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report Precision Medicine

"Patient centricity means communicating on eye level"

08.07.2019

The university hospital of Basel not only wants to use innovation, but also drive innovation. For this reason, the hospital established an Innovation Lab recently and launched an internal support program to help put innovation projects into practice. Driving forces behind this initiative are Jens Eckstein and Marc Strasser. DayOne asked Jens Eckstein about this push for innovation.

BaselArea.swiss: There are basically two reasons for driving innovation. Either it’s necessity or an inner drive. What drives you?

Jens Eckstein: Without an inner drive, I would certainly not have taken on this task, but a part of it can also be seen as necessity. Much of what we are doing now is simply homework that we had not completed until now. A patient coming to the clinic today usually experiences a step back in terms of information technology compared with what he is used to in his private life. Some of the systems we work with as a treatment team are 20 years old. At some point I said our IT can do better than that. A colleague replied, I should not moan but get on and do something. I am one of those people who takes pleasure in technology and innovation. That’s why these pain points were so difficult for me to bear.

Evidently, your concerns were heard?

Yes, IT and hospital management have given their full backing and we have reorganized ourselves. 50 percent I work as a clinician, the other 50 percent I am a Chief Medical Information Officer. Thus, I can act as a translator and build bridges between IT and the diverse departments.

What part of your homework did you tackle first?

Already before my change of function we fitted a large monitor on each floor, showing the responsible ward team with a photo.

That doesn’t exactly sound very disruptive?

It may sound trivial, but for many of our patients and their families it makes a big difference. Many of our patients are used to being constantly online and having access to all information. This makes it all the more stressful when this normal state is suddenly lost in hospital. Of course, all patients have Wi-Fi and internet access, but a lot of information that interests them is not yet available digitally. Hence patients often assume a passive role. If we want patients to take an active part in their treatment process, then this is exactly where we need to start. We need to provide them promptly with all the medical and organizational information of relevance to them. Only then will they be able to participate actively in the treatment process.

Do you want that as a doctor?

It is much more enjoyable working with informed patients! Today, everyone talks about “patient centricity”. If you take this concept seriously, it has far-reaching consequences for our profession. As a doctor, you are challenged to involve patients in the decision-making process. Our task is to advise and coach them. To avoid death at any price with a therapy may no longer be the sole aim of an intervention. Quality of life issues are just as relevant. Therefore, you need to communicate at eye level. The monitor on each floor was a first, very small step in this direction, so that everyone knows who is taking care of the patients.

Do patients actually want to have a say?

Yes, definitely. New technologies at present are positively mushrooming out of the ground which also increases the pressure on our hospital. No one expects a university hospital to become a boutique hotel. The focus is on first-class medical care. Digitization offers new opportunities, though, and a hospital needs to make the most of these opportunities for the benefit of both staff and patients. This is why we set up the Innovation Lab.

What exactly is that?

The Innovation Lab functions primarily as an entry lane for new technologies. To this end, we established an IT infrastructure separate from the clinic, which allows new applications to be quickly implemented in a protected area and tested, involving decision makers and patients. It’s a kind of sandpit or playground for initial pilot projects with new technologies, without these already having to meet all safety standards and the requirements of a medical device.

I could imagine you being quickly overrun with queries?

In fact, the situation is already difficult to cope with. I’m currently in the process of expanding the team. The interest among colleagues is fortunately huge. We started in cardiology, continued in surgery and will soon become active with projects in completely different areas as well, such as psychiatry and rheumatology.

What kind of projects are you dealing with?

It varies a lot. An external partner, such as a start-up, might want to get his application clinically validated with us. If we see a benefit for the patient, we will pursue the project further. However, the partner must agree to us publishing the results – even if they are not positive. Another possibility is that a member of the hospital staff has a brilliant idea and wants to pursue it further. Therefore, we launched Future Friday events this year, the aim being to hold them several times a year. We invite our 8000 members of staff to submit their innovation ideas and invite the three best submissions to pitch their ideas at the event. One of these ideas gets the go-ahead. The winning project is endowed with sufficient resources to drive the idea and to come up with an initial prototype within six months.

So far, it has not been part of the mission of a hospital to implement innovation. Why this change all of a sudden?

Research has always been a key part of the university hospital and repeatedly led to innovative spin-offs. By taking a more proactive approach to this process, we are now providing a catalyst for this potential and further burnishing our reputation. This puts our hospital on the global radar in a number of fields. We want to be among the best in terms of not only medicine, but also when it comes to innovation. The ecosystem in Basel offers outstanding conditions with its strong life sciences environment and a very dynamic start-up scene. The USB is already a partner of many interesting projects, which in turn gives us access to the most advanced technologies. For what is a medium-sized hospital by international standards, this is by no means a given. When it comes to agility, our constellation of university environment and strategic focus on innovation and digitization gives us a clear advantage.

