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RW Deep Dive
Innovation in medicine and healthcare

Koen Kas is a healthcare futurist, driven by the aim to make healthcare delightful, personalised, and preventive. He weaves together science, technology, and business model innovation into inspiring ideas for how to create novel and delightful health experiences. His keynote speech at Research Week 2023 aims to give his audience inspiration to change the way they work and practical ideas for how to do so.

What is it that you're going to do with the platform you've been given as a keynote speaker at RSU Research Week 2023?

It's funny that you use the word "platform," because that's exactly what I want to stress. We're on the cusp of moving healthcare onto a platform on a hospital, national, and global level. What I'm going to try to explain is how we can pivot from a care system where we hardly know anything about our patients, to an "always on", 24/7 care system that is no longer able just to cure me, but that gets way more empowered to predict diseases and prevent them from happening. I'm going to introduce how defragmented, de-siloed health data on a platform can be used to keep us healthy our entire lives.

How will this work on a practical, individual level?

I think it's not just about the individual. I'm going to try to emphasise that a nation, or a hospital, has the power to really initiate this new kind of thinking. If you think about a hospital, if you think about a nation, how much data they have on individuals, all this data is in silos, right? It is not connected. I'll try to show a number of examples where you bring data points from two silos together and all of a sudden you start to get new insights that might empower you to make you better as a doctor, to make you better as a care provider.

How will this help the doctor/patient relationship?

If you start to think about why people get sick in the first place, it's because we are disconnected from our patients. I can send a package from where I live in Antwerp to Latvia, and I can trace my package every five minutes on the website of the parcel provider. I find this normal, but my average cancer or cardiovascular patient, is by themselves 8,750 hours a year. They are not linked to your hospital, not linked to a care provider. That is what digital is going to do. It will help us medical providers, and us countries, governments, to enter into the real world of our patients, be with them, and become richer and better in the process.

Can you give an example?

Imagine I'm allergic to gluten. What I now have to do is to go to my retailer, put on my glasses, and then read the small print on every product to make sure that there is no gluten in it. In the future that I'm outlining, my online medical records can see that I'm allergic to gluten and my retailer can connect to that. From now on, there will be certain products I can no longer buy at my retailer. That's a pretty delightful service based on switching on one datapoint.

You use the word “delight” in your talks. What does that mean to you in this context?

We have introduced a methodology that we call "delight thinking". Delight thinking is creating healthcare experiences almost close to magic, but still real, based on providing doctors and governments with things they didn't know they didn't know - unknown unknowns. If you sell me that, I'll be hooked to you. Let me try to explain that differently. I have a birthday wish list, right? And if you give me a present from the list I'm super happy, but if you gift me something I didn't realise I would get, I'm super super happy. That is what healthcare is about. You as a nation, you as a doctor, you as a healthcare provider, as a nurse, as a caregiver, if you provide me with an experience that I didn't know I needed, that I didn't know I wanted, that is how we're going to move the world forward.

It sounds like it would enhance the human connection between the patient and the doctor if they feel more seen, and understood?

Yes absolutely. Let me give you another example. A lot of people have a scale at home, which can tell you your weight. How basic can it be? One of the key providers of scales last year added an API meaning that I can upload my weight data into the medical record of my clinic. And all of a sudden the world changes. The doctors says, "Now I trust that data point, now I can use those data points to become a coach." If you were a diabetic, I can start to use the scale to provide you with a small programme to change your eating habits. That would not have happened if the doctor would not have had the trust that a data point collected from the real world could be accessible and useable to provide care. And that is what again a platform will do. And then we start to come full circle, because if I have data from the hospital, and I start to be able to combine them with real world data, then indeed we're going to see that all these data points together provide us the opportunity and give us a number of services to keep our nation healthy.

What is an example of this in practice?

At some point, people with multiple sclerosis, or Parkinson's, start to freeze while they walk. Their gait basically locks, and they are stigmatised because people stare. Now we have digital therapeutics, which allows me to put a small sensor in the shoe of my patients, and that sensor measures the gait. It can tell when my patient is going to freeze. That sensor is linked to their Spotify account, and at the time that they're going to freeze, their music starts to play louder, and they get over the freeze and can walk normally. I haven't treated, or cured my patient, but I have destigmatised them. A patient that has a doctor like this will always come back to them, because their doctor has proven that they will keep learning about what's next, right?

If I'm a doctor or student attending your lecture, and if I really connect with your ideas, is there anything I can do as an individual, or should I just wait for a system to change?

First of all, people often use the word "system" but I don't think there is a system. A system is people as well, right? It's a number of people who do things the way they do things over the years. And incidentally in healthcare, it takes a minimum of seven, but very often up to 17 years before an innovation is really implemented well among people. That's an issue. So when I started to do what I do now, to talk about the future, a lot of doctors said "Well, we'll see. It might change too much, it will take a lot of time, it will be too expensive." This was ten years ago. Now, each time I speak, at least five doctors come to me and ask how they can be a part of this revolution. And the answer is always the same. You should never start by boiling the ocean. You should always start with boiling a very small lake. And for that, what we have done is the following. We have launched a super simple website with all the certified digital health apps on the planet. It's not a huge list. That is not like in the Google or Apple store, where there are 130,000 apps that claim to do something with fitness and wellness and health. Our database only has 300 applications. Out of these, 50% are for doctors, 50% are patient-centric. If you look at them, and you're for example a paediatrics doctor, or you're an ophthalmologist, or you're a cardiovascular surgeon, by just looking at what is out there, you start to see what becomes feasible for you to start using in your practice. 

What is one of the biggest misconceptions about your field?

Very often I get the question "Is digital going to make healthcare less human?" I think in contrast, that the digital is going to make healthcare way more human. One of the biggest misconceptions is that technology and artificial intelligence will replace what we're used to doing, but let me counter this with an example. During corona, I gave my father a loudspeaker, one of these search engines that use voice recognition that we can ask when our next meeting is, etc. I gave him that so that it could tell him to take his medication. He found it cool, but didn't like it too much. He didn't like the Siri voice. We scouted for a piece of technology that allows me to talk to my computer for two minutes, and after two minutes, I can type in whatever text, which then gets pronounced with my voice. I put that on the speaker, and all of a sudden my father heard me say "Daddy, it's time to take your medication at 5." And that he liked. I'm still not there in person, I couldn't be there, but it made me a better human.

What was it that initially attracted you to this field?

My world changed completely, when I came to western China for the first time and discovered a very old healthcare system, more than 2,500 years old, in which the doctor got paid as long as he kept the people in his village healthy. Once you got sick, you no longer had to pay. That became my dream, to build that world.