Out of prehistoric times!
Out of prehistoric times!

Gabrielle Speijer, MD

ICT&Health, 03/2019

Out of prehistoric times!

Changes sometimes seem to occur unnoticed, even in clinical practice. For example, in a brain tumor that induces bitemporal hemianopsia (blindness in both outer halves of the visual field) due to its relatively slow growth just at the junction of the optic nerves. Vision can go unnoticed for a long time until the moment the patient bumps into something, falls and further analysis yields the diagnosis.

For example, it remains self-evident for many who bear responsibility in the medical world that we have been skyping, ordering online and using social media for years. But as soon as we go through the revolving door of clinical practice, outpatient visits that could also have been done via video calling, (digitized) paper and non-communicating digital systems – without any self-learning talents – are completely normal.

A warning to you as a reader is already too late, because every time you go through the revolving door, you are aware of this fact. Just like the table that stood in the way of that patient who had to hear the diagnosis a few hours later. But that is of course also my intention. I am convinced that it really can also be done outside the revolving door!

Where is the technology?

For this blog, let me take one more example that I and my colleagues have to deal with every day: multidisciplinary consultation. This is a great thing, don’t get me wrong. It is the moment when we are together to discuss the most optimal (treatment) proposal for the patient in question.

Nevertheless, I am annoyed with various aspects: why does this have to be so rigid at a certain moment, where is the technology that can enable us to provide 24/7 advice and, where necessary, to use video consultation for the more complex patient? And what could it improve our advice if we could immediately involve the patient digitally, link the underlying information to protocols and predict, based on earlier advice, how it could look best for the patient?

This is of course just a line of thought, because a change like this involves more than installing the camera and starting up a separate app group in a secure medium. It requires embedding technology, a tailor-made interface for both patient and healthcare provider.

On the other hand, it is very simple: it must improve our process, because the patient is the starting point and technology enables us to provide better care. If not, we will do worse than outside healthcare, because who uses an app that makes your life miserable? You don’t install it at all, do you?

Think with me

Whatever the motive for entering a revolving door of a care practice, I hope this blog has provided you with a picture of the prehistoric cave. Do not pass up this call, just think for a moment and bring in your ideas about what the first steps for improvement could be! Let’s form a group of open, empathetic and authentic doctors in the ever-expanding world of health and care, who will really make a difference with technology. You can find me at the editorial board at

Gabrielle Speijer (1976) works as a radiation oncologist at the Haga Hospital (RHG) in The Hague. She is convinced that technology can connect so smoothly in health and care that we can get a complete medical picture. Her drive and passion lies in establishing a coalition of doctors to substantially and sustainably improve healthcare and health. They are also welcome to take a seat on the editorial board of ICT & health. Send an email to

About the author

Gabriëlle Speijer is a Radiation Oncologist at the Haga Hospital, founder of the healthcare innovation company CatalyzIT, HIMSS Future50 International HealthIT leader and member of the ICT&health editorial board.