Why the hospital of the future will be your own home | Niels van Namen


Probably not a surprise to you, but I don’t like to be in a hospital or go to a hospital. Do you? I’m sure many of you
feel the same way, right? But why? Why is it
that we hate hospitals so much? Or is it just a fact of life
we have to live with? Is it the crappy food? Is it the expensive parking? Is it the intense smell? Or is it the fear of the unknown? Well, it’s all of that, and it’s more. Patients often have
to travel long distances to get to their nearest hospital, and access to hospital care
is becoming more and more an issue in rural areas, in the US, but also in sparsely populated
countries like Sweden. And even when hospitals are more abundant, typically the poor and the elderly have trouble getting care
because they lack transportation that is convenient and affordable to them. And many people are avoiding
hospital care altogether, and they miss getting proper treatment due to cost. We see that 64 percent of Americans are avoiding care due to cost. And even when you do get treatment, hospitals often make us sicker. Medical errors are reported to be
the third cause of death in the US, just behind cancer and heart disease, the third cause of death. I’m in health care for over 20 years now, and I witness every day how broken
and how obsolete our hospital system is. Let me give you two examples. Four in 10 Japanese medical doctors and five in 10 American medical doctors are burnt out. In my home country, the Netherlands, only 17 million people live there. We are short 125,000 nurses
over the coming years. But how did we even end up here, in this idea of placing
all kinds of sick people together in one big building? Well, we have to go back
to the Ancient Greeks. In 400 BC, temples for cure were erected where people could go
to get their diagnosis, their treatment and their healing. And then really for about 2,000 years, we’ve seen religious care centers all the way up
to the Industrial Revolution, where we’ve seen hospitals
being set up as assembly lines based on the principles
of the Industrial Revolution, to produce efficiently and get the products,
the patients in this case, out of the hospital as soon as possible. Over the last century, we’ve seen
lots of interesting innovations. We figured out how to make insulin. We invented pacemakers and X-ray, and we even came into this wonderful
new era of cell and gene therapies. But the biggest change
to fix our hospital system altogether is still ahead of us. And I believe it’s time now,
we have the opportunity, to revolutionize the system altogether and forget about
our current hospital system. I believe it’s time to create a new system that revolves around health care at home. Recent research has shown that 46 percent of hospital care can move to the patient’s home. That’s a lot. And that’s mainly for those patients
who suffer from chronic diseases. With that, hospitals can and should reduce to smaller,
agile and mobile care centers focused on acute care. So things like neonatology,
intensive care, surgery and imaging will still remain at the hospitals, at least I believe
for the foreseeable future. A few weeks ago, I met a colleague whose mom was diagnosed
with incurable cancer, and she said, “Niels, it’s hard. It’s so hard when we know
that she’s got only months to live. Instead of playing with the grandchildren, she now has to travel three times a week two hours up and down to Amsterdam just to get her treatment and tests.” And that really breaks my heart, because we all know
that a professional nurse could draw her blood
at home as well, right? And if she could get her tests
and treatment at home as well, she could do the things
that are really important to her in her last months. My own mom, 82 years old now —
God bless her — she’s avoiding to go to the hospital because she finds it difficult
to plan and manage the journey. So my sisters and I, we help her out. But there’s many elderly people
who are avoiding care and are waiting that long
that it becomes life-threatening, and it’s straight
to the costly, intensive care. Dr. Covinsky, a clinical researcher
at the University of California, he concludes that a third
of patients over 70 and more than half of patients over 85, leave the hospital more disabled
than when they came in. And a very practical problem that many patients face
when they have to go to a hospital is: Where do I go with my main
companion in life, where do I go with my dog? That’s our dog, by the way.
