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eHealth and future ICT

eHealth and future ICT. Tamás Klotz Senior Advisor Public sector. 7 of the 10 best hospitals in the world run SAP solutions. Source: Healthcare Global Top 10 Hospitals In The World 201 4. SAP Image ID # 275250. Traditional Healthcare Delivery Model. Teaching Hospitals.

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eHealth and future ICT

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  1. eHealth and future ICT Tamás Klotz SeniorAdvisor Public sector

  2. 7 of the 10best hospitals in the world run SAP solutions. Source: Healthcare Global Top 10 Hospitals In The World 2014 SAP Image ID # 275250

  3. Traditional Healthcare Delivery Model Teaching Hospitals 3° HealthCare Regional Hospitals PhysicalMovementofPatients District General Hospitals 2° HealthCare General Practitioners 1° HealthCare The Patient Community - Bottom of the pile!! Unchanged for 6000 years - circa 3000 BC!

  4. IT for Health industry I Shortterm high • BI • ERP Standard (extension) • MDM (Master Data Mgmt) • Netweaver PI • SRM (Supplier Relationship Mgmt) • PAM – Patient Mgmt & ISH-MED • CRM (Customer Relation Mgmt) • CHN (Collaborative Health Network) III 29 Talent Mgmt Facilities Mgmt 28 27 MSS/ESS 30 HCM 24 MM 21 QM 22 Inv Mgmt 19 ACM 26 II Mid-term REM 15 CPM Complexity of solution • eLearning/RDW • eRecruiting • DUET • Adobe • EHS (Env., Health, Safety)/ Emission Mgmt • GRC (Govern., Risk, Compl.) / Access Control • CPM (Corporate Performance Mgmt) • Asset Management / RFID • Solution Manager • Payroll Management • ACM • MRP (Material Resource Planning) • QM (Quality Mgmt) 23 PS II 25 Testing Tools 20 MRP EHS / Emission Mgmt 13 8 CHN 17 Solution Manager 16 Asset Mgmt / RFID 11 DUET 7 5 CRM SRM 14 GRC / Access Control 18 Payroll Management 2 6 PAM ERP (ext) 10 eRecruiting 9 eLearning I 3 MDM Longterm III 12 Adobe 4 Netweaver PI • Investment Mgmt • PS (Project Support) • MM (Materials Mgmt) • Testing Tools • Real Estate Mgmt • MSS/ESS (Employee Self Service) • Facilities Management • Talent Management • Human Capital Management low BI 1 low high Potential of effectivness

  5. TraditionalHealthcareIT • Focused on support systems • Electronic Records • E-Prescribing • Management Information Systems • Electronic Payments

  6. PatiantElectronichealthrecord

  7. Challengesremaintoday • Standard forcommunication of healthdata • ANSI X12 (EDI) - transactionprotocolsusedfortransmittingpatientdata. Popularinthe United Statesfortransmission of billingdata. • CEN's TC/251 provides EHR standardsin Europe including: • EN 13606, communicationstandardsfor EHR information • CONTSYS (EN 13940), supportscontinuity of carerecordstandardization. • HISA (EN 12967), a services standard forinter-systemcommunicationin a clinicalinformationenvironment. • Continuity of CareRecord - ASTM International Continuity of CareRecord standard • DICOM - an internationalcommunicationsprotocol standard forrepresenting and transmittingradiology (andother) image-baseddata, sponsoredbyNEMA (National ElectricalManufacturersAssociation) • HL7 - a standardizedmessaging and text communicationsprotocolbetweenhospital and physicianrecordsystems, andbetweenpractice management systems • ISO -ISO TC 215providesinternationaltechnicalspecificationsforEHRs. ISO 18308 describes EHR architectures

  8. The Paradigm Shift TheInformed Wired upCitizen Community The well-being factor C-Health WWW IDTV IDTV WWW Direct Access to specialists Freestanding Diagnostic Centres Acute Trauma CommunityHospitals(Non-acute) CommunityHospitals(Acute) HomeCare HealthKiosks DayCareSurgery Maternity Allied HealthCare Professionals Primary HealthCareThe ‘Super’ Primary Care Physician PRIMARY TELERADIOLOGYAND TELEPATHOLOGY ? ? eHealth & Telemedicine Clusters of Specialists with Global Access

