PowerPoint template, standard version 1

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Processes and Applications in eHealth
Karl-Jürgen Schmitt Siemens Medical
Solutions February 07, 2006
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Healthcare is one of the most important
infrastructure components just as ... Power
... Transportation ... Communication
...
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Healthcare as an Economical FactorHealthcare
could support the goals of the Lisbon Strategy

• Europe
• Expenses for health 8.6 of GDP in
  EU-15
• Employment around 10 of European
  workforce
• 10 increase in average life expectancy means
  0.35 increase of GDP per year
• Germany
• New Jobs in 2003 25 000
• Start-ups in 1995 2002 9 500
• (Medical Technology)

Source Macro-Economics and Health, J. D. Sachs,
WHO, 2001
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Need for more quality and transparency in
healthcare

• Less than 1 dead person on 100 000 adverse events
• Nuclear industry
• European roads
• Scheduled flights
• 1 dead person on 1 000 to 100 000 adverse events
• Road traffic at large
• Chemical industry
• More than 1 dead person on 1 000 adverse events
• Bungee jumping
• Mountain climbing
• Healthcare

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Therefore our common goal should be
Cost
Qualityof Care

• Innovation

By

• Process optimisation

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Improving efficiency with the patient in focus
Sick, injured
Examination
Healed,fit for work
Diagnosis
Therapy
Care
Patient Information Medical Knowledge
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IT is key in integrating and optimising
work-flows throughout the healthcare continuum
Med meets IT
Prevention / Early Detection
Home Care
HealthManagement
Care
Ambulatory Care
Stationary Care
Diagnosis
Therapy
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Optimising healthcare processes with IT
Example Conventional medication process
Review by Nurse
Transcription
Physician Order
Chart copy sent to pharmacy
Medication Errors in the USA Ordering 50 -
55 Transcription 6 - 12 Dispensing 5
- 14 Administration 33 - 38
Order Entry (Rx System)
Administration Documented
Medication Administered
Verification by Pharmacist
Nurse confirms drug, dose, route, time, and
patient
Medication Dispensed
Source Agency for Healthcare Research and
Quality, 2001
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Optimising healthcare processes with IT
Example Conventional medication process
Review by Nurse
Transcription
Physician Order
Chart copy sent to pharmacy
Medication Errors in the USA Ordering 50 -
55 Transcription 6 - 12 Dispensing 5
- 14 Administration 33 - 38
Order Entry (Rx System)
Administration Documented
Medication Administered
Verification by Pharmacist
Nurse confirms drug, dose, route, time, and
patient
Medication Dispensed
Source Agency for Healthcare Research and
Quality, 2001
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Optimising healthcare processes with IT
Example IT-supported medication process
Physician Order
Verification by Pharmacist

• Results
• Process simplification to
• reduce medication errors
• Includes software, barcodes, and
• an automated dispenser system
• All data available for later evaluation

Administration Documented
Medication Dispensed
Nurse confirms drug, dose, route, time, and
patient
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Proven Outcomes in medicationReal results
with IT-supported processes
Preventing 118 potential medication errors
monthly. Estimated annual savings 944 k
Virginia, USA
73 decrease in erroneous and unclear prescription
Stockholm, Schweden
52 reduction of medication turnaround time, 35
reduction of medication errors
Ohio, USA
96 decrease in medication turnaround time
New York, USA
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The applications drive eHealth infrastructure
Customizingand Installation
Integration and technical consultation
Project management andturn key
Consulting
Clinicial and administrative applications
eScheduling eDisease Management eHomecare
ePrescription eReporting ePatient Record
incl.
Network and Security Solutionsincl. VPN,
Directories, Mobile Solutions
Smartcard Solutionsincl. HPC HC
Client Server Hardware
Support incl. Help Desks and Service Hotlines
Operator Solutions incl. ASP
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Improving workflow is our strengthProven
outcomes ASP
ASP (Application Service Providing)
ASP Scale Effectfor 24 x 7 Operations 1

• Centralized data center

7,200people

• Significantly reduces healthcare systems
  investments in IT

• Healthcare systems pay per use

• In the U.S.
• 1,200 Customers
• 200,000 Physicians
• 137 M Transactions/Day

(3 shiftsx2 peoplex1,200sites)
75 people

• In Europe
• 20 customers, 60 potential customers in Germany
• Roll-out in other countries

IndividualDataCenters
ASP (Centralised Data Center)
1 Pure scale effect from human resources point of
view cost for network transmission has to be
added
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Archiving and Image Distribution throughout
Institutions and Hospitals in Austria
Referal
Referal
Institute
CT
Router
Laserprinter
MR
Report
Lasercamera
Images
Workstation
LIC
DLR
Specialist
Hospital
Router
Short Term Archiv
Web
Router
Long Term Archive
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Norway is a leader in utilizing eHealth
The only country-wide use of an Electronic
Patient Record (EPR)
Example Siemens DocuLive EPR in Mid

• 650,000 EPR
• 13,000 users, up to 1,100 concurrently
• (35,000 users in total in Norway)
• 10 Million documents, 25,000 documents per week
• 30,000 discharge summaries sent electronically
  per mo.

North
Mid
West
East
South
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A promising project for disease management with
IT in ScotlandDisease Management Diabetes,
Diabetic Retinopathy (DR)
Huge Potential

• Up to 10 of Europeans diabetic
• 60 of diabetics develop DR
• DR is leading cause of blindness for individuals
  gt 65 years of age
• Blindness can be avoided in 90 of DR cases if
  detected early

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Improvement of chronic conditions is key for more
efficient healthcare

• WHO concluded 60 of health expenditures are
• due to chronic conditions
• Studies indicate that 50 of hospital admissions
  of chronic
• heart failure patents can be avoided due to
  sophisticated
• DM programs containing patient education,
  care
• coordination, care plans and compliance
  monitoring
• The average Medicare beneficiary sees 7
  physicians and
• receives more than 20 prescriptions p.a.
• 18 of people with chronic conditions undergo
• duplicate tests or procedures and 17
  receive conflicting
• information from providers

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Standardize CHF Disease Management

• CHF Disease Management
• Simultaneous implementation of a CHF DM system at
  3 provider sites and subsequent ,joint study
  executed by a professional organization
• Goal
• To prove care quality improvement and demonstrate
  financial impact on providers in three different
  scenarios on a unified workflow, data and
  reporting model
• Method
• Application of
• Unified workflow engine
• Remotely accessible, shared data repository
• Integrated quality-management tools
• Fully automated telephony based patient
  monitoring system

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Streamline Workflow, Optimize Reporting

• LVA Donaustauf Asthma/COPD Disease Management
• Goal
• Optimized Asthma/COPD care in an integrated
  (Payer-Provider) setting
• Method
• Application of a unified workflow engine in a
  clinical-ambulatory scenario
• Integration of sophisticated reporting tools
  allowing the payer arm to efficiently steer
  patient care
• Participants
• PCPS and clinical Competence Centers,
  Call-Centers and patients

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Are high expenditures for health good or bad?
Health The Highest Asset?!
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People are willing to pay for quality (Example
Germany)
Expenditures for Cars
Expenditures of Compulsory Health Insurance
nursing and therapeutic services 25
repairs / maintenance 26
petrol engine oil 21
commodities 30
prevention / health protection 3
vehicle tax 2
others 9
car rental, inspection, parking 12
133 bn
174 bn
medical services 33
vehicles 39
incl. employers share 66,5 bn
Source Statistisches Bundesamt, 2004 (data for
2002)
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Healthcare our largest economic factor!
... its a fascinating area!