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Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
Health Valley Event Presentatie Rob ten Hoedt
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Health Valley Event Presentatie Rob ten Hoedt

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  • Medical Devices account for >5% of total healthcare spending in all the countries analyzed In contrast, operational expenses comprise a much higher proportion of overall costs, often over 80% of total spending
  • One increasingly important group of “customers” are HTA agencies that are demanding to see evidence of the clinical and economic value that our products bring, as a condition for recommending they be used in their respective health care system. HTA agencies have been proliferating in Europe and elsewhere around the world for over 10 years. We have a team of professionals who build working relationships with established and emerging HTA agencies, engage with them when they review our products, and influence HTA policy to ensure it is appropriately tailored to medical devices (as opposed to pharmaceuticals).
  • Like the NHS, Medtronic is celebrating its 60 th year
  • Innovation
  • Insatiable demand for an inelastic good that appears to be “free” Health care costs expected to compound at 7-8%
  • MD Start’s mission is to accelerate the development of revolutionary medical devices. MD Start provides inventors with a way to develop their ideas without having to abandon their patient or their research.
  • After you submit to our portal you will receive a confirmation email. Your submission will be shared with the appropriate therapy area leaders across Medtronic. If more information is needed to proceed with your idea, we will contact you using the contact details you provide on the submission form. We will review submissions as they come in and will get back to you as soon as we can, but at the latest we will inform you of our decision within 3 months. If we are interested in pursuing the development of your idea, you will receive a notification and you will be contacted directly by the appropriate therapy leaders within Medtronic. If, after review, your idea cannot be pursued by Medtronic at this time, you will also be notified. It is up to you if you want MDT to share your idea with MD Start, you can always say no thanks
  • Syncope is technically defined as a transcient, self limited loss of consciousness, usually leading to collapse. The onset is relative rapid and the recovery usually prompt. The underlying mechanism is transient global cerebral hypoperfusion. In simple language, syncope is a sudden blackout / T-Loc which is normally brief, does no permanent damage and which arises from a temporary reduction in the blood supply of the brain. Three main causes for blackouts: cardiovascular (insufficient blood reaches the brain), Neurological (ex. Diseases such as epilepsy), psychogenic (resulting from psychological disorder) Syncope can result from many cardiovascular causes: -cardiac causes - Structural heart diseases - Heart rhythm problems - Vascular causes - Reflex causes - Situational causes (coughing, straining, dehydration, …) - Postural causes (standing up too quickly)
  • The first specialist consulted for syncope in almost 23% of patients was an emergency medicine consultant. Cardiologists were the first specialists consulted in 43% of cases and neurologists in 11%. The last specialist consulted before the referral for implant of the ILR was a cardiologist in 72% of cases, with no other specialties represented in more than 10% of cases. Cardiologists were the most frequently consulted specialists, with general practitioners second-most consulted physicians overall. Forty-seven per cent of the study population had consulted a neurologist at some point. Overall, patients had seen an average of three different specialists for management of their syncope.  The median number of tests performed per patient in the total study population was 13. The tests performed most frequently were echocardiography, ECG, ambulatory ECG monitoring, in-hospital ECG monitoring, exercise testing, and orthostatic blood pressure measurements. About half the patient population had undergone an MRI/CT scan (47%), neurological or psychiatric evaluation (47%), or electroencephalography (EEG; 39%). In contrast, carotid sinus massage or tilt tests were only undertaken in one-third of subjects. The ILR was implanted during the initial phase of the diagnostic work-up (up to four diagnostic tests) in 128 patients (22%). In PICTURE, the EEG rates are most likely explained by the high percentage of referrals to neurologists. The clinical picture of syncope frequently includes neurological symptoms and is often mistaken for epilepsy, which probably explains why neurologists are frequently consulted. Conversely, epilepsy may be mistaken as syncope, but in such patients a Reveal may be a faster way to arrive at the correct diagnosis, if a Reveal recording can be obtained during a typical episode.Furthermore, almost half the patient population had undergone an MRI / CT scan, neurological or psychiatric evaluation. There were, however, simple diagnostic tests that could have been used more widely and would have been included in the initial phase of evaluation, e.g. carotid sinus pressure and orthostatic blood pressure measurements.
  • Transcript

    • 1. Health Valley Event De Vereeniging te Nijmegen 16 th March 2011 Rob ten Hoedt President Medtronic Europe
    • 2.
