With this presentation, the objective was to explain to an IT industry audience what eHealth, mHealth and telehealth is, not from an IT but an healthcare transformation perspective.

1. M2M & IoT, London 4 June 2014
Telehealth in practice
across Europe
Marc Lange, Secretary General

2. Competence
Centre
Health Care
Authorities
Industry
Health Care
Delivery
Citizens/Patient
Representative
Innovation
Agency
Insurers
Social Care
Dissemination
Organisation
European Health TELematics
A cross-(any)border and multidisciplinary
collaboration forum
M2M & IoT, London 4 June 2014
Sustainable and large scale
eHealth deployment
requires engagement and synergies
2

3. M2M & IoT, London
4 June
2014
3
Patient’s home Hospital or primary care or eHealth centre
SERVER
PATIENT
REGIONAL CENTRE’S
OPERATOR
TELEMONITORING
DEVICES
GENERAL
PRACTITIONER
CARDIOLOGIST
AT HOSPITAL OR
LOCAL HEALTH
DISTRICT
OTHER INVOLVED
HEALTHCARE
PROFESSIONALS
GATEWAY
& APP
Telehealth

4. Girona, 22 de Maig del 2013
Secure
Complex
Process Oriented
Well-defined models
Regulatoryframe
Agile
Private and personal
Universal Access
Innovation
Framework
From eHealth to mHealth
4 June 2014 M2M & IoT, London 4

5. PwC
20 December 2013
Keeping patients at the centre, we see six broad categories of
mHealth services currently being used for healthcare management
11
Section 2 – The emerging mHealth ecosystem
Socio economic impact of mHealth • Presentacio Mapa de Tendencies 2013
Wellness Services
Self-help services to adopt or avoid certain
behaviours / practices to maintain /
improve general wellness and fitness
levels
Monitoring Services
Services to periodically capture
body/health parameters of patients
who are chronically ill or undergoing
post-acute care or are participating in
clinical trials
Prevention Services
Services used by government and non-
government agencies to spread awareness
and encourage people to adopt or avoid
certain behaviours / practices to prevent
or control disease outbreaks
Diagnostic Services
Services that help healthcare professionals
determine the causes of symptoms; to
provide diagnosis or triage services
Treatment Services
Services that help treat patient
conditions and ensure adherence to
the required treatment regimen /
protocol
Individual Led
Healthcare Systems Strengthening
Solutions that enable provisioning at
institutional end for other service areas:
• Emergency Response
• Healthcare Practitioner Support
• Healthcare Surveillance
• Administration
1
2
3
4
5
6
Healthcare provider led

6. PwC
20 December 2013
As a result, 99 bn EUR could be saved in care costs by 2017 after taking into account
the 211,000 jobs needed to support mHealth deployments
4
Section 1 – Socio-economic impact of mHealth
Socio economic impact of mHealth • Presentacio Mapa de Tendencies 2013
• mHealth enabled cost efficiencies will help EU
economies to sustain social healthcare systems
• Payers will be able to treat additional patients for the
same costs
• Each of the 185 mn patients benefitting from mHealth
will cut their annual healthcare costs by 537 EUR
• Since every individual bears 14% of the annual per
capita healthcare costs out of one’s pocket, the
reduction in healthcare costs for the 185 mn patients
would translate to a saving of about 75 EUR per year
for each of them
99
bn
69
bn
3.7
bn
32
bn
.17
bn
Total healthcare cost
savings in EU in 2017
(EUR)
Wellness and
prevention Diagnosis
Treatment and
Monitoring
Cost savings
in ADE
6.2
bn
Workforce to
support mHealth
8
26
55
76
99
265
2013 2014 2015 2016 2017 Total
Between 2013 and 2017, a total of
265 bn EUR could be saved in
healthcare costs by using mHealth
Source; PwC analysis
Note: *OPE - Out of pocket expenditure that an individual contributes to one's healthcare spend

7. M2M & IoT, London
4 June
2014
7

8. mHealth potentials
• Potential for healthcare
→Increased prevention/quality of life approach
→More efficient and sustainable healthcare
→More empowered patients
• Market potential
84 June 2014 M2M & IoT, London

9. Green Paper - Issues identified
1. data protection
2. big data
3. patient safety
4. lack of knowledge about legal framework
5. mHealth role on healthcare and equal access
6. reimbursement issues
7. interoperability
8. liability
9. research and innovation in the field
10. international cooperation
11. access of web entrepreneurs to the market
94 June 2014 M2M & IoT, London

