Card enabled e-health network How to improve healthcare

Transcription

1 Card enabled e-health network How to improve healthcare Dr. Elmar Fassbinder Patrick Melioris Bratislava, 25. Sept Page 1

2 Agenda 1) The Vicious Circle in health care 2) Card enabled e-health Network Concept Benefits System Architecture Electronic Health Record - Field Trial in France 2006 Rollout Plan Germany 3) EMDS Consulting Approach Page 2

3 The health care cost dilemma: a vicious circle Insurance Premium (% of Gross Salary) Increase of insurance premiums New medical technologies Higher life expectancy Life Expectancy (Years) M F Cost increase Stone age: 21 Romans: 22 Page 3

4 Concept card enabled e-health network Card enabled e-health Network Health Card or Server Background system Card Contents Transfer data: Constant data: Dynamic data: Personal EHR (Electronic Health Record) Pharmacy e-prescription Text data: Diagnostic findings Physicians' reports Test results Specialist e-referral + report Chronic conditions - DMP Administrative data - co-payment Physician of choice General practitioner Specialist Hospital e-admission + report Patient Image data: X-rays CT MRT Emergency Service Emergency details Medication history, treatment history (pointer) Biosignals: ECG EEG Data Owner: Patient Data Owner: Patient Primary data: (often still in paper form) Physician 1... Physician n Hospital 1... Hospital n Data Owner: Physician/ Hospital Integrated Health Record Page 4

5 Benefits of a Card enabled e-health Network Patient Quality of medical care Patient empowerment Policymakers Provider Payer New e-health services Cost reduction Page 5 <<TITEL EMDS Slovakia, & UNTERTITEL>> s.r.o. Trnavská cesta Bratislava Tel.:

6 Benefits in Germany Topic Problems in Germany e-health network Benefits (EUR p.a.) e-prescription Media breaks and No media breaks, 200 Mio. cost for scanning Cost reduction from 0,34 to 0,07 per prescription Co-Payment Missing Co-Payment information Co-payment information on Health Card 250 Mio. Information Fraud Identification issue Identification via Health Card 800 to Mio. Drug interaction No drug history Drug history 500 Mio. Patient medical history Multiple medical files Electronic Health Record 5 to 10 % of health budget Page 6

7 Overview of System Architecture Planning, Implementation, Operation Setting Standards & Guidelines Operational Tasks Doctor s Office C PDC, HPC Pharmacy C PDC, HPC Hospital C PDC, HPC Self-Service Kiosk C PDC Status Inquiry, Directory- Services Card-DB Security, Transaction, and other Services Secure Medical Network ( Telematics-Platform ) Applications, e.g. e-prescription Medication Log Referral Letters Electronic Health Record (HER) HPC C C C Health Insurance Companies PDC Doctors Association HPC CAMS Trust Center Health Professional Card PDC Patient Data Card Secure Connector to the Network Page 7

8 Electronic Health Record (EHR) - Field Trial France Patient is back to his GP: GP consults results and files diagnosis and therapy in the EHR 1 Patient : authorizes GP 3 Patient sees Specialist: Specialist files test results in the EHR 2 Patient sees GP: GP consults EHR, referral to Specialist 5 Patient consults documentation and traces Page 8

9 e-health Applications as seen by the doctor Medical Application (practical example) 60 Patient insurance verifications 120 Prescriptions EHR 40 Reports / Test results 40 Referrals / Admissions 200 digital signatures per day Crucial for the medical cabinet: Easy to use digital signature Biometrics RFID instead of 6-digit PIN IHE conformity of doc s office system IHE conformity of EHR IHE Documents Page 9

10 Telematic infrastructure Germany Rollout plan offline period online period 100% Doc offices: Dentists: Hospitals: Pharmacies: Other Providers: I II III IV I II III IV I II III IV I II III IV I II III IV Patient Data Card: 82 Mio Insurance Comp.: 300 e-prescription (drugs) patient insurance verification EHR: emergency data drug history e-prescription (rest) Drivers for online: Insurance comp. Health associations Ministry of Health e-health industry Page 10

11 Thorough understanding of EMDS Consulting Offering the market: the 4 Ps - Patients, Payers, Providers, Policymakers the underlying infrastructure the objectives for introducing a card enabled e-health network A quick assessment and a solution vision can be created in about 2 weeks a feasibility study in about 2 months Result A draft of the most important underlying issues in cost and efficiency of healthcare A preliminary recommendation if and which type of a card enabled e-health network should be used A rough schedule and next steps Page 11 <<TITEL EMDS Slovakia, & UNTERTITEL>> s.r.o. Trnavská cesta Bratislava Tel.:

12 Back-up Page 12

13 Challenges in health care COST DISTRIBUTION!""#$ %!""&$ ' #($ &) *+ *)#+,!""#$ - ).!""&$ (Source: Page 13

14 Germany s layout of patient data card Page 14 <<TITEL EMDS Slovakia, & UNTERTITEL>> s.r.o. Trnavská cesta Bratislava Tel.:

15 Benefits Patient Providers Payers Interaction Provider to Provider Focus of Change Cooperation Patient to Provider Patient Empowerment Patient to Payer New Contract Models Payer to Provider HMO Agreements Page 15 <<TITEL EMDS Slovakia, & UNTERTITEL>> s.r.o. Trnavská cesta Bratislava Tel.:

16 (%) Zur Anzeige wird der QuickTime Acceptance of e-health from doctors in private practice General Benefit for Patients General consequence for German health care 40% 30% 30% 20% 20% 10% 10% 3% 25% 42% 18% 11% 5% 26% 29% 33% 8% very high high little very little no benefit very positive positive no change negative very negative Questioning 7/2005 Page 16