Health Care Impact in Michigan (Health care as an economic engine in Southeast Michigan)

1. Health Care Impact in Michigan(Health care as an economic engine in Southeast Michigan) Gregory Auner Wayne State University Smart Sensors and Integrated Microsystems

2. US Health Care Value Chain

3. Health Care in Michigan • Health care is one Michigan’s leading industry. • Provides billions of dollars in annual tax revenue and economic stimulus. • Health care jobs stabilize local economies

4. Health Care in Michigan In 2007 total full-time and part-time employment in the State of Michigan was 5,454,613 North American Industry Classification System(NAICS) industry. Health care and social assistance 634,675 Ambulatory health care services 220,806 Hospitals 192,006 Nursing and residential care facilities 96,985 Social assistance 124,878

5. Health Care in Michigan About 1 of every 10 jobs in Michigan is directly in health care and social assistance (2007 statistic). Michigan Metropolitan area accounts for 542,637 jobs of the 634,675 (2007 statistic) Detroit-Warren-Livonia account for 295,863 jobs (2007 statistic) Bureau of Economic Analysis

6. Rising costs of therapeutic interventions

7. Trends • Simplification • Generalists do specialist work • Nurses do doctors’ work • Patients do clinicians’ work • Machines do all the work • Automation • HIT • Robots • Postmodern Medicine • Mitochondrial • Gene Therapy and Pharmacogenomics (Personalized Medicine) • Regenerative Medicine • Bionic medicine • Globalization

8. Simplification • Home defibrillator • Home dialysis • Home pregnancy test • Home genetic tests • Self-triage, self-diagnose, self-treat on the Web/social media networks • Da Vinci, simulators, augmented reality, etc., simplify surgery • Decision-support software simplifies diagnosis, epidemiology, … • … and much, much more

9. Automation 1: Admin & Logistics • Administration • All aspects of workflow, from patient registration to discharge • Logistical systems • Equipment and supplies will be tracked, inventoried, and re-ordered using RFID (radio frequency identification) technology • Patients will also be tracked by RFID badges or bracelets, and point-of-care data from bedside monitors, testing devices, and other sources will be entered automatically into the EMR • Software-based workflow and RFID-based logistics management systems are substantially automated, reducing costs and enabling better service and care for patients • HIT • Robots

10. Automation 2: Communication • Free of the mess of personal pagers, overhead pagers, cell phones, and desk phones that add cost, clutter, complexity, confusion, and noise to most hospital environments • Personal communication systems • Wireless everywhere

11. Automation 3: Quality Measurement & Evidence-Based Medicine • Outcomes tracking – essential to gauge and constantly improve the quality of care delivered • Integrated with EMR, admin, logistics, … • Vital for evidence-based medicine • Data gathered via the EMR system will be mined for knowledge of what has worked best for patients with a particular medical makeup, history, and condition (MBE—medicine-based evidence) • Full integration of EMR, financial/admin/logistics systems, business intelligence is a major but necessary strategic investment

12. Automation 4: Telemedicine • Virtual office visits via live interactive video links and vital signs monitors over the Internet • Virtual rounding via fixed or mobile Internet videoconferencing systems • Specialist consultation via fixed or mobile Internet videoconferencing and remote biomonitoring technologies • Telesurgery now possible with Da Vinci • Continual biomonitoring of patient’s vital signs using sensor technologies in the home, or worn on or implanted in the body • Video will be 3-D/holographic

13. The Pittsburgh (Good) Example

14. Pittsburgh Life Sciences Greenhouse PLSG IMPACTS SINCE INCEPTION • Created 22,000 sq. ft. lab/office incubator space • Regional life sciences company formation rate has increased from 2-3 per year to 15-20 new companies per year • Imported 13 companies to western Pennsylvania • Invested $13.3M in VC Funding • Assisted with $18M in SBIR Funding to regional companies • 6,000 trainees in biotechnology • Over 5,000 jobs created

15. Return on Investment in Biomedical Research Journal of Life Sciences, 2008

16. Return on Investment From JOLS, 2008

17. Advanced Surgical Technology and Innovation Initiative (ASTi2)

18. Case Study- Real Time Burn Analysis or Cancer Diagnosis During Surgery

19. Cost Savings for Burn Patents

20. Technology- Cancer Detection Early and accurate diagnosis of disease is necessary to curtail the burgeoning costs of health care. The National Cancer Institute estimates the overall costs for cancer in 2006 at $206 billion; $78 billion for direct medical costs and $128 billion for low productivity and premature death. A 1% reduction in deaths from cancer would be worth $500 billion, approximately 2.5 times the annual cost of the disease in the US.

21. Acknowledgements • Dr. Michelle Brusatori (WSU SSIM Program) • David Ellis (DMC) • Laurie Forbes (iNETWORKS) • Steve Loree (DMC Economist)