IBM World Wide Healthcare Team

Smarter Healthcare

Telemedicine 2015

IBM Healthcare Solutions

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Telemedicine – A New Idea?

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Healthcare Global Challenges

Globalisation Healthcare costs are affecting competitiveness of companies, regions and countries

Consumerism More knowledgeable, demanding citizens

Changing demographics and lifestyles Aging and overweight populations

Diseases that are more expensive to treat Increased prevalence of chronic conditions – especially diseases of affluence

New technologies and treatments Advances revolutionizing risk assessment, diagnosis, and treatment

Financial constraints Pool of funds for healthcare is not limitless

Societal expectations and norms Is healthcare a societal right or a market service?

Lack of aligned incentives Few incentives to encourage the behaviour of collaboration and service transformation

Inability to balance short and long-term perspectives Common focus on urgent short-term needs, rather than long-term sustainability

Inability to access and share information Clinical data is being generated at unprecedented rates, but information sharing remains elusive

DRIVERS INHIBITORS

Source: “Healthcare 2015 Series,” IBM Global Business Services and IBM Institute for Business Value

IBM Point of View on eHealth

  Innovative use of IT will enable new healthcare delivery models:   Healthcare information becomes ‘digital’, and based on industry standards   This enables ‘views’ of the patient across organisational boundaries   Minimise patient travel – move patient information instead   Extend the reach of healthcare services to the home, workplace, community   Exploit the power of electronic media to educate, inform and support citizens

  This will deliver:   More convenient and safer care pathways for the patient   Improved demand management for medical (and social) care   Better informed and more ‘activated’ citizens   Reduced costs for the healthcare system   An affordable and sustainable service

Electronic networks are a pre-requisite

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Smarter Healthcare

+ + =

Improve operational effectiveness

Deliver collaborative care for prevention and wellness

Achieve better quality and outcomes

A smarter health system forges partnerships in order to deliver better care, predict and prevent disease and

empower individuals to make smarter choices.

Intelligent Instrumented Interconnected

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IBM in Healthcare

  Integration Strategy   Middleware   Dashboards   Analytical Tools   Infrastructure   Delivery and Transformational Services

  No Branded Devices   No Front End Operational Applications   Application Partners   Demonstrations, Pilots and References

Standards Based Integration and Presentation of Information for Smarter Healthcare

Sharing of Information = Performant Networks

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Home Care

PHARMACIES

Health & Wellbeing

PROVIDERS

RADIOLOGY PATHOLOGY

PBMs

PCT/Surgery

PUBLIC HEALTH

EMPLOYERS

LIFE SCIENCES

SMALL CORPORATIONS

Value

Selective Ability

New Care Delivery Models

Advances in Medicine/Procedures

LARGE CORPORATIONS

Patient

Scenarios drive the need for Healthcare IT systems to exploit data & interoperability standards to:

Connect – integrate sytems across the enterprise boundary Share – high value data among communities Accelerate Innovation – rapid deployment of new services Improve Efficiency – re-use existing assets and infrastructure Address Service Issues – transparently allow service trends to be captured and analysed for refinement and development purposes and to identify best practice.

Telehealth – The Wider Health Ecosystem

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Potential Entry Point – Medical Device Integration

MLLP HL7

Nurses

Proprietary

Proprietary

Proprietary

Vital Signs

Web Services

Proprietary

Hospital Patients

Nurses Dashboard

Clinical Applications

Integration Engine - ESB

Space

Intellivue Information

Centre

Alaris Gateway

Home Patients

Clinicians

Vital Signs

Device Manufacturer Data Aggregator

Collects data from devices for that manufacturer and sends out to other interested parties.

Device Manufacturer Medical Devices

Integration Engine - ESB

Overarching Data Aggregator. Collects feeds from different Device Manufacturer Data Aggregators and creates a

single feed in the format required for downstream

applications

Continua

Continua

IBM Remote Medical Device

Aggregator

XML

MLLP HL7

Web Services

Clinical Applications Clinical

Applications

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Demonstration IHE Connectathon, Vienna, April 2009 Monitoring for Diabetes

Wireless Pulse Oximeter

Devices Device

Manager

Care management platform for

monitoring diabetes patients and

supporting behavior change

IBM Sensor Event Platform Aggregate data from large

number of devices Perform event processing

Map into Provider Application

Collect device data

Remote Monitoring

Server

Devices to collect personal health data regarding diabetes

Wired Weighing Scale

Medication Pack

Wired Glucose Meter

IHE Affinity Domain

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Reference Dialog Pro-active Disease Management - Denmark

