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Opportunities with The New Danish ”Super” Hospitals

eHealth Roadshow, April 28- 2014

What is facing Denmark?

• An increasing elderly population

• New treatments and technologies

• Increasing expectations among patients

• Health service sector under tremendous pressure

• Better planned patient pathways

• Patient safety (i.e. single-rooms)

• Effective workflows through new technologies

• Fewer transport of patients, staff and goods

• Merging of administrative units and technical functions

Trends in health care in Denmark

• Reduction in number of hospitals and beds (20% down from app. 17,000 in 2011)

• Centralization and specialization

• Fewer hospitals with emergency wards

• Focus on pre-hospital emergency care

• Focus on intermediate care

• Hospitals to be renovated + new hospitals built

• GP’s collaborating in larger clinics

• Huge increase in outpatient visits (up 50% from 10.7 million in 2012)

• Average length of stay is now 4 days

Danish patients are guaranteed free treatment

All Danes holding a national health insurance card, The yellow

“Sundhedskort”, are entitled to:

• free consultation and treatment at emergency wards

including any subsequent hospitalisation

• free consultation and treatment at a local doctor’s

• free consultation and treatment at specialist doctors

• free choice of doctor, clinic or hospital

• National Health Insurance – tax-financed

Copenhagen Capacity | 13/12/2013

Future Investments in “Super” Hospitals

Officially planned until 2020:

• DKK 41.7bn / € 5.6bn

• Five new super hospitals

• Modernisation and extension of eleven hospitals

• Construction and modernisation of health centres and emergency

wards

• Approx. 50 % of total investments are allocated to Eastern

Denmark


Regional Investments

• The South Denmark Region DKK 8.45bn / € 1.14bn Odense: 6.3bn, Kolding: 0.9bn, Aabenraa: 1.25bn

• Central Denmark Region DKK 10.65bn / € 1.44bn Aarhus: 6.35bn, Viborg: 1.15bn, Gødstrup: 3.15bn

• The Capital Region of Denmark DKK 12.85bn / € 1.73bn Rigshospitalet: 1.85bn, Herlev: 2.25bn, Hvidovre: 1.45bn, Sct. Hans: 0.55bn, Bispebjerg: 2.95bn, Hillerød: 3.8bn

• Region Zealand DKK 5.35bn / € 0.72bn Slagelse Psykiatrisk: 1.05bn, Slagelse Akutmodtagelse: 0.3bn, Køge: 4bn

• The North Denmark Region DKK 4.10bn / € 0.55bn Aalborg: 4.1bn


Det Nye Universitetshospital i Aarhus. Budget: €800m. Investments in Health IT: €70m. Rollout: 2020, whereas the first phase will be ready for operation in 2016. First investments in Health IT: 2012

Det Nye Hospital i Vestjylland (Gødstrup) Budget: €450m.5659 Investments in Health IT: €35m. Rollout: The construction will break ground in 2013 and the complete rollout is set to 2020. The first investments in Health IT: 2016.

Odense Universitets Hospital Budget: €850m. Investments in Health IT: €70m. Rollout: The construction will break ground in 2014 and the rollout is set to 2018-2020. First investments in Health IT: 2016

Aalborg Universitets Sygehus Budget: €550m. Investments in Health IT: €45m. Rollout: The construction will break ground in 2013 and the complete rollout is set to 2020. First investments in Health IT: 2016.

Køge Sygehus Budget: €850m. Investments in Health IT: €70m. Rollout: The complete rollout is set to 2020. First investments in Health IT: 2016.

Bispebjerg Hospital (expansion) Budget: €400m. Investments in Health IT: €30m. Rollout: The construction will break ground in 2013 and the complete rollout is set to 2020. First investments in Health IT: 2016. Hospital Nordsjælland (in the planning process) Budget: €500m. Investments in Health IT: €40m. Rollout: The construction will break ground in 2017-2017 and the complete rollout is set to 2022. The first investments in Health IT: 2018.

Herlev Hospital (expansion) Budget: €560m. Investments in Health IT: €45m. Rollout: The construction will break ground in 2014 and the complete rollout is set to 2017. First investments in Health IT: 2014.

The New Super Hospitals in Denmark

The 16 Hospital Construction Projects


Expected gains with the new ”Super” Hospitals

• 50% increase in outpatient treatment

• 20% fewer beds

• Bed stays down to approximately 3 days (from 4.5 today)


The Patients of Tomorrow

• Patients regard doctors as advisors rather than an authority

• Patients’ families are active rather than passive

• Patients seek information and use it actively

• Patients want a team of experts

• Patients reserve the right to a second opinion

• Individual treatment instead of ”one size fits all”


The Hospitals of Tomorrow

• The patient as the central figure

• The framework for a positive experience

• A single room with computer, internet, monitor, etc.

• Space and room for the family

• E.g. ll options are kept open, for example:

Environment-friendly buildings, tele-medical and diagnostic

products, logistic systems, purchasing systems, intelligent beds,

anti-bacterial curtains, food and beverages, etc.

• Objective for 2025: 25 % efficiency gain


The Treatment of Tomorrow

• Large investments in med-tech products and equipment

• Future-oriented emergency wards

• Outpatient treatment will become more frequent

• Objective: quality gains in treatment and a better economy

for public hospitals


The Purchasing Structure of Today

• Each region has a purchasing office in the central administration

• The purpose of the centralised purchasing function is:

• to improve purchasing power

• to optimise standardisation

• All purchases with a value of DKK 500,000 take place through public tenders

• The five regions set up procurement partnerships for large-scale projects - and for high-volume standard products


The Purchasing Structure of Today (cont.)

