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denial & neglect
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As software is eating the world,
a digital strategy is needed.



Implementing will take you 5 years,
so welcome to 2012 …
©lucienengelen
As software is eating the world,
a digital strategy is needed.



Implementing will take you 5 years,
so welcome to 2012 …
©lucienengelen
©lucienengelen
©lucienengelen©lucienengelen
What will happen with
all those gasstations ?
©lucienengelen©lucienengelen
What will happen with
all those gasstations ?
©lucienengelen©lucienengelen
©lucienengelen
Driving
Prohibited
©lucienengelen
End of
Drivers’ license
& gas stations
Driving
Prohibited
©lucienengelen
End of
Drivers’ license
& gas stations
Driving
Prohibited
©lucienengelen
The end of
screens, laptops
and phones
iGlass
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
OnIntensiv
Current Vitals : Lucien Engelen
©lucienengelen
©lucienengelen
Life vitals in clinical patients
From three times daily to
24/7 continuous monitoring
Lean monitoring
… when they need to be
Continuous & Proactive
Health data now
©lucienengelen
Disruptive monitoring with new parameters
Blood glucose HRV
X
Interval X = 30 minutes
5.5 mmol/L
3.9 mmol/L
Early Warning Heart Rate Variability for drop glucose level
©lucienengelen
Diabetes type 1
one app for all
©lucienengelen
app Diabetes type 1 (preliminary results)
HbA1c bit lower, less worries, no increase hypo’s, more insights bolus calculator, more education needed
Wireless earbuds Dash
©lucienengelen
Wireless earbuds Dash
©lucienengelen
Wireless earbuds Dash
©lucienengelen
Wireless earbuds Dash
©lucienengelen
©lucienengelen
integrated not separated!
integrate not adding to !
©lucienengelen
How Apple just became an Academic Medical Center
©lucienengelen
700 Million research devices
18.000 inclusions in 48h
How Apple just became an Academic Medical Center
©lucienengelen
REach
REach
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
New paradigms ?
©lucienengelen
New paradigms ?
©lucienengelen
New paradigms ?
When is free will, no longer a free will?
Proof of concept
Medication status
in blockchain with acces
via bankcard
and randomreader token
Booth Deloitte demo
©lucienengelen
ACTUALLY DEFINES MULTIPLE
DEVELOPMENTS IN HEALTHCARE
THAT TAKE TIME
‘DR WATSON’
©lucienengelen
AI (Artifficial Intelligence)
• 1 system based on rules
• a system that predicts everything
• containing info about all the cancers of the world
• a system that replaces the professional
• useable by the patient
• working the Same as google (paris Hilton)
• a system that works out of the box in 1 day
WHAT ‘DR WATSON’ IS NOT
source Nicky Hekster IBM Watson Health
BUT IT IS A GREAT PROMISE FOR
IMPROVING HEALTH(CARE) WITH GREAT USE CASES
Healthcare will become a software branch.
©lucienengelen
Healthcare will become a software branch.
©lucienengelen
©lucienengelen
©lucienengelen
Radboudumc Virtual
