Healthcare systems through new technologies
As healthcare continues to emphasize patient-centered care, it is no surprise that access & collection of health data is part of the top trends for 2023. Yet, the fast speed of technologies’ development goes with other important challenges for the sector to address including: data privacy concerns, insurance coverage and supply shortages. Telehealth has the potential to answer long standing health inequities and the ability for major players to find the right value proposition.
Healthcare systems through new technologies was the main subject on stage, last June 30 at ICT Spring, during which seasoned experts presented their innovative solutions and insightful thoughts.
On this occasion, Luxembourg Ministry of the Economy Head of Digital Health Technologies Carole Bruckler served as Master of Ceremonies. During her opening speech, she highlighted that what happened during the Covid-19 pandemic contributed to raising awareness around the critical necessity of improving healthcare systems. In such a context, a patient should have access to its data anytime, and should also be able to take charge of its own health – it goes notably in consulting its vital parameters.
Revolution in healthcare leveraging IT solutions
To start the ball rolling, Agence eSanté Deputy COO Frédéric Markus presented the smart DSP, which is actually a service centralizing essential patient data electronically. He specified that, in Luxembourg, “hospitals, labs, and pharmacies, are already connected to the platform. This means that the DSP has [a patient’s] lab results, imaging, and other types of data”. All of this is automatized, and patients and health professionals – including hospitals – can also access this information when necessary.
As of today, Agence eSanté has more than 1 million DSPs activated in the country, and almost 10 million documents inside DSPs. Concretely, the DSP is static and is a storage space for passive data. Markus explained that the Smart DSP is, on its side, based on a data lake. What is it? He defined a data lake as “a repository of data extracted from multiple source systems. It is a storage system that holds a vast amount of data in its native format, including structures, semi-structured and unstructured data”.
This data lake enables the agency to convert passive data into “smart” data, to lead a population behavioral study in Luxembourg, to incorporate specific rules and patterns into the DSP, or to improve the management of chronic diseases and ALDs (Affection de Longue Durée or, in English, Long-Term Conditions). Overall, the Smart DSP data lake helps in the identification of disease, based on patterns and AI-powered parameters.
Speaking of data, Luxembourg National Data Service (LNDS) CEO Bert Verdonck presented its organization, supported by the government, which is actually providing services for value creation from public sector data. It focuses on enabling the sharing and the re-use of data for public and private data partners. LNDS aims to develop and support solutions for stakeholders so as to ensure responsible secondary use.
As Verdonck emphasized, LNDS mission “is almost not about technology, it is a lot about governance and software and soft infrastructure”. In other words, humans need to stay in control of AI and what data are used for; hence the importance of establishing proper governance, meaning an efficient implementation of rules and guidelines. “In order to do that, we will need technical services, compute, storage, cloud, and stay in control of those”, he added. To note that the government created the LNDS to stimulate the local data ecosystem, as Luxembourg prepares to join the European data space initiatives. The latter has set up ambitious objectives in terms of data and data spaces, which LNDS will try to make practical and implement for the stakeholders here in Luxembourg.
This is why LNDS is actively participating in the deployment of the Data Governance Act for instance; and also in the health domain, in the European Health Data Space. The organization aims to act as “a bridge between what is happening on the European scale and the local Luxembourg data ecosystem”. As a neutral multi-party environment, Gaia-X brings together a community of organizations around the common goal to boost the European data economy by enabling the creation of common data spaces. There are already several data spaces in preparation and deployment.
This shows that innovative IT can considerably revolutionize healthcare systems. And this is what ITQ CTO Jeffrey Kusters tackled on stage. He stated that “the healthcare industry is currently on a digital transformation journey. And this transformation is reshaping patient care and the structure of health systems”. Of course, this is not all about introducing new technology, but more about leveraging these advancements to enhance healthcare efficiency and to improve patient outcomes.
This nevertheless does not come without challenges. As concerns related to data security and privacy increase, how to ensure that new technologies are secure and seamlessly integrated into the systems? Kusters underlined that “strategic planning is crucial in this context”. This is how ITQ helped, for instance, the Dutch Cancer Institute Antoni van Leeuwenhoek (AVL), a leading institution in the global fight against cancer, counting over 650 scientists and more than 180 medical specialists working to advance cancer research and treatment.
ITQ introduced a unique solution that both catered to AVL’s digital transformation but also significantly lowered their Total Cost of Ownership (TCO): ‘VDI by day, compute by night’. The project focus was to modernize the workspace, to enable remote working, to empower employees with self-service, and to enable data scientists to rely on the platform for their research. Overall, Kusters demonstrated that ‘VDI by day, compute by night’ is efficient, adaptable, and cost-effective.
This set the stage for a roundtable, moderated by Carole Bruckler, to explore innovative healthcare solutions. Dynaccurate Co-Founder & CEO Dermot Doyle highlighted that AI is rather limited, notably in the hospital environment, in the sense that “you cannot use a broad trend to diagnose somebody as you have to put them through a number of tests”. In this context, AI can be used to carry out these tests and analyze the results, but human presence is essential to validate those. Nursing School of Coimbra Coordinator Professor Pedro Parreira mentioned that “all technology in healthcare systems must prove that it is reliable, safe, and creates results”.
Campus Technologie de la Santé (CTS) General Manager Europe Emovi and Special Advisor Yann Lamarche asserted that the healthcare sector is rather closed: “medical specialists are difficult to understand”. For this reason, “we need accelerators first, and we need a point of contact so these people can understand the healthcare environment”. It is to note that healthcare is the least internationalized industry: “we need to share information together in order to make new technologies successful”. It is necessary to go international to find solutions.
