"Patient centricity means communicating on eye level"
The university hospital of Basel not only wants to use innovation, but also drive innovation. For this reason, the hospital established an Innovation Lab recently and launched an internal support program to help put innovation projects into practice. Driving forces behind this initiative are Jens Eckstein and Marc Strasser. DayOne asked Jens Eckstein about this push for innovation.
BaselArea.swiss: There are basically two reasons for driving innovation. Either it’s necessity or an inner drive. What drives you?
Jens Eckstein: Without an inner drive, I would certainly not have taken on this task, but a part of it can also be seen as necessity. Much of what we are doing now is simply homework that we had not completed until now. A patient coming to the clinic today usually experiences a step back in terms of information technology compared with what he is used to in his private life. Some of the systems we work with as a treatment team are 20 years old. At some point I said our IT can do better than that. A colleague replied, I should not moan but get on and do something. I am one of those people who takes pleasure in technology and innovation. That’s why these pain points were so difficult for me to bear.
Evidently, your concerns were heard?
Yes, IT and hospital management have given their full backing and we have reorganized ourselves. 50 percent I work as a clinician, the other 50 percent I am a Chief Medical Information Officer. Thus, I can act as a translator and build bridges between IT and the diverse departments.
What part of your homework did you tackle first?
Already before my change of function we fitted a large monitor on each floor, showing the responsible ward team with a photo.
That doesn’t exactly sound very disruptive?
It may sound trivial, but for many of our patients and their families it makes a big difference. Many of our patients are used to being constantly online and having access to all information. This makes it all the more stressful when this normal state is suddenly lost in hospital. Of course, all patients have Wi-Fi and internet access, but a lot of information that interests them is not yet available digitally. Hence patients often assume a passive role. If we want patients to take an active part in their treatment process, then this is exactly where we need to start. We need to provide them promptly with all the medical and organizational information of relevance to them. Only then will they be able to participate actively in the treatment process.
Do you want that as a doctor?
It is much more enjoyable working with informed patients! Today, everyone talks about “patient centricity”. If you take this concept seriously, it has far-reaching consequences for our profession. As a doctor, you are challenged to involve patients in the decision-making process. Our task is to advise and coach them. To avoid death at any price with a therapy may no longer be the sole aim of an intervention. Quality of life issues are just as relevant. Therefore, you need to communicate at eye level. The monitor on each floor was a first, very small step in this direction, so that everyone knows who is taking care of the patients.
Do patients actually want to have a say?
Yes, definitely. New technologies at present are positively mushrooming out of the ground which also increases the pressure on our hospital. No one expects a university hospital to become a boutique hotel. The focus is on first-class medical care. Digitization offers new opportunities, though, and a hospital needs to make the most of these opportunities for the benefit of both staff and patients. This is why we set up the Innovation Lab.
What exactly is that?
The Innovation Lab functions primarily as an entry lane for new technologies. To this end, we established an IT infrastructure separate from the clinic, which allows new applications to be quickly implemented in a protected area and tested, involving decision makers and patients. It’s a kind of sandpit or playground for initial pilot projects with new technologies, without these already having to meet all safety standards and the requirements of a medical device.
I could imagine you being quickly overrun with queries?
In fact, the situation is already difficult to cope with. I’m currently in the process of expanding the team. The interest among colleagues is fortunately huge. We started in cardiology, continued in surgery and will soon become active with projects in completely different areas as well, such as psychiatry and rheumatology.
What kind of projects are you dealing with?
It varies a lot. An external partner, such as a start-up, might want to get his application clinically validated with us. If we see a benefit for the patient, we will pursue the project further. However, the partner must agree to us publishing the results – even if they are not positive. Another possibility is that a member of the hospital staff has a brilliant idea and wants to pursue it further. Therefore, we launched Future Friday events this year, the aim being to hold them several times a year. We invite our 8000 members of staff to submit their innovation ideas and invite the three best submissions to pitch their ideas at the event. One of these ideas gets the go-ahead. The winning project is endowed with sufficient resources to drive the idea and to come up with an initial prototype within six months.
So far, it has not been part of the mission of a hospital to implement innovation. Why this change all of a sudden?
Research has always been a key part of the university hospital and repeatedly led to innovative spin-offs. By taking a more proactive approach to this process, we are now providing a catalyst for this potential and further burnishing our reputation. This puts our hospital on the global radar in a number of fields. We want to be among the best in terms of not only medicine, but also when it comes to innovation. The ecosystem in Basel offers outstanding conditions with its strong life sciences environment and a very dynamic start-up scene. The USB is already a partner of many interesting projects, which in turn gives us access to the most advanced technologies. For what is a medium-sized hospital by international standards, this is by no means a given. When it comes to agility, our constellation of university environment and strategic focus on innovation and digitization gives us a clear advantage.
How does this work when doctors become entrepreneurs or so-called docpreneurs? Who gets what share on the newly established company?
We still need to test the suitable model for this. The core business of the hospital is and remains the treatment of patients. It is true that the hospital receives a fair share in the development of an innovation. There are two extremes: either the IP belongs entirely to us and we license the product, for example to the partner who then markets it; or the product belongs to the partner and we participate in its development with the aim of obtaining exactly the right application for us. The realistic scenario often lies somewhere in between.
So do you want doctors to become entrepreneurs?
In case of doubt, I would say no. And that’s a good thing. The aim is not for all our doctors to found start-ups. To us it is important that they increasingly participate in the innovation process by sharing their ideas and their specialist knowledge. In return, they should receive their fair share, for example shareholdings. The same should apply to non-medical staff.
About Jens Eckstein
Jens Eckstein is Chief Physician and Chief Medical Information Officer at the University Hospital of Basel. Eckstein is a specialist in cardiology and internal medicine and has completed his doctoral thesis on both the development of a heart valve prosthesis and the mapping of cardiac arrhythmias. He habilitated at the University of Basel and studied medicine in Lübeck and Freiburg. In his first profession he was a paramedic.
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