Telemedicine & Telehealthcenter
©lucienengelen
Reference Center remote monitoring
NW European region
implementation
order
Radboudumc Virtual
Telemedicine & Telehealthcenter
©lucienengelen
Reference Center remote monitoring
NW European region
implementation
order
Radboudumc Virtual
Telemedicine & Telehealthcenter
©lucienengelen
Reference Center remote monitoring
NW European region
implementation
order
©lucienengelen
ultrasound
©lucienengelen
ultrasound
©lucienengelen
Avatars & Humanoids
©lucienengelen
Avatars & Humanoids
©lucienengelen
Avatars & Humanoids
©lucienengelen©lucienengelen
Avatars & Humanoids
©lucienengelen©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
‘insideables’
©lucienengelen
Neural ‘dust’ UC Berkley
©lucienengelen
Neural ‘dust’ UC Berkley
©lucienengelen
Neural ‘dust’ UC Berkley
©lucienengelen
Neural ‘dust’ UC Berkley
©lucienengelen
Neural ‘dust’ ‘Insidables’UC Berkley
©lucienengelen
©lucienengelen
Center of reference for remote monitoring
Center of reference for AI & Data Analytics
©lucienengelen
Center of reference for remote monitoring
Center of reference for AI & Data Analytics
©lucienengelen
See the pattern here?
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
Video conferencing reimbursed in the NL
5 % of outpatient
visits
200 parking lots a
day
©lucienengelen
Video conferencing reimbursed in the NL
5 % of outpatient
visits
200 parking lots a
day
©lucienengelen
from ‘Hospital’ to ‘Home’
©lucienengelen
from ‘Hospital’ to ‘Home’
from ‘Hospital’ to ‘Phone’
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
Food, electronics, errands … pharmacy ?
Source REshape Center 2014
The delocalization of health(care)
©lucienengelen
- 70%
Source REshape Center 2014
The delocalization of health(care)
©lucienengelen
Everywhere Home Hospital Doctor
where good healthcare in 10 years
will be delivered :
conference: ‘get into the future’ TMG / SingularityU
©lucienengelen
Everywhere Home Hospital Doctor
where good healthcare in 10 years
will be delivered :
conference: ‘get into the future’ TMG / SingularityU
©lucienengelen
Everywhere Home Hospital Doctor
where good healthcare in 10 years
will be delivered :
conference: ‘get into the future’ TMG / SingularityU
©lucienengelen
Everyone, always, everywhere connected
©lucienengelen
People of age 65 and older 2000-2050
Source US Census Bureau
©lucienengelen
People of age 65 and older 2000-2050
over 65 over 85
Source US Census Bureau
©lucienengelen
©lucienengelen
using technology
1st wave
©lucienengelen
using technology
2nd wave
Obesity, Diabetes, Mental health issues
living in technology
1st wave
Photo courtesy of Christian Lüthen
©lucienengelen
©lucienengelen
©lucienengelen
exponential in 3 tweets
©lucienengelen
©lucienengelen
the end
of
banking..
©lucienengelen
all
Change
Is
Tough
©lucienengelen
©lucienengelen
“Don’t use old maps…
…To explore a New World”
Albert Einstein
©lucienengelen
©lucienengelen
Allistair Croll
Scale comes from process, IP, org chart, 

