Ton Van Den Hoven


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Ton van den Hoven, Sr Director Healthcare Informatics, Philips Healthcare
“Healthcare Informatics - The Growing Importance of IT Solutions to Improve Patient Care”

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Ton Van Den Hoven

  1. 1. Health d Wellbeing H l h and W llb i ...the important role of eHealth... Fibre To The Home conference Lisbon Feb 25th 2010 Ton van den Hoven Philips Healthcare
  2. 2. Healthcare is the world’s largest service sector world s 1% 5% Americas US H lth Healthcare E Expenditure: dit 8% ~ US$ 2,000 bln in 2007 Europe, Mid-East, 2% Africa ~ US$ 4,300 bln in 2017 China/HK Worldwide H lth W ld id Healthcare Expenditure: E dit 54% Japan ~ US$ 4,000 bln in 2006 30% US healthcare jobs vs. manufacturing India 1977 8% 22% Rest of Asia 2007 11% 10% Source: Medistat Source: 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 in to 11% in in US from 16% of GDP in 2007 to ~20% GDP in 2017 10% 8% 6% 4% 2% 0% Source: OECD, WHO, 1950 1990 2005 2015 PH Internal Analysis 2
  3. 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 p p g g personnel • Reducing healthcare variability Country differences in hospital mortality rates 40 35 35 30 27 25 18 20 13.8 15 10 6.9 5.3 5 0 Heart infarct Colon Cancer Stroke Source: OECD Health Care Quality Indicators Project Health Working Paper 22, 2006 3
  4. 4. Value based Value-based healthcare delivery From focus on Cost to focus on Value: • Value for patients: – Outcome: mortality, morbidity, physical and mental stress mortality 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 efficiency p y – More competitive healthcare delivery eHealth i pivotal i thi t H lth is i t l in this transformation t value-based h lth f ti to l b d healthcare d li delivery 4
  5. 5. eHealth definition definition* 1. Clinical Information Systems a) Specialized tools for professionals within care institutions b) Tools for primary care and/or outside the care institutions 2. Telemedicine and Homecare a) 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 eHealth 5
  6. 6. 2. Process eHealth key enabler in driving new care delivery models… Prevention Screening Diagnosis Treatment Management Surveillance Information and Communication … which together deliver a full set of care to a p g patient with a medical condition 6
  7. 7. …by integrating patient information by information… 7
  8. 8. 12-ld ECG to …into Care Cycles (1) into Cardiologist’s Hand-held H d h ld device Discovery to Balloon: y Treatment of Heart Attack Activate Simultaneous alerts to all Cath Lab clinical staff Advanced life Reliable 12-lead 12-lead Expedite Emergency Cath Lab or support monitor transmission forwarding & Department care Thrombolytic viewing therapy Discover Di Diagnose Treat Monitor Transmit View Transport Treat MRx Bluetooth over the 12-lead Transfer IntelliVue Monitor Allura 3D-CA Cath Monitor/Defibrillator Internet Station Lab Improve Workflow: Measure component times & feedback 8
  9. 9. …into Care Cycles (2) into ElectroPhysiology: Integration of information 9
  10. 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 component for • More than 835 employees • Unique screening workflow • 52 Mobile units 10
  11. 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. 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 Disease pp y • 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 years y • Partners: 19 (9 countries) • Announced EC-funding: ~€14.1 Mln – Largest FP7 project in “ICT for Health” ICT Health • Coordinator: Philips Healthcare 12
  13. 13. eHealth as a key enabler for Home Healthcare • Both in the “prevention” stage and “surveillance” stage of the care cycle, p g g y , Home Health needs to be integrated into the overall care-cycle view • Effective chronic disease management and post-discharge monitoring post discharge improves patients’ quality of life and reduces recurring hospitalization Telemonitoring proven to reduce cardiac eHealth enhances patients compliance patients’ 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. 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 Lancet “X-ray fluoroscopy for opening clogged kidney arteries saves about $15K per procedure.” - Radiology “Care Cycles are the best way to transform healthcare from a zero-sum game to a patient-value driven industry ” zero sum patient value industry. - Porter and Teisberg, Redefining Healthcare, 2006 14
  15. 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 p p proven innovations in the medical community y – 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 implementation 15
  16. 16. In summary eHealth can catalyze the summary, 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
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