To be, or well be, II
Teknologiat osana
palveluprosessin muutosta
Jaana Tuominen, GE Healthcare
GE Healthcare
GE Healthcare: A Unique Collection
of Expertise…
Technologies
Bio-Sciences
Information Technology
Imaging and Intervention
Molecular Diagnostics
Pharmaceutical Solutions
…creating advanced diagnostics
3 /GE
Need a fundamental change …
Cancer
Heart Disease
Brain Disorders
One person in three
will have cancer
50% die after 1st
heart attack
20% aged 75-84 suffer from
Alzheimer’s disease
4 /GE
A new age of medicine
21st Century Personalized Healthcare
Predict
Diagnose
Inform
Treat
5 /GE
If we can detect it here,
it may never appear here.
6 /GE
Predict
See the future.
Change the future.
Molecular understanding of
diseases
A new generation of
diagnostics
Identify the “genetic
fingerprints” of disease
Predict disease before the
onset
7 /GE
Diagnose
The earlier you detect
disease,
the earlier you can deal with it.
Transformational medical
imaging and medical
diagnostics
Visualize and analyze disease
at a molecular level
Diagnose disease more
precisely – based on the
individual patient
Improve patient outcomes
8 /GE
Inform
Enable better care through
molecular knowledge.
Provide life-critical patient
information – when, where
and how it’s needed
Empower through information
about “genetic signatures”
Tailor treatment to the patient
Monitor and manage the
efficacy of personalized
therapy
9 /GE
Treat
Read the genes.
Tailor the treatment.
Understand disease at a
molecular level
Develop more targeted and
effective therapies
Enable the development of
new, more targeted drugs…
faster
10 /GE
GE Healthcare Vision
At GE Healthcare, We Strive
to See Life More Clearly
We Help Predict, Diagnose,
Inform and Treat So That
Every Individual Can Live
Life to the Fullest
11 /GE
The Emerging Era of Chronic Disease
Response Needed for a New Era
1900-1950 Era of Infectious Disease Care
1950-2000 Era of Acute Care
2000-2050 Era of Chronic Care
Era of Chronic Care requires collection and
management of patient medical information
outside of the traditional hospital setting.
13 /GE
Population Managing Multiple
Diseases
Medical progress often turns an acute condition into a chronic one. Ex:
40% decline in mortality from coronary heart disease since 1980, but
more people are living with survival effects. A chronic condition lasts
more than one year, limits a patient’s abilities and requires ongoing
care. Chronic conditions include:
• Cardiovascular disease
• Arthritis
• Diabetes
• Some types of cancers
• Hypertension
• Asthma
• End-stage renal disease
(ESRD)
• Neurodegenerative
disorders (Alzheimer’s,
Parkinson’s, etc.)
• Chronic obstructive
pulmonary disease (COPD)
• Osteoporosis
• Chronic pain
• Stroke and other brain
injuries
14 /GE
Chronic Health Impact
Pending Dr. & RN Shortage
US Supply & Demand for Registered Nurses
Demand
Millions of Patients
2.9
2.7
Rising Costs of Healthcare
Patients With Chronic Conditions Account For:
Emergency
Room Visits
55%
Physician Visits
2.5
2.3
66%
Home Care
Visits
2.1
1.9
Supply
1.7
1.5
96%
Inpatient
Admits
60%
Hospital Stays
80%
2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 2020
0
20
40
60
80
100
120
Quality of Care Dilemma
Medicare Expenditures
Per # of Chronic Conditions
$12 973
• Medicare Insolvency by 2019
• Direct Costs $510 Billion, to $1.07 Trillion, 2020
• 80% of Healthcare Costs on 20% of Population
$4 701
$2 394
$211
None
Tw o
Three
• 60 Million Americans with 1 Chronic Disease
• 157 Million Americans with 1 by 2020
Four
• Chronic consuming 70% of Prescription Drugs
15 /GE
Ambulatory Care – to address
chronic diseases
Ambulatory Care
Address Key
Disease States…
Ambulatory Monitoring…
 Enables early intervention
 Improves patient outcomes
 Reduces hospitalization costs
Chronic patient,
managed at
home
Congestive Heart Failure
 Increases Cost Savings
 Increases patient compliance
+
 Improves provider productivity
 Improves quality of life
Asthma and COPD
MSU Telehealth Case Study:
Ambulatory Monitoring Solution reduced…
Ambulatory
diagnostic device
+ connection to
physician & EMR
Therapeutic dose
monitoring
Total Bed Utilization
 55%
CHF Patient Hospital Utilization
 43%
Urgent Care Visits
 35%
17 /GE
Market Drivers
• Aging population
• Acute conditions  chronic conditions
Acute intervention  managed care
• Increasing patient consumerism - “Worried well”
• Need for cost reductions in healthcare systems
• Changes in reimbursement to encourage
outpatient care
• Improvement in communications access
(Source: F&S 2004 US RPM)
www.cybernetmedical.com
www.medscape.com
18 /GE
Market Restraints
• High cost and inflexibility of products
• Limited scope of reimbursement
• Documentation of outcomes
• Legal issues (e.g. state licensure issues)
• Lack of standardization of clinical protocols
• Privacy concerns
• Tight budgets with home health care
• Lack of physician acceptance
(Source: F&S 2004 US RPM)
www.cybernetmedical.com
www.medscape.com
19 /GE
Product Needs
• Low cost
Key CHF Parameters…
•Weight
•Blood Pressure
•SPO2
•Drug Compliance
•ECG
•Activity Level
•Heart Rhythm
•Nutrition/Diet
• Flexibility
• Ease of Use (single button,
voice prompts)
• Unbreakable
• Designed for home
environment
• Communications
requirements
20 /GE
Remote Patient Monitoring Overview
Physician
Configured
Patient
Alertee (e.g., FNP)
Data
Home hub
Data alert
Results
Central platform
Data
EMR/
Patient
dashboard Professional
caregivers
Algorithm
PC/TV
Data
Sensing
• Non-invasive
sensors
• Novel
Parameters
• Drug Compliance
Network / Data
Pre-prosessing
• Smart alerts
• Wireless platform
Data management
Information
interface
•Novel
•Configurable
algorithms,
Alerts
modeling
•EMR Integration
• Information portal •Existing
•Patient Access
• Telecommunication algorithms
•Decision Support
Non-professional
caregivers
Customer interface
•Patient Triage
•Educate Patient
•Engage Family
21 /GE
Remote monitoring and viewing –
opportunities in the near future
The story of Joe Doe
14:32:23
Telemetry patient John Doe is
going to have a cup of coffee in
the hospital cafeteria.
14:32:28
RN M. Smith receives the ‘ST high’
alarm in her PDA. She checks the
snapshot, acknowledges the
message and hurries to the patient.
23 /GE
14:33:32
After examination she decides to
consult Dr. S. Jones who is the
physician in charge of John Doe.
14:33:55
The message shows the snapshot and RN Smith’s
request for advice
24 /GE
14:35:12
After looking at the John Doe’s
snapshot and real-time and trended
data, Dr. Jones gives care instructions
to RN Smith
14:36:38
RN Smith makes the lab test order
electronically with her PDA
25 /GE
15:17:09
The lab results are ready and they are
sent to Dr. Jones automatically by the
system
15:17:09
Dr. Jones makes the drug order with his
PDA, and sends it to RN Smith
26 /GE
15:21:17
RN Smith receives the drug
order and administers the drug
in John Doe’s IV bag
15:22:50
RN Smith documents the drug
treatment utilizing the bar code
scanner that is built-in her PDA
27 /GE
29 /GE