An Overview of TelemedicalServices Provided in Switzerland. Internet Economics HS 2012 University of Zurich Robert Stucki & Mathis Sommer

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1 An Overview of TelemedicalServices Provided in Switzerland Internet Economics HS 2012 University of Zurich Robert Stucki & Mathis Sommer

2 Introduction Health care costs (CH, per person/year in CHF) Data source: Internet Economics: Robert Stucki / Mathis Sommer 2

3 Introduction Age structure of residents, 2009 (CH) Source: Federal Statistical Office, The population of Switzerland 2009, 2010 Internet Economics: Robert Stucki / Mathis Sommer 3

4 Introduction Doctor shortage Experts say Switzerland risks a serious shortage of general practitioners in about 15 years as three out of four active GPs will have retired by then. Source: Urs Geiser, Remedy presented to cure doctor shortage, 2012 Internet Economics: Robert Stucki / Mathis Sommer 4

5 Introduction Possible solution? Source: CSC, Telemedicine: An essential technology for reformed healthcare, 2011 Internet Economics: Robert Stucki / Mathis Sommer 5

6 Agenda Introduction Fundamentals Requirements Government initiatives Existing Telemedical Services Future of Telemedical Services Opportunities & Risks Economic Impact Internet Economics: Robert Stucki / Mathis Sommer 6

7 Fundamentals Definitions History Stakeholders Internet Economics: Robert Stucki / Mathis Sommer 7

8 Fundamentals Definitions Health Telematics is a composite term for health-related activities, services and systems, carried out over a distance by means of information and communications technologies, for the purpose of global health promotion, disease control, and health care, as well as education, management and research for health Source: WHO, Information Technology: In support of health care, 2003 Internet Economics: Robert Stucki / Mathis Sommer 8

9 Fundamentals Definitions According to the steps during treatment Telemedicine Telemonitoring Teletherapy Teleconsultation Internet Economics: Robert Stucki / Mathis Sommer 9

10 Fundamentals Definitions Synonyms & Subcategories Telediagnostic Telerehabilitation ehealth Telecare Telesurgery Teletriage Internet Economics: Robert Stucki / Mathis Sommer 10

11 Fundamentals History NASA US-Army Expeditions Flying Doctor Internet Economics: Robert Stucki / Mathis Sommer 11

12 Fundamentals Insurance Companies Hospitals Patients Stakeholders Doctors Government Pharmacies Internet Economics: Robert Stucki / Mathis Sommer 12

13 Requirements Quality of medical services Self responsibility of the patient Data protection / security Legal conditions Effectiveness/ efficiency Acceptance Patient/Doctor/Other stakeholders Technology Internet Economics: Robert Stucki / Mathis Sommer 13

14 Government Initiatives Recent Projects New Insurance Card Internet Economics: Robert Stucki / Mathis Sommer 14

15 Government Initiatives Recent Projects i-engine e-toile Internet Economics: Robert Stucki / Mathis Sommer 15

16 Government Initiatives Recent Projects Pilot project Rete sanitaria Regioproject Telemedizin Internet Economics: Robert Stucki / Mathis Sommer 16

17 Government Initiatives New Insurance Card Internet Economics: Robert Stucki / Mathis Sommer 17

18 Existing TelemedicalServices Teleconsultation Telemonitoring Teletherapy Internet Economics: Robert Stucki / Mathis Sommer 18

19 Existing TelemedicalServices Teleconsultation Internet Economics: Robert Stucki / Mathis Sommer 19

20 Existing TelemedicalServices Teleconsultation Internet Economics: Robert Stucki / Mathis Sommer 20

21 Existing TelemedicalServices Teleconsultation Internet Economics: Robert Stucki / Mathis Sommer 21

22 Existing TelemedicalServices Telemonitoring Internet Economics: Robert Stucki / Mathis Sommer 22

23 Existing TelemedicalServices Teletherapy/-surgery da Vinci Surgical System Source: Internet Economics: Robert Stucki / Mathis Sommer 23

24 Future of TelemedicalServices Government Strategy New Products/Services Trends Internet Economics: Robert Stucki / Mathis Sommer 24

25 Future of TelemedicalServices Government Strategy E-health E-Patientendossier Webportal(state, cantons, townships) Quality standards for online information Enabler for new/better Telemedicine services Internet Economics: Robert Stucki / Mathis Sommer 25

26 Future of TelemedicalServices New Products/Services Telemedicine station Mobile medical station Mobile apps with sensors TES i8500 Mobile TS Source: Internet Economics: Robert Stucki / Mathis Sommer 26

