Working group members:
Lisette van Gemert – Pijnen (Chair), Sabine Siesling, Thomas van Rompay, Wouter Keijser, Christina Bode, Erwin Hans, Gerben Westerhof, Carine Doggen, Ariane Need
Advisory group members:
Menno de Jong, Maarten Ijzerman,Matthijs Noordzij, Karin Groothuis-Oudshoorn, Erik Koffijberg
Modern societies face important challenges regarding health and well-being, health technology and healthcare that simultaneously impact users of care, healthcare providers, and organisation of care. There is a rise in the amount of older citizens who at the same time live longer with more chronic illnesses. Healthcare costs are rising. Technological developments in diagnostics and treatments offer new possibilities in healthcare, but also often increase costs. At the same time citizens take more responsibility for their own health and care, which requires another relationship with healthcare providers, and vice versa. To face these challenges, novel health technologies must be developed in conjunction with end-users and healthcare providers in order to realize an affordable future-proof governance and organization of healthcare.
Health and well-being. These challenges ask for new approaches to foster health and well-being in societies. The first approach is public health prevention that has recently become even more important to increase the number of healthy years in the population. Public health prevention creates an environment in which healthy behaviours prevail. The second approach is to involve individuals in self-management and shared decision making in health-related matters. Increasingly, individuals take responsibility for their own health, and therefore self-management and shared decision making are of essential importance. The third approach is a shift towards adaptation and acceptance. Although prevention, early diagnosis and optimal treatment remain important it is highly unlikely that cure is always possible for every disease and illness. The shift to adaptation and acceptance is necessary as this is expected to lead to a high well-being even with chronic illness.
Novel health technologies. Novel health technologies provide opportunities to empower individuals and to innovate healthcare. These may improve prevention, diagnosis and treatment, clinical outcomes and quality of life of patients, reduce costs and enhance efficiency and communication amongst stakeholders. To be successful, health technologies must be developed and implemented with great consideration. Patients and healthcare providers must have enough motivations and skills to obtain most benefit from the new technologies. Examples of technologies are: high-tech biomedical devices and facilities supporting (early) diagnosis and personalized treatment of complex diseases; health information systems planning and management of healthcare; eHealth monitoring and coaching without the boundaries of organizations; pervasive environments embedding sensing technologies; and socially engaging networks providing possibilities for continuous monitoring and coaching. New technologies and systems can provide high volumes of data that ask for transparent ways of managing the flow of data and for advanced analytics with e.g. machine learning and (human) artificial intelligence in combination with health domain specific knowledge. Furthermore, the implementation of health technology with respect for ethics, privacy and responsibilities is an important challenge.
Transformation of healthcare governance and organisation. These new approaches to foster health and well-being and to successfully use novel health technologies, cannot be studied separately from developments in the ways healthcare procurement and provision is organised. Currently we witness a shift from institution-based care—in which increasingly specialised healthcare providers treat complex diseases—to home-based care and informal care for less complex care. As a consequence, a coherent collaborative (network) organisation of integrated and integral care between different organisations—such as hospitals, home care institutions, or municipalities—becomes increasingly important. In addition, the introduction of personalized interventions and shared-decision making challenges traditional systems for quality assurance and quality control, as well as logistics and operations management. At the same time, healthcare costs are rising while socioeconomic health inequalities increase—thus putting pressure on society level of healthcare systems. It is thus a challenge to organize and manage healthcare in such a way that it is inclusive, affordable, and cost-effective while at the same time providing optimal care in optimized settings reaching optimal patient tailored healthcare with optimal outcome, close to home if possible and further away if needed.
The BMS Health research program uses a cutting-edge and interdisciplinary approach for the integrated study of novel health technologies and healthcare transformation that determine the success of new approaches to health, wellbeing, and healthcare in society. The following research questions capitalize on the knowledge infrastructure and expertise available in the BMS Health research program, aiming to generate interdisciplinary breakthroughs within the coming years.
Health and well-being
1. How and under which conditions can we develop and implement efficient and personalised monitoring, coaching, and intervention strategies to increase inclusive preventive public health, self-management and shared decision-making, as well as adaptation and acceptance?
