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

Translator: Héctor Pardo Álvarez

Probably not a surprise to you,

Supoño que non os sorprenderá

but I don't like to be in a hospital

pero non me gusta estar no hospital ou ir ao hospital.

or go to a hospital.

A vostedes si?

Do you?

I'm sure many of you feel the same way, right?

Seguro que moitos de vostedes sentirán o mesmo.

But why? Why is it that we hate hospitals so much?

Mais, por que?

Por que odiaremos tanto os hospitais?

Or is it just a fact of life we have to live with?

Ou simplemente é algo co que temos que convivir?

Is it the crappy food?

Será polo mala que é a comida?

Is it the expensive parking?

Polo caro que é aparcar?

Is it the intense smell?

Será polo intenso cheirume?

Or is it the fear of the unknown?

Ou será polo medo ao descoñecido?

Well, it's all of that, and it's more.

Ben, é todo iso, e moito máis.

Patients often have to travel long distances

Os pacientes adoitan ter que viaxar longas distancias

to get to their nearest hospital,

para chegaren ao hospital máis próximo.

and access to hospital care is becoming more and more an issue

O acceso á atención hospitalaria

está a se converter nun problema cada vez maior no rural.

in rural areas,

in the US,

Nos Estados Unidos,

but also in sparsely populated countries like Sweden.

mais tamén en países con dispersión poboacional como Suecia.

And even when hospitals are more abundant,

E mesmo cando o número de hospitais é meirande,

a xente pobre e os máis vellos adoitan ter problemas para recibir atención

typically the poor and the elderly

have trouble getting care because they lack transportation

por careceren de transportes apropiados e accesibles para eles.

that is convenient and affordable to them.

And many people are avoiding hospital care altogether,

Moita xente evita ir ao médico en xeral,

and they miss getting proper treatment

e, así, non recibe o tratamento que necesita debido ao seu custo.

due to cost.

We see that 64 percent of Americans

Estamos vendo que o 64% dos estadounidenses

are avoiding care due to cost.

evitan ir ao médico por mor do seu custo.

And even when you do get treatment,

E mesmo cando recibimos tratamento,

hospitals often make us sicker.

os hospitais a miúdo fan que enfermemos máis.

Medical errors are reported to be the third cause of death in the US,

Os datos revelan que os erros médicos son a terceira causa de morte nos EE.UU.

just behind cancer and heart disease,

só por detrás do cancro e as doenzas coronarias.

the third cause of death.

Terceira causa de morte.

I'm in health care for over 20 years now,

Traballo na sanidade desde hai vinte anos

and I witness every day how broken and how obsolete our hospital system is.

e son testemuña todos os días

do estragado e obsoleto que está o noso sistema hospitalario.

Let me give you two examples.

Deixen que lles poña dous exemplos:

Four in 10 Japanese medical doctors

catro de cada dez médicos xaponeses

and five in 10 American medical doctors

e cinco de cada dez médicos estadounidenses

are burnt out.

sofren "esgotamento profesional".

In my home country, the Netherlands,

No meu país, os Países Baixos,

only 17 million people live there.

onde apenas viven dezasete millóns de persoas,

We are short 125,000 nurses over the coming years.

teremos un déficit de 125 000 enfermeiros/as nos próximos anos.

But how did we even end up here,

Pero, como chegamos até aquí?

in this idea of placing all kinds of sick people

A esta idea de xuntar toda clase de doentes nun edificio enorme?

together in one big building?

Well, we have to go back to the Ancient Greeks.

Pois temos que retroceder até a Antiga Grecia.

In 400 BC, temples for cure were erected

No 400 a.C., erixíronse templos para a curación,

where people could go to get their diagnosis,

para a xente poder ser diagnosticada, tratada e curada.

their treatment and their healing.

And then really for about 2,000 years,

Logo, durante uns dous mil anos,

we've seen religious care centers

tivemos centros sanitarios relixiosos,

all the way up to the Industrial Revolution,

até a chegada da Revolución Industrial,

where we've seen hospitals being set up as assembly lines

durante a cal se crearon hospitais concibidos como cadeas de montaxe,

based on the principles of the Industrial Revolution,

con base nos principios da Revolución Industrial

to produce efficiently

para producir eficientemente

and get the products, the patients in this case,

e conseguir que os produtos —os pacientes neste caso—

out of the hospital as soon as possible.

saísen do hospital decontado.

Over the last century, we've seen lots of interesting innovations.

