Difference between revisions of "The Future of Hospitals in Amsterdam in 2020"

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''MBA09 team:''<br>
==EMBA09 team==
Peter Hoppesteyn<br>
This team was formed by the following members of EMBA09:
Roel Kock<br>
*Peter Hoppesteyn<br>
Piotr Ptasinski<br>
*Roel Kock<br>
Miranda Tjiang<br>
*Piotr Ptasinski<br>
Marjoleine van der Zwan<br>
*Miranda Tjiang<br>
*Marjoleine van der Zwan<br>
<br>
<br>
''"Work under construction. In case you have any questions, additions or comments, please do not edit these pages, but you are more than welcome to [mailto:peter.hoppesteyn@xs4all.nl contact us].'''
<br><br>


==Scenarios:==
==Introduction==
UNDER CONSTRUCTION BY ** roel **
During the first meeting of Scenario Thinking we all presented our 'topics'. Based on the initial topic each of us could vote for his or her favourite. And it turned out that the 'future of hospitals in Amsterdam in 2020' was the most common favourite. With this topic in mind we did a small brainstorm on questions of interest.  
<br>
 
I like the coaching session, and think you have a good command of the topic. The key challenge is now going to take the stories we talked about (and others) and put them together in NEW and interesting ways.  Look at which stories you think fit well together and build the scenarios from that.<br>
*''Will we all have access to hospital care in Amsterdam in 2020, or do we have to travel to Utrecht or Brussels or The Bahamas for specific care? <br>
Good Luck - D
 
*''Will we live longer and have higher demands for quality?<br>
 
*''Will technology and ICT continue to devolope at high speed? <br>


<br>
*''How can health care be finances in 2020? <br>
1. Too much prevention<br>
''It is 2020 and we are living in Amsterdam. The number of people living in the capital of The Netherlands stabalised at around 750.000 many years ago. However, due to globalisation, the atractiveness of the city to foreigners, and relative high number of children per person of the allochtonous population compared to the number of children of the autochtonous population there is an increadible number of nationalities living on a relative small area. Therefore, the city is vulberable for pandemies. In 2015 the Bengalese flue had a major impact on the citizens (and the economy) of Amsterdam. When the pandemy peaked, more than one-third of the citizens of Amsterdam were sick. As a reaction to this disaster, people in Amsterdam started to focus on prevention of deseases. This resulted in beter public health, because people spend more time in sports schools than ever and healthy food is readily available. The last McDonalds in Amsterdam closed its doors one year ago! A drawback of this focus on prevention of deseases is that it is observed that human resistance to deseases significantly reduces. In the past people got a 'cold' or a flue every few years. Most people kept working or stayed at home for a couple of days. People recovered quite quickly. Nowadays, in general people have not been ill for a long time, but when the get a flue the need extra care and many times they end up in hospitals. In fact, the vulnerabiluty of the citizens of Amsterdam for a new pandemy is extremely high. Currently the Dutch government is investigating how to deal with this new threat. <br>


*''Will The Netherlands be a province of the European Union by 2020? <br>


2. Abandoning collective base insurance<br>
*''Are the negotiators from the health insurance companies taken over by European ones or even Azian or American?'' <br>
''
- strong differentiation against market price<br>
- insurance screens more severe<br>
- selection at the entrance of the hospital<br>
- decentralisation<br>
- care activities take place at home -> custom made<br>
- virtual hospital<br>
- Teleprevention -> doctors advises and communication is based on the implanted chip that shows current status<br>
- genetic screening-> downside: labelling and discrimantion<br>
- conditions of use of technology need to be optimalized <br>


Story
Who knows. Everything was more or less possible when we started this eight weeks parttime project. <br>
In the early years of this century various trends can be spotted. All electronic devices are getting simpler but have more functions. All devices are getting smaller and cheaper. This trend in combination with the increase of the hospital buildings, and the hospital diseases, have to a new kind of health care. All most 90% of the basic processes can be done at the private home of the patient. Room are turned into 'operations room' in a minimum of the current required time. Telemonitoring does take care of the recovery afterwards.  


