Ehip1 caring through-sharing the-e health-landscape dirk de langhe veronique lessens2
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Ehip1 caring through-sharing the-e health-landscape dirk de langhe veronique lessens2

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  • 1. The eHealth Landscape Veronique Lessens / Dirk De Langhe Agfa HealthCare, Market Intelligence Healthcare trends
  • 2. World population is growing expanding the number of “health” consumers Population Population Year (in billions) (in thousands) 2010 6,842,923 World 2015 7,219,431 Asia 2020 7,577,889 Africa 2025 7,905,239 2030 8,199,104 Europe Latin Am. 2035 8,463,265 & Car. 2040 8,701,319 Northern Am. 2045 8,907,417 2050 9,075,903 3 Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2004 Revision and World Urbanization Prospects: The 2003 Revision World population is ageing, especially in developed countries 30.0 28.1 25.0 Percentage 60 years or older 20.0 22.1 Global Explosion of 15.0 over 60 10.0 years -olds 10 8.1 5.0 6.9 0.0 1900 1950 2000 2050 2100 World population x is ageing 30% 25% 20% Ageing is 15% especially pronounced 10% in Europe 5% 0% E u ro p e N o r t h A m e r ic a A s ia L a t in A m e r ic a P e r c e n t 6 0 y e a r s a n d o ld e r , 2 0 3 0 p r o j e c t io n 4 Source: Long-Range World Population Projections: Based on the 1998 Revision. The Population Division, Department of Economic and Social Affairs, United Nations Secretariat; US Census Bureau
  • 3. Changing patterns of diseases: 60% of all deaths are due to chronic diseases • 35.000.000 people died from chronic diseases in 2005 in the world. • The highest chronic diseases prevalence are for: • Cardiovascular disease, mainly heart disease, stroke • Cancer • Chronic respiratory diseases • Diabetes • Without actions to address the causes, deaths from chronic diseases will increase by 17% over the next 10 years. • In the USA, 85% of all hospital costs and 69% of all physician costs go to treat chronic diseases Source: WHO (2006) 5 Number of procedures increases with age putting pressures on HC expenditures ƒMedical advancements result in people living longer Ageing ƒThe elderly consume even greater amounts of healthcare delivery Population is consuming services. more healthcare ƒWhen people are above 65 years old, they receive four times the number and of diagnostic procedures as others receive diagnostic Number of services procedures ƒAnnual rate of growth in the number of images radiologists must interpret increases – estimated at 6% to 12% with age x putting pressures on HC expenditures expressed as a share of GDP per capita Increasing Average expenditure per head age profiles put pressure on public health expenditures A g e g ro u p s 6 Source: Economic Policy Committee (2001) “Budgetary challenges posed by ageing populations”
  • 4. Healthcare delivery… a very risky activity Dangerous Regulated Ultra-Safe Total lives lost per year (>1/1 000) (>1/100 000) 100 000 Healthcare Driving 10 000 1 000 Scheduled Airlines 100 Mountain Chemical European Climbing Manufacturing Railroad 10 Bungee Chartered Nuclear Jumping Flight Power 1 10 100 1 000 10 000 100 000 1 000 000 10 0000 000 Number of encounters for each fatality More deaths per encounter than for any other activities ! Adverse events carry a high financial cost, £2 billion a year in additional hospital stays alone in the NHS ! 7 New trend: the patient has a voice and choice Comparative Social / Financial Public quality demographic responsibility policy indicators Connectivity changes Engaged patient Empowered patient • Patient empowerment is a increasingly undisputed fact • Patients are more informed and thus more opinionated • Informed patients will shop for healthcare providers that meet their specific needs and expectations • Informed patients want more customization and move convenience 8
  • 5. Public authorities search for answers to increased demand and cost escalation: Better quality can cost less ! ACCESS „ “Consumer led” delivery service QUALITY OF CARE „ Supporting increased demand for services (in volume and sophistication) „ Patient oriented care/Clinical pathways „ Meeting 24hour/7days a week service „ Collaborative care/Continuum of care Quality Access expectation „ Disease management programmes „ Facing ageing population and new „ “Voluntary” gatekeeper approach pattern of diseases (Global Medical Record) „ Facing individualism and diminishing „ Continuous medical education family care potential (Accreditation) & Peer Review „ Avoiding waiting time initiatives „ Increasing private care „ Increasing attention to Efficiency „ Increasing patient’s co-payment medical/medication errors „ Patient satisfaction Efficiency „ More evidence-based medicine (outcomes based) „ Matching capacity to demand „ Deploying resources more effectively „ Avoid abuse (multiple exams/acts, etc.) „ Reducing costs of well-established procedures „ Controlling escalation of costs „ Transforming healthcare (process & workflows) „ Using new ICT technology to support transformation 9 Public authorities need to do things differently: « Good health can save costs » From «late disease» To «early health» • Symptom based • Prevention / prediction • Data silos • Detailed patient info • Managing illness • Early diagnosis • Average therapies • Targeted therapies Critical information whenever and wherever it’s needed INFORM & SHARE Prevent Diagnose Treat Monitor Identify at risk patients earlier Earlier, more accurate diagnosis Earlier, more targeted treatment Track efficacy of treatment 10
