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Lucien Engelen (@lucienengelen)
•Director Radboud REshape & Innovation Center
•Head Regional Emergency Network
•Advisory to the Executive Committee
•Faculty Singularity University / FutureMed Silicon Valley
•NOT a doctor, but extremely IMpatient
•& a ‘bit’ of a rebel ;-)

360 and Above
Not me !
Lucien Engelen (@lucienengelen)
•Director Radboud REshape & Innovation Center
•Head Regional Emergency Network
•Advisory to the Executive Committee
•Faculty Singularity University / FutureMed Silicon Valley
•NOT a doctor, but extremely IMpatient
•& a ‘bit’ of a rebel ;-)

360 and Above
Niets doen is geen optie : 2020
•11.000 colleagues
•3000 students
•1000 beds
•ambition to close 500
•Significant impact on health(care)
•$1 billion revenue
•First Academic Centre outside US EPIC
•11.000 colleagues
•3000 students
•1000 beds
•ambition to close 500
•Significant impact on health(care)
•$1 billion revenue
•First Academic Centre outside US EPIC
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
performance
0
Clayton Christensen

time
performance

anding use
most dem
quality use
high

quality use
medium
quality use
low

0
Clayton Christensen

time
no
lo
gy

quality use
high

di
sr

up

tiv
e

te

ch

performance

anding use
most dem

quality use
medium
quality use
low

0
Clayton Christensen

time
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Linear à

1996
Market cap of
$28B
Revenue ~$16B
Employees
140,000

Exponential
Linear à

1996
Market cap of
$28B
Revenue ~$16B
Employees
140,000

Exponential

2012
Market cap <
$100M
Revenue ~$6B
Employees
17,000
Linear à

1996
Market cap of
$28B
Revenue ~$16B
Employees
140,000

Exponential

2012
April 9, 2012
Market cap < Facebook Acquires
$100M
Instagram for $1B
Revenue ~$6B
13 employees
Employees
17,000
Linear à

1996
Market cap of
$28B
Revenue ~$16B
Employees
140,000

Exponential

2012
April 9, 2012
Market cap < Facebook Acquires
$100M
Instagram for $1B
Revenue ~$6B
13 employees
Employees
17,000
Dorm Biotech

Garage Pharma

Garage Tech
Niets doen is geen optie : 2020
REshape Labs

Demand driven
relates to strategy

Design

Implement

REshape

Spinn-out
Business model

Scale

PVI

MOC’s
Moments of Choice
New Information Layers
Internet of Things
Sensor Networks
Health Data
Quantified Self Data
Crowd Sourced Info
Location
HTML (text)

Video

Social Profiles
Exponential going exponential
Niets doen is geen optie : 2020
Assumptions rule!

..Average doctor interupts patient
within 18 seconds..
…premature closure was
the single most common cause for
error ...
Diagnostic Error in Internal Medicine
System & Cognitive

No-fault only

System error only

Cognitive only

28%
46%

19%
7%

chance for improvement 74%!
h"p://archinte.jamanetwork.com/ar3cle.aspx?ar3cleid=486642
Cleveland Clinic doctors’ review of initial diagnosis

disagree(with(ini5al(diagnosis(

find(need(for(further(tes5ng(
recommend(major(changes(to(treatment(
plan(

11%

15%

18%

recommend(moderate(changes(to(
treatment(plan(
recommend(minor(changes(to(treatment(
plan(

26%

22%
Niets doen is geen optie : 2020
What if Watson proves
to be right 90%
and Physicians 50%?
Help is on the way
Google’s health venture for eternity

CaLiCo
Californian Life Company
Vinood Kosha

The best 10% MD will train new systems
that will bionical assist and amplify MD’s.
Shift to computerization started:
Airplanes, Stockmarket and Car driving
80% of what MD’s do can be replaced with
better average.
Challenges

Medical Data crime
Digital virusses in humans
Virusses have become biological software
2010 4 billion connected devices,
2020 will be 80 billion
Niets doen is geen optie : 2020
Lucien Engelen
Lucien Engelen

Mobile network operators will
become obsolete
Lucien Engelen

Mobile network operators will
become obsolete
Cable companies will offer
nationwide WiFi coverage
Grown up with a mouse

In 20 years majority of healthcare
consumers will have used a computer
for 40 years of their live and
by then the internet as #1 source for
Health(care)
Lucien Engelen
Lucien Engelen

but ...
Lucien Engelen

but ...
the BIGGEST change will be
Lucien Engelen

but ...
the BIGGEST change will be
Patients!
Niets doen is geen optie : 2020
HEALTH DATA

Patient care, measurements are mostly
EPISODIC & REACTIVE …
HEALTH DATA

… when they need to be
CONTINUOUS & PROACTIVE
We have to move to stage ‘Zero medicine’

survival rate
10%

Death rate
90%

late detection

death rate
10%

survival rate
90%

early detection

Daniel	
  kra@	
  
Lucien Engelen
Lucien Engelen

We’ll subscribe to patients’ data
Lucien Engelen

We’ll subscribe to patients’ data
health(care) will be a data-science
Lucien Engelen

We’ll subscribe to patients’ data
health(care) will be a data-science
More change from data science in 10
then medical science in 100 years
Coming to a ‘hospital’ IN your home
ECG made by iPhone sleeve
Diamond Concept Device

Piezo-ceramic
Stethoscope
Electrocardiograph((
(ECG(Sensor(
Posi=ve(Electrode)(
Electrocardiograph((
(ECG(Sensor(
Nega=ve(Electrode)(
Photoplethysmograph(
(PPG(Sensor)(
60 mm

Infrared(Thermometer(
Slide 11
39
39
Records

Exams

Labs

Vaccines

Rx

Drugs

History

Environment

Vitals
The idea of going down to your doctor’s office is going to feel
as foreign as going to the video store...
PHR

COMMUNITY

E-HEALTH
PHR

COMMUNITY

E-HEALTH
PHR

COMMUNITY

E-HEALTH
initiative of
PHR

COMMUNITY

E-HEALTH
initiative of
e-health integration (i.e. for research)
e-health integration (i.e. for research)
e-health integration (i.e. for research)
e-health integration (i.e. for research)
Patient at home
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Prototype CPR/AED Glass
Prototype CPR/AED Glass
61
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
“The	
  only	
  permanente	
  in	
  the	
  future	
  	
  	
  
	
  	
  will	
  be	
  :	
  change.
	
  
“The	
  only	
  permanente	
  in	
  the	
  future	
  	
  	
  
	
  	
  will	
  be	
  :	
  change.
	
  
“The	
  only	
  permanente	
  in	
  the	
  future	
  	
  	
  
	
  	
  will	
  be	
  :	
  change.
	
  The	
  only	
  way	
  to	
  cope	
  with	
  that
	
  	
  is	
  :	
  together”
	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  @lucienengelen
Niets doen is geen optie : 2020
€1699,€300,-
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
REshape FutureMed trip 2-8 November 2013
Niets doen is geen optie : 2020
Niets doen is geen optie : 2020
@lucienengelen

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