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Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. A New Vision for the EHR Sam Brandt, MD Chief Medical Informatics Officer Siemens.

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Presentation on theme: "Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. A New Vision for the EHR Sam Brandt, MD Chief Medical Informatics Officer Siemens."— Presentation transcript:

1 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. A New Vision for the EHR Sam Brandt, MD Chief Medical Informatics Officer Siemens Health Solutions

2 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 2 How Tall is K2?

3 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 3 How Tall is K2?

4 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 4 What Toxin is in the Skin of Poison Dart Frogs?

5 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 5 What Toxin is in the Skin of Poison Dart Frogs?

6 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 6 A pet store employee presents in the ER with rapid onset of confusion, hypotension, and decreased respiratory rate??

7 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 7

8 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 8 The Place for Calculators in 1974? Pros Faster Easier to use More significant places Eliminates decimal point transposition errors Cons Requires electricity Floating point errors Fosters Laziness

9 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 9 The Place for EHRs in 2009? Pros Faster & remote access to information Easier to find data Helps avoid double entry Can help with billing Cons Requires electricity Less portable Doesnt allow random data entry ? Fosters laziness

10 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 10 But….We Didnt Stop with Calculators! Spreadsheet programs allowed for modeling of financial data, with what if scenarios Word processors eliminated retyping for corrections, and added spell checking

11 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 11 And then…We Pushed the Envelope Computers opened new possibilities Expressing complexity Simulating scenarios Exploration and recognition Solving exhaustive computions

12 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 12 So…How Will EHRs Push the Envelope? Changing delivery system models Point of care decision support Personalized medicine – Genomics/Proteomics Patient-centric delivery models

13 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 13 Mar 5, :45 pm US/Eastern Obama: Healthcare At 'Thelma And Louise' Moment President Borrows Dire Movie Metaphor To Describe U.S. System As Heading Toward Cliff CBS News Interactive: Healthwatch CBS News Interactive: Healthwatch Obama said the participants - doctors, lawmakers, insurers, even skeptics - were universal in agreement that the need for health care reform "is here and now."

14 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 14 Impacts Bundled payments for hospitals and providers Efficacy standards imposed with controls on utilization variance Emphasis on healthcare delegation to most cost-effective venues with incentive alignments

15 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 15 ImpactsEHR Contributions Bundled payments for hospitals and providers Efficacy standards imposed with controls on utilization variance Emphasis on healthcare delegation to most cost-effective venues with incentive alignments Increased connectivity supports Virtual delivery systems Point of care decision support Enterprise research scheduling and process management

16 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 16 Genomics & Personalized Medicine Numerous Genotype/Phenotype correlation efforts Potentially thousands of significant variants Genome sequencing for $100 within 5 years Rising expectations for preemptive intervention Physicians will need to consider all diagnostic and therapeutic decisions in the light of the patients gene sequence

17 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 17 A Polymorphism* in the 5' Flanking Region of the CD14 Gene Is Associated with Circulating Soluble CD14 Levels and with Total Serum Immunoglobulin E Mauro Baldini, et al Am. J. Respir. Cell Mol. Biol., Volume 20, Number 5, May, TGF-β1 gene polymorphisms D. Bučkova et al Volume 56 Issue 12, Pages 1236 – 1237 Published Online: 20 Dec 2001 Gene polymorphism in Netherton and common atopic disease Andrew J. Walley 1 et al Nature Genetics 29, (2001) Published online: 4 September 2001; | doi: /ng728 Managing the Avalanche of Genomic Information

18 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 18 EHR and Personalized Medicine Patient Information Clinical Knowledge Patient Categorization Indications/ Contraindications Dx/Tx Selection Variance DB Gene Sequence

19 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 19 Patient-Centric Delivery Models Coordinates care across delivery system Schedules Tracks Intervenes Workflow orchestration Dx/Tx Selections Patient Processes Patient Processes Patient Processes Patient Processes Cross-process optimization (patient & resource) Patient-centric Process Sequence Workflow engineSimulation optimizer

20 Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Page 20 The Place for EHRs 2009 Brings valuable benefits compared with the limitations of paper charts 2011 and beyond Provides the needed framework for Changing delivery system models Point of care decision support Personalized medicine – Genomics/Proteomics Patient-centric delivery models


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