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Stan Smits

A vendor’s view on eHealth. Stan Smits. Philips Healthcare. 14 May 2008. Healthcare is the world’s largest service sector. US Healthcare Expenditure: ~ US$ 2,000 bln in 2007 ~ US$ 4,300 bln in 2017 Worldwide Healthcare Expenditure: ~ US$ 4,000 bln in 2006

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Stan Smits

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  1. A vendor’s view on eHealth Stan Smits Philips Healthcare 14 May 2008

  2. Healthcare is the world’s largest service sector US Healthcare Expenditure:~ US$ 2,000 bln in 2007 ~ US$ 4,300 bln in 2017 Worldwide Healthcare Expenditure: ~ US$ 4,000 bln in 2006 US healthcare jobs vs manufacturing1977 8% 22%2007 11% 10%Source Wall Street Journal Source: Medistat Healthcare cost will grow from 9% of worldwide GDP in 2005 to ~11% in 2015in US from 16% of GDP in 2007 to ~20% GDP in 2017 10% 8% 6% 4% 2% Source: OECD, WHO, PH Internal Analysis 0% 1950 1990 2005 2015

  3. Key challenges for the healthcare systems Europe’s 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 personnel • Reducing healthcare variability Source: OECD Health Care Quality Indicators ProjectHealth Working Paper 22, 2006

  4. Value-based healthcare delivery From focus on Cost to focus on Value • Value for patients: • Outcome: mortality, morbidity, physical and mental 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 efficiency • More competitive healthcare delivery eHealth is pivotal in this transformation to value-based healthcare delivery

  5. eHealth definition* • Clinical Information Systems • Specialized tools for professionals within care institutions • Tools for primary care and/or outside the care institutions • Telemedicine and Homecare • Personalized health systems and services, disease management (usually connecting patient to nurse) • Tele-medicine, tele-radiology, tele-care, tele-consultation (usually connecting physician to physician) • Integrated regional / national health information networks • Secondary usage non-clinical systems * Definition agreed with the ehealth Industry Stakeholders Group reporting to the i2010 subgroup on eHealth

  6. eHealth high on the i2010 agenda • “eHealth is worth it”: Case study of 10 projects with policy recommendations • “Accelerating the development of the eHealth market in Europe”: lead market initiative • FP7 ICT challenge 5: towards sustainable and personalized healthcare • Artemis SP2: Person-centric health management • ITEA2 Roadmap 3 attention for health in the Me, Group and Society domains

  7. eHealth key enabler in driving new care delivery models… … which together deliver a full set of care to a patient with a medical condition 2. Process Prevention Screening Diagnosis Treatment Management Surveillance Information and Communication

  8. …by integrating patient information…

  9. …into Care Cycles (1) ECG 12-ld ECG to Cardiologist’sHand-held device Discovery to Balloon: Treatment of Heart Attack Simultaneous Pagers to all Cath Lab staff Activate Cath Lab 12-lead forwarding & viewing Advanced life support monitor Reliable 12-lead transmission Expedite Emergency Department care Cath Lab or Thrombolytic therapy Diagnose Discover Treat Monitor MRx Monitor/Defibrillator Transmit Bluetooth over the Internet View 12-lead Transfer Station Transport IntelliVue Monitor Treat Allura 3D-CA Cath Lab Improve Workflow: Measure component times & feedback

  10. …into Care Cycles (2) ElectroPhysiology: Integration of information

  11. …into Care Cycles (3) Dutch Mammography Screening: 1 Million exams per year Exporting and importing > 450 GB per day 99.99 % uptime garantee for each component More than 835 employees Unique screening worklow 52 Mobile units 11

  12. eHealth for connecting lifestyle and healthcare prevention self care self pay chronic care home care insurance Examples: FP6 MyHeart: Fighting cardiovascular diseases by prevention and early diagnosis FP7 HeartCycle: Closed-loop management of medication and lifestyle compliance

  13. FP7 Project Patient Compliance is a major problem in healthcare today. • Aim:Closed-loop management of medication and lifestyle compliance • Applications: Heart Failure & Coronary Heart Disease • 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: March1, 2008 • Duration: 4 years • Partners: 19 (9 countries) • Announced EC-funding: ~14.1 M€ • Largest FP7 project in “ICT for Health” • Coordinator: Philips

  14. eHealth as a key enabler for Home Healthcare • Both in the “prevention” stage and “surveillance” stage of the care cycle, Home Health needs to be integrated into the overall care-cycle view • Effective chronic disease management and post-discharge monitoring improves patients’ quality of life and reduces recurring hospitalization Telemonitoring proven to reduce cardiac re-hospitalizations for CHF patients1 eHealth enhances patients’ compliance and self-care regimen 1 TEN-HMS Study published in JACC, May 17, 2005; John GF Cleland, MD, Aggie Balk, MD, et al clinical investigators

  15. Many grassroots eHealth activities • Microsoft HealthVault • GoogleHealth • Many Web 2.0 mash-up services $144.71 versus $301.23!!

  16. 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 proven innovations in the medical community – 15 years from proof of concept to mainstream • Foster international standards and profiles for eHealth interoperability (DICOM, HL7, IHE, Continua)

  17. In summary, eHealth can catalyze the 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) • 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

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