Irmtraut Gürkan

Administrative Director and

Vice-Chairwoman of the Board

The role in a competitive healthcare market -

Business Strategy

Visit of US Health-Executives on May 10, 2017

Heidelberg University Hospital

Department Orthopädie,

Unfallchirurgie und Paraplegiologie

(in Schlierbach)

Thoraxklinik

(in Rohrbach)

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 2 2

………………………………

Borderline between

Federal States

Baden-

Württemberg and

Hessen

Hessisches KKH Bergstraße Heppenheim

Basic Data (2016)

• 15 Clinics (45 divisions)

• 8 Institutes (13 divisions)

• 8.100 FTE (about 10.000 employees)

• 2.000 Beds for inpatients and daycare

• 66.000 Inpatient cases

• 56.000 Daycare patients

• 1.100.000 Outpatient visits

• approx. 975 million € revenue

organized in 8 departments

Corporate Group

(incl. subsidairies of Heidelberg

University Hospital)

91.500 inpatient cases

2.500 beds

10.300 FTE / 12.900 employees

approx. 1.2 billion € revenue

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 3

Range of performance – inpatient treatments

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+67%

+17,3%

Merger

Orthopedic University Hospital

with approx. 9.000 CM

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017

Executive Board of Directors University Hospital

Dean Medical

Faculty

Clinical

Departments

Academic Medicine in Heidelberg:

Organisational Structure

Institutes Admin.

Divisions

Central

Facilities Subsidiaries

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 5

Medical Director

Administrative Director

Director of Nursing

Dean of the Medical Faculty

Deputy Medical Director

Heidelberg University Hospital: Goals

Optimal care of patients:

Innovative and effective diagnosis and therapy for all complex

diseases.

Modern buildings with state-of-the-art equipment.

Proximity and interdisciplinary cooperation for optimal

treatment.

Science for patients:

The development of new forms of therapy and their quick

implementation for the benefit of the patient.

Imparting medical knowledge:

The Medical Faculty and Heidelberg University Hospital work

as a team to train outstanding doctors, dentists, nurses and

other health professionals.

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 6

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Tasks of the university hospitals

• Access to fundamental

principle based

research

(Campus-Concept)

• Clinical research

• Translational research

• Teaching

• Continuing

education + skill

advancement

•paramedical

professions

(education/training)

• stationary and

outpatient

medical care

•supra-maximum

medical care

• „Unicum (unique)“ –

services

• medical innovations

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017

Selected Areas of

Medical Expertise

• Oncology, Radiotherapy

• Cardiovascular Diseases

• Transplantation (living and cadaver

liver and kidney transplantation,

stem cell transplantation, heart

transplantation)

• Pediatrics

• Orthopedics

• Gynecology and obstetrics

• Neurology and Neurosurgery

• Translational and

individualized Oncology

• Vascular ischemia and

myogenetic dysfunction

• Neurosciences

• Transplantation medicine

• Individualized immunology

• Infectious diseases

Research profile

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 8

Heidelberg University Hospital: Highlights

National Center for Tumor Diseases (NCT): first

comprehensive cancer center in Germany

Heavy Ion Beam Therapy Center (HIT): first clinical unit

providing Proton and Heavy Ion Therapy in a European

Hospital

Translational medicine: affiliated research institutes

(DKFZ, EMBL, MPI, ZMBH), transfer of results into

pharmaceutical production

German Federal Government initiatives:

• Heidelberg University 1/10 Universities of Excellence in

Germany (June 2012)

• University hospital is a member of 5/6 Health Research

Centers of Germany

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 9

National Center for Tumor Diseases

(NCT)

Comprehensive Cancer Center founded in 2004 in cooperation with German

Cancer Research Center, Thorax Clinic, Deutsche Krebshilfe (German Cancer

Aid)

22 Specialties offer interdisciplinary high-end medical care for cancer patients,

always including latest research results in the treatment plans.

• 5.500 sqm

• Costs: approx. 29 Mio. €

• Commencement: 2007

• Completion: End of 2009

• Pre-Financing of the

Building by the Deutsche

Krebshilfe, Discharge of

debt by the Heidelberg

University Hospital and

DKFZ starting 2019

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 10

Heidelberg Ion-Beam Therapy Center (HIT) (Proton and Heavy Ion Beam Therapy)

• World wide „stand alone“ innovation

• Costs approx. 30 000 Euro/ per case

• 800 Pat. / annually

• High business and financial risk!

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HIT is the first center of its kind in Europe and offers a

new treatment option for patients with malignant, often

otherwise incurable tumors, e.g. skull base tumors.

• 5,000 m²

60,000 m³

• Cost of building and

technical equipment:

119 mill. €

• Commencement

Patient treatments:

Nov. 2009

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017

Schwer-Ionen-Bestrahlung

© stern GESUND LEBEN, Heft 6, 29.11.2006, Ein Gigant gegen Krebs, Martin Freiling (Illustration) 12 12

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German Hospitals - Situation after

14 years with the DRG-Reimbursement System

• „in the red“, insolvency / bankruptcy

(every 2nd University Hospital is in deficit)

• Pressure of competition within the service providers

• Substantial economic pressure, reduction in hospital

beds / restructuring or reorganizing of the hospitals

• Wave of mergers and privatization

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017

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FAZ vom

26.11.2006

Who wants to purchase a University Hospital?

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017

Our strategy:

Focus on high-end medicine

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 16.07.2015 15

• To concentrate and strenghten the maximum care

at the University Hospital

• Securing primary health care and basic care in the

region with cooperating hospitals

Strong local and regional hospital

cooperation network

• 11 Departments in cooperating hospitals managed by

medical directors from the University Hospital

• Deployment of 70 doctors to cooperating hospitals

• Cooperation contracts with approx. 50 hospitals

• Connection via Telemedicine and Teleradiology of

approx. 38 hospitals

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 16

Cooperation network Heidelberg

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Cooperation network Region

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017 18

© Irmtraut Gürkan, Universitätsklinikum Heidelberg 19

Example - Casemix-Index Surgery (2015)

Quelle: Verband der Universitätsklinika Deutschlands e.V.

CMI with ZE, NUB, General Surgery 2015 (without transplants)

Pancreas – complex interventions

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Conclusion

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• There is a strong competition within the German health

care sector between the providers

• The strategy of Heidelberg University Hospital is to focus

on high end medicine in combination with patient

oriented research

• We want to be the driver for innovative structures in the

system

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017

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Thank you for your attention!

© Irmtraut Gürkan, Universitätsklinikum Heidelberg, 10.05.2017