1. Siemens medical solutions that help Competence in Quality Jon Zimmerman Vice President e.Health December 12, 2002 Connecting the Health Community The Next Dimension for Patient Centered Care Jon Zimmerman Vice President e.Health 23 May 2003

2. 2 Siemens medical solutions that help Competence in Quality Objectives CDevelop a Common Understanding of: BProblems BOpportunities BAssets CUnderstand How to Align to Address Market Needs CBuild a Plan to Focus Our Efforts in Ways that Matter to: BProviders BPatients BPayers BGovernment CAchieve

3. 3 Siemens medical solutions that help Competence in Quality The Mission: CTo deliver proven outcomes by securely transforming, exchanging and integrating information throughout the entire health community. Hospitals Patient Centric Staff Physicians Community Physicians Community Laboratory Community Pharmacy PayersPatients

4. 4 Siemens medical solutions that help Competence in Quality Topics CThe Connecting for Healthcare Initiative CRelationship to IHE CThe Industry Challenges CActions CAssets CWorkflow Approach CHow to Start

5. 5 Siemens medical solutions that help Competence in Quality A Flood of Data Clinical data for medical practice is undergoing a fundamental change.

6. 6 Siemens medical solutions that help Competence in Quality The eHealth Initiative is a public-private partnership aiming to improve Healthcare through Applied Information Technology & Standards MissionTo drive improvement in the quality, safety, and cost-effectiveness of health care through information technology. Consumers, providers and those responsible for population health will have ready access to timely, relevant, reliable and secure health care information through an interconnected, electronic health information infrastructure. Practicing Clinicians Hospitals, Academic Medical Centers Payers Pharmaceutical companies Quality Improvement Organizations … with the broad participation necessary for success Vision Government – CDC, CMS, FDA, State Organizations Researchers Independent Software Vendors Application Vendors

7. 7 Siemens medical solutions that help Competence in Quality The National Healthcare Collaboration Network is the response to numerous converging environmental pressures in the healthcare industry CPrivate industry demanding reform in Healthcare to slow inflation CSuccess of technology to transform other industries; the maturation of collaborative technologies and analytical tools CPublic health surveillance being thrust to the forefront of national agenda CFederal agency focus on informatics as tool for governmental reform CLeadership from key national stakeholders coming together to promote change

8. 8 Siemens medical solutions that help Competence in Quality A Multidimensional Expansion of Integration 3 rd Dimension: Increasing the Number of Vertically Integrated Departments Master Patient Index Clinical Patient Record Ordering Process Patient Registration R a d i o l o g y C a r d i o l o g y Laboratory P h a r m a c y O t h e r s... IHE Vision for Growth 1 st Dimension: Workflow inside department 2 nd Dimension: common consistent data 4 th Dimension: The Community

9. 9 Siemens medical solutions that help Competence in Quality Industry Challenges CRising Costs & Premiums – Plans & Employers CShrinking Reimbursements – Practices & Health Systems CMalpractice Costs – Practices and Health Systems CGrowing Regulation – Plans, Health Systems & Practices BHIPAA, Patient Safety, etc CStaffing Shortage – Health Systems and Practices BPhysicians, Nurses, Techs, Admin. CHealth & Drug Spend Rising – Plans & Employers CMust Have: Innovation Integrated With Operations BPure Innovation is Just a Dream BPlain Operations is the Path to Obsolescence

10. 10 Siemens medical solutions that help Competence in Quality CImprove accuracy without adding complexity BLet the systems communicate to get the right data CImprove efficiency – Reduce Manual Tasks BEliminate unnecessary phone calls and paper BConnect intra and inter-entity workflows BReduce shared operational costs CImprove convenience for all stakeholders BPatients/members drive revenue BSuperior patient/member access drives convenience BConvenience helps drive market share BMarket share is a measure of competitive success Imperative Actions

11. 11 Siemens medical solutions that help Competence in Quality Standards and reliable technology are vital Rollout and implementation make or break the value proposition Adoption will be the key determining factor Proven, incremental workflow improvements are the best adoption accelerant Imperative Actions

12. 12 Siemens medical solutions that help Competence in Quality Value via Integrated Business Processes Delivered via Networks of Interconnected Business Systems to Serve the Health Community Objective: Replace $Billions of Inefficiency With Systems for Affordable & Effective Care Goal:

13. 13 Siemens medical solutions that help Competence in Quality How Do Industry Assets and Competencies Complement and Add Enough Value to Our Customers and Their Communities to be Economically Viable? Question:

14. 14 Siemens medical solutions that help Competence in Quality The Government: NHII NHII – National Health Information Infrastructure CCommunication Connections Among: BHospitals BClinics BPractices BEmergency Response Ceners BGovernment Health Agencies BHealth Plans BCommunity Clinical Providers CUsed for Commercial and Public Health Purposes Today CImmediately Expandable to Respond to Emergency Situations

15. 15 Siemens medical solutions that help Competence in Quality Eight Areas of Focus 1. privacy & confidentiality 2. architecture 3. standards & vocabulary 4. safety & quality 5. financial incentives 6. consumer health 7. homeland security 8. research & population health Back to the Business……….

