1. 1 Karl-Jürgen Schmitt Siemens Medical Solutions June 07, 2005 eHealth 05 eHealth as a Driver to Optimise Healthcare Processes eHealth 05 eHealth as a Driver to Optimise Healthcare Processes

2. 2 QualityCost Through: Innovation Process optimization of healthcare delivery A common goal: Improve healthcare efficiency Proven Outcomes

3. 3 Sick, injured Healed, fit for work Patient Information Medical Knowledge Examination DiagnosisTherapyCare Improving efficiency with the patient in focus

4. 4 Therapy Diagnosis Health Management Mobile Care Home Care Ambulatory Care Stationary Care IT is key in integrating and optimising work- flows throughout the healthcare continuum Prevention / Early Detection

5. 5 Health Management Med meets IT Therapy Diagnosis Mobile Care Home Care Ambulatory Care Stationary Care Prevention / Early Detection IT is key in integrating and optimising work- flows throughout the healthcare continuum

6. 6 Integrated IT platforms help improve efficiency Dicom Market-driven communication standards must be used IHE HL7

7. 7 Costs for the insured Early recognition Diagnosis TherapyRehab. ‘Adverse Events’ Actual (w/o ‘Adverse Events‘) Ideal Significant potential to improve the quality of the healthcare system 90,000 Deaths 1 1 Source: Institute of Medicine, To Err is Human, 1999, p.26. American Hospital Association. Hospital Statistics. Chicago. 1999

8. 8 Chart copy sent to pharmacy Medication Errors in the USA Ordering 50% - 55% Transcription 6% - 12% Dispensing 5% - 14% Administration 33% - 38% Physician Order Review by Nurse Transcription Order Entry (Rx System) Administration Documented Verification by Pharmacist Medication Dispensed Nurse confirms drug, dose, route, time, and patient Medication Administered Optimising healthcare processes with IT Source: Agency for Healthcare Research and Quality, 2001 Example: Conventional medication process

9. 9 Chart copy sent to pharmacy Medication Errors in the USA Ordering 50% - 55% Transcription 6% - 12% Dispensing 5% - 14% Administration 33% - 38% Physician Order Review by Nurse Transcription Order Entry (Rx System) Administration Documented Verification by Pharmacist Medication Dispensed Nurse confirms drug, dose, route, time, and patient Medication Administered Source: Agency for Healthcare Research and Quality, 2001 Deaths7.000 (1999) Savings Potential$1.6... 5.6 billion * in US hospitals Effects on Healthcare System * Optimising healthcare processes with IT Example: Conventional medication process

10. 10 Verification by Pharmacist Administration Documented Nurse confirms drug, dose, route, time, and patient Medication Dispensed Physician Order Results Process simplification to reduce medication errors Includes software, barcodes, and an automated dispenser system All data available for later evaluation Optimising healthcare processes with IT Example: IT-supported medication process

11. 11 73% decrease in erroneous and unclear prescription Stockholm, Schweden „Proven Outcomes“ in medication: Real results with IT-supported processes Quality Costs Preventing 118 potential medication errors monthly. Estimated annual savings: $944 k Virginia, USA 96% decrease in medication turnaround time New York, USA 52% reduction of medication turnaround time, 35% reduction of medication errors Ohio, USA Quality Costs Quality Costs Quality Costs

12. 12 Project Outcome (2001 – 2002) Participants 7,000 20% = 1,400 Quantifying Vascular Risk Screening: A successful method of Telematic Internet-based prevention method to quantify vascular risks De-central examination, central and quality controlled reporting by experts Participant with higher risk can subscribe in a Disease Management Program Partner: University Erlangen- Nürnberg, Siemens Insurance Fund and Siemens Medical Solutions Project Higher Risk Disease Management Program Continuation in larger cities with up to 50 000 participants/year

13. 13 A promising project for disease management with IT in Scotland Disease Management Diabetes, Diabetic Retinopathy (DR) Up to 10% of Europeans diabetic 60% of diabetics develop DR DR is leading cause of blindness for individuals > 65 years of age Blindness can be avoided in 90% of DR cases if detected early Huge Potential Quality Compliance Processes Use of Resources Outcomes Improved... Implementation of an integrated, IT-supported Disease Management NHS Scotland and Siemens Medical Mobile Examination Inform Patient Central Evaluation by Experts Registration, Invitation 300.000 exam- inations / year planned 73 locations 5 regional evaluation centers

14. 14 The potential of care quality remains very large to improve the eHealth... the key enabler

15. 15 What do we need to do to realize the potential?  Patients / healthy individuals must be in focus  Define which healthcare services should be regulated and which aspects should be open to competition (more competition)  Define which healthcare services should be publicly financed and which services should be an individual’s responsibility (more individual responsibility)  Implement standardized quality metrics  Performance needs to be recognized. Healthcare must be attractive for the best and brightest minds

16. 16 Healthcare is one of our most important infrastructure components just as... Power... Transportation... Communication...

17. 17 The EU Commission concluded: Good health is the basis for economic growth*  Increase of 10% of life expectancy leeds to 0.35% of GDP growth  50% of the growth differential between rich and poor countries are due to bad health and lower life expectancy People conclude: Health is the most valuable asset Health is the lever for prosperity * Macroeconomics and health: investing in health for economic development, Report on the Commission on Macro-economics and health, Jeffrey D. Sachs, WHO, 20 December 2001 Change of paradigm

18. 18 How to draw attention to this possibility? 1.Through contacts to and information of national health authorities 2. Through a congress: “Improving Healthcare Infrastructure in an Enlarged Europe” Organized by the “European Health Forum Gastein” on October 04, 2005 in Bad Gastein, Austria and at least two follow up congresses in 2006 and 2007 Target Groups:  European Commission (showing the potential)  Health Authorities of new Member States (proposing projects) Sponsor: COCIR

19. 19 Healthcare … our largest economic factor ! Healthcare … our largest economic factor !... eHealth plays a key role!

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