1. Seamless solutions for Hospitals Tanya Znamenskaya Microsoft Industry Manager Central Europe

2. Healthcare Worker Challenges Lots of manual administrative work: 30% Lots of manual administrative work: 30% Inefficient collaboration Inefficient collaboration Disconnected islands of data Disconnected islands of data Multiple devices and interfaces Multiple devices and interfaces Loss of data Loss of data Fatigue Fatigue Medical Errors!!! Medical Errors!!!

3. Medication Mgmt– Medical Errors Are an Issue Germany: 50.000 death due to medication intervention Czech:57% of hospitals report medical errors, 45%unexpected death 0,5% admitted patients die because of iatrogenic damage (i.e. caused by medical interventions); 50% is avoidable = 0,25% of admitted patients die because of avoidable mistakes– Harvard University study Italy there are at least 14.000 persons who die every year because of adverse events UK: 40.000 people annually are dying from the wrong diagnosis– British Medical Journal

4. Ensuring continuity: Prevention diagnosis treatment, follow up Microsoft Vision: ICT for Person-Centered Health systems Improving access, quality and efficiency for everyone Connecting all the points of care: Hospitals Physicians-GPs Pharmacies laboratories Homes DOCTOR PHARMACY HOSPITAL LABS HOME IT systems can reduce as much as 75 percent of serious medical errors

6. Share Point Site Typical (or ideal ?)Hospital Scenario Typical (or ideal ?)Hospital Scenario Info Access InfoPath InformationCreation DataWarehouse Integration hub BizTalk server With shared services With shared services HL7 CDA XML X Ray, Surgery X ray Remote Hospital Doctor’ officeNurse Doctor’s home HL7 CDA XML HMS HL7 CDA XML

7. Ingolstadt Trauma Centre Customer Profile: Ingolstadt Hospital is a medical center with 1,100 beds that serves a catchment area in the center 25,000 emergency patients each year 20 concurrent patient treated in the emergency ward Customer Profile: Ingolstadt Hospital is a medical center with 1,100 beds that serves a catchment area in the center 25,000 emergency patients each year 20 concurrent patient treated in the emergency ward Business Situation Business Situation Staff at Ingolstadt Hospital’s emergency ward manually collected and submitted patient data to hospital systems. Handling paper forms and repetitive data entry took time away from treating patients and impeded efficient communication between hospital staff resulting in increased wait times for patients. Staff at Ingolstadt Hospital’s emergency ward manually collected and submitted patient data to hospital systems. Handling paper forms and repetitive data entry took time away from treating patients and impeded efficient communication between hospital staff resulting in increased wait times for patients. Solution Solution Windows XP Tablet PC, InfoPath, SharePoint Portal. Windows XP Tablet PC, InfoPath, SharePoint Portal.

8. eHealth Interoperability platform: Askelpios Hospital Cooperation with Intel and Microsoft Cooperation with Intel and Microsoft Integration of Smart Card with EPR Integration of Smart Card with EPR GP using admission portal to access patient examination results GP using admission portal to access patient examination results Using common infrastructure AD services and security Using common infrastructure AD services and security Integration with “Functional Divisions” Integration with “Functional Divisions” http://www.asklepios.com/FutureH ospital/Mediathek/Showroom http://www.asklepios.com/FutureH ospital/Mediathek/Showroom http://www.asklepios.com/FutureH ospital/Mediathek/Showroom http://www.asklepios.com/FutureH ospital/Mediathek/Showroom

9. CHF Business Framework A Business Pattern for Healthcare Patient Component Professional Access History Component Patients’ Events Component Patient Consents Component Health Subject Component Care Pathways Component Appointments Component GP & Hospital Systems Access Component Clinical Processes Component Groups & Teams Component Professionals Component Permissions

10. Connected Health Framework 10 A Stable Foundation for Agile Healthcare S T A B L E A G I L E. Torrevieja SaludTorrevieja Salud

11. CHF :Valencia Hospital Customer Profile: 250 beds, 11 OP theaters, 22 surgical beds Customer Profile: 250 beds, 11 OP theaters, 22 surgical beds Problem: No communication between Hospital departments, lots of paper work Problem: No communication between Hospital departments, lots of paper work Solution Florence: handles all clinical and administrative functions Solution Florence: handles all clinical and administrative functions Fully operational in 2 years, 22 people Fully operational in 2 years, 22 people Costs: approximately $600.000 Costs: approximately $600.000 MS Products: SQL Server, Exchange, MS Dynamics NAV, BizTalk, HL7 Adapter, Spare Point, Net Framework MS Products: SQL Server, Exchange, MS Dynamics NAV, BizTalk, HL7 Adapter, Spare Point, Net Framework

12. Azzixy: Washington Hospital Centre Customer Profile - largest teaching hospital with 250.000 patients annually Problem - 300 isolated data islands in different formats Customer Profile - largest teaching hospital with 250.000 patients annually Problem - 300 isolated data islands in different formats Solution Solution - 11 000 data records - Real-time Repository for electronic medical records - collects and stores data from all medical systems (images, video etc) - 50 TBD online data per hospital growing 4 TBD annually - 0,2 sec - 11 000 data records - Real-time Repository for electronic medical records - collects and stores data from all medical systems (images, video etc) - 50 TBD online data per hospital growing 4 TBD annually - 0,2 sec - customized view on a patient (cardiology, neurology etc, specific) - customized view on a patient (cardiology, neurology etc, specific) Benefits Benefits - 3 mil annual savings in a single department with manual process automation - 3 mil annual savings in a single department with manual process automation - 13 months of implementation and development - 13 months of implementation and development

13. Cardiologist Mr. Smith View Patient Census The doctor pulls up her personalized user view that she has set up based on how she likes to treat patients. She first clicks on the cardiology patient census to pull up a complete patient list. She clicks on the patient, Mr. Smith.