      • Overview of the medical technology industry in Europe
      • Medical technology in today’s complex, rapidly evolving European healthcare environment
      • Looking ahead! What role will Medtech (Medtronic) play
      • Innovation initiatives in Europe
      • Conclusion/Discussion
      Agenda
    • 3. Europe as the Innovation Leader in Med Tech
      • >11.000 companies (80% SMEs)
      • € 70 billion in sales (8% in R&D)
      • ~500.000 employees
      • ~500.000 products*
      * Eucomed; OECD 2009
    • 4. New Recognition: Value of EU MedTech – EU Commission «Exploratory Process» 2009-10 1. Public health challenges Holistic approaches Scope and role of Medical Devices sector Public health policies Involvement, education and training of the different actors Patient Safety & Quality of Care Fight against counterfeit medical devices 2. Encompassing innovation 3. Value of and access to medical devices 4. Industrial challenges Innovative technologies/products Involvement for innovation Procurement procedures and reimbursement Research and development Market Availability Measuring value of medical devices technologies Inclusion of medical devices within the scope of the national health insurance systems and funding systems Public procurement Late payments Generation of data Information to patients and clinical practices Global context for research investments FINANCIAL CHALLENGES Industrial environment Regulatory framework Involvement in decisions on access Patient empowerment Transparency Governance in the evaluation and decision making processes “ The Exploratory Process strongly endorsed the need for a clear political vision of the role of the medical device sector in the health of citizens and the economy. … the European Union should act to make Europe the global leader for medical devices by promoting innovation, efficiency and sustainable health outcomes. … A strong medical device sector in Europe will play a central role in supporting the broader EU aspiration that citizens live a longer and healthier life.”
    • 5. Key Trends in European Healthcare Environment Increased focus on prevention Increasing expectations of citizens Increase of chronic and multiple diseases Shift from public to private funding Shift to community and homecare Increasing role of purchasing & paying institutions Declining “power” of healthcare professionals Increasing e-solutions Increased demand for medical technology and services * Ageing populations * Budget deficits * Growing shortage of healthcare workers
    • 6. Impact on European Med Tech Landscape 2. Intensification of ongoing healthcare reforms 4. Increasing demands for evidence 3. Expanded set of “customers” 1. Short-term cost containment pressures Value-for-money environment
      • Hospital budget cuts, reimbursement cuts, late payments to suppliers,…
      • Increasing acceptance of “good enough” low-cost devices
      • Intensification of reimbursement, HTA, purchasing and regulatory reforms underway for years
      • Including govt. agencies, payers, hospital managers, purchasing and procurement organizations and patients
      • Payers want scientifically-valid evidence of clinical and economic benefits -- via pre-market clinical trials and real-world data
    • 7. MedTech Represents a Small % of Total Healthcare Spending Source: Espicom; WHO; World Bank, LEK analysis Medical devices represent <5% of overall spend and offer limited potential cost savings Huge opportunities elsewhere Devices Pharma Operating and other costs 0 100 80 20 60 40 CY08 Device Spending as a % of Total HC 4% 3% 3% 3% 3% 2% 2% 2% 4% 5% Sweden US Hong Kong Taiwan UK Singapore Canada Germany Norway China 2 3 1
    • 8. Increasing Demands for Evidence The rise and rise of Health Technology Assessment (HTA)
      • Increasing HTA agencies: @ national level and within healthcare systems
      • More resources & power: working in powerful global networks
      • Increasing evidence demands and sophistication: in HTA evaluations
      2 3 4 1
    • 9. Our Environment: “Navigating through Uncertainty” ( Source: Ernst & Young “Pulse of the Medtech Industry” Oct. 09)
      • Demonstrate value proactively
      • Prepare for comparative effectiveness in the US (HTA well established in Europe)
      • Identify and articulate value proposition for products early in the R&D process
      • Develop new pricing models
      • Use capital efficiently
      • Doing more with less
