ech campus: dr sascha henke (bosch)

Connected Health Leadership Summit - 2009

Connected Health Market Development:

Recent Results

Dr. Sascha Henke, Robert Bosch Healthcare


1.Situation

2.Motivation

3.Action

Agenda


1. Situation • Demographic shift, patient numbers, chronic

diseases, long-term care (chronic disease treatment > 70% of healthcare costs).

• Number of nurses and physicians will decrease (> 20%).

• Policymakers have to perform balance: improving quality, productivity, effectiveness and efficiency of healthcare delivery.

• Most promising approach: integrated and preventive healthcare

• Telemedicine one of the fastest growing markets in the medical device business ⇒ motor for job creation in the European Union.


1. Situation

What is Telemedicine/Telehealth?

Doc 2 Patient(RPM)

Doc2Doc


1. Situation

What is Remote Patient Monitoring?

Remote patient monitoring (RPM) uses devices to remotely collect / send data (using DSL, broadband, cellular, satellite networks or conventional telephone lines) to a monitoring station for interpretation.

Such RPM applications include morbidity relevant vital signs, knowledge and behaviour as well as therapy management programs to monitor and manage behaviour of patients living at home or otherwise outside the expensive infrastructure of a hospital.

Such services can be used to support any medical service providers as physicians, hospitals, disease management organizations and to supplement the use of visiting nurses.


1. Situation / 2. Motivation

• Communication of EU Commission on Benefits of

Telemedicine for EU citizens (11/2008)

• Statement Ilias Iakovidis, January 13th, 2009:

“In 2009 our priorities are interoperability and telemedicine”,

“Personal health systems have become a priority area“,

“Current economic crisis could offer a huge opportunity to

invest in e-health to stimulate jobs and economic growth“.

(„Health is wealth“)

E-Health Europe


2. Motivation

What can we expect from Telemedicine (benefits) ?

Interactive flexible RPM solutions support individuals with chronic conditions, by telehealth and clinical-intelligence for physicians and nurses to make directed interventions.

Fill a gap in the continuum of care

• Early detection of exacerbations / impairment of health

• Efficient, exception-based, individualized interventions

• Patient empowerment, education, behaviour change, motivation

->

• Reduced Hospitalizations + Improved Quality of Life


2. Motivation

What can we expect from Telemedicine Industry ?

Technology `Invented for life`, which means

… reliable technology, designed to last

… technology that accompanies people for a good part of their lives

… intelligent, innovative and beneficial technology to help make peoples lives easier and more enjoyable


End-to-End Solution to provide a holistic Model of Care

System technology based on well established Appliance User friendly appliance base station and peripheral biometric devices, Clinical content designed to patient condition(s), Patient management software and secure IT/data infrastructure.

Implementation and management support provided by TM suppliers Organisational support to build, integrate and operate clinical workflows, Management reporting and clinical trials/health economic outcomes.

TM regions: Local services provided by local partners 1st level technical and clinical triage, patient home installation, training and refurbishment.

Patient empowerment

Effective clinical

intervention


System View


Patient empowerment by helping to understand their Illness and motivate Change in Behaviour

Knowledge

Behaviour

Symptoms

Knowledge

Behaviour

Symptoms

Knowledge

Behaviour

Symptoms

‘The start’: Understand health risk Identify potential problems and address causes

(including co-morbidities and psycho-social factors)

‘The training’: Strengthen behavioural change

Identify change in health status


Effective Clinical Intervention via Clinical Content and Workflows

Other Key Services

Therapy Programmes

ClinicalWorkflow

Technology, process and skills in place to adapt to customer needs

Evidence-based content for CHF, Diabetes, COPD and co-morbidities available – EU covered by 2009

Key content elements: Address vital signs and subjective symptoms, behaviour, knowledge – rules to assess and alert to risks

Knowledge from various customer projects on role of 1st level clinical support, communication flow to physicians, escalation procedures

Address adoption barriers Enhance programme effectiveness with emphasis on

consultative programme design


Consistent and unparalleled Results

High Patient

Acceptance

Improved Clinical

Outcomes

Reduced Health Care

Cost

New four-year VA study shows 19% drop in admissions, 25% decrease in bed days with population of >17,000

University of Colorado COPD study with Kaiser shows decreased symptoms, increased exercise tolerance, and decreased smoking rates

Long-term unpublished controlled study shows continuously dropping health care costs:Quarter 10 of study showing 32% drop in costs on intent-to-treat basis

85% of patients in VA are using the Appliance daily 90% recommend use of System


Consistent and unparalleled ResultsCondition # of

Patients% Decrease

Utilization

Diabetes 8,954 20.4

Hypertension 7,447 30.3

CHF 4,089 25.9

COPD 1,963 20.7

PTSD(Post Traumatic Stress Disorder) 129 45.1

Depression 337 56.4

Mental Health, other 653 40.9

Single Condition 10,885 24.8

Multiple Conditions 6,140 26.0Dr Darkins et al, 2008


Goal: Telehealth Applications all across the Continuum

Fit

& h

ealt

hy

Critica

lly ill

Guided training (depends on fitness level)

Instruction on health- conscious behavior

Motivation and instructionon active, healthy lifestyle

Monitoring of symptoms and self-assessment

Acute state monitoring and emergency interventions

Wellness At RiskChronic

ConditionsHigh-Risk /Complex

Future Today

Health management for individuals at any location, at any time from multiple sources


3. Action

Challenges in RPM calling for action:

• Reimbursement

• Recognized IT/ interoperability standards (⇒ scaling)

• Acceptance (physicians and patients; medical content; usability)

• Integrated end2end Solutions (industry cooperation with medical/ political)

Cross EU – regions activities/comittees

ech campus: dr sascha henke (bosch)

Health & Medicine