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ADL - 9iun2011


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ADL - 9iun2011

  1. 1. Experiences from national eHealth Roll-out in Slovakia June 09, 2011 Arthur D. Little GmbH Danube House Karolinská 650/1 186 00 Prague 8 Czech Republic Tel.: +420 224 941 303 Fax: +420 224 941 302
  2. 2. Content 1 ADL Introduction 2 Experiences from national eHealth roll-out in Slovakia
  3. 3. Arthur D. Little is the world’s first management consulting firm A Long and Proud History & Heritage We focus on combining strategy, technology and innovation <ul><ul><li>Founded in 1886 as the world’s first management consulting firm </li></ul></ul><ul><ul><li>Today a premier global management consulting firm with 35 offices worldwide </li></ul></ul><ul><ul><li>Serving 75% of FTSE and Fortune 100 </li></ul></ul><ul><ul><li>A member of the Altran Technology group </li></ul></ul><ul><ul><li>NASA and ADL </li></ul></ul><ul><ul><ul><li>Arthur D. Little was hired to assist in the planning and execution of the Apollo 11 mission </li></ul></ul></ul><ul><ul><ul><li>The result: NASA kept their deadline of putting a man on the moon before the end of the decade </li></ul></ul></ul>
  4. 4. A Global Player: We have the global reach and local market experience to ensure our clients achieve their objectives Also at our disposal are Altran’s considerable resources – more than 18,000 consultants worldwide ( <ul><li>Berlin </li></ul><ul><li>Brussels </li></ul><ul><li>Cambridge </li></ul><ul><li>Duesseldorf </li></ul><ul><li>Gothenburg </li></ul><ul><li>Lisbon </li></ul><ul><li>London </li></ul><ul><li>Madrid </li></ul><ul><li>Milan </li></ul><ul><li>Munich </li></ul><ul><li>Paris </li></ul><ul><li>Prague </li></ul><ul><li>Rome </li></ul><ul><li>Rotterdam </li></ul><ul><li>Stockholm </li></ul>Europe Middle East South America Asia / Pacific North America <ul><li>Boston </li></ul><ul><li>Houston </li></ul><ul><li>Buenos Aires </li></ul><ul><li>S ã o Paulo </li></ul><ul><li>Rio de Janeiro </li></ul><ul><li>Dubai </li></ul><ul><li>Riyadh </li></ul><ul><li>Wien </li></ul><ul><li>Wiesbaden </li></ul><ul><li>Zagreb </li></ul><ul><li>Zurich </li></ul><ul><li>Bangalore </li></ul><ul><li>Beijing </li></ul><ul><li>Delhi </li></ul><ul><li>Hong Kong </li></ul><ul><li>Kuala Lumpur </li></ul><ul><li>Seoul </li></ul><ul><li>Shanghai </li></ul><ul><li>Singapore </li></ul><ul><li>Tokyo </li></ul>Europe Offices worldwide: 35 Consultants: 800 Employees 1,000 Consultants in group 18,000 Arthur D. Little’s global presence Thinking Globally – Acting Locally
  5. 5. Content 1 ADL Introduction 2 Experiences from national eHealth roll-out in Slovakia
  6. 6. Majority of projections on healthcare cost development in the coming decades expect substantial increase in healthcare costs across the globe 14 Expected development of healthcare costs as a share of GDP Source : Arthur D. Little research 5% 20% 15% 10% Western Europe North America 0% Central and Eastern Europe Asia Latin America Middle East Predicted development Comments <ul><ul><li>Until 2020, we can expect significant growth of healthcare costs in US as well as in countries of Western and Eastern Europe </li></ul></ul><ul><ul><li>Some of the reports project increase of US healthcare costs to the level of 22% of GDP </li></ul></ul><ul><ul><li>The costs of healthcare in Western Europe should reach by 2020 level of 13% to 14% of GDP </li></ul></ul><ul><ul><li>Conservative prognosis of healthcare costs in Slovakia in 2025 reaches level of 9.1% to 11% </li></ul></ul><ul><ul><li>Analysis of ADL predicts the healthcare cost development in SR, if no measures are taken to stabilize growing costs, to reach level of 1 1 .5%-1 2 % by 2020 </li></ul></ul>Healthcare trends
