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Debold & Lux. Cost Benefit Analysis of the eHealth Platform in Germany. ePrescription and HealthCard: Synergies of an optimal Solution 3 rd Annual EHTEL Conference Delivering eHealth Across Europe Bruges 2002 Andreas Lux.

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Cost benefit analysis of the ehealth platform in germany

Debold & Lux

Cost Benefit Analysisof the eHealth Platform in Germany

ePrescription and HealthCard:Synergies of an optimal Solution

3rd Annual EHTEL Conference

Delivering eHealth Across Europe

Bruges 2002

Andreas Lux

Advice Company for Information Technology and Organization in Health Care Systems Hamburg


Scope and intention of the cost benefit analysis

Debold & Lux

Debold & Lux

Scope and Intentionof the Cost-Benefit-Analysis

  • Communication Platform in Health Care

    • Implementing an Infrastructure

  • Assistance with Applications

    • Mass application

    • In daily use of all Health Professionals

    • Easy telematic realisation

    • Expected financial contribution

  • The identified Applications are:

    • New Health Insurance Card (HIC) with online update

    • Electronic Prescription (EP) of Drugs

    • Medication History Documentation (MHD) with Screening

CBA - eHealth Platform


Agenda

Debold & Lux

Debold & Lux

Agenda

  • Benefit

  • Costs

  • Allocation of costs and benefits

  • Results

CBA - eHealth Platform


Health insurance card savings in the business processes

Debold & Lux

Debold & Lux

Health Insurance Card Savings in the business processes

  • High legitimation of the insured persons

    • yearly 18 Mio. new insurance cards,nevertheless only a mistake in 0,25 – 0,35 % of the cases

    • Misallocation is economical irrelevant (inside the compulsory insurance system)

  • The costs of the maintenance of the old HIC are savings – 24 million € per year

  • Great failure in the handling of the relieving Co-Payment

    • it doesn't work - insured persons with a relieving pays and insured persons without a relieving don‘t pay

CBA - eHealth Platform


Relieving from co payment projection in comparison

Debold & Lux

300

260

257

250

225

200

153

150

Million Euro

100

50

0

AOK H

AOK Sachsen

GEK

Debold & Lux

Relieving from Co-paymentProjection in comparison

Annual deficit for the compulsory health insurance companies (Projection)

used in

the CBA

CBA - eHealth Platform


Saving potential of the eprescription transaction costs

Debold & Lux

Debold & Lux

Saving potential of the ePrescriptionTransaction Costs

EP - Paper Administration 5 Mio. €

EP - Image Administration 20 Mio. €

Providing physicians with EP forms 5 Mio. €

Reducing administrative costs in pharmacies 40 Mio. €

Improvement of the prescription proof 75 Mio. €

CBA - eHealth Platform


Medication history documentation mhd model calculation and estimated in the cba

Debold & Lux

Result

600

551

500

400

300

Million €

200

Estimated

128

100

0

Result DHD

Debold & Lux

Medication History Documentation (MHD) Model Calculationand estimated in the CBA

  • Only hospital costs

  • Ambulant treatment costs are not included

  • No, estimations regarding economic effects, like loss of working days

Reasons for the reduced benefit in the CBA calculation

  • Application is voluntary for the patient

  • Application is voluntary for physicians and pharmacists

  • The quality of the reaction in the use of warning information isn’t proofed

CBA - eHealth Platform


Savings amount and allocation

Debold & Lux

Insurances.

Pharmacists

Physicians

Debold & Lux

551

260

SavingsAmount and Allocation

153

150

128

100

77

Million €

50

24

41

24

5

0

A

B

C

D

E

A Paper Forms B HIC old

C Billing Proof D Co-Payment

E Medication History Documentation

CBA - eHealth Platform


Investment 559 mio

Debold & Lux

Education

Insurance Card

InfrastructureCommunication

PKI

Project

Debold & Lux

Investment559 Mio. €

- Working hours physician / staff

- direct education costs

600

116

- Chipcard for the insured people

500

400

187

- Server Routing/Transport/HI

- Communication server with Firewall physicians/pharmacists

Million €

300

143

- HPC for Health Professionals

- Card terminals

200

100

- Planning and concept

- Realisation of a pilot(ca. 100.000 insured people)

99

14

0

CBA - eHealth Platform


Accumulation of costs and savings break even point bep

Debold & Lux

1.500

1.000

Million €

500

0

year 0

year 1

year 2

year 3

year 4

year 5

Investment

Running Costs

Savings

Debold & Lux

S+Co-Payment

S+Co+MHD

Accumulation of Costs and SavingsBreak Even Point (BEP)

BEP

CBA - eHealth Platform


Allocation of costs and benefit

Debold & Lux

Debold & Lux

Allocation of Costs and Benefit

2023

2.000

1.800

1.600

1.400

1.200

million €

1.000

800

600

26

400

204

227

287

Savings in 5 years

200

45

125

Investment

0

192

62

Insurances

Running Costs in 5 years

Physicians

Pharmacists

CBA - eHealth Platform


Result infrastructure economical and health political

Debold & Lux

Debold & Lux

Resultinfrastructure, economical and health political

  • Liability is given, security infrastructure is implemented

  • A refinancing of the investment is possible

  • The medical applications will have the biggest potential, the administrative applications are only starter

  • Political acceptance for this model requires,

    • Balance of the asymmetric allocation of costs and benefits

    • Benefit from the new technology not only for the health insurance companies, but also for physicians and patients

CBA - eHealth Platform


Contact and more information

Debold & Lux

Debold & Lux

Contact and more Information

The complete Cost-Benefit-Analysis is available in German language and a short summery in English on the following links.

www.Debold-Lux.com

Sponsors of the Study:

Federal Union of German Associations of Pharmacists – ABDA

www.abda.de

Verband der Angestellten-Krankenkassen e.V. - VdAK, Siegburg

www.vdak.de

CBA - eHealth Platform


Are the results transferable

Debold & Lux

Debold & Lux

Are the results transferable?

  • Costs

    The results are transferable in the most European countries

  • Benefits

    • New Health Insurance Card

      Special situation in Germany

    • Electronic Prescription of Drugs

      There should be an equal situation in other countries. The administrative processes for clearing and proof became more efficiency

    • Medication History

      Equal situation and effects in other countries

CBA - eHealth Platform


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