Years ago, Philips decided to narrow its portfolio and focus on health technology solutions for consumers and healthcare professionals. The company strengthened its development, research and production of technologies that enable early screening of diseases, precision diagnostics and, subsequently, minimally invasive image-guided treatment of diseases such as heart and vascular conditions or certain cancers and the treatment of chronic conditions. Dr. Jan Kimpen is the Chief Medical Officer at Philips. The Medical Tribune asked him several questions during a teleconference. Our inspiration was his blog on “Why is Trust the Secret to Achieving Zero Preventable Deaths”?
Doctor Kimpen, how would you describe Philips's vision?
OK, let's start our interview with one of Philips's main visions. We want to be partners to healthcare professionals and their collaborators, not just developers and retailers of healthcare equipment. I spent twenty-five years in pediatric practice, of which I worked at a pediatric clinic for eight years. During that time, I have come to believe that patient safety is the most important issue for both physicians and hospital management. If we want to be genuine partners, we have to offer healthcare professionals solutions to ensure the safety of their patients.
Can you give specific examples?
We develop hardware and software to help doctors identify signs of impaired functions in advance. Our first solution in this area was the monitoring system for patients who have just left the intensive care unit. These patients stopped being monitored continuously and their condition was checked by a nurse's personal visit at several-hour intervals between which the patient's condition could worsen unnoticed. For these cases, we designed a continuous monitoring system, with patient sensor data displayed on a nurse's console. As a superior application, we have built in an artificial intelligence to warn about the patient's condition worsening earlier than at a glance. Thus, we can predict heart failure 8 hours ahead or predict a septic shock several hours before it actually occurs. In this way we help doctors improve the clinical outcomes of their work.
How do you want to eliminate human errors in patient monitoring in the ICU?
In intensive care units there is a phenomenon known as monitor fatigue, which leads to a delayed response or even the absence of an alarm response. There are just too many monitors. That's why we invented the electronic intensive care unit (e-ICU). The signals from the patient's sensors do not come directly to the nurses, but to a console located in another room, where another healthcare professional monitors the alarms and evaluates which alarms are relevant and only passes those to the nurse.
In normal conditions, it is difficult for a nurse to decide which alarm is necessary to be taken seriously and which alarm is false. In addition, at the time of a serious alarm, she may tend to another patient. Therefore, it is essential that another person evaluates the alarm´s severity. This will reduce alarm fatigue, reduce the number of unnecessary personal checks of a patient who does not require them, ultimately reducing or minimizing the number of missed alarms.
This is a technical solution of the problem, to which Philips has also developed educational programs. Our consultancy department helps healthcare professionals and the hospital management to take the necessary steps to change.
How do you want to minimize invasive procedures during diagnosis and treatment?
To minimize invasive techniques, we have developed one of our most powerful technologies, image guided therapy. An example is the catheterization laboratory, where the use of radiation always is a major challenge. Doctors apply the contrast agent and then monitor its distribution under the X-ray. It is not always possible to reach a definite conclusion for the first time, so the test is repeated. As a result of this procedure the radiation load increases for both personnel and patients. The second problem is the doubt about whether the catheter is being correctly located. Adding a second imaging method, such as ultrasound, will increase the accuracy of the examination and reduce the radiation load. Our new catheter type can be seen on the screen before the contrast medium is applied. With the help of artificial intelligence, we are able to recreate a three-dimensional image of the heart of any concrete patient, which can be viewed from all sides to accurately identify the position of the catheter and accurately locate the affected area for intervention. This helps doctors to introduce the catheter easier and at the same time to reduce the radiation load.
What solutions does Philips offer for complex everyday diagnostic and therapeutic procedures?
