@ehealthireland stay left, shift left!
TRANSCRIPT
@ehealthireland
eHealth Ireland will be Enabling Connected Health Through Digital @ehealthireland
Stay Left, Shift Left! A Moore’s Law for Irish Healthcare
Name Martin CurleyTitle Chief Information Officer, HSE, CO, eHealth IrelandTwitter @martingcurley1Email [email protected]
@ehealthireland
Transforming Health through Digital @ehealthireland
“The dogmas of the quiet past
are inadequate to the stormy
present.”Abraham Lincoln
@ehealthireland
Who knows best?
@ehealthireland
Moore’s Law
@ehealthireland
SHIFT LEFT: Highest Quality of Life at the Lowest Possible Cost
Shift Left StrategyDevelop Moore’s Law For Irish Healthcare
Find and sequence eHealth interventions to
drive and improve quality of life and
reduce cost of care
@ehealthireland
Stay Left, Shift Left: Moore’s Law for Healthcare
Cost of Care
Qu
ality of Life
The Continuum of Care
“Shift Left !”
Independent Healthy Living
Doctor’s OfficeChronic Disease
Management
CommunityClinic
Home Care
Primary/Community Care
Skilled Nursing Facility
Assisted Living
Acute Care
Speciality Clinic
ICU
Community Hospital
Shift Left – Highest Quality of Life at the highest possible cost avoidance
Preventative/Proactive Healthcare
Life Style Nutrition
Scanning Monitoring
Genetics Environment
Primary Care Centre
Qu
ality of C
are
Immunisation
B
ACurrent Situation:50% backlog90 day average wait5% prescribing errors
€ € € € € € € € € €
Clin
ician Exp
erience
@ehealthireland
Open Innovation 2.0: The new mode for Digital Innovation; enabled, fuelled and built using Digital Technology – Virtuous Cycle
Source: M Curley/B Salmelin
Leveraging
Collective
Intelligence and
Energy;Multiplicative, Synergy and network effects
Hospital
Start-up
University
Company
Primary CareCentre
User
Co-innovator
CreativeCommons
GovernmentEcosystemsupport
Students
Home
@ehealthireland
Stay Left, Shift Left: Moore’s Law for Healthcare
Cost of Care
Qu
ality of Life
The Continuum of Care
“Shift Left !”
Independent Healthy Living
Doctor’s OfficeChronic Disease
Management
CommunityClinic
Home Care
Primary/Community Care
Skilled Nursing Facility
Assisted Living
Acute Care
Speciality Clinic
ICU
Community Hospital
Shift Left – Highest Quality of Life at the highest possible cost avoidance
Preventative/Proactive Healthcare
Life Style Nutrition
Scanning Monitoring
Genetics Environment
Primary Care Centre
Qu
ality of C
are
Immunisation
€ € € € € € € € € €
Clin
ician Exp
erience
@ehealthireland
@ehealthireland
Personalised
Care shift from population-based to person-based prevention and treatment
Care
Networkingshift from institutions to preventative, proactive, mobile, home-based, & community care.
Care Anywhereshift from solo to community and team-based care across orgs and IT systems
Evolve Strategy to a Shared Vision
@ehealthireland
Aligning and Orchestrating the eHealth Ireland EcoSystem to Implement Shift Left Strategy
DynamicPortfolioApproach
Shift Left
Budget
- Slainte Care- eHealth Strategy- Healthy Ireland
Conversion Efficiency = Value/Spend
is HIGHeHealth Capability
Alignment, Acceleration, Amplification, Adoption
Better Outcomes,Efficiencies,Economic Growth
Reinvestefficiencies
Societal, Political , Economic Context
EIIDASFI
S;a
Slaintecare Report May 17
Quadruple Aim
@ehealthireland
Quadruple Helix Innovation
Government, Academia, Industry and Citizens collaborating
together to drive structural changes far beyond the scope of
any one organization could achieve on it’s own
Government/Public
Academic
Industry
Citizen
Copyright © Intel 2015
@ehealthireland
eHealth Ireland will be Enabling Connected Health Through Digital @ehealthireland
IT-CMF
Significantly
Improve
IT Capability
and Capacity
www.ivi.ie
@ehealthireland
Intel Confidential | 14
Build a Roadmap for Ambition, Implementation
and Success
eHealthBudget
eHealthCapability
eHealth Business
Model
eHealth Macro Capabilities
SustainableEconomic
Model
FundingAmplification
ManagedSpending
Full Visibility ofSpending
European Leader
Mediocre
Average
Managed Yield and Portfolio
Optimized TCO
EstablishBenchmark
ServiceCentre
Cost Centre
InvestmentCentre
Beginning
OptimizedValue
World Class
Initial
Basic
Advanced
Intermediate
MaturityLevels
Optimizing
3.
2.
4.
5.
1.
Value Centre
2018
2020
2023
Timeline
0.85% ofBudget
2% Budget
3% Budget
eHealthValue
Better Outcomes
Resource Efficiencies
Wealth Creation
© Confidential property of Bluedrop Medical Ltd. Not to be shared without written consent
Shift Left And Diabetic Foot Ulcers
Simon KierseyCo-Founder and COO
Bluedrop Medical
Future Health Summit29th May 2018
@ehealthireland
Shift Left: Moore’s Law for Healthcare
Highest Quality of Life at Lowest Possible Cost
Qu
ality of Life
The Continuum of Care
“Shift Left !”
