You may wonder whether this title applies to you, being an electronics, informatics, mathematics, physics, medical or non-technical student, engineer, PhD or PD Eng. Student, professor or member of the scientific staff? But it does!
And you may wonder whether you are a member of e/MTIC, the Eindhoven MedTech Innovation Centre while working in Catharina Hospital, Máxima Medical Centre, Kempenhaeghe, Philips or at the TU/e? But you are!
Building on a long term partnership for many years already, e/MTIC is an official innovation organization since 2018 in which many disciplines and the above mentioned organizations work together in HealthTech innovation. Apart from having specialist technical and clinical research in the area of cardio-vascular, perinatal and sleep, we very much look at how our research results can be applied much faster in the clinical practice and contribute to solving societal challenges in healthcare. This requires to link the various disciplines in the value chain, from research to patient and to measure our results in terms of patient outcome.
For individual researchers this may be a challenge but we can make a difference by building a collaborative and communicative community. That is why I am very pleased with this first issue of the e/MTIC regular newsletter.
The newsletter will inform you on the activities of individual researchers but also on the teams that support them in common subjects such as regulatory affairs, project funding opportunities, data platforms for data analytics and AI and educational programs. We also intend to strengthen a joint valorization team that can help researchers to put their work in a value based healthcare perspective in an early stage.
Via the newsletter we will also invite you to interesting events and you can use this as a platform to find partners that can help you in your research challenges.
And last but not least, we will inform you on the strategic directions we are taking in our collaboration to increase the relevance and success of e/MTIC and its partners.
I trust you will enjoy reading our newsletter and contribute to next issues, building a community of e/MTICs.
I hope to see all of you at the e/MTIC symposium ‘Technology meets Value-Based Health Care' on October 11th, 2019.
Kees van der Klauw
Ecosystem Manager e/MTIC
Doctoral research TU/e: putting the patient at the heart of cardiovascular care
How Value-Based Healthcare helps reduce mortality rate and the number of complications among heart patients
Treatment results for patients at the Catherina Heart Center in Eindhoven have improved considerably thanks to a new approach in quality management. This is the conclusion of PhD researcher Dennis van Veghel, care manager at Catharina Hospital and director of the Dutch Heart Registration. Van Veghel used the principles of Value-Based Healthcare, which put the value for patients at the heart of healthcare. His results show that measuring and evaluating the results for patients closely and using them as a guide for better care, leads to significant improvements in outcomes for patients. Van Veghel will defend his PhD thesis on August 29th at the department of Biomedical Engineering of TU/e.
As in many other countries, hospitals in the Netherlands focus primarily on volume and costs, due to the funding agreements they have made with health insurers. As a consequence there is less attention for treatment effects that matter most to patients, such as complications and re-interventions.
In contrast, Value-Based Healthcare (VBHC) puts the outcome for patients at the heart of healthcare. "The core strength of VHBC is that all involved parties focus on what is essential in care: what health gains are there for the patient, and at what cost? We call this the patient value ratio. An important parameter in this is quality of life", explains Van Veghel.
Applying these principles at the Catherina Heart Center resulted in, among other things, more attention for pre-operative care, more multidisciplinary collaboration and the introduction of additional checklists, for instance in the operating room.
This new approach not only reduced mortality rates among patients, they also suffered less complications, and they needed fewer repeat interventions. The mortality rate dropped from 2.3 to 1.0 per cent within 120 days after a bypass intervention, and from 3.1 to 2.0 per cent within one year. The rate of reinterventions decreased from 5.0 to 3.2 per cent. Every year approximately 1000 patients undergo a bypass procedure at the Catharina Hospital.
And this is not only good news for the patient. It is also the hospital and the health insurers who benefit, as complications and reinterventions tend to be costly.
According to Van Veghel, to get this practice really off the ground, it is essential that healthcare providers and insurers put the outcome for patients at the center of the agreements they make with one another. He has drawn up a number of new models that help all parties involved to focus on what is important for the patient.
In the current system, hospitals tend to get less funding if they are successful in reducing the number of reinterventions. They are also no real incentive to improve the care in the whole chain of care.
The researcher proposes an alternative model, which makes the hospital performing the bypass responsible for the long term results, even after the patient has left their care. This encourages hospitals to seek quality improvements with doctors who take over from them in the recovery phase. Especially in complex interventions like bypasses, patients often spend only a limited time in the center that performs the surgery. Aftercare is usually provided in a hospital closer to the patient’s home.
VBHC holds much promise, says Van Veghel, since the methodology can act as a guide for policy decisions, for instance in determining the value of technological innovations at an early stage. He also sees an increasing role in VBHC for Artificial Intelligence, because it can provide much smarter data analysis.
Related articles (Dutch only)
For the neurodevelopment of premature babies, hearing the continuous beeping sounds of alarms is unhealthy. Further, Joshi, who analyzed millions of alarms from two neonatal intensive-care units (NICUs), discovered that three quarters of these alarms do not provide any relevant information for nurses. Among other things, he developed algorithms that can help in triggering only useful alarms, while still ensuring that the vital functions of the premature babies are safely monitored.
The researcher used machine learning for this purpose. Machine learning algorithms build a mathematical model based on data, in order to make predictions or decisions. For example: algorithmically recognizing whether changes in vital signs are pathophysiological or innocent? The arithmetic models used by Joshi can link physiological changes to previous situations and use them as a basis for setting off an alarm or not.
This research shows how data driven solutions and algorithms based on machine learning can optimize clinical decision making and improve the workflow within NICUs. A contactless monitoring solution that was also developed by Joshi offers new ways of reliable monitoring, which are both comfortable for premature babies and a source of new physiological information. Finally, his research provides quantitative and visual evidence of the benefits of parent-baby bonding. Within Philips Research, Joshi is working on the same topics. The ultimate goal is: silent intensive care units (silent ICUs).
In addition to Joshi’s promoters, Máxima MC, Philips Research and e/MTIC were also involved in this research. e/MTIC is a collaboration between TU/e, Philips, Máxima Medical Centre, Catharina Hospital and Expertise Centre Kempenhaeghe. This should lead to more technical innovation in healthcare. Within the consortium, about one hundred TU/e PhD students are working together with a similar number of experts and scientists from TU/e, the hospitals and Philips. Over the past 15 years, the parties have been working bilaterally on projects with different focus areas. The partners expect that the intensive cooperation between clinic, science and industry will considerably shorten the development time of research as a result for the patient.
Joshi's research has appeared in the media several times in recent weeks: he was interviewed by NemoKennislink [Dutch only], Smarthealth [Dutch only] en NOS [Dutch only]. TU/e also paid attention to his research (English).