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telekom healthcare SOLUTIONS
BADALONA , 12 NOVEMBER 2015
November 11, 2015 2 For external use
1. Telekom Healthcare Solutions
2. Digital Healthcare: Tendencies
3. Digital Services: Charitè Berlín
DEUTSCHE TELEKOM HEALTHCARE SOLUTIONS
AGENDA
DEUTSCHE TELEKOM HEALTHCARE SOLUTIONS
November 11, 2015 3 For external use
DEUTSCHE TELEKOM HEALTHCARE SOLUTIONS
1. Telekom Healthcare Solutions
2. Digital Healthcare: Tendencies
3. Digital Services: Charitè Berlín
AGENDA
DEUTSCHE TELEKOM HEALTHCARE SOLUTIONS
November 11, 2015 4 For external use
TELEKOM HEALTHCARE SOLUTIONS COMPANY PROFILE FACTS & FIGURES (A Selection)
Employees & Responsibilities Certified partner (ISO 27001, 14001/18001, ITIL)
in DC services, ICT systems and convergence solutions
Strategic E2E solutions: cloud, clinical, telemonitoring, telematic
The highest compliance to data security / privacy standards
Standardised healthcare solutions: HL7 and IHE (health data exchange), PME, Six Sigma, ITIL
Experts worldwide: 50 offices in AME, EMEA & APJ + HC Competence Centers (HU, AT, DE, ES, SG)
THS in figures 2015 > 170 Mio. € Revenue with Healthcare Solutions
worldwide
> 350 global HIS Implementations
> 100 Clinics with IT-Services/Outsourcing
> 9500 Medical suppliers connected to our platform
> 690 Healthcare experts worldwide in Sales, Delivery and Development
> 24 years of expertise in HIS market, developing and implementing solutions with SAP/Cerner
Markets No 1 in the Healthcare-ICT market in Germany
No 3 in the Healthcare-ICT market in Europe
Positioning as the Enabler for Connected Healthcare
Strategic industry for Deutsche Telekom
Focus on open Platforms, Cloud and Data Center-Services
Intelligent portfolio expansion through global shareholdings and partnerships (e.g. ITH, Visus, Healthways, Silvermedia, SAP, Cerner)
Trusted company also by the public players: leading provider since 30 years (NATO, UN, German Army/Police)
November 11, 2015 5 For external use
CURRENT INTERNATIONAL FOOTPRINT
INTERNATIONAL presence
Focus
Revenue
Employees
*2013 FIGURES
Market position No. 1
No. 2
No. 2
OFFICES IN OVER 20 COUNTRIES, GLOBAL DELIVERY CAPABILITY
LARGE CORPORATIONS, MULTI-NATIONAL COMPANIES, PUBLIC SECTOR AND HEALTHCARE ORGANIZATIONS
€9.5 BILLION*
*2013 FIGURES
APPROX. 50 000 (27 000 IN GERMANY, 23 000 OUTSIDE GERMANY)*
ICT provider in Germany
Systems integration in Germany
Manufacturing IN EMEA
November 11, 2015 6 For external use
DTHS PROPOSITION AS A PARTNER
TIME to focus on what I value more: my patients/my customers
EXPERIENCE: 24 years of expertise in HIS market, developing and implementing solutions with SAP/Siemens
EXPERTS: Sales (47), Delivery (222), Developers (540)
CERTIFIED partner (ISO 27001, 14001/18001, ITIL) in DC services, ICT systems and convergence solutions
STANDARDISED healthcare solutions: HL7 and IHE (health data exchange), PME, Six Sigma, ITIL
EXPERTS WORLDWIDE: 50 offices in Americas, Europe and APJ + Healthcare Competence Centers (HU, AT, DE, ES, SG)
REFERENCES: 280 clients with i.s.h.med in 17 countries
STRATEGIC E2E solutions: cloud, clinical, telemonitoring, telematic
STRATEGIC PARTNERS: IHE, Tiani, Portavita, SAP/Siemens
one MAJOR PARTNER able to invest 80€ M in the last 3 years in development of new IT healthcare solutions to the market
TRUSTED company also by the public players: leading provider since 30 years (NATO, UN, German Army/Police)
The highest compliance to DATA SECURITY/ PRIVACY standards
November 11, 2015 7 For external use
DEUTSCHE TELEKOM HEALTHCARE SOLUTIONS
1. Telekom Healthcare Solutions
2. Digital Healthcare: Tendencies
3. Digital Services: Charitè Berlín
AGENDA
DEUTSCHE TELEKOM HEALTHCARE SOLUTIONS
November 11, 2015 8 For external use
MARKET POTENTIAL 50 bn connected devices by 2020
Cloud industry digitalization >100 bn € market potential in 2017
Big data: by analyzing streaming patient data one can reach 20% decrease in patient mortality
TRENDS In 2005 only 30% of office based physicians
and hospitals used EMRs. In 2011, this figure rose to 50% of use by physicians and 75% by hospitals (McKinsey 2013)
Patients are becoming more proactive in managing their own health
CHALLENGES
Lack of coherent strategies linking healthcare IT investments to desired health outcomes
Fragmentation and lack of coordination in healthcare delivery.
