1.Health d Wellbeing H l h and W llb i...the important role of eHealth...Fibre To The Home conferenceLisbon Feb 25th 2010 Ton van den Hoven Philips Healthcare

2. Healthcare is the worlds largest service sector world s1% 5% Americas US H lth Healthcare EExpenditure: dit 8% ~ US$ 2,000 bln in 2007 Europe, Mid-East,2% Africa ~ US$ 4,300 bln in 2017 China/HKWorldwide H lthW ld id Healthcare Expenditure: Edit54%Japan ~ US$ 4,000 bln in 200630%US healthcare jobs vs. manufacturing India 19778% 22% Rest of Asia200711%10% Source: MedistatSource: Wall Street Journal Healthcare cost will grow f H lth t ill from 9% of worldwide GDP i 2005 t ~11% i 2015 f ld id into 11% inin US from 16% of GDP in 2007 to ~20% GDP in 2017 10%8%6%4%2%0% Source: OECD, WHO,1950 199020052015PH Internal Analysis2 3. Key challenges for the healthcare systems Europes 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 p p g gpersonnel Reducing healthcare variabilityCountry differences in hospital mortality rates 40 3535302725 1820 13.81510 6.95.3 5 0 Heart infarct Colon Cancer Stroke Source: OECD Health Care Quality Indicators ProjectHealth Working Paper 22, 20063 4. Value based Value-based healthcare deliveryFrom focus on Cost to focus on Value: Value for patients: Outcome: mortality, morbidity, physical and mental stressmortality morbidity 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 efficiencypy More competitive healthcare delivery eHealth i pivotal i thi tH lth is i t l in this transformation t value-based h lthfti to l bd healthcare d li delivery 4 5. eHealth definition definition*1. Clinical Information Systemsa) Specialized tools for professionals within care institutionsb) Tools for primary care and/or outside the care institutions 2. Telemedicine and Homecarea) 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 eHealth5 6. 2. ProcesseHealth key enabler in driving new care delivery models Prevention ScreeningDiagnosis TreatmentManagement Surveillance Information and Communication which together deliver a full set of care to a pgpatient with a medicalcondition6 7. by integrating patient informationby information7 8. 12-ld ECG tointo Care Cycles (1)into CardiologistsHand-heldH d h lddevice Discovery to Balloon:yTreatment of Heart AttackActivate Simultaneousalerts to all Cath Lab clinical staff Advanced life Reliable 12-lead 12-leadExpedite EmergencyCath Lab or support monitor transmission forwarding & Department care Thrombolyticviewingtherapy Discover Di DiagnoseTreat Monitor Transmit ViewTransport Treat MRx Bluetooth over the 12-lead TransferIntelliVue MonitorAllura 3D-CA Cath Monitor/Defibrillator Internet Station LabImprove Workflow: Measure component times & feedback 8 9. into Care Cycles (2)into ElectroPhysiology: Integration of information9 10. into Care Cycles (3)into Dutch Mammography Screening: 1 Million exams per year Exporting and importing > 450 GB per day 99.99 % uptime guarantee f each componentfor More than 835 employees Unique screening workflow 52 Mobile units 10 11. eHealth for connecting lifestyle and healthcare prevention ti chronic care h i 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 11 12. Patient Compliance Patient Compliance is a major problem in healthcare today. Aim: Closed-loop management of medication and lifestyle compliance Applications: Heart Failure & Coronary Heart Diseaseppy 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: March 1st, 2008 Duration:4 yearsy Partners:19 (9 countries) Announced EC-funding:~14.1 Mln Largest FP7 project in ICT for Health ICT Health Coordinator: Philips Healthcare12 13. eHealth as a key enabler for Home Healthcare Both in the prevention stage and surveillance stage of the care cycle, pgg y ,Home Health needs to be integrated into the overall care-cycle view Effective chronic disease management and post-discharge monitoring post dischargeimproves patients quality of life and reduces recurring hospitalization Telemonitoring proven to reduce cardiac eHealth enhances patients compliancepatients re-hospitalizations for CHF patients1 and self-care regimen 1 TEN-HMS Study published in JACC, May 17, 2005; John GF 13 Cleland, MD, Aggie Balk, MD, et al clinical investigators 14. Innovation and integration across the care cycle help deliver better care at lower costs Ultrasound guidance in placing large catheters reduces infections. - British Medical Journal Image-guided stents for brain aneurysms allow patients to return to normal lives after only a month vs. a year. - The LancetX-ray fluoroscopy for openingclogged kidney arteries savesabout $15K per procedure.- Radiology Care Cycles are the best way to transform healthcarefrom a zero-sum game to a patient-value driven industry zero sum patient valueindustry.- Porter and Teisberg, Redefining Healthcare, 2006 14 15. How to encourage adoption of eHealth Create a Lead Market for eHealth at European, national and regional level to connect healthcare providers across the care- cycle, including family doctor, pharmacy, hospital and home care provider Address increase in evidence requirements, also in Europe and the slow adoption of pp proven innovations in the medical communityy 15 years from proof of concept to mainstream Foster international standards and profiles for eHealth interoperability (DICOM, HL7, IHE, Continua) Create Infrastructure and develop enablers for implementation15 16. In summary eHealth can catalyze thesummary, 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)g(q) 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 16