What are the main characteristics of the hospital of the future?

Of all the characteristics, I would say that the centrality of the patient, the orientation to the data (Data Driven) and the medicine based on value are the main characteristics of Hospital 4.0. I could talk a lot about this topic, but if we look at what has happened in hospitals in the last ten years, the enormous amount of data that has been generated must be managed. Now, in addition, comes Artificial Intelligence and decision-making support to help healthcare professionals.

And when it comes to the centrality of the patient, all our efforts should be focused on their care. The hospital of the future will be eminently conceived for patients, who must be at the center of the system.

Mathias Goyen, during the interview with Redacción Médica.
Mathias Goyen, during the interview with Redacción Médica.

We are talking about hospital 4.0. How have hospitals evolved since 1.0?

1.0 could be the situation we were in 10 or 15 years ago, when there was no digitization at all. After that there was a breakthrough with the entry of imaging equipment such as X-rays, the ability to print radiographs, and the use of imaging. Now, thanks to digitization, we have access to data.

This opens up new opportunities to make life easier for radiologists. For example, streamlining workflows. In addition, we have an operational Artificial Intelligence applied to the image, which further improves all these possibilities and opens even better ones.

“Precision medicine means doing the right thing at the right time”

What does the term “value-based medicine” mean?

Value-based medicine is one of the key concepts of the hospital of the future, along with patient centricity and data orientation. Until now, the reimbursement to hospitals was produced by volume. The more citizens you dealt with, the more money you received. However, health actors are increasingly interested in a value-based approach. In other words, incentivization is being stopped due to the volume of activity (inputs) and is beginning to be done due to results (outputs).

This represents a big change in the questions we ask ourselves to consider value: Is this or that therapy really good? Are patients benefiting from it? However, it is not as easy to measure results as the number of patients being treated, but, for example, many insurance companies are already investing in evaluating results. That’s what value-based medicine means: measuring results. This puts the patient back at the center of the system, a trend that started in part in the US, and is now reaching Europe.

What role does technology play in health promotion and care?

It plays a very important role in promoting health. If we look at the role that patients play, it will no longer be a passive attitude. The patient has taken charge of their own health and searches Google for their own diagnoses (although it is always preferable to consult a doctor). And it also looks for if a hospital is doing its job well and what are its rates or its indicators for different diseases. In addition, patients have started to wear smart watches and other wearables to monitor their health.

The last chapter is also marked by all the omics sciences, which are revolutionizing health care thanks to precision medicine.

Precisely, how is Artificial Intelligence going to change the concept of medicine? What does precision medicine mean?

Until now we used to always diagnose and treat disease in the same way. Now, as we are talking about, we know that every patient is different. And that there is not a single breast cancer but there are 25 types of cancer. In fact, every breast cancer is different. Therefore, doing precision medicine means doing the right thing, at the right time, for each and every patient.

For example, we have a pill that lowers cholesterol levels. In these cases, it is not clear that cholesterol lowers in the same way in two different patients, since, although from a genetic perspective humans are 99.5 percent the same, there is still a 0.5 percent variation, that makes a difference. And understanding this is tremendously important when it comes to precision medicine. In these cases, Artificial Intelligence has been the one that has made this advance possible, since it allows us to analyze a large amount of information.

“Artificial intelligence not only helps to make a more accurate diagnosis, it also improves workflows”

What is the advantage of health systems that apply these technologies?

When you apply Artificial Intelligence, it not only helps you make a more accurate diagnosis, but it also improves workflows. For example, if a patient cancels a test 30 minutes earlier, that time the scanner is free. And that is a lot of money to lose. Artificial Intelligence can also predict the probability that an appointment will be canceled. That is operational AI (Artificial Intelligence).

Plus, it can analyze thousands of images in ten seconds. For radiologists and also for other doctors it is incredible that hundreds and hundreds of images can be compared. Not counting, of course, on the diagnostic aids offered by the data. There is information in the images that is invisible to the human eye. Something that might seem ‘normal’ to a radiologist, to a computer, comparing hundreds and hundreds of images, clinical and case histories, could find certain patterns that not even the best radiologist could see.

And now, in addition, a radiologist can explain to us that we have the same type of tumor that has occurred in other similar cases, and if surgery or chemotherapy is more indicated to treat it. This is where predictive medicine also comes into play, which can ‘predict’ the evolution of the disease thanks to Artificial Intelligence and is what is known as radiomics.