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New information technologies for Human Health Whats new in e-Health? Jean-François Penciolelli Global Business Development Director IBU Healthcare and.

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Presentation on theme: "New information technologies for Human Health Whats new in e-Health? Jean-François Penciolelli Global Business Development Director IBU Healthcare and."— Presentation transcript:

1 New information technologies for Human Health Whats new in e-Health? Jean-François Penciolelli Global Business Development Director IBU Healthcare and Life Sciences

2 * Target opportunities identified by text in red Source: Accenture + Oracle Monitor Planning Current Work Opportunity Status Data N/A or No EHR Presence Considering EHR England: EHR initiative in process, PACS project is running in north region France: EHR mandated by National RFP has been issued Singapore: EMR system tender expected Q Chile: National RFP for EHR project is expected soon Argentina: 1 st adoption of a digital radiography solution South Africa: No EHR – but infrastructure being developed Australia: HealthConnect is developing a National Information Network USA – Federal ONC NHIN contract underway. Multiple State initiatives for RHIOS. Still emergent – national EHR by 2014 – Obama Stimulus Plan Canada – Infoway set up to design and procure National EHR - $2 billion of government backing for regional EHR projects Germany: One regional deal underway. Future EHR efforts are expected to be regional New Zealand: National EHR system in place (complete) Hong Kong: Territory wide Patient Master Index Brazil: National Health Card Project. Finland: National eHealht- Archives to be established Netherlands: National Switch Hub Malaysia: Lifetime Health Record (LRH) by 2010 Mexico: No EHR but aim for HL7 Integration – National Disease Surveillance going on China: Plans to develop a national EHR Italy: EHR regional initiatives have begun Ireland: Procurement contracting has started to drive national EHR effort Spain: Regional initiatives are being considered e-Health is all over the place! National and regional initiatives Russia: 15 Diagnostic Centers project in progress. Plans being developed for national HER for 145 million people. SEE: Bulgaria, Romania, Turkey and Serbia all developing national eHealth strategies. Sweden: Developing a National Patient Summary Denmark: New National IT-strategy to standardize EHR´s

3 Many e-Health usage scenarios Public Health Registries –References: STAKES, Italian Ministry of Health Healthcare Interoperability Platform (Patient/Provider Collaboration, Provider/Provider Collaboration, Provider/Insurer Collaboration) –References: Lombardia, STAKES, Rikshopsitalet, Balearics, Andalucia DIRAYA Electronic Health Record (incl. Document Management) –References: Andalucia, Rikshospitalet, Stockholm County, Lombardia Region Electronic Prescribing / Medication Management –References: Andalucia RECETA XXI, Lombardia, Swedish APOTEKAT Electronic Healthcare Card –References: Lombardia, Andalucia, Bundesknappschaft, Italian Army Chronic Disease Management –References: Riskhospitalet (MyJournal), Friuili Venezia Guillia, CNAM-TS Sophia Disease Surveillance –References: Washington D.C. Telehealth (Sensor-based, Personal Health Mgt Tools, Homecare) –References: ACTION, Sweden, Patient Relationship Management –References: Andalucia Salud Responde

4 Relationship between Cost and Quality of Life Cost of Care/Day 0% 100% $1 $10$100$1,000$10,000 Source: Intel Corp 2006 Acute Care Residential Care Home Care ICU Community Hospital Specialty Clinic Assisted Living Skilled Nursing Facility Doctors Office Community Clinic Chronic Disease Mgt Healthy Independent Living QoL

5 Managing and Supporting the Patient Flow Improving the Patient Experience and Quality of Life Aware patient Patient Visits HC Prof snal Get Treatment Patient is Compliant Patient is Stable Unaware patient Patient Dis- charged I may be at risk… Consumer Awareness I should talk to my Dr. Pushing Consumer to Waiting Room It is important I take my medication Adherence I know when my condition is getting better/worse Monitoring I am happy with my Quality of Life Meeting ALL of the Patients Needs I am prepared for my appointment Wasted Appointments Which Provider should I Choose? Attracting Patients

6 The need for a Service Delivery Platform –Identifying, Stratifying and Targeting Patients –Attracting Patients –Improving Administrative Processes improve utilisation of resources help Patients get treatment improve patient experience –Support after Discharge –Adherence –Patient Monitoring –Supporting Patient Behaviour Modification –Making interventions Focus is on Access, Resource Utilisation and Attracting Patients Focus is on Outcome, Experience and Quality of Life Aware patient Patient Visits HC Prof snal Get Treatment Patient is Compliant Patient is Stable Unaware patient Patient Dis- charged Increase Velocity Down the FlowKeep Patient Here Here Is Where We Focus Here is more Vision

7 Why Focus on Chronic Conditions? 81% of inpatient stays 80% of US/Europe healthcare spending 91% of prescriptions 76% of physician visits 98% of home healthcare visits

8 Patient Relationship Management Definition Patient Relationship Management is about personalising interactions and interventions based on patient preferences, behaviours and their disease states to improve outcomes, safety and quality of life

9 A typical pattern in chronical treatment Adherence drops – patients are at risk TIME ADHERENCE VISIT VITAL SIGNS Source: Mengden et al. ISH 18th meeting, Chicago P21.02

10 PRM platform Solution: continuous interaction to drive adherence Enabled by patient relationship management TIME VISIT sms Source : Pierre Leurent, Voluntis