How does this work when doctors become entrepreneurs or so-called docpreneurs? Who gets what share on the newly established company?

We still need to test the suitable model for this. The core business of the hospital is and remains the treatment of patients. It is true that the hospital receives a fair share in the development of an innovation. There are two extremes: either the IP belongs entirely to us and we license the product, for example to the partner who then markets it; or the product belongs to the partner and we participate in its development with the aim of obtaining exactly the right application for us. The realistic scenario often lies somewhere in between.

So do you want doctors to become entrepreneurs?

In case of doubt, I would say no. And that’s a good thing. The aim is not for all our doctors to found start-ups. To us it is important that they increasingly participate in the innovation process by sharing their ideas and their specialist knowledge. In return, they should receive their fair share, for example shareholdings. The same should apply to non-medical staff.

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"I am amazed by the level of innovation in the Jura"

11.06.2019

The Switzerland Innovation Park Basel Area already has two sites, in Allschwil and Basel, and will soon add a third in the Jura. It will be located on the Innodel campus in the municipality of Courroux, between Delémont and Courrendlin. Work is ongoing at the Jura site, which is set to officially open on 25 October.

This will be the culmination of a huge amount of work by various regional stakeholders as part of an ambitious federal project. The aim is to boost research and development in the region in particular and in Switzerland in general, as Frank Kumli, Head of Innovation & Entrepreneurship at BaselArea.swiss says in the interview with "Le Quotidien Jurassien".

Le Quotidien Jurassien: What's the significance of the new Jura site for Switzerland Innovation Park Basel Area?

Frank Kumli: It's a step forward for regional innovation. Like the others, the park will be dedicated to accelerating innovation. The Jura will finally be able to participate in the innovation park. It's very important to us for the Jura to be able to join us and for us to be able to draw on the region's skills and knowhow, while at the same time supporting local economic development and innovation. For us at Switzerland Innovation Park Basel Area, it's a unique opportunity to lead and support this Jura site.

What are your expectations for the Switzerland Innovation Park in the Jura?

Naturally, we hope it will be a vibrant site, where lots of things happen, where people come together to develop new ideas, discuss ideas and launch innovative projects. It should be an interface between the three cantons of Basel-Stadt, Basel-Landschaft and Jura in the field of innovation.

How many workstations will there be on this site?

In total, we will have a floor space of 1,200 m2, which could equate to sixty or so workstations, some split, so around 30 to 35 jobs.

Has there been any interest yet?

We are working closely with the Jura Chamber of Commerce and Industry, and its director, Pierre-Alain Berret, to promote the innovation park to heads of local SMEs. Several are interested in participating. Local and French start-ups have also expressed interest in setting up at the site.

And what about educational establishments?

On the academic side of things, we have also received interest from the Swiss Center for Electronics and Microtechnology (CSEM), which will have a presence on the site. We have also had discussions with Haute Ecole Arc (HE-Arc) locally to see how we can represent them on the site. We're in the process of signing some contracts. The aim is to have a mix of start-ups, some academic projects and, above all, lots of business projects.

What areas will the Switzerland Innovation Park Basel Area in the Jura be active in?

We will have projects in two areas: healthcare and business agility. We're not going to reinvent watchmaking. Instead, we’ll see how local businesses can be transformed, how they can become more agile in responding to the challenges of a changing world. For healthcare, we're working closely with the Jura Hospital and its director Thierry Charmillot, as well as the head of the Jura's Public Health Service, Nicolas Pétremand.

What exactly are you going to do in the field of health?

A consultation exercise is underway with Professor Hans-Florian Zeilhofer of Basel University Hospital. We have several projects planned with him. Professor Zeilhofer specialises in robotics and automation in surgery. He is convinced that there is a great deal of know-how in the Jura that can be put to use in this field. He is already cooperating on projects in the Jura, specifically in the field of 3D printing. With home automation, the idea is to make the home environment safe so that patients can be discharged from hospital more quickly, while also delaying their move to care homes, therefore maximising their time in their own home.

How long do you think it will take to hit your stride?

We're relatively optimistic, given the help that we are receiving from the Chamber of Commerce, the Jura Hospital, the Public Health Service and universities. I think that we should hit our stride in about a year's time, not in terms of jobs total but in terms of having a vibrant site with lots of innovative ideas. We've had lots of help locally to help find the right projects quickly.

