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A vendor’s view on eHealth. Stan Smits. Philips Healthcare. 14 May 2008. Healthcare is the world’s largest service sector. US Healthcare Expenditure: ~ US$ 2,000 bln in 2007 ~ US$ 4,300 bln in 2017 Worldwide Healthcare Expenditure: ~ US$ 4,000 bln in 2006 - PowerPoint PPT Presentation
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214 May 2008 - Stan Smits Philips Healthcare
Source: Medistat
Source: OECD, WHO, PH Internal Analysis
30%
2%
8%
1% 5%
54%
Americas
Europe, Mid-East,Africa
China/HK
J apan
India
Rest of Asia
US Healthcare Expenditure:~ US$ 2,000 bln in 2007 ~ US$ 4,300 bln in 2017
Worldwide Healthcare Expenditure: ~ US$ 4,000 bln in 2006
US healthcare jobs vs manufacturing1977 8% 22%2007 11% 10%Source Wall Street Journal
Healthcare is the world’s largest service sector
Healthcare cost will grow from 9% of worldwide GDP in 2005 to ~11% in 2015in US from 16% of GDP in 2007 to ~20% GDP in 2017
0%
2%
4%
6%
8%
10%
1950 2005 20151990
314 May 2008 - Stan Smits Philips Healthcare
Key challenges for the healthcare systems
Building sustainable healthcare systems:
• Value-based reimbursement systems
• Reducing the prevalence of chronic disease
• Coping with the shortage in healthcare personnel
• Reducing healthcare variability
Europe’s population by age groups, 1950-2050
Source: OECD Health Care Quality Indicators ProjectHealth Working Paper 22, 2006
Country differences in hospital mortality rates
13.8
5.3
35
6.9
18
27
0
5
10
15
20
25
30
35
40
Heart infarct Colon Cancer Stroke
414 May 2008 - Stan Smits Philips Healthcare
Value-based healthcare delivery
From focus on Cost to focus on Value
• Value for patients: – Outcome: mortality, morbidity, physical and mental stress,
length-of stay
– Avoiding medical errors
– Disease specific Care Cycles
• Value for society:– Increasing the health of the population and thus economic value
• Value for healthcare systems:– Continuous improvements for more effectiveness and efficiency
– More competitive healthcare delivery
eHealth is pivotal in this transformation to value-based healthcare delivery
514 May 2008 - Stan Smits Philips Healthcare
eHealth definition*
1. Clinical Information Systemsa) Specialized tools for professionals within care institutions
b) Tools for primary care and/or outside the care institutions
2. Telemedicine and Homecarea) Personalized health systems and services, disease management
(usually connecting patient to nurse)
b) Tele-medicine, tele-radiology, tele-care, tele-consultation (usually connecting physician to physician)
3. Integrated regional / national health information networks
4. Secondary usage non-clinical systems
* Definition agreed with the ehealth Industry Stakeholders Group reporting to the i2010 subgroup on eHealth
614 May 2008 - Stan Smits Philips Healthcare
• “eHealth is worth it”: Case study of 10 projects with policy recommendations• “Accelerating the development of the eHealth market in Europe”: lead market
initiative
• FP7 ICT challenge 5: towards sustainable and personalized healthcare• Artemis SP2: Person-centric health management• ITEA2 Roadmap 3 attention for health in the Me, Group and Society domains
eHealth high on the i2010 agenda
714 May 2008 - Stan Smits Philips Healthcare
2. Process
Prevention Diagnosis Treatment SurveillanceScreening Management
Information and Communication
eHealth key enabler in driving new care delivery models…
… which together deliver a full set of care to a patient with a medical condition
914 May 2008 - Stan Smits Philips Healthcare
Discovery to Balloon: Treatment of Heart Attack
Advanced life support monitor
Reliable 12-lead transmission
12-lead forwarding & viewing
Expedite Emergency Department care
Cath Lab or Thrombolytic therapy
Discover Diagnose
Monitor
MRx Monitor/Defibrillator
Transmit