27 Future of TelemedicalServices Trends Internationalization M-Health Rise of virtual medical centers Importance of networks Standardization Internet Economics: Robert Stucki / Mathis Sommer 27

28 Opportunities & Risks Opportunities for Patients Opportunities for Doctors Opportunities for Society Opportunities for Insurance Companies Risks Internet Economics: Robert Stucki / Mathis Sommer 28

29 Opportunities & Risks Opportunities for Patients Faster reaction in emergency case Higher therapy loyalty because of more information for patients Lower insurance premium Saved time and reduced ways to the GP Quality of life for the elderly and highmaintenance patients (Telemonitoring) Internet Economics: Robert Stucki / Mathis Sommer 29

30 Opportunities & Risks Opportunities for Patients Further step to a 24h society More autonomy/ psychosocial improvement Internet Economics: Robert Stucki / Mathis Sommer 30

31 Opportunities & Risks Opportunities for Patients ehealth Strategy Safer treatment (no false medications) No double diagnostic evaluation Less bureaucracy Internet Economics: Robert Stucki / Mathis Sommer 31

32 Opportunities & Risks The monitors all show that you re dead but to be sure, we ll need to run some more tests. Internet Economics: Robert Stucki / Mathis Sommer 32

33 Opportunities & Risks Opportunities for Doctors Administrative processes become simpler Higher quality: Interaction of medical experts Home care of the elderly becomes easier New job profiles for health care and new operation fields Internet Economics: Robert Stucki / Mathis Sommer 33

34 Opportunities & Risks Opportunities for Insurance Companies Administrative processes become simpler Less costs? Teletriage Focus on important cases (62% of cases are conclusively treated) Internet Economics: Robert Stucki / Mathis Sommer 34

35 Opportunities & Risks Opportunities for Society Development of new technologies Export of health care Efficiency Fair distribution of health services Internet Economics: Robert Stucki / Mathis Sommer 35

36 Opportunities & Risks Risks Patient are more involved Usability Data privacy/ Data protection Security Source of innovation unclear Acceptance Internet Economics: Robert Stucki / Mathis Sommer 36

37 Opportunities & Risks Risks Judicial and political guidelines Standards (e.g. quality control of forums) Education of new medical staff Import/Export of health services (cross border health care) Risks of national IT-project ehealth Internet Economics: Robert Stucki / Mathis Sommer 37

38 Economic Impact Markets Estimates Internet Economics: Robert Stucki / Mathis Sommer 38

39 Economic Impact 2008: A Lead Market Initiative for Europe Promotion of the six biggest and most inventive growth markets Forecast 2020: 300 Billion business volume 3 Million more jobs Internet Economics: Robert Stucki / Mathis Sommer 39

40 Economic Impact Markets ehealth Sustainable construction Protective textiles Bio-based products Recycling Renewable energies Internet Economics: Robert Stucki / Mathis Sommer 40

41 Economic Impact Markets The health sector in the European Union (EU) employs almost 10% of the total workforce and corresponds to almost 9% of gross domestic product (GDP). Health spending is rising faster than GDP and it is estimated to reach 16% of GDP by 2020 in OECD countries. Source: ec.europa.eu/enterprise/policies/innovation/policy/ lead-market-initiative/ehealth/index_en.htm Internet Economics: Robert Stucki / Mathis Sommer 41

42 Economic Impact Estimates Saving potential in telemedicine TA Swiss: Industrial countries 30% SATW: Switzerland 10% Dr. med. Denz: Switzerland 5% ehealthincludes reorganization of public health care (difficult to approximate) Internet Economics: Robert Stucki / Mathis Sommer 42

43 Questions Internet Economics: Robert Stucki / Mathis Sommer 43

44 Discussion Topic I: Thesis: Hirslanden clinic is promoting Telemonitoring services to acquire new clients/patients. Does Telemedicine really save health costs in the long term? Internet Economics: Robert Stucki / Mathis Sommer 44

45 Discussion Topic II: If there is the possibility, would you use a teleconsultation rather than visit your GP? Internet Economics: Robert Stucki / Mathis Sommer 45

46 Discussion Topic III: The ehealthstrategies of other countries strongly vary in their success. England s project, for example, just consumed millions without any advantage. Should the Swiss government enforce, promote and finance the use of telemedicine or leave it to the private sector? Source: Internet Economics: Robert Stucki / Mathis Sommer 46

47 Discussion Topic IV: Thesis: Telemedicine enables patients to become their own doctor and to save money. Antithesis: Telemedicine overburdens especially the elderly patients and will rather cause more health costs than prevent them. Internet Economics: Robert Stucki / Mathis Sommer 47

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