Lucien Engelen:
Well, thank you very much, it's great to be here again. This is my Twitter handle for if there will be questions afterwards, I will be most happy to take them of course. The thing is, the group of us with 45 people from the network of Radboud University Medical Center are on a journey, like you are. We're trying to figure out what's going to happen in the next years, like 5, 10, 15 years maybe. And when we step back and look a bit about all the technology that has been presented in the last couple of days one could ask the question, "Why is it still that healthcare is using sticks to make fire?" As a metaphor for that.
And although we don't have all the answers for that, I would like to try to take a bit of a dive into that and help you a bit and what-- in our perspective. I know what's not the problem for that, it's not about passion. When I get to the University Medical Center early in the morning I'm definitely not the first one and not the last one to leave late at night. Everyone at our place is working fiercely to solve that one disease, create the best intervention in the best interest of those patients.
But why is it still that, if you look it into our model, it's old fashioned? If the patient has to visit the doctor we'll have to take a day off. We'll burn fossil fuels to go to the hospital to find that for every one single parking spot on the premises. Run to the department, check in at the front desk, and the nurses says, "Just wait a minute, the doctor is running late," for 10 minutes. And the minute you get in to the office of the doctor, six, seven, eight minutes later after that, time's up. And we have to, again, burn fossil fuels to go backwards [INAUDIBLE]. Why is this, in a world that's completely interconnected in every spot and almost every animal as well, is getting internet into it?
So in some of my lectures, I ask my audience, often patients and also other crowds, a couple of questions. So let me try to do this with you as well, and please reply to it as an individual, not as a professional or whatever. How many of you are taking their blood pressure at home right now? How many of you have sent that in to the doctor's office? A lot less, right? And that's in a world where we've got all kinds of great technology that's validated, easy to use, fits in the comfort of the palm of your hand, to really take the blood pressure and also send it off to your doctor's office.
Let me try another one, video conference. Who of you has, in the last, let's say, week or two, had a video conference with his friends, family, coworkers, or whatever? Who has done this with his health care professional in the last year? Catch my drift? That's one of the problems. Although the technology is present, like our face talk application that we created ourselves, it's secure, it's possible, and in the Netherlands by the way, it's completely reimbursed also. So that could not be the barrier.
And the last question I ask my audience often is about urine analysis. So don't be afraid, I won't ask you if you did that lately, but we all know what it is to pee in this little pot. And there there's technology, for instance, from Scanadu very soon available as well, to do this in the comfort of your own home. Dip the stick in the urine, wait about 60 seconds, the app that goes with it will tell you exactly how long to wait. Take a picture of it and within four seconds or something like it, it gives you the results of the 12 most common urine analyses. Including whether or not you're pregnant, which would be an interesting one in my case, but you never know.
So what to think about these little machines, a robot, that without the intervention of a physician or nurse, would take your blood in 1.20 minutes based on all kinds of great technology. And I really do think that within a decade from now, these kind of machines will sit next to the empty bottle machine in your supermarket taking your blood. Because that's not something that you, by then, go into the hospital for those kind of things anymore. And we were able to, with patches, take all kinds of vital signs for the next four or five days remotely. And this is a great suit from Tesla, this time not from Elon Musk by the way, completely packed with all kinds of sensors and motors. And the physiotherapist at the left is giving physiotherapy also, if needed, 100 miles away to this patient and help him to stretch a bit longer or to do the exercises a bit better.
Those kind of technologies are getting smaller and smaller. Taking an EKG would normally take about, 12 lead EKG, and we've seen Dave Albert with his life core unit and very shortly, as they stated, also with the wrist band. And a couple of weeks ago I was given this business card, supposedly running an EKG for $0.28 business card. Of course this is phony, but I think in a year from now this will be possible. That's the pace that these kind of things are going. And my ear buds from Bragi Dash, I'm testing those for two years already, listening completely wireless to my music. I could make a phone call to Daniel, and whenever I look into the sky for three seconds or longer it would say, "Hey, you're in San Diego. Let me give you the weather report," meanwhile measuring my heart rate, oxygenation level, and all kinds of other sensors.
