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© 2010 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 1 Cisco Confidential 1 © 2010 Cisco and/or its affiliates. All rights reserved.

Showcasing Innovations in Care Delivery

Ash Shehata, Senior Executive Director Cisco Systems Healthcare Business Transformation, The Americas February 21, 2012

© 2010 Cisco and/or its affiliates. All rights reserved. Cisco Confidential 2


Industry Trends

Innovations

Getting Started

Case Studies/Demonstrations


“Our goal is for Cisco to lead the transformation in the healthcare industry's complex transition.”

John Chambers, Cisco CEO,

October, 2011


Providers Payers Pharma and

Biotech

Medical Device

Manufacturers


Providers Payers Pharmaceutical

and

Biotech

Companies

Medical Device

Manufacturers

Providers

• Consolidate

• Reduce costs

• Increase productivity

• Shift to new care

settings



and

Biotech

Companies

Medical Device

Manufacturers

Payers • Inspire better

choices

• Reward preventative

behaviors

• Reduce

administration, not

access



Companies

Medical Device

Manufacturers

Pharmaceutical and Biotech Companies

• Innovation/Sales

Effectiveness

• Shift to more

generic drugs

• Increasing importance

of developing countries



and

Biotech

Companies

Medical Device

Manufacturers

Medical Device Manufacturers

• Monitor chronic

conditions

• Develop for an

aging population

• Balance

innovation with

cost


Five Realities for Healthcare

Healthcare is borderless

Patient experience will be the differentiator

Payments are tied to quality, cost and access

Social services are integrated with healthcare

Healthcare is adapting to new business models

1

2

3

4

5

Cisco Confidential 11 © 2010 Cisco and/or its affiliates. All rights reserved.

Global economics have caused your workforce

to become more distributed

and outsourced

Influenced by the consumer world, your

employees have changed the way they

work

Customers expect timely, personalized responses,

interactions with communities, and the ability

to self-serve

Your Customers Have Changed

Your Business Is Distributed

Your Employees Have Changed

Source: Cisco IBSG, 2009


Sources: NCR, 2008; Avenue A / Razorfish, 2007

Consumers Want Responsive, Personalized Experiences

Online penetration: Europe, 43%; U.S., 71%; Asia, 14%

Mobile phone penetration: Europe, 96%; U.S., 80%; Asia, 27%

46% of mobile phone users view social networking pages on mobile devices

1B instant messaging users

Discussion forums are new

support channel

U.S. / Canadian consumers

prefer self-service

86% prefer companies

with self-service

66% believe self-service

creates positive image

Customers want a say in

the design process

Nokia, P&G, others

co-create products

with customers

Millions of people use social networking sites

21% use discussion boards

100,000 blogs created daily

41% publish their own blog, or comment on blogs

12% post ratings / reviews

62% read peer reviews before purchasing

Embracing Technology

Sharing Thoughts and Ideas

Self-serving and Co-creating


What Is Collaboration?

Collaboration:

People Working Together Toward a Common Goal

Shared Vision, Rules, and Rewards

Knowledge Sharing

Timely, relevant

Innovation Open, inclusive,

needs-driven

Decision-making

Diverse, empowered

Operational Excellence

Aligned, efficient



TIME

• By 2015 there will be 7.4 billion 802.11n devices in the

market.*

•1.2 billion smartphones will enter the market over the

next five years, about 40% of all handset shipments.*

• Smartphone adoption growing 50%+ annually.**

• Currently 16% of mobile data is diverted to Wi-Fi, by 2015

this will number will increase to 48%.*

• By 2012, more than 50% of mobile devices will ship

without wired ports.***

Source: *ABI Research, **IDC, *** Morgan Stanley Market Trends 2010

Big

http://www.youtube.com/watch?v=Ct0KTSHhhg8&feature=player_embedded


Our users

…are diverse


Yesterday’s solutions aren’t enough. Customers want to

be taken care of...

at any time, in any location, and on any device.