14. Cardiologist View All Recent Diagnoses She then uses her personal view to pull up all of Mr. Smith’s pertinent health info organized how she likes to view patient information with the following customized columns of information to view on Mr. Smith. Name, Age, Sex, Past Medical History, All ICD9 or CPT diagnoses, Chief Complaint, Physiologic data, LVEF, Cardiac Echocardiogram images, Angiography images, Nuclear Medicine Images, All Radiology images, Stress test results, All Medications, All Labs. All historical data is kept in Azyxxi and never archived. It is always available for the clinician to view at any time.

15. Cardiologist Cardiology Scenario Showcase One click to see full screen Thumbnail view to peruse EKGs

16. Insight Clinical View All Lab results

17. Insight Clinical View All Medications

18. April 16 th, Berlin EMEA Health Partner Conference Microsoft NHS UK CUI program. Design Guide Focus Areas Information Display Standards Information Display Standards Information Input Standards Information Input Standards Abbreviations and Acronyms Abbreviations and Acronyms Terminology Terminology Decision and Knowledge Support Decision and Knowledge Support Ordering and Scheduling Ordering and Scheduling Patient Administration Patient Administration Patient Record Views Patient Record Views Reports Reports Noting and Assessment Noting and Assessment Structured Planning of Care Structured Planning of Care Consistent Navigation Model Consistent Navigation Model Accessibility Accessibility Agent to Agent Communication Agent to Agent Communication Medications Management Medications Management Generic / Miscellaneous Generic / Miscellaneous Over 110 areas of Design Guidance across the following categories:

19. Clinical Application - Demonstrator

20. Demonstrator & Design Guidance

21. Microsoft Dynamics Business Solutions: How to measure hospital efficiency Financial management Financial management  including specific legislation for healthcare Controlling Controlling Asset management Asset management Invoicing, receivables and health insuarance Invoicing, receivables and health insuarance Payables and purchasing management Payables and purchasing management Internal requests, order forms and approval processes Internal requests, order forms and approval processes Pharmacy (internal & commercial) Pharmacy (internal & commercial) Catering (incl. electronic orders) Catering (incl. electronic orders) Increased security of information Increased security of information Hospital Information systems Clinical information systems Enterprise resource planning

22. Czech Republic:Nemocnice Na Homolce controlling – management of the hospital „by one number“ – flexible matrix of key performance indicators controlling – management of the hospital „by one number“ – flexible matrix of key performance indicators Easy reporting: # of admissions, # of interventions, # of days treatments, average length, breakdown of the main diagnoses, mortality, referrals, type of admissions, bed occupancy, average length of treatments Easy reporting: # of admissions, # of interventions, # of days treatments, average length, breakdown of the main diagnoses, mortality, referrals, type of admissions, bed occupancy, average length of treatments „the doctors should treat, not be administrative forces“ „the doctors should treat, not be administrative forces“ ROI achieved during one year: 36% surplus ROI achieved during one year: 36% surplus Previously: 95% time on data preparation, Now 5% on data preparation, the rest on analysis and decision processes Previously: 95% time on data preparation, Now 5% on data preparation, the rest on analysis and decision processes

23. Profitability 2005 a 2004 Profitability 2005 a 2004 Reporting

24. DAILY, TEN-DAILY AND MONTHLY REPORTS Reporting

25. Budget Items  Cost, commercial revenue (SU, AU)  Goal – achieve the specified bottom line Budgeting

26. Budget – APPROVED Budgeting

27. Intervention Costing – Dept. of Internal Medicine Intervention Cost

28. Material Cost Tracking Reporting

29. Supplier Analysis – Price & Quantity

30. Benchmarking Reporting

31. Deliverables to seamless health CHF Reference templates for developing scalable replicable commodity solutions CHF Reference templates for developing scalable replicable commodity solutions CHF Architecture Blueprints infrastructure based on industry standards CHF Architecture Blueprints infrastructure based on industry standards CUI program customized to specific needs of the medical professional CUI program customized to specific needs of the medical professional Platform for Financial and cost controlling solutions Platform for Financial and cost controlling solutions

32. April 16 th, Berlin EMEA Health Partner Conference Getting More Information Microsoft Health Site for Application Developers MSDN.MICROSOFT.COM/HEALTH Microsoft Health Site for Application Developers MSDN.MICROSOFT.COM/HEALTH MSDN.MICROSOFT.COM/HEALTH Microsoft NHS Resource Centre WWW.MICROSOFT.COM/UK/NHS Microsoft NHS Resource Centre WWW.MICROSOFT.COM/UK/NHS WWW.MICROSOFT.COM/UK/NHS NHS CUI Download site WWW.CUI.NHS.UK NHS CUI Download site WWW.CUI.NHS.UK WWW.CUI.NHS.UK CHF Full Documentation is on http://solshare.net CHF Full Documentation is on http://solshare.nethttp://solshare.net Health Connection Engine http://www.codeplex.com/HCE -- reference implementation of a generic integration connector (including code) Health Connection Engine http://www.codeplex.com/HCE -- reference implementation of a generic integration connector (including code) http://www.codeplex.com/HCE