Healthcare in the digital age

As healthcare systems and companies alike seek to engage with digital technology to improve patient outcomes, someone with a clear view of the challenges faced by both is Prof Jan Kimpen.

He’s served as chief medical officer for Royal Philips since January 2016, and before that had a wide-ranging medical and academic career that included six years leading Utrecht’s University Medical Center (UMC), and it was also at UMC that he spent a decade as a paediatrician.

One of the largest academic healthcare organisations in the Netherlands, in 2014 employing some 11,000 people, UMC focuses on treating brain, infective and immunological conditions, regenerative medicine, children’s health, cancer and cardiovascular diseases.

Medical, healthcare tech

“What I have seen in the hospital is that you can do the work both more effectively and more efficiently by using digitalisation. I still remember the days when we had paper records - and between 10-15% of the records would not be there when patients showed up in the outpatient departments.”

Faced with records being lost or languishing forever, unseen, in the archives, Kimpen’s frustration is still evident. “People were writing the notes again, asking the same questions again and again,” he says, pointing out how even then notes would continue to reside in separate places.

One of the first things on Kimpen’s agenda when he was appointed chief executive officer of UMC was to implement a “completely integrated electronic medical record - that was my first encounter with digitalisation”.

The next major step for the healthcare organisation saw it offer patients a new level of access to their information. “In 2014 we took the courageous step to open up the electronic medical records completely and in real-time for our patients,” Kimpen says. “That’s when I realised digitalisation was not only the key for working effectively and efficiently, but also for empowering patients and putting them in the driver’s seat for their own health and disease.”

In doing so it radically altered the doctor-patient relationship and conversations between the two about healthcare, but it was not without its challenges. Patients were suddenly able to log-in and see “everything that was written down there, every single letter, and they could look at it in real-time”.

Information challenges

The change meant that lung cancer patients, for example, no longer had to go to hospital for an examination, wait 10 days for their next doctor’s appointment, sit around for a couple of hours in the waiting room and then have the diagnosis delivered in five minutes flat. Instead patients could see their results almost immediately at home.

“Of course it creates some stress, because the patient is going to see it first. But on the other hand, they can deal with it at home in their family circumstances and then have more prepared conversations with their doctor.” And after catching up with the medical centre’s CIO after he had left UMC, Kimpen was told the heaviest users of the system were those aged 65-70 and over who “have skin in the game” with chronic diseases but are also happy to learn about digital technology where it has a clear benefit. “It’s not the patient who has a ski accident and breaks his leg that’s going to look into the patient record to see about his cast, but if you have high blood pressure or kidney disease you can feel empowered to keep track and proactively do something about your health and well-being, instead of waiting for each appointment with your doctor.”

But the system, and this could well apply to most technology, is “not a magic wand”. For UMC this meant it faced a greater behavioural challenge than it did a technological one. The example Kimpen gives is that for doctors “the ‘bad news’ conversation is completely different, because the bad news has already been delivered and the patient wants to know: What does this bad diagnosis mean? What is the prognosis? What do you think about treatment? What is the outcome?”

It’s these kinds of conversations and the relationships behind them that are often the lesser-covered aspects of the way digital technology is changing healthcare. “It is a change in the behaviour of doctors, a change in the behaviour of nurses, and that will pave the way for the future as patients increasingly become owners of their own health because they want to be in the driver’s seat more than they are now.”

Innovating digital healthcare

“I had seen the landscape changing over, let’s say, the last 10 years in terms of digital healthcare, so the transition to Philips was almost a natural one, because the digital world had already entered healthcare, and Philips is just a continuation of that,” he explains.

He joined as Royal Philips hived off its lighting interests to complete its transformation from a large conglomerate business with a varied portfolio of products and services to a “pure-play health technology company”.

It is now focused on the innovation of digital healthcare solutions comprising systems, smart devices, software and services. Spanning personal care, clinical and home settings, as part of its transformation Philips created its first company-wide chief medical officer role, for which Kimpen was recruited. It’s one that saw him assume overall leadership for clinical innovation, clinical strategy, medical affairs and Philip’s health economics activities.

This last element should have pharma companies pricking up their ears. The success of companies, including Philips, will depend on a combination of new innovations and gaining reimbursement for them. “You have to stop just making things and trying to push them in the market,” Kimpen says, adding: “You have to think about why a new product is better than what was there before - how does it add extra value to the life of patients and to the working of doctors? How does it relate to a better outcome and how could it increase productivity in the hospital environment so that costs come down?”

It’s these kinds of big questions that Kimpen is focused on: What do hospitals need? What is healthcare looking for? What do patients need?

Establishing its ‘triple aim’ of better health, better care at lower costs, Philips as a health technology company has “transformed enormously”, Kimpen notes. Now it’s looking to build on its smart devices portfolio, combining that with software and services “in other words, digitisation and connectivity”.

“Approximately 50-60% of our R&D folks are working on digital solutions because we feel increasingly that turning data - data storage, data management and data analytics - into actionable decision support is the way to go. That’s what hospitals and patients asked for.”

Ultimately, Kimpen says, harnessing digital technology to improve health outcomes is inevitable, driven by patients behaving like consumers, the ‘post-iPhone’ acceleration of digital uptake since 2007 and the demographic challenge that healthcare systems face. “Everybody is connected, everybody wants to measure, everybody wants to know,” he concludes.

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