Emerging technologies such as artificial intelligences, blockchain, 3D printing or the use of augmented realities offer new opportunities to transform the way we receive and provide healthcare services. “The digital transformation will make healthcare even more human. It will enable us to provide preventive and personalized healthcare,” claims Professor Dr. Koen Kas, healthcare futurist, in an interview with MedicalView prior to the Swiss eHealth Summit in Bern (11-12 September).

Interview: Sascha Keutel

Professor Kas, how does the healthcare system of the future look like to you?
In order to talk about the future, we have to go back in time. We had once a perfect system of healthcare in ancient China. 2,500 years ago, doctors were living in villages and were paid only as long as the other villagers remained healthy. Once you got sick, you no longer had to pay. What an incentive towards an outcome based medicine. However, currently I hardly know anything about my patients.

When I send a package from Zurich to Tokyo, I can trace the package every few seconds and now exactly where my package is. Tracking my package is normal for many people. However, 8,750 hours a year my patient is not linked to the healthcare sector. He is by himself. So a package is better off than me and the patient. That has to change.

How would introducing more technology into the healthcare system change that?
Digital technologies such as wearables and sensors enable us to monitor someone 24 hours a day – even a healthy person. They allow us to collect various data of a person’s daily life such as heartbeat, activity levels, eating habits or how someone pronounces his vowels. Changes in these indicators could alert your physician that a certain medical problem may arise. In other words, using this real world health data helps us to anticipate things before they happen, before the citizen becomes a patient. Digitalization empowers us to move from reactive sick care to proactive health care.

The entire digital revolution will allow me to go back to that ancient form of care. Except the Chinese doctor will become a digital avatar of myself. It will contain my biology, my genome, my social profile, my whereabouts, and my data on how much pollution I have encountered or how much or little I moved. This digital twin will provide me with the best possible care. We will find completely new ways to make it rewarding, fun, exciting and delightful for people to know as much as possible about themselves to prevent them from getting sick.

Does this kind of monitoring not invade a person’s privacy?
Some would argue that this is Orwellian, but I don’t see it that way. Let me give you some examples: Dehydration is a big problem for the elderly, as they start to forget to drink regularly. Wouldn’t it be great to give them some kind of a patch which measures their hydration? Maybe link it to some kind of entertaining system like a TV. Now imagine that TV would remind said elderly every three hours to drink something. All of the sudden I have combined new technologies – a patch that measures dehydration – with a digital tool to protect me from dehydration.

Another example: Let’s pretend that I suffer from allergies and have to carry an inhaler with me. But it’s not a simple inhaler, it’s a smart one which is linked to the internet. Then, one day I take a stroll through a park or into a forest. However, in that park or forest there are several flowers that I am allergic to and I get an asthmatic reaction. Now, as soon as I use my inhaler, a message is sent to my co-patients that warns them not to go to the same park or forest. So, that digital tool helps me to prevent others from going through the same ordeal that I have gone through. I don’t think that that is bad, in fact I want to get alerted myself.

Of course, we will have to address the privacy and ethical issues. In the end we have to find the proper balance between dealing with my data, all that makes me who I am and the willingness to share my data with my healthcare environment. I think that the more we share our data, the more our healthcare environment is able to prevent us from getting sick.

So the digital transformation has only a positive impact on the healthcare system?
There is so much to gain from embracing more technology into the healthcare system. I truly believe that there can be a world where becoming ill is a thing of the past. Even better, a world where one starts to make money from staying healthy. Imagine if everyone knew their full biological profile. Almost everyone has certain predispositions to illnesses. Therefore insurance companies could not refuse them as that would obviously be bad for business. On the other hand, an insurer may be prepared to offer you a cheaper rate if you canverify through your real life data, that you have substantially reduced certain health risks.

Another sector that will change profoundly is pharmacy. Today, the pharmaceutical sector is built on a business model that has proven its profitability for decades. A patient gets sick and the doctor prescribes a medication. Those drugs have been tested in an artificial environment, in clinical trials in hospitals. I think there is another way. The medication for a diabetes patient is aimed at adjusting certain biological processes in the body. However, a study has shown that diabetes patients have better results with the same medicine if they also increase their daily exercise. That is something that you cannot discover in an artificial environment. That only becomes evident if you take real life data into account. Therefore we have to start to collect data of who I am at where I actually live: at home, in my car or in the fitness center. By collecting these kinds of data, all of the sudden pharma companies see that they can get insights why a drug does or does not work with me. In other words: The pharmacy of the future will no longer sell drugs to make me healthy but sell digital health tools to keep me healthy.

The digital revolution will force companies to turn around a number of business models dramatically. For some this might sound disruptive, but for me it is about delighting the healthcare customer.

What technological advancement will have the greatest effect on the healthcare system?
Genomics – without a doubt. Today, we know only the tip of the tip of the iceberg, we hardly understand it. But the exponential insights are rising up so dramatically, that the stupidest thing we could do, is not to bank on our genome. Digital tools allow us to unlock our biology. The genomic revolution will facilitate personalized and predictive medicine, and it will enable us to cure diseases. In the future, we may use various technologies like artificial intelligences to extract diseases from a human genome – and then optimize them to live long and healthy lives.

Profile:
Professor Dr. Koen Kas is a healthcare futurist and Professor of Oncology at Ghent University, Belgium. He is the CEO of Healthskouts, chairs the scientific committee of the European Cancer Prevention Org and serves on the Advisory Board of several pioneering healthcare companies. He has over 25 years of experience in the health and biomedical sciences (elucidating disease, developing drugs & biomarkers, creating digital health plays beyond the pill). Kas is driven by the aim to make healthcare more personalized, predictive, participatory, preventive and delightful. He wrote 2 books on this topic: ‘Sick no more’ and ‘Your Guide to Delight’ (koenkas.com/books)

 

On 11 September 2018, Professor Koen Kas will open the Swiss eHealth Summit in Bern with his keynote: “Digital Transformation – Implications for Healthcare, Barriers, Drivers and Outcomes”