Gezondheidheidszorg kan niet zonder E-health

Ladies and gentlemen,
I am pleased to have been asked to speak here today at this ‘World Congress on Information Technology’. I am also proud that this prestigious conference is being held for the first time in the Netherlands, and I am very gratified to see that ‘e-health’ has been designated one of the nine tracks of the ‘Challenges of Change’ programme.

I can sum what I am about to say in two words: urgency and opportunities.
I shall stress the urgent need for innovation in healthcare based on Information and Communications Technology. I shall also offer a few examples of how this can be achieved, in the hope that they inspire you to take the next step.

First, the urgency. I am convinced that ICT and e-health applications are absolutely essential if the quality of healthcare is to be maintained, and if healthcare is to remain accessible and affordable.

‘Affordable’ is an important aspect. The healthcare system is under financial pressure, not merely due to the economic crisis. We have to do everything possible to ensure that services remain of high quality, responsible and safe, both today and in the future. The tenability of our Dutch healthcare system is at risk, as is that of virtually every country worldwide. At present, the Netherlands spends over sixty billion euros a year on health and welfare. By 2020, that amount will have risen to some 75 billion euros (80 bilion dollars).
Innovation and e-health are essential elements in addressing the challenges we face. Those challenges are immense.
We see an ongoing increase in the demand for care. This is due to various factors, including population ageing and a growing number of chronic diseases. Advances in medical technology have opened up new possibilities. At the same time, we face an impending shortage of staff.

The Dutch Healthcare Innovation Platform – about which I shall say more in a few moments – has done much to raise awareness of the staffing problem with its report, ‘Care for people, people for care.’ It concludes that by 2025 there will be very few extra personnel available to the healthcare sector, although we shall actually need 470,000 additional healthcare professionals.

Today, some fifteen per cent of the Dutch population are aged 65 and above. By 2025, that figure will have risen to 22%. Innovations which address this situation are of great importance. If we fail to act today, a quarter of our elderly, chronic or disabled patients will be denied the care they need. The Healthcare Innovation Platform ensures that this problem will not be ignored.
It coordinates initiatives, will speed up innovations and helps to set the political agenda.

It is clear that the manner in which we currently provide care services will eventually meet the boundaries of the possible. People are living longer and are enjoying more years of their lives in good health. That is, of course, a very welcome development. But because there will be a greater number of elderly citizens in society, there will inevitably be a greater number of people suffering from chronic conditions.

In fact, the number of younger chronic patients is also rising. This is due to several factors: changing lifestyles, lack of exercise and overweight, for example. Today, the Netherlands has 4.5 million chronic patients. The total population is slightly more than 16 million, so that is over one in four. And this figure can only increase, whereupon the demand for care will do likewise.

How can we address these challenges? It is our duty to ensure that we can continue to offer good, safe and accessible care.
Not only for ourselves, but for our children, our grandchildren and the generations yet to come.

Wherever possible, we must avoid simply passing the costs on to the public by increasing insurance premiums, imposing larger personal contributions or significantly reducing the basic cover. We cannot reduce the salaries of healthcare professionals or slash the budgets of the hospitals and other healthcare institutions.

I consider it my duty to look first at improving quality and strive for more efficiency before I even think about asking people to pay more. I am convinced that innovation, and particularly e-health applications based on ICT and the internet, will play a very important part in improving quality.

And this brings me neatly to the second of my keywords: opportunities. I can offer many examples. It is important that there should be full interaction between the public domain, the social domain and the creativity of the market itself. A good example of such interaction is the ‘e-cardiocare’ project, a collaborative venture involving the health insurer Achmea, the multinational electronics company Philips, the Netherlands Organization for Applied Scientific Research and the Fluent consultancy. The project provides an e-health service for patients with chronic heart failure. It is already operating in a small number of hospitals. With the support of the Healthcare Innovation Platform, the project is to be rolled out into no fewer than twenty hospitals nationwide, where it will help over one thousand patients.

Innovations can be linked together as a chain, thus achieving even greater success. One example is ‘MijnZorgNet’, which brings together a number of integrated healthcare networks addressing various patient groups. Later, Prof. Bas Bloem will share with you his experiences of chain care for Parkinson’s diseaesed. It is an extremely successful approach putting the patient in the center, which has resulted in significant health gains. In short, the net result is better care at a lower price. Or as President Obama has so succinctly put it, “saving lives and costs.”