I can give an example from oncology. In the diagnosis and therapy of breast cancer, doctors (repeatedly) collect all patient history data, the doctors themselves then assess all findings of imaging examinations, laboratory results, findings of a pathologist, genomics. They then integrate all this data into a particular finding. And this is done by all members of the multidisciplinary team individually. With our new solution, all relevant findings will appear on the screen of all the members of the multidisciplinary team without their preceding analysis. Artificial intelligence does the "machine" work and the doctors can only deal with relevant findings. Then the team has the capacity to determine the optimal follow-up for a concrete patient. Based on the big data from previous patients and clinical outcomes, artificial intelligence can also predict the right course of action and solution for an individual patient and avoid mistakes stemming from excessive unnecessary information.
Artificial intelligence is a promise for the future of healthcare. How important is its development for Philips?
Philips is a leader in artificial intelligence development, with a large team of developers working on it. At least half of the Philips R&D team are experts in software and data processing. We believe in the power of big data and artificial intelligence that can help doctors. Artificial intelligence is part of our devices, monitoring systems, smart phone solutions and other mobile solutions that doctors and patients use.
For example, if a young mother needs advice on taking care of her newborn, she can use our application and get familiar with the basic measures for childhood diseases, as well as use its monitoring possibilities.
The question of education of doctors is closely connected with improving patient safety. Does Philips (as a wellbeing company) support postgraduate medical education?
Philips organizes training for both doctors and nurses, and not only on how to use our devices and new software. We also publish educational materials not directly related to our products. And finally, we have a healthcare consulting department that helps hospital workers learn how to handle devices and applications.
The aging population (and doctors) is a major problem of our time. Do you think that artificial intelligence could be a solution?
We all live to a higher age, so we are ageing. This is positive news. On the other hand, our population has a higher incidence of chronic diseases than ever before. People over the age of 65 have two, three, and often more diseases that have to be managed at the same time. This puts an enormous burden on the physicians, exhausts them, and often the optimal patient care is beyond their real potential. Then it may happen that the patient's health deteriorates. The solution could be a mobile application monitoring the patient's condition at home and sharing data with a doctor via smartphones/tablets, but the findings have to be “pre-evaluated” by artificial intelligence and only the data worthy of attention transmitted to the doctor.
Philips has a development center in Arizona, where we monitor the elderly in their home environment. Their monitoring can prevent thirty percent of emergency medical visits and seventy percent of hospitalization cases. This can reduce health care costs by 35 to 40 percent.
How would you comment on this year's Philips Future Health Index?
This is our most important publication summarizing the findings of a large number of data. The research was conducted in fifteen countries and about 15 000 patients and 3 000 healthcare professionals in total answered our questionnaire. This year's research was focused primarily on digital solutions and digitization of healthcare, which helps the cooperation of doctors and patients. For us, three most important conclusions have been drawn:
1. Doctors are increasingly open to the use of digital applications and telemedicine in their daily work.
2. Patients, if they have access to their health information in electronic form, are better able to understand the nature of their disease and the principles of therapy. Patients who do not have access to information about their health are less satisfied with healthcare, but they would like to have this information available.
3. The third interesting observation was, that countries where healthcare systems are being built, such as China, Saudi Arabia or India, are more responsive to digital technology and data sharing than traditional Western countries where the healthcare system has been implemented for decades. It seems, as if these countries, which are currently building their healthcare system, have skipped the stage where digital technology was not available and the system was built based on different principles.
How is Philips different from its competitors?
Philips is not just a device retailer, our priority is to be a partner for healthcare professionals. We are talking to them daily and listening to what they need, what they expect from new technologies. We are in contact not only with our clients, but with all kinds of healthcare facilities so that we can understand what can be done and how to improve the work of healthcare professionals to allow them take better care of their patients. Our solutions are the result of working with doctors and nurses to help Philips meet the needs healthcare professionals will have in the future. For example, for catheterization laboratories, the system was developed in collaboration with thirty cardiologists. Philips did not just invent something to sell, we developed the system in cooperation with our partners. In our work we combine very deep technological capabilities with design and expert consultations. This is the basis of our innovations.