Leading medical technology programs in, for instance, the implementation of electronic health records, among other breakthrough advancements, Richard Kamman perceives himself as an intermediate between care, cure, and technology: “I am always working on the edge of technology, introducing new amendment policies and techniques in healthcare, being somewhat the link between what is possible in medical technology, and what is really needed in the healthcare practice.”
His work at the Princess Maxima Center for Pediatric Oncology in Utrecht started in 2016. Richard was responsible for the whole program for ICT and medical technology, from the hardware components to the hospital’s applications for ensuring the children’s safety. By mid-2018, the hospital was opened for infant cancer patients.
According to Richard, technology is present and available in many different contexts, and it exists in companies and all kinds of innovation centers. However, the big questions one should be asking when using technology in healthcare are: “‘How can you implement it in healthcare in a functional and sensible way? And ‘How can you introduce cutting edge technologies in the field?'” he inquires, and adds, “I think that establishing that bridge has been my main job.”
Richard started his career in hospitals in 1985. As he recalls, hardcopy films were still the trend in that period, and doctors still did their reports on audiotapes. That was also the moment when MRI, CT, ultrasound, and nuclear medicine were new technologies arising in hospitals, replacing the old, analogical applications.
As he explains, “We were shifting to the digital at that moment, and I was tracing that wave of technologies to hospitals. So, I oversaw the introduction of new applications in our work in the University Center of Groningen.” Richard was also directly responsible for implementing the shift from the old-fashioned analog system to the digital one.
For the physician, information and location have established the major changes in the healthcare sector. “In the old days, when you were admitted to the hospital as a patient, you received a diagnosis, but you had no information of what was going on with you. There was a kind of a black hole in information,” Richard reveals. He explains that patients were kept in the dark regarding their condition, possible treatments, side effects, time for recovery, etc.
This lack of communication was not a privilege of patients, though, but a reality among professions as well. “The radiology exams were kept in the radiology department. So, surgeons had to go to the radiology department to study the image and hope they could fully remember it when performing the actual procedure. The same is true for laboratory results and so on. These gaps in information between professionals played a significant role in why so many things went wrong in the past. There was no information exchange between departments in hospitals, and also between hospitals and GPs, and home care or physical therapy clinics,” explains Richard.
That has radically changed. Nowadays, information is much more readily available for patients. Furthermore, the exchange between professionals is prevalent, as the view is focused on the whole chain of healthcare surrounding the patient and the development of a more personal approach to that journey. “You can see what is going on, and follow the history of your treatment, what will be done in the future, and be informed about the actual numbers of the laboratory results. You can even see the images made within radiology; you can see your own MRI and CT, etc. So, it is much easier to see what’s happening around your illness, and it’s, therefore, much easier for connected and involved professionals to see what other professionals have done,” says Richard. For him, we are in a more patient-centered dynamic instead of a healthcare professional and hospital-centered one, which is a considerable change in the perspective.
In terms of location, another significant change occurs. In the past, the hospital was the only place to go when one had an illness or an accident. The hospital of the future, on the other hand, is much more home-centered. For the upcoming years, Richard predicts a transition from the hospital to the home care. As he remarks, “If you have, for example, to do high tech and diagnostic imaging, you have to go to the hospital. But even cancer treatment can be done in a home situation, which is much safer than a hospital, a possibly dangerous environment, a concentration of all kinds of sick people.” He adds that “Bringing sick people together increases the risk to get something you didn’t have; it increases the risk of infections. At home, you’re much safer, you get better food, you are less stressed, and that is one of the factors that boost the chance of a quick recovery.”
At home, patients can follow simple therapies and safely make appointments, measure blood pressure, heart rate, etc. Then, they would visit the hospital for special treatments only. In the case of surgical intervention, instead of spending the whole recovery time in the hospital, which can range from days to months, patients could spend that time in their homes’ safety and warmth. In this aspect, the stability, reliability, and extra bandwidth provided by 5G networks can play a significant role in delivering these services safely.
As a patient, one is always anxious about what is happening in their treatment. So how can the system help the patient in overcoming the stress of undergoing a medical procedure? In 2013, while working on the new Amphia Hospital project in Breda, Richard was an active thinker when it came to the discussion over what was necessary for this space to contemplate the patients’ needs in a better, more contemporary approach. It was when Richard wrote a “dream hospital” tale. “My starting point was ‘what if I were a patient? What would be pleasing to have?’ So, I wrote a nice story, kind of a fairy tale, with a narrative about me as a patient. I came up with several relevant but straightforward things that could make my life as a patient much easier and less stressful,” he explains.
Richard narrates that his journey as a hypothetical patient would start by being monitored by the physician remotely and entering the hospital only when his condition would make that relevant enough for that. Then, there would be a parking position reserved for him at his arrival. After the procedure, the patient would go straight home, if his condition would provide it, with constant monitoring by the physician. Patients and doctors would have access to all data and electronic healthcare records at all times, as well. “You see, a lot of things I envisioned are only small details, like having access to a wheelchair when you are not mobile enough, having a nicer way of ordering food, caterers being mindful of allergies. But all this contributes to the reduction of the stress in the patient,” Richard says.
With the introduction of sensor technologies, Richard visualizes hospitals assuming the function of a logistic center. At the same time, home care would have a much more prominent role in this patient-centered process. For him, there are some logistic problems to be overcome in terms of delivering the needed supplies for in-home patients. However, “nowadays, with drones with sensors, track and trace, etc., it is possible to deliver medication in due time to a patient. Likewise, thanks to the extra low latency offered by 5G, it is possible to monitor patients securely, whether at home or in another location, in real-time. By using sensor technology, powered by platforms like 5G, you can optimize the whole procedure around care and cure for the patient. I think that is one of the main things I see happening in the future of healthcare,” he predicts.
When asked about how initiatives like the 5G Hub and its ecosystem of partners could assist in shaping the future of hospitals and health care in general, Richard does not think twice: “I think they could contribute by not taking only the technology into account, but by also talking to patients, to medical professionals, to GPs, and inquiring what they truly need. There are many fantastic technological options available, and there are many more to come in the near future. However, they are not used appropriately, or they might not be in use at all at this moment.”
As Richard states, “one can talk about all kinds of fancy things, but if your network is not stable and reliable enough, then they might have a big problem in terms of shortage of service.” That is where 5G technologies come into play: by bringing an enormous roll of possibilities to enhancing the healthcare solutions of the future. Among other features, 5G can power image machines and their usually extra-large files much more easily with the extra bandwidth it offers. It can also guarantee a stable, uninterrupted connection for hospitals and other healthcare facilities, thanks to its higher capacity of network slicing. As such, 5G can assist in home care treatments by ensuring the real-time monitoring that patients need from their physicians, for example.
In Richard’s opinion, it is crucial that all the parties involved get together to think about the present restrictions and discuss possible solutions. As a significant first step, he suggests exchange sessions between the healthcare sector and technology developers, for the latter to showcase what technology can really offer and for doctors and caretakers to think of how these new findings can fit into the medical context, helping healthcare professionals and patients in their home situation. “Think if you, as a 5G Hub, can start to promote roundtables with the medical community; then you get a feeling of the direction healthcare is taking, not only by sending but also by receiving information. That, I think, is an essential thing.”