Some thoughts on health and healthcare

Abstract Introducing Artificial Intelligence (AI), Large Language Models (LLMs), and Robotic Process Automation (RPA) in a Belgian hospital should not be treated primarily as an IT procurement exercise. It is a clinical, legal, organizational, and ethical transformation. AI can support diagnosis, triage, logistics, population health, and administrative optimization; LLMs can assist with documentation, translation, summarization, coding, and knowledge retrieval; and RPA can automate repetitive digital workflows such as data entry, report routing, claims preparation, and system monitoring. In Belgium, however, implementation must be aligned with the General Data Protection Regulation (GDPR), the EU Artificial Intelligence Act, the European Health Data Space (EHDS) Regulation, Belgian health-data governance structures, and the hospital’s duty to preserve clinical safety, security and patient trust. The safest introduction model is therefore phased: establish governance, select low-risk hi...

Introduction A terminology of "monoliths" for "High-Complexity Hubs" and "swarms" for "Distributed Care Network" is evocative rather than standard in health-services research, but it captures a real and increasingly well-documented transformation. The academic and policy literature more commonly describes this transition as a move toward  centralization of high-complexity services  alongside  decentralization of appropriate care  through integrated, people-centred networks, telemedicine, hospital-at-home models, virtual wards, and hub-and-spoke systems. In that sense, the future hospital is not disappearing; it is being reconstituted as a  networked institution : centralized where rarity, risk, and capital intensity require concentration, and decentralized where continuity, accessibility, and lower-acuity care favor delivery closer to the patient. In this essay I want to argue that hospitals will evolve along three interlocking dimensions.  S...