• The committee of the region (“Regionsudvalget”) composed of

regional politicians draw up the hospital budget

• Purchases exceeding DKK 1.5Mio / € 0.2Mio are carried out by

way of EU tender procedures at www.ted.europa.eu

• Purchases exceeding DKK 0.5Mio / € 0.07Mio are carried out by

way of tender procedures at www.udbud.dk

• Purchases below DKK 0.5Mio / € 0.07Mio fall within the decision-

making powers of the individual hospitals

• Purchases below DKK 50,000 / € 7,000 fall within the decision-

making powers of the individual hospital wards


http://www.ted.europa.eu/

http://www.udbud.dk/

The Purchasing Structure of Tomorrow

• Each hospital ward manages a procurement budget and makes all

decisions as to purchasing equipment

• Purchasing conditions may differ between hospitals

• Hospitals have an equipment committee (“Apparaturudvalget”)

composed of experts with a consultative function

• Hospitals have a med-tech department (“Medico-Teknisk Afdeling”

-MTA) responsible for installing and maintaining med-tech

products and acting as adviser to the equipment committee

• Test equipment and diagnostic products must be accredited by the

clinical chemical department (“Klinisk Kemisk Afdeling”)


The Purchasing Structure of Tomorrow

• Intelligent purchasing instead of sole focus on price

• Consideration of all financial aspects of a product with regard to

purchase and use

• The regions buy high-volume standard products through

procurement partnerships

• New tenders value expected CA 1-1.5 Billion Euro

• In Capital region alone, 300 tenders to come

• Steering group in place May 2014, cross region tenders

• Timing: ca 2 years prior to opening of new hospitals

• Dialogue with key partners


10 guidelines for joint initiatives

1.Strategic procurement for the new hospitals

2.Medicine

3.Technologies for transportation

4.Sterile inventory handling

5.Development of a dynamic virtual hospital

6.Total economic evaluations

7.Establishment of best practice at room level

8.Common tools for the building process

9.IT supported contact with patients and their relatives

10.Traceability of apparatus, equipment, patients and personal

Eight focus areas for content development

1. Organizational structures with focus on patient demand and

need

2. New forms of management of hospitals

3. Cross sector boundaries and collaborations

4. Organization of emergency medicine

5. Easier and faster access to diagnostic

6. Workflow in operation rooms

7. Work flow in outpatient clinics

8. Offices and mobile work places

www.danishhospitalconstruction.com

The best way to approach is

Each region is responsible for the

construction in their own region

For each region a project/advisor group

is established – contact point for

companies – project executive

Danske Regioner is ensuring

coordination

The web will be updated continuously

with info on •The framework and terms for the building projects •Status of the building projects – follow the building processes •Contact persons for the building projects •Expected time for procurements •Relevant conferences and courses

http://www.danishhospitalconstruction.com/

Opportunities

E-heatlh roadshow

Why Denmark?

• Major investments in “super hospitals” and focus on welfare

technology

• Regional governments welcome Public – Private partnerships and

offer testing facilities

• Strong R&D capabilities with several universities and world leading

research centers including medtech and industrial design

• Most flexible labor market in the Nordic region

• Traffic hub of Scandinavia (Copenhagen is the biggest international

airport in Scandinavia)

How to Get Started ?

• Local presence is highly recommended, for instance a sales office in Copenhagen with the purpose of:

• ensuring direct market contact

• showing real interest in the market (the costs of establishing an ApS will total approx. € 10,000)

• Building up an organisation in Denmark

• that takes part in the development of hospitals

• that has thorough knowledge of the Danish rules on public procurement as well as EU tender requirements


How to Get Started?

• Contact language: Danish (English not recommended), e.g.

having a Danish-speaking person is strongly recommended.

• A consortium may be a possible solution for large-scale projects.

• Let your Danish presence serve as a springboard for entering the

other Scandinavian markets

• Establish contact to European companies already operating in the

Danish market.


Specific business potentials

• Public/private partnerships

• Development of new technologies and solution within logistics, IT

and diagnostics (telemedicine and home monitoring, patient/staff

tracking, It supported interaction between patient, family and

hospital/primary care sector)

• Patient empowerment through health-it solutions

• Effective energy solution and environmental solutions

• Non-patients related functions

Attractive features for R&D companies in Denmark

• Attractive tax schemes for foreign researchers and other key

personnel

• Grants to employ PhD students

• Danish National Advanced Technology Foundation (EUR ~2 billion)

• Strategic Research Councils

• Private foundations (EUR ~43 million)

Copenhagen Capacity | 27-04-2014 29

Copenhagen Capacity, the Capital region’s inward investment agency supports you with :

27-04-2014

Copenhagen Capacity | 30

• General or individual information on

economic opportunities

• Planning and execution of visiting programs

and support during the visits

• Objective consulting: Individual cost

calculations and location tools

• Contact with potential partners from

different industries and research facilities

• Contact with venture capital companies and

other investors

• Support during and after your settlement in

Copenhagen

We support you through the different steps

Before Information

gathering/Analysis

During Practical

Assignments

After After-care services

Copenhagen Capacity |

Business days

Marketanalysis

Introduction to relevant contacts

Access to a large network

Company establishment

Assistance with practical assignments

Matchmaking with potential partners

Access to cluster partners

Benchmarking: cost/quality calculations

Support with expansion

Support with consolidation

Support with retention

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Copenhagen – where business is hot and life is cool.

32

Your contacts

Medicon Valley Copenhagen Capacity www.mediconvalley.com www.copcap.com

Sylvie Bove Senior Investment Manager/ Head of Life Science [email protected]

Thanks Sylvie Bove, Senior Investment Manager, Head of Life Science

E: [email protected]

www.mediconvalley.com / www.copcap.com

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