  9. TELEMEDICINE • Focused on patient care • Telehealth • Mobile Health (mHealth) • Remote Monitoring • Outsourced Specialty Services • Telecare • E-Health

  10. WORLDWIDE DRIVERS FOR TELEMEDICINE • Accelerating demands and costs • Shortages of health professionals • Global public health concerns

  11. HISTORY OF TELEMEDICINE

  12. HISTORY OF TELEMEDICINE Boston Logan Airport to Massachusetts General Hospital 1967

  13. HISTORY OF TELEMEDICINE STARPAHC – On the Papago Indian Reservation 1975

  14. TELEMEDICINE SERVICES Service contracts - prisons, oil rigs, ships, international Outsourced services – teleradiology, neurology, mental health

  15. EMERGENCY SERVICES AND DISASTER RESPONSE

  16. Moving to ehealth Telemedicine Store&Forward Healthcare Telehomecare eHealth Telesurgery

  17. What is eHealth? • Proliferation of terms: • Ehealth, telehealth, telemedicine, mhealth ….. teleoncology, teledermatology • World Health Organization: • eHealthis the transfer of health resources and health care by electronic means. • delivery of health information, for health professionals and health consumers, through the Internet and telecommunications • using the power of IT and e-commerce to improve public health services, e.g. through the education and training of health workers. • use of e-commerce and e-business practices in health systems management.

  18. Technology We need a HTA approach Etical Legal Clinicalefficacy efficency E-Health Economy Organization User Perception

  19. eHealth in the Americas July 2014 Situation Analysis Member States that participated in WHO’s Second Global Survey on eHealth (2013) indicated: 82% 54% 45% 91% 82% 36% * Argentina, Belize, Brazil, Canada, Colombia, El Salvador, Mexico, Panama, Paraguay, Peru, USA

  20. eHealth in the Americas July 2012 Content This presentation 25

  21. ICT tools and methodologies to improve Public Health Mobile (mHealth) PC Telemedicine WWW • PAHO/WHO content; • Public Health (Certified and open access) content; • Other (certified) content – GHL –VHL HINARI – AGORA – OARE; • Other (relevant) content. • Trainings; • Learning objects; • Web Conferences; • Lectures; • Open content for educational resources. • Teleconsulting; • Telemedicine; • Web Conferences & lectures; • Content aggregators (Blogs, Wikis, etc); • Social networks

  22. Future is theCollaborativeeCare Management

  23. Future ICT environments drive changes CABLE LAN-WAN WIRELESS NETWORKS e-COMMERCE C-HEALTH Health Contact CENTRE e.g.NHS DIRECT ELECTRONIC HEALTH RECORD FIXED & MOBILE VIDEO PRODUCTS MEDICAL DEVICES & VITAL SIGNS MONITORING

  24. The 4 Most Widely Implemented eHealth Services • Levels of development (%): • Established - continuous service supported through funds from government or other sources • Pilot - testing and evaluation of the service • Informal - services not part of an organized program

  25. Telehealth ConsultationIndirect and Direct Care Photo Credit: ODCHC, 2009 Photo Credit: averaphoto42012

  26. NEUROSURGICAL TELECOUNSELLING ICT allows to sharing information and CT images between peripheral hospital and central hospital with Neurosurgeon - in all hospitals of Veneto region and in 4 european regions Emergency room Peripheral Hospital Central hospital Neurosurgery Form for request+images Form for response Neuroradiology X

