TED@UPS
Niels van Namen: Why the hospital of the future will be your own home
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Nobody likes going to the hospital, whether it's because of the logistical challenges of getting there, the astronomical costs of procedures or the alarming risks of complications like antibiotic-resistant bacteria. But what if we could get the lifesaving care provided by hospitals in our own homes? Health care futurist Niels van Namen shows how advances in technology are making home care a cheaper, safer and more accessible alternative to hospital stays.
Niels van Namen - Health care futurist
Niels van Namen leads the UPS Europe Healthcare team as the Vice President for Healthcare. Full bio
Niels van Namen leads the UPS Europe Healthcare team as the Vice President for Healthcare. Full bio
Double-click the English transcript below to play the video.
00:13
Probably not a surprise to you,
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but I don't like to be in a hospital
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or go to a hospital.
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Do you?
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I'm sure many of you
feel the same way, right?
feel the same way, right?
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But why? Why is it
that we hate hospitals so much?
that we hate hospitals so much?
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Or is it just a fact of life
we have to live with?
we have to live with?
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Is it the crappy food?
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Is it the expensive parking?
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Is it the intense smell?
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Or is it the fear of the unknown?
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Well, it's all of that, and it's more.
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Patients often have
to travel long distances
to travel long distances
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to get to their nearest hospital,
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and access to hospital care
is becoming more and more an issue
is becoming more and more an issue
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in rural areas,
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in the US,
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but also in sparsely populated
countries like Sweden.
countries like Sweden.
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And even when hospitals are more abundant,
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typically the poor and the elderly
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have trouble getting care
because they lack transportation
because they lack transportation
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that is convenient and affordable to them.
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And many people are avoiding
hospital care altogether,
hospital care altogether,
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and they miss getting proper treatment
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due to cost.
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We see that 64 percent of Americans
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are avoiding care due to cost.
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And even when you do get treatment,
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hospitals often make us sicker.
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Medical errors are reported to be
the third cause of death in the US,
the third cause of death in the US,
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just behind cancer and heart disease,
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the third cause of death.
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I'm in health care for over 20 years now,
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and I witness every day how broken
and how obsolete our hospital system is.
and how obsolete our hospital system is.
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Let me give you two examples.
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Four in 10 Japanese medical doctors
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and five in 10 American medical doctors
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are burnt out.
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In my home country, the Netherlands,
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only 17 million people live there.
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We are short 125,000 nurses
over the coming years.
over the coming years.
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But how did we even end up here,
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in this idea of placing
all kinds of sick people
all kinds of sick people
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together in one big building?
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Well, we have to go back
to the Ancient Greeks.
to the Ancient Greeks.
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In 400 BC, temples for cure were erected
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where people could go
to get their diagnosis,
to get their diagnosis,
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their treatment and their healing.
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And then really for about 2,000 years,
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we've seen religious care centers
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all the way up
to the Industrial Revolution,
to the Industrial Revolution,
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where we've seen hospitals
being set up as assembly lines
being set up as assembly lines
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based on the principles
of the Industrial Revolution,
of the Industrial Revolution,
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to produce efficiently
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and get the products,
the patients in this case,
the patients in this case,
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out of the hospital as soon as possible.
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Over the last century, we've seen
lots of interesting innovations.
lots of interesting innovations.
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We figured out how to make insulin.
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We invented pacemakers and X-ray,
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and we even came into this wonderful
new era of cell and gene therapies.
new era of cell and gene therapies.
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But the biggest change
to fix our hospital system altogether
to fix our hospital system altogether
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is still ahead of us.
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And I believe it's time now,
we have the opportunity,
we have the opportunity,
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to revolutionize the system altogether
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and forget about
our current hospital system.
our current hospital system.
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I believe it's time to create a new system
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that revolves around health care at home.
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Recent research has shown
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that 46 percent of hospital care
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can move to the patient's home.
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That's a lot.
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And that's mainly for those patients
who suffer from chronic diseases.
who suffer from chronic diseases.
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With that, hospitals can and should
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reduce to smaller,
agile and mobile care centers
agile and mobile care centers
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focused on acute care.
