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1. Dr. Nick Guldemond +31648261929 04‐08‐2014
n.a.guldemond@umcutrecht.nl 1
Zorgtransitie & digitalisering
…besturen of bestuurd worden?
Dr. Nick Guldemond | Associate Professor Integrated Care & Technology
2007 EU
• average ≈ 1:4
• differences between countries
2050 EU
• 1:3 (NL)
• 1:1.5 (Italy and Spain)
• average ≈ 1:2
2050 China
• average ≈ 1:<1
population aged (>65) in proportion to working
population (15-65)
Dr. Nick Guldemond
% population with 1 or more chronic diseases
2005
> 1 chronic disease
1 chronic disease
0 chronic disease
NL population
age
Dr. Nick Guldemond
Overall increase since 2005 17%
Increase co‐morbidity since 2005 26%
Dutch population with co‐morbidity 11.3%
…current healthcare system sustainable?
Dr. Nick Guldemond
Dr. Nick Guldemond
Healthcare paradigm shift

2. Dr. Nick Guldemond +31648261929 04‐08‐2014
n.a.guldemond@umcutrecht.nl 2
medical curative model
community care
specialized institutions
local institutions
social (interconnected)
health perspective
community care
advanced local
care centres
high
specialized
cure
Paradigm shift
Dr. Nick Guldemond
self
management
delivery
system
decision
support
information
systems
supportive
environment
public
health
community
action
Integrated Care
Health SystemsCommunity
improved outcomes
interactions
productive
activated community support
Dr. Nick Guldemond
clinical pathway / patient journey
Dr. Nick Guldemond
clinical pathway / patient journey
Dr. Nick Guldemond
Health & Technology
Health status over time
0‐35 36‐65 66‐80 > 80
healthyhealthychronicchronicacute careacute care
life style ‐ health education ‐ risk monitoring
self‐management support tools
(home) care technology
dependent independent assisted dependent
age
living
health status
no technology
with technology
techology
Dr. Nick Guldemond
health & technology
cure technology

3. Dr. Nick Guldemond +31648261929 04‐08‐2014
n.a.guldemond@umcutrecht.nl 3
Cardiovascular Care Cycle Process
Dr. Nick Guldemond
Home care technology & Assisted Living
Dr. Nick Guldemond
Health data & informatics
INTERACTION
USER PROFILE
& SERVICE
INTEGRATION
Commuting
Travels
Meetings
Communications
Sleeping
Wake‐up times
Office time
Location patterns
People’s behavior
User attention
Emotion
Smartphones communicator & Sensor of Human Behavior
INFORMATION
Dr. Nick Guldemond
social (interconnected) health team
instruction
advise
task
allocation
planning
monitoring
& control
coordination
Dr. Nick Guldemond
Decision
making
Logistics
Health
promotion
Systems medicine
Determinants,
risk factors
& pathways
Disease
interaction
Dna transscription Dr. Nick Guldemond
Environment

4. Dr. Nick Guldemond +31648261929 04‐08‐2014
n.a.guldemond@umcutrecht.nl 4
Quantified
Self
Personalised local
Care
Point of Care
Diagnostics
Dr. Nick Guldemond
INTERACTION
INFORMATION
Real-time interaction research & care
Knowledge
institutionsLocalities
Creating
person centred,
community based
health solutions
Multi‐level framework for community based
co‐creation of health
EU
National
Regional
Local
communitycommunity
based
co‐creation
Technology
Service models
Business models
Dr. Nick Guldemond
Community Based Co-creation
Health insurers
Healthcare
professionals
Patient
organisations &
consumers
Social workers
& charities
Inventors
Local SME’sLocal government
Public organisations
Knowledge
institutions
Industry
Dr. Nick Guldemond
Dr. Nick Guldemond Dr. Nick Guldemond

5. Dr. Nick Guldemond +31648261929 04‐08‐2014
n.a.guldemond@umcutrecht.nl 5
monitoring
behaviour
effect
outcome
quality
standards
Data analytics public health management
Dr. Nick Guldemond
annotation
tagging
Classification
algorithms
rules
Conversion
Information
data
fusion
Context data
reference
data
Interpretation
protocols
guidelines
decision support
patient
profile
tailored
care
personalised
Plan
Practise team
Cloud
device
environment
demographic data
Data
• Landelijke kaders, locale implementatie, regionale opschaling
• Interoperabiliteit, standaarden
• Regelarm experimenteren, reflectie, kennisdeling
• Lessons learned: brilliant failures, good practices, opschaling
• Besturen of bestuurd worden…..
Overwegingen
Dr. Nick Guldemond
Thank you!
Dr. Nick Guldemond
Email: n.a.guldemond@umcutrecht.nl
Mobile: +31 6 48 26 19 29
Dr. Nick Guldemond