1. Lucien Engelen (@lucienengelen)
•Director Radboud REshape & Innovation Center
•Head Regional Emergency Network
•Advisory to the Executive Committee
•Faculty Singularity University / FutureMed Silicon Valley
•NOT a doctor, but extremely IMpatient
•& a ‘bit’ of a rebel ;-)
360 and Above

2. Not me !
Lucien Engelen (@lucienengelen)
•Director Radboud REshape & Innovation Center
•Head Regional Emergency Network
•Advisory to the Executive Committee
•Faculty Singularity University / FutureMed Silicon Valley
•NOT a doctor, but extremely IMpatient
•& a ‘bit’ of a rebel ;-)
360 and Above

4. •11.000 colleagues
•3000 students
•1000 beds
•ambition to close 500
•Significant impact on health(care)
•$1 billion revenue
•First Academic Centre outside US EPIC

5. •11.000 colleagues
•3000 students
•1000 beds
•ambition to close 500
•Significant impact on health(care)
•$1 billion revenue
•First Academic Centre outside US EPIC

11. performance
0
Clayton Christensen
time

12. performance
anding use
most dem
quality use
high
quality use
medium
quality use
low
0
Clayton Christensen
time

13. no
lo
gy
quality use
high
di
sr
up
tiv
e
te
ch
performance
anding use
most dem
quality use
medium
quality use
low
0
Clayton Christensen
time

19. Linear à
1996
Market cap of
$28B
Revenue ~$16B
Employees
140,000
Exponential

20. Linear à
1996
Market cap of
$28B
Revenue ~$16B
Employees
140,000
Exponential
2012
Market cap <
$100M
Revenue ~$6B
Employees
17,000

21. Linear à
1996
Market cap of
$28B
Revenue ~$16B
Employees
140,000
Exponential
2012
April 9, 2012
Market cap < Facebook Acquires
$100M
Instagram for $1B
Revenue ~$6B
13 employees
Employees
17,000

22. Linear à
1996
Market cap of
$28B
Revenue ~$16B
Employees
140,000
Exponential
2012
April 9, 2012
Market cap < Facebook Acquires
$100M
Instagram for $1B
Revenue ~$6B
13 employees
Employees
17,000

23. Dorm Biotech
Garage Pharma
Garage Tech

25. REshape Labs
Demand driven
relates to strategy
Design
Implement
REshape
Spinn-out
Business model
Scale
PVI
MOC’s
Moments of Choice

26. New Information Layers
Internet of Things
Sensor Networks
Health Data
Quantified Self Data
Crowd Sourced Info
Location
HTML (text)
Video
Social Profiles

27. Exponential going exponential

29. Assumptions rule!
..Average doctor interupts patient
within 18 seconds..
…premature closure was
the single most common cause for
error ...

30. Diagnostic Error in Internal Medicine
System & Cognitive
No-fault only
System error only
Cognitive only
28%
46%
19%
7%
chance for improvement 74%!
h"p://archinte.jamanetwork.com/ar3cle.aspx?ar3cleid=486642

31. Cleveland Clinic doctors’ review of initial diagnosis
disagree(with(ini5al(diagnosis(
find(need(for(further(tes5ng(
recommend(major(changes(to(treatment(
plan(
11%
15%
18%
recommend(moderate(changes(to(
treatment(plan(
recommend(minor(changes(to(treatment(
plan(
26%
22%

33. What if Watson proves
to be right 90%
and Physicians 50%?

34. Help is on the way

35. Google’s health venture for eternity
CaLiCo
Californian Life Company

36. Vinood Kosha
The best 10% MD will train new systems
that will bionical assist and amplify MD’s.
Shift to computerization started:
Airplanes, Stockmarket and Car driving
80% of what MD’s do can be replaced with
better average.

37. Challenges
Medical Data crime
Digital virusses in humans
Virusses have become biological software
2010 4 billion connected devices,
2020 will be 80 billion

39. Lucien Engelen

40. Lucien Engelen
Mobile network operators will
become obsolete

41. Lucien Engelen
Mobile network operators will
become obsolete
Cable companies will offer
nationwide WiFi coverage

42. Grown up with a mouse
In 20 years majority of healthcare
consumers will have used a computer
for 40 years of their live and
by then the internet as #1 source for
Health(care)

43. Lucien Engelen

44. Lucien Engelen
but ...

45. Lucien Engelen
but ...
the BIGGEST change will be

46. Lucien Engelen
but ...
the BIGGEST change will be
Patients!

48. HEALTH DATA
Patient care, measurements are mostly
EPISODIC & REACTIVE …

49. HEALTH DATA
… when they need to be
CONTINUOUS & PROACTIVE

50. We have to move to stage ‘Zero medicine’
survival rate
10%
Death rate
90%
late detection
death rate
10%
survival rate
90%
early detection
Daniel
kra@

51. Lucien Engelen

52. Lucien Engelen
We’ll subscribe to patients’ data

53. Lucien Engelen
We’ll subscribe to patients’ data
health(care) will be a data-science

54. Lucien Engelen
We’ll subscribe to patients’ data
health(care) will be a data-science
More change from data science in 10
then medical science in 100 years

55. Coming to a ‘hospital’ IN your home

56. ECG made by iPhone sleeve

57. Diamond Concept Device
Piezo-ceramic
Stethoscope
Electrocardiograph((
(ECG(Sensor(
Posi=ve(Electrode)(
Electrocardiograph((
(ECG(Sensor(
Nega=ve(Electrode)(
Photoplethysmograph(
(PPG(Sensor)(
60 mm
Infrared(Thermometer(
Slide 11

58. 39

59. 39

60. Records
Exams
Labs
Vaccines
Rx
Drugs
History
Environment
Vitals

61. The idea of going down to your doctor’s office is going to feel
as foreign as going to the video store...

62. PHR
COMMUNITY
E-HEALTH

63. PHR
COMMUNITY
E-HEALTH

64. PHR
COMMUNITY
E-HEALTH
initiative of

65. PHR
COMMUNITY
E-HEALTH
initiative of

66. e-health integration (i.e. for research)

67. e-health integration (i.e. for research)

68. e-health integration (i.e. for research)

69. e-health integration (i.e. for research)

70. Patient at home

89. Prototype CPR/AED Glass

90. Prototype CPR/AED Glass

91. 61

99. “The
only
permanente
in
the
future
will
be
:
change.

100. “The
only
permanente
in
the
future
will
be
:
change.

101. “The
only
permanente
in
the
future
will
be
:
change.
The
only
way
to
cope
with
that
is
:
together”
@lucienengelen

103. €1699,€300,-

113. REshape FutureMed trip 2-8 November 2013

116. @lucienengelen