Collecting and analyzing increasingly vast volumes of medical data can improve illness detection and treatment while saving healthcare systems huge sums of money, said SAP co-founder Hasso Plattner, in an interview with Handelsblatt.
But as the global digital healthcare market rapidly advances, Germany is stumbling over an acute case of big-data phobia, he added.
“We have the data and we have the know-how, but we can’t use this because we’re not allowed to — that has to change,” the 72-year-old German business software pioneer said, warning that Germany is in jeopardy of blowing a tremendous growth opportunity with major health benefits.
Globally, all big technology firms are staking their claims in digital healthcare. Apple, Goggle and IBM are investing billions into networking diverse healthcare data – from biological makeup to clinical history to lifestyle choices.
Consultancy Arthur D. Little forecasts the global market for digital health products and services to more than double to $233 billion by 2020 as the era of wireless patient monitoring and electronic medical records takes shape.
“Let’s first see how far we get with a pilot system, and then let’s talk about data protection.”
Mr. Plattner sees enormous advantages in applying big-data analytics to the healthcare industry. By harnessing the explosion of medical data, “one can determine prognoses, begin early treatment and save so much money,” he said.
The entrepreneur noted that healthcare costs account for 11 to 17 percent of gross domestic product among members of the Organization for Economic Cooperation and Development, which includes the world’s most advanced countries.
“Imagine cutting these costs by 30 percent by simply making diagnoses for certain diseases with greater probability,” Mr. Plattner said.
But applying the concept to clinical reality is proving to be a difficult task in some places, especially in Germany.
Mr. Plattner faults Germans’ anxiety over technological advancement and, in his view, the country’s overblown concerns over data security. Moreover, every doctor and hospital in Germany silos healthcare information in an exclusive database, rather than sharing it for the greater good, he complained.
That’s why Mr. Plattner – a self-made billionaire who remains one of Germany’s most influential technologists – is calling for greater collaboration among the various players in country’s health sector, including doctors, researchers, pharmaceutical companies, makers of software and hardware, and “innovative thought leaders.”
Such an effort, he said, needs “a clear goal to create systems,” suggesting the group coalesce around a transparent pilot project.
“We must break out of our conventional patterns and not simply build better what we already have; rather, let’s think about how an ideal system could look,” Mr. Plattner said. “Let’s first see how far we get with a pilot system, and then let’s talk about data protection.”
Such a pilot project could help to address what he views as the biggest technical challenge: the actual networking of data.
“Every doctor and every hospital has heaps of data,” Mr. Plattner said. “The problem is that everyone’s got a different filing procedure, a different storage system, and that the data is not shared with others. There is no exchange.”
Another serious challenge is that acceptance of digital healthcare is lacking throughout Germany’s medical community, not just among patients. “Doctors don’t even want it,” he said.
In one research project, SAP created a database of 60,000 cancer patients for the Charité university hospital in Berlin. “Researchers were thrilled over everything one can now do, but doctors at the clinic were not,” Mr. Plattner said.
He argues that doctors fear losing their unique role in diagnosing illness. “Today, no one steers a ship across the ocean without GPS navigational tools,” he said, “and no-one says, ‘I’m not going to let GPS instruments tell me where I am; I’d rather navigate by the stars.’ We must learn that systems can lend us assistance.”
In some ways, doctors are not so different from the big-data analytics Mr. Plattner believes should increasingly augment patient care. For instance, experienced doctors create internal databases in their heads from years of medical practice, training and professional development.
“If we analyzed the genome and also the proteome and maybe more from one person, and gathered and evaluated variations from many more people, then we would have a database that is multitudes larger than the doctor’s,” he said. “We can now say exactly which disease risk a person has with a certain fingerprint from a certain ethnic group in a certain region.”
Mr. Plattner called it “unbelievable” that patients were being denied such capability, “even though it would be possible today.”
Nevertheless, computers and big data analytics are no replacement for doctors. “The computer stands behind the doctor and supports him,” he said.
Given Germany’s reluctance to embrace big-data analytics in healthcare, the most important initiatives are occurring abroad.
In one project with the American Society of Clinical Oncology, SAP is working with 35,000 doctors in the United States who are storing information from 1 million patients into the company’s enterprise data platform HANA.
“With certainty, completely new linkages about cancer diseases will come to light in the future,” Mr. Plattner said. “That will make treatment more successful.”