Ao longo do último século, presenciamos unha morea de innovacións interesantes.

We figured out how to make insulin.

Descubrimos como producir insulina,

We invented pacemakers and X-ray,

inventamos os marcapasos e os raios X,

and we even came into this wonderful new era of cell and gene therapies.

e mesmo acadamos esta formidable era de terapias celulares e xenéticas.

But the biggest change to fix our hospital system altogether

Con todo, o maior reto,

arranxar o noso sistema hospitalario no seu conxunto,

is still ahead of us.

témolo aínda por diante.

And I believe it's time now, we have the opportunity,

E penso que este é o momento.

Temos a oportunidade de revolucionar integramente o sistema

to revolutionize the system altogether

and forget about our current hospital system.

e esquecer o noso actual sistema hospitalario.

I believe it's time to create a new system

Penso que é hora de crear un novo sistema

that revolves around health care at home.

que xire ao redor da atención sanitaria no fogar.

Recent research has shown

Estudos recentes revelan

que o 46% da atención hospitalaria

that 46 percent of hospital care

can move to the patient's home.

podería trasladarse ao fogar.

That's a lot.

É moito.

And that's mainly for those patients who suffer from chronic diseases.

E correspóndese nomeadamente con pacientes que sofren doenzas crónicas.

With that, hospitals can and should

Deste xeito, os hospitais poderían e deberían reconverterse

reduce to smaller, agile and mobile care centers

en centros de saúde de menor tamaño, áxiles e móbiles,

focused on acute care.

centrados no tratamento de casos agudos.

So things like neonatology, intensive care, surgery and imaging

Así, a neonatoloxía, os coidados intensivos,

a cirurxía ou o diagnóstico por imaxes

will still remain at the hospitals,

permanecerían nos hospitais.

at least I believe for the foreseeable future.

Penso que así será, polo menos no futuro próximo.

A few weeks ago, I met a colleague

Hai algunhas semanas, coñecín un colega

whose mom was diagnosed with incurable cancer,

a cuxa nai lle diagnosticaran un cancro incurable,

and she said, "Niels, it's hard.

e díxome: “Niels, é duro."

It's so hard when we know that she's got only months to live.

"E moi duro saber que só lle quedan uns meses de vida

Instead of playing with the grandchildren,

e que, en vez de xogar cos netos,

she now has to travel three times a week

vai ter que viaxar tres veces á semana

dúas horas ida e volta

two hours up and down to Amsterdam

para ir a Ámsterdam someterse ao tratamento e facer probas”.

just to get her treatment and tests."

And that really breaks my heart,

E iso realmente rómpeme o corazón,

because we all know that a professional nurse

porque todos sabemos que unha enfermeira profesional

could draw her blood at home as well, right?

tamén lle pode sacar sangue na casa, non?

And if she could get her tests and treatment at home as well,

E se puidese tamén facer probas e seguir o seu tratamento na casa,

she could do the things that are really important to her

podería facer as cousas que realmente lle importan nos seus últimos meses.

in her last months.

My own mom, 82 years old now -- God bless her --

A miña nai, que ten 82 anos —Deus a bendiga— ,

she's avoiding to go to the hospital

evita ir ao hospital porque lle parece difícil planificar e xestionar a viaxe.

because she finds it difficult to plan and manage the journey.

So my sisters and I, we help her out.

Entón, as miñas irmás e eu axudámola.

But there's many elderly people who are avoiding care

Pero hai moitos anciáns que evitan ir ao médico,

and are waiting that long that it becomes life-threatening,

e agardan tanto que chegan a poñer en risco as súas vidas,

and it's straight to the costly, intensive care.

e rematan en coidados intensivos.

Dr. Covinsky, a clinical researcher at the University of California,

O Dr. Covinsky, investigador clínico na Universidade de California,

he concludes that a third of patients over 70

concluíu que un terzo dos pacientes de máis de setenta anos

and more than half of patients over 85,

e máis da metade dos maiores de oitenta e cinco

leave the hospital more disabled than when they came in.

saen do hospital peor do que entran nel.

And a very practical problem

E un problema práctico

that many patients face when they have to go to a hospital is:

ao que se enfrontan moitos pacientes cando teñen que ingresar no hospital é:

Where do I go with my main companion in life,

onde vou co meu mellor compañeiro na vida?

where do I go with my dog?

Onde vou co meu can?

That's our dog, by the way. Isn't she cute?

