Unraveling the E-health Conundrum

1. Unraveling the E-health Conundrum Detmar Straub Sweta Sneha December 1, 2010

2. Issues • What is E-Health? • Current Trends and Practices • Impact of E-Health: Quality and Efficiency of Healthcare Services • Implementation Issues and Challenges

3. Agenda • Traditional Healthcare • Drivers of E-Health • E-Health Model of Healthcare Delivery and Practice • Enabling Technologies • Value Proposition Framework • Benefits and Challenges • Conclusion

4. Traditional Healthcare • Local Orientation of Healthcare • Typically Reactive in Nature • Operating Inefficiencies • Limited Access to Suppliers • Low Buyer Power • Limited Access to Pertinent Information • Adverse Impact on Quality of Care • Limited Communication with Patients

5. MyConsult.com After 10 years, the Internet revolution is finally affecting the healthcare profession.

7. Interaction among Healthcare Stakeholders

8. Migration To E-Health • Graying of the Globe • Multiple Chronic Diseases • Diabetes • Cardiovascular • Exponential Rise in Healthcare Expense • Limited Financial and Human Resources

9. Migration To E-Health • Need for Preventive Healthcare and Disease Management • Access to Relevant Information As and When Needed • Patient’s Medical Records • Allergies, Medications, Past History • Treatment Alternatives • Cost-Efficient Operation

10. Satellite-based systems Cellular/ PCS /GSM W-LAN E-Health: Promises and Benefits Remote Patient Monitoring Assisted Independent Living Ubiquitous Communication Distributed Computing PDAs, Laptops Smart Sensors Grid Computing Microprocessors Prevention PATIENTS Ubiquitous Computing Early Diagnosis and Treatment Biomedical Sensors and Clothing and Measurement Devices Disease Management Ubiquitous Biometric Data Measurement ENABLING TECHNOLOGIES Adapted from Sneha and Varshney, Decision Support Systems, 2009

11. E-health can be defined asthe application of information communication technologies (ICTs) across the entire range of functions involved in the practice and delivery of healthcare (Eysenbach, 2001; Silber 2003). What is E-Health?

12. E-Health Model -Optimizing the Delivery and Practice of Healthcare Services

13. E-Health: Enabling Technologies

14. Why E-Health? Provide Quality Care To Patients Stay Current With and Access Relevant Information As Needed Provide Reliable/ Accurate Disease Diagnosis Provide Treatment Options and Information Regarding Each Disease Management Crisis Prevention Primary Value Processes Administrative Functionalities, Billing, Legal Medical Supplies Support Value Processes New Research and Development in Healthcare e6710aeff Management of Human and Financial Resources Value Proposition Framework of E-Health (Based on Porter’s Value Chain) 14

15. Primary Value Process: Pre Diagnosis Knowing What is Known

16. E-Health Model Access to Clinical Information Knowledge Transfer among Physicians and Specialists E-Learning Empowered by Broadband and PDAs as Repositories of Medical Reference Material Examples Internet Based www.webMd.com www.Merck.com www.MayoClinic.com www.PennHealth.com Intranet Based MEDLINE Database journal articles, textbooks, diagnostic tests CliniWeb Primary Value Process: Pre Diagnosis Knowing What is Known

17. Why E-Health? Provide Quality Care To Patients Stay Current With and Access Relevant Information As Needed Provide Reliable/ Accurate Disease Diagnosis Provide Treatment Options and Information Regarding Each Disease Management Crisis Prevention Primary Value Processes Administrative Functionalities, Billing, Legal Medical Supplies Support Value Processes New Research and Development in Healthcare Management of Human and Financial Resources Value Proposition Framework of E-Health (Based on Porter’s Value Chain) 17

