The future of healthcare

END HO VEN, the Netherlands – "Convergence" has been a buzzword for more than a decade now. Unlike the "old convergence," which was a battle to win consumers with technological solutions, "new convergence," according to Philips Consumer Electronics CEO Rudy Provoost, is not about new technologies but about "new experiences centered around consumers through existing and emerging consumer electronics (CE) platforms."

The Dutch company Royal Philips Electronics, based in its sprawling High Tech Campus Eindhoven in the Netherlands, has been moving in the direction of lifestyle and healthcare for several years now. While it has always allotted 10 percent of its annual turnover to research and development (R&D), the way this 10 percent is being spent has changed in recent years. A majority of it used to be devoted to CE; today it is spent on healthcare.

According to global studies, healthcare is the biggest industry in the world particularly in developed countries, and by the end of the decade, it is predicted that it will consume 10 percent of the world’s gross domestic product (GDP).

What Philips is doing right now is using its expertise in consumer electronics and medical technologies to come up with ways to improve people’s lives at lower costs. As they like to say in Eindhoven: "Sustainability has always been in our DNA."

The company has adopted an open innovation philosophy that lets its research go further than ever before – working with academe, scientists from multi-disciplines, hospitals, other industry-related companies, and government commissions to lead research programs into such fields as molecular medicine and cardiovascular diseases.

Paul Smit of Philips Medical Systems Strategy and Business Development says, "We focus in our healthcare business both on the needs of the patients and on healthcare providers. Our vision is to eliminate boundaries that prevent or slow down a patient’s progress through the care cycle – for example, by eliminating the need to visit a doctor or hospital to get advice or diagnoses, or by developing simple-to-use defibrillators that can save a life before paramedics can arrive on the scene."

The company acquired early this year Lifeline Systems Inc., a leading personal emergency response service company. This acquisition was described by Philips CEO Gerard Kleisterlee as "an important step in the company’s roadmap for growth in healthcare. By targeting seniors and other people who want to continue living independently and exerting more control over their health and lifestyle, we aim to become a global player in the evolving home healthcare market."

Philips’ Motiva, winner of a Medical Design Excellence Award and named one of the "Top 5 Disease Management Ideas of 2005," is a TV-based personalized healthcare platform for remote patient management.

Trials on home-based telemonitoring have shown that it reduces the number of days patients spend in hospitals by 26 percent and leads to an overall 10 percent cost savings compared to nurse telephone support. It also improves survival rates relative to usual care and leads to high levels of patient satisfaction.

The goal of telemonitoring is to promote patient self-care through education with the end result of better patient compliance, thus empowering him to play an active role in his own healthcare management.

"We are bridging the gap between the hospital and home by creating systems that continuously monitor a patient’s condition while they are at home and automatically communicate significant changes to their healthcare providers," says Ivo Lurvink, CEO if Philips Consumer Healthcare Solutions.

Targeted to organizations that provide healthcare management to patients with diseases such as diabetes, asthma, heart disease, depression and other chronic diseases that affect the quality of life of millions of people worldwide, Motiva lets the organization collect data, tailor the right level of care, coach and guide patients to better health.

How does it work? Once enrolled in Motiva, the patient receives a set top box for the broadband connection as well as a wireless device to measure weight, and in future models, other vital signs such as blood pressure and glucose measurement will be incorporated. This data is then collected by the healthcare provider, which gives remote one-on-one interaction with the patient, and is used to assess, educate and help the patient manage his disease.

Reducing unnecessary hospitalization does not only benefit the patient, it also benefits the entire industry by freeing doctors to see other chronically ill patients.

Another of Philips’ innovative products is the HeartStart Home Defibrillator, which uses voice instruction that guides the user through every step of the process. It’s so easy to operate, says Lurvink, that "even a 10-year-old can use it."

Their hope is that in the future, every home will have one just as it has a fire extinguisher.

Philips Research senior vice president Henk van Houten says that the healthcare industry is undergoing three major paradigm shifts that will lead to less traumatic experiences and enhanced quality of life for patients.

One is the move from anatomical imaging to functional imaging in support of diagnosis and therapy. "For example, Positron Emission Tomography (PET) is the most sensitive imaging system and leading in molecular imaging. Philips’ unique time-of-flight technology has led to dramatic improvement in spatial resolution and sensitivity of this imaging model. And by combining PET with computed tomography (CT), it is now possible to reveal both functional and anatomical detail at the same time. Together with appropriate modeling and software tools, PET-CT is poised to extend its importance as a diagnostic and therapy guidance tool for cancer and brain disease."

