Why have we chosen to dedicate
our professional lives
to healthcare?
Whether we are physicians
or whether we are physicists?
Because we are fascinated
and humbled by the
unique combination of knowledge,
of trust and of empathy
this field stands for,
to me this picture
illustrates exactly that.
Where are we in the year 2020
when it comes to digital health?
I think, on the one hand
we made enormous progress.
Medical information is doubling
every 73 days and there is
fascinating progress
in the subspecialties,
and on the other hand,
I think we need to admit that
when it comes to
the basic categories
of trust, of knowledge,
of empathy, which I outlined
in the beginning,
progress is still rather limited.
Patients feel uncertainty,
they hunt for second opinions,
they “google” the internet
to find out what is wrong,
and they need to navigate the
healthcare system by themselves.
When I look at the situation,
what sometimes helps me
is to reduce it to basically
the two fundamental questions
in healthcare,we want to solve.
Number one: How am I?
What is my health status?
Number two:
What is my path to health?
It helps me to use the analogy
that we have solved
over the last centuries,
a very similar problem.
The problem of: Where am I?
And what is my path to where
I want to go,
how do I get there?
Let us look at how we did this.
In the beginning,
we just looked around
50,000 years ago.
We used verbal tradition
to explain each other the way.
Then we discovered new ways
of orienting ourselves.
We discovered the stars
to find out where we are
and we started codifying
our knowledge in the first maps.
We discovered tools
to support us in the question
where we are.
The compass and all maps
got better and better.
I am always fascinated,
how these old maps
are a combination of
knowledge and myth.
There is the map and then
there is the monster.
Step by step
you get more rational
and knowledge takes over.
We developed new tools, the GPS
and the Atlas of the world
got completed.
But still the whole thing
was not very user friendly.
While today, by just using
our smartphone
we can find out where we are.
We can have access to all
knowledge of the world
on places on planet earth,
and it suggests
how we can get there,
we can even choose preferences
how we can get there.
This is exactly, how I believe,
the future of healthcare
will look like
and how we will answer the two
basic questions in healthcare.
How am I?
And what is my path to health?
What is the path
we have been on in healthcare?
We started with
the physical exam,
we wrote the first book
on what we have found.
We found tools,
like the compass, the X Ray
to better define
the individual patient
and the libraries of medicine
became fuller and fuller.
We decoded the human genome,
we found
subspecialty Congresses,
exciting platforms like ECRs
to share our knowledge
and more and more knowledge
about the individual patient
is generated, at the same time
we know more and more
about medicine.
I am convinced, the main benefit
of digitalization is,
to now make things simple again,
and to get back to
where we started, to knowledge
and trust and empathy,
that in the end we will have an
as simple situation as
in the question: Where am I?
and how do I get there?
There will be a digital twin
of ourselves on our smartphone,
exactly describing
our health status and
we will have access to pathways
exactly describing us
how we can get to health.
I am convinced the future of
Healthcare is simple.
There will be digital twins,
and pathway companions.
I am fascinated by the idea of
a digital twin since I saw
the first work
of our research team,
which was done together with
the University of Heidelberg.
The idea was to create
the digital twin
of a human heart and
it was fascinating how
they could make the heartbeat,
how they could see the effect
or make visible the effect of
arterial fibrillation,
how they could make
the heart beat again,
and how we started to plan
that this is a way to
select patients who can be cured
with CRT and how CRT
should be performed.
We are now adopting this idea
in all of our work,
I'm convinced personally that
you need to take
a crawl, walk, run, approach.
You start small and work
your way up because it is
too easy to become a victim of
a boil the ocean approach.
Here we show a very
simple challenge using
a digital twin of a patient
to do the right positioning
in a MR scan.
We work on a more general
digital twin model
of the patient to use this
twin model,
the “avatar” of the patient,
for treatment planning,
for surgery planning
and for positioning in imaging.
Together with leading
institutions worldwide
we also use the digital twin
in the context of COVID-19.
We take a digital twin
of each patient's lung,
and based on AI, we compare
this lung with a standard
lung model
to quantify the disease.
The next step is building
the bridge to treatment.
This is what we do
with a digital twin used for
radiation therapy planning,
with a digital copy
of the human body.
We select the organs
we identify tissue at risk
as much as the tumor
to be radiated, and use this
as the basis for treatment.
And now coming to the
pathway companion, step by step
we look into
bigger and bigger challenges.
It is not only about
radiation planning
of the next fraction, it is about
taking a fingerprint of the
individual patient and
finding out what should be
the treatment regime and
feedback the outcome to make
the algorithms even better.
I am very proud of
the Lancet publication
of our team.
The same principle we use
in our virtual liver project
for targeted tumor ablation.
We use a digital twin of a
patient's liver to exactly plan
the needle electrode position
and the power and duration
of the treatment.
To come to the picture of
a pathway to health,
we have to move one level up
and give a map for certain
diseases of medium complexity,
and we started with
prostate cancer.
Here our so called
pathway companion starts with
all relevant patient context
for supporting the
subsequent radiological reading.
It gives a very easy overview
of all diagnostic results,
gives an overview of all
potential decisions to be made,
and then highlights the
upcoming pathway of the patient.
I hope you can see
how all this fits together,
the vision of a future
where we have one digital twin
and one pathway companion
to health is far away.
But it was also very far away
for people 500 years ago
to believe how we have solved
the problem of Where am I and
how do I get to where I want?
I am convinced this is
the path we are on, I believe
that we as a community,
medtech and you as radiologists
are exactly the ones driving
this development forward.
We often hear that healthcare
is behind
when it comes to digitalization.
I see it completely differently.
Healthcare is not behind
when it comes to digital.
Digital healthcare is
the Holy Grail of digitalization
because it is more challenging.
Why? Because it is about
human lives, it is about trust,
it is about data privacy,
it is a very complex topic
and there are very strong
established structures.
We are the ones dealing with
the Holy Grail of challenges
in digitalization
and in order to solve it
we also have to think about
how we tackle it. We need to
start by looking at ourselves,
how we interpret
what we are doing.
I think,
it is extremely important
that each of us,
whether we are physicians
or whether we are in medtech,
that we elevate our roles,
that we look at our role:
our role is
what technology currently
cannot yet do,
and as soon as technology
can take over we need
to get to the next frontier.
I always say I want to focus on
what AI cannot do yet.
We need to take a clear position
of thought leadership when
it comes to AI and data privacy.
We need to work closely with
adjacent fields, and I believe
that nobody else than us
is better positioned to be
the innovators of healthcare.
You, as the technology experts
in medicine, and us
as the medical experts
in technology.
I believe this is an extremely
rewarding path we are on
because in the end it is about
using all we have
accomplished over the years,
to get back to this picture,
and why we are
in the field of Medicine.
It is about knowledge,
it is about trust and
it is about empathy.
Thank you very much
for your attention.