WHY DOES THE WORLD NEED A HEALTH ORGANIZATION

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AIM Association Internationale de la Mutualité
Chronic Disease Management A Common Vision 20
October 2010 - Dr. Jan Van Emelen
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Overview

1. The Organizations
2. The Challenge
3. The Common Vision
4. The MLOZ experience
5. Our Committment

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AIM
Activities Healthcare financing Healthcare
provision Social services, pensions For 240 mln
citizens
Membership 41 national federations 27 countries
worldwide Europe, Middle-East, Africa,
Latin-America
Values and principles Health and
well-being Autonomous management Not-for-profit
orientation Solidarity
Objectives Interest representation Knowledge
exchange Lobbying Promotion
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COCIR

• Membership
• Companies from HIT, Imaging and Electromedical
  sectors
• National Trade Associations from 13 countries

• Objectives
• Provide the industry voice on healthcare matters
  in EU and abroad

• Focus
• Sustainability of healthcare systems in EU
• Value-based healthcare technology to contribute
  to better health
• Streamline market access and fair competition

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Global Riskschronic disease
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Rise in chronic disease - Healthcare systems
become unsustainable
1 Billion people overweight in developed
developing countries
35 million deaths from chronic disease
60 of all deaths result from chronicdisease
80 of chronic disease deaths occur in low-mid
income countries
Deaths from chronic disease will increase by 17
by 2015
376million type 2 diabetic patients by 2015,
stroke heart disease rising
2
17.5mm
Chronic disease deaths Worldwide
7.6mm
4.1mm
1.4mm
Cardiovascular diseases
Cancer
Chronic respiratory disease
Diabetes
HC spend of GDP
Source WHO Preventing Chronic Diseases October
05
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Our Common VisionFrom treating illnessto
staying healthy
AIM/COCIR Common Vision
For every patientcustomized care

• Health is an investmentnot a cost
• Systematic development and use of best practices
  (e.g. Cancer)
• Improve coordination of care
• Improve patient compliance in medication
  and life style adoption
• Consistent use of HCIT
• Routine use of data analysis to improve
  treatment process and outcome
• Technology enabled
• Hospital to Home for Chronic care
• Broad use of Electronic Health Records

Health Disease Management
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Technology is advancing fast
IT bioengineering
Biotech Genomics
Diagnostics

• eHealth/Telemedicine
• Mobile solutions
• BioSensors
• Computer Aided Diagnostics
• Patient monitoring

• Targeted therapy
• Proteomics/DNA
• Biomarkers
• Rapid screening tools
• Vaccine development

• Faster, accurate imaging
• Molecular imaging
• Minaturisation/portability
• Point of Care diagnostics
• Therapy selection/monitor

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BUTchange is slow

• EU needs policies that facilitate disease
  management approaches
• Focus on disease risk stratification, prevention
  screening programmes
• Encourage best practice patient centric
  processes
• IT solutions to drive quality, safety and
  efficiency, and telemedicine
• Encourage more integrated care delivery
• Use of regulatory procurement to accelerate
  uptake of proven technologies

Obesity-Diabetes, CVD Malnutrition
Cancer
Screening, Early detection Targeted therapy
Stop disease progression
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Disease Management ofCancer
Diagnosis of Recurrence
Detection of Residual Disease
PET/CT New markers
Therapy Evaluation
In-vitro test
Therapy Selection
Cancer Disease Management Track
F18 Agents PET
Staging
CTMRI Radiation Treatment
Diagnosis
Optical Functional Marker
Screening
PET/CT Functional marker
Microarray PACS Electronic Health
Record Medication Management
Predisposition
Microarray
CT MR PET/CT Nuclear Med
Proteomics
Ultrasound MR
Genomics Risk Profiling
Exist Today Emerging Research and Technologies
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Disease management approach will enable shift in
care

• Focus on acute conditions
• Hospital centred
• Physician dependent
• Episodic, reactive care
• Passive patient
• Slow uptake of technology
• Budget silos

• Focus on acute long term conditions
• Community centred
• Team based
• Integrated preventive care
• Knowledgeable patient
• Localised integrated high tech solutions
• Fund continuum of care

Hospital
Home
Primary care/clinic
FUTURE
PRESENT
Low
Acuity
High
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MLOZ experience Mutualités Libres
Onafhankelijke Ziekenfondsen

• Quality and access to care for chronic disease
  Platforms for chronic diseases in the
  complementary insurance, launched in 2005
• Lessons
• HIF is not the place for medical follow-up !
• Healthcare providers were not sufficiently
  involved
• What did we do since?
• AIM DM Working group
• USA Kaiser Permanente
• Israel Maccabi
• Holland Meavita, Groningen
• Assess initiate discussions with all
  stakeholders
• Pilot projects education-coaching ZorgTV
• National Initiative creation of DMC, supported
  by stakeholders and industry
• European Common Initiative AIM-COCIR

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Disease Management needs

• Services development in 4 domains
• Professional enrollment of patient with
• Identification
• Stratification
• Patient empowerment education, coaching,
  monitoring, self-management
• Healthcare providers Process and IT support
• Assessment medical/economic
• New partnerships national and international
  Health insurance funds - healthcare providers
  industry
• New Structures program

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AIM and COCIR are committed to playing our part
to

• Facilitate the building of a Disease Management
  System at European and national levels and
  integrate existing applications
• Participate in European policy development for
  the implementation of this solution (financing/
  legal framework/ adoption by professionals and
  patients)
• Engage with other key stakeholders (e.g. CPME,
  EPF, etc)

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Appendix
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Diabetes a new care pathway
Commonly used BMI cut off values to diagnose
obesity have high specificity, but low
sensitivity to identify adiposity, as they fail
to identify half of the people with excess BF.
Systematic review. Okorodudu, Int J Obesity
201034791-799.
Stop Progression to disease

• Patient _at_ centre
• Improve compliance

• Early visualisaton of body fat - a game changer
  for public health
• Monitor therapy and lifestyle choices, reduce
  drug costs, improve wellness
• Treat patients locally HCIT is critical Expert
  Patient Home Monitoring ?travel

Improved outcomes
Makes Economic Sense