Esta é a nosa cadela.

A que é riquiña?

(Laughter)

But it's not only about convenience.

Mais non é só cousa de comodidade.

It's also about unnecessary health care stays and costs.

Tamén vai de estadías hospitalarias e custos innecesarios.

A friend of mine, Art,

Hai pouco tiveron que hospitalizar un amigo meu, Art,

he recently needed to be hospitalized for just a minor surgery,

por unha cirurxía menor,

and he had to stay in the hospital for over two weeks,

e tivo que quedar no hospital máis de dúas semanas

just because he needed a specific kind of IV antibiotics.

só porque precisaba un tipo específico de antibióticos intravenosos.

So he occupied a bed for two weeks

Así, ocupou dúas semanas unha cama

that cost over a thousand euros a day.

que custou por volta de mil euros diarios.

It's just ridiculous.

É absurdo.

And these costs are really at the heart of the issue.

E nestes custos está o quid da cuestión.

So we've seen over many of our global economies,

En moitas das nosas economías globais, vimos observando

health care expense grow as a percentage of GDP

como creceu a porcentaxe do PIB que é investida en sanidade

over the last years.

durante os últimos anos.

So here we see that over the last 50 years,

Así, aquí vemos como nos últimos cincuenta anos,

health care expense has grown from about five percent in Germany

o gasto en sanidade aumentou en Alemaña desde o 5% ao 11% actual.

to about 11 percent now.

In the US, we've seen growth from six percent to over 17 percent now.

Nos EE.UU. vímolo medrar desde o 6% até o 17% actual.

And a large portion of these costs are driven by investments

E unha boa parte destes custos

explícase polos investimentos en grandes e flamantes hospitais.

in large, shiny hospital buildings.

And these buildings are not flexible,

Estes edificios non son flexibles e perpetúan un sistema

and they maintain a system where hospital beds need to be filled

conforme ao cal as camas han estar ocupadas

for a hospital to run efficiently.

para o hospital funcionar eficientemente.

There's no incentive for a hospital to run with less beds.

Non hai incentivo ningún para que un hospital funcione con menos camas.

Just the thought of that makes you sick, right?

Só pensalo pon a un enfermo, verdade?

And here's the thing: the cost for treating my buddy Art at home

E esta é a cuestión:

o custo de tratar na casa o meu colega Art

can be up to 10 times cheaper than hospital care.

pode ser até dez veces menor que nun hospital.

And that is where we're headed.

E cara a aí nos diriximos.

The hospital bed of the future will be in our own homes.

A cama de hospital do futuro ha estar nas nosas casas.

And it's already starting.

E isto xa está a comezar.

Global home care is growing 10 percent year over year.

A atención no fogar está a aumentar globalmente un 10% ano tras ano

And from my own experience, I see that logistics and technology

e, dende a miña experiencia,

vexo que a loxística e a tecnoloxía

are making these home health care solutions work.

están a facer que as solucións de atención sanitaria no fogar funcionen.

Technology is already allowing us to do things

A tecnoloxía xa nos permite facer cousas antes só reservadas aos hospitais.

that were once exclusive to hospitals.

Diagnosis tests like blood,

Algunhas probas diagnósticas como análises de sangue, glucosa ou ouriños

glucose tests, urine tests, can now be taken in the comfort of our homes.

agora poden realizarse na comodidade dos nosos fogares.

And more and more connected devices

Cada vez dispomos de máis e máis dispositivos conectados,

we see like pacemakers and insulin pumps

como marcapasos e bombas de insulina

that will proactively signal if help is needed soon.

capaces de avisar de maneira activa se for precisa axuda inminente.

And all that technology is coming together

Toda esta tecnoloxía

in much more insights into the patients' health,

redunda nun mellor coñecemento da saúde dos pacientes,

and that insight and all of the information leads to better control

e esta información tradúcese nun maior control

and to less medical errors --

e en menos erros médicos,

remember, the third cause of death

que, lembren: son a terceira causa de morte nos EE.UU.

in the US.

And I see it every day at work.

Eu véxoo todos os días no traballo.

I work in logistics

Traballo en loxística

and for me, home health care works.

e, para min, a atención sanitaria no fogar funciona.

So we see a delivery driver deliver the medicine

Un condutor de reparto leva a menciña á casa do paciente.

to the patient's home.

A nurse joins him and actually administers the drug

Unha enfermeira acompáñao e adminístralle a menciña ao paciente na súa casa.

at the patient's home.

