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To have a significant impact on health care ?
How a 13 year old kid, inspired an Academic Medical Center start building a bridge!
Radboudumc
Director REshape Center for Innovation
To have a significant impact on health(care)
Lucien Engelen
Radboudumc
Director REshape Center for Innovation
To have a significant impact on health(care)
Lucien Engelen
Radboudumc
Director REshape Center for Innovation
To have a significant impact on health(care)
Not me !
•11.000 colleagues
•3000 students
•1000 beds
•ambition to ‚close’ 500
•Significant impact on health(care)
•$1 billion revenue
•First Academic Center outside US EPIC
•11.000 colleagues
•3000 students
•1000 beds
•ambition to ‚close’ 500
•Significant impact on health(care)
•$1 billion revenue
•First Academic Center outside US EPIC
foresight 5-10-25 years
Passion
approx. 500 BC
The Hippocratic oath
No mention of the role of the ‘patient’ or ‘patior’
Does mention the Godly powers of the doctor
To keep uninformed was common
Sir Luke Fildes 1887
Banking will be disrupted
Banking will be disrupted
❖ Since 2006
Banking will be disrupted
❖ Since 2006
❖ after announcement IPO in 5 hour $800M
Banking will be disrupted
❖ Since 2006
❖ after announcement IPO in 5 hour $800M
❖ At IPO net worth $8.9B
Banking will be disrupted
❖ Since 2006
❖ after announcement IPO in 5 hour $800M
❖ At IPO net worth $8.9B
❖ in beween Google and Twitter
Banking will be disrupted
❖ Since 2006
❖ after announcement IPO in 5 hour $800M
❖ At IPO net worth $8.9B
❖ in beween Google and Twitter
❖ this … is WE banking
Patients
&
Technology
Intensive
On wardIntensive
On wardIntensive
Buildable
Buildable
Moveable
Buildable
Moveable
Buildable
Moveable
Carriable
Buildable
Moveable
Carriable
Wearable
Buildable
Moveable
Carriable
Wearable
‘insideables’
It’s just getting started….
It’s just getting started….
Dokter Gadget ?
“for the first time ever in history,
we will be present when a person gets sick.
Professionals will subscribe to patients’ data"
@lucienengelen
2015 / 2016 : 8200
printing meds
M
E
D
- 70%
- 70%
Scotty beam me up !
Innovation
time
performance
0
Clayton Christensen, Harvard
Innovation
time
performance
0
most demanding use
high quality use
medium quality use
low quality use
Clayton Christensen, Harvard
Innovation
time
performance
0
most demanding use
high quality use
medium quality use
low quality use
disruptive technology
Clayton Christensen, Harvard
Neglect
time
performance
0
Lucien Engelen 2011
Neglect
time
performance
0
Lucien Engelen 2011
pre-gap
Neglect
time
performance
0
Lucien Engelen 2011
pre-gap
post-gap
Finding a new balance with the patient as partner
Time for change ?
image Mark McConnell
fór
Innovation shift
fór wíth
Innovation shift Patients
Included
PatientsIncludedisaTrademarkoftheREshape&InnovationCenter
™
fór wíth by
Innovation shift Patients
Included
PatientsIncludedisaTrademarkoftheREshape&InnovationCenter
™
DIY Health-hack
DIY Aorta mesh
Tal Golesworthy, suffers from Marfan
syndrome.
Invented mesh aortic, that got placed by
surgeons
There is a lot of doctor-talk
going on…. but
Don’t forget the (impact) on
nursing
There is a lot of doctor-talk
going on…. but
Don’t forget the (impact) on
nursing
WE are the problem,

creating our own reality,
Our patients are way ahead of us.
everyone, everywhere, always connected
NL in 5 years 100 %
already 70% follow-up
FaceTalk 2.0 launch March
Snel weer ouderwets…
The real patient engagement
complaint or
mismatch
giving
information
listening &
responding
consulting &
advising
Bate & Roberts, 2006
The real patient engagement
complaint or
mismatch
giving
information
listening &
responding
consulting &
advising
experienced based
CO-design
Bate & Roberts, 2006
PHR
eCo-system needed
PHR COMMUNITY
eCo-system needed
PHR COMMUNITY
E-HEALTH
eCo-system needed
Flipping the coin
via HC IT systems
Flipping the coin
via HC IT systems Via the ónly constante in

healthcare: The patient
+
Who you trust your data ?
Who you trust your data ?
Who you trust your data ?
Who you trust your data ?
Who you trust your data ?
Who you trust your data ?
7 weeks after 1st cup of coffee
Modules
Modules
COPD / CHF
Hypertension
Diabetes 1 & 2
Parkinsons
Pregnancy monitoring @risk
Pre and post operative
Early stroke
CML
eCo-system
eCo-system
eCo-system
5. Extension
(other disorders internationally)1. Networks of experts
2. The patient as partner 4. Transparent quality control
3. Fee for outcome
Five	
  key	
  components
% patients with hip fracture
Bloem & Munneke, Br Med J 2014; 348: g1838
% patients with hip fracture
Bloem & Munneke, Br Med J 2014; 348: g1838
Regular care ParkinsonsNet care
sit back and relax … ?
Routine personal interactions will be surpassed by
algorhytms.
The professional in primary care will move to 

a position dominated online
The ‘every day’ pharmacist will only exist in the cloud, 

the rest in supermarket.
Time will change…
Time will change…
4D
•Democratisation
•Delocalisation
•Digital
•Dollars
New alliances
New alliances
New alliances
New alliances
New alliances
New alliances
New partnerships for international transition of health
New partnerships for international transition of health
New partnerships for international transition of health
How Apple just became an Academic Medical Center
700 Million research devices
18.000 inclusions in 48h
How Apple just became an Academic Medical Center
Research is about asking.
Crowdsourcing is co-creation.
Research is about asking.
Crowdsourcing is co-creation.
“this will push into era of Patient Owned Research (POR)”
@lucienengelen
a THIS is your new backyard
We need a Global reimbursement system
a THIS is your new backyard
Digital Health(care) Transformation


The overall change that is happening
driven by digital technology
New business models
Role change / power shift
Impact of availability data
Burden of continuously change
New generation in targeted groups
Impact on infrastructure
New players
From CURE to CARE to PREVENT to WELLNESS
Delocalisation
Democratisation
Digital
Dollars
Pursuit by choice ?
❖ After initial innovators and early adopters
❖ The chasm occurs as most crucial phase
❖ Boosting the momentum is key
❖ Lagging that will kill all prior effort
❖ Succes will create a tipping point
Paradigm shift is here already
It is yet not evenly distributed
Takes 7 - 17 years
2015, the tipping point of health(care).
2015, the tipping point of health(care).
2015, the tipping point of health(care).
2015, the tipping point of health(care).
So Health(care) is changing, massively!
Oppertunities to engage!
Are YOU going to take that chance and firestart?
@lucienengelen
573.388 followers

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