      • Smaller firms : Lower burn rates & extend life of existing resources
      • Larger firms : Focus on bottom-line in addition to top-line growth; restructure operations & manage debt
      • Embrace business model innovation
      • Medtech has survived challenges and funding droughts in the past
      • Apply creativity and nimbleness to develop new models
      • Deliver healthcare outcomes rather than simply selling a product
      • Address regulatory/policy change
      • Get ahead of the changes
      • Monitor changes and understand their potential impact
      • Adapt strategies and operations accordingly
      2 3 4 1
    • 10. Medical Device Regulation in Europe 2008-11 EU Commission consultations on “recast” of Med Device Directives Access to market Pre-clinicals Design Clinical evaluation Actual use Notified Body Conformity assessment Quality audits Competent Authority Authorization Clinical Studies AE reports Market Surveillance / Inspections / Vigilance Reporting Recalls / Field Actions Surveillance of NBs Pre-Market Post-Market
      • Benefits
      • Short approval times
      • New technologies come to market
      • Safe products
      • No duplication
    • 11. Brussels, 28 January 2011 – A report of the Boston Consulting Group (BCG) shows medical device recalls in the U.S. and Europe occur at the same rate while the approval process in Europe is significantly faster. The decentralised oversight in Europe, which is the essence of the regulatory system, allows people to benefit from the latest innovative products while guaranteeing the highest level of patient safety and fostering innovation. The findings of the BCG report are in line with an earlier report by Dr. Josh Makower, one of America’s leading medical technology entrepreneurs, which detailed how patients in Europe get access to new therapies an average of two years before patients in the United States due to regulatory challenges at the FDA. By analysing publically available data on severe recalls of medical devices in Europe (equivalent to a Class I recall in the US) the study shows that the number of recalls in Europe is identical to that in the United States, and the therapeutic mix and type of recall is also similar to that in the US. The report states that ‘this initial assessment of comparable recalls between the US and Europe does not suggest that different approval processes, and earlier approvals, in Europe come at a cost in terms of patient safety’. In reaction to the study John Wilkinson, Chief Executive of Eucomed comments:  “This is the second study within the last few months that clearly indicates that the current EU regulatory system makes innovative medical technology available to people the fastest in the world while ensuring the highest safety standards. We are currently in the process of a recast of the EU medical device legislation and we believe that the current concept of decentralised oversight must remain. The notified body based system requires improvements in implementation but the system does not need a major overhaul. This BCG study shows that the regime of certification with CE marking has given patients and consumers in Europe the fastest access to the most innovative devices with the highest quality and safety standards in the world.” The report was prepared by Scott Davis, Erik Gilbertson and Simon Goodall of The Boston Consulting Group, a global business management consulting firm, and sponsored by Advamed, the U.S. Advanced Medical Technology Association. Eucomed: Research shows medical device recalls in Europe and U.S. are at similar rates
    • 12.  
    • 13. Founded in 1949 as a Minnesota Medical Equipment Service Company
    • 14. Manufacturing and R&D Minneapolis, U.S.A. Tolochenaz, Switzerland Tokyo, Japan Galway, Ireland Puerto Rico Tijuana, Mexico Montréal, Canada Neuchâtel, Switzerland Netanya, Israel Kerkrade & Maastricht, The Netherlands Fourmies & St. Aubin, France Deggendorf, Germany U.S.A. Irvine, CA Los Angeles, CA Memphis,TN Santa Rosa, CA Danvers, MA Jacksonville. FL Sunnyvale, CA Santa Barbara, CA San Antonio, TX Fort Worth, TX 40,000 Medtronic Employees 120 countries
    • 15. CHRONIC DEGENERATIVE DISEASES IMPLANTS >6 million patients/year $1.5 Billion/ yr on R&D Parkinson ’s Disease Essential Tremor Chronic Pain Gastroparesis Urinary Incontinence Dystonia Spasticity
    • 16.
      • How Does The MedTech Industry
      • Continue to Add Value?
