“Healthcare is a people business. To be sustainable, health organizations must communicate and connect with their customers through innovative approaches and fresh perspectives...” Top 7 Trends in Health Care, PricewaterhouseCoopers’ Health Research Institute, 2007
Demand Management and Secondary Care: How healthcare technology helps Erik Sande, GM International Home Monitoring Philips Home Healthcare Solutions King’s Fund Winter Series, February 8, 2012
Interventional X-Ray Analog & Digital X-Ray
CT MR
Nuclear Medicine Radiation Oncology
Sleep & Respiratory Care
Home Healthcare
Ultrasound Cardiac Resuscitation
Ventilation ECG Solutions
Children’s Medical Ventures
Medical Consumables & Supplies
Emergency Care Services
Anesthesia Informatics Cardiology Informatics
Critical Care Informatics
Clinical Decision Support Systems
Maternal & Perinatal Monitoring Solutions Patient Monitoring
Systems Clinical Informatics
Site Planning & Project Management
Ambient Experience Education Services
Performance Services Managed Services
Equipment Maintenance
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The macro view
Demographic challenges are
increasing in advanced economies…
•In US, oldest baby boomer now 66 years old. Large bolus of seniors coming while birth rates and immigration decline.
•Issues compounded in both Europe and Asia, where birth rates and social policies have suppressed birthrates.
•European programs to reverse the low birth rates achieving only limited success, compounded in short-term by debt crisis and impending EU recession
*
4
Prevalence of chronic disease expected to rise 25 and older (millions)
37.033.2
29.1
1.2%
2023 2013 2003
Pulmonary Conditions
20.517.6
14.6
2003
1.7%
2023 2013
Diabetes
64.755.9
46.8
2023 2013 2003
1.6%
Hypertension
33.528.3
23.8
1.7%
2023 2013 2003
Heart Disease
7.96.5
5.4
1.9%
2023 2013 2003
Stroke
47.836.6
30.3
2.3%
2023 2013 2003
Mental Disorders*
* Mental disorders is for all ages, not only 25+ Source: Milken Institute: Economic Burden of Chronic Disease
16.1% 16.4% 16.5%
8.1% 8.7% 9.1%
26.0% 27.7% 28.9%
13.2% 14.0% 14.9%
3.0% 3.2% 3.5%
10.4% 11.5% 13.9%
% of 25+ Pop.
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Majority of health spend on ageing & chronic conditions
Source: Rand Health White Paper – WP-137 (200)3
• Approximately 25% of all healthcare spending occurs at end of life
• 63% of health spending is on 10% of the population; 21% of health spending is on 1% of the population
• 75-80% of healthcare spending is on Chronic Conditions
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How can eHealth help?
Improved outcomes – Financial: lower cost for same/better results – Mortality: lower in randomized control trials – Medical: fewer hospital visits, less bed-days
Higher efficiency – Treating more patients with same number of
care providers Support care coordination
– Enabling sharing of information among different healthcare specialists
Care closer to home – Less visits to the hospital – Less strenuous for frail patients
Empowering patients to be part of their own care
7
The current state: rising costs, staffing shortages, fragmented data, limited interoperability and intelligence
8
The Future: Connected Health Empowering better outcomes and lower costs
9 9
10
Disease Progression (Patient acuity level)
Heartfailure
Diabetes
COPD
Chronically Ill
Observation
Education & Coaching
Monitoring & Education
Frail & Elderly
TeleHealth Solution – Level of Intervention
Patient Empowerment
Cost of disease vs. Acuity level
Implant TH
Vital Sign Mon.
