John Crawford – Healthcare Solutions, IBM Europe
25 May 2010
eHealth and Europe – Why we need Smarter Healthcare
© 2010 IBM Corporation
Citizens are largely dissatisfied with their healthcare systems
and spending more money does not appear to be the answer
Healthcare spend as a percent of
GDP, 2004/5 (%)
Citizens’ views of healthcare systems
and healthcare expenditures
United States
15%
Germany
Netherlands
Canada
10%
Australia
United Kingdom
5%
50%
60%
70%
New Zealand
80%
% of citizens who believe their healthcare system requires
either fundamental change or complete rebuilding, 2007 (%)
Source: OECD, “OCED Health Data” (2007); Commonwealth Fund, “2007 Commonwealth Fund International Health Policy Survey” (2007)
© 2010 IBM Corporation
Healthcare as a global priority and IBM’s role
Global Environment
Market Response
• Economic and societal
demands for improved
value and outcomes
• National efforts to improve
health system efficiency and
effectiveness
• Healthcare costs
outpacing GDP growth
• Public health improvement
programmes / legislation
• Aging populations
• Educating and activating the
citizen
• Increasing rates of
chronic conditions
• Improving access to services
• Concerns for patient
safety
3
• Healthcare IT as a key
enabler:
– EHR / Interoperability
– Business Intelligence
– Telemedicine
– Health 2.0
IBM’s Role
• Deliver innovative solutions
– Integrate information
– Optimise workflows
– Improve flexibility
• Promote collaboration
– Among stakeholders
– Policies and standards
– New care delivery models
• Lead as a best practice
employer
– Promote patient-centric
care
– Reward healthy work-life
balance
© 2010 IBM Corporation
Challenges for European Health Systems
– Citizens’ expectations for high-quality care
– Demographic changes
How to offer
high-quality &
affordable care?
– Increased prevalence of chronic diseases
– Increased mobility of citizens and patients
– Staff shortages, unequal territorial distribution
– Reactive model of healthcare delivery
– Rising healthcare costs
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© 2010 IBM Corporation
eHealth Deployment in the European Union
Over 22 countries have explicit eHealth strategies, but:
18
17
16
16
14
Priority (wish)
No. of EU 12
Member
10
States
Reality
8
6
3
4
2
0
0
Complete EHR /
interoperability
ePrescription
Source: www.ehealth-era.org
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© 2010 IBM Corporation
The European Commission view on eHealth
eHealth is a Lead Market (of ‘strategic societal and economic interest’)
European Commission – “Communication on a lead market initiative for
Europe’ - COM(2007) 860 final *
 eHealth can help to deliver better care for less money within citizencentred health delivery systems. Nevertheless, the ICT investments in
this area have stayed behind that of other service sectors. The take-up of
technical and organisational solutions is often hindered by a strong
fragmentation of the market, e.g. due to different social security systems
and a lack of interoperability. This prevents economies of scale. This is
aggravated by a lack of legal certainty as regards reimbursement, liability
and a lack of awareness on the correct application of the legal provisions
on the protection of personal data. This hampers both the product takeup and business investments.
