© 2006 Hewlett-Packard Development Company, L.P.The information contained herein is subject to change without notice

NettverksmNettverksmøøtete4 4 septemberseptember 20082008Roger MorbergDirector, Health Centre of ExcellenceHewlett-Packard Company

Overview

− Healthcare Business Intelligence− The Digital Hospital− Health Centre of Excellence

Information Challenges for Healthcare Providers Quality and Patient

SafetyOperations and Management

Financial Management

• Adverse drug events• Hospital acquired

infections• Procedural complications• Hospital readmissions

• Expense Management• Payer Performance• Cash flow• Contract evaluation

• Resource productivity• Bed utilization• Employee retention• Strategic planning

Trend #1: BI StrategyStepping back to plan the way forward• A common theme among many

organizations in 2007 is the desire to create or re-evaluate their strategy for proactively moving forward with BI

• A BI strategy can take a number of different forms− A high-level business case and vision for

enterprise BI− A roadmap that defines specific BI projects

over a multiyear time frame− An assessment of BI challenges and pain

points• Any strategy effort must meet tactical

information needs while moving toward a more strategic approach to BI

Trend #2: BI GovernanceEnsuring the effectiveness of programs and

investments• A successful governance function ties business

and IT together to help enterprises manage their BI programs and investments

• Governance helps enterprises answer some of their most pressing BI questions:− How do we make sure the dollars we’re spending on

BI are being used effectively?− How do we reconcile conflicting answers we get from

different BI applications?− How do we develop and deliver shared BI services?

• BI governance is a new frontier for many organizations, but there are models for success

Trend #3: C-Level InvolvementSenior executives recognize the importance

of BI• In a 2006 BusinessWeek Research /

Knightsbridge survey of 359 senior executives, more than half the respondents named the CEO as a top decision maker, while almost 40 percent said the same about the CFO

• CFOs in particular are becoming more involved as sponsors of BI− CFOs have growing responsibility for managing

corporate performance− Regulatory scrutiny leads CFOs to champion

data governance programs− CFOs are increasingly seen at the top of

organizational charts for BI and information management centers of excellence

Trend #4: Performance Management

Striving to be more strategic• Performance management is one of the

highest-priority areas for enterprises considering wanting to monitor their activities and operations

• However, many organizations struggle to make their performance management implementations more strategic

• Enterprises struggle with− Defining KPIs that align with business

objectives− Extending usage of those KPIs across

functional areas and employee levels− Integrating data so that they can truly

understand the impact of operational activities on financial outcomes and strategic objectives

Trend #5: Master Data Management

Moving from hype to reality• Enterprises continue to invest in MDM,

but their enthusiasm has been tempered somewhat by challenges they’ve faced− Organizational barriers to prioritizing subject

areas and reaching common definitions− Confusion about MDM technology vendors’

capabilities

• Organizations that are starting out with MDM can make their implementations manageable by − Focusing on a single domain or subject area,

such as customer data integration (CDI) or product information management (PIM)

− Taking a regional approach to MDM–incorporating multiple subject areas but limiting geographical reach

94 September 2008

HP IT 2005: Large scale and scattered

IT 4+% of IT 4+% of revenuerevenue

<50% of <50% of resources resources

time time dedicated to dedicated to innovationinnovation

750+ 750+ data data

martsmarts

100+ HP 100+ HP IT sites IT sites in 53 in 53

countriescountries

5,7005,700applicationsapplications

85+ data 85+ data centers in centers in

29 29 countriescountries

UnderUnder--managed managed networknetwork

>1,240 >1,240 active IT active IT projectsprojects

30% IT 30% IT managemanaged by ITd by IT

~19,000 IT ~19,000 IT professionalprofessional

ssincluding including

contingent contingent workforceworkforce

104 September 200810

HP Top 5 IT Initiatives

Global DataCenters

PortfolioManagement

World-ClassIT

ITWorkforce

Effectiveness

Enterprise Data

Warehouse

114 September 2008

• 30% fewer servers

• 80% more processing power

• Decreased storage cost

• Double the storage (all data replicated)

• 50% lower networking cost

• Triple the bandwidth

• Fewer sites • Faster application rollout

• 60% lower energy bill

• Optimised floor occupancy

HP data center transformationSimplified infrastructure delivers more

MoreLess ==

Process ComplexityClinical Productivity

Steps taken to discharge a patient

Source: Jones, D and Mitchell, A (2006): Lean thinking for the NHS.A report commissioned by the NHS Confederation

Steps taken to discharge a patient from Bolton hospital –results of mapping exercise undertaken by hospital staff