Lack of commitment to standards that enable interoperability across the health system.
EVERYTHING THAT CAN BE DIGITISED, WILL BE DIGITISED …
11.11.2015 8
… and everything that can be connected, will be connected! Timotheus Höttges, CEO Deutsche Telekom
NICHOLAS NEGROPONTE, PROFESSOR AT MIT
demographic changes
Age pyramid / Immigration
Increasing chronic disease
Social diseases
External requirements and regulation
DRG
eHealth / Horizon 2020
Data privacy guidelines
Medical products guidelines
Growing knowledge
Exponential growing knowledge
From experts‘ to team knowledge
New, flexible value added chains e.g. competence centers, councils)
Patients knowledge
Technological transition
Progress in the IT medicine Cloud Computing
Mobility
Web 2.0
Ready for Wearables?
2020 500 Mio. active wearables – new tariffs for customers who monitor their health.
Digitalization brings opportunities & challenges for healthcare
economic pressure
Increasing demand
New, more expensive options
Investment bottleneck
Competition (intercantonal)
regional lack of doctors
Shortage in countryside regions
Uneven retribution for GPs
Investments in IT & Infrastructure
November 11, 2015 10 For external use
eAkte
health 4.0: on the go
eHealth
IT supports processes with cooperation partners without media disruptions
LIVE DATA
Transmission of data from ambulance on the way to the hospital
referral management
Systemic , steered cooperation/ communication between hospital and referred sites
EMPOWERED Patient
Patients want to be informed and involved in the decision making process regarding their theraphy
Social Media
Open and striking expression of will and attitude e.g. over evaluation portals in Facebook
Telemedicine / AAL
Services for patients out of the hospital
changed regulatory and framework conditions
Guidelines to cost efficiency, quality or patient safety
Prevention
Healty patients as customers
New business models
Comprehensive cooperation and changed roles (in gradual treatment models)
Quantified Self
Usage of patient generated data as self-monitoring
November 11, 2015 11 For external use
Internet of things
Machine2Machine, IHE
Future workstation from doctors and caretakers
Chief resident on duty can instruct an assistant via iPad; caregivers can document data in real time
Quality management
Securing of /compliance with hygiene, medication und treatment standards
Patient reported outcomes
Patient records evaluation of the treatment in the file
health 4.0: internal hospital view
Location Tracking Services:
Where are the patients, devices and employees at this moment?
It support
Competent support over IT – together with partners to fight against the complexity of technology
Specific applications
Variety of specific applications are enclosed by a comprenhensive patient file
administration & Steering
for Management Information, surgery planning, emergency admission, epidemies, etc Big Data
Electronic dispatcher for logistic or decision making support for diagnose and theraphy
Patients Entertainment
Contemporary configuration for inpatient installations (WLAN, video on demand)
Digitalisisation or processes Availlability of findings at patients bed
November 11, 2015 12 For external use
CHANGE FROM CIO TO CHIEF DIGITAL OFFICER (CDO)
Future: ICT is core and a differentiation factor in busines processes for products and services
■ ICT is a central lever of the company‘s performance – the CIO becomes the CDO
■ Approach: decentralisation of the old IT systems by having a clear enterprise architecture
■ Specialist deparments: more flexibility and speed with dynamic and subject-oriented Business Process Management
The role from ICT ■ in customer interaction: manages to be close to customers and to
promote the dialogue ■ inside companies: orchestrate complex value-added networks ■ regarding infrastructure: decentralised assets are available according to
current needs
So far: IT served as enabler of the core business
■ IT is a support function, used by different departments to improve themselves
■ Approach: constant new silos and endless migrations
■ Specialist departments: existant processes are described in detail in order to generate IT specifications Improvements can happen due to the redesign of processes
The role of IT ■ in customer processes: monitoring of status & generation of data for
reports ■ inside companies:support for decision making process ■ regarding infrastructure: yield of economies of scale and centralisation of
assets
IT as Enabler ICT as Core of Business
November 11, 2015 13 For external use
DEUTSCHE TELEKOM HEALTHCARE SOLUTIONS
1. Telekom Healthcare Solutions
2. Digital Healthcare: Tendencies
3. Digital Services: Charitè Berlín
AGENDA
DEUTSCHE TELEKOM HEALTHCARE SOLUTIONS
November 11, 2015 14 For external use November 11, 2015 14 For external use
CHARITE: TELEMEDICINE REFERENCE CENTER The Charité is one of the largest university hospitals in Europe. 3700 doctors and scientists heal, do research and teach at the top international level. More than half of the German Nobel Prize winners in medicine and physiology come from the Charité, among them Emil von Behring, Robert Koch and Paul Ehrlich. The Charité also has an international reputation for excellence in training. It extends over four campuses with almost 100 clinics and institutes
Founded in 1911
103 departments Turn-over 2009: 1.200 M€ Scientific budget 2009: 127M€
11 Nobel laureates 12.922 employees 7.112 students
bundled under 17 Charité Centers. With 13,100 employees, The Charité generates about 1.400 Million euros in sales per year and is one of the largest employers in Berlin. In 2010, the Charité could look back and joyously celebrated its 300-year anniversary
November 11, 2015 15 For external use November 11, 2015 15 For external use
CHARITÉ-CENTRE FOR CARDIOVASCULAR TELEMED.
