SensUs Interviews:
Tom Oostrom

Recently we had the honour to welcome the Dutch Kidney Foundation (DKF) as an affiliate of SensUs. For this edition of SensUs Interviews we speak with Tom Oostrom. He is the managing director of the DKF and the newest member of our committee of recommendation. His answers introduce the DKF and give insight in the applications of the future creatinine sensors.

Can you tell something about yourself, and about your role as director of the Kidney Foundation?
I started my career as a nurse, later I studied health management and policy. I worked in different organizations and positions as policy advisor and management consultant. From 2005 I work for the DKF, and now as the director. Being a director is the best job I have ever had.

The DKF is independent of the government and has to arrange for its own income. This creates a dynamic environment with highly motivated employees. We are the third largest health foundation of the Netherlands with a turnover of 20 million euros in 2015. The money raised through collecting door to door was 3,5 million euros last year. We receive a lot of money from estates (6 million last year), financial donors (6 million), major donors, events and we are sponsored by the Vriendenloterij and the Lotto.

The money is spent on research and non-research activities, e.g. in the field of kidney failure and prevention. How can we detect a kidney failure as soon as possible? The salt campaign is an element of this program. Furthermore, we strive for more organ donations, and there is a travel program that enables dialysis patients to go on holiday.
My goal as the director of the Kidney Foundation is to make sure that the organisation runs smoothly. I have many conversations with partners, funds, insurance companies, etc. We try to stimulate collaborations on important topics, such as the portable artificial kidney.

How does the Kidney Foundation stimulate innovation?
We find it important that research results lead to tangible benefits for the patients. This requires that research results are translated into prototypes and products, which requires the involvement of companies for example. We try to stimulate such translation and collaboration.

What is your view on the role of patients in innovation?
There are three levels of innovation: Technological innovation, social innovation (relating to the behaviour of patients and health professionals), and healthcare innovation (relating to the overall healthcare system). We think that patients should already be involved in the early stages of research. Take the example of the portable artificial kidney. First we focused on a device that patients could carry 24 hours per day. After some time we asked patients what they thought about the concept and their responses were not all positive. They answered that they did not want to carry a machine for 24 hours per day. They did not want to be constantly reminded of the device. They preferred a device that they could connect to when they wanted. Therefore, we decided to develop a device that could be placed on a bedside table. This also relieved an important technical problem, because it is extremely difficult to achieve 24 hour blood vessel access. This example shows that involving patients at an early stage can accelerate innovation. We were actually late, because we had been working for some time on a concept that the patients did not like.

What do you think of the SensUs concept and vision?
We definitely see the added value of pocket biosensors and in-vivo sensors. Early detection is very important. Furthermore, the concept of having a competition is fantastic. A few years ago we participated in a Battle of the Universities where student teams where challenged for only 24 hours, but even in such a short time they came up with surprising results.

Do you see a future for point-of-care testing and biochemical patient monitoring in the field of kidney disease?
Point-of-care testing is important for early detection, disease self-management, and personalized healthcare. Albumin and creatinine testing can assist in early detection of kidney failure. An albumin test helps the GP to refer patients to a specialist. Creatinine testing is important to determine if medication can be safely taken.

Patients with kidney failure have a badly regulated water and electrolyte balance. Such patients are on a diet with minimal potassium and sodium intake. With a sodium and potassium measurement, immediate feedback can be given on the diet, so that they can better manage their own disease.

Finally, in-vivo sensing is very important for patients with chronic kidney failure. Every patient is different. With biosensors one could personalize the treatment and maximize treatment effectiveness.

How might patients benefit from a creatinine biosensor in the future?
A patient on dialysis costs around 90 000 euros annually, so preventing dialysis saves an incredible amount of money. Early detection and the personalization of treatment may delay the need for dialysis or organ transplantation, or may even prevent it. Dialysis has an enormous impact on the lives of our patients, so there is a large potential to enhance the quality of life of patients.

Do you have an advice and/or a question for the SensUs students and stakeholders?
General Practitioners will prefer a sensor that measures more than creatinine. The sensing systems must be a relief for doctors and patients. So carefully analyse how your sensor concepts can have the biggest impact in the healthcare system.