  27. CONTINUING MEDICAL EDUCATION

  28. Telehealth Mentoring

  29. ADVANCED TECHNOLOGIES Remote Surgery Robotics Live Monitoring via Cell Phones

  30. Telehealth Monitoring

  31. Patient’s home Regional eHealth Centre TELEMONITORING OF CHRONIC PATIENTS ICT allows to physician to manage the chronic patient (COPD, Diabetes, CVD) in remote way PATIENT GATEWAY SERVER GENERAL PRACTITIONER TELEMONITORING DEVICES 7 1 3 2 6 5 4 HOSPITAL OR LOCAL HEALTH DISTRICT INTERVENTION SERVICE ALARM DEVICE SOCIAL WORKER REGIONAL CENTRE’S OPERATOR FAMILY DATA TRANSMISSION DATA ACCESS THROUGH HOME CARE PORTAL ALARM MANAGEMENT CONTACT WITH PATIENT

  32. Global Distribution of Mobile eHealth: 14 Most Widespread Mobile Services Health call center Toll-free emergency Emergencies Mobile telemedicine Appointment reminder Community mobilization Treatment compliance Patient records Information Patient monitoring Health surveys Surveillance Awareness raising Decision support

  33. Connected HealthCare

  34. SAP Image ID # 275891 More than 7,900healthcare providers in 94 countries are innovating with SAP solutions.

  35. Az információ, mint stratégiai erőforrásNagy adatmennyiség, gyorsan, számos forrásból – miért SAP HANA? • 2010 – Törvény az adatvagyon fontosságáról A kormányzati stratégia része – szilárd bázis az egészségügyi teljesítmény-adatok szervezésének, monitorozásának fejlesztéséhez • Big Data az egészségügyben – Pulzus projekt • Hozzávetőlegesen évi 450 millió rekord • Járóbeteg-szakellátás • Fekvőbeteg-szakellátás • További egészségügyi adatbázisok adatai • Klasszikus megoldások - Adattárházak, adatpiacok (Relációs, OLAP) • Új-generációs megoldások - Hadoop ,MapReduce, Hive, Appliance • Kombinált megoldás - SAP HANA in-memoryappliance • Adatbázis, és alkalmazás-platform • Tisztán memória-alapú • Duplikáció, és aggregátumok nélkül • Valós idejű elemzések

  36. Adattárház építés Elvárt eredmény Definiálás helyett használat Sebesség Strukturálás helyett a teljes adatbázis elemzése Sebesség In-Memory Betöltés helyett replikáció Tömörítés Kiindulópont

  37. Az elemzéstől a beavatkozásig Egészségügyi szakrendszerek Személyes adatok Master Patient Index Konszolidáció Támogató rendszerek

  38. Web Intelligence – Infarktus Riport

  39. Visibility for Sound Decisions for Collaborative Care Management

  40. SAP Image ID # 275958 10 of the 10top biomedical research institutions in the United States run SAP solutions. Source: Fierce Biotech Research, The top 10 biomedical research institutions

  41. Futurechallenges • Usage of AI indifferentdomains • Eg.IBM Watson services • Usage of VirtualRealityeg: • Surgicaltraining and planning • Medicaleducation • Radiationtreatmentplanning and control • Rehabilitation and sportstherapy • Disabilitysolutions • Neurologicalevaluation • Psychiatric and behaviouralhealth (e.g. treatmentforvariousphobias)

  42. eHealth in the Americas July 2012 Challenges “some abuse” in the social networks

  43. Challenges - Privacy& Security (HIPAA) • Live video stream is “patientcommunication” (must be encrypted)Secureconnectionsareavailable, butnotalwaysguaranteed • – Security= system of documentedpractices • Internet chat providerswon’tattesttosecurity (Skype, iChat, Google) Encrypted session H.323 Internet H.323 ??? Server webcam SIP SIP Encryptedsessions Internet computer

  44. Smart solutions eHealth World Assess to care (Social and political stakeholders) Quality of care (healthcare professionals, citizens, associations) China & South Africa – the Limpopo project Telemedicine/eHealth/Telehealth Mobile health TELEMACO, Piedmont Economy of care (Industry, economists, insurances) Chronic diseases management After Healy J.C. 2007, Med-e-Tel www.medetel.eu

  45. Future ICT ineHealth video Thankforyourattention Tamás Klotz SeniorAdvisor Public sector Tamas.klotz@sap.com +36 70 903 4143

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