European priorities for e Health and implications for ITTanya Znamenskaya

Microsoft Senior Business Developer Central& Eastern Europe

E Health The European approach to eHealth should be about: spending euros on patients not

on paperwork!” “For example, electronic medical records can help doctors to diagnose illness and prescribe treatments more accurately, thus reducing medical errors. It also means cutting down paperwork to improve efficiency. Electronic patient referrals in Denmark are saving €1 million a year and could rise to to €3.5 million a year, if all referrals were sent electronically.„

Health can really help empower patients. Europeans increasingly want to play an active role in decisions relating to their health. eHealth can give them the easy access to high quality health information that they need to achieve this. As part of its current eHealth action plan, the Commission will launch an EU Health Portal later this year, providing a “one stop shop” for health information produced by the EU and a gateway to the websites of national and regional health authorities and civil society groups in the health field

Viviane Reding, European Commissioner for Information Society and Media..

Total Health Expenditures per CapitaEU 15 health spend: 8,6 % of GDPNew Members: 5,8 % per GDPEconomic DrivesEconomic Drives50% of the growth difference between rich and poor is due to ill health 10% increase in life expectancy at birth will increase annual economic growth by 35%Key IssuesKey IssuesSignificant Budgetary Problems – IT Investment Competes with Funding for Other Priorities (Medical Equipment, Medicines, Building Infrastructure) Low end IT FocusKey Investment AreasKey Investment Areas Hospital Information Systems (Local Solutions) Electronic Patient Records (Local Solutions) ERP Functionality, CRM Patient Management Mobile Solutions for Emergency Services (Ministries of Health)

Integrated Hospital Solutions: Hospitals Are Key to Health ModernizationIntegrated Hospital Solutions: Hospitals Are Key to Health Modernization In-patient care accounts for 50% of total healthcare spending in

many European countries Structures are large and complex

Some have more than 10,000 employees and 5,000 beds• EUSF give preference to projects with fast ROI and replicable

solutions

Corporate ManagementBoard Relations, Strategy & Planning, Legal, Accreditation/Compliance, Risk Mgt.

PatientAdministration

Admissions,Scheduling,Registration

PaymentClaims Mgt.,

Revenue CycleMgt., Billing

Enterprise Business OperationsHR/Payroll, Accounting & Finance, Procurement, Materials Mgt., Public Relations

Enterprise IT SystemsSupporting enterprise business operations such as HR, Finance, Supply Chain

Clinical Mgt.Clinical Depts.,Laboratories,

Imaging Centers,Pharmacies

Medical Records

Counter

AncillaryServicesOutpatientCenters,

Social Programs

ExternalExternalChannelsChannels

Insurancecos.

Govt.health

agencies

Patients

Physicians

External External Stakehold.Stakehold.

Healthcare Provider Operations

Mail

Fax

Call Center

Internet

Hospital Budget – Central Europe

Salaries52%

IT4%

Other Eqp10%

Medicine16%

Other18%

Hospital Sector Accounts for 40% of all Health Spending

Good Health in Europe: View of the future

The financial envelope of the public health programme for the period 2003-2008 is € 353.77 million.Budget available for 2006 Euro 55,817 mil

Change of paradigm: towards preventive health: EPR Decision support systems for citizens Connected Europe for Health : e Health research centers across EU Health card it the pocket, e Health records People access to Healthcare services (electronic booking, electronic

prescription..)

Enabling Good Health. A reflection process for a new EU Health Strategy. July 15 2004

EU eHealth: MilestonesEnd 2005:End 2005: National roadmap for eHealth Services EU public health portal

End 2006:End 2006: Common approach for patient identifiers Interoperability standards for messages and records Common approach to finance of eHealth

End 2007:End 2007: Standardized testing and accreditation

End 2008:End 2008: Electronic health insurance card Teleconsultation e- prescription e- referral Telemonitoring, Telecare

Collaborative technologies to support eHealth:Integrated secure infrastructure where physicians, nurses, and administrators share and collaborate on

information in a seamless manner that revolves around a patient thru the continuum of care.

