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Interview: The times of ‘the sky is the limit’ for expensive innovative products are ending

Prof. Nick Guldemond

Prof. Nick Guldemond hold degrees in medicine and electric engineering and a PhD from Maastricht University. He was the CEO and founder of the Medical Field Lab (early 2000) i.e. the first international example of a university hospital based ‘living lab’ dedicated to science, innovation and societal impact. In this period he was experimenting with early days university based open-innovation concepts, co-creation, service design and building innovation ecosystems. In doing so, he performed groundbreaking work with the development of the first low-temperature 3D printing technology for bone structures, mobile monitoring systems for various diseases, early days smartTV (2007) based blended homecare, virtual surgical systems with augmented reality and haptic feedback as well as innovative care service concepts: diabetes, oncology and frail elderly.

He is also Professor for Public Health and Healthcare at various universities and holds a position as a Senior Researcher at Leiden University Medical Center in the Netherlands. During his career, Prof. Guldemond worked as a clinical researcher on numerous health innovation projects, often in collaboration with partners in the pharmaceutical, medtech, health IT and finance sectors. He has successfully managed various multidisciplinary/multicultural teams and established two successful companies. As a key expert on Health and integrated care, he is an Expert Member of the WHO Working Group Digital Health, WHO Pan-European Commission on Health and Sustainable Development and a consultant for Health programmes and medical curriculum development in various countries on different continents, NGO’s, multi-nationals and start-ups. Prof. Guldemond also served as the coordinator of EU EIP on Healthy and Active Ageing, as expert at the World’s Organisation of Family Doctors (WONCA) and as an expert implementation human rights in biomedicine at the European Council. He is associated editor for the Journal of Integrated Care and a member of the editorial board of the European Medical Journal.

What are your impressions from the conference “Leadership in Healthcare Amidst New Technologies”? Any special take-aways, impressions?

The conference had an impressive line-up of speakers, was rich in content, there was an open dialogue (with humour), was a proof of ambition to make technology work for better and sustainable healthcare including prevention. Relevant people were there from ministries, providers, academia and industry.  I think this is a very good basis to take Slovenian healthcare to the next level. So, the vision and ambition as expressed by both ministers are great, but the success is in the implementation.

It does feel a bit unusual and surprising to read your CV. How come that you combine Medicine & Care with Technology? Where do pharmaceutical, MedTech, Health IT and finance sectors overlap?

With my training in engineering (first) and medicine (after), my reasoning with these different topics goes so natural and intuitive when working in clinical practise as well as research and innovation. In my career, I experienced the increasing convergence and integration of diagnostic approaches and treatment modalities with MedTech, pharmaceutical and data. The same convergence is happening with disciplines and expertise. Financially, you saw over the last decade a trend towards outcome-based payment, which is also a sort of convergence of costs for different activities, services and products in one single payment. Globally, healthcare budgets are under pressure and choices what to reimburse and where to invest will increasingly more difficult: times of ‘the sky is the limit’ for expensive innovative products are ending and new business strategies are needed.

You worked also on national levels – with Moldova, Ukraine, Saudi Arabia, Brazil, China etc.  What do you do in the role of expert on Digital Health and integrated care for various governments on different continents, NGO’s, multi-nationals and start-ups?

Basically, help them with developing their own strategy and plans for realisation with critical questions, examples and lessons learned. Developing strategies comprises the consideration of a whole health system on different levels (from policies to operational processes) and multiple domains (services, technology, governance, legislation/regulation, finances) as well as public-private aspects, macro-economic and political choices. My flexibility to reflect on the different topics while zooming-in and -out help them to understand the complexities and dilemmas by which choose a strategic direction and make practical decisions.

What should digital health strategies of the countries (if you know enough of Slovenia, please refer to Slovenia) contain?

Political leadership is important for establishing a coherent national vision and a strategy for transformation. Political leadership should provide guidance for implementation framework and region-specific actions tailored to meet the needs of local populations. Strategies should involve patients and all relevant stakeholders through co-creation should ensure the development of concrete action plans that consider local needs and context which, in turn, will increase the support for adaptation. At the conference it was very good to see that both ministers presented vision along this approach. As said, eventually implementation plans should be executed with concrete actions supported with investments, coordination and monitoring.

What does Europe lack in this perspective?

The European Commission is actually doing very well with a comprehensive European vision on digitally enabled care while establishing legislation and regulation (AI act, EHDS, GDPR, MDR) as well as supporting research, innovation and implementation funding programmes. The main challenges are at a national level. Most countries (including the Netherlands) lack a coherent digitalisation strategy, coordination, adequate investments, often focused on pilots and single projects, etc.

What are the best examples of social based healthcare that you advised in various countries?

Best is to look at regions since healthcare is in many countries organised at a regional level. The Nordics are doing overall very well. In Finland, health and social care is managed by one ministry and the result you see in their digitally enabled integrated community-oriented approach. Spanish regions like Galicia, Catalunya and the Bask country are doing very well while the UK also provides good practices.

Author: Tonja Blatnik, Slovensko inovacijsko stičišče, evropsko gospodarsko interesno združenje, SIS EGIZ

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