11 Distribute information processing Sensium - Sensor interfacing - Wireless transceiver - Local processing filtering data Lots of fuzzy and uncoordinated data Personal DA - Wireless network coordinator - Personal information - Local database Moderate but somewhat processed data Health database - Authorized (HL7) - Combined - Aggregated - High quality Data prepared and mined For health personnel Continuous Monitoring: Sensium

12 Source: EMBL-EBI Create the medical avatar: the new frontier!

13 What about Oracle?

14 Home Care Nurse Primary Care Physician Medical Office Staff Orthopedic Specialist RadiologistPayer Healthcare Interoperability Clinical IT Reality GP System HIS System CIS System Radiology System Payer System Nursing System Process claim Schedule appointment Order test Discharge Patient Update medical record Diagnosis Submit claim Treatment Send discharge letterReceive report Perform procedure … Write report Start rehabilitation Submit resultsFollow-up Support patient Refer patient

15 Home Care Nurse Primary Care Physician Medical Office Staff Orthopedic Specialist RadiologistPayer Healthcare Interoperability Clinical Integration Framework GP System HIS System CIS System Radiology System Payer System Nursing System Process claim Schedule appointment Order test Discharge Patient Update medical record Diagnosis Submit claim Treatment Send discharge letterReceive report Perform procedure … Write report Start rehabilitation Submit resultsFollow-up Support patient Refer patient Process claim Schedule appointment Order test Discharge Patient Update medical record Diagnosis Submit claim Treatment Send discharge letterReceive report Perform procedure … Write report Start rehabilitation Submit resultsFollow-up Support patient Refer patient Process claim Schedule appointment Order test Discharge Patient Update medical record Diagnosis Submit claim Treatment Send discharge letterReceive report Perform procedure … Write report Start rehabilitation Submit resultsFollow-up Support patient Refer patient SOA Orchestration Clinical Portal Clinical Context Management Single Sign On

16 Improved quality –Information sharing –Better planning and monitoring –Reduced administration –Specialization, higher volumes Reduced cost –Loadbalancing –Higher througput –Improved work / life balance Healthcare Interoperability SOA Platform Collaborative Network Hospital Portal Orchestration GPHome nurse HospitalPrivate Practice Enabling Collaborative Networks Collaborative services –Teleradiology –E-referral –E-prescribing –Homecare Pharmacy

17 Clinical Portal MMA Viewer Business Intelligence PrescribingHomecare Health Information Access Layer Connectivity PackagedDatabase Messaging Orchestration Transformation & Routing ? ETL TerminologyEMPIEHR Index Healthcare Infrastructure Services MultiMedia Medical Archive Clinical Data Repository Datawarehouse Clinical Data Repositories RIS System PACS System EMR System Accounting System Existing Legacy Applications Security & Privacy Management & Monitoring Blueprint Architecture Healthcare Interoperability Application Server & Database E-Health Applications CRM

18 Clinical Portal MMA Viewer Business Intelligence PrescribingHomecare Health Information Access Layer Connectivity Orchestration Transformation & Routing ETL TerminologyEMPIEHR Index Healthcare Infrastructure Services MultiMedia Medical Archive Clinical Data Repository Datawarehouse Clinical Data Repositories RIS System PACS System EMR System Accounting System Existing Legacy Applications Security & Privacy Management & Monitoring Oracle/partner footprint Healthcare Interoperability E-Health Services CRM OBIEESiebel AS&DB BPEL ODI HTB – ECM - CDMS DB 11g IAM BAM ESB MDM TerminologyEHR Index ESB

19 Clinical Portal MMA Viewer Business Intelligence PrescribingHomecare Health Information Access Layer Connectivity Orchestration Transformation & Routing ETL TerminologyEMPIEHR Index Healthcare Infrastructure Services MultiMedia Medical Archive Clinical Data Repository Datawarehouse Clinical Data Repositories RIS System PACS System EMR System Accounting System Existing Legacy Applications Security & Privacy Management & Monitoring Oracle/partner footprint Healthcare Interoperability E-Health Services CRM Concerto OBIEESiebel AS&DB cIndex BPEL Rhapsody ODI Rhapsody HTB – ECMDB 11g IAM BAM ESB MDM

20 Technology Roadmap Access and Utilisation (Cost) Outcome (Care) Quality of Life Interaction Channels Agent (Telecarer) Assisted Web/Portal Phone Web Conference Web 2,0 Patient Info Case Info Knowledge Base Patient Info Case Info Knowledge Base Training Smart Phone External Systems External Systems Dashboards Analytic Apps Medication Tracker Clinical Data Repository Business Intelligence WWW Home Hub Appliance Cholesterol Monitor Blood Pressure Monitor Pedometer Glucose Sensor WWW Digital Plaster

21 Oracle Products Access and Utilisation Outcome Interaction Channels Agent (Telecarer) Assisted Portal Collaboration Suite Phone Collaboration Suite Web Center Siebel Call Centre Learning Mgt Oracle HTB Smart Phone Oracle Business Intelligence Oracle Crystal Ball Oracle Business Intelligence Oracle Crystal Ball WWW Home Hub Appliance Cholesterol Monitor Blood Pressure Monitor Pedometer Glucose Sensor Medication Tracker WWW Dashboards Analytic Apps Quality of Life Oracle Lite Edge Server External Systems External Systems Fusion Middleware Edge Server Digital Plaster Oracle AERS Oracle AIA

22 A Q &

23 New information technologies for Human Health Whats new in e-Health? Jean-François Penciolelli Global Business Development Director IBU Healthcare and Life Sciences


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