What will be developed as part of industry 4.0?

For us, industry 4.0 is, of course, about production technologies. We're going to focus on agility, with an emphasis on the human aspect, teams, business models and, in the background, the technologies necessary for transformation and production. It's about giving SMEs more agility so they can more easily respond to changing demand in terms of the number and type of parts ordered. To do so, you need teams that are much more responsive. We talked about this with the heads of the Chamber of Commerce CCIJ, including the new president Georges Humard. They confirmed that the areas they are interested in are design thinking, agility and lean processes. There will be many seminars, courses, awareness raising events and support.

When it comes to healthcare, what are we talking about exactly?

We have developed three areas through numerous meetings with Professor Zeilhofer, the Jura Hospital and the Chamber of Commerce. The first area will be pure medical technology, with implants and 3D printing, specialisms very close to the Jura's know-how. This will be the biggest focus. The second will be what they call health-tech, which involves connectivity and digital health. Jura Hospital and the Public Health Service believe that there's much to do in the canton. The third area is the health system. Both the Health and Economy Minister, Jacques Gerber, and Nicolas Pétremand are convinced that the Jura's relatively small health system means it can experiment and innovate much more quickly than in other cantons.

Your list also includes setting up projects, funding, leadership, working methods…

We are working to release funds at cantonal level as well as supporting businesses in securing funding at federal level. We have promised to provide them with people who can navigate the bureaucracy of innovation funds, so they can access this funding faster.

What's so special about Jura business culture?

Here, discretion is above anything else. The Jura entrepreneur does everything himself. As a result, there's little visibility of the skills that Jura businesses have. When we speak to businesses from the biomedical engineering group at Allschwil, they often ask us to help them find the right skills in the Jura for their projects. People know that there is a lot of know-how in the Jura, but they don't know how to access it. This suggests businesses must do more to make their skills known. With the Chamber of Commerce, we're going to link up with Basel-Stadt and Basel-Landschaft. An informal group that includes businesspeople, the Jura Hospital and universities will support the innovation park.

Is there a lack of access to a community and network of innovators and experts for research and development in the canton of Jura?

Yes. There is a real appetite for working with the University of Basel, the FHNW School of Engineering and HE Arc at Neuchâtel on the technology side of things. I think that we will be able to create links between Jura entrepreneurs and universities. The clients of Jura entrepreneurs also want these entrepreneurs to collaborate with the universities, we've been told. There is a lot more innovation than people think. Every time I visit a Jura business, I am amazed by the level of innovation. I think it's great to see that, when you talk to Jura businesspeople, they have lots of pragmatism for moving forward.

Interview: Georges Maillard, Le Quotidien Jurassien

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“Here at Bell, we combine handcraft and automation”

06.05.2019

Over the space of 150 years, a butcher’s in Basel has grown into an international food company, with the Bell Food Group now employing more than 12,000 people in 15 countries. Markus Ettlin, Head of Industry 4.0/Automation at the Bell Food Group, provides an update on the company’s current Industry 4.0 projects, the limits of automation, and innovations in the food sector.

BaselArea.swiss: When will robots start making sausages?

Markus Ettlin: An extremely large amount of handcraft, experience and skill goes into making a sausage. At the moment, it would be virtually impossible to have the work done by a machine – that is not our goal either. For us, it’s a balancing act to find the sweet spot between tradition and innovation. When it comes to sausages, tradition and handcraft are extremely important. Robots will not be making sausages in the foreseeable future.

Is this because there is no demand for it?

I believe that our customers want a handmade product and not fully industrialised sausages. A sausage is a natural product with natural characteristics that must be satisfied. A great deal of experience is also required. Whether it’s sausages or ham, production requires a great deal of experience and all of our senses. We are, however, in the process of automating certain sub-processes. We want to combine handcraft and automation.

Which areas are suitable for automation?

We need to distinguish between the handcraft sector and convenience products. Great importance is attached to handcraft in the production of sausages and ham. In the Convenience sector, where products have to be more uniform, the progress made with automation is at a much more advanced stage. For example, the production of hamburger patties and chicken nuggets is highly automated, as they are shaped by machines. We have successfully introduced automation technologies in the Logistics division as well as for repetitive work and physically demanding jobs.

Where do you see the greatest potential?

