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  1. Health 4.0: How Virtualization and Big Data are Revolutionizing Healthcare.
  2. ISBN 10: 3319476165.
  3. Clinical Decision Making in Fluency Disorders!
  4. Kinetic theory : classical, quantum, and relativistic descriptions.

Full Name Comment goes here. Healthcare providers should be paid if the patient leaves healthy and subsequently stays healthy. Many challenges and issues remain, like regulatory permissions, reimbursement and payment, data privacy and of course general adoption of such a setup.

Overview of Health Care Data Analytics

It can already be safely forecasted though, that some home-based diagnostic platforms will soon arrive and with that start to establish medical care at home [3]. A pre-requirement is however that the images provided by the radiology systems are standardised and that the obtained results are comparable to each other. These could then be shared and combined with additional information to create a multi-dimensional data set. So, while it is likely that the standard image interpretation will disappear for the radiologist and for that matter clinicians in other segments that my be affected by the new technologies there will be other responsibilities and opportunities for the human radiologists [4] [5].

New technologies will not only change the diagnostics, but will also have a huge effect on the treatment of for example cancers. We will there see new imaging systems that are combined with robotics and radiation therapy systems. These systems will be able to distinguish between the cancerous and healthy cells and only selectively kill, which will resultin a very personalised treatment with minimum side-effects.

However, for that a fast on-site digital pathology is also needed [6]. Even surgery, while being a manual discipline, will be digitised. Modern surgery has to be concerned about outcome of the surgery, associated cost of surgery and rehab measures, as well as about the inflicted surgical trauma. E- health and IoT connection of all surgery devices and associated systems ligh- ting, diagnostic imaging, monitoring equipment, surgical table, … will be a key for improving efficiency and accountability.

The captured data and subsequent analysis of the patient specific data genetic, pre-diagnostic, histology, … with the surgical procedure and outcome will provide optimised surgical models with the help of machine learning and AI approaches. Complicated cases could also be supported by experts through advanced telesurgery procedures from any- where in the world [7]. And many other applications from prevention to treatment, subsequent rehabilitation, and elder care or home-care will be influenced by the digitisation promising a faster, more efficient, and cheaper healthcare delivery in the coming decades [8].

But will these technologies also be able to address unequal delivery of healthcare in developing nations? Or will the developing nations be providing solutions that are also applicable for use in developed nations? One of the major problems for the implementation and acceptance of new technologies in the healthcare systems of the developed world is the current setup and associated adoption issues. Also, the regulatory environment in Europe, Northern America and Japan is already very complicated and slow … and, it will probably get even more complicated and slower in the near future.

While it is obvious that health care providers will receive less revenue in the future there is no real interest to rethink the current healthcare delivery and to start thinking about more cost-efficient solutions.

Data Storage for Healthcare & Research

Some of these solutions have been developed by the developed world for developing nations and a few others are directly originating there that address vital local problems. High-priced and complicated medical equipment is normally produced by developed nations for developed nations and is typically installed and used for 5 - 15 years. An alternative is to build a lower specified system that more closely fits the requirements of the healthcare system and clinical needs in these nations. What we will see more often in the future is that these nations actually will build dedicated systems for the needs of their population that are typically quite simple, very efficient, and can be manufactured for a fraction of the cost of the advanced technologies that are produced by the developed nations.

These point of care and local technologies could therefore have a valuable use in our healthcare systems as well. This process of adopting low-cost, efficient,and easier solutions from developing nations is called Reverse Innovation and highlighted in Figure 4. It has been proven that developing nations can come up with and subse- quently develop and produce extremely efficient products addressing local pro- blems that could substitute expensive products in the developed world and therefore could easily be transferred [10].

Figure 4. The traditional and current innovation process for medical technology is an either stripped down or used product that comes from a developed nation to a developing nation. Companies located in the developed world have a hard time accepting that however, as it would stipulate a complete rethinking and reorganisation process of their operation. Only very few companies have therefore invested in reverse innovation.

