The State of Healthcare, Trends and Future Developments

1. Healthcare 2.0 The State of Healthcare, Trends and Future Developments Nick van Terheyden, MDChief Medical Officer

2. Agenda Healthcare Problems Current Proposals Meaningful Use and Healthcare Reform Healthcare 2.0 and Social Networking Healthcare Future

3. Hospital Problems

4. 4 Current Problems Facing Clinicians in Healthcare According to an American College of Physician Executives survey, 6 in 10 physicians have considered leaving the profession due to burnout low morale/depression loss of autonomy low reimbursement rates patient overload bureaucratic red tape loss of respect, and medical liability environment “It's getting worse. It's almost like a snowball rolling downhill. No one ever taught us this in medical school. No one ever said, 'Folks, the world is going to change professionally for you, not only technologically, but also in the way that business is done.‘ Complexity and workload is crippling Physicians and hindering their ability to deliver High Quality Care

5. Total Health Care Expenditure as % of GDP

6. Or Put Another Way

7. Compare Healthcare to Other Industries Buy a shirt inTysons Corner This triggers an automatic order to producer in Hong Kong Producer aggregates orders and ships depending on real time demand Order Arrives in Store with little or no human intervention Doctor sees patient Hand writes a prescription Multiple stops for the patient before departing with piece of paper Arrive at pharmacy and find script is incorrect or uncovered or not in stock

8. Foodservices Lab $3,233 About that Bill Administration Pharmacy $1,433 Plant Radiology$1,290 Cardiology$3,943 Billing Intensive Care $17,664 Operating Room $36,127 Meet Gerard Donovan…. ... and his 150 medical staff...

9. Electronic Health Record Universe Critical to the success of electronic health records is to reconcile two opposing needs Enterprise need for structured and coded information capture Physician’s practical need for a fast and easy method for creating clinical notes.

10. Reading to Keep up – Information Overload Today's experienced clinician needs close to 2 million pieces of information to practice medicine Doctors subscribe to an average of seven journals representing over 2,500 new articles each year, making it literally impossible to keep up-to-date with the latest information about diagnosis, prognosis and therapy Comparison of the time required for reading (for general medicine, enough to examine 19 articles per day, 365 days per year ) with the time available (well under an hour per week by British medical consultants, even on self-reports ). Furthermore, the interpretation of patient data is difficult and complicated, mainly because the required expert knowledge in each of the many different medical fields is enormous and the information available for the individual patient is multi-disciplinary, imprecise and very often incomplete.

11. General Risks Odds of being an astronaut: 13,200,000 to 1 Odds of being struck by lightning: 576,000 to 1 Odds of becoming a pro athlete: 22,000 to 1 Odds of injury from fireworks: 19,556 to 1 Odds of being murdered: 18,000 to 1 Odds of injury from shaving: 6,585 to 1 Odds of injury from using a chain saw: 4,464 to 1 Odds of injury from mowing the lawn: 3,623 to 1 Odds of fatally slipping in bath or shower: 2,232 to 1 Odds of finding out your child is a genius: 250 to 1 Odds of getting away with murder: 2 to 1

12. Think about this…... A. The number of gun owners in the US is 80,000,000 B. The number of accidental gun deaths per year (all age groups) is 1,500 C. The number of accidental deaths per gun owner is .0000188 ** **Statistics courtesy of the FBI A. The number of physicians in the US is 700,000 B. Accidental deaths caused by physicians per year is 120,000 C. Accidental deaths per physician is 0.171 * *Statistics courtesy of the US Dept. of Health & Human Services Statistically, doctors are approximately 9,000 times more dangerous than guns p < 0.0000000001

14. Healthcare Risks Chance of dying from SARS in the United States: 1 in 100,000,000 Chance of contracting the human version of mad cow disease: 1 in 40,000,000 Chance of developing schizophrenia: 1 in 100 Chance of getting colon / rectal cancer: 1 in 26 Chance of getting the flu this year: 1 in 10 Chance of getting breast cancer: 1 in 9 Chance of getting arthritis: 1 in 7 Chance of suffering from asthma or allergy diseases: 1 in 6 Chance of getting prostate cancer: 1 in 6 Chance of having a stroke: 1 in 6 Chance of an American woman developing cancer in her lifetime: 1 in 3 Chance of dying from heart disease: 1 in 3 Chance of American man developing cancer in his lifetime: 1 in 2

15. © Gartner Hypecycle for Healthcare Provider Technologies 2006 15

16. Healthcare 2.0 Takes 17 years for Medical Facts to reach routing practice Publication system is flawed Web 2.0/Social Media represents a new way of working – we must all interact Science 2.0 – consumers share more observational data real time Medical Record Banking Patients Like me

17. time ViewForum MRcardio anatomy function perfusion flow viability

18. Fused Visualizations Hemodyn

19. Blood-Flow Simulations Hemodyn Flow velocity on a cut plane along the centerline Flow velocity profile Flow velocity visualized with particles

20. Perceptive Pixels - Multitouch

21. Where are we Headed in Healthcare

22. Nick van Terheyden, MD, CMO, M*Modal Twitter http://twitter.com/drnic1 Technorati http://technorati.com/people/technorati/nvt1 RSSSpeech Understanding http://speechunderstanding.blogspot.com/feeds/posts/default MyBlogLog http://www.mybloglog.com/buzz/members/nvt LinkedIn http://www.linkedin.com/in/nickvt Plaxo http://nvt.myplaxo.com FaceBook http://profile.to/drnick Digg http://digg.com/users/nvt1 Delicious http://delicious.com/nvt1 E-Mail nvt@mmodal.com GrandCentral (301) 355-0877 Where You Can Find Me

23. Give me Some Loving

24. M*Modal Speech Understanding: Nick van Terheyden, MDChief Medical OfficerM*Modal