* http://eur-lex.europa.eu/LexUriServ/site/en/com/2007/com2007_0860en01.pdf
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© 2010 IBM Corporation
European eHealth market size and growth
 High potential for growth and jobs in the EU
eHealth market
2008
€ 14.3 billion
Est. annual
Growth Rate
2.3%
eHealth market
2012
€ 15.6 billion
Source: EU e-Health Business Models,
Capgemini Consulting, Rand Europe, 2009 (Ongoing study funded by the EC)
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© 2010 IBM Corporation
The EU Roadmap for eHealth in 2010 (direction of travel)
Towards the full picture of
the individual’s health status
3
2
1
1990s
8
Connecting individuals
with Health Information Networks
Linking all the points of care
Today
© 2010 IBM Corporation
EC funding instruments (summary)
EU has supported over 500 eHealth projects with > €1 Billion since 1989
Current support (~ €100 Million a year)
Stand alone systems
EU R&D
Programmes
Research
(EHR, messaging,
healthcards, VPH, PS
PHS)
Larger pilots with
online services
Research &
Technology
Development
Pilots
validation
Innovation
(e.g. Home-based Monitoring)
Large scale
deployment,
support to
policies
1990
9
Large scale validation
Member States +
EU eTen & CIP
programmes
1994
1998
(EU wide services
interoperability, mobility)
2002
2006
2010
© 2010 IBM Corporation
Large Scale Pilot on cross-border eHealth interoperability
epSOS (European Patient Smart Online Services)
 Involves 12 member states: AT, CZ, DE, DK, EL, ES, FR, IT, NL, SK,
SE, UK and is running from 2008 to 2011
 To deploy concrete cross border services ensuring safe, secure and
efficient medical treatment for citizens travelling across Europe:
 Patient Summary for EU Citizens
 ePrescribing for EU Citizens
 To build on existing National eHealth Projects and use experiences
and knowledge from all Member States
http://www.epsos.eu/
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© 2010 IBM Corporation
Large Scale Pilot on telehealth
Renewing Health
 Nine regional healthcare authorities directly responsible for the
deployment of existing or planned telemedicine services.
 To build up the largest multi-centre clinical trial ever deployed in Europe
to measure the effectiveness and cost effectiveness of Telemedicine
solutions for chronic disease management (COPD, CVD, diabetes).
 Operation started in February 2010, for an expected duration of three
years.
http://www.renewinghealth.eu/
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© 2010 IBM Corporation
“A Digital Agenda for Europe” published 19 May 2010
(COM (2010) 245)*
 The Commission will work with Member States competent authorities and all interested
stakeholders to:
– Undertake pilot actions to equip Europeans with secure online access to their medical
health data by 2015 and to achieve by 2020 widespread deployment of telemedicine
services
– Propose a recommendation defining a minimum common set of patient data for
interoperability of patient records to be accessed or exchanged electronically across
Member States by 2012
– Foster EU-wide standards, interoperability testing and certification of eHealth
systems by 2015 through stakeholder dialogue
– Reinforce the Ambient Assisted Living (AAL) Joint Programme to allow older people
and persons with disabilities to live independently and be active in society
* http://ec.europa.eu/information_society/digital-agenda/index_en.htm
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© 2010 IBM Corporation
“A Digital Agenda for Europe” published 19 May 2010
(COM (2010) 245)*
 The Commission will work with Member States competent authorities and all interested
stakeholders to:
– Make proposals to reform of rules on implementation of ICT standards in Europe to allow
use of certain ICT fora and consortia standards
– Promote interoperability by adopting in 2010 a European Interoperability Strategy and
European Interoperability Framework
– Issue a Communication in 2011 to provide guidance on the link between ICT
standardisation and public procurement to help public authorities to use standards to
promote efficiency and reduce lock-in
– Adopt in 2010 a Broadband Communication that lays out a common framework for
actions at EU and Member State to meet the Europe 2020 broadband targets (basic
broadband to all Europeans by 2013 and, by 2020, (i) all Europeans have access to
internet speeds of above 30 Mbps and (ii) 50% or more of European households
subscribe to internet connections above 100 Mbps)
– Review the EU data protection regulatory framework with a view to enhancing
individuals' confidence and strengthening their rights, by the end of 2010
* http://ec.europa.eu/information_society/digital-agenda/index_en.htm
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© 2010 IBM Corporation
Smarter Healthcare
A smarter health system forges partnerships in order
to deliver better care, predict and prevent disease and
empower individuals to make smarter choices.