But the ones that did were rather successful [11]. And there is plenty of data supporting such joint activities and the value of a development focus on creating less expensive devices. The products that come from these low income nations very often are quite disruptive and creative, with a technology basis that is significantly simpler that competing technologies from developed nations. But this process and the focus on disruptive value based clinical innovation can also be initiated and managed by entrepreneurs through dedicated start-up companies in LIN or HIN [13] [14].

Without entrepreneurs that challenge the current setup and that come-up with alternative and new systems, methods and processes a healthcare change as outlined will not happen soon. The large medical device companies and healthcare providers do not have a large enough incentive to start a rethinking process immediately and to a full extend.

Part of this slow and little radical innovation process are regulatory issues and high cost of entry. But, we are now on the way to a late transition from home-care to the health- care providers and from a reactive healthcare delivery process to a more preven- tion oriented and personalised pro-active one.

There will for sure be entrepreneurs that will tackle and address the oppor- tunities that come with such a transition and that will nevertheless put the patient in the midst of their thinking, while maintaining the regulatory rules that come with new healthcare products and services [15]. These entrepreneurs and the more progressive established medical techno- logy suppliers and healthcare providers will also learn that valuable products and services can be developed and introduced adapted to the local needs with key value propositions like inexpensive and easy to use.

These systems could also open opportunities for local manufacturing, servicing, and support companies with that creating employment and tax in- come [16]. Entrepreneurs in that segment will understand that success is predominantly based on the knowledge of the local markets and customer needs.

These needs are locally different and may require completely different product features when HIN and LIN are compared to each other Figure 5.

JMIR Publications

And, it also requires a different skill set that is commonly not provided as part of a university based training. To address the mentioned healthcare innovation, reverse innovation and entrepreneurial opportunities, a special skill set and dedicated knowledge is required that can only be taught in a university within a new degree program. But it does not prepare the student for being a future leader in healthcare innovation. You need to be creative and visionary and also be trained in personal skills, like leadership, social responsibility and in an empathic understanding of.

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Figure 5. Successful local healthcare products and services are predominantly related to how well the market and customer needs are known. This then determines the local features and regulatory compliance issues. Figure 6. Entrepreneurial basics with a focus on healthcare need to be addressed and taught. Future entrepreneurs that can collaborate with the medical device or healthcare provider industry, researchers, clinical staff and public organisations, will have a distinct advantage and be able to more easily identify real innovations solving medical needs [18].

And that not limited to just incremental innovations. These are of of course needed, but they will not solve the problems with healthcare cost constraints, availability of treatment options for everyone and everywhere, personalised approach to cancer treatment,…, and many others. Disruptive ideas and concepts are needed that could potentially solve a lot of these problems and at the same time provide large business opportunities, which are however hard to implement in modern healthcare systems [17]. A new study program Bachelor or Master or Post-Graduate incorporating knowledge of healthcare system and provision, innovation challenges and stra- tegies, basic knowledge of clinical problems and future oriented technical possi- bilities, interdisciplinary and international team work, combined with manage- ment and entrepreneurial skills should be initiated.

Exponential technologies could lead to a dramatic change in the way that healthcare is delivered. Currently, almost all of the national healthcare systems treat sick patients rather than to prevent people from becoming patients. The future will be a pro-active predominantly data based healthcare that will collect, process, and analyse information providing a personalised report that would also allow preventive measures [1].

Digitisation is a key requirement for these developments.

Health 4.0: How Virtualization and Big Data are Revolutionizing Healthcare

With that real disruptive medical technologies could be developed, which would change dia- gnosis, treatment, billing, financing, and many other aspects of healthcare delivery [2] [19]. These disruptions may come with convinience to use, less complex, and much more affordable solutions; some of them originating from low income nations that are subsequently adapted by the developed world as they have proven to provide adequate or even superior solutions for a fraction of cost.

Entrepreneurs will play a vital role in the future change of healthcare, as they will develop and introduce solutions that are based on addressing local clinical needs.