128 sensors packed in these kind of little guys, and one could wait up until somebody would step up to bring this mainstream. And I think Apple did this recently with the launch of the Apple AirPods. No sensors in it yet, but within one or two years, you can easily imagine it also, heart rate and oxygenation level will come into these kind of things, and that's where things are going to get mainstream. But let's be honest, I think a lot of us are from the generation that we know what this is, right? And let me do-- have some talking about this.
Lucien Engelen:
And I put on steroids. So it was promised to us already, back in the 70s, and you heard Peter and others talk about the X Prize running for these kind of things. And I wanted to share with you one of the finalists that still is in the game, I think, that creates a system that fits in your bathing room with all kinds of sensors. Supposedly running 19, I think it's 19, diagnoses remotely in a couple of years from now. So that's the way that we are heading.
And also from wearables, we now get into a different realm where neural dust sprinkled on your cortex that's connected to a node on the top of the skull, and back then also into the cloud, is also cheering in the next phase, which I like to call insidables, as the next step for it. So when you take a step back and look into all these kind of developments there's a pattern here, right? It's getting smaller and smaller, and it's getting into technology that you and me are using on an everyday basis. No longer being discriminated as a medical device, but everyday technology. And that's where things really start to happen. And I really think that we'll go from academical healthcare into subclinical health care, from that into supermarket health care, and then to people's homes.
A lot of companies talk about from hospital to home, and I really do think that in the end of the day we'll take a step extra. That this technology is giving us also the opportunity to go from hospital to phone in the end of the day. And that's an interesting perspective, I think, where we also see that the delocalization of health care is really kicking in, with all kinds of questions also in real estate. That's also the reason why a lot of our real estate friends joined us lately, because we really think that in seven years from now about 70% of all the routine measures that we take at Radboud Hospital no longer are being done at our premises and our campus. So this is an exchange from bricks to bytes, but really this is all about behavior, from my colleagues, from patients, family, and formal care, and policy makers, of course.
And a lot of people are afraid for their jobs, obviously. This is a very old picture, we kind of photoshopped into it, and we also see that there's also a lot of new jobs coming up, and there's no need to be afraid of having jobs in healthcare. If you look into the next, let's say, 30 years, the number of people above 65 will almost double. No way we are going to handle that in the way that we're doing this right now, right? So, that's the good part. The sad part is, there's a different reality. A reality in where the American Medical Association, in this keynote from the CEO of them, is referring to digital products as the modern snake oil. Go figure. This is one of the biggest groups in the United States, that is referring to medical doctors, that positioning these kind of things where the technology is supposedly the hype, and don't look into what's happening really, in terms of in terms of the change. And that's an interesting perspective. Innovation in health care has more and more became something like a completely risk mitigating system, where we know everything that will happen with the next step that we take. And all of a sudden in Silicon Valley, Friday afternoon somebody publishes an app. And as a dermatologist, in the weekend, your world has changed.
An interesting phenomena happens, what this chart described as the pre gab then, that kicks in where we bring in all kinds of barriers. There's no funding, there's no reimbursement, it's not FDA approved, patients do not want it. Meanwhile, the companies go on. And in the end of the day it's getting reimbursed, it's FDA approved, like Dave Albert said, and patients do want it. And that's where you got Uberized, let's call it like that, because somebody has stole your cheese, actually. So why don't we also, in terms of digital health, refer to that like we do in pharma? We know that for every drug that comes out, 15 or 20 or maybe 30, did not make it in to the end. Digital health care innovation is not 100% secure early, and we have to take into account that things will fail.
