On June 27th the Medical Delta Event event entitled 'We add value – Value based healthcare & the role of technology' took place. A great line-up of speakers took their audience from undeniable facts and figures along razor-sharp quotes to conclusions inspiring anything from worry to pride. What deserves to be remembered is definitely this: all ingredients for success are there. “So let's roll up our sleeves and continue on this journey together.”
Students, professors and entrepreneurs alike found their way to the ambiance of the 'grand old' Leiden Stadsgehoorzaal – in such large numbers that it was almost entirely packed. Already in the first minute it became clear that this event was not about contemplating the last ten years in a laid-back way. It was much more about hard labour during the decade ahead. Chair of the day David Abbink did a welcoming round among the public and landed the microphone box in the hands of Medical Delta Professor Hans Tanke. He stated: “The first question everybody always asks about Medical Delta regards added value. The recent comparison with other top-ranking medical technology hot spots worldwide by an international panel led to the following conclusion: when all results are added up, the Medical Delta scores okay. But when looked at it separately, the results are not yet quite good enough.”
There's work to be done, especially because the ingredients to become one of the most innovative regions in Europe are there. “Together we have amazing complementary knowledge. This holds incredible potential. It's about time we realise how much we can accomplish together if only we add more goals and focus.”
Pancras Hogendoorn, Dean, member Executive Board LUMC and member of the Medical Delta Board took the stage to explain how the Medical Delta goals could be aligned with the Dutch Research Agenda (NWA) the 2015 Vision for Science, EU programmes and societal trends to reach maximum impact. “The future of medicine goes from hospital to clinic to home, characterised by trends such as better imaging, data to knowledge, smart devices and intelligent systems.” He made clear that Medical Delta's capabilities to answer unmet medical needs will be key for success.
Dimensions of value
Professor of Health Economics Werner Brouwer, member of the 'Zorginstituut', confronted his public with the inconvenient truth of infinite needs and limited resources. Healthcare expenditures keep on growing. The Netherlands, with 12% of GNP spent, now has the second most expensive healthcare system worldwide. “Novel health technologies will have to take value for money into account, as it is unavoidable to trade off costs and benefits.”
Some dazzling numbers: every decade we gain 2.5 years in longevity. “Politicians agree, that benefits from new technologies should outweigh the costs, but don't act on it. Health technology can be a cost saver, but usually it isn't.” The Quality Adjusted Life Year (QALY) is the currency of health economics, which should be invested with the thought in mind: 'you always sacrifice the alternative spending'.
Hans Schikan, Top team member of the Top Sector Life Sciences & Health, pondered various other dimensions of value. “Only a couple of years ago, it would have been impossible to have six generations in one photo. Now it can be done. Universities, business, government and patients should co-operate to further the idea of vital citizens in a healthy economy.”
The Dutch life sciences sector already employs 165,000 people in 2,500 companies with a total turnover of 33 billion euros. “The Netherlands rank fourth on the European Innovation Scoreboard. Given the growth trend, we're heading for the runner-up position.” Thanks to the vastly enhanced knowledge, the sky is no longer the limit. “This knowledge can be utilised to boost precision medicine, for instance to develop orphan drugs for thirty million Europeans suffering from one of five to eight thousand rare diseases.”
One of the keys to success is to bridge the gap between disciplines, director a.i. Agaath Sluijter of Medical Delta told her audience. “We have Medical Delta Professors, joint education programmes, public private partnerships and see to it that business meets science. A new, hands-on addition are the Living Labs which offer real life settings for testing the efficacy, safety and cost-effectiveness of new technologies in hospitals, rehabilitation centres and the patient's home.”
Minimal invasive devices can make the surgical process more effective and less complex. Gamification and robotics enable more intensive, more cost effective and more successful rehabilitation. The Living Labs speed up the process of new technologies toward their market launch.
Rian Rijnsburger, Programme Manager Medical Delta Living Labs handed out four Living Lab Vouchers to projects to develop and test their products within the Living Labs of Medical Delta. The first one went to the ResearchOR project, the second to Adjuvo Motion to test devices that remind and trigger rehabilitation patients to exercise. The third voucher was for 2M Engineering for an activity tracker especially for wheelchair users. The fourth one went to Heemskerk Innovative Technology for testing 'Rose', a support robot for self reliance.