      Innovation Innovation in Health Care Delivery Innovation in Reimbursement Innovation in Distribution Innovation in Manufacturing Innovation in Research & Development
    • 17. Themes for the Decade
      • Demographics Swell Patient Population
      • Chronic Degenerative Diseases Prevail
      • Costs Must Decrease
      • Evidence and Comparative Effectiveness Trump “Clinical Judgment”
    • 18. Demographics Drive Demand As the Average Age of the Population Is Increasing… % of Population Over 65 Years of Age 2004 2040 Source: World Health Organization 25% 31% 32% 36% 40% 40% 17% 21% 21% 25% 25% 26% 0% 10% 20% 30% 40% 50% US UK France Germany Italy Japan
    • 19. Demographics Will Continue to be a Challenge Because People Are Living Longer…
      • Age 60 – 2 Billion
      • Age 80 – 380 Million
      • Age 100 – 2 Million
      Worldwide Population by 2050 Source: World Health Organization, Population Report 2004
    • 20. The Burden of Chronic Disease Nearly Half of the Western World population will have Chronic Conditions by 2030 Partnership for Solutions 2004, Chronic Conditions: Making the case for ongoing care
    • 21. Chronic Diseases Have Staggering Costs Chronic Conditions Account for 83% of Health Care Spending Partnership for Solutions 2004, Chronic Conditions: Making the case for ongoing care
    • 22. Healthcare Costs Continue to Increase … Not Only in the US …
        • By 2016, health care will approximate $4.1 trillion, 20% of GDP
      U.S. Health Expenditures and as a % of GDP $Trillions Source: Office of the Actuary – Centers for Medicare & Medicaid Services 14% 16% 16% 17% 18% 20%
    • 23. Themes for the Decade
      • “ Personalized Medicine” replaces “Population Medicine”
          • Genomics
          • Proteomics
    • 24. Themes for the Decade
      • Restoration replaces Palliation
        • Biologics replace small molecules
          • Proteins/ Cells/ Genes
              • Delivery Devices Essential
    • 25. Fulfilling Our Mission Implantable Electro-mechanical Devices Palliation Biologics Promise of Restoration/Cure Neurological Conditions Heart Failure Diabetes Management Spinal Disorders Peripheral Vascular Disease Sudden Cardiac Death Heart Valve Disease Incontinence Chronic Pain G/I Reflux Spasticity Ear, Nose & Throat Disorders Cardiac Arrhythmias Coronary Artery Disease
    • 26. Biotech Opportunities Across Medtronic
      • Heart Failure
      • Diabetes
      • Parkinson ’s Disease
      • Epilepsy
      • Obesity
      • Alzheimer ’s
      • Bradycardia
      • Coronary Artery Disease
      • Tachycardia VT/VF
      • Degenerative Spine Disease
      Biologics Proteins Cell Therapies siRNA Gene Therapies
    • 27. Themes for the Decade
      • Communication/Information Technologies Converge with Devices
    • 28. REMOTE WIRELESS MANAGEMENT OF DEVICES AND PATIENTS IMPLANTED & WEARABLE SENSORS DISTANCE TELEMETRY HANDHELD COMMUNICATION DEVICES BROADBAND WIRELESS NETWORKS DATA STORAGE & ANALYSIS
    • 29. Wireless Networks Remote Patient Monitoring
      • Intimate Area Network
        • Device to Device within the body
      Intimate Area Network: (In body) Personal Area Network (Out of body)
      • Worldwide Mobile Network Carrier
        • Moving data from body to instrument (programmer/Patient Companion) to Wireless Carrier Worldwide.
      • Personal Area Network
        • Move data from device to programmer or device to device
        • Distance: inches to several feet
      (Worldwide)
    • 30. Remote Patient Monitoring
    • 31.
      • Wireless connectivity
      • Network operations
      • Wireless server applications
      Sensors Bigger than Medtronic Medtronic
    • 32. Connectivity Opportunities Across Medtronic
      • Heart Failure*
      • Diabetes*
      • Hypertension*
      • Parkinson ’s Disease
      • Epilepsy
      • Rhythm Management*
        • Bradycardia/Tachycardia
      • Ischemia*
      • Depression
      • Vascular Inflammation
      Connectivity Remote Monitoring Disease Management Device-to-Device Communication Wearable Implantable Sensors
    • 33. Implantable Devices Nanotech Polymers MEMS Communication Technology IT/Bio- Informatics Biologics Proteins siRNA Cell Rx Genes Imaging & Navigation BY CONVERGENCE Better Care Better Value INNOVATION
    • 34. Medtech Initiatives are all around in Europe!!
    • 35. Medtech Initiatives…
      • Barcelona (MedTech University, Corporate, EU)
      • Canton Vaud Switzerland (EPFL, Local Government, Venture, Corp.)
      • Zurich Region, Switzerland
      • Germany ( Heidelberg University, Local Government)
      • England (NHS, Companies)
      • Denmark (Medtech Bootcamp)
      • Belgium (Leuven area)
      • Health Valley Arnhem/Nijmegen
      • ETC..
    • 36. Invitation to co-invest in Medtech Bootcamp 2011
    • 37. “ Startup-bootcamp” is an European accelerator program for start-ups Highlights:
      • 10 great startups teams are selected from 150+ applications
      • The focus is on Medtech companies
      • Each team is offered EUR 3,000 in seed funding per team member
      • Free incubator space is offered in a cool location in central Aarhus
      • 50+ mentors who are all successful entrepreneurs work intensively with the teams for 3 months
      • The program ends with an Investor Demo Day where the teams pitch to 75+ international business angels and VCs
      • Medtech Bootcamp gets 8% equity in each of the ten startups
    • 38. MD START
      • Is an Independent EPFL Lausanne-based medical device incubator of which Medtronic is a founding member and co-funder
      • Its Mission is to help grow innovative European physician ideas into viable companies through provision of technical, legal, commercial, and financial support
      • If an incubated idea achieves “proof of concept” it will be incorporated, seek Series A financing from outside the accelerator, and separate management will be assigned
      • MD Start receives ideas through Medtronic as well as other sources (i.e. co-funder European-based Venture Capitalists, Sofinnova Partners as well as Versant and other partners)
    • 39. MD Start : The First VC/Corporate-backed Medtech Incubator in Europe
      • MD Start’s mission is to accelerate the development of revolutionary medical devices.
