in medication - ehealth

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eHealth05
eHealth as a Driver to
Optimise Healthcare Processes
Karl-Jürgen Schmitt
Siemens Medical Solutions
June 07, 2005
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A common goal: Improve healthcare efficiency
Through:
• Innovation
• Process
Quality
Cost
of healthcare delivery
optimization
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Improving efficiency with the patient in focus
Sick,
injured
Examination
Healed,
fit for work
Care
Therapy
Patient Information
Medical Knowledge
Diagnosis
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IT is key in integrating and optimising workflows throughout the healthcare continuum
Prevention /
Early Detection
Home
Care
Diagnosis
Health
Management
Ambulatory
Care
Mobile
Care
Stationary
Care
Therapy
Care
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IT is key in integrating and optimising workflows throughout the healthcare continuum
Med
meets IT
Prevention /
Early Detection
Home
Care
Diagnosis
Health
Management
Ambulatory
Care
Mobile
Care
Stationary
Care
Therapy
Care
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Integrated IT platforms help improve efficiency
HL7
Dicom
IHE
Market-driven communication standards must be used
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Significant potential to improve the
quality of the healthcare system
Costs for the insured
90,000 Deaths
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‘Adverse Events’
Actual
(w/o ‘Adverse Events‘)
Ideal
Early
recognition
1Source:
Diagnosis Therapy
Rehab.
Institute of Medicine, To Err is Human, 1999, p.26. American Hospital Association. Hospital Statistics. Chicago. 1999
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Optimising healthcare processes with IT
Example: Conventional medication process
Transcription
Physician
Order
Review
by Nurse
Medication Errors in the USA
Administration
Documented
Ordering
50% - 55%
Transcription
6% - 12%
Dispensing
5% - 14%
Administration
33% - 38%
Medication
Administered
Nurse confirms drug,
dose, route, time,
and patient
Medication
Dispensed
Chart copy sent
to pharmacy
Order Entry
(Rx System)
Verification by
Pharmacist
Source: Agency for Healthcare Research and Quality, 2001
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Optimising healthcare processes with IT
Example: Conventional medication process
Transcription
Physician
Order
Review
by Nurse
Medication
Errors in System
the USA *
Effects
on Healthcare
Ordering
Administration
Documented
Chart copy sent
to pharmacy
50% - 55%
DeathsTranscription 7.000
6% -(1999)
12%
Savings
Potential $1.6
5.6 billion
Dispensing
5% ...
- 14%
Administration
* in US hospitals
33% - 38%
Medication
Administered
Nurse confirms drug,
dose, route, time,
and patient
Medication
Dispensed
Order Entry
(Rx System)
Verification by
Pharmacist
Source: Agency for Healthcare Research and Quality, 2001
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Optimising healthcare processes with IT
Example: IT-supported medication process
Physician
Order
Verification by
Pharmacist
•
•
Administration
Documented
•
Results
Process simplification to
reduce medication errors
Includes software, barcodes, and
an automated dispenser system
All data available for later evaluation
Nurse confirms drug,
dose, route, time,
and patient
Medication
Dispensed
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Costs
Costs
Quality
Quality
„Proven Outcomes“ in medication:
Real results with IT-supported processes
Preventing 118 potential
medication errors monthly.
Estimated annual savings: $944 k
Virginia, USA
73% decrease in erroneous
and unclear prescription
Costs
Costs
Quality
Quality
Stockholm, Schweden
52% reduction of medication
turnaround time, 35% reduction
of medication errors
Ohio, USA
96% decrease in medication
turnaround time
New York, USA
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Quantifying Vascular Risk Screening: A
successful method of Telematic
Project
• Internet-based prevention method
to quantify vascular risks
• De-central examination, central and
quality controlled reporting by
experts
• Participant with higher risk can
subscribe in a Disease
Management Program
• Partner: University ErlangenNürnberg, Siemens Insurance Fund
and Siemens Medical Solutions
Project Outcome (2001 – 2002)
7,000 Higher Risk
20% =
1,400
Disease
Management
Program
Participants
Continuation in larger cities with up to 50 000
participants/year
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A promising project for disease management
with IT in Scotland
Disease Management Diabetes, Diabetic Retinopathy (DR)
Huge Potential
• Up to 10% of Europeans diabetic
• 60% of diabetics develop DR
• DR is leading cause of blindness
for individuals > 65 years of age
• Blindness can be avoided in 90%
of DR cases if detected early
NHS Scotland and
Siemens Medical
Implementation
of an integrated,
IT-supported
Disease Management
Improved ...
 Quality
 Compliance
 Processes
 Use of Resources
 Outcomes
• 300.000 exam•
•
inations / year
planned
73 locations
5 regional
evaluation
centers
Registration,
Invitation
Mobile
Examination
Central Evaluation
by Experts
Inform
Patient
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potential
The
remains very large
to improve the
quality
of care
eHealth
... the key enabler
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What do we need to do to realize the potential?
 Patients / healthy individuals must be in focus
 Define which healthcare services should be
regulated and which aspects should be open
to competition (more competition)
 Define which healthcare services should be
publicly financed and which services should
be an individual’s responsibility (more
individual responsibility)
 Implement standardized quality metrics
 Performance needs to be recognized.
Healthcare must be attractive for the best and
brightest minds
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Healthcare
is one of our most important
infrastructure components
just as
... Power
... Transportation
... Communication
...
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Change of paradigm
Health is the lever for prosperity
The EU Commission concluded:
Good health is the basis for economic growth*
 Increase of 10% of life expectancy leeds to 0.35% of GDP growth
 50% of the growth differential between rich and poor countries
are due to bad health and lower life expectancy
People conclude:
Health is the most valuable asset
*Macroeconomics and health: investing in health for economic development,
Report on the Commission on Macro-economics and health,
Jeffrey D. Sachs, WHO, 20 December 2001
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How to draw attention to this possibility?
1. Through contacts to and information of national health
authorities
2. Through a congress: “Improving Healthcare Infrastructure
in an Enlarged Europe”
• Organized by the “European Health Forum Gastein”
on October 04, 2005 in Bad Gastein, Austria
and at least two follow up congresses in 2006 and 2007
• Target Groups:

European Commission (showing the potential)

Health Authorities of new Member States
(proposing projects)
•
Sponsor: COCIR
Healthcare
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… our largest economic factor!
... eHealth plays a key role!
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