18. Primary Value Process: Accurate, Reliable Diagnosis and Treatment Options

19. E-Health Model Evidence Based Medicine Electronic Medical Records (EMR & PEHR) Clinical Decision Support Systems Virtual Consultation and Collaboration among Doctors Tele-surgery Examples Telemedicine Endeavors Applications Suite Supporting EMR Allscripts, Inc. Teleradiology E-Cleveland Clinic The Anderson Cancer Center in Houston Texas Primary Value Processes: Accurate, Reliable Diagnosis and Treatment Options

20. Why E-Health? Provide Quality Care To Patients Stay Current With and Access Relevant Information As Needed Provide Reliable/ Accurate Disease Diagnosis Provide Treatment Options and Information Regarding Each Disease Management Crisis Prevention Primary Value Processes Administrative Functionalities, Billing, Legal Medical Supplies Support Value Processes New Research and Development in Healthcare Management of Human and Financial Resources Value Proposition Framework of E-Health (Based on Porter’s Value Chain) 20

21. Primary Value Process: Post Diagnosis Prevention of Crisis and Disease Management

22. E-Health Model Tele-care Ubiquitous Healthcare Remote Patient Monitoring Assisted Living Facilities Examples Internet Based Diabetes Management myDiabetes LifeMasters Impact of DM: Patients with Diabetes Mellitus (2005) www.elite-care.com CardioNet LifeMinder Primary Value Process: Post Diagnosis Prevention of Crisis and Disease Management

23. Why E-Health? Provide Quality Care To Patients Stay Current With and Access Relevant Information As Needed Provide Reliable/ Accurate Disease Diagnosis Provide Treatment Options and Information Regarding Each Disease Management Crisis Prevention Primary Value Processes Administrative Functionalities, Billing, Legal Medical Supplies Support Value Processes New Research and Development in Healthcare Management of Human and Financial Resources Value Proposition Framework of E-Health (Based on Porter’s Value Chain) 23

24. Support Value Processes

25. Support Value Processes (Continued)

26. E-Health Value Chain - Connecting the Key Stakeholders of Healthcare B 2 B B 2 C Support Value Processes Primary Value Processes CONSUMERS HEALTHCARE ORGANIZATION SUPPLIERS

27. E-Health Applications: Business To Consumer (B2C) • Connecting Patients and Physicians • www.medicineonline.com • www.ienhance.com • Online posting of surgical procedures including costs, and sorting results • Remote Patient Monitoring • St. Luke’s Health System – Cardiac and Diabetic Monitoring of Patients • Efficient Disease Management • Less Chances of Complications and Hospitalizations • Online Second Opinion • My Consult Program of The Cleveland Clinic • Partners Healthcare E-Consultations of Critical Patients • Electronic House Call System • HealthBuddy by Health Hero Network in California, USA

28. E-Health Applications: Business To Business (B2B) • Operating Efficiency - Higher Buyer Power • Online Claims Submission and Reimbursements with Insurance Carriers • Connects Multiple Suppliers and Buyers • One Stop Shopping – MedPool, Reverse Auctions • Electronic Prescriptions • Reduces Errors, Saves Lives, Increases Efficiency • Online Pharmacy • Targeted Marketing

29. E-Health: Issues and Challenges • Information Communication Technology Infrastructure • Telecommunication • Electricity • Access to Computers • Internet Hosts and Internet Service Providers (ISPs) • High Bandwidth and Broadband Access • Socio-Culture • Accessibility to Personal Computers (PC), PC Penetration Level • Ease of Use • Cost Effective for Consumers and Providers

30. E-Health: Issues and Challenges • Technological and Financial • Availability and Accessibility of Technology • Finances for Supporting E-Health • Governmental Rules/ Regulations • Reimbursement Policies • Support

31. E-Health: Conclusions • Not Merely a Technological Innovation – But a Paradigm Shift • Holds the Promise of Efficiency and High Quality of Healthcare Delivery and Practice • Litmus Test of Success – Usage and Adoption of E-Health at a Global Scale • Need for research to assess the drivers and impediments of E-Health across the globe!