“We are all noticing that the pressure on healthcare is increasing. The population is ageing, people are living longer, and they have much more access to information. They are quicker to ask for a referral if they think they feel unwell, and then the task lies with us to give the patients answers.”

This is how rheumatologist Petra Kok describes the current situation in healthcare, and then immediately adds her mission: “I want to help organise healthcare in such a way that it fits in with the present and the future.”

Since she was asked ten years ago to contribute ideas for the tendering process for the electronic patient file at the Erasmus Medical Centre and to help steer its introduction, she has been fascinated by the opportunities that digitisation and, more recently, artificial intelligence (AI) offer for healthcare.

“At the time, I immediately set up an e-health working group with another rheumatologist in the Dutch Rheumatology Association (NVR) to join forces on digital possibilities in healthcare, but also to ensure that they are in line with daily practice in the consulting room. Because that is where everything ultimately comes together.”

Manometric

“A few years later, I was offered a job at the Reiner de Graaf Hospital (RDG) in Delft and was asked to become Chief Medical Information Officer as well. Additionally, I became an ambassador for the digitisation of healthcare. I also came into contact with hand surgeon Gerald Kraan, who had just set up a study with Manometric, a company run by graduates of the Delft University of Technology.”

“They had made a hand scanner. It had to be validated and the braces that came out of it had to be proven to work just as well or even better for patients with osteoarthritis. Gerald asked: ‘Gosh, can’t rheumatology get involved too?’ And just like that, I became enthusiastic about the collaboration between TU Delft and the RDG and saw how many young, creative talents there are and how you can connect that to daily practice in healthcare. Like with the 3D printed braces from Manometric, which I notice on a daily basis in the consulting room that people really benefit from.”

For the past year, she has also been a board member of another collaboration with TU Delft. Via Delft Design Lab Health Journeys, she and students are looking at how the workflow in healthcare can be better coordinated. Because, as she puts it, “my workflow consists of a train. And if I have one car drive supersonically fast and the rest of the cars are still at steam locomotive level, we will still only be travelling at the same pace.”

Autoscriber

Time does not stand still: in the year 2025 she is one of the great advocates of Autoscriber and e-consultation, among other things. During a consultation, Autoscriber records the conversation and makes a short summary of it. The doctor reviews it and corrects and supplements it where necessary. “Normally, I am looking at my screen a lot and I miss a whole lot of non-verbal communication. If you can look someone in the eye and see their body language, you can read them much better. If you mention a certain medication, you can already see the reaction. Just today, I was talking to a woman about lifestyle, and I could see that it touched her emotionally. The conversation takes a different turn.”

“You notice that the programme generates more attention for the patient and more job satisfaction and ease of use for the doctor. Although there is still room for improvement in terms of content and technology.”

“For example, we sought out cooperation with the software company Chipsoft to link Autoscriber with the electronical patient record. That sounds very simple, but it is a very complicated process.”

“Another example is that first aid worker Manchu Mahayan found out that patients only remember 30 percent of what the doctor has said and advised. Together with Delft University of Technology, she has worked on a patient-friendly summary of the conversation. Now we can use Autoscriber to create a summary in comprehensible language without medical jargon that patients can read in their own portal. This also has a link to Manometric: you look at what the problem is and how you can find a solution together.”

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Threshold

“Autoscriber is now spreading like wildfire throughout the hospital. It does require a change in the way we work and I see that as a major challenge for healthcare providers. They suddenly have to leave the writing up of reports to the computer, and that is a huge psychological barrier.”

She also works a lot with so-called e-consultations, where patients can ask questions digitally, prepare for a consultation, video call with the doctor or get a digital coach for their medication use. She is enthusiastic about it, but it does not reduce her workload. “You are basically opening a kind of 24/7 supermarket when you offer people the option of sending an e-consultation at any time. They can send one every second of the day from their phone or computer. But I notice that people like it. They are more easily reassured and live more comfortably with their illness. But if you ask me if I can now see more patients, the answer is: no.”

Bumps in the road

Expectations surrounding digitisation and AI are high. But there are still a few bumps in the road to be taken: “First of all, it takes time to get something done really well, and we sometimes forget that when we say that AI is going to save healthcare. Then my question is: how? Then you go back to the daily practice of a collaboration of three parties – government, doctors and companies – that have to create something that can be scaled up for healthcare practice. And then you run into limitations again, such as financing. A considerable portion of hospitals’ budgets goes to ICT. We can make very nice technology, but it costs a lot of money and where do you get that money from when you also have to cut healthcare costs? And of course companies want to make money.”

Vision

“I have been meeting with companies every two weeks for a year now and I don’t write invoices for that. I don’t have to, because it earns me enough in the consulting room with patients. And yes, people have something to say about that. They say you should just ask for money. But I focus on working together on a person-to-person level. Respect, trust, the element of gratitude and ultimately more attention and consideration for the patient: that is crucial to me. Is that naive when you talk to large commercial parties?  No, I am very aware of that. Ultimately, everything should be available to everyone. That is an idealistic vision and I want to dedicate myself to it. Will I succeed? I don’t know, but I will certainly try.”

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