Sharing our data will make us live healthier, happier and longer lives.

Koen Kas, Professor for Oncology at Ghent University, in Belgium, is a healthcare visionary driven by the aim to make healthcare delightful, personalised, and ultimately preventive. And the key to his vision is digitalization.

asut: You have written a book («Sick no more») painting a very optimistic picture of the digitalized health care of the future. Why should still more technology lead to a more human system?

Koes: Because currently we don't have health care, we have sick care, a system built on the premise that we treat people only once they get sick. By the time you get diagnosed with diabetes, for example, the disease has started 15 years earlier without you even noticing. So the question we should ask is: What can we do in the 15 years before, what kind of behavioral changes are needed to prevent the sickness from breaking out?

And here digitalization comes into play?

Change people’s behavior is one of the toughest things to do. Smart analytic tools can learn what keeps us fit and happy. And they can be used to bring experiences to people that are fun and at the same time reward them to know as much about themselves as possible in order to remain healthy. Technology itself will disappear into the background, while in the foreground doctors and healthcare provider will get more human because for the first time they will get the opportunity to keep you healthy instead of curing you when you’re already sick. So yes, a digitalized heath care system will be more human.

And it will, as you say, rely on a lot of technology in the background?

When I send a package from Bern to Lyon, I can trace it every few minutes and know exactly where it’s located. A patient, on the other hand, spends about 8,750 hours a year not linked to the healthcare system. He is all by himself. So the average package is better monitored than the average patient. That has to change and digital technology is key to get closer to our patients. Sensors, wearables (around, on and soon also in our body) in our daily lives will constantly monitor our state. They will collect data on various indicators, from heartbeat and activity levels to eating habits or whether someone posts pictures with reddish and orange hues or with predominantly blue and grey shades on social media platforms. Changes in these indicators or in behavior patterns can alert your doctor to an imminent health problem. In this way we will be able to anticipate and prevent sickness. We will move from reactive sick care to proactive health care.

When we speak of digital health we mostly discuss things like electronic health care files or in other words: about digitalizing the health care system by breaking down analogue silos and enabling quick access to patient records from multiple sources for more coordinated, efficient care.

These are necessary changes that need to be made and are liable to bring huge benefits to the health sector. But this approach is a legacy of the past because it is still dealing with sick data, while the majority of my life is about health data. To keep me healthy you have to find out how I live every day. You have to motivate me to do my 150 minutes of weekly exercise because you know that this is what will keep me from dying prematurely. By monitoring my surroundings, you will maybe understand that I don’t exercise as much as I should because the street lights in front of my house are broken and I’m afraid to go out. You’ll feed that information to the community where I live and see to it that the lights are fixed which is in everybody’s interest because it helps preventing the societal costs associated to bad health.

What about data protection and privacy if we’re going to be monitored 24/7?

If we can explain in a transparent fashion that by constantly sharing their real life data with the healthcare environment people will get more in return, they will be happy to. To give you an example: If you are allergic to a certain substance, wouldn’t you appreciate being warned in time to avoid locations where you’re going to have trouble breathing? So, do I pay for this? Yes, sure. But do I get back more? Big time yes: Data provides information, information provides knowledge, knowledge provides freedom, and freedom provides anticipation.

Medical treatments today are pretty much one size for all. Digitalization carries the promise of a more personalized and predictive medicine. But what about the cost?

For every 100 CHF we pay for sickcare today, almost 90 CHF are spent in the last two years of life. Digitalization will allow us to turn this ratio completely upside down. Let’s take an example: If I have diabetes, my kidneys will eventually fail. I will have to go on a dialysis machine and when that doesn’t work anymore, I’ll have to get a kidney replacement. And I also get blind in the process. Now, if we can predict that I am liable to get diabetes and make me change my behavior accordingly in time, get me to adapt my diet and exercise more, this will come only at the cost of a number of apps and a number of behavior change tools. Prevention costs almost nothing. And it’s getting more and more granular and efficient, because technology gives us the possibility to really know our patients.  60 years ago when I had a blood tumor, I had one type of disease. Today, thanks to healthcare technology advancements such as genomics and DNA sequencing, we know more about our biology than ever before. We now know that a blood tumor can be due to 100 different diseases, each with its specific markers, which can be detected and treated with personalised and individually created treatments before the illness declares itself.

What will the pharma industry do in a world where nobody gets sick anymore?

They will have to start develop treatments aimed at preventing people from becoming patients rather than at treating patients. And for this they will have to not only develop pharmaceuticals but, relying on real world patient data, digital tools aiming to keep their customers healthy. But it’s not just pharma companies that will have to adapt their business model: Slowly every player, from insurance companies to banks, will have to become involved in this new world of digitalized healthcare. Telecom companies will be instrumental in helping this change along.

Their role being?

They will play a pivotal role building the infrastructure enabling an environment where an invisible layer of technology becomes the default and data can be shared in a trusted way. This will be a world where we do not have to moralize or nag people about what they should or should not do in order to remain healthy. Instead we will be able to impact people’s behavior while at the same time offering them pleasurable experiences. Elderly people for instance often forget to drink. To give them a patch measuring their hydration is not good enough. But by adding a layer of electronics to this patch so that it can communicate with their TV which, in turn, will remind them to drink, that’s different. For this we need the Internet of things, linking data collecting devices between each other and with the internet. The objective being to better understand how to care for people.

The Swiss health care system today is based on solidarity. Won’t a system relying on tracking individual behavior – and therefore individual responsibility – call this principle into question?

You have certainly heard that China plans to set up a vast surveillance system that will track and give a credit score to every single one of Beijing’s 22 million citizens. We're not there yet in Europe, but the solidarity principle is not going to work forever. There are bound to be some obligations. Do you remember when wearing a seat belt was made compulsory? In the beginning there were some complaints about the loss of freedom, but the measure reduced the risk of death by nearly half.  In a digitalized healthcare system, we are also going to restrict freedom in some ways. On the other hand, even if our predisposition for certain illnesses were known, insurance companies couldn’t refuse to insure us on this basis – they would go out of business since almost everyone is susceptible to develop some ailment eventually. So it is time to confront people and explain that the idea of privacy is a fallacy. It is time to see the glass half full and to come up with completely new patient models and consumer experiences based on trust and the knowledge that sharing our data will make all of us live healthier, happier and longer lives.

Interview by Christine D'Anna-Huber


Ted Talk: Access to our biological code, our genome, will soon become a commodity. But what can we do with it, what would we like to do with it, how could we deal with it, and would it make us ... better? Koen Kas takes us through a likely future.

Koen Kas

Koen Kasis a health care futurist, entrepreneur, professor of molecular oncology, international keynote speaker, and author of "Sick no more" and "Your guide to Delight". He is revolutionizing health care through his speaking, writing and workshops by helping Healthcare providers prepare for future realities. He is focused on pioneering the novel concept of Delight thinking, combining his expertise in genomics, drug discovery and biomarker research with his expertise in shaping Digital Health companies. He combines Real World data with design & business model innovations into novel experiences redefining Health. Koen is chairman of the European Cancer Prevention Organisation; ambassador of Health House; Jury of the Prix Galien and editor of the mHealth and EJCP journals.