“Healthcare is a people business. To be sustainable, health organizations must communicate and connect with their customers through innovative approaches and fresh perspectives...” Top 7 Trends in Health Care, PricewaterhouseCoopers’ Health Research Institute, 2007

Demand Management and Secondary Care: How healthcare technology helps Erik Sande, GM International Home Monitoring Philips Home Healthcare Solutions King’s Fund Winter Series, February 8, 2012

Interventional X-Ray Analog & Digital X-Ray

CT MR

Nuclear Medicine Radiation Oncology

Sleep & Respiratory Care

Home Healthcare

Ultrasound Cardiac Resuscitation

Ventilation ECG Solutions

Children’s Medical Ventures

Medical Consumables & Supplies

Emergency Care Services

Anesthesia Informatics Cardiology Informatics

Critical Care Informatics

Clinical Decision Support Systems

Maternal & Perinatal Monitoring Solutions Patient Monitoring

Systems Clinical Informatics

Site Planning & Project Management

Ambient Experience Education Services

Performance Services Managed Services

Equipment Maintenance

3

The macro view

Demographic challenges are

increasing in advanced economies…

•In US, oldest baby boomer now 66 years old. Large bolus of seniors coming while birth rates and immigration decline.

•Issues compounded in both Europe and Asia, where birth rates and social policies have suppressed birthrates.

•European programs to reverse the low birth rates achieving only limited success, compounded in short-term by debt crisis and impending EU recession

*

4

Prevalence of chronic disease expected to rise 25 and older (millions)

37.033.2

29.1

1.2%

2023 2013 2003

Pulmonary Conditions

20.517.6

14.6

2003

1.7%

2023 2013

Diabetes

64.755.9

46.8

2023 2013 2003

1.6%

Hypertension

33.528.3

23.8

1.7%

2023 2013 2003

Heart Disease

7.96.5

5.4

1.9%

2023 2013 2003

Stroke

47.836.6

30.3

2.3%

2023 2013 2003

Mental Disorders*

* Mental disorders is for all ages, not only 25+ Source: Milken Institute: Economic Burden of Chronic Disease

16.1% 16.4% 16.5%

8.1% 8.7% 9.1%

26.0% 27.7% 28.9%

13.2% 14.0% 14.9%

3.0% 3.2% 3.5%

10.4% 11.5% 13.9%

% of 25+ Pop.

5

Majority of health spend on ageing & chronic conditions

Source: Rand Health White Paper – WP-137 (200)3

• Approximately 25% of all healthcare spending occurs at end of life

• 63% of health spending is on 10% of the population; 21% of health spending is on 1% of the population

• 75-80% of healthcare spending is on Chronic Conditions

6

How can eHealth help?

Improved outcomes – Financial: lower cost for same/better results – Mortality: lower in randomized control trials – Medical: fewer hospital visits, less bed-days

Higher efficiency – Treating more patients with same number of

care providers Support care coordination

– Enabling sharing of information among different healthcare specialists

Care closer to home – Less visits to the hospital – Less strenuous for frail patients

Empowering patients to be part of their own care

7

The current state: rising costs, staffing shortages, fragmented data, limited interoperability and intelligence

8

The Future: Connected Health Empowering better outcomes and lower costs

9 9

10

Disease Progression (Patient acuity level)

Heartfailure

Diabetes

COPD

Chronically Ill

Observation

Education & Coaching

Monitoring & Education

Frail & Elderly

TeleHealth Solution – Level of Intervention

Patient Empowerment

Cost of disease vs. Acuity level

Implant TH

Vital Sign Mon.

