Healthy Start Stories |
Maaike Kleinsmann

Smart technology in healthcare: ‘How do we use technology in such a way that children with a chronic disease still grow up healthy and normally?’

About one in five children in the Netherlands suffers from a chronic condition. This concerns, for example, asthma, diabetes or chronic heart disease. Due to their disease, these children do not grow up without worries. They have to go to hospital regularly, sometimes for a long time. As a result, they miss everyday things. How can we let these children grow up as healthy and normal as possible despite their disease? And how can smart technology help with this? Maaike Kleinsmann, professor of ‘Design for digital transformations’ at TU Delft and the Leiden University Medical Center, and one of the initiators of Healthy Start, tells us about this.

“Children with a chronic disease develop in many ways a backlog at an early age. For example, they often cannot just participate in fun activities, such as a school trip or a party. And due to hospital visits, they regularly miss school and sports lessons. As a result, these children often develop physical and mental retardation in addition to their disease. That is shocking. I want to know what we can do to give these children a good start in life. This is not only in the interest of the children and their parents, but also in the interest of the future of healthcare. Medical and psychosocial insights are desperately needed to provide chronically ill children with the best possible care. But also knowledge about technology should not be missing in my opinion. I am thinking, for example, of a smart watch to measure vital functions, home monitoring and artificial intelligence. I hope that through the combination of different areas of expertise, we can help children with a chronic disease grow up as healthy and normal as possible.”

Children with a chronic disease develop backlog in many ways at an early age

Industrial design for people and society

“At a young age I was already interested in how technology can enrich people’s lives. It was therefore a logical step to study Industrial Design Engineering at TU Delft. At the time, I didn’t know exactly what I wanted to do with this course. Afterwards, the first seed for the direction of medical technology was planted during my master’s thesis. At the time, I was doing research into home monitoring of patients with cardiovascular disease. After my master’s, I explored other directions. For example, as a PhD student I researched how teams can innovate through ‘co-creation’. This is a form of collaboration in which different target groups, such as companies, customers and end users, are actively involved in the development of new products and services.

In the years following my PhD, I delved deeper into this subject. But gradually I found out that I didn’t just want to deal with products and services. I would rather really contribute to society by combining knowledge about industrial design with scientific research. From that moment on, my interest shifted more and more to medical technology. And so I came back to remote patient management. A large-scale consortium (Edison-RPM) has now started from which we work on technological solutions for home monitoring. Ultimately, I hope that this development will give patients more control over their lives.”

Afterwards, the first seed for the direction of medical technology was planted during my master's thesis

Smart technology in the care of chronically ill children

“Within Healthy Start I can perfectly combine my passion for industrial design and medical care. I am mainly concerned with the question of how we can use smart technology and remote patient management to optimally organize the care for chronically ill children. That is desperately needed. Not only to improve the quality of life of the child, but certainly also to reduce the pressure on the already overburdened care. For example, we are currently investigating how we can improve the so-called patient journey with smart technology. Patient journey refers to the ‘journey’ that a patient takes within the healthcare system: from the first contact with a healthcare provider to diagnosis, treatment plan, admissions and follow-up. I am curious whether, for example, we can use simulation models to predict which care is needed at what time. And can we monitor the condition of the heart at home so that children with heart disease do not have to go to the hospital as often?

In addition, I am concerned with the question of how we can get children with a chronic disease to exercise more. Pediatric cardiologists regularly see that children with heart disease exercise too little, sometimes even less than one hour a day. Due to insufficient physical exercise, these children run the risk of developing even more health problems later in life. Think of obesity or depression. These conditions in turn entail additional healthcare costs. I am now investigating whether, for example, a smart watch and an exercise vest help children to exercise in a fun and accessible way. We also involve the parents in this. We know that some parents do not let their children move too much out of fear. Within this project I not only work with pediatric cardiologists, but also with scientists in the field of family sociology.”

Room to pioneer

“I find it very valuable that I can be at the helm of Healthy Start together with Eveline Crone (Erasmus University Rotterdam) and Vincent Jaddoe (Erasmus MC). It is special to see how many possibilities this collaboration already offers. That also applies to me personally. We have sufficient knowledge and resources to really investigate the potential of smart technology for children and young people. In addition, I have never worked with so many top scientists at the same time before. I also learn to work with new partners outside of science. Because of my background, I am mainly used to working with companies. Now I also work a lot with medical specialists and policy officers. At the same time, I can share my own experiences here. Not only in terms of content, but also in terms of process. I am used to working iteratively: taking small steps and asking for feedback quickly and often. That is certainly not standard within traditional science. I enjoy adding that knowledge to Healthy Start.

What I also find special about doing research within Healthy Start is that we can really pioneer and that there is room for uncertainty. For example, we do not yet know what impact a smartwatch has on a child with a chronic disease. Hopefully it encourages the children to exercise more, but it may also have a stigmatizing effect. It is important that we keep an eye out for these kinds of unintended effects.”

Can we reduce hospital visits of children with a heart disease through heart monitoring?

Looking for your own place

“Healthy Start is a unique consortium in which many different people work together. For me, this also meant that I had to start looking for my role as an industrial designer. I also see the search for a personal role in the consortium among young scientists. Within Healthy Start we have a strong focus on teamwork and social output. That is quite challenging when you are at the beginning of your career. Young scientists still have to build up their own profile and unfortunately scientific articles still weigh more heavily than social outcomes. That’s why it’s so important to help each other. So let’s support the new generation of scientists as best we can so that they can really flourish.”

Maaike Kleinmann’s Healthy Start perspective
“Healthy Start gives me the opportunity to follow my heart on the content. I really hope that we can motivate chronically ill children to exercise more, in a way that suits them and is sustainable. In addition, I think it is very important that the child becomes much more central within the care. Ultimately, I also hope that our knowledge can be used to improve care for other patient groups. And maybe even be used in other countries. I am thinking, for example, of countries such as Kenya. Where the need for good care is very great. And by that I don’t mean that we just go there to tell them what’s going on, but that we work together with local scientists and healthcare providers. I am convinced that such cooperation will also give us a lot of insight into how we can do better ourselves.”

Maaike Kleinsmann is Professor of Design for Digital Transformation at Delft University of Technology. She is Academic Lead of Healthy Start and involved in the ambitions ‘pediatric hospital of the future’ and ‘digital empowerment of (children’s) physical activity’. 

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