From healthcare to health: Preparing for a sustainable future

Lucien Engelen

CEO Transform.Health / Fellow Center for the Edge Deloitte : Global Strategist Digital Health / Keynote Speaker / Author

From healthcare to health: Preparing for a sustainable future

17 December 2019 | 9min

Quick Takes

  • Digitalization has enhanced many aspects of our lives, and now healthcare must undergo this digital transformation to improve patient satisfaction and care

  • Digitalizing healthcare is not changing what we do now into something digital – we must actively listen to patients and their families and rethink our healthcare system to fit their needs

  • Creating a new and sustainable approach to healthcare, which is more applicable to today’s society, requires cultural change and the freedom to fail in a safe environment

Lucien Engelen is the CEO of Transform.Health, a company that operates at the intersection of innovation and strategy to prepare executive boards, governments, corporates, and professionals for a sustainable future global healthcare system. 

In this inspiring and candid interview, he tells us how he sees the future of health and what leaders can do to prepare for it. 

HT: How do you think healthcare providers can improve patient experience right now?

Lucien Engelen: The best way to improve patient experience is to adhere to things that we, as citizens, are already used to in our everyday lives. Look at the patient’s experience from the perspective of a person, instead of a patient. 

Everything now is being handled digitally. A lot has changed in the way we fly, buy, and pay. Now it is time to make that digital change possible for improving patients’ lives. The same goes for communication. Everyone is mobile. We are connected and always on. Speed is key. Now is the time to connect, not only to people but also to patients. 

In 2008, I founded and was the Director of the REshape Center for Innovation at the Radboud University Medical Center in Nijmegen, The Netherlands, and I appointed a Global Chief Listening Officer in my team. Her main role was to listen. To visit patients in hospitals, in public areas of clinics, and also in their homes to really join the conversation and listen to what they and their families had to say and what they really cared about. 

The sort of knowledge that we got from genuinely listening to patients and their families was almost the complete opposite of what came out of the scientific papers and research we performed. The key is to understand what matters to somebody. 

Doctors tend to ask, “What’s the matter?” when they should ask, “What matters to you?”. Almost the same words, but a very different approach to the situation. Without connecting to patients, we will not be able to make the change needed to improve patient care.

We have built a healthcare system that is adjacent to our normal life. It’s like someone flips a switch and all of a sudden, you are not a person anymore, but a patient. Even when we ask healthcare professionals, they feel the same way; that there is a moment when you stop feeling like a person and start feeling like a patient. Two different systems. Life versus healthcare, where speed, interaction, and connection are lacking.

HT: Does that mean that the healthcare system we have created all those years ago is not fit for purpose anymore?

Lucien Engelen: Indeed, no longer fit for purpose related to our current understanding and how we run our lives. I trust that it was built for the right reason but there’s a lot of difference between then and now. Healthcare demands have doubled, yet hospitals have the same resources to work with. The world is changing so quickly, while healthcare is not. 

We need to understand what matters to our patients and their families and connect. That is where opportunities lie. Different opportunities for someone living with diabetes, to someone that suffers from cancer, to someone that has a chronic migraine condition, but that are otherwise the same in everyday life. Through listening, we can make the situation fit everybody’s needs.

HT: Can you see how new technologies can change the patient care model? 

Lucien Engelen: I see a transformation from healthcare to health. Using current technology, we can be measured anywhere, anytime, and even in real-time. This will allow us to signal, diagnose and treat early, and create a further switch from treatment to prevention. I actually think the solution for many challenges healthcare faces is actually (creating) health. 

Digitalizing healthcare is not changing what we do now into something digital. We have to genuinely change. We have to rethink our complete healthcare system.

We will move from healthcare to health through four pillars:

  1. Delocalization: Healthcare available always and everywhere. Not only in a clinic or in a hospital, but at home, while walking the dog, using your mobile device, your phone, or your watch. 
  2. Democratizing: Putting the patient at the center, with their data in their hands. 
  3. Digitalization: Transforming healthcare to adapt to the digital revolution happening around us.
  4. Dollars: Improvement through investment of existing and also new players.

HT: In your book, Augmented Health(care), you mentioned the organizational resistance to transformation. What is this organizational resistance and why is it a problem?

