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In a weekly column, alternately written by Lucien Engelen, Mary Fiers, Maarten Steinbuch, Carlo van de Weijer, and Tessie Hartjes, E52 tries to find out what the future will look like. All five contributors – sometimes accompanied by guest bloggers – are working on solving the problems of our time. Everything to make Tomorrow Good. This Sunday, it‘s Lucien Engelen’s turn, with a special one, on the occasion of publishing his new book “Augmented Health(care)™, the end of the beginning”. Here are all the previously published columns.

The world is changing, society is changing, technology is changing, and so health(care) is. And it does so at ever increasing speeds. Platforms like Facebook, Youtube, Spotify, and Amazon have entered our life and are here to stay. Many of these platforms did not exist 15 years ago, and some of them will no longer exist 10 years from now. And now health(care) is the next stop for the digital transformation into what I named: Augmented Health(care)™

Sharing with you, as my E52 community, two chapters of my new book: Augmented Health(care)™, “the end of the beginning”. Next to the introduction-chapter below you also could read “the Prologue.”

For the research of the book I identified 5 major themes:

Theme 1. What’s been going on?

In 2007 the first iPhone was introduced, changing the way we interact with technology forever. Who would have figured, back then, that these powerful supercomputers in our pocket would become an important part of data collection for medical purposes and clinical trials? The world has changed funda-mentally since the turn of the century: technology grows with exponential speed. “Omnia mutantur nos et mutamur in illis”: Everything changes, and we change with it. That notion seems even more true in 2018, and beyond. The way we interact with new technologies has changed our social, cultural and economic systems, health(care) included.

We are entering a world of Augmented Health(care)™, as I coined it. What are the main changes I have witnessed in healthcare and technology in the past eight years I’ve been in health(care) innovation and part of ‘the system’? Theme 1 will touch upon some major developments, from an international perspective. With a number of noted guest contributors, I will dive into the emergence of #patientsincluded™ and #nurseincluded™ as an unstoppable force, the digitization of the healthcare sector and the need for alternative business models, coming from international tech companies such as

Apple, Amazon, Google, with a strategic focus on healthcare. We will start with the earliest uses of the Internet in healthcare – mostly as a source to search for medical information – and fast forward to crowdsourcing medical data and novel ways of doing clinical research. We will share about the future of real estate. At Radboudumc, we are about to begin the biggest real estate transformation in years, building a hospital that is fit for the future. But how do you build a future-proof building in an era of exponential technology? It’s like building a plane in mid-air. As Rene Bleeker points out: a strategy must be built on bricks, bytes and human behavior. These are not abstract visions, these are the things that are happening right now, this very moment. Want to know what’s been going on in healthcare? Start here.

Theme 2. Cracks in the system

As we continue to live longer, we are not necessarily living healthier: more and more people develop one or multiple chronic diseases, which will cost money and demand services in terms of healthcare. We will have a huge number of people that are moving into retirement age: a “silver tsunami”, as HIMSS CEO Hal Wolff calls them in his contribution. These are the economics that will drive the next ten years in our healthcare systems.

What are these “cracks” in the system? How do they manifest? This theme will not only focus on the increasing pressure that (inter)national healthcare systems are facing. As I will argue in this book, our medical systems mostly consist of logistic processes I reckon 80%: only 20% of our time and energy goes to medicine. Solving the current inefficiencies in this system could be a possible solution. Therefore, we need a new perspective on supply chain management, providing service and customer excellence, as experts from outside healthcare are eager to point out (see, for example, Michiel Muller’s vignette: “We need to optimize the chain with the use of data”). At the same time, digital healthcare seems like a different planetary system. We come up with separate names, separate reimbursement models and separate workflows when it comes to digital health(care). And as long as a separate digital portal or an app per institution to access your medical records is needed, a challenge (at least, in the Netherlands) remains, we will continue to experience inefficacy and information asymmetry in health-care. The only solution to stud these cracks in our system is to fully embrace the digital transformation.

Theme 3. Taking part is the only way

“Stop talking, start doing.” It seems so simple, yet most people find it so hard to make the first step and just begin. It’s is one of my mantras that I must have shared almost a thousand times on stage: taking part is the only way. We’ve seen over and over again the hurdles we’ve discussed in all of those sessions prior to the start, in the end, appeared to be different ones. You have to get your feet wet, get into the mud and take the messy, slippery road of innovating in healthcare. It is the only way to excellence in the end. You neither can learn how to bike from a book, can you?

In this theme, the learnings and experiences from the REshape Center, the innovation department at the Radboud University Medical Center that I was granted to found in 2011, take a central place. How do you “manage” innovation? How do you prepare an organization – in our case, a university medical center with 13.000 students and professionals – for the future? What can you learn from our mistakes? Theme 3 takes you on a – by no means all-encompassing – guide for innovation. What is a “moonshot project”? Why is focusing on the “day after tomorrow” so important, yet so hard for most teams or organizations?

How do you tackle resistance in your team, amongst your colleagues or in your board? What is the role of leadership and management in organizations when it comes to innovating? For those interested in our journey of innovation at REshape: I have included some of my memories and recollections in this theme as well, by including some of my Linkedin blogs (still stunned it has over 750.000 followers already) from earlier days to give some perspective. I have not only been using Gartner’s Hype Cycle to handle the predicted breakthrough moment of technology, but we used it internally as well, as I noticed that every innovation project was roughly going through the same phase of the Hype Cycle. I started to try to influence a specific portion of it, more as a guidance of how projects evolve. Speeding up the Hype Cycle, in my opinion, could increase the actual access to and use of innovation and adoption of the #patientsincluded™ model.

Theme 4. Digital Strategy

The digital evolution is impacting the way we work, the resources we use, and the nature of technology itself. If organizations hope to respond swiftly to change, reap the business benefits of new digital innovation, and attract top-tier talent in the future, their operating model must evolve accordingly into a digital TOM (Technological Operating Model). For a lot of organizations, however, the digital strategy that they have identified does not fit their current (traditional) OM: it’s like trying to fit a UK plug into a US Power socket or to fit a square peg into a round hole as they say. I have joined forces with Deloitte, to translate into health(care) the nine significant shifts they’ve identified that will influence the model of the future and that need to be discussed in conjunction with each other since they are highly interdependent. This theme is the strategic core of this book. It is not a handbook, nor a blueprint or a generic approach. Consider this ‘Digital strategy’ merely as the start of a framework for the different steps one could set to see whether or not they’re ready for the things that lie ahead and to offer some assistance.

Theme 5. This revolution will not stop

A book on healthcare innovation would not be complete without a brief look into the future. I am grateful for an international team of guest contributors to share their vision of healthcare in 2030, whether it is the future of pharmaceutical care (Claudia Rijcken), the digital skillset that is needed in an exponential age (Daniel Kraft), how an average day of a general practitioner looks like (Bart Timmers) or how Maarten Steinbuch sees the future. These vignettes will transpose readers to the future of healthcare. In this final theme, I share my own vision on the future of healthcare as well. We will be entering an era of Augmented Health(care)™, a layer of smart technology and data that comes around us and that helps us make better decisions. With us, I mean everyone who is involved in the healthcare: care providers, patients, family, government, industry and informal caregivers. Whether that layer is projected via glasses or in another way such as on your phone, refrigerator or smartwatch, is not that important. What matters most is that in the future, everyone will have exactly the information they need to be able to do their profession or work well, follow a therapy well, or receive the right information at the right time. With Augmented Health(care)™ healthcare professionals and patients are given digital tools to process and analyze the ever-expanding oceans of data in a meaningful way.

Read more about the book