16. 16 Siemens medical solutions that help Competence in Quality Current and Intended Uses CCurrent Commercial BClinical Data Access & Transaction Processing BStandard Vocabulary & Translation Engine BAdministrative Simplification CCurrent Public Health BDisease Reporting & Adverse Events BDisease Surveillance (Limited) CFuture Commercial BExpanded Clinical Data Access Using Standards to Drive More Information to More Authorized Points of Presence BBetter Integrated, More Simplified Administrative Uses BAutomated, Standard Quality Performance Reports CFuture Public Health BExpanded Disease Surveillance & Emergency Response HL7 & XML SNOMED X12 LOINC, HL7 & XML HL7 & XML for Denial Avoidance & Care Management

17. 17 Siemens medical solutions that help Competence in Quality Drivers & Levers Drivers CEconomics CHIPAA CMedical Specialty Societies Levers CStandards CTechnology CHealth and Human Service

18. 18 Siemens medical solutions that help Competence in Quality Follow the Flow Consumers & Patients via Employers & Govt. Consumers & Patients via Employers & Govt. Payer Equipment, Pharmaceutical, Laboratory Equipment, Pharmaceutical, Laboratory Hospital Physician Practice Physician Practice Admin MD NP/PA Transactions Documents Portals Phones/Faxes Revenue Cost Quality Compliance 30 Billion / Year

19. 19 Siemens medical solutions that help Competence in Quality Rational Business Framework PracticesPatientsPlans Top Line Growth Profitability Quality User Experience Business Efficiency Compliance OBJECTIVESOBJECTIVES HEALTH SYSTEM AUDIENCES

20. 20 Siemens medical solutions that help Competence in Quality Rational Business Framework PracticesPatientsPlans Top Line Growth Profitability Quality User Experience Business Efficiency Compliance OBJECTIVESOBJECTIVES Transactions Electronic Documents Clinical and Administrative Portals Secure Messages & Infrastructure Screening / Monitoring System Business Process Driven Integration: Revenue Cycle Health Information Management Practice Affinity Patient Affinity ELIMINATE PAPER AND PHONE CALLS! HEALTH SYSTEM AUDIENCES

21. 21 Siemens medical solutions that help Competence in Quality IT-Functionalities of departments overlap ECG, waveforms Anesthesia ICU Intensive Care Unit Clinical Information Systems Bedside device interfaces Oncology POE, therapy planning, photographs Film Management, Registry Data, Data Management, Archiving OR Operation Room Cardiology Radiology image acquisition ADT, Scheduling, Documents, Nursing, Results, Queries, Billing, Image access, Supplies

22. 22 Siemens medical solutions that help Competence in Quality IT Functionalities Meet the Community Hospitals Staff Physicians Community Physicians Community Laboratory Community Pharmacy PayersPatients Patient Centric

23. 23 Siemens medical solutions that help Competence in Quality Hospitals Staff Physicians Community Physicians Community Laboratory Community Pharmacy PayersPatients Patient Centric IT Functionalities Meet the Community Collect, Process, Bill, Process, Re-Process, Settle X12 & XML & ACH Encounter / Diagnose XML & HL7 & DICOM Information + Knowledge = Order HL7 & CV & DICOM Observe + Monitor = Order, Test & Document HL7 & CV & DICOM & CDA Access & Discharge X12 & XML & NCPDP

24. 24 Siemens medical solutions that help Competence in Quality Access & Discharge X12 & XML & NCPDP Collect, Process, Bill, Process, Re-Process, Settle X12 & XML & ACH Encounter / Diagnose XML & HL7 & DICOM Information + Knowledge = Order HL7 & CV & DICOM Observe + Monitor = Order, Test & Document HL7 & CV & DICOM & CDA IT Functionalities Meet the Community Hospitals Staff Physicians Community Physicians Community Laboratory Community Pharmacy PayersPatients Patient Centric

25. 25 Siemens medical solutions that help Competence in Quality HIPAA CChanges All Billing Transactions & the Revenue Cycle CEstablishes Standards & Use Cases CDrives Data & Privacy Protection BTo Facilitate Confident Use of Networks CEnables Interchange BBusiness & Research CSets the Platform for Clinical Interchange CWe Still Need a Standardized Use of Standards