Lucien Engelen: By organizational resistance, I mean the resistance to cultural change. Change is impossible without changing culture. I have seen examples of potentially great projects; The money was invested, the technology was in place, and everything had been approved by the legal department. We had checked all the boxes. But, without any investment in changing the culture or the behavior, the projects were not as successful as planned. 

We continuously underestimate the cultural aspect, which again means listening to people. Cultural change is very hard to manage, especially when there is no readiness to invest in it. Everyone wants to innovate, but no one wants to change. 

HT: You have coined this term: HUX – Healthcare user experience. Can you explain a little more about what this means? 

Lucien Engelen: If we would redesign our healthcare system based on 2019 standards, it would look completely different from what we have in place now. We would do the majority of things on our mobile devices. We would have the choice to either go to the hospital or choose a digital consultation, for example. We now know that we always carry our devices with us and they say a lot about us. They know us better than we know ourselves. 

Moreover, you can turn that around. We know our devices very well. They have been designed in a way that makes it very easy for us to understand how they work. Even my mother-in-law gets it (really, if you want to see cat pictures, I am your man ;-)). 

In our healthcare system, it is the complete opposite. We have to explain every step to our patients, because it often is designed too complicated, which is of no fault to the patient but how the healthcare system is currently set up. The healthcare system needs to be redesigned to fit the needs of today’s patients by applying human-centered design principles. For instance, If we would run the healthcare system the way major tech companies run their business by focusing on the end-user experience, the healthcare system would look very different. 

For example, a chronic patient needs to go to the hospital to see the doctor for a monthly check-up. It will take lots of time to travel there, wait for the doctor, travel back, and all just to tell your doctor how you feel or to share some data with him. All things that could have been done remotely. But, when you have a spontaneous question and you need to consult your doctor, there is no time. The doctor is fully booked. 

If we would change this approach to a digital, more patient-focused approach, we win time – valuable time that a doctor can use to be there for his patients when needed. 

HT: You mention that your goal is to create sustainable global health(care) for all by preparing for “a soft landing into the future”. What kind of message would you want to give to C-Suite healthcare providers to help achieve this?

Lucien Engelen: Here I have to quote Richard Branson: “Clients do not come first. Employees come first. If you take care of your employees, they will take care of the clients!”. Of course, in this case, we would have to swap clients for patients. Major change does not happen top-down, but bottom-up. So indeed empowering patients, but through the empowerment of those that are delivering – that are doing the job – is essential. 

People stepping into the workforce now don’t know where they will end up in forty years, as it may have been in the past. Harnessing that flexibility is important to create the culture necessary for change. 

So, to create a soft landing, it’s choosing to keep doing the good you are doing right now because that’s needed. But also be sure that over the next 10 to 15, maybe even 20 years, you have to create a mind shift as well. We need to create a different approach to healthcare that is more applicable based on technology and the asks of society. 

That brings in cultural changes and uncertainty about your business model.  You have to invent new business models, some of which probably won’t work so you have to be ok with failure. Failure is not the only part of the equation, but creating failure in a safe environment.

What I see a lot in healthcare is that people wait. They say, “Oh, it’s not good enough yet. I want to be a follower. I don’t need to be on the front end of it.” Being a follower now is taking the approach to become obsolete at the end of the day. This is not for healthcare alone, but for all industries. 

The only way to predict the future is to create it.

HT: To make sure that we can keep up with this constant change, do we also need to change our educational system?

Lucien Engelen: Yes, for the next generation of physicians and nurses, the only constant is change. Is the way we are educating our healthcare providers still applicable? No, because both the cultural education as well as the focus on digitalization are lacking. Maybe they get some information about remote blood pressure measuring, but that is about it. There is nothing on artificial intelligence, on data management, on using apps or social media to improve patient experience and, in the end, the patient’s life. 

However, this is improving. More universities are adapting their curriculum. Education, like policy, is always lagging behind, but I am thrilled to see more and more schools and universities thinking out of the box and getting ready for the now, or even better, for the future.

Lucien Engelen is the founder and CEO Transform.Health. He is a frequent global keynote speaker on the Future of health. As a strategist, he leads the Global Digital Health department for Deloitte’s Center for the Edge and he was the founding director of the REshape Center at Radboud University Medical Center in The Netherlands.