Bluetooth over the Internet
View
12-lead Transfer Station
Transport
IntelliVue Monitor
Treat
Allura 3D-CA Cath Lab
Treat
ECG
Activate Cath Lab
Simultaneous Pagers to all Cath Lab staff
12-ld ECG to Cardiologist’s
Hand-held device
Improve Workflow: Measure component times & feedback
…into Care Cycles (1)
1014 May 2008 - Stan Smits Philips Healthcare
…into Care Cycles (2)
ElectroPhysiology: Integration of information
1114 May 2008 - Stan Smits Philips Healthcare 11
…into Care Cycles (3)
Dutch Mammography Screening:
• 1 Million exams per year
• Exporting and importing > 450 GB per day
• 99.99 % uptime garantee for each component
• More than 835 employees
• Unique screening worklow
• 52 Mobile units
1214 May 2008 - Stan Smits Philips Healthcare
prevention
self care
self pay
chronic care
home care
insurance
eHealth for connecting lifestyle and healthcare
Examples:FP6 MyHeart: Fighting cardiovascular diseases by prevention and early diagnosisFP7 HeartCycle: Closed-loop management of medication and lifestyle compliance
1314 May 2008 - Stan Smits Philips Healthcare
FP7 Project
• Start: March1, 2008
• Duration: 4 years
• Partners: 19 (9 countries)
• Announced EC-funding: ~14.1 M€
– Largest FP7 project in “ICT for Health”
• Coordinator: Philips
Patient Compliance is a major problem in healthcare today.
• Aim: Closed-loop management of medication and lifestyle compliance
• Applications: Heart Failure & Coronary Heart Disease
• Solution:
– Multi-parametric monitoring of vital signs and other variables
– Physiological and statistical modelling of medication and lifestyle effects
– Motivating patients to adhere to treatment regime
– Decision support system for physicians and patients
1414 May 2008 - Stan Smits Philips Healthcare
eHealth as a key enabler for Home Healthcare
• Both in the “prevention” stage and “surveillance” stage of the care cycle, Home Health needs to be integrated into the overall care-cycle view
• Effective chronic disease management and post-discharge monitoring improves patients’ quality of life and reduces recurring hospitalization
Telemonitoring proven to reduce cardiac re-hospitalizations for CHF patients1
eHealth enhances patients’ compliance and self-care regimen
1 TEN-HMS Study published in JACC, May 17, 2005; John GF Cleland, MD, Aggie Balk, MD, et al clinical investigators
1514 May 2008 - Stan Smits Philips Healthcare
Many grassroots eHealth activities
• Microsoft HealthVault
• GoogleHealth
• Many Web 2.0 mash-up services
$144.71 versus $301.23!!
1614 May 2008 - Stan Smits Philips Healthcare
How to encourage adoption of eHealth
• Create a lead market for eHealth at European, national and regional level to connect healthcare providers across the care-cycle, including family doctor, pharmacy, hospital and home care provider
• Address increase in evidence requirements, also in Europe and the slow adoption of proven innovations in the medical community – 15 years from proof of concept to mainstream
• Foster international standards and profiles for eHealth interoperability (DICOM, HL7, IHE, Continua)
1714 May 2008 - Stan Smits Philips Healthcare
In summary, eHealth can catalyze the transformation to value-based healthcare delivery
• Shift from expensive treatment of acute disease in hospital setting to more cost-effective prevention in the primary care setting (however also requires reimbursement incentives)
• Reduce prevalence of chronic disease through early detection and lifestyle compliance
• Reduce the healthcare burden of treating the chronically ill
• Support independent living of the elderly
• Increase productivity to reduce demand for scarce talent and cost
• Increase quality of care using Clinical Decision Support tools
• Improve quality of care and reduce costs through minimally invasive procedures
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