QUALITY OF CARE: COST OR INVESTMENT?" IT IS POSSIBLE A HEALTHCARE SYSTEM LOW COST?

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1 QUALITY OF CARE: COST OR INVESTMENT?" IT IS POSSIBLE A HEALTHCARE SYSTEM LOW COST?

2 ASL NAPOLI 2 NORD 1. WHO WE ARE 2. WHAT WE HAVE DONE 3. AN EXAMPLE OF ROI IMPLEMENTATION OF THE UNITED COMMUNICATION 10/8/2014 2

3 1. WHO WE ARE: ASL NAPOLI 2 NORD SURFACE AREA : 411,43 Kmq POPULATION : citizens CITIES: 32 HEALTH DISTRICTS: 13 DEPARTMENTS: 6 HOSPITALS: 5 RESIDENCE FOR THE ELDERLY: 2 3

4 INVESTMENT EXPENSES ARE JUSTIFIED BY ITS COSTS? COST - EFFECTIVENESS (outcomes assessment in natural units of health benefit) COST BENEFITS (outcomes assessment in monetary terms)

5 TOWARD DIGITAL HEALTHCARE COST EFFETTIVENESS COST BENEFIT

6 I.C.T. balanced scorecard (BSC) The total cost of the ICT system is commensurate with that produces on the company's management?! Financial Processes, management and internal resources are tailored to the needs of the company?! Customer: Process & People: Learning & growth:

7 Approach adopted Strategia ICT Vision e processi Progetti in corso Construction of an ICT strategic plan strongly connected to business needs, characterized by a high level of expected efficiency and effectiveness of the investment required NEW APPLICATIONS - BPR - SISTEMI LEGACY - APPLICAZIONI WEB e-propositions QUICK WINS Evaluation State of art ICT Architecture of reference ICT Strategic Plan ADJUSTMENT OF INFRATRUCTURES, SKILLS AND MANAGEMENT OF ICT - LEGACY - INFRASTRUCTURES - TECHNOLOGIES - RESOURCE - ICT MANAGEMENT ICT DEVELOPMENT PLAN: PROGRAM & CHANGE MANAGEMENT

8 Summary Positioning Technology - application diagram Administrative Datawarehouse Management Control Directional Area Sanitary Datawarehouse Management Dashboard- MD External bodies Administrative Area Hospital Area Territorial Area Region Contabilità generale Contabilità intramuraria Cespiti ed inventario Laboratorio analisi Pronto soccorso Smart ADI Cure paliative Medicina legale Visite fiscali INPS Magazzino economale Controllo Fatturaz. Gare appalto SMART C6 (Malattie) Ordini beni sanitari Affari legali Ordini beni Non sanitari Asset Inventory Anatomia patologica Gestione ADT RIS / PACS Gestione Accreditam. CUP Interno PUA Sceening oncologico Vaccinaz. Riabilitaz. Protesica Consultorio familiare Igiene ambientale INAIL Regional bodies Paghe Rilevazione presenze Gestione risorse umane Controllo SDO Sistema Cuprecall Sale operatorie DWH Flussi farmacie Visite ispettive Assistenza socio sanit. other P.A. Repository / PHR - Documentum Register of assisted - MS CRM SOGEI SIEM DAM Log accessi ICT Asset inventory ESB Documentum Infrastructural Area Protocollo Workflow Trouble Shooting Help Desk Connettivity adapters HL7 Web Services Proxy e Antivirus WEB Mail Reporting SLA Disaster recovery In cloud Intranet Portal of Services Central Reservation Service

9 2. WHAT WE HAVE BEEN

10 3. WHAT WE HAVE DONE NEW DATA PROCESSING CENTER - HW TODAY (2013) ONE PROCESSING SYSTEM SIZED FOR THE NEXT 10 YEARS A COMPLEX STORAGE SYSTEM FOR ALL KIND OF NEEDS (SAS SATA SSD DISK) PROCESSING CAPACITY THAT ADAPTS TO THE PREVAILING REDUCED COST OF POWER SUPPLY

11 UNTIL TODAY WE HAVE SAVED MORE THAN ,00 EUROS PER YEARS OF SERVER MAINTENANCE

12 VIRTUALIZATION SCHEMA Cluster A.D. Cluster Applicazioni ASL Cluster Exchange Cluster Lync VMware vcenter Suite VMware vsphere Servizi per le Applicazioni Scalabilità Sicurezza Disponibilità DRS Hot Add Vshield Zones VmSafe Vmotion Storage vmotion HA Fault Tolerance Data Recovery Compute Storage Network Servizi per le Applicazioni ESX e ESXi DRS e DPM Memory Overcommit VMFS Thin Provisioning Storage I/O Control Distribuited Switch Network I/O Control

13 OUR INFRASTRUCTURE NETWORK DATA PRIVATE CLOUD PCS MPLS DPC Two separate way for network data exchange INTERNET

14 OUR CLOUD IDENTITY USER (AD) VoIP APPLICATION SW MAILING FREE DATA

15 the only access point from outside to our cloud through the portal of services

16 MEDICAL CARE MODELS Proposed Model Medical Care Current Model Patients Hospital Often complex and large hospital infrastructures High management costs and capital investments Difficult territory reach SPOKE 1 SPOKE 2 HOSPITAL (HUB) Patients High-tech specialist hospitals In-mobility medical care Population screening in the field to increase knowledge and prevent Continuous medical education and training Health care planning and control to predict and organize effective response High modularity to develop and roll-out the global medical care Hospital beds often used to care for chronic old patients Long waiting times for specialist exams No economies of scale

17 EXAMPLE OF ROI: THE UC PROJECT 2009 PUBLIC PHONE CENTRAL Exchange Mail Active Directory IP PBX Alcatel MOBILE PUBLIC PHONE INTERNAL PHONE Intranet

18 Phase 1: ibrid system toward the UC FULL IP Centrale telefonica Pubblica VoIP Gateway Lync 2010 Exchange Mail e Voic Active Director y IP PBX Alcatel Intranet Cellulare Telefono pubblico Telefono interno Lync 2010 Edge Internet Cellulare

19 Phase 2: UC FULL IP

20 WHAT DOES IT MEAN SWITCH TO VOIP: SERVICE COST/YEAR IN 2009 COST/YEARS AT CONCLUSION OF PHASE 2 SAVING/YEAR MAINTENANCE TRADITIONAL VOICE , , ,80 CDN FEES RTG, PRA, BRA FEES , , , , ,16 TOTALI , , ,96

21 RETAIL COST AND ESTIMATED SAVING

22 MOBILITY COST SAVING

23 COST OF TIME

24 TOTAL COST SAVING

25 AT END INNOVATION IS A INVESTMENT IF IT IS WELL KNOWN FROM WHERE YOU START AND WHAT YOU WANT TO GET

26 THANK YOU

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