      • MD Start provides inventors with a way to develop their ideas without having to abandon their patient or their research.
      MD Start offers a more nimble approach to achieving success in an increasingly competitive and drawn out exit process.
    • 40. MD Start Validation Process MD Start ability to accelerate the development process cheaply and quickly will help leap over the ‘funding gap’ between early stage ideas and current expectations for A round financing
    • 41. Introduction to Medtronic EUreka
    • 42. Medtronic EUreka, a European new product innovation portal
      • Why Europe for Innovation?
      • European inventors and physicians have fueled many of the breakthrough inventions in the medical device field that have led to improving patients’ lives worldwide
      • Today, ideas generated in Europe remain critical to helping Medtronic fulfill our mission of bringing innovative products to improve patient care
      • Medtronic is committed to the European market and to European innovation and R&D
      • Medtronic EUreka: An Innovation portal for physicians’ product ideas
      • In 2010, Medtronic has launched Medtronic EUreka, the European idea submission program for physicians across all business units
      • As the funnel for new product innovation to Medtronic, EUreka drives partnership with European inventors to bring novel product concepts to improve healthcare
      • Medtronic EUreka has been live in 10 languages for 3 months and has generated significant interest throughout the medical device world (>60 press articles, 60 submissions)
    • 43. EUreka’s results are promising
      • Strong results across a range of European countries
      • Strong interest from inventors in a web-solution
        • ~10,000 visits on the EUreka site/month
        • 91% of visits from new inventors each month
        • Russia / Germay / Italy represent >50% of the visits (Russia r=~20% alone)
      • 60 innovative ideas collected
        • Submissions received every 2 days
        • Submitted ideas from nearly all European countries
        • Already 18 submissions have been transferred to MD Start for a second, independent, evaluation process
        • The remaining submissions are still under review by Medtronic
    • 44. 2 ways to capture European Innovation 1. Medtronic EUreka Medtronic’s centralized, streamlined process to capture and evaluate physician ideas in Europe across all therapeutic areas Inventor ideas that are not a fit for MDT may be reevaluated by MD Start 2. MD Start An independent incubator co-founded by MDT and other partners (including VC) to bring med tech innovations forward for further investment OR Physician/Inventor ideas
    • 45. Medtronic EUreka Evaluation Process 1. Submit Your Idea Through www.MedtronicEUreka.com Immediate email confirmation 2. Your idea is shared with the appropriate therapy area evaluation team If more info is needed, they’ll contact you 3. We’ll let you know our decision on your idea as soon as we can You’ll hear from us within 3 months 4. If your idea is a “Fit” with MDT we’ll start to work with you on the next steps to develop your idea into reality If not, we can also share your idea with MD Start…
    • 46. The Portal: www.MedtronicEUreka.com
    • 47. How EUreka’s success is measured # pages views # submissions # ideas transfered to MD Start # EUreka sourced ideas pursued by MDT In the past quarter: Nearly 60,000 60 18 More that 25,000 website visits 2 since EUreka launch More that 25,000 website visits
    • 48. Medtronic EUreka in the News: >60 press articles
    • 49. It takes more than “just” product innovation to bring solutions to the Health Care Systems
    • 50. Value Chain Collaboration: consulting services dedicated to Operational Excellence in Healthcare Objective Help healthcare institutions improve quality, reduce costs and enhance their revenue Clinical performance optimization Services Operational workflow optimization
      • Reduce non-value added work, shorten cycle time and improve efficiencies while maintaining or raising quality
      • Leverage blend of MDT supply chain and Lean Sigma expertise and industry best-practices
      • Train hospital personnel and transfer knowledge and tools for continuous improvement
      Goals Approach
      • Streamline patient flow, improve safety, gain capacity for additional revenue, reduce cost and raise patient and employee satisfaction
      • Leverage blend of Hospital clinical and MDT process expertise as well as industry best-practices
      • Work in tandem with hospital team to make change stick
    • 51. We provide an integrated service framework to optimize operational workflows and set best-in-class capabilities Optimize administrative flows Optimize logistics operations Optimize asset management
