Lucien Engelen’s 4D

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3 question to Lucien Engelen, the founding director of the REshape Center for Innovation, advisory to the executive board of Radboud University Medical Center in Nijmegen the Netherlands.

Healthcare is 80% logistics. Only in 20% it’s medicine.

Delocalized, democratized, digital and… dollars. That’s your vision of healthcare in the future (4D). Could you describe it?

I think healthcare will become delocalized over the course of next few years where we – due to technology – will be able to do things in the different places. No longer you need to go to the hospital or another healthcare institution to get help. Things will shift.

Democratization means also that the data is getting into the hands of citizens and patients themselves. They get access to it, they can collect it by themselves. In this way, healthcare institutions will have to make a subscription on the data of patients, not the way around.

The third component of 4D healthcare is digital. Digital healthcare have two meanings: in term of technology and in term of speed. To get an information you don’t have to travel, get to the place where the data is stored. All you need is to open your computer. The distance barrier is the thing of the past.

And finally dollars… new big players are entering healthcare arena, pouring in millions of dollars to get foot in the door. We will see a flow of all kind of new different technologies that will change the game rules we know (hence the new Apple Watch Series 4 with FDA-cleared ECG).

We are in the era where disease patterns are being recognized based on data analysis and there will be a continuous monitoring of every aspect of the life. In my opinion, healthcare is 80% logistical operations, for example: somebody has to go to the professional and wait in the waiting room or the other way around; doctor has to get an access to data and analyze it. The rest, 20% of healthcare is medicine which is extremely important. The point is to automatize the administrative tasks so that doctor can focus on medical aspects.

What are the biggest advantages of digitalization in health and care?

Digital health can also bring efficiency but I think first of all it will bring comfort for people that want to get healthcare in a place where they want to, at the moment they need it and also in the way they wish to have it. Apple, Google, Amazon have an experience in creating a great user interface. And I think that’s exactly broken in healthcare. Healthcare interface is not anymore calibrated with the outside word. Societal recalibration is needed to create a better user-experience. That’s the priority we should focus on, otherwise healthcare will be revolutionized by the companies from the outside like Apple, Amazon or Google.

If some of the processes will be automatized, how the work of healthcare professionals will change?

Profoundly. Doctors’ work will be augmented by all kinds of data, information and visualizations. That is also why I called my book “Augmented health(care)™”. There are three pillars of this augmentation. From the medical perspective – decisions based on health data made by the professionals will include patient’s opinion. The data coming out of the care components, for instance from the homes of people, will become a part of the care. In the middle part of augmented healthcare is the lifestyle data. All of the three elements will create a set of complete information visualized in the way that we understand it, including a great user interface for that.

timelime-3-bolletjes (1)Timeline of disruption. From May 2017 till March 2018 big tech companies have made significant steps into healthcare. Amazon and Apple are planning to build clinics for its workers, Apple has launched Apple Watch Series 4 with ECG, atrial fibrillation monitoring and fall detection. What’s next?


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