  7. 7. The roll-out of Slovak national eHealth system is mostly financed from EU structural funds under Operational Program – Informatization of Society The combined costs, state budget and EU structural funds, for Slovak national roll-out is estimated at 138 mil. EUR Management structure of Slovak national eHealth roll-out Implementation structure of national eHealth roll-out in Slovakia Ministry of Finance SR <ul><ul><li>Management authority for Operational Program – Informatization of Society </li></ul></ul><ul><ul><li>Project objectives fulfilment monitoring </li></ul></ul>Ministry of Healthcare SR <ul><ul><li>eHealth strategic direction </li></ul></ul><ul><ul><li>eHealth implementation fund recipient </li></ul></ul><ul><ul><li>Tendering and contractual body for 3 rd parties </li></ul></ul>National Center for Health information <ul><ul><li>National eHealth implementation authority </li></ul></ul><ul><ul><li>PMO of eHealth roll-out </li></ul></ul><ul><ul><li>National eHealth operator </li></ul></ul>Ministry of Healthcare SR EU Funding EU Funding HC budget
  8. 8. After parliamentary election in July 2010, the new political leadership in Slovakia have initiated a thorough audit of national eHealth rollout Shift in priorities with change of political leadership on Slovakia Shift in national eHealth priorities 2008 2009 – 06 /2010 07 / 2010 2014 <ul><ul><li>Focus on decrease of national DALY* and increase of citizen’s health </li></ul></ul><ul><ul><li>Building robust and centralized national eHealth solution </li></ul></ul><ul><ul><li>Increase healthcare efficiency </li></ul></ul>Governmental eHealth strategy formulated Feasibility studies and technical architecture and implementation kick-off 03 / 2011 Parliamentary election resulting in opposition forming new government - Implementation Audit Revised Governmental eHealth strategy developed Expected deadline for national eHealth implementation Milestones in eHealth deployment Key priorities for national eHealth system <ul><ul><li>Preparation of technology strategy for eHealth system </li></ul></ul><ul><ul><li>Preparation of two feasibility studies evaluating eHealth deployment and defining scope of service offered </li></ul></ul>Arthur D. Little involvement <ul><ul><li>Project objectives primarily focused on: </li></ul></ul><ul><ul><ul><li>Cost savings </li></ul></ul></ul><ul><ul><ul><li>Increase of efficiency </li></ul></ul></ul><ul><ul><ul><li>Increase of citizen’s satisfaction </li></ul></ul></ul><ul><ul><li>Building less centralized and gradually deployed eHealth solution </li></ul></ul><ul><ul><li>Revising feasibility study for the second phase of eHealth rollout in order to include shift in changed priorities as well </li></ul></ul>2 3 1 *Disability-Adjusted Life Years 2 1
  9. 9. The costs of eHealth implementation in selected European countries varies and is often influenced by the scope and duration of the implementation 140 Costs of eHealth implementation Source:EC report * estimate Costs of eHealth implementation in selected countries and regions of Europe eHealth syst e m Region / Country Population Implementation costs (mil. EUR ) Costs per capita (EUR) Implementation years Computerised patient record system Canton Geneva , Switzerland 453 tis. 59.4 mil. 131 10 Regional EHR and ePrescribing system Andal us ia, Spain 8.3 mil. 170 mil. 20 7 Regional integrated EHR and ePrescribing Kronoberg, Sweden 177 tis. 85 mil. 480 8 Dossier Patient Partagé Réparti (DPPR) Rhone-Alpes , France 6 mil. 44 mil. 7 7 The health information platform SISS Lombard y , Italy 9.9 mil. 595 mil. 60 7 National eHealth System National roll-out, Slovakia 5.4 mil. 138 mil.* 26 7*
  10. 10. The expected return on investment from Slovak eHealth rollout in terms of years to positive return is similar to other European eHealth implementations 2 Overview of return on investment of selected eHealth systems in Europe Key impacts Calculation of socio-economic return is methodology used by European Commission for calculation of overall return from eHealth system implementations Return on investment from eHealth deployment <ul><ul><li>Citizens </li></ul></ul><ul><ul><ul><li>Reduction of errors in care </li></ul></ul></ul><ul><ul><ul><li>Better informed diagnostic and medication decisions </li></ul></ul></ul><ul><ul><ul><li>Decrease of duplicities in diagnosis, tests and therapy </li></ul></ul></ul><ul><ul><li>Healthcare providers </li></ul></ul><ul><ul><ul><li>More effective care </li></ul></ul></ul><ul><ul><ul><li>Reduced costs of drugs </li></ul></ul></ul><ul><ul><ul><li>More informed diagnostic procedures </li></ul></ul></ul><ul><ul><li>Insurance companies </li></ul></ul><ul><ul><ul><li>Decreased costs </li></ul></ul></ul>Source: EC Report in socio-economic returns of eHealth implementations 9 Kronoberg (Sweden) Rhone–Alp. (France) 7 8 7 Diraya (Andalusia, Spain) HUG (Canton Geneva) 8 Lombardy (Italy) 8 Average Years to positive cumulative SER* Year to positive SER* Years Slovakia 7.8
