Telemedicine Building

Transcription

1 Telemedicine Building Telemedicina e e-saúde 2010/11 Pedro Brandão References Sources are indicated by [RefSource] where the complete citation will be at the end Insite citations will be From: CitationSource Telemed 10/11 - Telemedicine Building - pbrandao 2 Telemedicine Building Systems 1

2 BUILDING A TELEMEDICINE PROGRAM Telemed 10/11 - Telemedicine Building - pbrandao 3 Building a Telemedicine Program Based on Lorenzo Valeri, Daan Giesen, Patrick Jansen, Koen Klokgieters Business Models for ehealth Final Report, ICT for Health Unit DG Information Society and Media European Commission, Feb 2010 BUSINESS MODELS FOR EHEALTH EU REPORT Telemed 10/11 - Telemedicine Building - pbrandao Telemedicine Building Systems 2

3 Business Models for ehealth EU Report Report that discuss business models for ehealth within the EU context o Analyses 5 successful case studies Telemed 10/11 - Telemedicine Building - pbrandao 5 Motivation From [EUREP] European ehealth market estimated at EUR million in 2008 Projected to EUR million by 2012, o compounded annual growth rate of 2.9%. Major European ehealth markets: o France, Germany, Italy, Spain and United Kingdom Based on an analysis undertaken by Capgemini Consulting in the context of the report Telemed 10/11 - Telemedicine Building - pbrandao 6 Telemedicine Building Systems 3

4 EHealth European Market From a study from CAPGEMINI in [EUREP] Telemed 10/11 - Telemedicine Building - pbrandao 7 Market composition in Europe Market Composition in 2008 Clinical Information System (CIS) 22.50% Secondary Usage Non-clinical Systems (SUNCS) 71.60% Telemedicine 0.90% Integrated Health Clinical Information Network (IHCIN) 5.00% From a study from CAPGEMINI in [EUREP] Telemed 10/11 - Telemedicine Building - pbrandao 8 Telemedicine Building Systems 4

5 Expect Growth ehealth market Compounded Annual Growth Rate (CAGR) ( ) per market sector From a study from CAPGEMINI in [EUREP] Telemed 10/11 - Telemedicine Building - pbrandao 9 Social Insurance financing models Centred on public taxes (Beveridge Model) o UK, Spain, Portugal, Italy, Greece Compulsive Social Insurance (Bismarck Model) o Germany, France, Netherlands, Switzerland Voluntary private insurance + standard social insurance o Ireland Out-of-pocket o Not used in Europe See this article and other Telemed 10/11 - Telemedicine Building - pbrandao 10 Telemedicine Building Systems 5

6 Financial Building blocks of the business model Key Partners What can partners do to leverage your ehealth system/service (better, at lower cost)? Resources Key Activities What key activities do you need to perform and how easily can you do this? Key Resources What key resources does your ehealth system/service requires? Cost structure What is the cost structure of your ehealth system/service and is this in line with the core values of the business model? Offer Value Proposition Which of your clients (patient/doctor/ user) problems do you solve and which needs are satisfied Relation Clients What kind of relations does your patient/doctor/user expect and which do you maintain? Channels Through which means do your clients want to be reached to leverage ehealthcare and which means do you utilise? Revenue streams From [EUREP] Patient/doctor/ user segments What are your patients, doctors, users needs, problems desires and ambitions? What value are your clients willing to pay for and what is the preferred payment mechanism? Telemed 10/11 - Telemedicine Building - pbrandao 11 Recommendations I [EUREP] Identifications of stakeholders is key o Their role and value Business model flexible and adaptable to new situations o phased step-by-step approach involved actors can adapt/adjust. Stable financial support. o long time until return on operational and financial results. o Senior management key to insure constant funding, o Allocate funding to cover staff time for their involvement Telemed 10/11 - Telemedicine Building - pbrandao 12 Telemedicine Building Systems 6

7 Recommendations II [EUREP] Clear and precise understanding of the specific needs of patients. o Directly or indirectly involve them in designing the functionalities. o Operational process for capturing these evolving needs Use of open standards and applications (not necessarily open source software). o Prepare for integration with current and future systems Telemed 10/11 - Telemedicine Building - pbrandao 13 Recommendations III [EUREP] Use of regular operational assessments while system is developed and/or delivered o Internal and external reviews; o Intangible benefits o Evaluate internal and external benefits; o Evaluate financial and socio-economic gains Security, privacy, data protection and safety o Use of appropriate regulations and protocols o Incorporate them in the design process Telemed 10/11 - Telemedicine Building - pbrandao 14 Telemedicine Building Systems 7

