the evolution of personal health data systems, the Radboud REshape & Innovation Center started a noncommercial service to set up these systems, validate them scientifically, and make them widely available. The Center recently introduced HereIsMyData, a service that provides a personal health record, as well as a platform for patients, caregivers, and families to talk about a specific disease, and connectivity tools for personal health devices, data visualization tools, and the Center’s own FaceTalk™ and MedCrowdFund™.
This initiative has made the Center a clearinghouse for developing, implementing, and evaluating medical innovations. Last summer, upon discovering that the viewing angle of Google Glass prevents surgeons from using it optimally, the Center provided the Google Glass team with valuable feedback — and continued receiving and implementing ideas from inspired medical professionals worldwide on how to use Google Glass to improve quality of care. This approach will enable the Radboud REshape & Innovation Center to beat the dodo.
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Lucien Engelen is the Director of the Regional Acute Healthcare Network at Radboud University Nijmegen Medical Center in the Netherlands, as well as an advisor to the executive board on questions relating to changes in healthcare, enhancing patient participation, and working toward participatory healthcare. He is the founding director of the Radboud REshape & Innovation Center, an institution that creates, develops, and implements healthcare innovations.