Isn’t she cute? (Laughter) But it’s not only about convenience. It’s also about unnecessary
health care stays and costs. A friend of mine, Art, he recently needed to be hospitalized
for just a minor surgery, and he had to stay in the hospital
for over two weeks, just because he needed
a specific kind of IV antibiotics. So he occupied a bed for two weeks that cost over a thousand euros a day. It’s just ridiculous. And these costs are really
at the heart of the issue. So we’ve seen over many
of our global economies, health care expense grow
as a percentage of GDP over the last years. So here we see
that over the last 50 years, health care expense has grown
from about five percent in Germany to about 11 percent now. In the US, we’ve seen growth
from six percent to over 17 percent now. And a large portion of these costs
are driven by investments in large, shiny hospital buildings. And these buildings are not flexible, and they maintain a system
where hospital beds need to be filled for a hospital to run efficiently. There’s no incentive
for a hospital to run with less beds. Just the thought of that
makes you sick, right? And here’s the thing: the cost
for treating my buddy Art at home can be up to 10 times cheaper
than hospital care. And that is where we’re headed. The hospital bed of the future
will be in our own homes. And it’s already starting. Global home care is growing
10 percent year over year. And from my own experience,
I see that logistics and technology are making these home
health care solutions work. Technology is already
allowing us to do things that were once exclusive to hospitals. Diagnosis tests like blood, glucose tests, urine tests, can now
be taken in the comfort of our homes. And more and more connected devices we see like pacemakers and insulin pumps that will proactively signal
if help is needed soon. And all that technology is coming together in much more insights
into the patients’ health, and that insight and all of
the information leads to better control and to less medical errors — remember, the third cause of death in the US. And I see it every day at work. I work in logistics and for me, home health care works. So we see a delivery driver
deliver the medicine to the patient’s home. A nurse joins him
and actually administers the drug at the patient’s home. It’s that simple. Remember my buddy, Art? He can now get the IV antibiotics
in the comfort of his home: no hospital pajamas, no crappy food and no risk of these
antibiotic-resistant superbugs that only bite you in these hospitals. And it goes further. So now the elderly people
can get the treatment that they need in the comfort of their own home while with their best companion in life. And there’s no need anymore
to drive hours and hours just to get your treatment and tests. In the Netherlands and in Denmark, we’ve seen very good successes
in cancer clinics organizing chemotherapies
at the patient’s homes, sometimes even together
with fellow patients. The best improvements for these patients have been improvements
in reduction in stress, anxiety disorders and depression. Home health care also helped them
to get back a sense of normality and freedom in their lives, and they’ve actually helped them
to forget about their disease. But home health care, Niels — what if I don’t even have a home,
when I’m homeless, or when I do have a home
but there’s no one to take care of me or even open up the door? Well, in comes our sharing economy, or, as I like to call it,
the Airbnb for home care. In the Netherlands,
we see churches and care organizations match people in need of care and company with people who actually
have a home for them and can provide care and company to them. Home health care is cheaper, it’s easier to facilitate,
and it’s quick to set up — in these rural areas we talked about,
but also in humanitarian crisis situations where it’s often safer, quicker
and cheaper to set things up at home. Home health care is very applicable
in prosperous areas but also very much
in underserved communities. Home health care
works in developed countries as well as in developing countries. So I’m passionate to help facilitate
improvements in patients’ lives due to home health care. I’m passionate to help facilitate that the elderly people
get the treatment that they need in the comfort of their own homes, together with their
best companion in life. I’m passionate to make the change and help ensure that patients,
and not their disease, are in control of their lives. To me, that is health care
delivered at home. Thank you. (Applause)

