Dutch Digital Health Night, 9 April 2019, Dutch Embassy, Berlin

Thank you chair for your introduction and for the opportunity to address this immensely creative and innovative public in digital health. Also, thank you deputy head of mission for hosting this event and bringing together all these creative minds here.

Dear ladies and gentlemen,

Let me start with something funny yet quite striking, in November last year a Dutch emergency doctor tweeted that he had discovered the digital highway in healthcare! In fact he was referring to the A1 highway, on which a taxi, carrying a DVD with medical images, was travelling to another hospital twenty miles away.

Today, under the shadow of the DMEA event, we are addressing the many common challenges under the denominator of digital health. Here, together, we are laying the foundation for a sustainable, modern and future proof healthcare system.

For us in The Netherlands, this is an ongoing journey of experimenting, learning and adapting. I want to share with you our approach.

As a government, we have the responsibility to serve our citizen’s interests, and we do this by celebrating the many heroes in Digital Health. The passionate professionals who work tirelessly every single day. The relentless patient advocates who share their compelling stories to keep us all on the right track. The rebel entrepreneurs who defy the system and disrupt the status quo. The change-makers who see possibilities and have the courage to act on them. Change-makers that are in this room today. We should celebrate them, learn from them, question them and most of all embrace them. The one thing we cannot do is ignore them. Because they are the change. They invent. They imagine. They explore. They create. They move. This evening I want to celebrate one of my heroes: the late Niels Schuddeboom.

For over a year, Niels was a valuable member of the Ministry’s Board of Directors, our first Chief Experience Officer. As such, he got access to all board meetings, often with a virtual presence. When dealing with the complex changes required for digital health, Niels chose empathy over distance, humour over judgement and dialogue over opinions. He learned to dance with the system, and be the change he wanted to see. Sadly, he lost the fight from cancer. In his last year, he mobilized like-minded people, heroes in their own right. They are the ones who will continue the great work Niels had started. They too are the change. We now have over 50 Chief Experience Officers for which Niels paved the way.

Ladies and gentlemen, innovation in healthcare is what I call a wicked problem. It is complex, as it involves many different stakeholders with diverging interests. The conservative powers are often very strong, working to keep the status quo.

Governments have a responsibility towards people like Niels to accelerate health innovation, so the benefits are available to them at the right conditions. We need to ensure

  • that digital health adds value to patients and keeps citizens healthy

  • that it enables healthcare professionals to spend their valuable time and knowledge on meaningful results, providing the best possible care at the right place, instead of on useless red tape and procedures and

  • that all digital communication is trustworthy and safe.

Government alone can never bring the change we need. For this we need the whole ecosystem. And our role is to bring everyone together. To show leadership and go from making legislation to kick-starting the broad social movement to empower citizens to become the master of their own health. To bring cold technology to enable warm care. To take healthcare from the waiting room to the living room. With a strong focus on high impact, using proven technology and getting measurable and meaningful results.

Data is the blood and oxygen of modern healthcare. We need to be able to trust that the right information, in the right form, is in the right place at the right moment. But as obvious as this sounds, it doesn’t come naturally.

In 2014, after travelling through space for over 10 years, the European Rosetta Philae space probe successfully landed on the surface of comet 67P, about 490 million kilometers from Earth, travelling with a speed of 135 thousand kilometers per hour. This extraordinary feat required an international collaboration spearheaded by the European Space Agency, groundbreaking communication with the Rosetta spacecraft and extreme precision calculations. It is truly a tribute to what humankind is capable of achieving with technology. And yet, 5 years later, with technology at least 15 years more advanced, we are not able to guarantee that digital medical image data is available in a hospital 20 miles away.

Ladies and gentlemen, modern healthcare is a flourishing ecosystem of interconnected people. An ecosystem needs a good climate that enables the stakeholders to do what they do best. It is the responsibility of government to ensure that the incentives are aligned and that there is an open and level playing-field for everyone -from the current players to the disruptors. There isn’t a tried and tested model for what this will look like, it is a learning process for everyone.

