Rutger van Wijk in conversation with Lucien Engelen, Edge Fellow at Deloitte Center for the Edge
In the midst of the future
An interview with Lucien Engelen about the sustainability of healthcare, the impact of technology, patient empowerment and the future that is already here. About Lucien: Lucien Engelen is former Director of Radboudumc REshape Center for Innovation and currently Edge Fellow at Deloitte Center for the Edge. Lucien is also a speaker and consultant on (technological) changes in healthcare, where patient participation in their own care process is central. Never before has healthcare faced such major challenges. Lucien’s vision and ideas stimulate us to look at healthcare differently and really bring it forward.
Technology and society
Lucien starts with the changing society: “We are aging and dejuvenating, but above all we are dealing with a changing demand for care. The demand for care is increasingly transcending the traditional medical specialties and the threshold to request care is getting lower and lower. Millennials are developing completely different care demands; for example, they are increasingly focused on obesity and mental complaints, such as burn-out and stress.
The younger generation also expects a different approach: accessible and tailored to their situation, in their own environment, and digital. This requires a different interface where technology can help. However, whereas the consumer experiences technology as a pull, the healthcare professional experiences it as a push. The reason for this is that, for the moment, this type of technology has not yet landed in healthcare and that healthcare, with its quality philosophy, naturally looks for ‘evidence-based’ quality. But this practice is not always adhered to in technology, given the rapid succession of technological developments.
New market entrants see healthcare as a consumer product with a high level of service. Using the latest technologies, they can organise care differently. By offering healthcare as a data-driven product, they enable care consumers to have their health status available continuously and in real time, in their own environment. Normally the market comes to the consumer, in healthcare the consumer has to go to the care. The new entrants are responding to this and are contributing to the realisation of ‘patient empowerment’.
Health as a service
To keep healthcare affordable, an increasing and more complex demand for care must be met while the budget remains constant. Patients will manifest themselves even more as consumers who obtain personalized care in their own environment when they consider it necessary. As a result, the demand for care cuts across the existing pillars. Decompartmentalisation of cure and care is a natural consequence. Technological innovations greatly increase patient mobility, with its own set of medical data. The changing demand for care and increased mobility result in ‘patient empowerment’. Care will increasingly be offered ‘Health as a Service’ (H.A.A.S. Lucien once called it). Technological innovations also result in shorter stays in hospital, the disappearance of waiting rooms, and a cross-specialty interpretation of medical data. Monitoring is increasingly being handled outside the hospital (heart, lung, weight). Data-driven diagnostics is already taking place, using AI, focusing on health and on preventing the demand for care.
All this makes it necessary for healthcare organisations to rethink their rationale. In addition to their current revenue model, care organisations must also look for a new role and function in the care landscape. This requires managerial courage. Hospital Bernhoven is a good example of this. They are reassessing who they work with and what their mutual added value is. A hospital will always exist, but increasingly for high-tech, medically complex interventions.
How to cope with all these changes? Lucien: “What is needed is a change in attitude and behaviour. Look for what is possible and don’t start by identifying what is impossible.” This means, for example, working on issues on an interdisciplinary basis, and untangling these issues with all people involved, instead of blaming the ones that are not present. This requires a different type of managers, who should be more tech-savvy and entrepreneurial. Rather than the ball being in the court of ICT, accommodation or FM, collaboration will ensure that the transition to a new care environment succeeds. This does not require a system change, but changing the way we think from silos to care chains, organised around the ‘patient journey’. A way of thinking that focuses on prevention and health, facilitated by the government with a well-designed system that ensures safety.