standardization, capitalization.
All of these assume the

future will be like the past, only more so.
awakening
©lucienengelen
awakening
©lucienengelen
Digital first, physical next
©lucienengelen
Digital first, physical next
©lucienengelen
•15.000 colleagues
•1000 beds
•ambition to ‚close’ 500
•Significant impact on health(care)
•$1 billion revenue
•First Academic Center outside the USA EPIC
•Digital first, physical next
•15.000 colleagues
•1000 beds
•ambition to ‚close’ 500
•Significant impact on health(care)
•$1 billion revenue
•First Academic Center outside the USA EPIC
•Digital first, physical next
Digital strategy is not translating
what you do now digitally.



It is completely rethinking 

your model groundsup
©lucienengelen
Digital strategy is not translating
what you do now digitally.



It is completely rethinking 

your model groundsup
©lucienengelen
Health(care) is now Global!
©lucienengelen
“be curious” ©lucienengelen
©lucienengelen
assignment REshape Center
Convergence Technology & Patient Empowerment
To scout, explore, research and advocate (the use of) new exponential
growing technology in a disruptive era, to design a more participatory
and sustainable health(care) system, with a global perspective.
Explore the World Create solutions Share & discuss
©lucienengelen0 to 1 0,8 to 1,2 1 to 100
adaptedfromcentralofficeofdesign
©lucienengelen0 to 1 0,8 to 1,2 1 to 100
adaptedfromcentralofficeofdesign
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
exponential in 3 tweets
©lucienengelen
Concept to prototype
Ideas from:
Patients HCP &
Network
patients
primary care
Information-
Management
health insurance
Industry
other institutions
Innovations with
significant impact
on health(care)
Implement
MOC : on hold or terminated
Test and Evaluate
Chance of success
Idea to concept
sharing
(MoC)
(MoC)
(MoC)
(MoC)
Innovation Radboud university medical network
©lucienengelen0 to 1 0,8 to 1,2 1 to 100
75
“dare to fail”
©lucienengelen
©lucienengelen
©lucienengelen
we are here
©lucienengelen
©lucienengelen
“be curious” ©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
Reshape center for european healthcare design
Novartis Patient Academy
Patient journey
©lucienengelen
Reshape center for european healthcare design
Novartis Patient Academy
Patient journey
Institution journey
©lucienengelen
Reshape center for european healthcare design
Novartis Patient Academy
Professional journey
Patient journey
Institution journey
©lucienengelen
Reshape center for european healthcare design
Novartis Patient Academy
Professional journey
Patient journey
Life journey
Institution journey
fór wíth by
Innovation shift Patients
Included
PatientsIncludedisaTrademarkoftheREshape&InnovationCenter
™
©lucienengelen
fór wíth by
Innovation shift Patients
Included
PatientsIncludedisaTrademarkoftheREshape&InnovationCenter
™
©lucienengelen
©lucienengelen
Reshape center for european healthcare design
Novartis Patient Academy
5.000.000 patients
Owning your own
(health)data should be a
constitutional right
©lucienengelen
@lucienengelen 2017
“for the first time ever in history,
-we will be present when a person gets sick,
-professionals will subscribe to patients’ data,
-the middle-man will become disrupted “
@lucienengelen
©lucienengelen
Government
no standard
no money!
©lucienengelen
e-health m-health i-health
e-health : healthcare practice supported by electronic processes and communication (Wikipedia)
m-health : practice of medicine and public health supported by mobile devices (Wikipedia)
i-health : practice of medicine and public health supported by (artificial) intelligence, deep & machine learning. (Lucien Engelen 2016)
©lucienengelen
e-health m-health i-health
e-health : healthcare practice supported by electronic processes and communication (Wikipedia)
m-health : practice of medicine and public health supported by mobile devices (Wikipedia)
i-health : practice of medicine and public health supported by (artificial) intelligence, deep & machine learning. (Lucien Engelen 2016)
©lucienengelen
digital health(care)
e-health m-health i-health
e-health : healthcare practice supported by electronic processes and communication (Wikipedia)
m-health : practice of medicine and public health supported by mobile devices (Wikipedia)
i-health : practice of medicine and public health supported by (artificial) intelligence, deep & machine learning. (Lucien Engelen 2016)
if not embedded in regular process
e-health will always be corpus alineum
©lucienengelen
if not embedded in regular process
e-health will always be corpus alineum
©lucienengelen
©lucienengelen
©lucienengelen
Ceo Bernard tyson


270.000 employees
11.000.000 members
52% e-visits 2015
Papers per year in Pubmed
0
750
1500
2250
3000
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
pubmed - eHealth pubmed - mHealth OR "mobile health" pubmed - digital health
TomvdBelt&LucienEngelen
©lucienengelen
©lucienengelen
©lucienengelen
94
94
the Power of the human touch
Experience
Driven
Health(care)
©lucienengelen
Evidence based
Experience
Driven
Health(care)
©lucienengelen
Evidence based
©lucienengelen
Delocalized
©lucienengelen
Delocalized
Democratized
©lucienengelen
Delocalized
Democratized
digital
©lucienengelen
Delocalized
Democratized
digital
dollars
©lucienengelen
©lucienengelen
it is not the most intellectual of the species that
survives; it is not the strongest that survives;

but the one that is able best to adapt and adjust to
the changing environment in which it finds itself.
Charles Darwin
(1809-1882)
©lucienengelen
denial & neglect
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
©lucienengelen
@lucienengelen
676,312 followers
©lucienengelen

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