Two, due to progress in the study of DNA coding, biologically active proteins and biomedicine, there is now a better understanding of "disease pathways at these levels, which is a focus of an emerging area of research known as systems biology." This means that in the foreseeable future, in-vitro molecular diagnostics and in-vivo molecular imaging will be used for early detection and monitoring of diseases.

"By detecting the precursors of disease at the molecular level of the body, the new technology of molecular medicine will allow diseases to be detected and cured well before the patient suffers from symptoms," says Paul Smit. Put another way: biosensors that are needed to be developed must be able to detect specific molecules in the blood "at concentrations equivalent to a grain of salt in an Olympic-size swimming pool."

Molecular medicine not only enables early and precise detection of diseases, it also helps prevent disease and allows patients to get personalized treatments that are more effective, cause fewer side effects, and are cost-effective.

This month, Philips will open its Life Sciences Facilities in Eindhoven, a multidisciplinary research facility, for advanced research programs in molecular biology with partners in molecular medicine, biotech, in-vitro diagnostics, pharmaceutical, medical technology and healthcare IT.

Third is the shift from hospital to patient-centric care. It’s about empowering the patient, linking the clinical world with that of the consumer, coming up with the right business models, and inventing monitoring tools that can be worn unobtrusively on the body or that can be incorporated in the home environment.

Prototypes are already being tested in Europe under the MyHeart project, a project supported by the European Commission and led by Philips, which develops intelligent systems for the prevention and monitoring of cardiovascular diseases.

Among these is biomedical clothing, which integrates functional clothes with on-body sensors and electronics. For women, the devices are integrated into their sports bra, and for men they are worn like a simple heart-rate monitor but they do so much more. The device monitors one’s stress levels, quality of sleep, overall health status, and dispenses health advice and the type of activities one must do to achieve better health. The display is integrated into everyday appliances like a bathroom mirror, which becomes a touch-screen monitor.

When demonstrated to visiting Southeast Asian journalists, our feeling was it was so futuristic it was like watching a sci-fi movie – except that this will soon be a reality, and perhaps as common as an electric shaver in the bathroom.

There are many more inventions the Philips has brought from concept to marketable products. One of these demonstrates so vividly its long heritage of innovation in lighting, X-ray technology and consumer electronics.

Catharina Hospital in Eindhoven, a 696-bed hospital that admits more than 350,000 patients a year, is the first hospital to have the Ambient Experience in its CathLab (Catherization Lab). The procedure has doctors inserting a thin, flexible tube or catheter in a heart patient’s blood vessel to allow access to the heart or blood vessels without major surgery. With the help of X-ray imaging, doctors can then examine and diagnose the patient’s blood vessels and heart.

The Ambient Experience, as the name implies, gives the room a more soothing atmosphere not just for patients (they must be awake while undergoing the procedure) but also doctors who do multiple procedures in a single day, which often lead to backache since they have to wear heavy vests to protect them from radiation.

The patient can choose the lighting color and the visual theme in the room, which are accompanied by a sound and scent that represent the theme. For instance, he chooses a meadow theme. LCD panels in the ceiling then show moving visuals while unobtrusive lighting gives the room a soft glow – a far cry from the usual bright, fluorescent lighting used in CathLabs.

Initial trials and current procedures show that the Ambient Experience is leading to faster diagnoses, lower radiation doses and calmer patients (we all know that atmosphere can spell the difference between an anxious patient and a calm one).

For the medical staff it means an improved workflow. Using diffused lighting, any shadows or reflections on monitors are eliminated while equal light distribution makes the room relaxing to the doctors’ eyes.

And in another sci-fi-like setting, doctors can check patient data before the procedure starts. A mirror TV placed in the physician’s preparation room (while they’re scrubbing) displays all the necessary information.

At the tableside, the doctor needs to focus on the patient, not the system. With the Philips voice control system there is no need for the doctor to push buttons as the system follows his voice commands.

"The first experiments already proved this to be a very important investment for our hospital," says cardiologist Jacques Koolen of Catharina Hospital. "The room design and the lighting are so good, they can really speed up our workflow. This might even result in less radiation, as our first experiments have already shown. My colleagues and I are also very pleased how this ambient CathLab takes into account the sometimes difficult working conditions we as physicians encounter – extremely long working hours where concentration and patient focus are essential."

The atmosphere is almost like a spa’s, it’s no wonder patients always request to have the procedure done in the Ambient Experience room.

Now if Philips can only do something about hospital food.