European priorities for e Health and implications for IT Tanya Znamenskaya Microsoft Senior Business Developer Central& Eastern Europe

E Health The European approach to eHealth should be about: spending euros on patients not on paperwork! For example, electronic medical records can help doctors to diagnose illness and prescribe treatments more accurately, thus reducing medical errors. It also means cutting down paperwork to improve efficiency. Electronic patient referrals in Denmark are saving 1 million a year and could rise to to 3.5 million a year, if all referrals were sent electronically. Health can really help empower patients. Europeans increasingly want to play an active role in decisions relating to their health. eHealth can give them the easy access to high quality health information that they need to achieve this. As part of its current eHealth action plan, the Commission will launch an EU Health Portal later this year, providing a one stop shop for health information produced by the EU and a gateway to the websites of national and regional health authorities and civil society groups in the health field Viviane Reding, European Commissioner for Information Society and Media..

Total Health Expenditures per Capita EU 15 health spend: 8,6 % of GDP New Members: 5,8 % per GDP Economic Drives 50% of the growth difference between rich and poor is due to ill health 10% increase in life expectancy at birth will increase annual economic growth by 35% Key Issues Significant Budgetary Problems – IT Investment Competes with Funding for Other Priorities (Medical Equipment, Medicines, Building Infrastructure) Low end IT Focus Key Investment Areas Hospital Information Systems (Local Solutions) Electronic Patient Records (Local Solutions) ERP Functionality, CRM Patient Management Mobile Solutions for Emergency Services (Ministries of Health)

Integrated Hospital Solutions: Hospitals Are Key to Health Modernization In-patient care accounts for 50% of total healthcare spending in many European countries Structures are large and complex Some have more than 10,000 employees and 5,000 beds EUSF give preference to projects with fast ROI and replicable solutions Corporate Management Board Relations, Strategy & Planning, Legal, Accreditation/Compliance, Risk Mgt. Patient Administration Admissions, Scheduling, Registration Payment Claims Mgt., Revenue Cycle Mgt., Billing Enterprise Business Operations HR/Payroll, Accounting & Finance, Procurement, Materials Mgt., Public Relations Enterprise IT Systems Supporting enterprise business operations such as HR, Finance, Supply Chain Clinical Mgt. Clinical Depts., Laboratories, Imaging Centers, Pharmacies Medical Records Counter Ancillary Services Outpatient Centers, Social Programs External Channels Insurance cos. Govt. health agencies Patients Physicians External Stakehold. Healthcare Provider Operations Mail Fax Call Center Internet

Hospital Budget – Central Europe Hospital Sector Accounts for 40% of all Health Spending

Good Health in Europe: View of the future The financial envelope of the public health programme for the period is million. Budget available for 2006 Euro 55,817 mil Change of paradigm: towards preventive health: EPR Decision support systems for citizens Connected Europe for Health : e Health research centers across EU Health card it the pocket, e Health records People access to Healthcare services (electronic booking, electronic prescription..) Enabling Good Health. A reflection process for a new EU Health Strategy. July

EU eHealth: Milestones End 2005: National roadmap for eHealth Services EU public health portal End 2006: Common approach for patient identifiers Interoperability standards for messages and records Common approach to finance of eHealth End 2007: Standardized testing and accreditation End 2008: Electronic health insurance card Teleconsultation e- prescription e- referral Telemonitoring, Telecare

Collaborative technologies to support eHealth: Integrated secure infrastructure where physicians, nurses, and administrators share and collaborate on information in a seamless manner that revolves around a patient thru the continuum of care. Collaborative Healthcare Scenarios: Clinical and Administrative Forms Automation Business Intelligence Healthcare process integration Telemedicine and Real-Time Communications Healthcare Portals & Collaboration Key Challenges: Interoperability Integration Security

SharePoint Site Typical Hospital Scenario Info Access InfoPath InformationCreation DataWarehouse Message hub BizTalk server HL7 CDA XML X Ray, Surgery X ray Remote Hospital Doctor officeNurse Doctors home HL7 CDA XML HMS HL7 CDA XML

Microsoft Vision for Health

Hospital information system solution for Hospitel of Levoča Slovakia. EUSF Hospital Shared solutions : Solution HIS: Business management (Navision) Hospital management (EPR – Electronic Patient Record including subsystems: clinical, doctors, pharmacy, laboratory, biochemistry, hemathology, radiodiagnostics, health insurance connector and managerial overview) Staff training (300 users) Total project time: 8 months Total project cost: SKV 9.580k (Euro 240k) 50 hospitals in the pipeline

Integrated Care Management Lead: public payer Implementation of eHealth networks between physicians, provider, Rehabilitation services and public payer care services aim: integral treatment and support DRGs, case flat rates eHealthCard (federal ministry of health and social security) Definition of the framework conditions for a security and telematics infrastructure in the health service advisory consortium: IBM, SAP, FHG-IAO ICW, ORGA: HPC Health Professional Card Lead: Landes-Ärztekammer und Landes-KV (country state medical board of registration and country payors Provider: federal states and state medical board of registration for physicians, provider, pharmacies, rehabilitation services Pilot regions – HPC und eHealthCard competition for the best IT solution Main projects in e Health. Germany: eHealthCard: Integrated Care Networks: Implementation of eHealth networks between physicians, provider and payers

Cocoon Building knowledge driven & dynamically adaptive networked communities within European healthcare systems (FP Solution: Decision support system integrated with EPR unifying general practices, clinical experts, regional HC services to provide clinical guidelines using semantic integration via web services The following main functionality is expected: Fast and effective search of relevant medical information Quick on-line access to specialist consultation and opinion Implementation of automated support for diagnosis and treatment based upon clinical guidelines Consortium: ASSOCIAZIONE IMPRESA POLITECNICO (IT), CEFRIEL (Centre for Research and Training in Information Technology), Telecom Italia, Simenes Informatica, EMIC (European MS innovation Centre), INTEGRATED CARE SYSTEMS FRANCE - I.C.S.F. GL2006 EUROPE (UK ), Laguagae and computing (Belgium), Institute of Technology Israel, Politecnical University Madrid, Logicom Greece Countries: Italy, UK, Greece, Spain, Israel, Belgium Finland The project also expects to involve around health care professionals in platform trial activities

Microsoft in Healthcare NHS UK (England) Leuven Hospital Belgium Lan Dill Hospital Germany Madrid Healthcare 1177 – Emergency system Sweden Children Regional Medical Centre – US Guys and St Thomas Hospital NHS Trust –UK Copenhagen Hospital Arfox Healthcare -SA East Anglia Ambulance Trust Inland Imaging Centre Spokane, US IMS Health UK Clalit Health Services Israel Emergency system Israel Private Medical Centre Moscow