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  • Professor Leonard Witkamp

Why hospitals are an old fashioned idea and ripe for disruption

Current healthcare systems – which are based on brick and mortar, in-person, hospital-centric models – are ripe for disruption in order to alleviate these pressures and to serve future populations.

Healthcare systems today are facing monumental challenges. A significant increase in demand caused primarily by growing and aging populations, coupled with increased access and availability of healthcare treatments is putting unmaintainable pressure on healthcare providers.

Slowly but surely, innovative technology is leading major transformations in healthcare, and there are five significant changes that I expect to see in the foreseeable future.

1. We’ll have longer appointments with healthcare professionals, less often

With demand on healthcare systems growing, a large bulk of senior medical specialists’ time is spent practicing routine care in hospitals that could be carried out by paramedics, nurses, optometrists, etc instead.

Over the next 15-years, I expect that technology will be employed to support healthcare professionals with some of this routine care. As a result, we will see senior medical professionals become more specialist and they will have more time to spend with the patients that need their expertise most.

Although I foresee a future where healthcare specialists will see fewer patients, people will still need healthcare services, but not necessarily in-person.

2. Virtual care: Hospitals will no longer be the center of healthcare systems

For example, at KSYOS TeleMedical Center, the first virtual hospital in the Netherlands, we deliver a teledermatology service. Instead of referring a patient physically to a hospital, a general practitioner may choose instead to take photographs and send them to the dermatologist that the patient would otherwise be referred to physically. From there, the dermatologist will make an assessment.

We have seen a 74% reduction in physical referrals as a result of this teledermatology service. Moreover, it is common for waiting lists for dermatology specialists to be weeks long – months in some countries – but teledermatology reduces the whole process to just 4-5 hours, and at a quarter of the regular costs.

Similarly, we use telemedicine to help control retinopathy in diabetic patients, resulting in a 96% reduction in physical referrals to the hospital.

Over the next few decades, as telemedicine and other innovative health technologies advance, I expect to see more and more virtual healthcare solutions gradually introduced to healthcare systems.

3. Digital processes will improve efficiency

Healthcare is overdue for a digital revolution to help improve efficiency. Several other industries have been transformed, from finance, travel, and hospitality through to retail.

An important transition that I foresee as more and more health data becomes available, is the introduction of intelligent systems that will simplify existing complex processes, and support healthcare professionals with decision making.

That doesn’t mean that we will be treated by robots instead of humans. In fact, I think the main role of the healthcare professional in the future will be to provide the human touch. Technology will make it possible to propagate the human touch in healthcare because if a healthcare professional rushes through 30 patients in an afternoon, it leaves little time for personalized care. However, if you replace these 30 patients with just four that really need your help, it introduces a human element back into treatment for those patients that will benefit most from it. And I expect that would be much more rewarding for the healthcare professionals too.

4. Sharing health data

With the systems in place at the moment, it is challenging for healthcare professionals to share data with each other, or between hospitals. In an era where sharing data has never been easier, this is a huge frustration for doctors and patients alike. In order for healthcare professionals to share patient data efficiently, they will need access to secure, reliable and effective tools that allow them to do so.

Meanwhile, the potential of consumer health trackers means patients will be generating a lot more health data themselves that is not being shared with their healthcare professionals. I expect that in the next 5-years or so, as these healthcare devices improve in quality and produce medical grade data, they will be incorporated into treatment plans. Health data could be shared remotely, so patients may no longer need to visit hospitals for routine tests that could be performed accurately from home.

Before we can tackle patients sharing appropriate data with their healthcare providers, it’s important that it is made possible for healthcare professionals to share data with each other effectively first.

5. The growing role of prevention in healthcare

As populations get older and live longer, some of the major illnesses we see affecting people, and which are straining health systems, are in part caused by lifestyle choices and are preventable. For example obesity, cardiovascular diseases, osteopathy, and even depression are all impacted to varying degrees by addiction to food, tobacco and lack of exercise.

As such, prevention is an integral part of healthcare, from testing blood pressure and cholesterol to educating citizens about the risk of over-eating, smoking and the benefits of a healthy and active lifestyle.

The introduction of initiatives that focus on prevention will likely increase in the coming years with the aim of avoiding people becoming unwell in the first place, and to improve health outcomes.

The biggest challenge for moving towards healthcare systems that focus on prevention and population management is that it requires behavioral change on an incredibly large scale, which will be a huge hurdle, and one that shouldn’t be underestimated. It will require the healthcare industry, education providers, policy makers, and insurance companies to work together and this will take many years.

Overcoming the barriers

With so many innovative solutions coming out of the healthcare industry designed to help alleviate the unrelenting pressure on healthcare systems, what is holding back the transitions that we need to see? A significant factor is that funding is currently allocated based on traditional healthcare models, it is very difficult to scale-up the innovative technology that we’re seeing on a large scale.

Unlike other industries that have been suddenly disrupted by a single type of technology (for example what Airbnb did for the hospitality industry, or what Uber did to the transport industry), change in the healthcare industry will be an evolutionary one, not a revolutionary one.

I am confident the industry will adapt, and that the healthcare industry is going to facilitate and embrace change as it evolves into something very different to what we see today.

Professor Doctor Leonard Witkamp

Prof. Dr Leonard Witkamp is a former dermatologist and director KSYOS TeleMedical Centre, the first virtual hospital in The Netherlands. He has been appointed by the Royal Dutch Medical Association as Professor in TeleMedicine at the Department of Medical Informatics of the Academic Medical Centre in Amsterdam.

He founded the KSYOS organisation in 2001 to develop, investigate and implement large TeleScreening, TeleConsultation and TeleMonitoring programs. KSYOS works together with a network of over 12,000 healthcare workers in TeleDiagnosis, TeleConsultation and TeleMonitoring. KSYOS yearly performs over 100,000 Teleconsultations.

Over 1,500 patients are seen on a daily basis. His experience as research fellow in market research, as university professor and researcher, as practicing dermatologist and as director of KSYOS has been an excellent base for his present function as Professor in Telemedicine.


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