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So things like neonatology,
intensive care, surgery and imaging
intensive care, surgery and imaging
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will still remain at the hospitals,
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at least I believe
for the foreseeable future.
for the foreseeable future.
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A few weeks ago, I met a colleague
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whose mom was diagnosed
with incurable cancer,
with incurable cancer,
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and she said, "Niels, it's hard.
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It's so hard when we know
that she's got only months to live.
that she's got only months to live.
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Instead of playing with the grandchildren,
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she now has to travel three times a week
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two hours up and down to Amsterdam
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just to get her treatment and tests."
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And that really breaks my heart,
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because we all know
that a professional nurse
that a professional nurse
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could draw her blood
at home as well, right?
at home as well, right?
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And if she could get her tests
and treatment at home as well,
and treatment at home as well,
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she could do the things
that are really important to her
that are really important to her
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in her last months.
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My own mom, 82 years old now --
God bless her --
God bless her --
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she's avoiding to go to the hospital
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because she finds it difficult
to plan and manage the journey.
to plan and manage the journey.
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So my sisters and I, we help her out.
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05:15
But there's many elderly people
who are avoiding care
who are avoiding care
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and are waiting that long
that it becomes life-threatening,
that it becomes life-threatening,
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and it's straight
to the costly, intensive care.
to the costly, intensive care.
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Dr. Covinsky, a clinical researcher
at the University of California,
at the University of California,
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he concludes that a third
of patients over 70
of patients over 70
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and more than half of patients over 85,
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leave the hospital more disabled
than when they came in.
than when they came in.
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And a very practical problem
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that many patients face
when they have to go to a hospital is:
when they have to go to a hospital is:
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Where do I go with my main
companion in life,
companion in life,
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where do I go with my dog?
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That's our dog, by the way.
Isn't she cute?
Isn't she cute?
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(Laughter)
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But it's not only about convenience.
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It's also about unnecessary
health care stays and costs.
health care stays and costs.
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A friend of mine, Art,
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he recently needed to be hospitalized
for just a minor surgery,
for just a minor surgery,
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and he had to stay in the hospital
for over two weeks,
for over two weeks,
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just because he needed
a specific kind of IV antibiotics.
a specific kind of IV antibiotics.
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So he occupied a bed for two weeks
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that cost over a thousand euros a day.
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It's just ridiculous.
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And these costs are really
at the heart of the issue.
at the heart of the issue.
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So we've seen over many
of our global economies,
of our global economies,
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health care expense grow
as a percentage of GDP
as a percentage of GDP
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over the last years.
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So here we see
that over the last 50 years,
that over the last 50 years,
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health care expense has grown
from about five percent in Germany
from about five percent in Germany
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to about 11 percent now.
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In the US, we've seen growth
from six percent to over 17 percent now.
from six percent to over 17 percent now.
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And a large portion of these costs
are driven by investments
are driven by investments
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in large, shiny hospital buildings.
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And these buildings are not flexible,
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and they maintain a system
where hospital beds need to be filled
where hospital beds need to be filled
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for a hospital to run efficiently.
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There's no incentive
for a hospital to run with less beds.
for a hospital to run with less beds.
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Just the thought of that
makes you sick, right?
makes you sick, right?
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And here's the thing: the cost
for treating my buddy Art at home
for treating my buddy Art at home
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can be up to 10 times cheaper
than hospital care.
than hospital care.
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And that is where we're headed.
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The hospital bed of the future
will be in our own homes.
will be in our own homes.
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And it's already starting.
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Global home care is growing
10 percent year over year.
10 percent year over year.
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And from my own experience,
I see that logistics and technology
I see that logistics and technology
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are making these home
health care solutions work.
health care solutions work.
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Technology is already
allowing us to do things
allowing us to do things
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that were once exclusive to hospitals.
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Diagnosis tests like blood,
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glucose tests, urine tests, can now
be taken in the comfort of our homes.
be taken in the comfort of our homes.
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And more and more connected devices
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we see like pacemakers and insulin pumps
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that will proactively signal
if help is needed soon.
if help is needed soon.
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And all that technology is coming together
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in much more insights
into the patients' health,
into the patients' health,
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and that insight and all of
the information leads to better control
the information leads to better control
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and to less medical errors --
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remember, the third cause of death
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in the US.