But such big projects,” he added, “happen in other countries, not in Germany, because here, we start asking about data protection before we can even take a first step.”
Meanwhile, discussion in the United States centers on a medical “moonshot” for the healthcare sector, as IBM chief executive Ginni Rometty has called IBM’s Watson Health initiative. More than 5,000 technical and medical experts are seeking to apply the cognitive capabilities of the IBM supercomputer Watson to healthcare.
The system has access to more than 300 million patient records stored in the Watson Health cloud, in addition to data from thousands of healthcare facilities and around 1.2 million medical research papers.
One analytical tool for diagnosing and treating cancer already is in clinical use.
“Watson collects the knowledge of many experts and makes it available for every doctor,” said Matthias Reumann, an engineer at IBM’s research center in Zurich.
Internet goliath Google is focused on its own medical moonshot though California Life Company, known as Calico, a subsidiary it funds to conduct research on human longevity. Another Google subsidiary, Verily, is developing sensors and systems aimed at monitoring and managing chronic ailments such as diabetes and cardiovascular disease.
“We are good in physics, biology, chemistry, medicine and engineering. But we now need mathematics as an additional scientific pillar.”
Pharmaceutical firms Novartis, Sanofi and Bayer are cooperating with Google.
Stefan Oschmann, the incoming chief executive of the pharmaceutical company Merck in Darmstadt, says companies such as his are being forced to boost their competency in big-data analytics.
“We are good in physics, biology, chemistry, medicine and engineering, Mr. Oschmann told Handelsblatt. “But we now need mathematics as an additional scientific pillar at Merck.”
While industry collaboration is needed to foster greater acceptance of digital healthcare in Germany, its development over the next decade “depends heavily on the political framework,” Mr. Plattner noted.
German Health Minister Hermann Gröhe, a member of Chancellor Angela Merkel’s Christian Democratic Union, is promoting the digitalization of the domestic healthcare industry through a new law that went into force at the beginning of the year.
But it could still take some time to implement the most critical facets of digitalized healthcare, such as networking of diverse datasets.
The new law foresees the creation of an electric health card for every person in Germany by 2018. Pending patient consent, the cards will include important health information that doctors, hospitals and pharmacies across the country can access.
Certain preconditions for exchanging electronic medical reports, x-rays or vaccination certificates are to be set by the end of 2018.
In the meantime, however, Justice Minister Heiko Maas, a member of the center-left Social Democratic Party, has said he wants to regulate access to health data.
“That is again typically German,” Mr. Plattner said. “In America, there are rebates for people who want to share fitness data.”
But even in the United States, where he lived for many years as chairman of SAP America, there are many different platforms and “constant technological change is a problem,” he said. “That’s why we also need the cloud, so we can distribute development faster. But even that doesn’t work in Germany, since medical data is not allowed to be located in the cloud.”
Such restrictions on cloud-based healthcare information in Germany need to be eliminated, Mr. Plattner argues. “If we can encrypt a mobile phone so that the NSA cannot get inside, then we really should be able to also secure patient data so that it remains anonymous,” he said.
While he doesn’t believe big data’s reach into the medical field is overwhelming people, Mr. Plattner cautioned it could create unease for some. “It’s there in Germany; less so in other placesor not at all. That is our particular German problem: our fear of the new,” he said.
Since fear is subjective, however, the software pioneer said he could not judge whether that feeling was right or wrong.
Mr. Plattner noted that in the United States, it is “clear to everyone that, somewhere, there is data about them, data that exactly describes who I am, what I am, how I think and what I feel,” and “hardly anone” is worried about the situation.
Does Germany’s angst limit its technological development?
“Yes, our exaggerated fear that someone could know something that he should not know is a clear hindrance,” Mr. Plattner said, adding that regardless of whether there is fear or not, “data collection is coming either way.”
But how does the technology developer and advocate himself feel about sharing his health details?
“I would trust all those who promise to help the development of my personal health,” he said. “I would release the data for analysis if, in return, I could receive a better diagnosis, early detection or treatment through the application of personalized medicine. When it comes to medicine, we need data, data, data.”
Maike Telgheder is an editor at Handelsblatt, covering the health economy, pharmaceutical companies and chemistry. Grisch Brower-Rabinowitsch heads Handelsblatt U.S. coverage from New York. To contact the authors: firstname.lastname@example.org and email@example.com