prof. ali akbar safavi f marjani -...

Prof. Ali Akbar Safavi&

F MarjaniSchool of Electrical and Computer Engineering

Shiraz University1

- Topics

• Introduction• Some Economic aspects• The case study of Fars Province• Conclusions

2

- eHealth Introduction

3

• The importance of Health and Technology Opportunities

• The Governments, Private Sector, and People should all be aware of opportunities, financial market, savings, and the possible services.

• Some analysts are predicting another big year for venture capital investment in digital health.

• There are also indicators that this market is not a bubble. All of which begs the questions: – is your money in digital health yet?

– how much areyou getting the services?

-

4

• According to research by Mercom Capital Group, consumer-focused technologies took in 65% of all VC investments in Q3 of 2014, including $345 millions in mobile health deals and $101 millions in telehealth funding.

• VC firms also invested $85 million in personal health firms, $70 million in social health companies, and $23 million for tech supporting medical scheduling, rating and shopping. These investments are up sharply from 2013

5

http://mercomcapital.com/healthcare-it-sector-attracts-$956-million-in-vc-funding-in-q3-2014-reports-mercom-capital-group

• Top 10 mHealth Apps for in 2015 (Surveying more than 65,000 physicians in

a network and an additional 500,000 in some referral network)

10. Pocket First Aid & CPR (Jive Media)

9. Glucose Buddy – Diabetes Log (Azumio)

8. Fooducate – Healthy Food Diet (Fooducate)

7. Instant Heart Rate (Azumio)

6. Emergency First Aid/Treatment (Phoneflips)

5. RunKeeper – GPS Track Run Walk (FitnessKeeper)

4. First Aid (American Red Cross)

3. Lose It! (FitNow)

2. White Noise Lite (TMSoft)

1. Weight Watchers Mobile (Weight Watchers International)

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• On the other hand:

• The use of mobile and wireless technologies to support the achievement of health objectives (mHealth) has the potential to transform the face of health service delivery across the globe.

• Fourteen categories of mHealth services were surveyed: health call centres, emergency, toll-free telephone services, managing emergencies and disasters, mobile telemedicine, appointment,reminders, community mobilization and health promotion, treatment compliance, mobile patient,records, information access, patient monitoring, health surveys and data collection, surveillance, health,awareness raising, and decision support systems.

• WHO supports7

- The Case Study in Fars Province(Studied in 2013-2014)

• Focus on attending of two major medical centers in Shiraz (Imam Reza and Motahari Clinics)

• Statistical information from IT center of Imam Reza and Motahari Clinics

• Approximately 300 questionnaires

9

- Result of questionnaires

10

On average, about 3,500 people visited the two clinics

• Daily attending percentage for different medical experts

24%

15%8% 6% 5% 3% 1%

38%

0%5%

10%15%20%25%30%35%40%


• Distribution of patients from different provinces

11

86%

6%4%

3% 1%Fars

Kohkiloye va boirahmad

Bushehr

Khozestan

Hormozgan


• distribution of patients according to the patient's location distance (in percent )

12

34%

14% 13%

34%

4%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Shiraz city Less than 50km

50 to 100 km Between 100and 500 km

More than 500km


• Frequency of number of accompanied persons for patients (in percent )

13

11%

42%

33%

14%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Unaccompanied One Two Three or more


• Frequency of travels on road to Shiraz (in percent )

14

36%39%

22%

3%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Less than 2 hours Between 2 to 4hours

4 to 8 hours More than 8hours


• Frequency of a vehicle 's trip to Shiraz (in percent )

15

1%

41% 40%

18%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Plane Public transport Private car Taxi charter


• Types of transport vehicles are used (in percent )

16

11%

43%40%

6%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Bus General Taxi Private car Taxi charter


• Frequency of Public transportation costs to Shiraz (in percent )

17

34% 33%

28%

5%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Less than 15tomans

Between 15 to 30tomans


More than 80thousand tomans


• Types of resting places in Shiraz (in percent )