The prevention of illness is also done by telemonitoring. The patient is constantly being monitored by his hospital (online service company) and incase of any threaths prevention actions are suggested to the patient. The prevention action can vary from online tips (by e-mail), service call from doctors or even vitits.  
In order to investigate the different possibilities we researched literature, had interviews with three executives (CEO, Planning & Control, Construction) and were coached by our professor Erasmus.  


Because of a DNA file, family history and life monitor real pro-active prevention can be taken care of. A patient is never off line. Taken care of a patient is a 24 hours / 7 days a week service. All done remote.
These sources of information form the basis under the four scenarios of the future of hospitals in Amsterdam in 2020:<br>


[[1. Transsensual]]<br>
[[2. Unsolidarity?]]<br>
[[3. The health community system]]<br>
[[4. All together now]]<br><br>


==Driving forces==
All teammembers of the group improved two already existing Driving Forces and made and added two new Driving Forces (with a focus on the subject "The Future of Hospitals in Amsterdam in 2020). The most important Driving Forces are shown below:
* [[Innovation in health care]]<br>
* [[Accessibility of hospitals in Amsterdam]]<br>
* [[Biometrics]]<br>
* [[Aging population]]<br>
* [[Low cost of internet connections]]<br>
* [[Continuously growing demand for new medical applications]]<br>
* [[Consumer health informatics in the information age]]<br>
* [[Emergence of new Technology Related Diseases]]<br>
* [[Increasing empowerment of consumers]]<br>
* [[Increasing Neglect of the Elderly]]<br>
* [[Medicine]]<br>
* [[Religion]]<br>
* [[Segmentation]]<br>
* [[Number of people in Amsterdam]]<br>
* [[Number of visitors in Amsterdam]]<br>
* [[Financing and costs of the Dutch health care system]]<br>
* [[The power of insurance companies in health care]]<br>
* [[Decrease Labor productivity in health care]] <br>
* [[Impact of Social and Cultural Differences in Healthcare ]] <br><br>


3. Lifestyle "the health community system"<br>
==Mind Map==
Keywords:  
Our first brainstorm session on Driving Forces resulted in the following mind map:
- Mind, body  and soul<br>
- Experience<br>
- Gym, yoga exercise more,  coach, facial, psychiatrist<br>
- Role of insurance<br>
- Incentive if you life your life “GOOD”<br>
- Role pharmacy<br>
- Biological food, healthy recepies<br>
- FCG supplier<br>
- Prevention<br>
- Tailormade<br>
- Healthcenter<br>
- Knowledge of food (yellow carrot of India)<br>
- How to get there is easy with public transport or own car<br>
- Allignment, better communication with specialists that also are more centralised and consolidated their power<br>
- More accessible<br>
- Shops/Branding (Nike, Healthy food)<br>
- Doctors (1e lijns)<br>
- Dentists<br>
- Chip, with personal file<br>


Story
In the beginning of the 20th century people living in each other neighbourhood were most of the time closely related. And when people needed care there was always a family member or neighbour around. In those days the neighbourhood was a close community. Nowadays people do not even know one another in their neighbourhood. People live their live very individualistic and communities are fragmented and more established by activities or events e.g. a gym, mall, etc. Still the need of care is increasing especially because people are getting older. Above that the multicultural differences can add to further fragmentation. A community that can supply several services that will answer the common needs of men and woman,  young and old, with any kind of cultural background.
Purpose<br>
The HCC will take care of the mind, body and soul of all her members in the following way: to prevent, to inform, to advise and to guide along in the process from birth till death
Organised<br>
There are no real hospitals anymore. Health care is organised differently:
The health community knows your profile, knows what is good for your mind, body and soul. If you are a member of Amsterdam you are a member of the HCC. The community provides all the tools and services to life your life at the utmost healthiest way. Every year a basic check up is done. There are no specialists working but 1e line doctors. Specialists are consolidated in their own centres. If something is not going well the HCC will take care of you and advise which process(es) are needed and have to take place and will make all the arrangements with the specialists that have their own centres.
Financed<br>
The HCC is financed by the government, insurance and citizens of Amsterdam. If you are a citizen of Amsterdam you are a member and you need to pay to use the basic services. Other services and products are optional you can pay them yourself or via your insurance. Those shops/stores that supply the variable goods and services have to pay rent.


