@ehealthireland stay left, shift left!

@ehealthireland

eHealth Ireland will be Enabling Connected Health Through Digital @ehealthireland

Stay Left, Shift Left! A Moore’s Law for Irish Healthcare

Name Martin CurleyTitle Chief Information Officer, HSE, CO, eHealth IrelandTwitter @martingcurley1Email [email protected]

@ehealthireland

Transforming Health through Digital @ehealthireland

“The dogmas of the quiet past

are inadequate to the stormy

present.”Abraham Lincoln

@ehealthireland

Who knows best?

@ehealthireland

Moore’s Law

@ehealthireland

SHIFT LEFT: Highest Quality of Life at the Lowest Possible Cost

Shift Left StrategyDevelop Moore’s Law For Irish Healthcare

Find and sequence eHealth interventions to

drive and improve quality of life and

reduce cost of care

@ehealthireland

Stay Left, Shift Left: Moore’s Law for Healthcare

Cost of Care

Qu

ality of Life

The Continuum of Care

“Shift Left !”

Independent Healthy Living

Doctor’s OfficeChronic Disease

Management

CommunityClinic

Home Care

Primary/Community Care

Skilled Nursing Facility

Assisted Living

Acute Care

Speciality Clinic

ICU

Community Hospital

Shift Left – Highest Quality of Life at the highest possible cost avoidance

Preventative/Proactive Healthcare

Life Style Nutrition

Scanning Monitoring

Genetics Environment

Primary Care Centre

Qu

ality of C

are

Immunisation

B

ACurrent Situation:50% backlog90 day average wait5% prescribing errors

€ € € € € € € € € €

Clin

ician Exp

erience

@ehealthireland

Open Innovation 2.0: The new mode for Digital Innovation; enabled, fuelled and built using Digital Technology – Virtuous Cycle

Source: M Curley/B Salmelin

Leveraging

Collective

Intelligence and

Energy;Multiplicative, Synergy and network effects

Hospital

Start-up

University

Company

Primary CareCentre

User

Co-innovator

CreativeCommons

GovernmentEcosystemsupport

Students

Home

@ehealthireland

Stay Left, Shift Left: Moore’s Law for Healthcare

Cost of Care

Qu

ality of Life


“Shift Left !”



Management

CommunityClinic

Home Care



Assisted Living

Acute Care

Speciality Clinic

ICU

Community Hospital




Scanning Monitoring


Primary Care Centre

Qu

ality of C

are

Immunisation

€ € € € € € € € € €

Clin

ician Exp

erience

@ehealthireland

@ehealthireland

Personalised

Care shift from population-based to person-based prevention and treatment

Care

Networkingshift from institutions to preventative, proactive, mobile, home-based, & community care.

Care Anywhereshift from solo to community and team-based care across orgs and IT systems

Evolve Strategy to a Shared Vision

@ehealthireland

Aligning and Orchestrating the eHealth Ireland EcoSystem to Implement Shift Left Strategy

DynamicPortfolioApproach

Shift Left

Budget

- Slainte Care- eHealth Strategy- Healthy Ireland

Conversion Efficiency = Value/Spend

is HIGHeHealth Capability

Alignment, Acceleration, Amplification, Adoption

Better Outcomes,Efficiencies,Economic Growth

Reinvestefficiencies

Societal, Political , Economic Context

EIIDASFI

S;a

Slaintecare Report May 17

Quadruple Aim

@ehealthireland

Quadruple Helix Innovation

Government, Academia, Industry and Citizens collaborating

together to drive structural changes far beyond the scope of

any one organization could achieve on it’s own

Government/Public

Academic

Industry

Citizen

Copyright © Intel 2015

@ehealthireland


IT-CMF

Significantly

Improve

IT Capability

and Capacity

www.ivi.ie

@ehealthireland

Intel Confidential | 14

Build a Roadmap for Ambition, Implementation

and Success

eHealthBudget

eHealthCapability

eHealth Business

Model

eHealth Macro Capabilities

SustainableEconomic

Model

FundingAmplification

ManagedSpending

Full Visibility ofSpending

European Leader

Mediocre

Average

Managed Yield and Portfolio

Optimized TCO

EstablishBenchmark

ServiceCentre

Cost Centre

InvestmentCentre

Beginning

OptimizedValue

World Class

Initial

Basic

Advanced

Intermediate

MaturityLevels

Optimizing

3.

2.

4.

5.

1.

Value Centre

2018

2020

2023

Timeline

0.85% ofBudget

2% Budget

3% Budget

eHealthValue

Better Outcomes

Resource Efficiencies

Wealth Creation

© Confidential property of Bluedrop Medical Ltd. Not to be shared without written consent

Shift Left And Diabetic Foot Ulcers

Simon KierseyCo-Founder and COO

Bluedrop Medical

Future Health Summit29th May 2018

@ehealthireland

Shift Left: Moore’s Law for Healthcare

Highest Quality of Life at Lowest Possible Cost

Qu

ality of Life


“Shift Left !”