8 Telemed Supplies Building a Telemedicine Program USING COTS SYSTEMS Telemed 10/11 - Telemedicine Building - pbrandao Using COTS System Commercial Off The Shelf From [COTS] When cost and requirements can be simultaneous met o Assume some customization needed Differences to a customization approach o Minimal custom coding/programming; o Flexible requirements to meet market s offers; o Flexible business process to adapt to COTS. Telemed Supplies Telemed 10/11 - Telemedicine Building - pbrandao 16 Telemedicine Building Systems 8

9 Integration Life-Cycle Image from [COTS] Telemed 10/11 - Telemedicine Building - pbrandao 17 COTS Steps I Determine the Organizational Fit o Incorporate Multiple Views of Requirements; o Make requirements definition and design interactive. Consider Selecting a System Integrator Don t Rely on the Vendor for Everything Identify gaps Data schema changes From [COTS] Telemed Supplies Telemed 10/11 - Telemedicine Building - pbrandao 18 Telemedicine Building Systems 9

10 COTS Steps II From [COTS] Have a Complete Set of Selection Criteria o Functionality o Architecture o Life-cycle costs o Vendor/product stability o Vendor Licensing (model, approaches) Vendor assumptions Additional vendor services o Infrastructure and training needed Consider Test installation Telemed Supplies Telemed 10/11 - Telemedicine Building - pbrandao 19 Building a Telemedicine Program Based on Defining the needs of a Telemedicine Program, Gray Doolittle and Ryan Spaulding; Successffuly Developing a Telemedicine System, Peter Yellowlees; Evaluating Telemedicine Services and Systems Paul Taylor from the book Introduction to Telemedicine 2 nd Ed, Edited by Richard Wootton, John Craig, Victor Patterson SUMMARY STEPS Telemed 10/11 - Telemedicine Building - pbrandao Telemedicine Building Systems 10

11 The triple constraint From [PAPLE] Cost/Resources Time Quality Telemed 10/11 - Telemedicine Building - pbrandao 21 From [PAPLE] 7 imperatives for success 1. Strong commitment from administration to change. 2. Ownership by end-user of system design, implementation and standardization 3. Establish and communicate realistic goals and expectations 4. Clinician s involvement 5. Internal marketing from physician champions 6. Process redesign is more effort than system design 7. Learning as continuous process Telemed 10/11 - Telemedicine Building - pbrandao 22 Telemedicine Building Systems 11

12 A. Define what is the need Involve stakeholders/users o Local support (willingness) of clinicians Needs assessment: o o o Clinical Economic Equate remote site economic responsibilities; Funding sources. Technology Telemed 10/11 - Telemedicine Building - pbrandao 23 B. Plan the service Responsible team involving all sectors (physicians, nurses, technicians, information technologists, administrators); o Program champions Involve local clinicians; Business plan User-friendly technology Telemed 10/11 - Telemedicine Building - pbrandao 24 Telemedicine Building Systems 12

13 C. Develop healthcare team o Remote team and Hub team o Train and support D. Market the program/service o To clinicians in the planning phase Telemed 10/11 - Telemedicine Building - pbrandao 25 E. Evaluation Safety o Information is available/usable without any degradation o Patient care is same or better than conventional Feasibility User satisfaction Clinical outcomes Randomized controlled trials Cost-effectiveness (compare to absence of) o Remember cost analysis Telemed 10/11 - Telemedicine Building - pbrandao 26 Telemedicine Building Systems 13

14 END OF TELEMEDICINE BUILDING Telemed 10/11 - Telemedicine Building - pbrandao Referências Building [COTS] C. Todd Couts and Patrick F. Gerdes, Integrating COTS Software: Lessons from a Large Healthcare Organization, IEEE IT Pro March/April 2010 [EUREP] Lorenzo Valeri, Daan Giesen, Patrick Jansen, Koen Klokgieters Business Models for ehealth Final Report, ICT for Health Unit DG Information Society and Media European Commission, Feb 2010 [PAPLE] Keith Shelman, Changing from Paper to Paperless Hospitals in Busy Academic Centres, Chapter from Current Principles and Practices of telemedicine and e-health, ed Rifat Latifi, 2008 IOS Press Telemed 10/11 - Telemedicine Building - pbrandao 28 Telemedicine Building Systems 14

15 Acronyms Building CAGR Compounded Annual Growth Rate COTS Commercial Off The Shelf CIS Clinical Information System IHCIN Integrated Health Clinical Information Network SUNCS Secondary Usage Non-clinical Systems Telemed 10/11 - Telemedicine Building - pbrandao 29 Telemedicine Building Systems 15