The Migration of Healthcare to E-Health

1. The Migration of Healthcare to E-Health Detmar Straub Sweta Sneha Georgia State University IACe-T Conference Keynote Speech October 15th, 2008

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 • Driving Factors Towards E-Health • E-Health Model of Healthcare Delivery and Practice • 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. After a dozen years, the Internet revolution is finally affecting the healthcare profession.

6. Cleveland Clinic MyConsult

8. Patients Traditional Healthcare in US Insurance Carriers Vendors/Suppliers Sickness Treats, Prevents Manages Healthcare Providers (Private Sector or Gov’t) Pharmaceuticals

9. Patients Healthcare in Other Countries Vendors/Suppliers Sickness Treats, Prevents Manages Healthcare Providers (Private Sector or Gov’t) Pharmaceuticals

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

11. 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

12. 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?

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

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 Management of Human and Financial Resources Value Chain of the Healthcare Organization (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 Chain of the Healthcare Organization (Based on Porter’s Value Chain) 17

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

19. E-Health Model Evidence Based Medicine Virtual Consultation and Collaboration among Doctors Electronic Medical Records (EMR) Clinical Decision Support Systems Telesurgery 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 Chain of the Healthcare Organization (Based on Porter’s Value Chain) 20

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

22. E-Health Model Telecare 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 Chain of the Healthcare Organization (Based on Porter’s Value Chain) 23

24. Support Value Processes (Continued)

25. Support Value Processes

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, 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

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 Lies in Use and Acceptance