PERSONALISIERTE MEDIZINTECHNIK -- Monitoring & Entscheidungsunterstützung

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1 PERSONALISIERTE MEDIZINTECHNIK -- Monitoring & Entscheidungsunterstützung Dr. Kai Kück Dräger PRÄSENTIERT AUF: DGBMT (VDE) Konferenz Münchner Medizintechnik Forum 2012, Der individuelle Patient Chancen und Limitierungen Personalisierter Medizintechnik Konferenzzentrum München der Hanns-Seidel-Stiftung e.v., München am Innovationen-MMF2012.aspx (LAST ACCESS: Feb 2012)

2 SETTING THE SCENE Healthcare Expenditures vs. Healthcare Quality Reactive --> Preventive Medicine Levers with Significant Potential Predictive Medicine Mass Customization Quality Management Personalized Monitoring and Decision Support is Major Enabler 2

3 Personalized Monitoring and Decision Support OTHER MAJOR DRIVERS AND ENABLERS Medicine: Move towards Evidence Based, Quality Managed 3

4 TRADITIONAL QUALITY ASSURANCE Focus on the Tail threshold Identify, eliminate serious failures better worse better Quality Quality worse 4 Modified from Brent James, Intermountain Healthcare, 2007

5 QUALITY IMPROVEMENT Focus on many/most cases -- at a personalized level of detail Eliminate inappropriate variation Create best practice, Continuously improve better Quality worse 5 better Quality worse Modified from Brent James, Intermountain Healthcare, 2007

6 Personalized Monitoring and Decision Support OTHER MAJOR DRIVERS AND ENABLERS Medicine: Evidence Based, Quality Management Technology: Ubiquitous/Mobile/Broadband Internet Data Storage/Mining Embedding of Intelligence and Knowledge Smart Phones Connectivity, Interoperability Aging Generation: Desire for Independence Grown up with Technology Western Vendors: need for differentiation from emerging market competitors 6

7 Health Self-Management Ambient Assisted Living / Chronic Disease Management Post-Hospital / Integrated Care In-Hospital Care Hospital Wide Monitoring (General Wards) Step Down Units Critical Care 7

8 SELF-MANAGEMENT OF PERSONAL HEALTH Contributors to Disease Hu et al. NEJM Stampfer MJ et al. N Engl J Med. 2000; LAST ACCESS: Jan

9 SELF-MANAGEMENT OF PERSONAL HEALTH Personalized Monitoring LAST ACCESS: Jan

10 Health Self-Management Ambient Assisted Living / Chronic Disease Management Post-Hospital / Integrated Care In-Hospital Care Hospital Wide Monitoring (General Wards) Step Down Units Critical Care 10

11 AMBIENT ASSISTED LIVING Personalized Monitoring: Chronic Disease Management The European Ambient Assisted Living Innovation Alliance (Aalience). Ambient Assisted Living Roadmap. VDI/VDE-IT Aaliance Office. Last Access Jan

12 Personalized Monitoring: Chronic Disease Management EVIDENCE SUPPORTS VALUE OR REMOTE MONITORING 35-56% reduction in mortality 47% reduction in risk of hospitalization 6 days reduction in length of hospital admission 65% reduction in office visits 40-64% reduction in physician time for checks 63% reduction in transport costs from: Last Access: Jan 2012 Quoted Sources Cleland et al 2005; Lee R, Goldberg et al, 2003; Scalvini S et al., 2001; Elsner et al, 2006; Van Ginneken et al

13 Health Self-Management Ambient Assisted Living / Chronic Disease Management Post-Hospital / Integrated Care In-Hospital Care Hospital Wide Monitoring (General Wards) Step Down Units Critical Care 13

14 In-hospital Personalized Monitoring HOSPITAL-WIDE (GENERAL FLOORS) EXAMPLE: Oxford Biosignals HR RR BP SpO2 Multi-Parameter Probabilistic "Deviation from Normal" Temp "Avg 6.3 h advance warning of critical instability"hravnak et al. Arch Intern Med 2008 "Avg 9.4 min earlier warning than single channel alarms"hravnak et al. Crit Care Med 2011 "Only 1.6 false alerts per 100 hours of monitoring"tarassenko et al (LAST ACCESS: Jan 2012) 14

15 Health Self-Management Ambient Assisted Living / Chronic Disease Management Post-Hospital / Integrated Care In-Hospital Care Hospital Wide Monitoring (General Wards) Step Down Units Critical Care 15

16 Personalized Monitoring CRITICAL CARE (PERIOPERATIVE) 16. Oct Massachusetts General Hospital 16

17 Personalized Monitoring CRITICAL CARE (PERIOPERATIVE) Intelligent Integrated Context Aware Interactive Adaptive Personalized Skin Color Sweating Frowning Respiration Heart Rate (Pulse Pressure) (Body Temperature) 17

18 Personalized Monitoring DRÄGER's SMART PILOT VIEW: Advanced Anesthesia Monitoring 18

19 Personalized Monitoring INTEGRATING DATA TO INFORMATION 19

20 In-hospital Personalized Monitoring CRITICAL CARE Dräger M540, part of the Infinitiy Acute Care Station Critical Care Monitor, all routine parameters 12-lead ECG, RR, NIBP, BP, SpO2, etco2, Temp Portable Docking Station: Bedside Display Standard WiFi (Central Display, incl. backfilling) 20

21 Health Self-Management Ambient Assisted Living / Chronic Disease Management Post-Hospital / Integrated Care In-Hospital Care Hospital Wide Monitoring (General Wards) Step Down Units Critical Care 21

22 PERSONALIZED MONITORING Challenges ahead changing the culture patients more involved in their care clinical care providers: demand more device (system) functionality medical device industry scaling this globally developing the market both on demand and on supply side adopting consumer level technologies quality of service, reliability, regulatorily compliant) healthcare delivery industry wholistic perspective (instead of optimizing "silos" or players) while maintaining local, market-driven decision making 22

23 Our work is driven by the awareness that every life is unique. Dräger products protect, support and save lives. Technology for Life 23

24 Vielen Dank! Fragen! Dr. Kai Kück Dräger