  • 6. New ways of working opening doors to collaborative platforms (eHealth) L a b r e s u lt s I n s u r a n c e in f o r m a t io n D ia g n o s t ic im a g in g More and S c h e d u lin g more collaboration P a t ie n t h is t o r y is required M e d ic a l r e c o r d s ( E M R ) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Today 2002 S o u r c e : T h e F u t u r e o f H e a lt h C a r e 2 0 0 5 , D e lo it t e D e v e l o p m e n t L L C . Collaborati x on @ GP “Early @ H o s p ita l @ L o c a l fa c ilitie s @ S p e c ia lis t Health” R a d io lo g y P ro v id e r/ breaking the in fo rm a tio n P a tie n t s y s te m s a n d hospital m e d ic a l boundaries te c h n o lo g ie s @ T e le ra io lo g y c o m p a n @ P riv a te R a d io lo g y c e n tre s 11 Source: The Future of Health Care 2005, Deloitte Development LLC. Summary: The Healthcare paradigm is evolving … TODAY TOMORROW Treatment of Paradigm Health of citizens patients Focus Provider centric Patient centric Episodic approach, Time Scope Lifetime care, preventive curative Decentralized, Space Scope Hospital based community based Treatment & Invasive, Less invasive visualization imaging scope uncomfortable & treatment Workflow Fragmented Integrated & automated 12
  • 7. Transforming healthcare… The Problem… 14
  • 8. And… 15 Defining a Vision of the Future: eHealth Today Tomorrow Technology Disparate Information Systems Connected Information Systems Data Access Limited, Difficult to Access Ready Real Time Access Data Accuracy / Manual Systematic Controls / Checks Completeness Decision Support Personal Preference Rules / Evidence Based Ordering Process Manual, Multiple Hand-Offs Automated, Minimal Hand-Offs Care Delivery Individual Experience Adoption of Clinical Best Practices Patient Record Multiple Sources, Incomplete Single Integrated / Complete Source Outcome No Linkage to Care Structured Data Repository Linking Measurement Delivered Outcomes to Care Delivered 16
  • 9. The eHealth market Global Healthcare IT (eHealth) market worth €55 Billion… but representing only 1.5% of HC spending GDP 5.4 % GDP = $46,305 billion 9.9% GDP ICT market = $2,490 billion 45.3% ICT market HC market = $4,581 billion IT market = $1,129 billion 6.0% IT market 1.5% HC market HC IT market* (per year) = $68 billion * HC IT market includes Government, Payers and Providers 18 Source: European Information Technology Observatory in co-operation with IDC (2006): Cutler & McClellan; Health Industry Insights, an IDC company (2006); Clinica (2003); Espicom; Agfa’own estimates.
  • 10. Healthcare currently one of the lower IT spending sector although urgent need for transformation % of IT spending on total revenues 12.00% 11.10% 10.00% 8.00% 6.00% 3.90% 4.00% 1.50% 2.00% 0.00% Healthcare Retail Financial • Currently one of the lower IT spending sector with 1.5% average (w.r.t. revenues) compared to retail (~4%) and financials (10+%) • Set to increase at an annual growth rate of ~9% 19 Source: European Information Technology Observatory in co-operation with IDC (2006): Cutler & McClellan; Health Industry Insights, an IDC company (2006); Clinica (2003); Espicom; Agfa’own estimates. Although one of the most complex and information-intensive, spend per employee are far behind other sector domains £8,790 Annual spend per employee (UK only) £5,538 £4,333 £3,833 £3,393 £3,017 £2,920 £979 lth ies s s on ce t ing ce en ice a ilit an uti i He rnm tur erv erv Ut Fin r ib fac rs ss ve t Dis nu he Go es Ma Ot s in Bu 20 Source: HINE (2004)
  • 11. European end-users also lacking behind … with 70% of EU hospitals spending less than 2% of revenues IT Budget as % of total budget 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2% or less 2.1 - 2.5% 2.6 - 3% 3.1 - 4% >4% EU 70.4% 10.9% 6.8% 5.9% 6.1% USA 24% 25% 18% 19% 9% • In Europe, 70% of the hospitals spend less than 2% of their total revenues, while 70% of their US colleagues were spending more than 2% in 2004. • But spending are on the increasing pattern. 21 Source: HINE 2005&2006; HIMSS Analystics 2005&6 eHealth creating tremendous opportunity for Europe at the crossroads of Health and Technology Healthcare Healthcare IT Health is Wealth A tool for transformation Responding to healthcare challenges for the citizens • Escalating demands Demand for automation solutions • Labour shortage • Higher quality health services • Eliminate manual, error-prone workflow • Patient safety imperative • Improve clinical productivity • At a ‘contained’ cost level • Re-allocate resources; emphasize revenue Health is important to a country’s economy. generating opportunities • Health employs currently 10% of Europe’s workforce Digital medical record initiatives • Health represents 8.6% of the EU-15’s economy • Must be multimodal • Health is expected to triple by 2020 and reach 16% • Workflow includes clinical patient data of GDP. Health infrastructure is key • Maximize value of IT investments • Health infrastructure which improves health and supports strategic objectives of prosperity, Government initiatives solidarity and security is needed. • National/Regional programs Health is wealth. • E-Health • A society in good health leads to higher productivity, increased labour supply, better • Disease management/Population Management education and contributes to sustainable long- term growth. Innovation supporting paradigm shift from “sick care” to “health care”, the so-called Continnum of Care 22 Source: Agfa’own estimates
  • 12. But … Key issues to address • eHealth currently treated as an add-on rather than part of an integrated eco-system. • Standards for interoperability of ICT, being adopted consistently, should be further encouraged. • Increased funding and alignment of Incentives between who pays and who benefits from ICT in health should be undertaken. • People, processes and change management should receive more attention for implementation. • The involvement of end users (health professionals and patients) is essential for developing ICT solutions. • An emerging challenge is coming to widely held concepts of privacy and confidentiality. • Innovation and research should be stimulated and better coordinated at crossroads of social, health, ICT and life science aspects. • 23 24