On his side, Myelin-H Co-Founder & CEO Zied Tayeb commented that it is notably necessary to ensure that regulations (GDPR compliance, AI Act,…) help companies and innovators, instead of being a potential obstacle to innovative solutions. Besides, Parreira added that patients should be at the center of technology and solution development: patients should experience added-value in using such technologies for their health.
Making data actionable in healthcare
DPhil in Clinical Medicine and Luxembourg Institute of Health Strategic Program Lead Dr. Jasmin Schulz came next on stage to introduce Clinnova, a solution to boost precision health in the heart of Europe. Precision health is essential “for the patient to have the best quality of life, with the best treatment, but also for healthcare systems”. Change is paramount, as the latter are under immense pressure, notably with: aging population, increase of non-communicable diseases, inefficient processes, some patients do not have connected data sources.
This said, transformation is hence a prerequisite for sustainable healthcare, and this will generate large amounts of data. And this is going to be difficult for humans to analyze, hence why it is fundamental to rely on AI. In this context, Clinnova aims to unlock the potential of data science and AI in healthcare. Unlikely to one can think, the “key innovation driver is not the AI or machine Learning (ML) algorithms, it rather lies in a data-enabling environment producing standardized, quality-controlled data around relevant use cases”. This encompasses for instance immune diseases, such as multiple sclerosis, inflammatory bowel disease, or rheumatic diseases.
Clinnova puts physicians and patients in the center. By supporting the assignment of the right and personalized medication, it tends to return value in the short term to the very patients and physicians who make data available. And in the medium term, data analyzes will generate insights into biomarkers, and drug targets. Clinnova has also the ambition to build C-DIC, an interoperable health and research data space in Luxembourg.
As ITTM Co-Founder & Managing Director Dr. Andreas Kremer declared that there is a paradigm shift towards personalized and evidence-based medicine. The main challenges lie in connection of medical/clinical care and self-reported outcome measurements, data exchange and data access, and fast development versus regulation. Regarding clinical data, he stated that “you can generate a huge amount of data, and even unlimited value, if you make it useful, actionable”, from imaging, literature to biological process or gene regulation – among others. Hence the necessity to harmonize them in a constructive and interoperable way.
In this sense, Kremer specified that “observational study data are more and more into the picture in order to assess the safety, effectiveness, and cost effectiveness, of medical technologies”. This said, operational, technical and methodological challenges limit its widespread use. Yet, common data models and federated data networks offer a potential solution to many of these problems. And this is what ITTM does, encompassing: data management & data processing, interoperability by design, data privacy & protection by design, process optimization. The company is part of the Observational Health Data Sciences and Informatics (OHDSI) – a multi-stakeholder, interdisciplinary collaborative to bring out the value of health data through large-scale analytics – and EHDEN – a trusted open science community built with standardized health data via a European federated network.
To continue the afternoon, House of Biohealth and HEAL Campus Director & Co-Owner Jean-Paul Scheuren pointed out that there are interesting opportunities to position Luxembourg as a major player in innovative medicine, such as its ideal size (Luxembourg and Greater Region), good financial backbone, CNS as one central institute, and political opportunity (support of Ministry of Health and Ministry of the Economy). This is proven in the sense that the “Health Valley Luxembourg” includes: 4 main hospitals and healthtech actors, first in class research institutes (LNS, IBBL, LIH, Uni.lu), interdisciplinary centers (LCSB, Clinnova, SnT), innovative initiatives, IT infrastructures (MeluXina HPC, TIR 3 Centers).
Considering these opportunities, Scheuren introduced the HEAL (Health and Advanced Lifescience) Campus. Its mission statement is to “provide a unique interlinked data driven and healthy campus so that innovative companies and their talents can thrive, and create next generation solutions that improve human health”. He continued by saying that HEAL’s vision is, by 2036, to “become a globally recognized and interconnected campus to be a world class health science hub”.
The overall concept of the HEAL Campus is really to create an integrated platform combined with research, healthcare, and health economics, to bring all ambitions together, to dedicate a campus to digital health and personalized medicine, to gain the critical mass for dynamic growth and, finally, to combine both the financial and health sectors.
SciPharm Managing Director Michael Beckers closed the afternoon session with a keynote on regulatory changes in medical devices. For context, SciPharm is a 10+-year Luxembourg-based company, initially involved in the development of pharmaceutical treatments against orphan diseases. Since 2017, the company “is also involved in medical devices, and it has been our core activity ever since”, he said.
In terms of regulations, there used to have two main directives regulating medical devices, being the Directive on active implantable medical devices (AIMDD) and the Directive on medical devices (MDD). Both of them were replaced by the EU Regulation on medical devices (MDR). In the meantime, the Medical Device Coordination (MDCG) produced documents to give guidance on for instance assignment to Medical Device Software, on qualification and classification of software in MDR and IVDR, on cybersecurity for Medical Devices, or on Clinical Evaluation (MDR). “Clinical Evaluation is one of the focus points of MDR”, he specified.
It all means that the healthcare system is faced with “all kinds of standards and guidelines, apart from MDR”. Although it is all easy to follow, “the problem is the resources and the time it takes: these are the biggest issues we face”, he commented. This will of course be a lot of work, but “it is still doable”, he concluded.