Simple Information Passing E-mail/

Voicemail/ Chat

Rich Discussion

Videoconference/ Videomail

Information Review

Phone/ Web Conference/

Shared Workspace

Complex/Emotional Interaction

Face to Face


Ris

k

Hig

h

Lo

w

Trust Low High


Tailored Unique Experience & Performance Profiles, and Enforcement for each User, Device, Location & Application

Secure Connected: Wired, Wireless Protected from Internet & Apps

Apps Delivered- Always Rich Media (Voice, Video) Experience, HA, Seamless Mobility VDI- Any scale, Any time Location Enhanced

Device Confidence & Choice 1000’s of devices certified to interop


Connected Care Patient

Mobile HealthPresence Clinic

HealthPresence Patient side

HealthExperience

HealthPresence xR

EMR/HL7Networks

Cisco MDES

HealthPresence Doctor side

Cisco Healthcare Services Exchange

Ambulance IPCC

Connected Care Team

HealthPesence xR


Source: Cisco IBSG 2011, pateintslikeme.org, Clay Shirky, Here Comes Everyone , Penguin Press 2008

Business-class social networks Organizing without organization Crowdsourcing


Release 2.0 - A Comprehensive Collaboration Platform

Content

Management

Social Tagging

People, Communities,

Information, Search

Click to:

Call, IM, Meet

Personal

Dashboard

Directory

Profile

Blogs, Wikis,

Forums

Video

Community

Team Space

UC-Enabled

Browser

Policy and

Security Micro-Blogging


• Video informed consent improved patient

comprehension (78%) compared to verbal

informed consent (65%) for knee

arthroscopy 1

• Video chemotherapy education improved

retention of information and management of

side effects 2

• Video improved sunscreen adherence and

melanoma knowledge 3, 4

• Video educated heart failure patients had

better self adherence 5

Source:

1 Guttman D, et al. Arthroscopy ,June 2005

2 Kinnare N, et al. European Journal of Cancer Care, July 2008

3 Idriss NZ, et al .Telemed J E-Health, December 2009

4 Loescher LJ, et al. Arch Dermatology, August 2010

5 Albert, NM, et al. Patient Education Council , December 2007


Conversational Interfaces

Source: Cisco IBSG, 2006-2008

Automatic emotions, gestures and responses

Speech recognition

Text to speech

Knowledge of previous encounters (memory)


• Self service

• Connected to internal

information

• Connected to external

information

• Virtual person user interface



Pharmacist or Technician Introduces the Virtual Health Advisor Station

Customer Tries the Station

Talks to Expert

Scans in Prescription

Gets Product Information



Marketing

Data Member

Plan

Data

Clinical

Data

Claims

Data

Chat

Email

Web Portal

Video Content

Phone

Kiosk

Intelligent Routing Engine


Combining Traditional Tools

Finesse Agent Desktop

Virtual Contact Center

Routing & Reporting

Social Media Customer Care

Speech Self-Service

Multi-Media Capture & Storage

UC Integration

Video-Enabled Customer Care

Multichannel / CRM

Customer Collaboration

with the Power of the Future


Customer Service

(VoWLAN)

Find item

In-Store Concierge

Come Help Me!

(location-based

– Phase 3)

POS and

Home delivery Price/Inventory

Check

Shopping

List

Mobile Concierge Applets

Recipes

(video clips)

Pharmacy

My Promos

(coupons)

Shopping

Buddies (IM)

?

Prescription is ready

http://images.google.com/imgres?imgurl=http://www.impartex.ca/images/delivery_icon.jpg&imgrefurl=http://www.impartex.ca/photo4.html&h=157&w=157&sz=5&hl=en&start=4&um=1&tbnid=_QjQ8HmhYck2kM:&tbnh=97&tbnw=97&prev=/images?q=home+delivery+++icon&svnum=10&um=1&hl=en

http://images.google.com.au/imgres?imgurl=http://www.muppetcentral.com/_images/artwork/chef.jpg&imgrefurl=http://www.muppetcentral.com/news/2001/070301.shtml&h=307&w=246&sz=20&tbnid=MInS2PAOE9ACjM:&tbnh=117&tbnw=94&prev=/images?q=chef+pictures&start=2&sa=X&oi=images&ct=image&cd=2

http://images.google.com/imgres?imgurl=http://www.rivnet.net/nnfhc/Logo.jpg&imgrefurl=http://www.rivnet.net/nnfhc/&h=1455&w=1582&sz=63&hl=en&start=10&sig2=R9pF1-O8XKSg1TlSc3u7GQ&tbnid=PogcauR2tI1xGM:&tbnh=138&tbnw=150&ei=Rij8RsWrIozGgAOUpPzqDQ&prev=/images?q=pharmacy+logo&gbv=2&svnum=10&hl=en