18

2%

11%3%

84%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Hotel Inn Motel We don’t need a place to rest


• Costs of resting place in Shiraz (in percent )

19

86%

6% 3% 5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Less than 15tomans


Between 30 to 50thousand tomans



• Frequency of food in Shiraz (in percent )

20

8%

24%

56%

12%

0%

10%

20%

30%

40%

50%

60%

Bring own food Family home General Dining Is not required


• Frequency of food costs in Shiraz (in percent )

21

51%

27%

13%9%

0%

10%

20%

30%

40%

50%

60%

Less than fivethousand tomans

5 to 15 thousandtomans




• Visiting a doctor for treatment per patient per year

• (in percent )

22

31%

24% 24%21%

0%

5%

10%

15%

20%

25%

30%

35%

First time One to threetimes

Four to six times More than sixtimes


• The waiting time for patients to get appointment(in percent )

23

34%

43%

17%

6%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Less than 30minutes

Between 30minutes to 1 hour

Between 1 to 2hours

More than 2hours


• The waiting time for patients to see a doctor (in percent )

24

25%

39%

28%

8%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Less than 2 hours Between 2 to 3hours

Between 3 to 5hours

More than 5hours

1. Evaluation of Social costs2. Evaluation of the initial investments required to provide

telemedicine applications

Some Economic aspects

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- Total costs

Total initial costsTotal Mode Each Station

Data transmission equipment costs - 2,147,500

Cost of software and systems for telemedicine 50,000,000 -

The cost of training staff and doctors - 200,000

Total 50,000,000 2,347,500

Running initial costsTotal Mode Each Station

Salary of new employee 4,000,000 2,900,000

Internet fee - 170,000

Total 4,000,000 3,160,000

2.1. Fuel consumption

2.2. Levels of air pollution.

2.3. The amount of dead and injured in transport accident

2.4. Travel time

2.5. Travel and transportation expenses

2.6. Local Economy

2.7. Quality of life

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2. Evaluation of the economic advantages of telemedicine in different dimension


• Typical Energy Consumption of various transportation systems in Iran

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Average fuel consumption of automobile in road: 7.72 liters per100 Km

Average distance traveled to receive Shiraz: 308.15 km

Average petrol cost : 550 tomans

Average clinic visitor : 3500 patient

Percentage of patient use car : 58 %

Average distance travel in Shiraz city : 25.1 km

Average fuel consumption of automobile in city : 11.65 Liter

Average fuel consumption of automobile in road: 7.72 liters per100 Km

Average fuel consumption of Public Vehicle in road: 24.58 liters per100 Km

Average Gasoline cost for Public transport : 250 tomans

Percentage of patient use Public transport : 41%29


30


In Day In Year

Average fuel consumption

(liter)

Average fuel consumption cost

(toman)

Average fuel consumption

(liter)

Average fuel consumption cost

(toman)

Road trip by automobile

4,829,370 2,656,255,0001,762,720,050

969,533,075,000

Road trips by public transport

10,868,690 2,717,172,5003,967,071,850

991,767,962,500

Travel in city 909,580 500,269,000 331,996,700 182,598,185,000

Total 16,607,640 5,873,696,5006,061,788,600

2,143,899,222,500

The total fuel cost of the patients transportation

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2.2. Standards of air pollution.

Date CP THC NMHC Nox HC + NOx PM P***

Euro1 July 92 2.72(3.16) - - - 0.97(1.13) - -

Euro 2 January 96 2.2 - - - 0.5 - -

Euro 3 January 2000 2.3 0.2 - 0.15 - - -

Euro 4 January 2005 1 0.1 - 0.08 - - -

Euro 5 January 2009 1 0.1 0.068 0.06 - 0.005** -

Euro 6 January 2014 1 0.1 0.068 0.06 - 0.005** -

• Average of HC and NOx releases : 0.295 gr/km

• Average of Co releases : 0.98 gr/km

• Formula 1: Average Co , HC and NOx releases per day =

Average distance (km) * (Co +HC+ NOx (g/km)) * Average number of visitors per day