Our approach focusses on unleashing the positive energy that is already there in the field, removing obstacles and creating the conditions for mutual learning and cooperation. This approach is proven to be successful in creating breakthroughs.

We stimulate this learning by accelerating breakthroughs with so-called Health Deals. We bring people together and will not let them go home until they have committed themselves to creating a breakthrough. So far, 5 Health Deals have been signed, ranging from personal prevention with eHealth and gaming, to dealing with chronic pain and using e-health for vulnerable youths.

We reduce the risk for digital health investors by creating a seed capital fund, so they accept the possibility of failures more easily. As you all know, failure is the best way to learn.

With the Health Innovation School, we invest in the innovation skills of the healthcare leaders of tomorrow. Here they learn how to become Change-Makers. The first two rounds of 50 future leaders have been trained, now the Health Innovation School is growing regionally, spreading the knowledge and network deeper into the healthcare organizations.

The second thing any ecosystem needs is fertile ground. That is the foundation on which modern healthcare is built. It is the standards and requirements and legal frameworks that ensure that all communication is safe, secure and trustworthy.

  • That we know who we are communicating with.
  • That our communication has not been altered along the way.
  • That the data is not misinterpreted.
  • And that we can use the data in our own systems.

Therefore, we created a National Health Information Council. A public-private partnership, including patients, doctors, nurses, other health professionals, insurers, hospitals, care institutions, general practitioners and governments. Or as I'd like to call it: we got the whole system in a room. With the Ministry in the role of a system therapist. And also as law maker providing both carrots and sticks to speed up and force electronic exchange of data in health care.

Together, we have set ambitious but achievable outcome goals: improving medication safety, promoting patients access to their medical data, enabling safe data exchange and improving the quality of data. One time registration at the source and multiple re-use. To reach these goals we need mutual agreed upon standards for information exchange.

In my experience, a lack of vision on the future of healthcare is not the problem. The technology is not the problem either. It is the implementation. The main challenge in digital health we face today is how do we scale up working and proven solutions to benefit all our citizens and professionals?

I believe the killer breakthrough to scale up innovation is to free personal health data from the silos and give people the tools to leverage that data to improve their health. In The Netherlands we have MedicalMe, or MedMij as we call it.

MedMij is a patient-led coalition of insurers, healthcare providers, health IT industry and government, creating the national trust framework for an ecosystem of personal health systems. They develop and test a set of standards to exchange personal health data with citizens: structuring clinical data based on SNOMED, exchanging data using IHE-profiles and communicating with citizens using FHIR. MedMij is privacy-by-design, as it puts you in charge of your own data. It is longitudinal, as it is the national standard for exchanging personal health data with patients. Standards that will be enforced by law as the same standards must be used in exchange of data between health care providers. MedMij is no longer just an idea. The Trust Framework has been published, the first use-case based FHIR-profiles are ready, over 50 personal health data service providers are in the certification process to be part of the trust framework and over 80 healthcare organizations are working on implementing MedMij for their patients. This is just the start. It is real, and it is scalable, as it allows for different solutions for different people, all on a common foundation of trusted communication. It is growing fast. From October on every Dutch citizen can use a MedMij-certified personal health environment for free. Suplliers will be reimbursed by the government.

Ladies and gentlemen,

My message to you today is to continue the great work that you are doing. And to work and learn together, like we do tonight, also across borders. National borders are man-made barriers. This city has a rich history unleashing energy through breaking down barriers and tearing down walls. There is a parallel with freeing personal health data from silos, as you understand. To us governments the task to take down implementation barriers that prevent scaling up the innovative solutions you will be presenting this evening. I also call upon my colleagues to come together and agree on common standards to be used in our healthcare system to allow the effortless flow of data within and across our national borders. The future is now and you are part of it. A special good luck to all the pitchers. Regardless of who will take home the prize, I consider all of you winners.

Thank you.