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And I see it every day at work.
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I work in logistics
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and for me, home health care works.
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So we see a delivery driver
deliver the medicine
deliver the medicine
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to the patient's home.
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A nurse joins him
and actually administers the drug
and actually administers the drug
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at the patient's home.
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It's that simple.
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Remember my buddy, Art?
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He can now get the IV antibiotics
in the comfort of his home:
in the comfort of his home:
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no hospital pajamas, no crappy food
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and no risk of these
antibiotic-resistant superbugs
antibiotic-resistant superbugs
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that only bite you in these hospitals.
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And it goes further.
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So now the elderly people
can get the treatment that they need
can get the treatment that they need
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in the comfort of their own home
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while with their best companion in life.
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And there's no need anymore
to drive hours and hours
to drive hours and hours
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just to get your treatment and tests.
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In the Netherlands and in Denmark,
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we've seen very good successes
in cancer clinics
in cancer clinics
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organizing chemotherapies
at the patient's homes,
at the patient's homes,
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sometimes even together
with fellow patients.
with fellow patients.
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The best improvements for these patients
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have been improvements
in reduction in stress,
in reduction in stress,
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anxiety disorders and depression.
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Home health care also helped them
to get back a sense of normality
to get back a sense of normality
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and freedom in their lives,
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and they've actually helped them
to forget about their disease.
to forget about their disease.
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But home health care, Niels --
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what if I don't even have a home,
when I'm homeless,
when I'm homeless,
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or when I do have a home
but there's no one to take care of me
but there's no one to take care of me
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or even open up the door?
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Well, in comes our sharing economy,
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or, as I like to call it,
the Airbnb for home care.
the Airbnb for home care.
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In the Netherlands,
we see churches and care organizations
we see churches and care organizations
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match people in need of care and company
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with people who actually
have a home for them
have a home for them
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and can provide care and company to them.
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Home health care is cheaper,
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it's easier to facilitate,
and it's quick to set up --
and it's quick to set up --
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in these rural areas we talked about,
but also in humanitarian crisis situations
but also in humanitarian crisis situations
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where it's often safer, quicker
and cheaper to set things up at home.
and cheaper to set things up at home.
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Home health care is very applicable
in prosperous areas
in prosperous areas
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but also very much
in underserved communities.
in underserved communities.
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Home health care
works in developed countries
works in developed countries
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as well as in developing countries.
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So I'm passionate to help facilitate
improvements in patients' lives
improvements in patients' lives
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due to home health care.
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I'm passionate to help facilitate
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that the elderly people
get the treatment that they need
get the treatment that they need
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in the comfort of their own homes,
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together with their
best companion in life.
best companion in life.
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I'm passionate to make the change
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and help ensure that patients,
and not their disease,
and not their disease,
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are in control of their lives.
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To me, that is health care
delivered at home.
delivered at home.
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Thank you.
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(Applause)
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ABOUT THE SPEAKER
Niels van Namen - Health care futuristNiels van Namen leads the UPS Europe Healthcare team as the Vice President for Healthcare.
Why you should listen
Niels van Namen has more than 20 years of experience in the health care and life science industry, working closely with customers across R&D, supply chain and manufacturing. He is passionately involved in key developments and supply chain challenges in the health care value chain; in clinical and commercial biopharmaceutical supply chains; in the complexities of medical device distribution, returns, consignments; in hospital logistics; and in final mile, home healthcare distribution and care systems. He is responsible for all health care customers and the team across all UPS business units, providing strategic direction to leverage UPS's expertise in supply chain transportation, inventory management, distribution and regulatory compliance to support healthcare companies.
van Namen started his career as an engineer and an entrepreneur in clinical trials management. He initiated Diagnostic Units, a company performing clinical trials and providing regular diagnostics and care to patients in Europe. And he worked in the IBM Healthcare consulting practice and then joined DSV to lead the global Healthcare solutions industry.
van Namen is a PDA member, holds an MSc from Delft University of Technology, obtained his MBA on the Rotterdam School of Management and holds a certificate from l'École Nationale des Ponts et Chaussées in Paris. He lives in the Netherlands, is married and has three children.
Niels van Namen | Speaker | TED.com