<br>
[[Image:Ziekenhuizen 2020.jpeg|900px]]


==Research Questions==
We did research how our first questions made the link with the drivers each of us made individually and the mind map that we build together. <br>
* What is the hospital capacity in Amsterdam and The Netherlands?<br>
* Which differentiations are there at the moment?<br>
* Which stakeholders are known in health care?<br>
* What is the demand?<br>
* What are the trends?<br>
* How is the health care financed?<br>


4. Solidarity within families<br>
''Shift from individualism to collectivism in Amsterdam
- Role of insurance<br>
- Feeling of community<br>
- Basic care is provided for everyone -> Same care for the same for everyone -> no difference between poor and rich<br>
- Hospitals interiors are basic and simple, rooms are large and offer place for many patienst<br>
- Family takes care of food, washing<br>
- Consequence people will go abroad for health care that can provide higher services<br>
- Creates a market for care takers<br>


Story
During the first years of the century the costs of healty care and the various hospitals have risen enourmously. This steep increase in costs of healty care made health care allmost unaffortable for the majority of the people of Amsterdam. To reduce costs most of the healthcare have been reduced from it's 'nice to have' services. In the hospitals 90% of all health care related actions are taken care off. The 'specialities' are being done in special hospitals. In the normal hospitals only the core product is being offert. The extra's can either be bought or taken care off yourself. This means to families will take care of the food, washing, entertainment of the patient. Even the supply of pills is done by the familie or friends. If these activities are not being taken care of a fine has to be paid. In and around the hosipitals extra services can be bought in from local entrepeneurs.


==Research Questions:==
<br><br>
<br><br>
To be added<br><br>


==Driving forces:==
==Interview Questions==
• [[Innovation in health care]]<br>
Each of us made a list of at least 3 questions he or she wanted to ask the interviewee. Together we made even more questions, consolidated the list and choose the best questions. Naturally we also discussed the background of our interviewees, how to start the interview and how to keep the interviewees triggered in his story but also answering our questions.<br>
• [[Accessibility of hospitals in Amsterdam]]<br>
The questions we made were:
• [[Biometrics]]<br>
* Which developments were the most impressive to you over the last 15 years?<br>
• [[Aging population]]<br>
* Which developments will have the most impact on your hospital over the next 10 years? <br>
• [[Low cost of internet connections]]<br>
* Which developments do you see in Amsterdam? <br>
• [[Continuously growing demand for new medical applications]]<br>
''a. Which of these developments have a potential impact on hospitals? <br>
• [[Consumer health informatics in the information age]]<br>
''b. Which developments outside The Netherlands have a potential impact on hospitals? <br>
• [[Emergence of new Technology Related Diseases]]<br>
''c. Which developments deserve more attention and/of investigation? Why? <br>
• [[Increasing empowerment of consumers]]<br>
* What are the biggest changes for your hospital in the short time (up till 2 years)? <br>
• [[Increasing Neglect of the Elderly]]<br>
* What are the biggest opportunities and threats for your hospital between now and 5 years? <br>
• [[Medicine]]<br>
''For example: <br>
• [[Religion]]<br>
''a. How will prevention and home health care change demand and how is the hospital going to prepare for these changes? <br>
• [[Segmentation]]<br>
''b. How is aging affecting the hospital care? When is it the highest impact expected in Amsterdam and in The Netherlands? <br>
• [[Number of people in Amsterdam]]<br>
''c. Regarding transplantations: what is the need? What is the impact on your hospital? <br>
• [[Number of visitors in Amsterdam]]<br>
* A trend in society is “custom made”; how is your hospital adapting to that trend? <br>
<br><br>
* What are the major technological developments and which of them will have the biggest impact on health care in the coming years? <br>
* For which trends is the hospital preparing? <br>
* What do you think hospital care looks like in 2020? <br>
* What needs to be changed in 2020? <br>
* Will there be the same players? <br>
* What shifts do you expect the coming years? <br>
* Will there be a shift in focus? <br>
* Is there enough hospital capacity in 2020? If not, how big is the over- or under capacity? <br>
* Do you expect other demands or changes in health care due to the multiplicity of cultures in Amsterdam in 2020? <br>
* What differences in health care do you expect in Amsterdam compared to the rest of the Netherlands? <br><br>
 