Division of the Department of Cardiology (Prof. Dr. med. Gert Baumann) : Founded: 1st April 2008 16 Employees (7 doctors, 5 nurses, 2 study nurses, 1 scientist, 1 student)
Social Media Participación
Autogestión
Telemedical care of patients
Research Projects: • Partnership for the Heart (PfH) • Health Region of the Future Northbrandenburg - Fontane •Nanoelectronics for Mobile AAL-Systems
Education
November 11, 2015 16 For external use November 11, 2015 16 For external use
TELECARDIOLOGY
Connectivity between health care providers
„doc2doc“ systems
Connectivity & Collaboraton between doctor and patient (remote patient management)
„ doc2patient“ systems
Telecardiology = Telemedicine in Cardiology Remote patient monitoring, diagnostics and therapy using modern information and communication technologies
(ICT) Basic Scenarios
November 11, 2015 17 For external use November 11, 2015 17 For external use
CONCEPT OF REMOTE PATIENT MANAGEMENT
November 11, 2015 18 For external use November 11, 2015 18 For external use
CHRONIC HEART FAILURE – A DEMOGRAPHIC BURDEN
Incidence approx. 1.2 million patients (every tenth German citizen over 65 years)
Approx. 200.000 new cases per year Approx. 9% Mortality in class NYHA II/III per year
Costs
3
Morbidity
2
Epidemiology
1
Major cause of hospitalization (approx. 375.000/year)
Non-cardiovascular co-morbidity (renal failure, COPD; depression)
200.000 patients with 375.000 Hi-hospitalizations
Therapy costs – 3.000 M€/year Approx. 85 % of the costs for hospital stay
1. Reduction of HF-hospitalisation („Champion Trial“)
2. Improvement of quality of life („TIM-HF“, „Champion Trial“))
3. Potential for reduction of CV-mortality („TIM-HF“ Subgroup)
For recently hospitalised HF-patients only (1/6 of the total HF-population):
November 11, 2015 19 For external use November 11, 2015 19 For external use
FOUR GENERATIONS OF REMOTE PATIENT MANAGEMENT SYSTEMS
November 11, 2015 20 For external use November 11, 2015 20 For external use
ARCHITECTURE OF THE „PFH-SySteM“
November 11, 2015 21 For external use November 11, 2015 21 For external use
PATIENT & DOCTOR PORTAL
November 11, 2015 22 For external use November 11, 2015 22 For external use
IMPLICATIONS ON HEALTH QUALITY & ECONOMY
Patient profile of responders to telemedicine
• after a HF-hospitalization; without depressive symptoms;
• cardiac function not too weak (LVEF > 25%)
• 1.2 million HF-patients in GER (NYHA stages I - IV NYHA)
• 200.000 HF-patients causing approx. 375.000 HF-hospitalizations per year
• Prevalence for telemedicine in heart failure patients:
• reduction of HF-hospitalizations by 20%
• (health economics is currently under analysis)
• annual constant savings potential of € 150 million (5% of the total treatment cost)
Results for the risk group : 333 (47%) of the 710 TIM-HF patients
• ~ 50% lower cardiovascular mortality due to telemedicine
• ~ 50% reduction in the number of days lost due to cardiovascular mortality and HF hospitalization
November 11, 2015 23 For external use November 11, 2015 23 For external use
CONCEPT OF TELEMEDICAL CENTERS - 1ST&2ND LEVEL
Berlin
Frankfurt
Bonn
Stuttgart
Munich
Challenge: Need for a 24/7 RPM (2/3 of the emergency calls occure during night time and bank holidays) vs. high cost and need for appropriate TMC workload during nighttime network between Telemedical Centers of 1st and 2nd level
2nd level Telemedical Center Working hours: 24/7 Workload: daily Remote Patient Management of the own patients (500 Patients) During nighttimes: management for the own patients + management of the patients from different 1st level TMC´s (approx. 1,000 patients)
1st level Telemedical Center Working hours: Mo-Fr; 9-5 h Workload: ca. 200 Patients During nighttime RPM provided by 2nd level Telemedical Center within the Region
November 11, 2015 24 For external use November 11, 2015 24 For external use
CONCLUSION
• 1/6 of the total HF-population needs telemedicine as a „bridge to stability“ (12 months after HF-hospitalisation), afterwards self-empowerment strategies should be carried out lifelong for all HF-patients.
• Remote Patient Management has to be organized within the regions with a network of TMCs of the 1st level and 2nd level.
• Need for 2nd level TMC for approx. 5 Mio. inhabitants.
• The outcome of telemedicine in rural areas is currently under investigation.
• Remote Patient Management allows individualized patient monitoring (e.g. diabetes, COPD, depression).
November 11, 2015 25 For external use November 11, 2015 25 For external use
DEUTSCHE TELEKOM HEALTCARE SOLUTIONS
DRIVER FOR CONNECTED HEALTHCARE
Thank You!
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