Addressing care coordination & TeleHealth
11
0
1000
2000
3000
4000
5000
6000
7000
Nurse Telephone Support Home Telemonitoring
To
tal C
ost
per
Pat
ien
t (E
uro
)
HomeTelemonitoringService
NurseTelephoneSupport
Hospitalization/Medical Cost
14.8
17.5
10.9 11.5
02468
101214161820
Hospital Days per member Hospital Days/Hospitalization*
Day
s in
Hos
pita
l
Nurse Telephone Support Home Telemonitoring
Reduced Hospitalizations
Cost Savings
Source: TEN-HMS Study, JACC May 17, 2005
Earlier TeleHealth studies have shown benefits 2005 European TEN-HMS Study
Home Telemonitoring led to:
• 26% fewer days in hospital than Nurse Support
• 10% cost savings over Nurse Support program
• ROI of 2.1 vs. Nurse Support
• 29% higher survival rate than Usual Care
12
67,8% 57,2%
62,9%
HF Other cardio
Total cardio
Spanish TeleHealth study showed reduced hospitalization & improved quality of life 2010 Carme Study (92 patients)
13
Consistent findings in 2007 North Carolina Community Health Center study
• Hospitalizations and ER visits decreased during home telehealth program • Positive results continued after telehealth program ended • Total hospital charges dropped 81% during telehealth and continued to decrease
n = 40 In-home patients Analyzed charges are related to diseases being monitored.
Roanoke Chowan Community Health Center / PPCTN Cost Data Ending December 2007
6 - 9 months 9 - 12 months
38 14 11
0
5
10
15
20
25
30
35
40
Prior During Post
Nu
mb
er o
f H
osp
ital
izat
ion
s
Prior 26
During 7
Post 8
0
5
10
15
20
25
30
Num
ber o
f Vis
its
6 months prior
6 - 9 months 9 - 12 months 6 months prior
↓ 63% ↓ 71% ↓ 73% ↓ 69%
Hospitalizations ER Visits
14
2011 Whole System Demonstrator Trial validates earlier studies
WSD Trial • DoH 2 year study of > 6000 patients with long-
term conditions • Patients’ conditions managed at home using
Telemonitoring • 3 trial sites in UK What clinical trial aimed to prove: • If home healthcare reduces mortality rates • If home healthcare reduces hospital visits
How was Philips involved? • 1 of 3 companies chosen: Philips Motiva • 550 patients in London Borough of Newham used
Philips Motiva
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WSD home healthcare study in numbers
Reduction in A&E visits
Reduction in emergency admissions
Reduction in bed days
Reduction in mortality rates
Reduction in tariff costs
NHS potential savings per year using TeleHealth
Knowledge
Timely Reminders and Goal Setting
Health Surveys Feedback on Goals
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Concept: COPD Caregiver Assurance Pack
Medication Dispensing Benefit: • Monitors med adherence
Health Measurement Benefits: • Monitors changes in patient
status
O2 and CPAP Therapy Devices Benefits: • Daily usage information • Insights on patient condition
Emergency Response Benefits: • Escalation in time of need • Call center support
Data to Caregiver Benefits: • Peace of mind • Better care • Ability to manage time efficiently
+
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Home monitoring technology roadmap Common platforms, mobility, apps, international, telecare & telehealth integrated
Exit 1
Exit 2
Exit 3
Exit 4
Exit 6
Exit 5
Cloud Computing
Mobile PERS & Telehealth Gateway
Common Device Platform
mHealth – mobile apps EcoSystem
International
Common Service Platform
Enabled by: Common Architecture, Standard Technologies and Leveraging Philips Global Capabilities
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Slide Number 1Slide Number 2Slide Number 3The macro viewPrevalence of chronic disease expected to rise�25 and older (millions)Majority of health spend on ageing & chronic conditionsHow can eHealth help?The current state: rising costs, staffing shortages, fragmented data, limited interoperability and intelligenceThe Future: Connected Health�Empowering better outcomes and lower costsSlide Number 10Slide Number 11Earlier TeleHealth studies have shown benefits�2005 European TEN-HMS StudySlide Number 13Slide Number 142011 Whole System Demonstrator �Trial validates earlier studiesSlide Number 16Slide Number 17Concept: COPD Caregiver Assurance PackHome monitoring technology roadmap�Common platforms, mobility, apps, international, telecare & telehealth integrated