Process complexity and likelihood of error

0.950.610.0850

0.900.370.006100

0.980.780.2825

0.9990.990.951

0.9990.990.95# of

process steps

Probability of success, each process step

Few

er s

teps

Improve quality of each step

Source: Lean thinking for the NHS; Jones, Mitchell

Doctor’s & Nurse’s daily walking• Doctors ~ 9 - 13 km per day ~ 2 - 3 hours−~ 100 - 150 € per doctor per day

• Nurses ~ 4 - 8 km per day ~ 1 - 2 hours−~ 25 - 50 € per nurse per day

• Doctors mileage− Jones (BMJ 1996;312:1542)

• 10,9 km on call per 24 hours (Senior House Officers in General Medicine)

−Clement (BMJ 2006;333:911)• 9 km on a normal day• 11-13 km on an on-call day.

The solution?• Work harder• Work smarter• Or both

HP Digital Hospital Vision

What is a Digital Hospital?

− Relies on technology as an integral & fundamental part of its business strategy

− Enables the organization to leverage its potential for delivering higher-quality care in increasingly efficient ways through the use of IT & process redesign.

− Goes beyond advanced clinical systems & includes additional integration between IT, medical, communication, & building technologies to create a real-time health information environment

Source: PWC

The importance of availability

Time

Clinical Adoptionof IT solutions

Expectations of Availability and Service

Clinician Tolerance for downtime and poor service

Value

Source: CHIME, TLP

• As care processes be-come more dependant on IT clinical expectations of availability increase• Clinicians are used to high availability technical infrastructures e.g. delivery of electricity

St. Olavs Hospital - case

Alarm and tracking

Patient Alarm Patient terminal IP TelephonyFixed/wireless

NetworkInfrastructure

Digital dictation

Peripherals

Cabling

Secure LogonCertificate

Audio/Video

MDA

Meta CatalogMessages application

TV distribution

Operational Tools St. Olavs NTNU

Public Network

ApplikData ApplikData

Implementation

The Digital Hospital Journey

Enhance Infrastructure• IP LAN• Wireless &

mobility• Security

InnovatePilot & rollout e.g.• Messaging & alerts• Location based

services• Asset tracking• RFID

Integrate• Enhance integration of

applications and services• Seamless communications

& alerts• Align applications with

business processes

Service evolution/ New InfrastructureNetwork enhancement

Physical integration

Change Management

Logical integration

Ecosystemintegration

• IP Telephony• Wireless

• Patient bedside terminal/portal

• Patient monitoring

• Better quality of care

• Reduced number of errors

• Improved productivity and decreased cost

• Converged IP network for voice, data and video

• Reinvention and redesign of care processes

• Organizational virtualization

• Ecosystem partner integration

Current state:

Inefficient manualprocesses

Future state:

Technology enabled efficient processes

Alignment - Governance

Clinical Technology

Digital Hospital

Administration

Achieving Change• Vision• Leadership• Buy-in• Internal Champions• Sense of Urgency• One step at a time• Keep Things Simple

BenefitExpectations

Digital Hospital Delivering Business Outcomes

Solution Overview

• Clinical information automatically captured and fed into elec patient record

• Electronic decision support --- accelerating and improving treatment decisions

• Interactions between patients and staff are radically improved

• Changes in patient conditions can be communicated real time enabling faster response

• Location-based services and WiFi tags helps staff locate resources faster and manage assets better

• Bar coding and RFID technologies greatly improve medication administration – one of the most error prone care procedures

• Portable devices and wireless communication extend the organizational boundary, leading to better, more efficient care for chronic-condition patients

• Vast amounts of data can be captured for medical research, speeding the creation of new treatments and healthcare delivery options

• Patients are happier

Accelerate business growth:Speed innovation to transform health

Lower costs / increase efficiency:Improve operational efficiencies

Mitigate risks:Improve quality of care

Benefits for NursesWalking distances

significantly reduced−Old facility 5.3 km = 1

hour 7 minutes of a 7 hour shift

−New facility 3.5 km = 45 minutes of a 7 hour shift

“And I now have greater freedom to deliver on that core service to my patients, thanks to the new tools that the digital hospital solution has given me. I have more time to spend with patients, which I used to spend filling out forms, making endless phone calls, chasing after relevant patient information and test results, or just plain tracking people down.”- Aud Olsen, Head Nurse

© 2007 Hewlett-Packard Development Company, L.P.The information contained herein is subject to change without notice

HP Health Center of Excellence

• State of the art technology center

• Knowledge hub−Subject matter expertise−Best practice

• Market enablement • Education/training center• Research• Lab/test/demo center

Health Alliance partners

• Telenor

• Imatis

• Microsoft

• Cisco