This is Amsterdam Central Station, where recently a doctor's shop was opened including a pharmacy and stuff like it, and we see this all across the United States already. But still, people are looking away in terms of this is not going to work. And one of the questions that I would have recently, when I was on the highway, what are we going to do with all the gas stations when all of us start driving electrically? Maybe we could turn them into health shops. Where, when you're away to charge your car, for instance, you take a very brief health checkup for them.
So Klaus Schwab, who is the chairman of the World Economic Forum, talks about the fourth Industrial Revolution that we're in midst in the midst of, the internet of things. And he states, as opposed to small waves of innovation there will be tsunamis that will accumulate, and we will go from prodding innovation into system innovation. And I think we're witnessing this thing, the last days and also the next two days, exactly that. We all have the sense that things are changing. We're also in this, what I like to call, the 5th Democratization, after travel, music industry, and retail. At the intersection of patients and technology, that's a market that's getting refreshed on a daily basis. People get born and people will pass away. So that's one of the reasons why all these big corporates are trying to get a hold on this as a big market for them.
I was in an ambulance service for over 35 years, and sometimes prior to lunch we had this, from womb to tomb. We had a baby born somewhere in the middle on the stairs often, for instance, and also people passing away. And with all this technology, I can imagine that at one point in my life I would be submitting all my data to these great cloud initiatives, and an ambulance would drive up to my curbstone, would ring the bell at the front desk, at the front door, and I would open up and I would see a former colleague of mine. He would say, "Hey Lucien, we're here for the cardiac arrest," and I would say, "There's no cardiac arrest." And they would say, looking on their iPad, "You want to bet? You might want to take a seat, in three minutes this is going to occur." So we will be able to prevent these kind of things prior to the moment in time that this lifetime events will happen. And I really do think that within the near future, we will be present when somebody gets sick or have the ability to scroll back the data to see what happened at that very moment.
So how to work with that? For one, I think we as health care professionals will start to take a subscription on the data of patients, where now it's the other way around. Patients will maybe even start a marketplace for their data. Just imagine. So how to run with that? How to get to that shore as health care institution? That's one of the things that we looked at at the Radboud University Medical Center. So we do show and tell, we take people with us, we show what's happening, we try to increase the validation speed in it, and we also experiment. The only way to get this right is to experiment a lot and fail a lot, because we learn a lot about these kinds of things.
Secondly, we also have to use everyday technology to make health care location independent because that's exactly what's going to happen, and we also will see a big growth in data. So we're curious, that's the way we run these kind of things. We take, like Daniel said for the fourth time a group of 45 people over here, then we try to be a rebel. As opposed to innovate for patients, a couple of years ago in the research center we started to work with patients, and now we have patients innovating themselves. Trying to get these things up and running that matter the most to them. And they also see not only that patient should have been included in these processes, the same is also true for nurses. How many nurses in the audience? One, two, three, four, that's it. We have to change that mindset as well, and from entrepreneurs we should become into entrepe-nurse-ial. Which was coined by Shawna Butler late last night, I think.
So that alley that we're on, and I stole this shamingly from Peter Thiel. At our research center we tried to create something from out of nothing, from 0 to 1. And then we start scaling, start scaling and also try to fail in these kind of things. This is, and I'll share slides later on, the way how we proceed with all our innovations that are going to different moments of choice phases to really execute on it or to stop it. And once we've done that, we also start scaling from 1 to 100, which is a completely different group, different competencies, of course. This also implicates that we had to change our medical curriculum. Which we did September of last year, where e-health social media and all these kind of things that also, Clay was talking about, is incorporated, including the patients at their site from as of day one, and we really think that that's a very important step of that.
So wrapping up, what we're trying to do is we're trying to create an alley where digital first and physical next is the mantra. To offer also a digital alley to a patient for those who want and who can, for those who do not want and can't, we still are open, of course, at the front door. We start subscribing to patient's data, and all of you could help. Whenever your physician asks you to come to his doctor's office, ask them whether or not that there is a different option for that. With that, I would like to leave you, and thank you very much for your attention.
[AUDIENCE CLAPS]
[MUSIC PLAYING]