Management

CommunityClinic

Home Care



Assisted Living

Acute Care

Speciality Clinic

ICU

Community Hospital




Scanning Monitoring


Qu

ality of C

are

Primary Care Centre

Diabetic Foot Ulcers

17

• 25% of diabetics will experience a foot ulcer at some point

• Up to 15% of ulcers will lead to an amputation

• Simple issues can lead to devastating outcomes

• Very high cost for the patient

• Very high economic cost to the healthcare system

BLUEDROP MEDICAL

511Amputations

per year

10Amputations

per week

IRELANDTHE DIABETIC FOOT

391

443 451

511

350

400

450

500

550

2013 2014 2015 2016

Am

pu

tati

on

s

Year

Economic Cost of Diabetic Foot Ulcers

19

Costs

• Average DFU treatment cost in an Irish hospital is €23,5001

• In 2016 DFU cost the HSE €84m2

• NHS spends £1.2 billion, 1% of budget on diabetic foot

• USA spends $17 billion on the diabetic foot

63

71

84

50

60

70

80

90

2014 2015 2016

Cost (€ m)

Year

Cost Per Year

1. The cost of managing diabetic foot ulceration in an Irish hospital. (Smith et al 2004 Irish Journal of Medical Science Vol 173)2. Irish Diabetes Association

Global Issue20

GERMANY

48,000Amputations

In Germany per year

230,000ulcers per year

8,395Amputations

in England in 2016

£1.2 Billion1% of entire NHS budget

is spent on the diabetic foot

ENGLAND USA

$17 Billion

75,000Amputations

in USA in 2016

70% of Ulcers are Preventable

21

• Daily temperature monitoring can detect inflammation due to the injury

• Proven in 3 RCTs with 483 patients, 70% of ulcers prevented compared to control

Bluedrop Medical

22

• Smart weighing scales which scans the soles of the feet

• Doctor is alerted if an issue is detected

• Early intervention prevents the ulcer developing

• Proven approach• Difficult to use

• Easy to use for patient• Remote monitoring

Shift Care Left with Early Detection

23

• Often initial presentation is with an infected ulcer

• The later an ulcer is detected the more complicated and expensive it is to treat

• Early detection allows the treatment to shift left

• Results in better outcomes, lower costs, lower resource utilisation

Intervention Stopwatch

Home

GP Clinic

Hospital

24

• 2,820 hospital admissions per year

• 14.5 day average duration

112 DFU patients in hospital every night

@ehealthireland


“In the next ten years Data Science

will do more for medicine than all of

the biological sciences combined.”

Vinod Khosla

@ehealthireland

New modelsof care forced

to emerge: Patient Centric

Shortage of Healthcare Professionals

Rising Costs of Healthcare

Aging Population

Perfect storm in healthcare…

eHealth IrelandSlainte Care

@ehealthireland

Small Business Innovation Research [SBIR]

HSE CHALLENGE

SBIR INDUSTRY

INNOVATION

SMART SOLUTIONS to Solve HSE Challenges

SHIFT LEFT: Highest Quality of Life & Care at Lowest Possible Cost

Small Business Innovation Research

@ehealthireland

Science Foundation Ireland Challenges

Shift Left – Digital Diabetes Management

Shift Left – Capacity and Demand Modelling

Shift Left – Flu and Trolley Crisis

Shift Left – Open Data

Shift Left – Datathon

Shift Left – Novel Instruments, Techniques and Technologies

Shift Left – Integrated Health Exchange

@ehealthireland


“You make a living by what you get, you

make a life by what you give.”

Winston Churchill

@ehealthireland


Thank you!

Name Martin CurleyTitle Chief Information Officer, HSE, CO, eHealth IrelandTwitter @martingcurley1Email [email protected]

@ehealthireland

Challenge

Creating interfaces between systems is a key challenge faced by many health care organisations

• differing implementation of standards in various vendor systems and creating a way to share information between those vendors is challenging.

• reduce our timeframe for implementations, deploy out of the box cross-system data flows, and inform clinical workflows.

Ultimately our goal is to improve the patient quality of life and quality of care while providing the clinical teams with an improved experience and reducing the cost of care.

Opportunity

The opportunity to work with the HSE to develop the HSE common framework for integration utilising existing standards and published architecture types for the EHR programme. The output of this work will be published and form the backbone of our clinical integration strategy. As the HSE embarks on the procurement and deployment of a national EHR, the first site being the national children’s hospital, the Health Service recognised the core need to ensure that all elements of the EHR and our existing suit of clinical applications and medical devices can share information at the patient level utilising standard architypes and standards. As this is the start of our country EHR deployment vendors would have the opportunity to participate in the design and deployment of national solutions for standards and architypes for integration of systems.

Impact

The impact of a successful strategy and deployment is the creation of an open data eco-system which could allow, with the correct data protection guidelines, vendors to develop innovative solutions to support the development of e-Health utilising the existing data with is held within existing solutions. This will allow vendors to develop and deploy solutions, which will have a direct benefit to the patient quality of life and quality of care while providing the clinical teams with an improved experience and reducing the cost of care.

Shift Left – Integrated Health Exchange

@ehealthireland stay left, shift left!

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