65 thoughts on “Why the hospital of the future will be your own home | Niels van Namen

  1. The future is now brother, I have everything I need on my back yard, vegetables and herbs, food and medicine, everyone should do the same.

  2. Be practical drs are there and they don't let it happen bitter truth but must be agreed bcz they put u in such dilemma tht u hve to agree them sad but true..😢

  3. We don't have Healthcare. It's "Sickcare". People are realizing that. There are many cures that are held back because the medical system and big pharma has put money over lives and for a long time now.
    Costs have skyrocketed, yet the care is worse now then when I was a kid.
    I am old enough to remember when the family Dr came to your house to see you.
    Look at the amazing technology we have, yet there are more sick people than ever. People are dying younger. I can go on and on because this is my main issue I have been fighting for the last 20 years.
    This guy is on the right path.. and we need those cures released.

  4. That's nothing new. It is just totally the way the "healthcare" system works in the Netherlands already: the doctors are useless and just send you home to get better on your own.

  5. One doctor per person, one factory per person, one tutor per person, one channel per person, and so on
    From one AI per person

  6. I've bee a live-in health/companion for a number of years because I gave up my marriage & home. Having some mobility issues now but am able to move around in a one level house without difficulty. I'm aware there are now computerized medical beds that compile data on bed's occupant & relays it. The one problem I see is power loss especially when a patient goes into crisis.

  7. If the country doesn't train sufficient nurses…doctors…specialist care and mental health staff…that's the reason for shortages

  8. I'm from Myanmar, a third world country.I'm about to start a clinic… and this video enlightened me that logistics is very important… it's not about getting more customers It's about providing better service to the patient…

    I'm still thinking why we need to go hospital for some minor treatment while we can order pizza to our home..

  9. In the US everything is a virus and therefore, you can go home to sleep it off. But that’s the catch, not enough sick days are provided by employers, as if we were the HEALTHIEST PEOPLE IN THE WORLD WITH ALL THE JUNK WE EAT!!!!

  10. Very ambitious ideas, but the practical hurdles to overcome are far higher than this one sided passionate talk adresses. This man clearly does only work on the logistics side of health care, not on the 'real' care side of the current health care system

  11. Haven't had my thyroid meds thanx to the nature of our screwed up mess. Blood test and a tiny pill but for the man with a suit and tie gatekeeper to the doctor, let alone cheaper and more efficient system.

  12. The hospital of the future is already in my home. I have an in-sink trash compactor that also does gender re-assignment surgery…

  13. presently, work at a home care agency. The conveniency of homecare is amazing but the only downside is the shortage of healthcare providers such as nurses.

  14. Yet another important talk! This "healthcare" madness has been going on for too long. In 2018 we can cover the logistics of this system with the current technology while providing necessary and useful jobs to caretakers.
    However the best thing you can do is work less, eat healthy foods, go outdoors more and you'd never have to visit a doctor ever again and money you invested in your health will stay IN YOU and not to hospitals. Prioritize your health over jobs and money!

  15. Yes finally someone who speaks my mind. Home healthcare would be so great. And it used to be a thing, that the family doc would come over and do a ll the regular tests and all the vaccines. But the insurance companys wanted more profit so now a doctor only get´s very little per patient so they try to cram in as many as possible.

  16. He is not really into health care like doctors and nurses are, he is a logistics manager at UPS. Of course it is more comfortable being at home when you are sick. But having 100.000 mini hospitals at home obviously means a lot more business for UPS then having it all in one place. Still, a lot of care now being provided in hospital can be provided at home as well. It is questionable however if that, over all, will be cheaper, or that it will only mean that the money goes more via UPS in stead of where it is going now. Healthcare will always have it's price. No one wants to pay for it and every one wants to be at the receiving end of the money. UPS is one of them. That is not right or wrong per se, but just a different perspective on this talk.

  17. Detenerse en el 9:56; los reparadores de máquinas, humanas, están mentalizados por el excremento del diablo; se han convertido en embaucadores de la salud. Hipocrátes, sostiene: el médico cura, sólo, la naturaleza sana. Finalmente: Distraete=olvida tu dolencia.

  18. Good. Although I'd say that preventive self-care should be the main focus, if people learn to have mental wellness, and therefore, a
    good physical condition, they won't even need to have a treatment at home because they're always going to be healthy. Just avoid getting sick by being positive and happy. Nice talk!

  19. I agree with him in principle but there are kinks to work out . There's a visiting nurses association where I live that a couple people I knew quit because they are nosy and sometimes get social services involved . There have also been complaints about lack of punctuality which annoys me in any care setting . Furthermore opening my home to the homeless like the speaker suggests wouldn't be something I'd be very comfortable with .

  20. A lot of things we make it as it invaded our natural life,
    Why use food Imperfect?
    Why do we use antibiotics and on the shelves of our kitchens better ones?
    Vinegar is very useful in the treatment of infections, effectively and quickly and strengthens the immune system – for exm

  21. It is sad this has to be a TED Talk when the solution is so obvious and beneficial to not only the individuals affected, but to every country as a whole and their entire financial future. What are we doing? 17% instead of 5% monetarily and providing worse treatment for ourselves. Capitalism cannot be placed over Care!!!