• Formula 2: Average Co , HC and NOx releases per year =

Average distance (km) * Average number of visit * (Co +HC+ NOx(g/km)) * Average number of visitor * 365 day

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The total Average pollution releases Due to

patients transportation (In grams)

33


Daily average pollution releases

Average pollution releases in year

Travel in road 1,375,119 1,897,252,202

Travel in city 134,768 185,938,720

Total 1,509,887 2,083,190,921

The number of injuries per 100 thousand population = 31.11

The number of deceased per 100 thousand population = 418.48

Average number of accompanied patient = 1.64

Percentage of non-resident attending Shiraz = 65.6%

Average daily clinic passengers = 0.656 * 3500 * (1 +1.64) = 6061.44

Average number of deaths caused by accidents in days:

(31.11 * 6061.44) / 100000 ≈ 1.9

Average number of dead caused by accidents in year:

1.9 * 365 = 693.5

Average number of injuries caused by accidents in days:

(418.48 * 6061.44) / 100000 ≈ 25.4

Average number of injuries caused by accidents in year :

25.4 * 365 = 9271 34

2.3. The dead and injured people in transport accidents

Total average time spent per visit to each patient,

1. Travel time

2. Waiting time to get an appointment

3. Waiting time for appointment

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2.4. Travel time

Average time

Average travel time 3 h , 9 min

Average waiting time to get an appointment 2 h , 40 min

Average waiting time for appointment 2 h , 50 min

Total 8 h , 39 min

- Direct costs:

1. Average Cost of transportation

2. Average Cost of Food

3. Average Cost of Accommodation

- Indirect costs:

1. Average number of off days

2. Average number of accompanied Patient

36


Total Average Cost for Per person:

37


Average Cost

Average Cost of transportation 30,515

Average Cost of Food 13,500

Average Cost of Accommodation 11,400

Total 55,415

Average number of accompanied Patient = 1.64

Total Average Cost for Per person:(1.64*55,415) + 55,415 = 146,296 toman

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2.6. Local Economy

Enhance social harmony and economic

•Availability and easy access for all citizen

•Reduce transportation

•Reduce air pollution

•Savings in energy costs

•Reduce traffic in city center

•Increase driving comfort

•Reduce the amount of dead and injured in transport accident

•Reduce diseases related air pollution

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2.7. Quality of life

Government Costs

1.For Fuel

2. For Road Accidents (Medical Services)

3. For Insurance Companies

4. For Pollution

40

• For Fuel

Daily :

toman11,831,956,500=58,285.5*58*3500

Annual :

toman4,318,664,122,500 =11,831,956,500*365

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Medical Services Costs (due to accidents)

• Injured Annually 6500

• Annually DEADs 520

• The average of 1,600,000 Rials per person (Daily) for medical services

• Insurance Companies costs annually

• 790,059 ,000,000 (rials)

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رار آنها در بخش حمل و نقل کشوشسهم آالینده ها در هزینه های اجتماعی ناشی از انت

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Social Costs due to Pollution

F = The social costs of transport

E = The total amount of fuel consumed by the vehicle used to transport

B =The total amount of fuel consumed to transport patients in day.

G =The total amount of fuel consumed to transport patients in year.

C =The total social cost of transportation of patients to consume in day.

A =The total social cost of transportation of patients to consume in year.

Barrel is equivalent to 158.99 liters .44

F = 31,571 Rls

E = 120.14 121.80 Liter = 12,256 Million barrels of crude oil

B = 16,607,640 Liter

B = 16,607,640 / 158.99 = 104,457.13 Barrels

B = 104,457.13 / 1,000,000 = 0.10445713 Million barrels of crude oil

G = 6,061,788,600 Liter

G = 6,061,788,600 / 158.99 = 38,126,854.52 Barrels

G = 38,126,854.52 / 1,000,000 = 38.12 Million barrels of crude oil

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C = (F * G) / E = (31,571 * 0.10445713) / 12,256 ≈ 0.2690 =

26.9 million riyals in DAY

A = (F * G) / E = (31,571 * 38.12) / 12,256 ≈ 98 =

9800 million riyals in YEAR

Thus providing telemedicine services can save a lot

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• There are vast opportunities for Governments, Private Sector, and People in eHealth and mHealth.