The degree of automation used in handling and packing tasks is higher than in other areas, but even here human staff are needed. We see great potential in the data and information that is generated on a daily basis. We want to learn from this data and improve ourselves. Let’s look at the cooking process, for example, where data such as temperature is measured. Here, we have target parameters, we have actual parameters, and at the end we have a result. Although the employees check the temperature, they cannot keep track of all of the parameters, the different values and the complex relationships. By analysing this data, we can safeguard and even improve the quality of the cooking process – and thus also the quality of the product. This data analysis also helps us to increase energy efficiency and make optimal use of system capacities.

On which transformations and in which areas is Bell focussing?

On the one hand, we should be able to trace the journey of the product; on the other hand, we should be able to understand why certain steps have been taken in the manufacturing process and what effects these steps have on the finished product. The main areas of focus here are thus standards and standardisation. We want to use standardised technology, transform automated processes and ensure transparency.

Which sectors are particularly interesting as a source of ideas for standardised technologies?

The meat processing specialist area is a leader in this regard. In my area, I am interested more in which technologies can be used for unconventional purposes. For example, if there are procedures and methodologies used in the pharma industry that could also work in the food industry. The pharma industry is able to handle large volumes of data, which is an extremely exciting prospect for my division. The automotive industry, for its part, has made great progress with automated processes. Car manufacturers frequently have to roll our large production runs. Within an individual production run, however, sometimes the steering wheel has to be installed on the left of the chassis, and sometimes on the right. These are topics we have to deal with as well, since we also have products that come in different forms – sometimes lighter, sometimes heavier, some in small packaging and others in large packaging. We like to draw inspiration from other industries.

What is being implemented?

We are building a huge state-of-the-art cold store with an extremely high level of automation. The aim is for logistics to be as fully automated as possible, for employees to spend as little time as possible in the cold store area, and to provide highly automated support processes. All of the systems and processes will generate data and information that we want to analyse in order to implement improvements, carry out maintenance work and raise efficiency. In all areas, the collection of data is an opportunity for us to improve and safeguard our quality levels.

What challenges does the upcoming transformation pose for Bell?

For us, Industry 4.0 is strongly linked to the production environment. Digitisation is a huge step for our employees. We want everyone to be involved and show them that new technologies are there to support them in their work. I also perceive a challenge in the fact that everything is increasing in complexity, that everything is interlinked. This is not always easy to understand. As a result, we also need to build up knowledge and generally raise awareness of Industry 4.0 issues. We additionally need to develop an understanding of where we're going to start with the implementation and how we're going to establish a meaningful roadmap.

Bell is taking part in our Industry 4.0 Challenge. What have you been able to learn from this so far?

I’ve come to know BaselArea.swiss from various events, where we’ve always made interesting contacts. In terms of the Industry 4.0 Challenge, I can easily see which ideas are represented on the market and how others see the world. In the case of large corporations, it’s often not quite as transparent how they’ve come up with their great solutions. Start-ups can quickly present a proof of concept, so I can imagine what it involves and what it would mean for me. This is, in my opinion, extremely exciting. Our division is also in contact with the companies that attended the last Industry 4.0 Challenge. Although we are more on the lookout for standardised tools, start-ups often bridge the gap between a major standard and the real world.

What kind of innovations can we expect to see in the food sector in the near future?

Meat that can be produced without having to kill any animals – the hamburgers produced by Mosa Meat are cultured from cells. Bell holds a stake in the Dutch company, which is currently working on making its concept ready for market.

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“The Basel region is very advanced in healthcare innovation”

02.04.2019

A new master’s degree at the FHNW University of Applied Sciences and Arts Northwestern Switzerland aims to prepare the next generation of professionals in the life sciences industries: Students in “Medical Informatics” are trained to apply the latest technologies during projects for the medical and pharmaceutical industries. Professor Enkelejda Miho from the Institute for Medical and Analytical Technologies at FHNW is confident that the combination of life sciences, informatics and business brings forward a desired new profile of professionals.

BaselArea.swiss: Enkelejda, do you think that the traditionally trained scientist who adds a technological perspective is the new normal?

Enkelejda Miho: Drug discovery is a large area. There are fields that will remain quite traditional while branches like real-world data and digital clinical trials are changing rapidly. Scientists cannot analyze their large-scale data with the same means used in former years. Further, a multitude of tools are ready to use today. The field is in the process of finding out how to combine these tools in order to bring drugs faster to the market. Applying cutting-edge technology to answer scientific questions is an integral part of the job as a scientist. We hear from pharmaceutical companies that the technologically savvy scientist is a desired profile, alas not necessarily the profile that is available on the market. Education has to catch up with what is happening in the real world.

