Extending boundaries of connected hospital

Extending the Boundary of the

Connected Hospital

Jim White, VP Connected Hospital

2 | Connected Hospital | April 2010 © Alcatel-Lucent 2010 All Rights Reserved

Specialty Telemedicine

Chronic Disease Management

Today’s FocusChronic Conditions


Source: Wu, Shin-Yi and Green, Anthony. Projection of Chronic Illness Prevalence and Cost Inflation. RAND Corporation, October 2000.

118125

133141

149157

164171

100

120

140

160

180

200

1995 2000 2005 2010 2015 2020 2025 2030

# of

Peo

ple

With

Chr

onic

C

ondi

tions

(m

illio

ns)

3

America’s Health Care CrisisPeople with Chronic Conditions


$850 $2,241

$4,256

$6,178

$8,518

$12,699

$0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 $9,000

$10,000 $11,000 $12,000 $13,000

0 1 2 3 4 5+

Ave

rage

Per

Cap

ita H

ealth

C

are

Spe

ndin

g

Number of Chronic ConditionsSource: Johns Hopkins. Partnership for Solutions, 2004

4

Health Plans Understand the Problem:

Copying, citing, quoting, or distributing without w ritten permission of UPMC Health Plan is prohibited .


23.6 million diabetics in the United States

57 million pre-diabetics in the United States

If every diabetic measures their blood glucose 3 times per day, 69 million readings per day or 25 billion annual transactions.

Consider:

� False positives

� Failed attempts

� Value of the trended information by individual, group, locality

� Opportunities for behavioral change

Large scale human sensing represents a profound opportunity and information management challenge

An extrapolation of a health sensor networking problem

6 | Connected Hospital | April 2010 © Alcatel-Lucent 2010 All Rights Reserved 6

Active Disease

Keeping healthy people healthy

Preventing new disease

Optimally managing active disease

Population segments (based on HA data)

Roam Care Objective

Lower Risk Moderate Risk High Risk Well Managed

Poorly Managed/

Catastrophic

Keep members to the left

35% 30% 25% 8% 2%

Why Telemedicine always fails


PLG Use Case Examples

Symptomatic/Risky

$5/month

Chronic

$15/month

Complex

$250/month

Continuity LayerSelf Directed

System

managed

Very limited involvement from healthcare system

System is a tool to better manage

significant system resources

Why Telemedicine always fails continued


Telephony

End points are People

6 B People

Voice ..64Kbits/sec

Few calls per hr

Point to Point comm.

Data Networks

Endpoints are Computers

>100B computers

Video and data .. 1 Mbit/sec

10’s transactions per hr

Server to many client comm.

Web/Content Servers

Sensor Networks

Endpoints are sensors

>1000B devices

Voice, video, sensor data

(10 mbits/sec)

100’s of transactions per hr

Many sensors to ‘data fusion server’

Evolution of Networks


Sensor Networking Applied to Healthcare

9

Home Aggregation

Analysis Apps

Contact Centre Apps

Clinical/EPR integration

Devices, Sensor, ControlsRoam

Aggregation


Addressing the Patient Care Cycle

Discover

Individual/preferences

Inform

/Educate

Monitor/Evaluate

Motivate

Recommend/treat

Follow-up

The Litmus Test


ContinuaHealth Alliance

Mobile terminal

Glucometer

LAN

Wireless

Home Gateway

AccessNetwork

Multiservice backbone

TransmittersSensors Case Management

BroadbandAccess

Anywhere

Oxymeter

Weight-Scale

Stetho

Camera

Bloodpressure

Patient Gateway

Spirometer

xDSL

FTTx

Clinical Apps

(Video)ContactCenter

CommunicationCollaboration

Patient Family & carers

Care provider

Telco

GP

Specialist

Nurse

Case manager

TeleHealthManager

Application

ElectronicHealthRecord

TechnicalTriage

Billing

Clinical Triage

Panic buttonMotion detect

VideoAssistance

ManagementServices

LocationBasedServices

Set-Top Box

Security &Compliance

TV/Display

E-Health Sensor Network Framework


Economics of Scalable Chronic Disease Management

Symptomatic/Risky

Chronic ComplexSelf Directed

System

managed

Example

sensor

gateway

Clinical System

Case Management

Obesity Mgmt Chronic diabetic CHF/COPD

Pedometer Glucose Monitor/ BP Monito

Scale/BP/ Stethoscope/ Video Camera

none Cell phone Touchscreen PC

Weight control.com

Diabetes mgmt software

Multi-disease management sys

1:10,000 coach 1:1,000 Nurse 1:200 Specialized Nurse

$5/Month $15/Month $250/month


1.Standardized definition of system elements (sub-systems)

2.Investment in development of sub-systems (eco system required/target customer required)

3.Influential (Financially) sponsor

4.Careful avoidance of over dependence on technology initially (i.e. expert systems). Manage cost of human intervention.

Success Factors


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