• mHealth is no different from other areas of eHealth in its need to adopt globally accepted standards and interoperable technologies, ideally using open architecture.

• The use of standardized information and communication technologies would enhance efficiency and reduce cost.

• To accomplish this, countries will need to collaborate in developing global best practices so that data can move more effectively between systems and applications.

Conclusions

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48

Thank You

Telemedicine setup include initial costs and running costs

1.1. Initial costs

1. Data transmission equipment costs

2. Cost of software and systems for telemedicine

3. The cost of training staff and doctors

4. The cost of equipment and telemedicine

1.2. Running costs:

1. Salary of new employee

2. Internet fee

1. Evaluation of the initial investment required to provide a telemedicine applications

49

1. Data transmission equipment costs

1.1. Initial costs

Device Min Cost (Toman) Med Cost (Toman) Max Cost (Toman)

Scanner 222,000 291,000 450,000

Digital Camera 195,000 400,000 2,000,000

Webcam 21,500 100,000 240,000

Headphones 45,000 265,000 750,000

Microphone 11,000 28,000 63,000

Computer 1,000,000 2,000,000 3,500,000

Modem 72,000 84,000 122,000

Phone 76,000 148,000 341,000

Fax 295,000 348,000 860,000

Printer 210,000 535,000 815,000

Total 2,147,500 4,199,000 9,141,000

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51


1.1. Initial costs

Features a telemedicine system :1 . Authentication to Log2 communicate to manage in order the problem3. Schedule plans to meet with a specialist4 . Ability to send and receive messages between doctors , counselors , patient and management system5 . Record patient information6 . Record physicians information7 . Online meetings

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1.1. Initial costs

Features a telemedicine system Continue:8 . Records for patients , including :8.01 . Records of individual patients8.02 . Experiments8.03 . Medical information8.04 . Vital Signs8.05 . Drug consumption8.06 . Registered nurses8.07 . Upload Medical Records8.08 . Action Report8.09 . Reported improvement9 . Add prescriptions per month10 . View all medical records by physicians.11 . X-RAY view images using a web-based PACS system12 . Medical sensor system to connect online and offline

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3. The cost of training staff and doctors

1.1. Initial costs

Sessions number

Each time sessions (hours)

Cost per hour (Toman)

Total Cost (Toman)

1 4 50000 200000

Train to doctors and specialists in financial and administrative support staff :1. Introduction to telemedicine services2. How to use telemedicine systems and equipment

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4. The cost of equipment and telemedicine

1.1. Initial costs

Specialist Device Min Cost (Toman)

Med Cost (Toman)

Max Cost (Toman)

ENT Digital Macro View Otoscope 521,500 1,361,500 3,553,725

ENT General Exam Camera 1,746,500 1,749,500 5,229,000

Dermatology Dermascope 138,215 315,000 6,387,500

Interior - Lung Spirometer 53,165 1,207,500 12,250,000

Heart Electronic Stethoscope 416,500 1,329,965 3,009,895

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1. Cost of new employee

1.2. Running costs

56

1.2. Running costs

Job Title Salary (Toman)

1 Project Manager 2,000,000

2 Finance and Administration Specialist 1,000,000

3 IT Specialist 1,000,000

4 Specialist Physician 1,500,000

5 (medical provider) 700,000

6 Technical Support 700,000

7 Local Doctor 1,500,000

8 Finance and Administration Specialist 700,000

9 Technical Support 700,000

Total 9,800,000

1. Salary of new employee

prof. ali akbar safavi f marjani -...

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