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Cost Benefit Analysis of the eHealth Platform in Germany

Debold & Lux. Cost Benefit Analysis of the eHealth Platform in Germany. ePrescription and HealthCard: Synergies of an optimal Solution 3 rd Annual EHTEL Conference Delivering eHealth Across Europe Bruges 2002 Andreas Lux.

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Cost Benefit Analysis of the eHealth Platform in Germany

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  1. Debold & Lux Cost Benefit Analysisof the eHealth Platform in Germany ePrescription and HealthCard:Synergies of an optimal Solution 3rd Annual EHTEL Conference Delivering eHealth Across Europe Bruges 2002 Andreas Lux Advice Company for Information Technology and Organization in Health Care Systems Hamburg

  2. Debold & Lux Debold & Lux Scope and Intentionof the Cost-Benefit-Analysis • Communication Platform in Health Care • Implementing an Infrastructure • Assistance with Applications • Mass application • In daily use of all Health Professionals • Easy telematic realisation • Expected financial contribution • The identified Applications are: • New Health Insurance Card (HIC) with online update • Electronic Prescription (EP) of Drugs • Medication History Documentation (MHD) with Screening CBA - eHealth Platform

  3. Debold & Lux Debold & Lux Agenda • Benefit • Costs • Allocation of costs and benefits • Results CBA - eHealth Platform

  4. Debold & Lux Debold & Lux Health Insurance Card Savings in the business processes • High legitimation of the insured persons • yearly 18 Mio. new insurance cards,nevertheless only a mistake in 0,25 – 0,35 % of the cases • Misallocation is economical irrelevant (inside the compulsory insurance system) • The costs of the maintenance of the old HIC are savings – 24 million € per year • Great failure in the handling of the relieving Co-Payment • it doesn't work - insured persons with a relieving pays and insured persons without a relieving don‘t pay CBA - eHealth Platform

  5. Debold & Lux 300 260 257 250 225 200 153 150 Million Euro 100 50 0 AOK H AOK Sachsen GEK Debold & Lux Relieving from Co-paymentProjection in comparison Annual deficit for the compulsory health insurance companies (Projection) used in the CBA CBA - eHealth Platform

  6. Debold & Lux Debold & Lux Saving potential of the ePrescriptionTransaction Costs EP - Paper Administration 5 Mio. € EP - Image Administration 20 Mio. € Providing physicians with EP forms 5 Mio. € Reducing administrative costs in pharmacies 40 Mio. € Improvement of the prescription proof 75 Mio. € CBA - eHealth Platform

  7. Debold & Lux Result 600 551 500 400 300 Million € 200 Estimated 128 100 0 Result DHD Debold & Lux Medication History Documentation (MHD) Model Calculationand estimated in the CBA • Only hospital costs • Ambulant treatment costs are not included • No, estimations regarding economic effects, like loss of working days Reasons for the reduced benefit in the CBA calculation • Application is voluntary for the patient • Application is voluntary for physicians and pharmacists • The quality of the reaction in the use of warning information isn’t proofed CBA - eHealth Platform

  8. Debold & Lux Insurances. Pharmacists Physicians Debold & Lux 551 260 SavingsAmount and Allocation 153 150 128 100 77 Million € 50 24 41 24 5 0 A B C D E A Paper Forms B HIC old C Billing Proof D Co-Payment E Medication History Documentation CBA - eHealth Platform

  9. Debold & Lux Education Insurance Card InfrastructureCommunication PKI Project Debold & Lux Investment559 Mio. € - Working hours physician / staff - direct education costs 600 116 - Chipcard for the insured people 500 400 187 - Server Routing/Transport/HI - Communication server with Firewall physicians/pharmacists Million € 300 143 - HPC for Health Professionals - Card terminals 200 100 - Planning and concept - Realisation of a pilot(ca. 100.000 insured people) 99 14 0 CBA - eHealth Platform

  10. Debold & Lux 1.500 1.000 Million € 500 0 year 0 year 1 year 2 year 3 year 4 year 5 Investment Running Costs Savings Debold & Lux S+Co-Payment S+Co+MHD Accumulation of Costs and SavingsBreak Even Point (BEP) BEP CBA - eHealth Platform

  11. Debold & Lux Debold & Lux Allocation of Costs and Benefit 2023 2.000 1.800 1.600 1.400 1.200 million € 1.000 800 600 26 400 204 227 287 Savings in 5 years 200 45 125 Investment 0 192 62 Insurances Running Costs in 5 years Physicians Pharmacists CBA - eHealth Platform

  12. Debold & Lux Debold & Lux Resultinfrastructure, economical and health political • Liability is given, security infrastructure is implemented • A refinancing of the investment is possible • The medical applications will have the biggest potential, the administrative applications are only starter • Political acceptance for this model requires, • Balance of the asymmetric allocation of costs and benefits • Benefit from the new technology not only for the health insurance companies, but also for physicians and patients CBA - eHealth Platform

  13. Debold & Lux Debold & Lux Contact and more Information The complete Cost-Benefit-Analysis is available in German language and a short summery in English on the following links. www.Debold-Lux.com Sponsors of the Study: Federal Union of German Associations of Pharmacists – ABDA www.abda.de Verband der Angestellten-Krankenkassen e.V. - VdAK, Siegburg www.vdak.de CBA - eHealth Platform

  14. Debold & Lux Debold & Lux Are the results transferable? • Costs The results are transferable in the most European countries • Benefits • New Health Insurance Card Special situation in Germany • Electronic Prescription of Drugs There should be an equal situation in other countries. The administrative processes for clearing and proof became more efficiency • Medication History Equal situation and effects in other countries CBA - eHealth Platform

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