Tx Ph Uimp

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Tx Ph Uimp

  1. 1. CSR/VNI domiciliaria y telemedicina. Incidencia, presente y futuro José María Fernández Philips Home Healthcare Solutions “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.”
  2. 2. Overview • CSR/VNI at home • Encorepro Anywhere: starting point • Challenges for the healthcare system • Technology examples : Decentralized approaches • Philips present & future in telemedicine “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 2
  3. 3. CSR/VNI at home “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 2
  4. 4. • CHF • Home care • Ventilation “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 2
  5. 5. SBAS Classification Complicated Breathing Pattern Obstructive Sleep Central Sleep Apnea Apnea Mixed Sleep Apnea Complex Breathing Pattern Complex Sleep Periodic Apnea Breathing Cheyne Stokes Respiration “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  6. 6. Cheyne-Stokes-Respiration (CSR): • Regulation of respiratory effort by the CO2 concentration in the blood is affected. • Reduced cardiac output and hypersensitivity of CO2 receptors. • Flow limitations and obstructions can worsen the situation. • Hypoventilation and Hyerventilation. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  7. 7. 1. Hanly PJ, Zuberi-Khokhar NS., Am J Respir Crit Care Med 1996. 2. Lanfranchi PA, et al., Circulation 1999. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  8. 8. SDB and Cardiology Two major groups • Hypertension • Chronic Heart Failure - App. 2% of the population are related to Heart Failure - Classification NYHA I -IV “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  9. 9. Heart Failure All Patients with Heart Failure SDB No-SDB “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  10. 10. Types of SDB in HF All Heart Failure SDB No-SDB CSR OSA OSA+CSR “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  11. 11. SDB and CHF  With 203 CHF-Patients New! 71% had an AHI >10, 43% of all CHF-Patients had OSA, 28% of the CHF-Patients had CSR. Obstructive Central Schulz, Blau, Duchna, et al. Apnoea Apnoea Eur Respir J 2007; 29: 1–5 / CSR  SDB in 70 % of 450 Patients with CHF (mean LVEF = 27.3 ± 15.6%) 33% central sleep apnoea/CSR, CHF Patients 37% obstructive sleep apnoea, 30% normal. Sin, et. al, AM J Respir Crit Care Med. 1999 “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  12. 12. Some calculations … • SPAIN population : > 45.000.000 • CHF = 2% population : 900.000 • SDB = 70% : 630.000 • CSR = 30 % : 190.000 “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  13. 13. ? CSR! “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  14. 14. 5 Min. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  15. 15. 10 Min. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  16. 16. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  17. 17. Successful Therapy with BiPAP autoSV. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  18. 18. 1.8i P ro re Enco “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  19. 19. Publications Automatic Servo-Ventilation (ASV) Kasai et al. First Experience of Using New Adaptive Servo-Ventilation Device for Cheyne-Stokes Respiration With Central Sleep Apnea Among Japanese Patients With Congestive Heart Failure. Circ J 2006; 70: 1148–1154: Conclusions „ASV markedly improved CSR-CSA in patients with CHF. In addition, the sleep quality improved significantly on ASV, including – arousal index (62.0±10.5 to 18.7±6.2 /h, p=0.012), – percentage of slow-wave sleep(2.6±2.6 to 19.4±4.8 %, p=0.042).“ “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  20. 20. Publications Automatic Servo-Ventilation (ASV) Zhang XL, et al. Efficacy of adaptive pressure support servo-ventilation in patients with congestive heart failure and Cheyne-Stokes respiration. Zhonghua Yi Xue Za Zhi. 2006 Jun 20;86(23):1620-3. 14 Patients, controll group, compared with O2-Therapy and ASV • ASV always more effective than O2-Therapy • AHI ↓ • Arousals ↓ • LVEF ↑ • Six minute walk distance ↑ „CONCLUSION: APSSV, more effective than oxygen therapy, is of great clinical significance in improvement of CHF and its prognosis by a better sleep and breathing.“ “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  21. 21. Reduction of AHI and mortality CANPAP-Study: • Support of CPAP pressure for HF was investigated. • With HF patients CPAP could improve – Nocturnal oxygen desaturation, – Ejection fraction of the heart (LVEF), – Physical capability (six minute walk). • But: with 50% of the patients the AHI could not be reduced. • Mortality over all was not improved (worsened in the beginning, better in the long term). Bradley TD, et al. Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med. 2005;353:2025–2033. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  22. 22. Reduction of AHI and mortality Post-Hoc analysis of CANPAP-Study: New! • Mortality was improved, whenever CPAP therapy could reduce AHI below 15/h. Michael Arzt, et al. A Post Hoc Analysis of the Canadian Continuous Positive Airway Pressure for Patients With Central Sleep Apnea and Heart Failure Trial (CANPAP) Circulation. 2007;115:3173-3180. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  23. 23. Reduction of AHI and mortality New! Michael Arzt, et al. A Post Hoc Analysis of the Canadian Continuous Positive Airway Pressure for Patients With Central Sleep Apnea and Heart Failure Trial (CANPAP) Circulation. 2007;115:3173-3180. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  24. 24. ASV (BiPAP® autoSV™) lowers AHI more effectively than CPAP New! Michael Arzt et al. Effects of Dynamic Bilevel Positive Airway Pressure Support on Central Sleep Apnea in Men with Heart Failure. Chest 2007 Oct 20; Epub ahead of print. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  25. 25. These patients … … Are treated at home … and can save costs by avoiding entering into the health system … can be followed up at home … telemedicine can help “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  26. 26. Encorepro Anywhere: starting point “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 2