It's that simple.

É así de simple.

Remember my buddy, Art?

Lembran o meu colega Art?

He can now get the IV antibiotics in the comfort of his home:

Agora pode recibir os seus antibióticos intravenosos na comodidade do fogar:

no hospital pajamas, no crappy food

nada de pixamas de hospital, comida noxenta

and no risk of these antibiotic-resistant superbugs

ou exposición a esas superbacterias resistentes aos antibióticos

that only bite you in these hospitals.

que só axexan nos hospitais.

And it goes further.

E a cousa non acaba aquí.

So now the elderly people can get the treatment that they need

Agora os nosos maiores poden recibir o tratamento que precisen

in the comfort of their own home

na comodidade do seu fogar

while with their best companion in life.

canda os seus mellores compañeiros na vida.

And there's no need anymore to drive hours and hours

E xa non hai necesidade de conducir horas e horas

just to get your treatment and tests.

para someterse a probas e tratamentos.

In the Netherlands and in Denmark,

Nos Países Baixos e en Dinamarca,

we've seen very good successes in cancer clinics

as clínicas para o cancro levan obtidos moi bos resultados

organizing chemotherapies at the patient's homes,

ao administrar quimioterapia nas casas dos pacientes;

sometimes even together with fellow patients.

ás veces, ata con varios pacientes xuntos.

The best improvements for these patients

As principais melloras que estes experimentaron

have been improvements in reduction in stress,

foron unha redución do estrés,

anxiety disorders and depression.

dos trastornos de ansiedade e da depresión.

Home health care also helped them to get back a sense of normality

A atención no fogar tamén lles axudou a recuperar

un senso de normalidade e liberdade nas súas vidas,

and freedom in their lives,

and they've actually helped them to forget about their disease.

e até a esquecer un pouco a súa doenza.

But home health care, Niels --

Pero atención sanitaria no fogar, Niels...?

what if I don't even have a home, when I'm homeless,

Que pasa se nin tan sequera teño casa, se son unha persoa sen fogar,

or when I do have a home but there's no one to take care of me

ou se teño unha casa mais non teño quen mire por min

or even open up the door?

ou me poida abrir a porta?

Well, in comes our sharing economy,

Ben, aquí é onde entra a nosa economía colaborativa,

or, as I like to call it, the Airbnb for home care.

ou, como a min me gusta chamarlle, o Airbnb da atención no fogar.

In the Netherlands, we see churches and care organizations

Nos Países Baixos, as igrexas e organizacións benéficas

match people in need of care and company

emparellan persoas necesitadas de atención ou compañía

with people who actually have a home for them

con outras que poden ofrecerlles un fogar,

and can provide care and company to them.

prestarlles atención ou facerlles compañía.

Home health care is cheaper,

A atención sanitaria no fogar é máis económica e doada de administrar,

it's easier to facilitate, and it's quick to set up --

e pódese organizar rapidamente nas zonas rurais das que falamos,

in these rural areas we talked about, but also in humanitarian crisis situations

pero tamén en escenarios de crise humanitaria

where it's often safer, quicker and cheaper to set things up at home.

nos que adoita ser máis seguro, rápido e barato artellar todo na casa.

Home health care is very applicable in prosperous areas

A atención no fogar

é moi susceptible de se aplicar en zonas prósperas

but also very much in underserved communities.

pero, sobre todo, en comunidades desfavorecidas.

Home health care works in developed countries

Funciona tanto en países desenvolvidos

as well as in developing countries.

coma en países en vías de desenvolvemento.

So I'm passionate to help facilitate improvements in patients' lives

Apaixóname contribuír a mellorar a vida dos pacientes

due to home health care.

por medio da atención sanitaria no fogar.

I'm passionate to help facilitate

Apaixóname contribuír a que os anciáns

that the elderly people get the treatment that they need

reciban o tratamento que precisan na comodidade dos seus fogares

in the comfort of their own homes,

together with their best companion in life.

e canda os seus mellores compañeiros na vida.

I'm passionate to make the change

Apaixóname impulsar a mudanza

and help ensure that patients, and not their disease,

e axudar a que sexan os pacientes e non as súas doenzas

are in control of their lives.

quen tomen o control das súas vidas.

To me, that is health care delivered at home.

Para min, niso consiste a atención sanitaria no fogar.

Thank you.

Grazas.

(Applause)

(Aplausos)