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reserved. 32

Care-at-a-Distance and Clinical

Workflow Solutions

Deliver better care and wellness whenever and wherever


Mobile Units Desktop Video

Stationary Care

Patient comes to

the clinic

Desktop care

Low cost

Low-bandwidth

SmartPhones

Wireless Tablets

Mobility

Mobile Devices

Mobile

Carts Mobile Care

Care comes to

the patient

QUAD

http://onetandberg/C1/Tactical/Image Library/Forms/DispForm.aspx?ID=5


Bedside Consults

Telehealth

Discharge Efficiency

Training/ Knowledge

Sharing

Language Interpretation

Home Healthcare



Medical-Grade

Network

1. Doctors requires

triage support

2. Place call to

specialist center

3. Call routed to appropriate

specialist center, based on

symptoms and preliminary

diagnosis

Establish Specialist Video Call

Establish Specialist Audio Call

• Greater access to specialists at time of need

• Higher staff productivity

• Leverages specialists across the healthcare delivery network

BUSINESS

VALUE

Cisco Expert on Demand Provides an Integrated Solution to Provide a Multimedia Service Between Healthcare Providers, Dependent of Specialty Required


Nurse Call Integration

Video-Based Training

Asset Tracking

Proximity-Based Care

Patient Tracking

Mobility

Improve clinical processes by integrating

location tracking and sensor monitoring.

• Cisco HealthPresence

Context-Aware Healthcare

• Combine RFID and

WiFi to track patients,

providers and equipment

• Track temperature and

humidity to monitor

expensive medications

and specimens

• Reduce over

procurement of assets

• Reduce cost by

leveraging the existing

network


• Manage medical equipment, hospital beds and controlling assets

• Issue patient location alerts and cost-effectively locate staff

• Reduce waste with condition alerts

• Manage security and regulatory compliance

BUSINESS

VALUE

Context-Aware Healthcare Improves Clinical Processes with Real-Time Resource Location Information and Access to Environmental Information

to Help Provide an Optimal Patient Experience

Asset Management

Equipment Maintenance

Condition Monitoring

Patient and Staff Safety

Patient Flow

Network Security

Network Visibility

Asset, Patient, and Staff Visibility Network Visibility

Cisco Confidential


reserved. 40

Continuing Health Education and

Collaboration Solutions

Collaborate to innovate using video for R&D, sales and marketing,

manufacturing supply chains, corporate functions, and more


CME Certification

Education and Employee

Communication

Research Trials

Training and Administrative

Communications

Crisis Management

Patient Wellness and Community Support Groups

Cisco Confidential


reserved. 42

Medical Grade Network


Medical Grade Network Framework

Data Center

Providing an Infrastructural Foundation Throughout the Continuum of Care

Enable patients and guests to stay connected through secure connectivity

Enable an interoperable healthcare ecosystem through a flexible and scalable network framework

Bring connectivity to the hospital's

infrastructure through automated biomed

devices

Meet government and industry mandates through a regulatory

compliant architecture (ex: PCI)

Allow nurses and doctors to administer patient care from anyplace, anytime through secure wireless capabilities


Ubiquitous Wi-Fi access

Secure access to patient EHR with AnyConnect

Enhances caregiver productivity with location information

Borderless

Healthcare

Delivers



Collaboration

Leadership Governance

Technology

Do you have the right leadership to drive

collaboration for your organization?

What is your governance model? Does it encourage / sustain optimal collaboration?

Do your employees have the competency

to collaborate?

Which collaborative technologies do you have? How do employees use them?