10. But time for action: already now!!
• What can you do?
• -Developers: develop solutions privacy by
design + user involvement + transparent
information
• -Healthcare professionals: get the digital skills
• -Consumer/patient association: raise
awareness about mHealth benefits and use +
• -Responsible authorities: enforce legislation
104 June 2014 M2M & IoT, London

11. M2M & IoT, London
4 June
2014
11
Patient’s home Hospital or primary care or eHealth centre
SERVER
PATIENT
REGIONAL CENTRE’S
OPERATOR
TELEMONITORING
DEVICES
GENERAL
PRACTITIONER
CARDIOLOGIST
AT HOSPITAL OR
LOCAL HEALTH
DISTRICT
OTHER INVOLVED
HEALTHCARE
PROFESSIONALS
GATEWAY
& APP
Telehealth

12. M2M & IoT, London 4 June 2014
The Secret?
From pilot to routine care …
12

13. Tools and methods are needed to deploy
telehealth services
Impact assessment framework
The results and lessons learned from Renewing Health
The approach of United4Health
Guidelines for large-scale deployment
The Momentum blueprint
Cost and benefit analysis toolkit
Innovation governance
…
4 June 2014M2M & IoT, London
13

14. Testing of Service Routine Care Service
Small Scale
Deployment
Large Scale
Deployment
Hospital Group
Department
Department
HealthCare
System
Piloted Service
Lessons learned from
deployment inside an
organisation
 Local champions
 Limited constraints
(e.g. at legal level)
 Cost and benefit analysis
 …
Lessons learned from
deployment across organisations
(for servicing the healthcare system)
 Institutional endorsement
 Legal constraints (if it is a D2P relationship)
 Need for robust methods
 Socio-economic analysis
 …
From pilot to routine care
4 June 2014M2M & IoT, London
14

15. 4 June 2014
A European
Telemedicine
Deployment Blueprint
M2M & IoT, London
15

16. Strategy
&
Management
Legal,
Regulatory
&
Security
Organisation
&
Change
Mgmt.
Technical
&
Market
relations
Four domains for deployment guidelines
4 June 2014M2M & IoT, London 16

17. Critical Success Factors for
Deployment Strategy
M2M & IoT, London 4 June 2014
1. Check that there is cultural readiness towards
telemedicine.
2. Ensure leadership through a champion.
3. Identify a compelling need.
4. Put together the resources needed for
deployment.
Strategy
&
Management
Legal,
Regulatory
&
Security
Organisation
&
Change
Mgmt.
Technical
&
Market
relations
17

18. Critical Success Factors for
Organisational Change
M2M & IoT, London 4 June 2014
5. Address the needs of the primary client(s).
6. Involve health care professionals and decision-
makers.
7. Prepare and implement a business plan.
8. Prepare and implement a change management plan.
9. Put the patient at the centre
of the service.
Strategy
&
Management
Legal,
Regulatory
&
Security
Organisation
&
Change
Mgmt.
Technical
&
Market
relations
18

19. Strategy
&
Management
Legal,
Regulatory
&
Security
Organisation
&
Change
Mgmt.
Technical
&
Market
relations
Critical Success Factors for Legal,
Regulatory and Security Compliance
M2M & IoT, London 4 June 2014
10. Establish that the service is legal.
11. Ask advice from legal, ethical, privacy and
security experts.
12. Apply relevant legal and security guidelines.
13. Ensure that telemedicine doers and users have
“privacy awareness”.
19

20. Strategy
&
Management
Legal,
Regulatory
&
Security
Organisation
&
Change
Mgmt.
Technical
&
Market
relations
Critical Success Factors for
Technology Decisions
and Procurement
M2M & IoT, London 4 June 2014
14. Ensure that the IT and eHealth infrastructures
needed are in place.
15. Ensure that the technology is user-friendly.
16. Monitor the service.
17. Maintain good practices in vendor relations.
18. Guarantee that the technology has
the potential for scale-up
(i.e., “think big”).
20

21. The challenge for scaling-up innovative
services in healthcare
This is about moving
From building tools and infrastructure
to developing service, redesigning care pathways
From collecting data
to integrating data into care processes
New Technology
+ Old System
= New Old System
M2M & IoT, London
4 June 2014
21

22. Any questions?
M2M & IoT, London 4 June 2014 22
Marc Lange
Secretary general
EHTEL Association
49/51, rue de Trèves
B-1040 Brussels Belgium
Tel: +32 (0)2 230 15 34
Fax: +32 (0)2 230 84 40
Mobile: +32 (0)475 27 71 45
Marc.Lange@ehtel.eu
www.ehtel.eu
More at www.telemedicine-momentum.eu