  27. 27. Challenges for Achieving Patient Compliance • Access to patient data for timely intervention • Too little time, so many patients • Communication and collaboration with “care team” Solution: The EncoreAnywhere “My Day” page automatically identifies patient specific issues enabling fast and easy prioritization of patient intervention. Data can be automatically downloaded on daily basis via a wired modem. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  28. 28. Challenges for Achieving Patient Compliance • Access to patient data for timely intervention • Too little time, so many patients • Communication and collaboration with “care team” • Reimbursement Solution: Through EncoreAnywhere, the entire care team has access to the same information and can communicate via notification messages. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  29. 29. System Overview Data Center Interne t Wired Modem Sleep Lab Standard Web Browser Smart card Homecare Physician Provider “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  30. 30. EncoreAnywhere Features • The Best of Encore Pro features with a Different “Look and Feel” – Patient record with demographics – Compliance downloads via SmartCard – Compliance reports – Device, mask, and accessory prescriptions • New features in EncoreAnywhere – Compliance data downloads via wired modem – Physician and Sleep Lab access and communication – Management by exception “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  31. 31. Access – Anytime, Anywhere “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  32. 32. Your first stop - The “My Day” Page “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  33. 33. Patient Record “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  34. 34. Prescriptions Send prescription via modem or smartcard. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  35. 35. Therapy Data “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  36. 36. Contacts and Questionnaires “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  37. 37. Notes “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  38. 38. History “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  39. 39. The “My Patients” Page “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  40. 40. M Series Wired Modem • Fits into smartcard accessory slot • No interference with patient phone use • Toll free outbound connections • Modem stores patient data and automatically downloads to Encore Anywhere • Automatic prescription changes (press and hold for 2 sec) “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  41. 41. Challenges for the healthcare system “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 2
  42. 42. Why ageing calls for healthcare reforms 50% 25% of healthcare costs of the population would is spent on people of 65 years and older 40% need to work in healthcare by 2040 to provide current of people in EU will levels of care be 65+ by 2050 75% 30% of healthcare costs is of doctors in former East Germany spent on chronic will retire by 2010, most without diseases 34% succession in place Of German hospitals is loss making “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  43. 43. Challenges for the healthcare system: Major Trends • Aging population • Resistance to pathogens • Patients as informed consumers • Growing importance of quality of life • Decentralization within the healthcare system • Convergence of diagnosis and therapy • Performance-based payment “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 3
  44. 44. Challenges for the healthcare system: Support from the Electrical Engineering Industry • The electrical industry has a major influence on product design, productivity progress and growth in various sectors • The electrical industry can provide extensive support with regard to improvements in the healthcare system – Link hospitals, doctors, therapists and patients – Wider use of sensor technology, remote monitoring – Improved diagnostics (imaging and analysis) “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  45. 45. Challenges for the healthcare system: Example - IT in the healthcare system • Wider use of IT can help to significantly reduce costs while improving quality • This can be achieved by – Simplifying and reducing processes – Increasing efficiency – Avoiding duplicate examinations “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 5
  46. 46. Demographic development: People Are Living Longer – Everywhere Proportion of the population aged over 65 World 2030 2000 US China Japan EU 0 10 20 30 40 “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes Proportion in percent no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  47. 47. Demographic development: Health Costs Increase with Age Annual expenditures in thousands of Euros, Germany 10 Men Women 5 0 10 20 30 40 50 60 70 80 90 Alter Age “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered Source: PKV-Kopfschadenstatistik (Private health association per-head damage statistics) (2004); in-house calculation physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  48. 48. Chronic Diseases; Cost Drivers in the German Healthcare System • Cardiac insufficiency (CHF) – 800,000 diagnosed patients, second-highest mortality rate – €2.4 billion in annual costs for the over-65s, 2/3 of which incurred by hospitals – 40 percent of cases require re-hospitalization in 3 – 6 months, half of which are avoidable • Diabetes – 5,700,000 diagnosed patients – Estimated diabetes-associated direct costs: €15 billion per year • Chronic respiratory illnesses (COPD) – 700,000 diagnosed patients in Germany – 50 percent re-hospitalization rate within 6 months “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  49. 49. Chronic Diseases: Making it Easier to Live with a Chronic Diseases • Develop decentralized solutions to increase quality of treatment and to reduce costs • Avoid hospitalizations or re -hospitalization “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 10