  11. 11. In the separate project, Arthur D. Little helped to define the overall eHealth strategy with focus on decisions Architectural Framework Key eHealth Attributes Integration Security Presentation eHealth services and domains Application components Database Database functions Data standards Operations Organization Infrastructure I &A mgmt. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1 2 8 3 1 3 1 4 3 4 7 9 12 11 14 15 6 13 11 10 1 5 eHealth strategy project The main goal of eHealth Efficiency in providing healthcare Health of citizens Security measures used Standard Higher than in other e-services <ul><ul><li>Number of eHealth operators </li></ul></ul>One operator Several Ownership of the eHealth operators State owned Private Access to eHealth services One access point More access points Database - registers Centralised Distributed Compatibility with other eGovernment services Basic Enhanced Number of authentication methods One mechanism More mechanisms Client data exchange standard used <ul><ul><li>HL7 v3 </li></ul></ul>EN 13606 (STN EN 13606) Personal Health Record concept PHR as a presentation component PHR as an integration component Clinical terminology <ul><ul><li>Snomed CT </li></ul></ul>Own terminology Integration architecture of eHealth domains Integration hub in SOA architecture Direct communication Database – clinical data Distributed Combined Electronic Health Record data model <ul><ul><li>Based on OpenEHR </li></ul></ul>Own design Data model of the database – registers Demographical data based on archetypes Fixed data model
  12. 12. Implementation of national eHealth system is a demanding initiative which requires fulfilment of several success factors Strong PMO / National operator Integration eHealth strategy Managing of buy-in of Healthcare providers 1 3 2 4 Key success factors Key lessons learned and key success factors <ul><ul><li>Evaluation and agreement on critical technological, organizational and operational aspects of eHealth solution </li></ul></ul><ul><ul><li>Agreement on key objectives, focus and scope of the eHealth system </li></ul></ul><ul><ul><li>Agreement on initial architecture of eHealth system </li></ul></ul><ul><ul><li>Establish and manage forum of recognized representatives of healthcare sector </li></ul></ul><ul><ul><li>Focus buy-in on explaining eHealth features that make “life easier” for medical community </li></ul></ul><ul><ul><li>Establish strong PMO organization with the managerial and technological capability of managing the implementation </li></ul></ul><ul><ul><ul><li>Formal PMO structure </li></ul></ul></ul><ul><ul><ul><li>Division of work into workstreams </li></ul></ul></ul><ul><ul><li>Establish communication with vendors of HIS/AIS IS – i.e. include representatives in the “eHealth forum” </li></ul></ul><ul><ul><li>Develop standardized interfaces and pre-discuss with software vendors </li></ul></ul><ul><ul><li>Consider providing a scheme of subsidies for integration of HIS </li></ul></ul>
  13. 13. Arthur D. Little is the oldest management consulting firm in the world and assists clients with complex assignments in a wide range of industries Arthur D. Little, founded in 1886, is a global leader in management consultancy, linking strategy, innovation and technology with deep industry knowledge. We offer our clients sustainable solutions to their most complex business problems. Arthur D. Little has a collaborative client engagement style, exceptional people and a firm-wide commitment to quality and integrity. Visit us at 50 Contact: Marcel Hominda Principal Arthur D. Little GmbH Organizacni slozka Danube House Karolinska 650/1 186 00 Praha 8 Tel.: +420 224 941 303 Fax: +420 224 941 302 E-mail: Thank you for attention
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