Addressing care coordination & TeleHealth

11

0

1000

2000

3000

4000

5000

6000

7000

Nurse Telephone Support Home Telemonitoring

To

tal C

ost

per

Pat

ien

t (E

uro

)

HomeTelemonitoringService

NurseTelephoneSupport

Hospitalization/Medical Cost

14.8

17.5

10.9 11.5

02468

101214161820

Hospital Days per member Hospital Days/Hospitalization*

Day

s in

Hos

pita

l

Nurse Telephone Support Home Telemonitoring

Reduced Hospitalizations

Cost Savings

Source: TEN-HMS Study, JACC May 17, 2005

Earlier TeleHealth studies have shown benefits 2005 European TEN-HMS Study

Home Telemonitoring led to:

• 26% fewer days in hospital than Nurse Support

• 10% cost savings over Nurse Support program

• ROI of 2.1 vs. Nurse Support

• 29% higher survival rate than Usual Care

12

67,8% 57,2%

62,9%

HF Other cardio

Total cardio

Spanish TeleHealth study showed reduced hospitalization & improved quality of life 2010 Carme Study (92 patients)

13

Consistent findings in 2007 North Carolina Community Health Center study

• Hospitalizations and ER visits decreased during home telehealth program • Positive results continued after telehealth program ended • Total hospital charges dropped 81% during telehealth and continued to decrease

n = 40 In-home patients Analyzed charges are related to diseases being monitored.

Roanoke Chowan Community Health Center / PPCTN Cost Data Ending December 2007

6 - 9 months 9 - 12 months

38 14 11

0

5

10

15

20

25

30

35

40

Prior During Post

Nu

mb

er o

f H

osp

ital

izat

ion

s

Prior 26

During 7

Post 8

0

5

10

15

20

25

30

Num

ber o

f Vis

its

6 months prior

6 - 9 months 9 - 12 months 6 months prior

↓ 63% ↓ 71% ↓ 73% ↓ 69%

Hospitalizations ER Visits

14

2011 Whole System Demonstrator Trial validates earlier studies

WSD Trial • DoH 2 year study of > 6000 patients with long-

term conditions • Patients’ conditions managed at home using

Telemonitoring • 3 trial sites in UK What clinical trial aimed to prove: • If home healthcare reduces mortality rates • If home healthcare reduces hospital visits

How was Philips involved? • 1 of 3 companies chosen: Philips Motiva • 550 patients in London Borough of Newham used

Philips Motiva

15

WSD home healthcare study in numbers

Reduction in A&E visits

Reduction in emergency admissions

Reduction in bed days

Reduction in mortality rates

Reduction in tariff costs

NHS potential savings per year using TeleHealth

Knowledge

Timely Reminders and Goal Setting

Health Surveys Feedback on Goals

17

Concept: COPD Caregiver Assurance Pack

Medication Dispensing Benefit: • Monitors med adherence

Health Measurement Benefits: • Monitors changes in patient

status

O2 and CPAP Therapy Devices Benefits: • Daily usage information • Insights on patient condition

Emergency Response Benefits: • Escalation in time of need • Call center support

Data to Caregiver Benefits: • Peace of mind • Better care • Ability to manage time efficiently

+

18

Home monitoring technology roadmap Common platforms, mobility, apps, international, telecare & telehealth integrated

Exit 1

Exit 2

Exit 3

Exit 4

Exit 6

Exit 5

Cloud Computing

Mobile PERS & Telehealth Gateway

Common Device Platform

mHealth – mobile apps EcoSystem

International

Common Service Platform

Enabled by: Common Architecture, Standard Technologies and Leveraging Philips Global Capabilities

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Slide Number 1Slide Number 2Slide Number 3The macro viewPrevalence of chronic disease expected to rise�25 and older (millions)Majority of health spend on ageing & chronic conditionsHow can eHealth help?The current state: rising costs, staffing shortages, fragmented data, limited interoperability and intelligenceThe Future: Connected Health�Empowering better outcomes and lower costsSlide Number 10Slide Number 11Earlier TeleHealth studies have shown benefits�2005 European TEN-HMS StudySlide Number 13Slide Number 142011 Whole System Demonstrator �Trial validates earlier studiesSlide Number 16Slide Number 17Concept: COPD Caregiver Assurance PackHome monitoring technology roadmap�Common platforms, mobility, apps, international, telecare & telehealth integrated