Competency

Focus on Four Critical Areas


Collaborative Applications

Composite Applications

Messaging Conferencing Informing Virtual Worlds

Secure, Reliable, Scalable, Virtualized Network as the Platform

Twittering

SMS / MMS

Instant messaging

IP telephony

Unified messaging

Email

Calendaring

Immersive

Video

Web

Voice

Wikis

Blogs

Forums

Podcasts

RSS / other

Semantic analysis / advanced search

Basic search / locate expertise

Socialization

Presence

Virtual beings

Artificial intelligence

Content creation

Virtual reality infrastructure

Real-time communication

Mobility Application

delivery Security Management Virtualization Transport

Enterprise systems / data Computing resource Storage resource Ecosystem sys. / data


Typical Existing Strategic

Foundation

Low-hanging

Fruit Advanced

Capabilities


Identify business drivers—what are the critical business challenges?

Conduct collaboration-readiness assessment—what are the gaps between processes, culture, infrastructure, and organizational capabilities?

Define scope—what are the relevant areas with highest impact?

Develop governance model—who is responsible / what is the process?

Build business case—which key benefits justify the effort / resources?

Develop architectural roadmap—what is the long-term technology plan to achieve the ideal future state?

Identify pilots—what are the optimal pilot and preproduction test environments for new processes and technologies?

Plan communication, training, adoption—what is the best way to raise awareness, develop skills, and change behavior for maximum adoption?





1. Patient Calls

for appointment

2. Master Scheduler

receives call

3. Scheduler books resources 4. Cisco Vitals shows appointment

5. Nurse greets patient on-site 6. Nurse uses the “One Click to Connect”

from Vitals App


Patients

Aged 16 to 75+

51% male, 49% female

Remote clinic experience for patients with non-life-threatening illnesses and injuries

Patient Results

99% 95% 93% Were satisfied with the

experience Felt the visit

was confidential Would recommend

the service


Cisco LifeConnections Health Center in San Jose provides an alternative to in-person doctor visits for employees in Research Triangle Park, North Carolina

UHG coordinated administrative process (scheduling, payments, coordination of benefits, network availability of clinical services)

Patient Results

97% 98% 90% Were able to communicate effectively with healthcare

professionals using the service

Were comfortable using the technology

Would recommend the service


CHALLENGE SOLUTION

RESULTS

• Increased patient access to quality care closer to home, reducing travel time, costs and stress

• Provided a patient experience similar to an office visit but with better specialist availability, increasing patient satisfaction and convenience

• Delivered enhanced acoustics and magnified exam images directly to the specialist

• Improved access to specialists and providers throughout the area while reducing “windshield time” for the specialist and patient alike

• To provide high quality, specialty healthcare services to remote patients

• To reduce travel time for specialists providing outreach services

• To reach efficiently extend the catchment area of St. Thomas Health

Converged communication and collaboration framework

Wide array of collaboration endpoints

Advanced telemedicine services


CHALLENGE SOLUTION

RESULTS

• Reduction in ER visits and outpatient diagnostic services: 10 % fewer than community

• Generic Dispense Rate: 73% vs. 62% community

• Medical Cost Avoidance: $ 4.7 M

• Drug Savings: $ 1.3 M per year

• Productivity Savings: $ 7.4 M per year

• Patient Satisfaction: 95% would use again in future; Patient wait time less than 3 minutes

• Reduce the health benefits cost for a large, young, corporate employee population

• Engage employees and dependents in the management of their health

• Use technology to enhance the patient experience and reduce non-clinical time in care process

• On-site clinic and pharmacy built on Patient Centered Medical Home model with broad continuum of integrative health services

• Technology solutions - from automated check-in and check-out to telehealth – to increase productivity and engagement in health as tenet of corporate culture



• “By virtualizing our data center and end-user workstations, we are well on the way to significantly increasing productivity for clinical users and for our team. Not only is virtualization viable for our clinical areas, it is a big improvement.”—Edward Ricks, Chief Information Officer and Vice President, Information Services

