Becker's Hospital Review caught up with Jeroen Tas, chief strategy and innovation officer for Philips, to discuss threats and opportunities facing hospitals and integrated delivery systems in 2019.
Mr. Tas joined the company in 2011 as group CIO and has since helped turn around Philips' healthcare IT business. In 2014, he became CEO of Philips Healthcare, Informatics Solutions & Services, overseeing digital health and clinical informatics. In 2016, Mr. Tas also took the helm of Philips' Connected Care and Informatics businesses.
As chief strategy and innovation officer, a role he has held since 2017, Mr. Tas is responsible for Philips' strategy, M&A, ventures, research and development, medical affairs, sustainability, experience design, technology platforms and emerging businesses.
Responses have been lightly edited for length and clarity.
Question: In 2019, who or what is the biggest threat to hospitals?
Jeroen Tas: The biggest threat to hospitals is not having a strategy to play a very explicit role in the broader healthcare system. I think every hospital has to rethink the value they provide in the healthcare system, as part of a network, because just being a place where people go for emergencies and acute care will not suffice. We're not seeing retailers get into acute or emergency care, but they are saying, "Hey, you can come here. We have a one-stop shop. There's a doctor on site and we'll help you with a diagnosis. We can do blood tests or even ultrasounds. We provide you with your prescriptions." I think having a continuous relationship with their patients will also put hospitals in a position to start better controlling when and where specialist care or acute care is required.
Also, employers are getting into the game. They want to better influence the overall health of their employees and give them tools to manage their care. "If I do this well" — they're thinking — "I also influence my premiums." That's where the Amazon-Berkshire Hathaway and JPMorgan venture comes in: creating a platform for employee health. Then of course you have consumers, who are going to go for choice and convenience.
There are pressures on many sides of the system. Hospitals have to be clear on what their value-add is, what their role is in their community, with whom they are going to collaborate and how they'll provide better outcomes for their population.
Q: What healthcare technology did you think would be the "next big thing," but never took off? Or what hospital technology did you once think would be a mainstay, but its days now appear numbered?
JT: I can give you an example of technology that I actually thought would have a much broader applicability, and it hasn't, but I still believe it will come. I don't believe virtual care's days are numbered; I think its days are coming.
Philips has a strong presence in the tele-ICU space. Basically, tele-ICU supports care remotely and ensures optimum care within the ICU by using telemetry and cameras to instruct nurses and clinicians remotely on how to take the best care of patients. I think it is a hardest use case for virtual care: caring for the sickest patients. I expected everything in last couple of years would have gone that way — tele-radiology, tele-cardiology, tele-pathology, tele-dermatology — but that didn't happen at scale. I don't think the concept is wrong or flawed. I think now people see virtual care really makes sense, and maybe we should start applying it to other areas at scale.
The adoption of virtual care starts with reimbursement; everybody will always align behind what and how things are reimbursed. Bundled payments already align incentives to create better outcomes. You have seen this with hip and knee replacements, for example, where people optimize the best outcomes for patients because if there is an infection or an artificial knee or hip doesn't fit well and the patient needs to be readmitted, that episode of care isn't going to be reimbursed. Ultimately people will treat patients better, make sure the procedure is better guided and outpatient care is better coordinated because all of it goes back to the bottom line. Medicare Advantage is based on capitated payments and thus creates an incentive to prevent patients from deterioration. Under that model, keeping people out of the hospital suddenly becomes a priority. If you say I'm going to pay you per patient per month, then the incentive is not having the patient in a $4,500 per-night ICU bed.
Employers may have different incentives for virtual care than payers. They have a double incentive to keep employees as healthy as possible — employees are more productive when healthy and the employer may see lower premium payments. That is very important.
But the changes required under virtual care are big. Instead of waiting for people to come here to the hospital, you will remotely monitor them. That way you will see which patient has the highest acuity and determine the best intervention. That is a big change, and it raises questions about how healthcare is delivered, for example in teams behind screens. What is the role of the general practitioner in this? What's the role of the family? It really forces you to rethink how you operate as a team and what metrics you drive the team on. These are big change management programs, and we've seen that with some of our customers, who concluded that this is a major change to manage.
Q: Who are hospitals in competition with for talent?
JT: There is a very vibrant startup world looking at what technologies like artificial intelligence and the internet of things can do for healthcare. I think that is also an opportunity for a hospital, since all of these companies need clinical support, validation and evidence that the technologies will work in clinical workflows. If you are an academic medical center, that should be part of your DNA — supporting invention and science and extending this to the risk-taking startup world, where you can jointly develop evidence for technologies. Many of the leading integrated delivery networks and academic medical centers have strategies to promote being active in innovation ventures, and I think that is an excellent way to keep talent close to home and actually make talent work for what you can do for healthcare in your captive areas.
We have worked with many of our customers on these joint innovation programs. In 2018, Philips launched a global start-up collaboration program focused on the application of AI in radiology, cardiology and oncology. We had 750 startups apply and selected 19 promising early stage start-ups that are now working with us and one or two customers. There is a very vibrant technological world that hospitals and health systems can link to their own institutions and make part of their larger ecosystems.
I think competition for talent links back to the first question, too, as hospitals define their roles in the system.
"Maybe I see myself as a hospital and take no more responsibility for my population. Or maybe I start looking at innovation to enable better clinical, social and economic outcomes and enable the ecosystem to do that." If the latter, you are redefining your role and future as a hospital. These are real opportunities, but it goes back to the first point — you have to decide on who you are and what you want to do. If you say your role is being a hospital that waits for people to come to and you'll give them the best care within the walls of the hospital — well, that is what most do today. But if you take responsibility of your population and decide to play a bigger role in better health outcomes and enabling innovation to get there with best clinical practices in specific areas and better access to 24/7 care and virtual means, you are redefining who you are.
We as Philips hold ourselves to the same challenge. It's about more precise diagnoses, guiding patients after they leave the hospital to ensure they adhere to therapies, and tracking patient reported outcomes to better understand patients and better orchestrate across ecosystem. Can we be more than the products we bring to market? Do they truly help our customers create better outcomes? Can we become an enabler of better outcomes? These questions define our company.
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