There are 2.6 times as many startups per 1 million people, compared to the European average in the Netherlands. The healthcare of the nation with 17.4 million people is highly digitalized, but the lack of data flow among institutions remains a challenge to be solved.

“93% of our patients, when they visit the hospital, use the electronic portal and look at their EMR records. And most of them are over 70 years old,” said Corne Mulders, CIO of University Medical Center Utrecht at a panel discussion about digital health in the Netherlands held at the mHealth Israel Conference in Tel Aviv in November 2022.

Good practices by the University Medical Centers

There are 8 University Medical Centers in the Netherlands and they approach innovation with different strategies and in-house innovation teams.

For example, a few years ago, the team at a hackathon at UMC Utrecht developed an AI solution that helps nurses recognize if prematurely born babies are sleeping or not. “One of our physicians who's working with premature babies told us that babies born within 24 weeks need to sleep a lot to develop their brain. But what we typically do is change their diapers every day at 8 am in the morning and most of our nurses who care for them don't really know if the babies are asleep or whether they're awake. So we used vital sign monitors and developed an AI tool based on derived vital function data to determine whether the child sleeps. After two days, we could tell with 92% accuracy if the child was asleep or not. And for me, that was what healthcare is about,” said Corne Mulders.

Erasmus University Medical Center is part of an effort to create an innovation hub by connecting Erasmus UMC, Erasmus University Rotterdam, and the Delft University of Technology.

Maastricht University Medical Center has successfully connected and exchanged data with nearby hospitals in Belgium and Germany. “While we have some trouble moving the data inside the country, we've been having a lot of success moving outside of the cross-country border. Which seems really strange, but it's true,” said Paul Hillman, CIO of Maastricht UMC.

Data fragmentation by design

The mentioned example of the cross-border data exchange is a great success in the Dutch context since the exchange of healthcare data inside the Netherlands is limited due to the fragmentation of the healthcare system. As noted in the 2022 OECD report, fragmentation is a design feature to ensure market mechanisms can function as intended. The competition law explicitly prohibits the exchange of information between providers in order to maintain the market mechanisms. In the panel discussion in Tel Aviv, Corne Mulders explained that this is a consequence of privacy concerns by lawmakers from a decade ago. “The Netherlands is quite a small country. And back in 2011, we had a law proposal that suggested the installation of one EMR system for the whole of the Netherlands. That has been fully wiped away by the politicians as a result of privacy concerns. And we've been suffering for 12 years already because of this problem. Not only was the decision made to not go to one EMR system, but also, all politicians have said we're never going to go somewhere in this direction. So as a ministry, any proposal that suggests moving in this direction could not be supported. Consequently, data is scattered, and we've always struggled with new opportunities. Everybody now sees we need to do things differently with data and digitalization.”

University medical centers are developing a new target architecture for Dutch healthcare data. By opening up the data in a platform consisting of regional hubs, medical centers could facilitate data-driven care, improve prevention and use the data for scientific research.

“We can do better with incorporating patient data to fuel innovation,” said Simon Vermeer, CIO of UMC Erasmus.

This is just an excerpt.

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