CEO of your own health
In a short movie, patient Tim Kroesbergen tells how an app for temperature, heart-rate and saturation monitoring on his smartphone is very reassuring to him. “Doctors need to be educated in such e-Health capabilities, as not all of them are aware of the added value e-Health can offer.”
The app has made Tim the CEO of his own health, Secretary-General of the Ministry of Health, Welfare and Sport, Erik Gerritsen underlined: “Low-tech with high-impact: that is what we should be aiming at. The website www.thuisarts.nl supports people to the extent that 700,000 visits per month to the general practitioner are reduced.”
The medical sector is expected to advance more in the upcoming ten years than it did during the last century. Gerritsen: “The pressure to move with the modern time is high, as for instance the number of avoidable deaths in healthcare, calculated by NIVEL at three times the number of traffic victims, is unacceptable.” This progress requires 'fertile ground' for patient centred e-Health: open standards, secure communication and a payment model allowing for innovation. Lack of interoperability and lack of standardisation should be solved. “Local ecosystems such as Medical Delta could play an important role in this”, Gerritsen emphasises.
After his lecture, Gerritsen invites six start-ups to pitch their product under the motto 'Medical Delta Young Talent in the spotlight'.
- Brainfly develops a device to monitor the influence of gravity on the astronaut's brain as well as monitoring the brain of ALS and stroke patients.
- ReaSONS has developed a small system for cheaper and better monitoring of the unborn child. Envision offers the visually impaired new ways to operate more independently thanks to a camera and artificial intelligence that orally describes the surroundings to the user.
- Cryo device for Africa developed a device to treat servical cancer in Africa.
- Exelscope shows a smartphone-based microscope, for instance to magnify a blood sample that can be instantly sent from an outpost to a hospital for professional evaluation of parasites.
- Eye Around the Corner introduces a cheap and simple device to ensure proper intubation.
The jury chose Exelscope as the winner, allowing Gerritsen to hand out a research voucher.
After this small ceremony the audience chose one of four parallel sessions to attend: on personalised healthcare, fetal and neonatal care, cyber-physical solutions in rehabilitation and care or on the future of e-health and self-management.
The audience gathered again for the plenary session by Dinko Valerio. He played a pivotal role in Crucell and Galapagos. He started off his speech by describing the cultural distinction between curiosity-driven scientists and entrepreneurs heading for a central goal. Both are necessary to attain success, Valerio emphasises. “Scientists understand that their science should be best in the world, but don't understand that exactly the same goes for the entrepreneurship required.” The recently deceased life sciences entrepreneur Henri Termeer has proven this beyond any doubt by opening the road to orphan drugs.
Termeer was with Valerio and Gerard Platenburg part of the founding team of ProQR, a Leiden based company determined to find a cure for cystic fybrosis. Fourth founding father was Daniel de Boer, who's drive and focus is nurtured by his son's fate as a cystic fybrosis patient. ProQR's time line is incredible: founded in 2012, included in Nasdaq in 2014, exciting results in mice the same year, announcement of a lead product in 2016. It is expected to enter the clinic in 2018: from scratch to clinic in six years. “When your're this driven to make a difference, no disease is safe”, Valerio concludes.
Yet another voucher is there to be handed out: the Medical Delta Young Talent Award for best PhD student. Leiden's mayor Henri Lenferink does the honours. The nominees are Aimée Sakes, Matthijs Blikkendaal and Gennady Roshchupkin. The jury had a hard time deciding, but eventually chose for Aimée Sakes based on quality, potential impact and feasibility of her research into the use of hammer-like instruments to break down occlusion in the heart.
Sakes used biomimicri to develop a solution, after she had concluded that the presently used tools – against what is basically brick – are too soft. When you want to destroy brick, you need a hammer, she concluded. Lenferink quotes the jury as he mentions her “ruthless creativity and perseverance” in creating a hydraulic prototype for a minimum invasive surgery device. Sakes herself in her word of thanks provides the best possible one-liner to close the event:
“Let's roll up our sleeves and continue on this journey together.” Aimée Sakes, TU Delft
Text by: Leendert van der Ent