"eHealth and

healthcare organizations

–

The chicken and the egg"

Source: Siemens elaboration from the report “XXI Century: Tentative of Identification of Some Great Trends”

Jerôme Bindé, Manager of the Office of Analysis and Foresight, UNESCO

Drinkable

water

Alternative

energies

Global warming

Sex equalityOil crisis

Information

society

Governability

Autonomy &

Welfare

Ethic

challenges

Population

ageing

Demographic

growth

Multi-

culturalism

Genetics &

Engineering

HealthPoverty

Terrorism &

Human Rights

The great challenges of the

XXIth century

Quality Cost

Through:

• Innovation

• Process

optimization

of healthcare delivery

How to best improve healthcare efficiency

Innovationin Healthcare

Increases patient comfort

Improves quality of care Reduces cost of care

• Reduced invasiveness

• Shorter examination times

• Less radiation

• Selective therapy

• More accurate, reliable diagnosis

• Fewer diagnostic and medication errors

• Faster report turnaround

• Faster acquisition times

• Higher patient throughput

In line with citizens’desire to stay as

healthy as possible during their lifetime

Essential as demographic trends put more and more demands on health-

care systems

Innovation helps to increase healthcare

efficiency and meet the public’s demands

One picture shows a dynamic process

Innovation

eHealth and healthcare organizationsProcess Optimization a challenge

Patient’s Home

Technology

Great Royal Hospital of Santiago de Compostela

(It started to work in 1509)

Hospital

(from latin “hospitalis”) as an aid place, charity,

Handout for the most disadvantages when they

got sick: Poors, pilgers, elders, …

eHealth and healthcare organizationsProcess Optimization a challenge

1- Hospital was an alternative to the care at home, which was habitual, when the social and economic circumstances did it possible.In the XX century, technological advances “take out” the diagnostic and treatment and they bring it at the hospital, with independence of the social situation of the patients.It becomes something universal and it concentrates all the medical knowledge.

eHealth and healthcare organizationsProcess Optimization a challenge

How the Healthcare System will be ?

eHealth and healthcare organizationsProcess Optimization a challenge

Healthcare Economy

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

curedSick,injured

DeathSenior careRehabilitation

Prevention

Acute diseaseBorn

Stroke

Cardio

Trauma

Desease Management

Care Management

MedicalInteraction Places

Treatment

Recovery

Beds

Stayhealthy

LEAN HOSPITALS

Integrated Diagnostics

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Sick,

injured

Healed,

fit for work

Patient

Medicine

Technology

Healthcare Economy

Healthcare System a challenge of the XXIth century

Medicine

MedicalInteraction Places

Technology

Healthcare Economy

Beds

Healthcare System a challenge of the XXIth century

Utilization ManagementPatient

MedicineUtilization Management

MedicalInteraction Places

Technology

Healthcare Economy

Beds

Healthcare System a challenge of the XXIth century

Sick,

injured

Healed,

fit for work

Patient

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

MedicalInteraction Places

LEAN HOSPITALS

Healthcare Economy

Beds

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Examination

DiagnosisTherapyCare

Sick,

injured

Healed,

fit for work

Patient

1- Hospital was an alternative to the care at home, which was habitual, when the social and economic circumstances did it possible.In the XX century, technological advances “take out” the diagnostic and treatment and they bring it at the hospital, with independence of the social situation of the patients.It becomes something universal and it concentrates all the medical knowledge.

2- The medical diagnosis and treatment are spot on. But the processes behind it are broken

eHealth and healthcare organizationsProcess Optimization a challenge

eHealth and healthcare organizationsWhat is workflow in healthcare?

Workflow \w ə rk-fl ō \ n :

a series of activities to produce a

pre-determined result

Industrial workflows are: Healthcare workflows are:

Linear

Unidirectional

Continuous

Have limited complexity

Non-linear

Multi-directional

Interrupt-driven

Have unlimited complexity

Today's Process inside

the clinic center

Roadmap/Concept of a

totally integrated and IT-

supported, controlled

Workflow

Improvement of actual clinical

workflow by use of latest modalities

and IT-Systems.

(solving the “low hanging fruits”)

Roadmap to an optimized workflow supported and guided by an integrated

“Workflow Engine” based on medical symptoms, guidelines and actual situation.

(e.g. automated scheduling, benchmarking, patient tracking)

Controlled Workflow

1

2

3

eHealth and healthcare organizationsWhat is workflow in healthcare?

Scope

Visualization

Workflow-oriented

facility planning

Benefits

Deeper understanding

of complex workflow

interdependencies

Faster identification of

bottlenecks

Comprehensive

space utilization

eHealth and healthcare organizationsWhat is workflow in healthcare?

Example “Hip Replacement”

= 26 Days

1 Day 1 Day 1 Day 3 Days 8 Days = 14 Days

1 Day 1 Day 1 Day2 Days3 Days 4 Days 14 Days

Ideal

Process

Actual

Process

eHealth and healthcare organizationsWhat is workflow in healthcare?