  22. It is a great concept, that would result in an easier recovery and less complications. However it is important to know why hospital came to be and fix the problems of the past where a similar system existed. First of all there would be shortage of healthcare workers. Even in the current system, there is a deficit of nurses, physicians, and other types of providers. If we were to establish a system where nurses administer treatment at home, the patient load they can logistically carry would decrease. The number of healthcare workers need to care for the same amount of patients would drastically increase and make the current problem even worse. Secondly although a lot patients in the hospital can be treated at home, the treatment they are on requires supervision for side effects or there is a possibility of their condition worsening and potential need more specialized care. This can be solved by either setting up secondary healthcare centers close enough to hospitals or determining very specific criteria for conditions and patients that can be given home healthcare.
    Overall the transition towards home healthcare has begun for simple conditions and patients who are responding well to treatment however it is important to have the vision to see potential problems and arrange solutions before we start treating patients with complex conditions at home.

  23. Why is health care so expensive? (1) Medical insurance, (2) Malpractice AKA defensive medicine (related to insurance), (3) wage & work rules in medical field, (4) drug prices (related to insurance), overuse of expensive tests & procedures(related to insurance and defensive medicine).

  24. My family hospital is our backyard, &our farm, growing my own , and if you read this please make sure you plant a moringa tree, doesn’t need a huge garden even a flower pot or old bucket will do..! Research on it 👌🏾 I believe every family needs this plant in their backyard/garden.

  25. This is a complex topic, there really is not a "one size fits all" type of solution, but one thing is certain and ubiquitous . . . people have to become much more proactive in managing their own health.
    This means much more focus on one's own preventative health management . . . better diet, exercise, common sense lifestyle. The days of people living very unhealthy lifestyles, over eating, smoking, excessive drinking and so on, and then showing up at the hospital with ailments that they caused to themselves, these days have to come to an end.
    Having said that, it does make sense that much of the care and procedures that had been relegated to the "big fancy hospitals" can in fact be rendered at home with current and emerging technologies. Which leads to a larger question, that being the required change of the "traditional" economic and business models that have surrounded so-called health care industry, and is now spiraling out of control.
    And yes, it is absolutely true that many doctors are getting completely burned out with the assembly line type of practice they find themselves in, and for many still in med school or starting out in residency, the extreme cost of the education and crushing debt incurred just to get to that point is daunting.
    This system is imploding in on itself . . . a radical change in so-called healthcare is necessary and unavoidable.

  26. Hospitals are very eager to get rid of chronically ill patients, claiming they're better at home. Usually a family member, completely alone, becomes responsible for continual care. Sure, the hospital will promise they will provide this that and everything, just to get the patient out the door. In reality, there is practically nothing in terms of community supports. Start there.

  27. This has already been considered:
    Jules Verne & Paschal Grousset – The Begum's fortune

    Main plot:
    Someone decides to spend his inherited fortune to build a city where home healthcare is used instead of hospitals, where drainage and sewerage work properly and pollution and endemics are not a problem anymore.
    (I hope someone tries to implement this someday. )

  28. This is the way we are going in Australia, especially for the elderly, as we are facing a crisis in a few years as our baby boomers are ageing. There aren't enough high care aged care facilities, so there has been a huge emphasis on home care. Not just nurses but also cleaners, personal carers and the like. And if admitted, people get out of hospital faster, and therefore more beds are available, but people feel better at home usually. Personal care buzzers such Tunstall provide are also there for people who need help after falling etc.
    Postnatal home care is huge, as well as aged care. There are now also mobile physios, podiatrists, occupational therapists. I'm not sure about the chemo treatment. I think some-one still has to go to hospital but once a stent is inserted, there is no reason why it can't be administered at home by a nurse. After-hours home visits by doctors are now becoming more common. I had one come to me on a weekend when I thought I had food poisoning but it turned out to be a severe case of diverticulitis. I didn't even know what that was, and if left untreated my bowel would have burst. I then ended up in hospital as it was necessary. It is changing for the better I think.

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