      • Supplier managed catalogs – product & prices
      • E-ordering & auto -replenishment
      • E-invoicing & automatic payment
      • Order-to-cash & procure-to-pay
      • Supplier deliveries consolidation vs. JIT
      • Transport operations
      • Receiving, storage & handling
      • Distribution & inventory deployment
      • Demand forecasting & planning
      • Inventory mgt & VMI
      • Infrastructure / OR utilization & capacity debottlenecking
      • RFID-enabled asset / product track & trace
      Optimize patient & work scheduling Exploit & integrate Information Technology Strengthen operational & change mgt skills
      • Staff planning & scheduling
      • Patient appointment scheduling
      • Job / operations scheduling & sequencing
      • Electronic Medical Record and Hospital ERP integration
      • RFID-enabled workflow optimization
      • Remote patient monitoring – Carelink integration
      • Business analytics
      • Supply chain & operations mgt training
      • Lean Sigma education
      • Business Process reengineering training
      • Project mentoring / coaching
      Readiness
    • 52. We leverage therapy expertise, process improvement techniques and collaboration with best practice networks to optimize care pathways Implement, pilot and institutionalize new process Identify opportunities and design blue print Heart failure therapy management Neuro stimulation enabled pain management Syncope diagnostic and management Aortic aneurysm treatment management … Diagnose current state and baseline performance Readiness
    • 53. Syncope definition, prevalence and challenges
      • 3-5% of all Emergency visits 1,2
      • 1-2% of all US hospital admissions 1,2
      • ~ 40% of the general population have experienced an episode of syncope in their lifetime 3
      • About one third of patients remain undiagnosed . 4,5
      Cardiac syncope patients have twice the mortality of the general population 6 Prevalence and challenges Definition (AHA) Temporary loss of consciousness and posture, described as &quot;fainting&quot; or &quot;passing out.&quot; Usually related to temporary insufficient blood flow to the brain. … in summary Unexplained syncope is an important clinical problem with adverse outcomes from associated physical trauma, negative impact on quality of life, and an increased cardiovascular risk 7,8
    • 54. Current care pathways are often ineffective and inefficient, as illustrated by the “PICTURE” registry Patients see in average 3 different specialists for their syncope mgt 13 tests performed per patient in the total study population (median #) … and still one third of patients remain undiagnosed Total recruitment 570 (100%) Standard ECG 556 (98%) Echocardiography 490 (86%) Basic laboratory tests 488 (86%) Ambulatory ECG monitoring 382 (67%) In-hospital ECG monitoring 311 (55%) Exercise testing 297 (52%) Orthostatic blood pressure 275 (48%) MRI / CT scan 267 (47%) Neuro. or psy. evaluation 270 (47%) EEG 222 (39%) Carotid sinus massage 205 (36%) Tilt test 201 (35%) Electrophysiology testing 144 (25%) Coronary angiography 133 (23%) External loop recording 67 (12%) ATP test 15 (3%) Other tests 52 (9%) No tests performed 1 (0%)
    • 55. Handicraft culture vs. Industrial culture Ownership Individual Company Product development Integrated Separated Knowledge transfer Personal Explicit Collaboration Interdisciplinary Cross disciplinary Decision Individual Evidence based Value Procedure Product Treatment Tailor-made Standardized Handicraft Industry
    • 56. Clear examples of Medtronic Cooperation in The Netherlands (just a few examples)
      • Octopus Beating Heart Cardiac Surgery Device (Utrecht)
      • AF Alert Device (Maastricht)
      • QT sensor in pacing (Utrecht/Groningen)
      • Interstim Incontinence Therapy (Maastricht)
      • Heart Failure research (Utrecht, Maastricht, Groningen, Leiden)
      • Etc.
      • We are ready for more…..
    • 57. Conclusion/Discussion
      • Europe is THE place to be for Medtech Innovation
      • Health Care Systems are ready for change
      • Regulatory System allows innovation
      • Creativity among MDs and engineers enormous
      • Start up companies are the key to medtech innovation
      • Companies and VC start to seriously invest in incubators
      • Cooperation between universities, hospitals and “small” companies extremely important
      • Governments in many countries (Switzerland, Spain, UK) put real money support in.
      • Governments need to stop talking and put the money in the mouths!!
    • 58.  

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