Health Care Impact in Michigan(Health care as an economic engine in Southeast

Michigan)

US Health Care Value Chain

Health Care in Michigan

Health care is one Michigan’s leading industry.

Provides billions of dollars in annual tax revenue and economic stimulus.

Health care jobs stabilize local economies

Health Care in Michigan

In 2007 total full-time and part-time employment in the State of Michigan was 5,454,613North American Industry Classification System (NAICS) industry.

Health care and social assistance 634,675 Ambulatory health care services 220,806 Hospitals 192,006 Nursing and residential care facilities 96,985 Social assistance 124,878

Health Care in Michigan

About 1 of every 10 jobs in Michigan is directly in health care and social assistance (2007 statistic).

Michigan Metropolitan area accounts for 542,637 jobs of the 634,675 (2007 statistic)

Detroit-Warren-Livonia account for 295,863 jobs (2007 statistic)

Bureau of Economic AnalysisBureau of Economic Analysis

Rising costs of therapeutic interventions

Trends

Simplification– Generalists do specialist work– Nurses do doctors’ work– Patients do clinicians’ work– Machines do all the work

Automation– HIT– Robots

Postmodern Medicine– Mitochondrial– Gene Therapy and Pharmacogenomics (Personalized

Medicine)– Regenerative Medicine– Bionic medicine

Globalization

Simplification

Home defibrillator Home dialysis Home pregnancy test Home genetic tests Self-triage, self-diagnose, self-treat on the Web/social

media networks Da Vinci, simulators, augmented reality, etc., simplify

surgery Decision-support software simplifies diagnosis,

epidemiology, … … and much, much more

Automation 1: Admin & Logistics

Administration All aspects of workflow, from patient registration to discharge Logistical systems Equipment and supplies will be tracked, inventoried, and re-

ordered using RFID (radio frequency identification) technology Patients will also be tracked by RFID badges or bracelets, and

point-of-care data from bedside monitors, testing devices, and other sources will be entered automatically into the EMR

Software-based workflow and RFID-based logistics management systems are substantially automated, reducing costs and enabling better service and care for patients

HIT Robots

Automation 2: Communication

Free of the mess of personal pagers, overhead pagers, cell phones, and desk phones that add cost, clutter, complexity, confusion, and noise to most hospital environments

Personal communication systems Wireless everywhere

Automation 3: Quality Measurement & Evidence-Based Medicine

Outcomes tracking – essential to gauge and constantly improve the quality of care delivered

Integrated with EMR, admin, logistics, … Vital for evidence-based medicine Data gathered via the EMR system will be mined for

knowledge of what has worked best for patients with a particular medical makeup, history, and condition (MBE—medicine-based evidence)

Full integration of EMR, financial/admin/logistics systems, business intelligence is a major but necessary strategic investment

Automation 4: Telemedicine

Virtual office visits via live interactive video links and vital signs monitors over the Internet

Virtual rounding via fixed or mobile Internet videoconferencing systems

Specialist consultation via fixed or mobile Internet videoconferencing and remote biomonitoring technologies

Telesurgery now possible with Da Vinci Continual biomonitoring of patient’s vital signs using

sensor technologies in the home, or worn on or implanted in the body

Video will be 3-D/holographic

The Pittsburgh (Good) Example

Pittsburgh Life Sciences Greenhouse

PLSG IMPACTS SINCE INCEPTION• Created 22,000 sq. ft. lab/officeincubator space

• Regional life sciences companyformation rate has increasedfrom 2-3 per year to 15-20 newcompanies per year

• Imported 13 companies towestern Pennsylvania

• Invested $13.3M in VC Funding

• Assisted with $18M in SBIRFunding to regional companies

• 6,000 trainees in biotechnology

• Over 5,000 jobs created

Return on Investment in Biomedical Research

Journal of Life Sciences, 2008

Return on Investment

From JOLS, 2008

Advanced Surgical Technology and Innovation Initiative (ASTi2)

Case Study- Real Time Burn Analysis or Cancer Diagnosis During Surgery

Cost Savings for Burn Patents

    Admit Discharge Day of Day of Day of Day of Day of Day of Day of Day of Day of Potential

MRN Enctr Date Date Surg 1 Surg 2 Surg 3 Surg 4 Surg 5 Surg 6 Surg 7 Surg 8 Surg 9 Savings

890085387 000714428927 08/28/08 10/24/08 15 22 27 33           14606

890093661 000714187648 06/23/08 07/10/08 9 16               5490

  000784934010 07/13/08 07/19/08 No Surg                 0

890183134 000714589207 10/20/08 10/29/08 8 1643

890191553 000784751505 05/29/08 06/01/08 No Surg                 0

  000714215092 07/02/08 07/04/08 No Surg                 0

890202164 000785718883 12/11/08 12/23/08 6 13 2707

890221825 000713773232 03/19/08 04/04/08 8 15               4616

  000786426213 04/01/09 04/02/09 No Surg                 0

890222312 000713806263 03/27/08 04/12/08 8 15 2805

890223517 000713896116 04/15/08 06/06/08 7 10 17 21 24 28 38 45 52 9805

890224468 000713952075 04/28/08 05/10/08 5 11 2419

890231448 000714448701 09/03/08 09/05/08 2 0

890232246 000714495959 09/17/08 10/30/08 8 16 22 27 34 6323

890235948 000714742103 12/16/08 12/30/08 8 15 4526

890236190 000714754496 12/29/08 01/08/09 3 10 888

890236291 000714759941 12/31/08 01/05/09 4 585

890236298 000714770278 01/01/09 01/06/09 5 2521

890237225 000714830171 02/03/09 02/20/09 10 17 6566

890949634 000785373853 10/12/08 10/17/08 4 1611

890961136 000784905655 07/05/08 08/07/08 7 10 14 19 24 27 33 2530

890982009 000785813866 12/29/08 01/02/09 3 927

890984867 000784465379 03/15/08 04/01/08 7 13 3853

890986463 000786060509 02/05/09 02/18/09 6 13 3431

890992181 000784677718 05/10/08 05/23/08 6 13 3014

890995418 000784928178 07/11/08 07/19/08 7 3852

890998884 000785210642 09/14/08 09/18/08 1 2 4             0

  000785244351 09/19/08 10/14/08 5 11 14 18 22         0

891000796 000785374109 10/12/08 10/17/08 3 768

891003739 000785628991 11/26/08 12/04/08 7 3968

891004498 000785689001 12/07/08 12/23/08 10 17 6302

891005521 000785779414 12/21/08 12/23/08 No Surg 0

891007572 000785940537 01/19/09 02/06/09 11 18 7532

981059113 000785677469 12/05/08 12/09/08 4 1508

981221599 000714550571 10/04/08 10/24/08 6 10 18 3508

981225002 000714589025 10/21/08 10/22/08 1                 0

  000714600350 10/28/08 10/29/08 1                 0

981237939 000714801784 01/22/09 01/23/09 1                 0

Total Potential Savings                       108,304

Cost Savings$10

8,304

Technology- Cancer Detection

Early and accurate diagnosis of disease is necessary to curtail the burgeoning costs of health care.

The National Cancer Institute estimates the overall costs for cancer in 2006 at $206 billion; $78 billion for direct medical costs and $128 billion for low productivity and premature death.

A 1% reduction in deaths from cancer would be worth $500 billion, approximately 2.5 times the annual cost of the disease in the US.

Acknowledgements

Dr. Michelle Brusatori (WSU SSIM Program) David Ellis (DMC) Laurie Forbes (iNETWORKS) Steve Loree (DMC Economist)