  50. 50. Decentralized healthcare: Decentralized Approaches Gain Acceptance • Telecommunications and broadband applications are gaining ground when it comes to supporting old and chronically ill people. Costs and availability are no longer an obstacle. • Telemedical solutions enable an increase in standard of life and a reduction in mortality rates: – Patients know their current state of health and learn how to live with their disease • Increasing acceptance of decentralized solutions: – In the UK and Sweden around 10 percent of seniors use such solutions whereas in other countries this figure is less than three percent “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  51. 51. Technology examples : Decentralized approaches “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 2
  52. 52. Decentralized healthcare: Decentralized Treatment. Example – Cardiac Insufficiency Diagnosis and feedback to patient Patient Monitoring Center Doctor Data transfer • Real-time information about state of health • Analysis and feedback “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 52
  53. 53. Decentralized healthcare: Benefits of Telemonitoring Support Conventional model Telemonitoring model Doctor Doctor Doctor Doctor Doctor Doctor Doctor Doctor State of health State of health Care Care Manager Manager Emergency Emergency doctor doctor Clinic Time Time “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes Collecting health status data no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential 13 Philips Home Healthcare Solutions
  54. 54. Decentralized healthcare: Continued Monitoring of Vital Body Signs “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  55. 55. Decentralized healthcare: Stroke Rehabilitation at Home Patient Therapist “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  56. 56. Decentralized healthcare: New Diagnostic Options Decentralizing examinations Now  In future + Central laboratory Ward Hospital bed At home Hours - days Immediately - in minutes Blood sugar/fat values     Heart failure/heart attack    + Chronic kidney failure    + Cancer - chemotherapy   + + Asthma   + + Sepsis   + + Osteoporosis   + + “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  57. 57. Decentralized healthcare: Home Treatment • Easy to use – the patient can conduct tests on his/her own at any time (as with diabetes) Analysis Behavior data info Philips Home Doctor’s Response Health Hub diagnosis • Send analysis data to doctor for analysis • Traffic light response to patient: go see the doctor, call the doctor, all is well “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions
  58. 58. Philips present & future in telemedicine “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 2
  59. 59. Philips Home Healthcare Solutions – Portfolio of Services Challenges of independent living for at-risk elderly and chronically ill people • Loneliness, uncertainty and social isolation • Delayed responses to emergencies • Inability of self health management (medication compliance, lifestyle, self monitoring) • Inability to perform Activities of Daily Living (dressing, bathing, nutrition) TeleCare TeleHealth / RPM Event Social Alarms (PERS) Telemonitoring Patient Empowerment Monitoring Philips Telemonitoring Services (PTS) “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 59
  60. 60. Philips Lifeline • Lifeline improves well-being and feelings of safety for patients and their caregivers • It is a trusted and affordable service, embedded in the communities it serves • 90% of subscriptions are paid out of pocket—half of those subscriptions are paid by the children • 96% of Lifeline calls are not related to emergency response, but related to reassurance and social support • Lifeline subscribers are 10 times less likely to be institutionalized in a long-term care facility • Lifeline subscribers had a 26% decrease in hospital admissions and a 23% decrease in length of stay. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 60
  61. 61. How Philips Lifeline Works 1 Subscriber Summons Help Personal Help Button / Lifeline Home Unit 2 Professional Intervention 3 Caring Lifeline Response 4 Follow up by Lifeline Professional “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 61
  62. 62. Personal Medication System MD2 “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 62
  63. 63. Philips Telemonitoring System (PTS) “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 63
  64. 64. Philips interactive telemonitoring healthcare platform • Providing an interactive care bridge between patients and their healthcare providers – Better patient health – Tailor-made care – Patient satisfaction “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 64
  65. 65. Tools to enable Patient Self-management Inform Nurse with Daily Health Surveys Timely Reminders and Goal Setting Knowledge Motivation Feedback on Goals “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 65
  66. 66. Portfolio of Raytel “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 66
  67. 67. Outlook and Conclusion Today Tomorrow Imaging – early and Image-based accurate diagnosis intervention and molecular diagnostics Clinical IT – Clinical decision-making correct information at and support through the right time increased use of IT Basic care Comprehensive delivery at home healthcare provisioning, telemonitoring, decentralized diagnostics “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 67
  68. 68. (the future) Philips Home Monitoring Platform “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions 68
  69. 69. “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Philips Home Healthcare Solutions

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