15,282 Patients

149 GP

12 Specialists

3 Out-Patient Clinics

Municipality of Odense

Implementation project in progress

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Devices

Quality Monitoring

National Clinical

Databases

GP and Speicalist

Out patient clinic

Municipality

Patient

Diabetes

Heart

Lung

xxx

Remote Monitoring

Patient Plan

Patient self treatment

Chronic Disease

Overview

Reference Dialog Pro-active Disease Management - Denmark

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Reference Brigham and Womens Hospital Radiology Theatre

Brigham Clinicians Share Medical Scans Remotely (e.g. Intensive Care and Cardiovascular Units) Providing Collaborative Diagnostics, Care Plans and Consensus of Opinion.

Project IBM Blue Spruce – Web Application Development

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Fact: Accessing quality medical care in remote locations is difficult and time-consuming (in this case no airstrip - 7 days travel by sea to Capetown)

What’s smart? •  Using telemedicine to provide access

to clinicians in University of Pittsburgh Medical Center

•  Provision of teleradiology, telepathology, doctor-to doctor, and doctor-to-patient consultations, all via satellite link

Smarter Business Outcomes •  Immediate referrals and 2nd opinions •  Improves quality of patient care •  Eliminates need to travel (a very long

way!) for specialist consultations

Reference Telemedicine – Tristan Da Cunha

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IBM Healthcare and Telehealth

  Worldwide Strategy now being promoted in UK   Investment in capability and resources   Integration and aggregation strategy   Utilisation of standards   Start simple and expand   Best of breed   Demonstrations and simulations   European and North American references   UK pilots

Better quality care - more consistent, more effective, more proactive, more efficient, less invasive and less

costly

Smarter Healthcare

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ibm.com/healthcare

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Distinctions and Definitions

Telecare Safety and security for independent living (panic buttons etc.)

Telemedicine Using ICT as a collaboration mechanism between healthcare professionals for diagnostic, therapy and care services

Telehealth Using ICT as a collaboration mechanism between the home and health service locations for proactive health monitoring, disease management and rehabilitation

A value-based healthcare system

20% of people generate

80% of costs

Healthy/ Low Risk

At-Risk

High Risk

Active Disease

Healthcare spending

Early Symptoms

Health status

Source: IBM Global Business Services and IBM Institute for Business Value

A value-based healthcare system should help citizens to better understand and manage their health risks

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  Automation of overall process   Doctor/patient interaction   Reconciliation / drug accountability

  Patient compliance   Records medication usage with time stamp   Improves patient compliance through reminders

  Electronic diary   Records and link patient experience, with time stamp,

to actual medication   Data management

  Increase overall data quality   Makes all data traceable

Introducing Cypak IPP - core benefits

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Wireless Vital Signs

•  Disposable non irritant patch sensor •  Reusable wireless electronics •  Quick and easy to apply

• Respiration

• Temperature

• Accelerometers

• ECG

• Blood oxygen (coming)

•  All in 1 disposable patch temp

resp

pulse ox

ecg

motion

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BiancaMed Contactless Sleep Monitoring

  SleepMinder™

  First wireless sleep measurement Biosensor

  In the convenience of person’s own bed!

  Biosensor/Mobile Phone

  Internet enabled, full service sleep data

  Features: •  Non-Contact Motion Sensor •  Measures body motion and respiration •  Continuously monitors the person as they

sleep •  Screens for:

–  Breathing Disorders -  Cheyne Stokes Respiration; -  Sleep Apnea

–  Sleep Quality

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Rationale for WSD

We want to know to what extent the WSD model of care:

  promotes individuals long term well-being and independence

  improves individuals and their carer’s quality of life

  improves the working lives of staff

  is more cost effective

  is more clinically effective

  provides an evidence base for future care and technology models.

(Tim Ellis – WSD Programme Update to Intellect – 3 March 2010)

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Quotes from WSD Participants

  “Living on my own it’s nice to know I can call for help if I feel ill during the night or fall.”

  “The alarm system allows me a lot more freedom and peace of mind.”

  “It means that I don’t have to go into a care home which I don’t want to do. I want to stay in my own home as long as possible.”

  “I feel much more confident knowing that someone is keeping an eye on my health every day. I think it’s great.”

  “Since I started using Telehealth I’ve been able to manage my condition better.”

  “It changes the whole concept of my life. I can get on with my daily activities... and am totally independent.”

  “Now if my condition changes I can speak to someone quickly and they have a record and can see what has changed - they know what to do to sort it out.”

(Tim Ellis – WSD Programme Update to Intellect – 3 March 2010)