26. 26 Siemens medical solutions that help Competence in Quality Medical Specialty Societies CCenters of Physician Trust CVery Strong Market Power CBuilding Systems Momentum CAssembling for Leadership and Self-Sustaining Systems Solutions

27. 27 Siemens medical solutions that help Competence in Quality Technology Leaders & The Internet CUbiquitous, Distributed Computing CUsed and Developed Open Standards CUnleashed Physical Connections CUnleashed Innovations BBusiness Implosions CUnleashing Integrations CWorkflow Integrations Will Drive Sustainability CStandards and Use Cases Will Drive Meaningful Integrations

28. 28 Siemens medical solutions that help Competence in Quality Health and Human Services CExperienced Action Oriented Executive Leader CRoot Cause Identifier BPreventive Care BChronic Disease BStandards CPay for Proof BDifferentials on Quality CNHII BBusiness, Public Safety, Fiscal Responsibility CPushing Congress to Act CThe Departments Clear Support of eHI Engineering a Better System

29. 29 Siemens medical solutions that help Competence in Quality A Flood of Data Clinical data for medical practice is undergoing a fundamental change. Incrementalism

30. 30 Siemens medical solutions that help Competence in Quality Connections for Payers: Administrative Transaction Services Lock Box Eligibility Referrals Transaction Infrastructure IntegratedNetworked IntranetInternet … AuthorizationsClaims Remittance Processing Patient Identification Revenue Optimization Compliance(HIPAA) X12 – XML – HL7 – Web Services – Highly Scalable Infrastructure

31. 31 Siemens medical solutions that help Competence in Quality Revenue Optimization Compliance(HIPAA) Physician Services Report Distribution General Financials & Human Resources Patient Management Patient Financial Services Medical Records Report Archive Coding Management R.O.I. Connections for Medical Records: Document Management Services Document Infrastructure COLD ScannedMultimedia Objects Patient Statements Document Formats – Web Services – Highly Scalable Infrastructure

32. 32 Siemens medical solutions that help Competence in Quality Connections for Doctors, Nurses & Patients: Information Access Portal Services Patient Inpatient Physician Nurse Health Information Manager Community Physician Payer Revenue Manager Cardiologist Portal Infrastructure Single Sign On & OffPersonalization SecurityScripting Physician/Staff Affinity Information Access R.O.I. … CCOW, HL7, XML – Web Services – Highly Scalable Infrastructure

33. 33 Siemens medical solutions that help Competence in Quality Connections Across the Community: Secure Messaging & Access Infrastructure Secure Messaging EncryptionLegacy e-mail Integration Easy Plug-Ins Patient SatisfactionPhysician Affinity R.O.I. E-mailDocument Delivery Authentication... ID Management XML, SAML – Web Services – Highly Scalable Infrastructure

34. 34 Siemens medical solutions that help Competence in Quality Connections for Patient Care: Care Management Infrastructure Disease Management ScreeningDevice and Person Data Capture Monitoring Patient SatisfactionPatient Affinity R.O.I. Disease Screening Post Discharge Monitoring XML, HL7 – Web Services – Highly Scalable Infrastructure

35. 35 Siemens medical solutions that help Competence in Quality Understand healthcare needs. Existing Processes, Inefficiencies and Friction Points Apply to Medical and IT technologies Clearly define patient, physician & payer expectations Transform knowledge & assets into unique solutions with measurable results. Set outcome-oriented goals – for key stakeholders Leverage cross-industry best practices Develop tactics and market introduction strategies, based on defined integration and workflow improvements Deliver innovative solutions with measurable results. Leverage collective technology, systems, and services Deliver best practice integration as defined by stakeholders Accommodate the individual Deploy for enabled delivery systems and communities How To Improve Workflow? Integrate to Eliminate Standardized Uses of The Standards

36. 36 Siemens medical solutions that help Competence in Quality Where Do We Start? CSelect High Impact Workflows to Integrate XAccess, Admission, Management, Utilization, Adjudication, Payments XFor each selected, define clear achievable goals XFor each selected, define: Economic Value Add, Measurable Outcomes, Success Factors CDefine the Assets to Leverage & Standards to Use CDefine the Market Sub-Segments, Drivers & Timing CDefine the Best Market Approach(es) CDefine Relationship Types – Pros and Cons CDevelop & Model Best, Worst and Most Likely Business Cases CSelect Targets BWorkflow, Assets, Market Segment, Approach & Business Model CSet a Date and Build the Timeline CSet the Team and Drive

37. 37 Siemens medical solutions that help Competence in Quality Objectives CDevelop a Common Understanding of: BProblems BOpportunities BAssets CUnderstand How to Align to Address Market Needs CBuild a Plan to Focus Our Efforts in Ways that Matter to: BProviders BPatients BPayers BGovernment CAchieve

38. 38 Siemens medical solutions that help Competence in Quality