Transform HC via interoperability to enable integrated care. Michael Graetz Healthcare EMEA RVP, IIG, EMC

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1 Transform HC via interoperability to enable integrated care Michael Graetz Healthcare EMEA RVP, IIG, EMC

3 NCDS effects today more than 100 million people in Europe NCDs accounts for 86% of deaths in Europe Cardiovascular estimates to cost 192B euro per annum, represent total 10% of EU healthcare cost COPD cause 20% of WW deaths Type 2 diabetes effects 10% of EU population and cost 160B euro per annum, By 2030, 35M people will be effected. WW 350M will be effected with a cost of dollars. Copyright 2013 EMC Corporation. All rights reserved.

4 The 6 Steps To Cure Healthcare 1.Specialize & organize around the patients condition 2.Measure & analyze outcomes & costs 3.Pay on value not volume 4.Integration removes duplication 5.Hub and spoke 6.Redefine current IT systems One of 4 finalists of the HBR McKinsey award 2013 for outstanding articles Source = HBR October 2013 Copyright 2014 EMC Corporation. All rights reserved.

5 What Does Good Enabling IT Look Like? Patient centered not discipline centered Encompasses all types of patient data Structured & Unstructured Uses common data definitions/standards Is accessible to all parties Templates and processes for each condition Big data analytics ready Copyright 2014 EMC Corporation. All rights reserved.

6 BILLIONS OF USERS 3 RD PLATFORM MILLIONS OF APPS HUNDREDS OF MILLIONS OF USERS Mobile Cloud Big Data Social Mobile Devices 2 ND PLATFORM TENS OF THOUSANDS OF APPS LAN/Internet PC Client/Server MILLIONS OF USERS 1 ST PLATFORM THOUSANDS OF APPS Source: IDC Mainframe, Mini Computer Terminals Copyright 2014 EMC Corporation. All rights reserved.

7 Old Tech New Tech BILLIONS OF USERS 3 RD PLATFORM MILLIONS OF APPS Mobile Cloud Big Data Social Mobile Devices HUNDREDS OF MILLIONS OF USERS 2 ND PLATFORM TENS OF THOUSANDS OF APPS Few hospital providers have got this far LAN/Internet PC Client/Server MILLIONS OF USERS 1 ST PLATFORM THOUSANDS OF APPS Source: IDC, Edits Andy Crowne HANDFULL OF USERS Mainframe, Mini Computer Terminals 0th PLATFORM TONS OF PAPER Copyright 2014 EMC Corporation. All rights reserved.

8 Platform 3 The Data Deluge The HIM guy generated unstructured data Copyright 2014 EMC Corporation. All rights reserved. EMR Analytics Integrated Patient Record 80Mb/person becomes 80Gb/person becomes 800Gb/person Patient & social generated unstructured data (BYOD)

9 OUR APPROACH Integrated Patient Record AGGREGATE SHARE OPTIMIZE Maintain content in its natural form to facilitate search, analysis, data mining and business policy enforcement, such as disposition. Exchange data within an IHE community using standards in healthcare to share records outside the provider organization Optimize data through the creation of an IPR that also accesses the EMPI for PIX/PQD, and can also connect to imaging sources through DICOM. Copyright 2014 EMC Corporation. All rights reserved.

benefits Ease of use Security Longevity Decoupled from EMR HL7, XDS, XCA, DICOM Solves platform zero

10 Content Enabled EMR Clinical Archiving Medical Image Management & Sharing Document Management & Sharing for Medical Records Clinical Viewer Integrated Patient Record (IPR) Keeps platform zero benefits Ease of use Security Longevity Decoupled from EMR HL7, XDS, XCA, DICOM Solves platform zero issues Completeness Searchability Accessibility Recoverability Copyright 2014 EMC Corporation. All rights reserved.

11 In Healthcare

Access and Sharing of information is critical for Healthcare Transformation Journey From current fragmented healthcare system with islands of connectivity.

12 Access and Sharing of information is critical for Healthcare Transformation Journey From current fragmented healthcare system with islands of connectivity... Public health entities Lab Pharmacy Insurers Clinics Pharmacy Research organizations Citizens Payer...Regional Exchanges connecting medical ecosystem Health members Info.Exchange) Public health entities Lab Pharmacy Lab Pharmacy Research organizations Member State Payer PBM Payer Health Info.Exchange)...to national connectivity Public health entities Regional Exchange Regional Exchange National Health Archive or Network Citizens Research organizations Lab Copyright 2012 EMC Corporation. All rights reserved. 11

Finland? OECD population 5,4 million GDP per capita 47 000$ 64 000 $) Life expectancy M 77 / F 83 years Total fertility rate 1.

4/100 6,5) (US (US 38% have tertiary education (US 41%) NEWSWEEK's list of the world s best counties to live 2010 1. Finland 2.

13 Finland? OECD population 5,4 million GDP per capita $ $) Life expectancy M 77 / F 83 years Total fertility rate 1.85 Infant mortality 2.4/100 6,5) (US (US 38% have tertiary education (US 41%) NEWSWEEK's list of the world s best counties to live Finland 2. Switzerland 3. Sweden Why cold, dark, small, and depressive nations top the rankings. Newsweek, Aug 16, :00 AM EDT Codrescu is the author of The Poetry Lesson and the editor of Exquisite Corpse (corpse.org). 5/27/14 Etunimi Sukunimi

14 IHE XDS eps OS NCP IHE XDS-I Public healthcare providers districts (20) Primary care org. (192) Private healthcare providers (4000) Pharmacies (~800) Citizens (> ) Health care professionals Swedish epsos NCP Other NCPs not yet connected Aged 18 and older Kanta services My Kanta pages Web services for HCPs Pharmaceutical database Ka nta me ssa gin g lay er eprescription service Renewals Patient data repository Patient summary management Diagnoses Procedures Risks Consent and will management Organ donation wills Prescriptions Health records, legacy (CDA R2 L1) Radiology DICOM studies Patient data management service Vaccinations Lab Health and care plan Living wills Logs Dispensations Metadata Logs Health records, structured (CDA R2 L3) Radiology Physical findings Medication Opt-ins and opt-outs Main standards HL7 V3: CDA R2 Level 3 and Medical Records IHE IT-I Profiles W3C XML DSig WS Addressing, WS-I TLS, X.509 Other national services National code server Code lists and terminologies Form and document structures Certification services Healthcare and social care organizations register Pharmacies register Health care professionals register

NATIONAL EHEALTH ARCHITECTURE - FROM STRATEGY TO PRACTICE. Ministry of Social Affairs and Health, Finland

NATIONAL EHEALTH ARCHITECTURE - FROM STRATEGY TO PRACTICE Ministry of Social Affairs and Health, Finland Agenda Finnish healthcare system on-going & upcoming reforms National ehealth architecture and implementation