Onno van Schayck Onno van Schayck Foto: Sacha Ruland

How do we keep Dutch healthcare affordable?

Written by  Jos Cortenraad Tuesday, 25 January 2011 10:04

CAPHRI brings Centre of Research Excellence to Maastricht 

Come up with clever technological solutions and launch these on the market, to ensure that healthcare in the Netherlands remains accessible and affordable. That, put simply, is the task of the Centre for Care Technology Research (CCTR), which was founded late last year. The Maastricht research institute CAPHRI will play a key role in the new centre. According to scientific director Professor Onno van Schayck, this represents nothing less than “a fantastic and tough challenge”.

There was certainly some celebrating to do when the funding body, the Netherlands Organisation for Scientific Research (NWO), recently named CAPHRI one of the chosen Centres of Research Excellence. “You can just imagine,” says Van Schayck. “Together with our partners, the research organisation TNO and the University of Twente, the intention is that we’ll get €26 million to play with for a period of seven years. On top of that we’ll jointly dedicate the same amount in person-hours. So it’s a great budget that will immediately make this new centre the largest programme ever within CAPHRI. It will help us to further deepen our research, offer dozens of PhD places and – in particular – give us a unique chance to integrate technology into healthcare.”

Clever technology

And that is something that’s sorely needed to maintain the state of Dutch healthcare. This may sound dramatic, Van Schayck realises as well, “but it’s indeed the case. We’re getting older, medical science is taking huge leaps forward, and the demands placed on healthcare are getting stronger than ever. At the same time, the number of healthcare workers is shrinking. So it’s just a question of time until the system gets completely bogged down. We’re running the risk of having insufficient capacity in first-line care and in healthcare centres. And the costs are spiralling out of control. What’s more, people want to remain independent longer and spend as little time as possible at the doctor’s office. One of the remedies is to make use of clever technology that will allow people to go to the doctor less often, but without having to compromise on diagnostics and treatment.”

Against this backdrop, in 2007 the NWO issued a call for grant applications that dozens of research institutes and universities responded to. Among them was CAPHRI. “The Maastricht UMC+ is specialised, among other things, in scientific research on first-line and public healthcare. We have one of the largest General Practice Medicine departments in Europe. And in our academic GP training, we do a great deal of first-line research. It felt like this call was just made for us, so we wrote a plan. During an initial meeting with a number of other parties, we found that our ideas fit perfectly with the plans of TNO and the University of Twente. We complement each other really well. So that was reason enough to join forces and together take a shot at getting the grant.”


And with success: together, the three institutes form the only centre that will be involved in the coming seven years in the development of what are known as extramural technologies. Luc de Witte, professor of Technology in Care at CAPHRI (and UM alum), will be one of the leaders of the CCTR. “We’ll work together with a number of care institutions, GP practices, patient associations and the business sector”, explains De Witte. “DSM and IBM will be joining us as larger partners, and we’ve also managed to get 13 smaller companies on board who can translate ideas into concrete devices and instruments. Within the CCTR it’s all about collaboration. It has to be possible to implement the ideas in practice. Doctors, nurses, voluntary carers and patients have to be able to put new findings to good use. So every idea is tested by all parties involved on its feasibility and user-friendliness. The CCTR is really a centre where science, society and the business sector come together. We’re here to translate science into everyday practice. It will also influence our teaching methods; for example, more attention will be paid to technology and research valorisation.”


Concrete examples

Naturally, these sorts of claims call for concrete examples. Van Schayck, responsible for leading the medical-scientific developments within the CCTR, grins: “We still have to get started of course, but there are already examples. Taking your own blood pressure and giving yourself insulin injections are the most widely known. But there’s more. For instance, Professor Edward Dompeling at CAPHRI has developed a device that helps to establish whether a young child has asthma or not. This is an issue that GPs often find themselves facing, and the diagnosis is very difficult. Certainly in children under the age of seven, because they’re too young for a lung test. You can use this new device to make the diagnosis, and that saves you all sorts of follow-up visits and over-treatment. But the point is that we still have to refine and test the device and get it on the market. And that’s what we’ll be doing in the CCTR.”


Monitoring and therapy

Other initiatives, too, could be launched on the market fairly quickly. “For example, remote monitoring of older people with early-stage dementia. And remote therapy as well. This is where a doctor or therapist uses a webcam to guide rehab exercises, such as practising fine motor skills after a heart attack or an operation. I can think of dozens of options where we’re already tinkering around in one way or another. In the CCTR, we now need to get this sorted out in a concrete sense and validate it. The ultimate goal is to unburden GPs and other physicians and, where possible, to pass on care to medical assistants, nurses or even voluntary carers.”

Onno van Schayck obtained his PhD at the Department of General Practice Medicine in Nijmegen’s medical faculty. Since 1997 he has been professor of Preventive Medicine at Maastricht University. In 2009 he was appointed scientific director of the School for Public Health and Primary Care (CAPHRI), which – with its 450 staff and 200 PhD candidates – is the largest research school at Maastricht University/Maastricht UMC+. CAPHRI was recently named an NWO Centre of Research Excellence.

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