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Karl-Jürgen SchmittSiemens Medical SolutionsJune 07, 2005

eHealth05

eHealth as a Driver to Optimise Healthcare Processes

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Quality Cost

Through:• Innovation• Process optimization

of healthcare delivery

A common goal: Improve healthcare efficiency

Proven Outcomes

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Sick,injured

Healed,fit for work

Patient InformationMedical Knowledge

Examination

DiagnosisTherapyCare

Improving efficiency with the patient in focus

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Therapy

Diagnosis

HealthManagement

Mobile Care

HomeCare

AmbulatoryCare

StationaryCare

Care

IT is key in integrating and optimising work-flows throughout the healthcare continuum

Prevention /Early Detection

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HealthManagement

Medmeets IT

Therapy

Diagnosis

Mobile Care

HomeCare

AmbulatoryCare

StationaryCare

Care

Prevention /Early Detection

IT is key in integrating and optimising work-flows throughout the healthcare continuum

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Integrated IT platforms help improve efficiency

Dicom

Market-driven communication standards must be used

IHE

HL7

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Cos

ts fo

r th

e in

sure

d

Earlyrecognition

Diagnosis Therapy Rehab.

‘Adverse Events’

Actual (w/o ‘Adverse Events‘)

Ideal

Significant potential to improve the quality of the healthcare system

90,000 Deaths1

1Source: Institute of Medicine, To Err is Human, 1999, p.26. American Hospital Association. Hospital Statistics. Chicago. 1999

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Chart copy sent to pharmacy

Medication Errors in the USA

Ordering 50% - 55%

Transcription 6% - 12%

Dispensing 5% - 14%

Administration 33% - 38%

PhysicianOrder

Reviewby NurseTranscription

Order Entry(Rx System)

AdministrationDocumented

Verification byPharmacist

MedicationDispensed

Nurse confirms drug,dose, route, time,

and patient

MedicationAdministered

Optimising healthcare processes with IT

Source: Agency for Healthcare Research and Quality, 2001

Example: Conventional medication process

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Chart copy sent to pharmacy

Medication Errors in the USA

Ordering 50% - 55%

Transcription 6% - 12%

Dispensing 5% - 14%

Administration 33% - 38%

PhysicianOrder

Reviewby NurseTranscription

Order Entry(Rx System)

AdministrationDocumented

Verification byPharmacist

MedicationDispensed

Nurse confirms drug,dose, route, time,

and patient

MedicationAdministered

Source: Agency for Healthcare Research and Quality, 2001

Deaths 7.000 (1999)

Savings Potential $1.6 ... 5.6 billion

* in US hospitals

Effects on Healthcare System *

Optimising healthcare processes with ITExample: Conventional medication process

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Verification byPharmacist

AdministrationDocumented

Nurse confirms drug,dose, route, time,

and patient

MedicationDispensed

PhysicianOrder

Results• Process simplification to

reduce medication errors

• Includes software, barcodes, and

an automated dispenser system

• All data available for later evaluation

Optimising healthcare processes with ITExample: IT-supported medication process

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73% decrease in erroneous and unclear prescription

Stockholm, Schweden

„Proven Outcomes“ in medication:Real results with IT-supported processes

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Preventing 118 potential medication errors monthly.Estimated annual savings: $944 k Virginia, USA

96% decrease in medication turnaround time

New York, USA

52% reduction of medication turnaround time, 35% reduction of medication errors Ohio, USA

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sts

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Project Outcome (2001 – 2002)

Participants

7,000 20% =1,400

Quantifying Vascular Risk Screening: A successful method of Telematic

• Internet-based prevention method to quantify vascular risks

• De-central examination, central and quality controlled reporting by experts

• Participant with higher risk can subscribe in a Disease Management Program

• Partner: University Erlangen-Nürnberg, Siemens Insurance Fund and Siemens Medical Solutions

Project

Higher Risk

Disease Management

Program

Continuation in larger cities with up to 50 000 participants/year

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A promising project for disease management with IT in ScotlandDisease Management Diabetes, Diabetic Retinopathy (DR)

• Up to 10% of Europeans diabetic

• 60% of diabetics develop DR

• DR is leading cause of blindness

for individuals > 65 years of age

• Blindness can be avoided in 90%

of DR cases if detected early

Huge Potential

Quality

Compliance

Processes

Use of Resources

Outcomes

Improved ...

Implementationof an integrated,

IT-supportedDisease Management

NHS Scotland andSiemens Medical

MobileExamination

Inform Patient

Central Evaluation by Experts

Registration,Invitation

• 300.000 exam-inations / year planned

• 73 locations• 5 regional

evaluation centers

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The potential

of carequality

remains very largeto improve the

eHealth ... the key enabler

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What do we need to do to realize the potential?

Patients / healthy individuals must be in focus Define which healthcare services should be

regulated and which aspects should be open to competition (more competition)

Define which healthcare services should be publicly financed and which services should be an individual’s responsibility (more individual responsibility)

Implement standardized quality metrics Performance needs to be recognized.

Healthcare must be attractive for the best and brightest minds

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Healthcare is one of our most important infrastructure components

just as ... Power ... Transportation

... Communication ...

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The EU Commission concluded:Good health is the basis for economic growth*

Increase of 10% of life expectancy leeds to 0.35% of GDP growth

50% of the growth differential between rich and poor countries

are due to bad health and lower life expectancy

People conclude:Health is the most valuable asset

Health is the lever for prosperity

*Macroeconomics and health: investing in health for economic development, Report on the Commission on Macro-economics and health, Jeffrey D. Sachs, WHO, 20 December 2001

Change of paradigm

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How to draw attention to this possibility?1. Through contacts to and information of national health

authorities

2. Through a congress: “Improving Healthcare Infrastructure

in an Enlarged Europe”

• Organized by the “European Health Forum Gastein”

on October 04, 2005 in Bad Gastein, Austria

and at least two follow up congresses in 2006 and 2007

• Target Groups:

European Commission (showing the potential)

Health Authorities of new Member States

(proposing projects)

• Sponsor: COCIR

19Healthcare … our largest economic factor!

... eHealth plays a key role!

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