:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

Health Information Exchange and Management, a DACH Perspective

Dr. Axel Paeger, Founder & Shareholder AMEOS Group, Zurich

Competence inACUTE MEDICINE, ACUTE PSYCHIATRY, and LONG-TERM CARE

www.AMEOS.eu

1. THE DACH HOSPITAL MARKET: EXAMPLE GERMANY

Dr. med. Axel PaegerMBA/MBI

Founder & Shareholder of

AMEOS GruppeBahnhofplatz8021 Zürich

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

GERMAN HEALTHCARE MARKET GROWING FASTER THAN GDP

Above GDP-growth of German healthcare market driven by favorable macro developments such as • Shift in demographic structure• Longer life expectancy• Increasing mental or behavioral disorders as a side

effect of ageing population• Increasing acceptance of psychiatric illness • Rise in number of complex treatment

methodologies• Progress of medical technology supports positive

market development

3

CAGR 05-14

in % of German GDP

10.5% 10.3% 10.2% 10.4% 11.4% 11.2% 10.9% 11.0%

117 120 126 132 138 142 144 147 156

25 26 27 28 29 30 31 31 3262 64 65 67 71 74 77 7982

163

33

86238 246

’10’09

270

’12’11

251 257282

’08’07

218 227

’14’05

210204

’06

Ø+3.7%

’13

German Healthcare Market Segments – ‘05-’14 (€bn) Key Drivers

3.6%

3.1%

3.7%

11.2%

Source: Destatis

Outpatient ServicesElderly CareHospitals

11.2%

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

Non-profit35%

Public29%

Private36%

1.956 hospitals (-19%)

Allocation2015

# HOSPITALS DECREASE WHILE PRIVATE ONES GAIN MARKET SHARE

4Source: Destatis

700679577

Non-profit39%

Public46%

Private15%

2.411 hospitals

Allocation1991

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

• Constant growth through acquisitions as well as improvement of medical services

• Steady growth of patients treated leads to continuous increase of revenues

• Turnaround of money losing acquisitions secures long-term EBITDA growth

• 2012/2013 acquisition of additional AMEOS Klinikain the Region East

• 2014 acquisition AMEOS Klinika in the Region West (states Bremen and Lower Saxony)

AMEOS REVENUUE GROWTH SINCE 2003

5

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

AMEOS DEVELOPMENT 2003 – 2016

1.040

11.960

11

68

0

10

20

30

40

50

60

70

80

0

2.000

4.000

6.000

8.000

10.000

12.000

'03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 HJ16Employees Beds/Places Facilities

Empl

oyee

s, B

eds/

Plac

es

Faci

litie

s

1.108

7.637

6

Faci

litie

s

www.AMEOS.eu

2. UNLOCKING PEAK PERFORMANCE: FULFILLING INFOR-MATION EXCHANGE NEEDS AND ADAPTING JOB PROFILES

Competence inACUTE MEDICINE, ACUTE PSYCHIATRY, and LONG-TERM CARE

Dr. med. Axel PaegerMBA/MBI

Founder & Shareholder of

AMEOS GruppeBahnhofplatz8021 Zürich

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

HUGE PORTION OF NO-/LOW-VALUE ADDING EMPLOYMENT TIME IN A TYPICAL HOSPITAL

Physicians on the ward(“residents”) spend about30-40 % of their time beingoccupied with tasks they would not have needed tostudy medicine for.

Nurses on the ward spendabout 20-30% of their timebeing occupied with tasksthey would not have neededto be educated as nurses for.

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

REALITY IN TOO MANY HOSPITALS:NO OR LOW CREATION OF VALUE

No creation of value: on thethird day after the patient’sadmission a medical residentspends two hours to searchfor the patient record.

Low creation of value as re-lated to education or pro-fession: a medical resident spends one hour to make phone calls and organize a patient’s EKG, x- ray, and ENT consult the same day.

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

ooo CXRooo EKGooo ENT consultooo trachea imageooo prepare blood sampling for:

- GPS- SD values (T3,T4,TSH basal)- EK (0/2)

ooo CXRooo EKGooo ENT consultooo trachea imageooo blood sampleooo WMCooo Check:

- lab- premedication protocol- OP consent- diagnostics ordered- cut drawn- histology- and taxi form filled

ooo nurse‘s OR preparationooo premedication

Explanations:o o o = ordered/ dated/

executed plus result availableo o o = grey boxes:

not relevant on this day

STRUMA RESECTION PATHWAY

Pre-Admission Day 1

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

CHANGE IN PROFESSIONS:NURSING TAKES CHARGE OF CLINICAL MANAGEMENT

Physician and nurse commonly use a „quick-check“ table of the pathway in A3 format (or even IT-based).

The resident adapts the pathway for the individual patient via „individual corrections“.

Case manager (primary nurse) is process owner of the patients way thru diagnostics and treatment.

She administers windows (time slots): Scheduling is based on pathway prescriptions.

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

REALLOCATION OF JOBS AND TASKS:BENEFIT FOR PHYSICIANS

Physicians having less documentation andcommunication load.

Physicians stating higher compliance of the nursing profession with prescriptions deviating from standard.

Physicians describing nursing profession as more interested and motivated.

Physicians profiting from improved development perspective for the nursing profession.

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

KEY ECONOMIC RESULTS OFSTRUCTURED INFORMATION EXCHANGE

LOS objectives reached

Costs „occurred“are accurate for diagnosis (DRG)

structured communication betweennurses and physicians

early and continuous discharge planning

13

:: Life and Health in good Hands ::

Session 9: Global perspective on Health Information ExchangeconhIT 2017 April 25th to 27th, 2017 in Berlin Dr. Axel Paeger

Dr. Axel Paeger

14

Thanx for Your Attention!