As I have said, the challenges are immense. We must invest in innovative solutions. That will not be easy, but let us not be pessimistic. Investing in innovation will open up countless opportunities. Our challenges are by no means unique: other countries are reaching the same boundaries. However, I believe that our starting position is indeed unique.
Dutch healthcare services are consistently rated among the very best in Europe. In fact, we are the undisputed leader in e mental health services.

We are also a leader in the development and use of ICT and other technology. Take for example the digitization of our breast cancer screening programme. In the past year alone, nine hundred thousand women have had digital mammograms taken at 64 mobile units. The Netherlands is the first country in the world to have implemented this form of screening on such a scale. The programme is also a prime example of public-private partnership, since it relies on an entirely new Information Management System which was purpose-built by Philips. The screening itself is more accurate; breast cancer can be spotted earlier and treated more promptly.

The result? Less suffering and fewer deaths. It is also worth mentioning that this innovation represents a major step forward in terms of sustainability, another challenge to be addressed by the healthcare system. Because the system is entirely digital, there are no X-ray plates to be developed and fixed. Chemical waste is therefore reduced by some 770,000 kilograms a year.

But it is not only the multinationals and large companies who are responsible for innovations in healthcare. I recently attended the launch of a new device which diabetics can use to measure their blood sugar levels. There are of course many such devices on the market. However, this one is unique. Not only can the results be read out digitally, but – even more important for the patient – it is entirely painless in use. This is an innovation devised by a private individual ‘in his garden shed’, so to speak, so that his diabetic daughter would no longer have to experience the distress and inconvenience associated with the usual thumb-pricks and test strips.

There are many other examples of new approaches. We now have healthcare-TV, screen-to-screen healthcare and the ‘health buddy’ who educates chronic patients and does much to encourage patient compliance: a system which has been adopted in many countries. We must now fast-track similar innovative developments and ensure that they are applied on a wider scale.

Patient and healthcare provider must develop a closer relationship. Unknown is unloved, as the Dutch saying goes.
The next speaker is a patient who has eagerly seized the opportunities made available by e-health. Indeed, he has achieved international fame as ‘e-patient Dave’. He will tell you his very interesting story, which I know will provide food for thought. Dave has taken responsibility for his own treatment. In my eyes, he is a role model for the ‘participative patient’ of the future.

And of course, the government also has an important part to play. It must ensure that legislation and system incentives do not stand in the way of further e-health applications. It must be alert to ways of promoting innovation.
The Healthcare Innovation Platform offers various programmes and resources which are designed to promote the large-scale adoption of innovative solutions. In this context, I would like to mention e-HealthNu. This is an active partnership between health insurers, public sector companies, research institutes, and the government, all of which have joined forces to remove the obstacles standing in the way of applications which will bring care closer to the patient. The partnership’s efforts are both timely and necessary. A study by the Rotterdam School of Management reveals that many useful innovations have already been developed but have not yet found their way into the GP’s surgery, the hospital or the physiotherapist’s practice.

It is clear that innovation in healthcare is both essential and inevitable. The effective, reliable and confidential exchange of information is a prerequisite to the desired situation in which all care services are fully integrated. Healthcare is a sector which relies heavily on knowledge and information. ICT is the key to success. The introduction of the Electronic Health Record will result in far fewer mistakes.
It will avoid duplication of medical tests and will save patients lives and decrease hospital admissions, by sharing information between numerous different doctors and specialists. In short, it will improve service to the patient.
In this day and age, it is inconceivable that professionals should not know what care has been provided to a patient by their various colleagues. It is also important that patients should have access to their own medical information, so that they can take a greater part in their own care and treatment.
ICT offers many opportunities for self management. Patients will have a greater say in their own care, and will bear greater personal responsibility. Research has shown that this is something that the patients themselves greatly appreciate.

The ability to share information in a secure and reliable way is certainly essential to good ‘chain care’. The patient is not under the care of one doctor but must regularly consult various specialists about his or her various conditions. The overall care process will be very much more effective if all the links in the chain know exactly what all the others are doing.

Ladies and gentlemen,

Innovation – a new manner of thinking and working – can greatly improve healthcare. That much has already been proven in practice. As always, the focus is the patient himself or herself. Care services should be organized around the patient. ICT and e-Health applications provide yet more opportunities to do so. The urgency exists, as do the opportunities. Let us therefore take the next step in ensuring that healthcare remains of high quality, accessible and affordable. During the coming three days, I hope that we shall establish a firm position from which to ‘beat the challenges of change’.

Thank you for your attention.