When will the digital transformation finally arrive in medicine?

Medical care is said to be excellent in Switzerland and Germany. If you compare it with other countries, this is undoubtedly true. And yet, if you take a step back from the existing structures, many things are completely out of kilter. And users in the medical sector are quietly undergoing a transformation to digital. People are better informed and ask more questions. These are the harbingers of an upheaval that will completely shake up an entrenched industry. Fortunately for us.

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Awakening experience: a visit to the doctor

I must be something like every doctor’s absolute nightmare: I’m highly hypochondriacal, morbidly inquisitive and internet-savvy. There’s always something. And so, that morning in 2013, I once again had diffuse chest complaints that I wanted to have clarified immediately and at all costs.

So I got to grips with the matter. A good hour later, I knew so much about the possible causes of the complaints that I was actually able to reliably assess them on my own. Mind you, I’ve been doing this for 15 years. I could have saved myself a trip to the general practitioner, but as a hypochondriac this is not an option. When 8 o’clock finally struck, I made an “absolutely today” appointment.

When I arrived at the doctor’s later that day, I described my complaints. What followed was the kind of dismissive dialog that might occur between a teacher and a notoriously corrective nerd. I was struggling. It was tedious.

Not the fact that the doctor couldn’t overlook the whole range of possible causes in 5 minutes, but that he always pretended to know everything. But quite obviously he didn’t.

And when he later pulled a book off the shelf that had been published in 1984, it really hit me. If he included such old knowledge, I was in serious danger. In danger of not being able to incorporate the findings of the last 30 years into my treatment. Something important would be overlooked and I would ultimately perish.

I kindly but firmly told the doctor that I had lost confidence at that very moment and left. I think he was secretly pleased.

“In general, I think the entire healthcare industry simply has a fundamental problem with data. It simply doesn’t have any

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The experience made me extremely perceptive and I’ve paid particular attention to it in recent years. The good news is that there are also many doctors who try to keep their finger on the pulse.

In terms of IT standards, a medical record is not qualitatively superior to a “notepad”.

Manually taking notes and sending medical records around is a sheer horror. I have seen countless times how important information has been lost between doctors and had to be laboriously exchanged again, usually by telephone.

Capture everything that is possible

I already know that initiatives to modernize the handling of health data are underway. The problem is, they have been for ages.

“What we need is a global, open standard for the collection and storage of health data!”

Every day, however, we are constantly losing opportunities to enable better treatments, find correlations and fundamentally improve medicine.

In many areas, medicine knows surprisingly little about the human body

If you have a broken leg or need a new knee joint, medicine pretty much knows what to do and does a good job.

Beyond that, however, the knowledge is comparatively banal. We still do not really understand, for example, how cancer develops and which treatment methods are the best.

Instead, billions are invested in the try-and-error development of generalized drugs with comparatively modest efficacy, especially in oncology.

What is particularly perfidious is that many highly decorated doctors constantly act as if they have these diseases under control. When a family member fell terminally ill with cancer a few years ago, it took seven doctors before one of them finally stood up and told us that it was simply the case that they had no real knowledge of how to get to grips with it.

Although there were studies and treatments of choice, none of them had any relevant prospects of success. That was bad. Certainly. But it was the right step for everyone involved. Not only were all the treatments useless, they were also extremely expensive for the general public.

This happens every day. Every day we pay for treatments that have little chance of success from the outset, place an additional burden on patients and keep a whole apparatus of doctors and nursing staff busy. And this is only because this area is over-regulated and simply undergoes very little fundamental renewal.

We all pay the bill

For some families, health insurance costs more than housing costs alone. Of course, this is also due to the fact that mortgage interest rates have fallen so much. But it is striking. We also pay 30% more in health insurance premiums for our family of five than the interest and amortization on our home.

Medicine must be data-driven – medicine must be digitalized

It is a shame that we do not systematically collect all disease data and finally start to use this data extensively for treatments and drug development.

It’s a shame that I can have my genetic material analyzed today, but in Switzerland and Germany, and in a few other countries, I’m not allowed to receive this data in a statistically evaluated context. So that I could see which diseases I am or am not more susceptible to from a purely statistical point of view. Even where a rudimentary database is available, there are still legislators who prevent its use.

We simply have to put an end to the endless series of tests to develop active ingredients that are then marketed as generic drugs. They must be replaced by highly personalized medicine. And this is only possible with a good database. This means that a new business model must be found for medical providers. Unfortunately, this is precisely why the big players are not doing more. They are afraid of losing more than they gain.

Data protection concerns are healthy!

Whenever I talk to people about these things, someone comes up again and has “data protection concerns”. “What if someone suddenly knows that I once had a stroke”. “I don’t want people to know that I’m HIV-positive”.

I understand the fears. But they are fears. Those who are really interested and who actually have a big impact are the insurers. And lo and behold, you are already obliged to disclose everything. And woe betide you if you have something medically significant. Immediately, for example, you will no longer be accepted for daily allowance insurance.

Individualized insurance

The topic of individualized health insurance in particular is an exciting and important one. Here, the polluter-pays principle, which is anchored in other areas like almost nothing else in our society, is pitted against the principle of solidarity.

The only reason we can’t apply the polluter pays principle is because we don’t have the data. Individualized insurance would be a good way to reduce healthcare costs. That doesn’t mean that we have to sacrifice solidarity.

Costs must come down

Costs must be fundamentally reduced, as such an inefficient healthcare system cannot continue to be financed. Just think of the demographic development. It shouldn’t be financially viable either.

We are talking about efficiency, automation and rationalization everywhere, and of course this has already arrived in the healthcare sector too. Unfortunately, it seems to me that the wrong places are being targeted: With carers, for example, who are essential because it’s all about people and social contact.

The medical revolution

It’s ripe: the medical revolution and the signs are better than ever, especially when it comes to cancer. It is hardly surprising that it is not the pharmaceutical companies that are leading the way here. No, it is once again a Silicon Valley company.

In my opinion, Google has done the most groundbreaking work in this area in recent years. Just a few days ago, Google (via Google Ventures) invested the ridiculous amount of USD 130 million in Flatiron Health.

An executive from Google Ventures commented on this to Techcrunch as follows:

“Cancer will likely touch all of us at some point in our lifetimes, either as a patient or as the family or friend of a patient. Flatiron has pioneered a way to learn much more about cancer, so that we can improve the way we care for patients and treat the disease. It’s rare to find a team of the caliber assembled by Flatiron Health that combines pragmatic insights from the healthcare industry with the deep technical insight of the IT industry. They are working on one of the biggest problems in healthcare, and their progress has been nothing short of stunning to date.

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And now imagine that instead of a few hundred million, countless billions from pharmaceutical companies would flow into the development of fundamentally new paradigms in medicine. Imagine that.

I just hope that we will see the same fundamental improvements in the next few years as we have seen in other areas. Before it gets me or my loved ones, or you and your loved ones.