European priorities for e Health and implications for IT

1. European priorities for e Health and implications for IT Tanya Znamenskaya Microsoft Senior Business Developer Central& Eastern Europe

2. E Health • The European approach to eHealth should be about: spending euros on patients not on paperwork!” “For example, electronic medical records can help doctors to diagnose illness and prescribe treatments more accurately, thus reducing medical errors. It also means cutting down paperwork to improve efficiency. Electronic patient referrals in Denmark are saving €1 million a year and could rise to to €3.5 million a year, if all referrals were sent electronically.„ • Health can really help empower patients. Europeans increasingly want to play an active role in decisions relating to their health. eHealth can give them the easy access to high quality health information that they need to achieve this. As part of its current eHealth action plan, the Commission will launch an EU Health Portal later this year, providing a “one stop shop” for health information produced by the EU and a gateway to the websites of national and regional health authorities and civil society groups in the health field • Viviane Reding, European Commissioner for Information Society and Media..

3. Total Health Expenditures per Capita EU 15 health spend: 8,6 % of GDPNew Members: 5,8 % per GDP Economic Drives 50% of the growth difference between rich and poor is due to ill health 10% increase in life expectancy at birth will increase annual economic growth by 35% Key Issues Significant Budgetary Problems – IT Investment Competes with Funding for Other Priorities (Medical Equipment, Medicines, Building Infrastructure) Low end IT Focus Key Investment Areas Hospital Information Systems (Local Solutions) Electronic Patient Records (Local Solutions) ERP Functionality, CRM Patient Management Mobile Solutions for Emergency Services (Ministries of Health)

4. Integrated Hospital Solutions: Hospitals Are Key to Health Modernization • In-patient care accounts for 50% of total healthcare spending in many European countries • Structures are large and complex • Some have more than 10,000 employees and 5,000 beds • EUSF give preference to projects with fast ROI and replicable solutions Corporate ManagementBoard Relations, Strategy & Planning, Legal, Accreditation/Compliance, Risk Mgt. ExternalChannels External Stakehold. Enterprise Business OperationsHR/Payroll, Accounting & Finance, Procurement, Materials Mgt., Public Relations Counter Insurancecos. Enterprise IT Systems Supporting enterprise business operations such as HR, Finance, Supply Chain Mail Govt.health agencies Healthcare Provider Operations Fax PatientAdministrationAdmissions,Scheduling,Registration Clinical Mgt.Clinical Depts.,Laboratories, Imaging Centers,Pharmacies PaymentClaims Mgt.,Revenue CycleMgt., Billing AncillaryServicesOutpatientCenters,Social Programs Patients Call Center Physicians Internet Medical Records

5. Hospital Budget – Central Europe Hospital Sector Accounts for 40% of all Health Spending

6. Good Health in Europe: View of the futureThe financial envelope of the public health programme for the period 2003-2008 is € 353.77 million.Budget available for 2006 Euro 55,817 mil • Change of paradigm: towards preventive health: EPR • Decision support systems for citizens • Connected Europe for Health : e Health research centers across EU • Health card it the pocket, e Health records • People access to Healthcare services (electronic booking, electronic prescription..) Enabling Good Health. A reflection process for a new EU Health Strategy. July 15 2004

7. EU eHealth: Milestones • End 2005: • National roadmap for eHealth Services • EU public health portal • End 2006: • Common approach for patient identifiers • Interoperability standards for messages and records • Common approach to finance of eHealth • End 2007: • Standardized testing and accreditation • End 2008: • Electronic health insurance card • Teleconsultation • e- prescription • e- referral • Telemonitoring, Telecare

8. Collaborative technologies to support eHealth: Integrated secure infrastructure where physicians, nurses, and administrators share and collaborate on information in a seamless manner that revolves around a patient thru the continuum of care. • Collaborative Healthcare Scenarios: • Clinical and Administrative Forms Automation • Business Intelligence • Healthcare process integration • Telemedicine and Real-Time Communications • Healthcare Portals & Collaboration • Key Challenges: • Interoperability • Integration Security

9. Info Access HL7 CDA XML InfoPath HL7 CDA XML Information Creation SharePoint Site HL7 CDA XML HL7 CDA XML HL7 CDA XML Typical Hospital Scenario Data Warehouse HMS Doctor’s home Surgery Message hub BizTalk server X Ray, X ray Doctor’ office Nurse Remote Hospital

10. Microsoft Vision for Health

11. Hospital information system solution for Hospitel of Levoča Slovakia. EUSF Hospital Shared solutions: • Solution HIS: • Business management (Navision) • Hospital management (EPR – Electronic Patient Record including subsystems: clinical, doctors, pharmacy, laboratory, biochemistry, hemathology, radiodiagnostics, health insurance connector and managerial overview) • Staff training (300 users) • Total project time: 8 months • Total project cost: SKV 9.580k (Euro 240k) • 50 hospitals in the pipeline

12. Pilot regions – HPC und eHealthCard competition for the best IT solution eHealthCard (federal ministry of health and social security) Definition of the framework conditions for a security and telematics infrastructure in the health service advisory consortium: IBM, SAP, FHG-IAO ICW, ORGA: HPC Health Professional Card Lead: Landes-Ärztekammer und Landes-KV (country state medical board of registration and country payors Provider: federal states and state medical board of registration for physicians, provider, pharmacies, rehabilitation services Integrated Care Management Lead: public payer Implementation of eHealth networks between physicians, provider, Rehabilitation services and public payer care services aim: integral treatment and support DRGs, case flat rates Main projects in e Health. Germany: eHealthCard: Integrated Care Networks: Implementation of eHealth networks between physicians, provider and payers

13. Cocoon Building knowledge driven & dynamically adaptive networked communities within European healthcare systems(FP6 507126http://www.cocoon-health.com/ Solution: • Decision support system integrated with EPR unifying general practices, clinical experts, regional HC services to provide clinical guidelines using semantic integration via web services • The following main functionality is expected: • Fast and effective search of relevant medical information • Quick on-line access to specialist consultation and opinion • Implementation of automated support for diagnosis and treatment based upon clinical guidelines Consortium: • ASSOCIAZIONE IMPRESA POLITECNICO (IT), CEFRIEL (Centre for Research and Training in Information Technology), Telecom Italia, Simenes Informatica, EMIC (European MS innovation Centre), INTEGRATED CARE SYSTEMS FRANCE - I.C.S.F. GL2006 EUROPE (UK ), Laguagae and computing (Belgium), Institute of Technology Israel, Politecnical University Madrid, Logicom Greece Countries: Italy, UK, Greece, Spain, Israel, Belgium Finland The project also expects to involve around 10000 health care professionals in platform trial activities

14. Microsoft in Healthcare • NHS UK (England) • Leuven Hospital Belgium • Lan Dill Hospital Germany • Madrid Healthcare • ”1177” – Emergency system Sweden • Children Regional Medical Centre – US • Guy’s and St Thomas’ Hospital NHS Trust –UK • Copenhagen Hospital • Arfox Healthcare -SA • East Anglia Ambulance Trust • Inland Imaging Centre Spokane, US • IMS Health UK • Clalit Health Services Israel • Emergency system Israel • Private Medical Centre Moscow