Independent Healthy Living
Doctor’s OfficeChronic Disease
Management
CommunityClinic
Home Care
Primary/Community Care
Skilled Nursing Facility
Assisted Living
Acute Care
Speciality Clinic
ICU
Community Hospital
Shift Left – Highest Quality of Life at the highest possible cost avoidance
Preventative/Proactive Healthcare
Life Style Nutrition
Scanning Monitoring
Genetics Environment
Qu
ality of C
are
Primary Care Centre
Diabetic Foot Ulcers
17
• 25% of diabetics will experience a foot ulcer at some point
• Up to 15% of ulcers will lead to an amputation
• Simple issues can lead to devastating outcomes
• Very high cost for the patient
• Very high economic cost to the healthcare system
BLUEDROP MEDICAL
511Amputations
per year
10Amputations
per week
IRELANDTHE DIABETIC FOOT
391
443 451
511
350
400
450
500
550
2013 2014 2015 2016
Am
pu
tati
on
s
Year
Economic Cost of Diabetic Foot Ulcers
19
Costs
• Average DFU treatment cost in an Irish hospital is €23,5001
• In 2016 DFU cost the HSE €84m2
• NHS spends £1.2 billion, 1% of budget on diabetic foot
• USA spends $17 billion on the diabetic foot
63
71
84
50
60
70
80
90
2014 2015 2016
Cost (€ m)
Year
Cost Per Year
1. The cost of managing diabetic foot ulceration in an Irish hospital. (Smith et al 2004 Irish Journal of Medical Science Vol 173)2. Irish Diabetes Association
Global Issue20
GERMANY
48,000Amputations
In Germany per year
230,000ulcers per year
8,395Amputations
in England in 2016
£1.2 Billion1% of entire NHS budget
is spent on the diabetic foot
ENGLAND USA
$17 Billion
75,000Amputations
in USA in 2016
70% of Ulcers are Preventable
21
• Daily temperature monitoring can detect inflammation due to the injury
• Proven in 3 RCTs with 483 patients, 70% of ulcers prevented compared to control
Bluedrop Medical
22
• Smart weighing scales which scans the soles of the feet
• Doctor is alerted if an issue is detected
• Early intervention prevents the ulcer developing
• Proven approach• Difficult to use
• Easy to use for patient• Remote monitoring
Shift Care Left with Early Detection
23
• Often initial presentation is with an infected ulcer
• The later an ulcer is detected the more complicated and expensive it is to treat
• Early detection allows the treatment to shift left
• Results in better outcomes, lower costs, lower resource utilisation
Intervention Stopwatch
Home
GP Clinic
Hospital
24
• 2,820 hospital admissions per year
• 14.5 day average duration
112 DFU patients in hospital every night
@ehealthireland
Transforming Health through Digital @ehealthireland
“In the next ten years Data Science
will do more for medicine than all of
the biological sciences combined.”
Vinod Khosla
@ehealthireland
New modelsof care forced
to emerge: Patient Centric
Shortage of Healthcare Professionals
Rising Costs of Healthcare
Aging Population
Perfect storm in healthcare…
eHealth IrelandSlainte Care
@ehealthireland
Small Business Innovation Research [SBIR]
HSE CHALLENGE
SBIR INDUSTRY
INNOVATION
SMART SOLUTIONS to Solve HSE Challenges
SHIFT LEFT: Highest Quality of Life & Care at Lowest Possible Cost
Small Business Innovation Research
@ehealthireland
Science Foundation Ireland Challenges
Shift Left – Digital Diabetes Management
Shift Left – Capacity and Demand Modelling
Shift Left – Flu and Trolley Crisis
Shift Left – Open Data
Shift Left – Datathon
Shift Left – Novel Instruments, Techniques and Technologies
Shift Left – Integrated Health Exchange
@ehealthireland
Transforming Health through Digital @ehealthireland
“You make a living by what you get, you
make a life by what you give.”
Winston Churchill
@ehealthireland
eHealth Ireland will be Enabling Connected Health Through Digital @ehealthireland
Thank you!
Name Martin CurleyTitle Chief Information Officer, HSE, CO, eHealth IrelandTwitter @martingcurley1Email [email protected]
@ehealthireland
Challenge
Creating interfaces between systems is a key challenge faced by many health care organisations
• differing implementation of standards in various vendor systems and creating a way to share information between those vendors is challenging.
• reduce our timeframe for implementations, deploy out of the box cross-system data flows, and inform clinical workflows.
Ultimately our goal is to improve the patient quality of life and quality of care while providing the clinical teams with an improved experience and reducing the cost of care.
Opportunity
The opportunity to work with the HSE to develop the HSE common framework for integration utilising existing standards and published architecture types for the EHR programme. The output of this work will be published and form the backbone of our clinical integration strategy. As the HSE embarks on the procurement and deployment of a national EHR, the first site being the national children’s hospital, the Health Service recognised the core need to ensure that all elements of the EHR and our existing suit of clinical applications and medical devices can share information at the patient level utilising standard architypes and standards. As this is the start of our country EHR deployment vendors would have the opportunity to participate in the design and deployment of national solutions for standards and architypes for integration of systems.
Impact
The impact of a successful strategy and deployment is the creation of an open data eco-system which could allow, with the correct data protection guidelines, vendors to develop innovative solutions to support the development of e-Health utilising the existing data with is held within existing solutions. This will allow vendors to develop and deploy solutions, which will have a direct benefit to the patient quality of life and quality of care while providing the clinical teams with an improved experience and reducing the cost of care.
Shift Left – Integrated Health Exchange