Discours de Lydia Mutsch: "Digital healthcare strategy, big data and personalized médicine"

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"Dear Prof. Balling and Prof. Schneider,
Dear Director Blomberg,
Dear Minister Hansen,
Honorable guests,

Let me start by congratulating the Luxembourg Center for Systems Biomedicine for establishing a Luxembourg-based ELIXIR node.

This step is a great international recognition for the outstanding competences of the Luxembourg scientists, the University of Luxembourg and the collaborating research centers.

There is no doubt that the biomedical research community urgently needs solutions such as highly performing management systems for the collection and integration of complex datasets as found in biomedicine, systems that are able to provide standardization but also protection of sensitive data. And for sure, in this regard, the EXILIR node project will be of great benefit to academia and industry.

However, as a Minister of health, the question I’m more specifically interested in is: how will digital health and big data analytics integrate and benefit the healthcare system and eventually the patient?

Healthcare systems typically value time-honored traditions and practices, and this for a good reason: physicians and other healthcare workers are reluctant to expose patients to potentially new risky procedures and treatments.

Despite this traditional approach, we have observed in the past years that the adoption of IT in healthcare has been rapid and that it has, in general, followed the same pattern as in other industries. Currently, a so-called “third wave” of IT adoption is ongoing in industry, bringing along a full digitalization of the entire enterprise, including digital products, channels, and processes, as well as advanced analytics that enable entirely new operating models. And there is little doubt that the healthcare industry will follow this path shortly, and will build a fully integrated healthcare IT system in the end.

As a Minister of Health, my main focus however is not so much the healthcare industry but first of all, the patient.

From many studies over the past years, we have learned that the patients all over the world are now ready to adopt the transition to digital services: they are not only waiting for it, they are eagerly requesting it – especially among the younger population.

In a large survey conducted by McKinsey from 2014, 75% of patients from all age groups expressed that they would be willing to use digital healthcare services, even if older patients preferred traditional digital channels such as websites and e-mail, while younger patients were, unsurprisingly, more open to newer channels such as social media.

The reason for the limited uptake of existing digital services until today does not lie in the reluctance or absence of trust of patients, as often speculated, but is rather due to the fact that current services do not meet the needs of the patients or are of poor quality.

This shortcoming needs to be addressed by our future reflections because public health policy should be primarily driven by the patients’ needs and on the equal right to access high quality health care services.

Finally, we know now that the core features that patients expect from their digital health system are surprisingly mundane:

-         efficiency,
-         better access to information,
-         integration with other channels,
-         and availability of a real person if the digital service does not give what they expect.

Highly innovative services, better apps and more social media are far less important to most patients.

Moreover, across the globe, most people want the same thing: assistance with routine tasks and navigating the often complex healthcare system.

In the 2014 McKinsey study the most requested digital service was “finding and scheduling physician appointments” followed by “selecting the right specialist” and “support for repetitive administrative tasks”. What most of these services have in common is that they do not require massive IT investments to get started.

Of course, there is more to come as big data now enters the field …

And for sure, healthcare data nowadays fully meet the definition of “big” data: healthcare has become a high-data volume domain where data comes from a variety of sources and has a high complexity including unstructured, semi-structured and structured information. Data is gradually becoming more dynamic including increasingly real-time streams, and it varies in its quality and complexity by containing biases, noise and abnormalities.

Despite this complexity, and provided that we can develop performant IT tools to handle it, there is little doubt that big data will eventually foster value-based, patient-centric care, by improving healthcare coordination and quality and hopefully reducing healthcare costs by minimising avoidable overuse or misuse of treatment.

Big data, together with a rapid progress in molecular medicine, will help to enable personalized medicine, giving the right treatment to the right patient at the right moment.

Let me also address the second revolution we are currently experiencing and which is the development of the healthcare internet of things. The rapidly increasing number of smart, interconnected devices and sensors and the tidal volumes of data they will generate is extremely interesting. Many of the measurements currently still require a follow-up visit with a physician, but smarter monitoring devices communicating with other patient devices could greatly refine this process, possibly lessening the needs for direct physician intervention.

Other smart devices already in place can detect if medicines are being taken regularly at home from smart dispensers. If not, they can initiate a call or other contact from providers to get patients properly medicated.  In a further development step, the processing of real-time events captured by monitors with machine learning algorithms can provide physicians with insights to help them make lifesaving decisions and allow for effective interventions.

The possibilities offered by the healthcare internet of things to lower costs and improve patient care are almost limitless.

However, today, the most widespread application of big data in healthcare is the electronic patient record. Although electronic patient records are a great idea, many countries still struggle to fully implement them. Europe lags behind, despite some plans to develop a centralized European health record system in a medium term future. I am pleased to announce today that the draft law regulating the “DSP”/dossier de soins partagé” will enter the legislative procedure in the coming weeks, thus putting an end to a long and successful pilot project.

Dear ladies and gentlemen,

All these exciting advances and many more will only happen if we set in place a coherent national strategy for the implementation of digital health.
Obviously, the Government needs to support research teams and provide them with the adequate infrastructures, including advanced datacenters and high performance computing capacities, and again the support to the ELIXIR Luxembourg node is a good example of such a successful project.

We also need to bridge the different disciplines involved in digital health, for example, we need to connect technological, environmental and social research with biomedicine. In that respect, we have to close a major gap between the worlds of research and healthcare.

We need researchers that understand medicine and physicians that practice research: this requires a profound change of mindset in our healthcare facilities, in parallel with a timely implementation of electronic patient records and their possible interface to research.

Training of healthcare providers in digital health will be crucial for the future: the ongoing inception of a medical school at the University of Luxembourg can be here a unique opportunity for our country, which we should not miss.

Finally, we have to make sure that our legal framework will be favorable for such an evolution. Privacy legislation and ethical considerations are central to our efforts to develop digital health.

I am convinced that Luxembourg offers the right environment for the cross-sectorial interaction needed to make digital health a reality and I can assure you of the full support of myself and the entire government in engaging into this process.

I thank you for your attention and wish you successful and enriching discussions!"