- How and under which conditions can technology contribute to these strategies?
- Which (elements) of these strategies are most successful? For whom?
- Which mechanisms underlie their effects?
- What governance and (inter-)organizational conditions stimulate their successful development and implementation?
Development of novel health technologies
2. How to develop, evaluate and implement new health technologies that engage end-users (patients, healthcare providers, stakeholders) to address the dynamically changing needs of individuals?
3. Which governance models in healthcare are necessary to provide all relevant stakeholders with proper incentives to develop and optimally implement new health technologies?
4. How do new health technologies impact on the health system as a whole, regarding changes in required resources (equipment, personnel, budget), responsibilities and tasks of healthcare providers, and collaboration between healthcare providers in healthcare?
Transformation of healthcare
5. How and under which conditions can we develop and implement new forms of governance, organisation, logistics, and finance of integrated institution-based care, home care and informal care in such a way that it balances the interests of all stakeholders and also make these more efficient and cost-effective?
- How and under which conditions can technology contribute to these new forms?
- Which elements of these new forms contribute most to balancing the interests of stakeholders and to their effectiveness and cost-effectiveness?
- Which mechanisms underlie the effects of these forms?
Research funding is increasingly based on societal developments and needs e.g. the Nationale Wetenschaps Agenda (NWA) and the European Funding (upcoming FP 9 call). To anticipate on societal challenges and also on future funding opportunities, the BMS health research program endeavours to make a societal impact on the health and well-being of individuals, the transformation of healthcare governance and organisations and the development of novel technologies, by iteratively including perspectives and preferences of all stakeholders and thereby contributing to an including and flourishing society. For instance a community based approach to healthy living might be developed by integrating new all-inclusive technologies in health initiatives and empower citizens to manage their own health and well-being even during and after illness. To this end, researchers work closely together with stakeholders and organizations in the health domain in developing and evaluating new technological interventions, evaluation methods and providing advice on their implementation.
Education and training of patients, healthcare providers (physicians, nurses, managers, etc.) and policy makers as well as publishing findings in scientific open access journals and lay media guarantees dynamic and innovation rich interaction with all relevant stakeholders. These collaborations stimulate and facilitate in return the social relevant BMS health research agenda setting.
Health@BMS is based on interdisciplinary collaborations to realize the scientific and societal challenges by developing and running projects and submitting grant proposals together. This is in line with BMS and UT vision which is visible in for example the mission “High Tech Human Touch”, the new TechMed centre and the Design lab. The current expertise of Health@BMS focuses on the development and analysis of novel healthcare processes, using process engineering; the assessment of the impact and requirements of novel health technologies, on individual, society and system level; the ethical and legal infrastructure to innovate healthcare using Big Data; the development and implementation of human centred and holistic monitoring technologies aimed at self-management and shared decision making; and impact of institutional changes and new technologies on professions and networks.
Furthermore, our interdisciplinary work is achieved by collaborating with different strategic partners, such as healthcare institutes, industries, healthcare providers and patient associations, hospitals, other (inter)national universities and local, regional and national governments.
To be optimally prepared for the upcoming research funding opportunities, infrastructure concerning advanced methodology is needed to optimize health, health technology and healthcare. Expertise is already present within the faculty BMS, but to set the future research agenda and to develop, apply, implement and evaluate advanced methodology, additional personnel is needed. Mainly with regard to:
- supporting the process of choosing between new and existing technologies, based on what the public, patients, healthcare providers and management deem necessary, and based on the expected impact of technologies;
- identifying the optimal way to develop and implement new user-centered technologies;
- developing and testing personalised, adaptive real-time feedback systems targeting behaviours on the individual and population level; to enable the monitoring of the temporal dynamics of an individual’s state in real time.
- investigating (transformation toward) network-based health systems, reimbursement and implementation decisions, new business models, adoption processes, and relating new governance models;
- domain expert-advanced statistical knowledge of ‘big data’, to analyse and interpret the huge amount of data generated by novel technologies.