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Connected Health: Improving Healthcare Quality, Access, and Costs

Learn how connected information can revolutionize healthcare by improving quality, access, and reducing costs. Explore the benefits of connected health initiatives and the challenges in implementing them.

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Connected Health: Improving Healthcare Quality, Access, and Costs

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  1. “Just make me better”From eHealth to Connected Health How we can use connected information to improve the quality, access and costs of healthcare Kevin Dean, Cisco Systems IBSG kevdean@cisco.com

  2. eHealth - an obvious investment? • Historically low investment in IT – 1% ? • Historically un-coordinated investment in IT & huge scale of organisations • Oversold, under-delivered past health and public sector IT • Complex “global” issues to solve – privacy, connectivity, standards • Melange of legacy systems & data…. &paper • Investment now vs benefits in 10, 20, 30 years time

  3. eHealth

  4. Health

  5. Connected Health

  6. Connected Health • Citizens should be helped to avoid being ill • Citizens and patients should be able to trust the “system” • The patient makes a journey through care, often a unique journey • Simple • Complex • Chronic …and should be agnostic to the organisation structures giving care • Clinicians should be, virtually, as good as each other • Managers should operate the healthcare business on lowest possible overhead and highest possible productivity

  7. Our Connected Health initiatives • Connected Health book • IBSG Advisors • The Hospital of the Future • The Business Case for eHealth • HealthGrid Available from www.cisco.com Available from www.healthgrid.org

  8. Top of Mind Issues – Healthcare “CEOs” Increase ProductivityHigher costsLimited budgets Improve Patient CareQuality, Consistency, Speed Be the Employer of ChoiceWorkforce shortage

  9. Top of Mind Issues – Clinician What did I do to you last?Quality, Avoid errors What did “they” do to you last?Quality, Avoid errors What should I / we / they do next?Quality, speed, Avoid errors

  10. Top of Mind Issues – “Worried Well” Rising costsHigher tax, premiums, medicines PrivacyProtect my confidential data Treat my family wellQuality, trust, transparency, access

  11. Top of Mind Issues – Patient Just make me better …don’t make me worse …wherever I am, or need to be… ..and be quick about it

  12. Benefits come from…. • Shorter route through treatment, fewer steps • Avoiding malpractice, misdiagnosis, misprescribing, misdispensing…. • Shorter hospital stays • Fewer tests and retests • Reduced drug budgets – cheaper prescribing, lower waste, less inventory • Scaling expensive resources • Prevention of disease • Lower whole-life treatment costs • Lower overheads in finance, human resources, transactions, efficient procurement • New streams of revenue

  13. Benefits come from…. Quality, Cost • Shorter route through treatment, fewer steps • Shorter hospital stays • Fewer tests and retests • Avoiding malpractice, misdiagnosis, mis-prescribing, mis-dispensing…. • Reduced drug budgets – cheaper prescribing, lower waste, less inventory • Scaling expensive resources • Prevention of disease • Lower whole-life treatment costs • Lower overheads in finance, human resources, transactions, efficient procurement • New streams of revenue Access, Cost Access, Cost Quality, Cost Access, Cost Access, Cost Access, Quality, Cost Quality, Cost Quality, Cost Access, Cost

  14. Reality – un-Connected Health hurts. • 44,000 Americans die each year because of medical errors – more than from breast cancer, AIDS or car accidents • Each year the NHS has a bill for £2 billion to cover prolonged stays in hospital because of errors • The USA and England are not alone….. France Italy Canada Germany

  15. Can’t we train away these “errors” ? “These quality problems occur typically not because of a failure of goodwill, knowledge, effort, or resources devoted to health care, but because of fundamental shortcomings in the ways care is organized.” Crossing the quality chasm: A new health system for the 21st century, Institute of Medicine, USA, 2001

  16. Automating current Healthcare practices, organisations, patient experiences is not the answer Re-engineer delivering quality care quickly to the patient connecting information assets across organisational boundaries

  17. The Connected Health Model…. Target Funding, Strong Governance, Manage Implementation and Change Working Practices, Increase IT Competence, Work with Industry Governance – National/Regional/Local processes, Funding, Metrics, IT Management, Business Cases Implementation planning – Capacity & capability, Industry & Services, Roll-out, Sourcing & Procurement Portfolio of Services for Citizens, Patients Clinicians, and Management Portfolio 2 – Knowledge Management & eLearning Portfolio 3 – E-Enablement eProcurement E-HR, E-Finance Secure, Intelligent, High Speed Infrastructure Web foundations – Directory, eMail, Consent/Authentication… Infrastructure (Devices, Desktop, Servers, Storage, LAN, WAN, Mobile / Wireless)