+
Instrumented
Improve operational
effectiveness
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+
Interconnected
=
Intelligent
Deliver collaborative care for
prevention and wellness
Achieve better quality
and outcomes
© 2010 IBM Corporation
Some IBM solution focus areas for Smarter Healthcare
1. Disease Management / Collaborative Care (Instrumented)
2. Electronic Health Records (Interconnected)
3. Healthcare Analytics (Intelligent)
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3/16/2016
© 2010 IBM Corporation
Disease Management / Collaborative Care
Remote
Monitoring
Server
Device
Manager
Devices
PAN
Provider
Applications
PHR
WAN
Wired Glucose Meter
EMR
Medication Pack
xHR
Disease
Management
Wired Weighing
Scale
Devices to collect
personal health data
regarding diabetes
·
·
·
Collect device data
Reliable Messaging
Identification
IBM Websphere Sensor
Events
·
·
·
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Aggregate data from large
number of devices
Perform event processing
Map into Provider
application
© 2010 IBM Corporation
Disease Management / Collaborative Care
Telemedicine on the island of Tristan da Cunha
What’s smart?
• Using telemedicine to provide access
to clinicians in University of Pittsburgh
Medical Center
• Provision of teleradiology,
telepathology, doctor-to doctor, and
doctor-to-patient consultations, all via
satellite link
Fact: Accessing quality medical
care in remote locations is
difficult and time-consuming (in
this case no airstrip so 7 days
travel by sea to Capetown)
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Smarter Business Outcomes
• Immediate referrals and 2nd opinions
• Improves quality of patient care
• Eliminates need to travel (a very long
way!) for specialist consultations
http://www-03.ibm.com/press/us/en/pressrelease/22576.wss
© 2010 IBM Corporation
Electronic Health Records
• What is the problem?
• Patient records exist in many places and in multiple formats
• Care information tends to be episodic - not continuous
• Standards have not been agreed until quite recently
• Technical standards (format, message structures etc)
• Semantic standards (terminology, meaning)
• Concerns about security, patient privacy and consent
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© 2010 IBM Corporation
Electronic Health Records
Thy-Mors Hospital (Denmark) uses visual patient records *
What’s smart?
• Visual representation of the health
status using a 3D avatar linked to
SNOMED-CT clinical terms
• Combination of visualisation and
medical record data
Fact: Reviewing electronic
patient records can be complex
and time-consuming – a simpler
approach is needed.
Smarter Business Outcomes
• Allows faster assimilation of relevant
medical information by clinicians
• Improves doctor/patient dialogue
• Supports move to ‘paperless hospitals’
* IBM Research project - now available through Nhumi Technologies - http://nhumi.com/
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© 2010 IBM Corporation
Healthcare Analytics
•Comprehensive use of data
•Statistical and quantitative analysis
•Explanatory and predictive models
•Fact based management to drive decisions and actions
•A subset of Business Intelligence
A set of technologies and processes that use data to
understand and analyse business performance
Source: Copyright 2007 - Competing on Analytics The New Science of Winning Thomas H. Davenport and Jeanne G. Harris
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© 2010 IBM Corporation
Healthcare Analytics
Geisinger Health uses a Clinical Decision Intelligence System
What’s smart?
• Standards-based Clinical Decision
Intelligence System (CDIS) enables
analysis and reporting of vital insights
from millions of patient encounters
• System incorporates Geisinger's
clinical, financial, operational, claims,
genomic and other medical data
Fact: Geisinger Health System
wanted to extract more value from its
vast array of medical information
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Smarter Business Outcomes
• Provides a massive store of clinical
information, procedure and research to
help doctors provide the best care
http://www.ibm.com/smarterplanet/global/files/us__en_us__healthcare__sc_ny_r_paulus_v03rp.pdf
© 2010 IBM Corporation
We’ve only just begun to
uncover what is possible on
a smarter planet.
The world will continue to become smaller, flatter
and smarter. We are moving into the age of the
globally integrated and intelligent economy, society
and planet.
To thrive in a Smarter Planet, we need a Smarter
Health System that supports a healthier and more
productive citizens. There’s no better time to start
building a smarter health system. And there’s no
better time to invest in creating the kind of society
we all desire.
Let’s work together to drive
real progress in our world.
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© 2010 IBM Corporation
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© 2010 IBM Corporation