CHALLENGE SOLUTION

RESULTS

• Physician Practices can get out of the business of acquiring, implementing and

maintaining electronic healthcare record applications

• Simplify the use of information by making the technology less visible

• Enables care coordination across corporate boundaries and different levels of

care

• Leveraging a collective repository of clinical information assets accelerates

research for new treatments

• Information about a patient is highly

fragmented and exists across many

different healthcare organizations such as

hospitals, clinics and claims systems

• Holistic management of this information is

currently lacking in the industry

• Coordination of care across the continuum

is impacted due to the inability to share

information

• Consolidated patient information moved into

the cloud that would let the physicians

access all of the information through a single

portal

• Leverage this same cloud platform to deliver

hundreds of other technology based

healthcare products

•Revenue Cycle Services

•Tools for Wellness Programs

•Pharmacy Benefits Management


• “By virtualizing our data center and end-user workstations, we are well on the way to significantly increasing productivity for clinical users and for our team. Not only is virtualization viable for our clinical areas, it is a big improvement.”—Edward Ricks, Chief Information Officer and Vice President, Information Services

CHALLENGE SOLUTION

RESULTS

• Decr monthly operational mtg costs 71 percent ~ $1.37 M annual savings

• Improved patient care and staff productivity due to increased collaboration

• Increased tumor board attendance by 100 percent

• Burnished Sentara’s reputation for leveraging technology to help business

• Improve access to clinical expertise and

knowledge within Sentara

• Dedicate more time to patient care by

reducing meeting and travel time

• Provide off-site access to WebEx when staff

is forced to travel

• Enhance patient care using innovative and

collaboration based technologies

• Implement Cisco WebEx throughout all

100 healthcare facilities

• Outsource collaboration solution to

provide more scalability


Physician receives

call about patient

Reviews

comprehensive view

of patient record

Looks up care team

for patient

Click-to-video

with nurse

Video consult

with patient

1 2 3 4

Enhance physician satisfaction by reducing complexity

Attract and retain best physicians creating competitive advantage

Improve patient care and accelerate time to treatment

Improve patient satisfaction

H

BUSINESS

VALUE


Patient presents at

Emergency

Department with

potential symptoms

of stroke

Triage nurse reviews

patient symptoms

Nurse initiates video

consult with stroke

consultant/

neurosurgeon

Stroke consultant is

on rounds

Uses Cisco Cius to

provide remote

diagnosis

1 2 3 4

Save valuable minutes in stroke diagnosis

Improved patient outcomes—prevent loss of brain cells

Better utilization of specialist resources

BUSINESS

VALUE

H


Medical sales rep

visits prospective

member

Prospective member

has questions on plan

information

Sales rep provides

up-to-date plan

information from

Cisco Cius

Customer has

additional questions,

requiring an expert

Cisco Cius enables

real-time video

collaboration with

expert

Electronically capture

signature, attach

supporting documents,

and initiate enrollment

1 2 3 4

Ensure availability of up-to-date product and provider information

Increase plan enrollment with on-demand and on-site product expertise

Streamline sales and enrollment process

BUSINESS

VALUE

H


Connected Workplaces:

• Increasing quality work hours by avoiding in-office distractions

• Spending commute time being productive

• Improving responsiveness to colleagues and clients with anytime, anywhere access to email and vital company data

• Enabling business owners and managers to monitor activities at the office, even when traveling for work or pleasure

Collaborative Tools Improve Convenience / Productivity

Distributed workforce can boost productivity through:

Projected real estate cost reduction: $82.5M

Projected annual energy cost reduction: $600,000

Cisco Connected Workplace Results:



Communication • Satellite Station • Structure Cabling System

Medical • AED • Health Assessment Devices • Oxygen Supply • Basic Medical Supply

Auxiliary Features • Air Conditioning • 50” LCD Display • Audio & Visual System • Real Time Surveillance Recording • Generator Set • 5.5m Elevate Flood Light System • Drinking Water • Lightning Protection • UV Emitter Cleaning System • TIO2 Self-Cleaning Coating • Storage Compartment

WIFI TelePresence Unified

Communication IPICS

IP Surveillance

Operation Mode

• Psychological Counseling Service

• Emergency Command Center

• Healthcare Service • Health Education


HK-SC HealthPresence Centre – Opened April 2009

Psychological Counselling Centre

Huaxi Hospital

Chengdu

Chengdu

People’s Hospital

Prince of Wales

Hospital Hong Kong

Mobile Clinic

Temp Clinic

Mobile hand-held device

HK-Sichuan Rehabilitation Centre: Traumatology


Documents

Showcasing Innovations in Care Delivery - cisco.com · creates positive image Customers want a say in the design process Nokia, P&G, others co-create products with customers Millions