  18. The full Connected Health Model Performance Measurement Performance Measurement Governance – National/Regional/Local processes, Target Funding, Strong Governance, Funding, Metrics, IT Management, Business Cases Manage Implementation and Change Working Practices, Implementation planning – Capacity & capability, Industry & Services, Increase IT Competence,Work with Industry Roll - out, Sourcing & Procurement Portfolio 1 – Clinical tools, Portfolio 3 – Health Records, Portfolio 2 – E - Enablement Portfolio 4 – Prescriptions Service, Knowledge eProcurement Patient Appointment Booking, Management & E - HR, Services Patient Access, eLearning E - Finance Images, Telemedicine…… Web foundations – Directory, eMail , Consent/Authentication… Web foundations – Directory, eMail , Consent/Authentication… Infrastructure (Devices, Desktop, Servers, Storage, Secure, Intelligent, High Speed Infrastructure LAN, WAN, Mobile / Wireless)

  19. Map of Medicine by Medic to Medic (UCL) Access – easily understood; share with patient; speed process Quality – applies guidelines; ensures communication; should eradicate some process steps Cost – radically change outpatients process Re-shaping cross-organisation processes Click for demonstration Medic to Medic’s Map of Medicine

  20. “Knowledge is the Enemy of disease”

  21. My life is on the web…. IP TV Directory Executive Information System CiscoCast Employee Connection VoD Training Virtual Classroom FAST Start Travel & Expense Benefits Enrollment End-to-End Staffing Technical Support Corporate Procurement

  22. Patient relationship www.nhsdirect.nhs.uk

  23. Bedside Services

  24. Bedside Services Softphone klient IP/Video klient Internet Billing solution with Smartcard/creditcard Standard touchscreen Smart-card reader Headphone or/and USB handset

  25. Healthcare – infrastructure dependencies

  26. Governance – National/Regional/Local processes, Funding, Metrics, IT Management, Business Cases Implementation planning – Capacity & capability, Industry & Services, Roll-out, Sourcing & Procurement Portfolio 1 – Clinical tools, Health Records, Prescriptions Service, Appointment Booking, Patient Access, Images, Telemedicine…… Portfolio 2 – Knowledge Management & eLearning Portfolio 3 – E-Enablement eProcurement E-HR, E-Finance Portfolio 4– Patient Services Web foundations – Directory, eMail, Consent/Authentication… Infrastructure (Devices, Desktop, Servers, Security, Storage, LAN, WAN, Mobile / Wireless….) Beyond immediate care • Performance Measurement • Waiting times • Outcomes • Financial • Disease patterns (Epidemiology) • Capacity • Feedback….

  27. The Big Challenge – “How?” Governance – National/Regional/Local processes, Funding, Metrics, IT Management, Business Cases Implementation planning – Capacity & capability, Industry & Services, Roll-out, Sourcing & Procurement Portfolio 1 – Clinical tools, PAS, PACS Health Records, Workflow, Prescriptions Service, Appointment Booking, Patient Access….. Portfolio 2 – Knowledge Management & eLearning Portfolio 3 – E-Enablement eProcurement E-HR, E-Finance Portfolio 4– Patient Services Web foundations – Directory, eMail, Consent/Authentication… Infrastructure (Devices, Desktop, Servers, Storage, LAN, WAN, Mobile / Wireless)

  28. Key Topics • Portfolio • Planning • Vision • Priorities • Obtain & • Manage Funding • Level • Distribution Business Case & Measuring results • Governance • Standards • Choice • Delivery Infrastructure design • National, Local • Services • Design • Interaction Developing Capacity • Implementation • Footprints • Priority Changing Working Practices Consent Authentication Authority Sourcing & Procurement Strategy

  29. All we have to do is solve…. • Portfolio • Planning • Vision • Priorities • Obtain & • Manage Funding • Level • Distribution Business Case & Measuring results • Governance • Standards • Choice • Delivery Locally ? Regionally ? Nationally ? EU Wide ? Global ? Infrastructure design • National, Local • Services • Design • Interaction Developing Capacity • Implementation • Footprints • Priority Changing Working Practices Consent Authentication Authority Sourcing & Procurement Strategy

  30. The Connected Health Model…. Target Funding, Strong Governance, Manage Implementation and Change Working Practices, Increase IT Competence, Work with Industry Governance – National/Regional/Local processes, Funding, Metrics, IT Management, Business Cases Implementation planning – Capacity & capability, Industry & Services, Roll-out, Sourcing & Procurement Portfolio of Services for Patients Clinicians, and Management Portfolio 2 – Knowledge Management & eLearning Portfolio 3 – E-Enablement eProcurement E-HR, E-Finance Secure, Intelligent, High Speed Infrastructure Web foundations – Directory, eMail, Consent/Authentication… Infrastructure (Devices, Desktop, Servers, Storage, LAN, WAN, Mobile / Wireless)

  31. Business case Reduction in medical errors; shorter stays Shorter waits; Choice Reduction in costs Top priorities Transferable medical record Reform cross organisation process Prescribing & prescriptions Imaging Tele-medicine Clinician engagement Clinician engagement; Clinician engagement; Clinician engagement Standards, interoperability Recognise importance Simple steps Build on current assets Information architecture But what is really important?

  32. NHS England Wales Scotland France Arras MdS Paris Italy USA Poland Norway Finland Spain Iceland Saudi Arabia Bahrain Dubai Health City The momentum is building….. • Germany • BIT4IT • Denmark • MedCom • European Commission • WHO • Australia • Ireland

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