Download An industry view on eHealth

A vendor’s view on eHealth
Stan Smits
Philips Healthcare
14 May 2008
Healthcare is the world’s largest service sector
1%
5%
Americas
8%
US Healthcare Expenditure:
~ US$ 2,000 bln in 2007
~ US$ 4,300 bln in 2017
Europe, Mid-East,
Africa
2%
China/HK
54%
30%
Worldwide Healthcare Expenditure:
~ US$ 4,000 bln in 2006
Japan
India
Rest of Asia
US healthcare jobs vs manufacturing
1977
8%
22%
2007
11%
10%
Source Wall Street Journal
Source: Medistat
Healthcare cost will grow from 9% of worldwide GDP in 2005 to ~11% in 2015
in US from 16% of GDP in 2007 to ~20% GDP in 2017
10%
8%
6%
4%
2%
0%
1950
1990
2005
2015
14 May 2008 - Stan Smits Philips Healthcare
Source: OECD, WHO,
PH Internal Analysis
2
Key challenges for the healthcare systems
Europe’s population by age groups, 1950-2050
Building sustainable healthcare systems:
• Value-based reimbursement systems
• Reducing the prevalence of chronic disease
• Coping with the shortage in healthcare personnel
• Reducing healthcare variability
Country differences in hospital mortality rates
40
35
35
30
27
25
18
20
13.8
15
10
6.9
5.3
5
0
Heart infarct
Colon Cancer
Stroke
Source: OECD Health Care Quality Indicators Project
Health Working Paper 22, 2006
14 May 2008 - Stan Smits Philips Healthcare
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Value-based healthcare delivery
From focus on Cost to focus on Value
• Value for patients:
– Outcome: mortality, morbidity, physical and mental stress,
length-of stay
– Avoiding medical errors
– Disease specific Care Cycles
• Value for society:
– Increasing the health of the population and thus economic value
• Value for healthcare systems:
– Continuous improvements for more effectiveness and efficiency
– More competitive healthcare delivery
eHealth is pivotal in this transformation to value-based healthcare delivery
14 May 2008 - Stan Smits Philips Healthcare
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eHealth definition*
1. Clinical Information Systems
a) Specialized tools for professionals within care institutions
b) Tools for primary care and/or outside the care institutions
2. Telemedicine and Homecare
a) Personalized health systems and services, disease management
(usually connecting patient to nurse)
b) Tele-medicine, tele-radiology, tele-care, tele-consultation
(usually connecting physician to physician)
3. Integrated regional / national health information networks
4. Secondary usage non-clinical systems
* Definition agreed with the ehealth Industry Stakeholders Group reporting to the i2010 subgroup on eHealth
14 May 2008 - Stan Smits Philips Healthcare
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eHealth high on the i2010 agenda
• “eHealth is worth it”: Case study of 10 projects with policy recommendations
• “Accelerating the development of the eHealth market in Europe”: lead market
initiative
• FP7 ICT challenge 5: towards sustainable and personalized healthcare
• Artemis SP2: Person-centric health management
• ITEA2 Roadmap 3 attention for health in the Me, Group and Society domains
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2. Process
eHealth key enabler in driving new care delivery
models…
Prevention
Screening
Diagnosis
Treatment
Management
Surveillance
Information and Communication
… which together deliver a full set of care to a patient with a medical
condition
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…by integrating patient information…
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ECG
…into Care Cycles (1)
Discovery to Balloon:
Treatment of Heart Attack
Advanced life
support monitor
Reliable 12-lead
transmission
Simultaneous
Pagers to all
Cath Lab staff
Activate
Cath Lab
12-lead forwarding
& viewing
12-ld ECG to
Cardiologist’s
Hand-held
device
Expedite Emergency
Department care
Cath Lab or
Thrombolytic
therapy
Diagnose
Discover
Treat
Monitor
Transmit
View
Transport
Treat
MRx Monitor/Defibrillator
Bluetooth over the Internet
12-lead Transfer Station
IntelliVue Monitor
Allura 3D-CA Cath Lab
Improve Workflow:
Measure component times & feedback
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…into Care Cycles (2)
ElectroPhysiology:
Integration of information
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…into Care Cycles (3)
Dutch Mammography Screening:
• 1 Million exams per year
• Exporting and importing > 450 GB per day
• 99.99 % uptime garantee for each component
• More than 835 employees
• Unique screening worklow
• 52 Mobile units
14 May 2008 - Stan Smits Philips Healthcare
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eHealth for connecting lifestyle and healthcare
prevention
chronic care
self care
home care
self pay
insurance
Examples:
FP6 MyHeart: Fighting cardiovascular diseases by prevention and early diagnosis
FP7 HeartCycle: Closed-loop management of medication and lifestyle compliance
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FP7 Project
Patient Compliance is a major problem in healthcare today.
• Aim: Closed-loop management of medication and lifestyle compliance
• Applications: Heart Failure & Coronary Heart Disease
• Solution:
– Multi-parametric monitoring of vital signs and other variables
– Physiological and statistical modelling of medication and lifestyle effects
– Motivating patients to adhere to treatment regime
– Decision support system for physicians and patients
•
Start:
March1, 2008
•
Duration:
4 years
•
Partners:
19 (9 countries)
•
Announced EC-funding:
~14.1 M€
– Largest FP7 project in “ICT for Health”
•
Coordinator:
Philips
14 May 2008 - Stan Smits Philips Healthcare
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eHealth as a key enabler for Home Healthcare
• Both in the “prevention” stage and “surveillance” stage of the care cycle,
Home Health needs to be integrated into the overall care-cycle view
• Effective chronic disease management and post-discharge monitoring
improves patients’ quality of life and reduces recurring hospitalization
Telemonitoring proven to reduce cardiac
re-hospitalizations for CHF patients1
1 TEN-HMS Study published in JACC, May 17, 2005; John GF
Cleland, MD, Aggie Balk, MD, et al clinical investigators
eHealth enhances patients’ compliance
and self-care regimen
14 May 2008 - Stan Smits Philips Healthcare
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Many grassroots eHealth activities
• Microsoft HealthVault
• GoogleHealth
• Many Web 2.0 mash-up services
$144.71 versus $301.23!!
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How to encourage adoption of eHealth
•
Create a lead market for eHealth at European, national and
regional level to connect healthcare providers across the carecycle, including family doctor, pharmacy, hospital and home care
provider
•
Address increase in evidence requirements, also in Europe and
the slow adoption of proven innovations in the medical community
– 15 years from proof of concept to mainstream
•
Foster international standards and profiles for eHealth
interoperability (DICOM, HL7, IHE, Continua)
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In summary, eHealth can catalyze the
transformation to value-based healthcare delivery
•
Shift from expensive treatment of acute disease in hospital setting to
more cost-effective prevention in the primary care setting (however
also requires reimbursement incentives)
•
Reduce prevalence of chronic disease through early detection and
lifestyle compliance
•
Reduce the healthcare burden of treating the chronically ill
•
Support independent living of the elderly
•
Increase productivity to reduce demand for scarce talent and cost
•
Increase quality of care using Clinical Decision Support tools
•
Improve quality of care and reduce costs through minimally invasive
procedures
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