==Summary of Interviews==
We had three interviews to give us more insight and information.<br>
*[[Interview with the chairman of the board of management]]<br>
*[[Interview with the financial controller]]<br>
*[[Interview with the responsible manager for housing and buildings]]<br><br>
 
==System Diagrams==
The photo (below) shows the Driving Forces and their impact on each other. <br><br>
Systems Diagram: first version <br>
[[Image:mindpic.jpg]]
<br><br><br>
The imput (shown on the picture) has been put in Powerpoint. And in various versions, updated by every teammember, to this presentation.<br><br>
Systems Diagram: final version<br>
[[Image:mindmap.jpg]]
<br>
 
==Scenarios==
Finally we choose and realized four scenarios.We build the story of the scenarios individually and together. In the scenarios we made links to the the drivers that inspired us to build the story of the scenarios. Most of the scenarios have the same drivers.<br>
[[1. Transsensual]]<br>
[[2. Unsolidarity?]]<br>
[[3. The health community system]]<br>
[[4. All together now]]<br>


==Resources:==
==Resources==
*[http://www.minvws.nl Ministry of Health Welfare and Sports]<br>
*[http://www.nza.nl Dutch Healthcare Authority]<br>
*[http://www.slaz.nl Sint Lucas Andreus Hospital]<br>
*[http://www.amc.nl Academic Medical Centre]<br>
*[http://www.wikipedia.nl Wikipedia]<br>
*[http://www.obesitas.nl Obesitas]<br>
*[http://www.rivm.nl National Institute for Public Health and the Environment]<br>
*[http://www.cpb.nl Netherlands Bureau for Economic Policy Analysis]<br>
*[http://www.amsterdam.nl Amsterdam]<br>
*[http://www.cbs.nl Statistics Netherlands]<br>
*[http://www.nictiz.nl NICTIZ]<br>
*[http://sync.nl/vinger-aan-de-pols-met-sensoren/1 SYNC on elderly people]<br>
*[http://sync.nl/ook-de-insulinepomp-krijgt-ipod-looks/ SYNC on modern healthcare tools] <br>
*[http://www.gvsmedia.com/video-2/rpJQNMBNtOo/-Way-of-the-Future---Nokia-Nanotech--Morph--Concept-Phone-- Nokia Nanotech]<br>
*[http://video.google.com/videosearch?q=nanotechnology+development+carbon&hl=en&emb=0#q=nanotechnology+example&hl=en&emb=0&start=60 Nanotechnology]<br>
*[http://sync.nl/hoe-een-robot-kan-helpen-bij-hartoperaties/ SYNC on healthcare robots]

Latest revision as of 21:54, 22 October 2009

EMBA09 team

This team was formed by the following members of EMBA09:

  • Peter Hoppesteyn
  • Roel Kock
  • Piotr Ptasinski
  • Miranda Tjiang
  • Marjoleine van der Zwan


Introduction

During the first meeting of Scenario Thinking we all presented our 'topics'. Based on the initial topic each of us could vote for his or her favourite. And it turned out that the 'future of hospitals in Amsterdam in 2020' was the most common favourite. With this topic in mind we did a small brainstorm on questions of interest.