Examination

DiagnosisTherapyCare

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

MedicalInteraction Places

LEAN HOSPITALS

Healthcare Economy

Beds

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Sick,

injured

Healed,

fit for work

Patient

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

MedicalInteraction Places

LEAN HOSPITALS

Healthcare Economy

Beds

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Treatment

Sick,

injured

Healed,

fit for work

Patient

Healthcare Economy

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

curedSick,injured Stroke

Cardio

Trauma

Desease Management

MedicalInteraction Places

Treatment

LEAN HOSPITALS

Integrated Diagnostics

Beds

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Sick,

injured

Healed,

fit for work

Patient

eHealth and healthcare organizationsProcess Optimization a challenge

1- Hospital was an alternative to the care at home, which was habitual, when the social and economic circumstances did it possible.In the XX century, technological advances “take out” the diagnostic and treatment and they bring it at the hospital, with independence of the social situation of the patients.

2- The medical diagnosis and treatment are spot on. But the processes behind it are broken

3- Integrated DiagnosticsThe convergence of laboratory diagnostics, medical imaging and IT solutions helps to advance the shift from a proactive to a more active care. "Although still in its infancy, integrated diagnostics has the potential to dramatically transform healthcare - and it will do it along the entire healthcare continuum, from prevention to early diagnostics to more-targeted, personalized therapies.

eHealth and healthcare organizationsProcess Optimization a challenge

Early Aviation Modern Flight Control

No flight plans

Each pilot had complete control

No coordination

Controls complete system

Flight plans; flights centrally

directed

Constant tracking and correction

Manages air traffic

- Safety

- Efficiency - Timeliness

- Coordinates resources

Modern Flight ControlControlled Workflow

Personalized Medicine

Knowledge-based

Medicine

Fast drug/medicines

development

Imaging biomarkers

Early detection of

diseases

Information flow

parallel to workflow

Past Future

Wait for symptoms or clear evidence of illness

Anatomical and functional image

Standard Therapy

Reactive medicineMolecular Medicine and

Knowledge Management

Predictive

Preventive

Personalized Medicine

eHealth and healthcare organizationsControlled Workflow

Healthcare Economy

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

curedSick,injured Stroke

Cardio

Trauma

Desease Management

MedicalInteraction Places

Treatment

Recovery

LEAN HOSPITALS

Integrated Diagnostics

Beds

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Sick,

injured

Healed,

fit for work

Patient

Healthcare Economy

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

curedSick,injured

DeathSenior careRehabilitation

Prevention

Acute diseaseBorn

Stroke

Cardio

Trauma

Desease Management

Care Management

MedicalInteraction Places

Treatment

Recovery

Beds

LEAN HOSPITALS

Integrated Diagnostics

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Sick,

injured

Healed,

fit for work

Patient

… year 2020

… year 2020

1- Hospital was an alternative to the care at home, which was habitual, when the social and economic circumstances did it possible.In the XX century, technological advances “take out” the diagnostic and treatment and they bring it at the hospital, with independence of the social situation of the patients.It becomes something universal and it concentrates all the medical knowledge.

2- The medical diagnosis and treatment are spot on. But the processes behind it are broken

3- Integrated DiagnosticsThe convergence of laboratory diagnostics, medical imaging and IT solutions helps to advance the shift from a proactive to a more active care. "Although still in its infancy, integrated diagnostics has the potential to dramatically transform healthcare - and it will do it along the entire healthcare continuum, from prevention to early diagnostics to more-targeted, personalized therapies.

In the XXI century, technological advances are going to take medicine at home. The hospital is going to change his role.

eHealth and healthcare organizationsProcess Optimization a challenge

Healthcare Economy

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

curedSick,injured

DeathSenior careRehabilitation

Prevention

Acute diseaseBorn

Stroke

Cardio

Trauma

Desease Management

Care Management

MedicalInteraction Places

Treatment

Recovery

Beds

Stayhealthy

LEAN HOSPITALS

Integrated Diagnostics

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Sick,

injured

Healed,

fit for work

Patient

IT Tools

Medicine

X-Ray

Angio

Bed OP

Intens.

Patientflow

out

in

MRCT

curedSick,injured

DeathSenior careRehabilitation

Prevention

Acute diseaseBorn

Stroke

Cardio

Trauma

Desease Management

Care Management

Beds

LEAN HOSPITALS

Integrated Diagnostics

Workflow Management

Utilization Management

Healthcare System a challenge of the XXIth century

Population Screening: OIS

MIS

Citizen Digital Health Records

Departmental Software:

RIS / LIS / Pharmacy

Pathologic Diagnosis / ICU

Hospital Information Systems

Health Records PACS

Knowledge-driven IT

The potential

Quality of care

remains very largeto improve the

Healthcare System a challenge of the XXIth century

Disclaimer: The views developed in this presentation are those of the author and do not reflect

necessarily the Siemens position on the subject matter

eHealth and healthcare organizations