Collaborative Healthcare Scenarios:• Clinical and Administrative Forms Automation•Business Intelligence•Healthcare process integration• Telemedicine and Real-Time Communications•Healthcare Portals & Collaboration

Key Challenges: • Interoperability• Integration Security

SharePoint SharePoint SiteSite

Typical Hospital ScenarioInfo Info

AccessAccess

InfoPathInfoPath

Information Information CreationCreation

DataDataWarehouseWarehouse

Message hubMessage hubBizTalk serverBizTalk server

HL7 CDA XMLHL7 CDA XML

HL7 CDA XMLHL7 CDA XML

HL7 HL7 CDA CDA XMLXML

X Ray,

Surgery

X ray

Remote HospitalDoctor’ office Nurse

Doctor’s home

HL7 CDA XMLHL7 CDA XML

HMS

HL7 CDA XMLHL7 CDA XML

Microsoft Vision for Health

Hospital information system solution for Hospitel of

Levoča Slovakia. EUSF Hospital Shared solutions: Solution HIS: Business management (Navision) Hospital management (EPR – Electronic Patient Record

including subsystems: clinical, doctors, pharmacy, laboratory, biochemistry, hemathology, radiodiagnostics, health insurance connector and managerial overview)

Staff training (300 users) Total project time: 8 months Total project cost: SKV 9.580k (Euro 240k) 50 hospitals in the pipeline

Integrated Care Management

Lead: public payer

Implementation of eHealth networks between physicians, provider,

Rehabilitation services and public payer

care services aim:integral treatment and

support DRGs, case flat rates

eHealthCard

(federal ministry of health and social security)

Definition of the framework conditions for a security

and telematics infrastructure in the health

service

advisory consortium:IBM, SAP, FHG-IAO ICW,

ORGA:

HPCHealth Professional Card

Lead: Landes-Ärztekammer und Landes-KV

(country state medical board of registration and country payors

Provider: federal states and state medical board of registration

for physicians, provider, pharmacies, rehabilitation services

Pilot regions – HPC und eHealthCardcompetition for the best IT solution

Main projects in e Health. Germany: eHealthCard: Integrated Care Networks: Implementation of eHealth networks between physicians, provider and payers

Cocoon Building knowledge driven & dynamically adaptive networked communities within European healthcare systems (FP6 507126http://www.cocoon-health.com/

Solution: Decision support system integrated with EPR unifying general

practices, clinical experts, regional HC services to provide clinical guidelines using semantic integration via web services

The following main functionality is expected: Fast and effective search of relevant medical information Quick on-line access to specialist consultation and opinion Implementation of automated support for diagnosis and treatment based

upon clinical guidelinesConsortium: ASSOCIAZIONE IMPRESA POLITECNICO (IT), CEFRIEL (Centre for

Research and Training in Information Technology), Telecom Italia, Simenes Informatica, EMIC (European MS innovation Centre), INTEGRATED CARE SYSTEMS FRANCE - I.C.S.F. GL2006 EUROPE (UK ), Laguagae and computing (Belgium), Institute of Technology Israel, Politecnical University Madrid, Logicom Greece

Countries: Italy, UK, Greece, Spain, Israel, Belgium FinlandThe project also expects to involve around 10000 health care

professionals in platform trial activities

Microsoft in Healthcare NHS UK (England) Leuven Hospital Belgium Lan Dill Hospital Germany Madrid Healthcare ”1177” – Emergency system Sweden Children Regional Medical Centre – US Guy’s and St Thomas’ Hospital NHS Trust –UK Copenhagen Hospital Arfox Healthcare -SA East Anglia Ambulance Trust Inland Imaging Centre Spokane, US IMS Health UK Clalit Health Services Israel Emergency system Israel Private Medical Centre Moscow