  • Will we all have access to hospital care in Amsterdam in 2020, or do we have to travel to Utrecht or Brussels or The Bahamas for specific care?
  • Will we live longer and have higher demands for quality?
  • Will technology and ICT continue to devolope at high speed?
  • How can health care be finances in 2020?
  • Will The Netherlands be a province of the European Union by 2020?
  • Are the negotiators from the health insurance companies taken over by European ones or even Azian or American?

Who knows. Everything was more or less possible when we started this eight weeks parttime project.

In order to investigate the different possibilities we researched literature, had interviews with three executives (CEO, Planning & Control, Construction) and were coached by our professor Erasmus.

These sources of information form the basis under the four scenarios of the future of hospitals in Amsterdam in 2020:

1. Transsensual
2. Unsolidarity?
3. The health community system
4. All together now

Driving forces

All teammembers of the group improved two already existing Driving Forces and made and added two new Driving Forces (with a focus on the subject "The Future of Hospitals in Amsterdam in 2020). The most important Driving Forces are shown below:

Mind Map

Our first brainstorm session on Driving Forces resulted in the following mind map:


Ziekenhuizen 2020.jpeg

Research Questions

We did research how our first questions made the link with the drivers each of us made individually and the mind map that we build together.

  • What is the hospital capacity in Amsterdam and The Netherlands?
  • Which differentiations are there at the moment?
  • Which stakeholders are known in health care?
  • What is the demand?
  • What are the trends?
  • How is the health care financed?




Interview Questions

Each of us made a list of at least 3 questions he or she wanted to ask the interviewee. Together we made even more questions, consolidated the list and choose the best questions. Naturally we also discussed the background of our interviewees, how to start the interview and how to keep the interviewees triggered in his story but also answering our questions.
The questions we made were:

  • Which developments were the most impressive to you over the last 15 years?
  • Which developments will have the most impact on your hospital over the next 10 years?
  • Which developments do you see in Amsterdam?

a. Which of these developments have a potential impact on hospitals?
b. Which developments outside The Netherlands have a potential impact on hospitals?
c. Which developments deserve more attention and/of investigation? Why?

  • What are the biggest changes for your hospital in the short time (up till 2 years)?
  • What are the biggest opportunities and threats for your hospital between now and 5 years?

For example:
a. How will prevention and home health care change demand and how is the hospital going to prepare for these changes?
b. How is aging affecting the hospital care? When is it the highest impact expected in Amsterdam and in The Netherlands?
c. Regarding transplantations: what is the need? What is the impact on your hospital?

  • A trend in society is “custom made”; how is your hospital adapting to that trend?
  • What are the major technological developments and which of them will have the biggest impact on health care in the coming years?
  • For which trends is the hospital preparing?
  • What do you think hospital care looks like in 2020?
  • What needs to be changed in 2020?
  • Will there be the same players?
  • What shifts do you expect the coming years?
  • Will there be a shift in focus?
  • Is there enough hospital capacity in 2020? If not, how big is the over- or under capacity?
  • Do you expect other demands or changes in health care due to the multiplicity of cultures in Amsterdam in 2020?
  • What differences in health care do you expect in Amsterdam compared to the rest of the Netherlands?

Summary of Interviews

We had three interviews to give us more insight and information.

System Diagrams

The photo (below) shows the Driving Forces and their impact on each other.

Systems Diagram: first version
Mindpic.jpg


The imput (shown on the picture) has been put in Powerpoint. And in various versions, updated by every teammember, to this presentation.

Systems Diagram: final version
Mindmap.jpg

Scenarios

Finally we choose and realized four scenarios.We build the story of the scenarios individually and together. In the scenarios we made links to the the drivers that inspired us to build the story of the scenarios. Most of the scenarios have the same drivers.
1. Transsensual
2. Unsolidarity?
3. The health community system
4. All together now

Resources

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