What changed in the understanding of healthcare?

Healthcare developed like every other field: We observed slow process over centuries. Then suddenly, technology brought things forward abruptly. Knowledge in health was always centered on organs, which helped to reduce complexity. You had the cardiologist, the pneumologist, the neurologist who tried to understand one problem at a time. Knowledge was dissected. This is changing massively.

How so?

New technologies are leading towards faster diagnostics and therapeutics. For example, we can train an algorithm to detect a tumor. The machine thus supports the specialized doctor in upscaling the quantity of patients he or she can see and diagnose. The first step is to apply what we know to accelerate diagnostics and therapeutics based on larger experience and faster knowledge processing. The second step is integration of knowledge from different systems. There are many different technologies. Now we have to ask how to apply them adequately. Integration of knowledge is key.

Which role does Artificial Intelligence play in this?

Instead of asking one question at a time, AI allows to integrate not only health data but also other information like the times you went to the doctor, the prescribed therapies and symptoms as well as social and environmental data. AI helps to integrate all that to support us making better choices and better diagnostics so people don’t go for the wrong therapy or suffer treatments that are not specific to them.

Are we prepared for healthcare innovation?

We are on a very good way. The first challenge is standardization. There is no aligned idea of which method to use when and how they compare – there are just so many. Research groups, labs and pharmaceutical companies could do more in the precompetitive space so we don’t make the same mistakes all over again. We could learn a lot from software development where sharing is common. The second challenge is the bias that we introduce to the algorithms. Researchers have to think thoroughly about matching the right question with the right data set – a computer is not able to do that. We need researchers who are aware of the potential pitfalls of applying AI and machine learning to healthcare.

How far are we in Basel?

The Basel region is very advanced compared to other regions. We have major players, we have a startup environment and we have major research institutions and applied institutions like University of Basel, ETH, FHNW and the Friedrich Miescher Institute. All the components are here. I believe there is need for more cross talk between the stakeholders, though, instead of trying to bring the whole machinery forward by oneself. BaselArea.swiss and DayOne help as they bring different perspectives together. There could be more dedicated resources to spark the interaction, though. This would also help to retain the talent we need to bring this field forward.

Which difference does the new Master in Medical Informatics make?

We fill a gap. Talking with the industry, we discovered that everyone is moving into applying the new technologies like machine learning and AI. This requires specialized knowledge. On the one hand, you need to know about chemical molecules and biology because you need to understand the data you are analyzing. On the other hand, you need knowledge in programming and in the mathematical framework of applying machine learning. So, a broad knowledge is required to apply an exact part of data and an exact method of machine learning to a very specific project. You need a background of everything to be a master of one specific question. This is the challenge that other institutions in Switzerland and in the European countries have not tackled yet.

What is your approach?

The FHNW is known for being an applied institution to the latest questions. We are giving the students diverse enough background in life sciences, in informatics and business and then bringing these students to real life projects from pharmaceutical companies and hospitals. If you know the drill, you can apply it for another question as well – that is the ambition. Our students will deal with the diversity of projects, with databases, with citizen-patients, with classification and automation. How can you automatize image analysis in the pharma industry or in the hospital? How can you be of support to regulatory agencies, knowing the latest trends and pitfalls? We are the first with this twist of educational purpose. We are training the new generation of professionals, considering the digital transformation in the application field.

We are not talking about data ethics?

You cannot escape the ethics. It’s the most important question we face in digital health. But sometimes you need to walk the line to understand what is needed in terms of ethics and data privacy. We try to address these questions in the frame of specific projects. Discussion is great for preparing the ground and for creating awareness. We are more about the doing.

What students do you expect?

We wanted to give FHNW trained students the possibility to get into cutting-edge projects. What we experience is that companies are also very interested in the Master program. This program connects the life sciences and the business world based on the informatics ground. Together with Prof. Dr. Knut Hinkelmann, Head of the Master of Science in Business Information Systems at FHNW, we are producing a profile that understands the needs of science but that can actually apply it with regard to cybersecurity, data privacy and business applications. We train the people in the best tradition of the Fachhochschule to get the job done.

There are different initiatives in digital health education from ETH, University, and Swiss Tropical and Public Health Institute, too. How do you value these efforts?

These efforts are valuable and relevant for our community. I don’t see any overlap in these programs. While the focus at the FMI, ETH and University of Basel is more research driven, here at the FHNW we are going for hands-on application-driven education. We are in collaboration with the University of Basel, especially the Innovation offices, and with FMI and ETH as well. At last, it’s a community effort.

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