Latest Trends in

Health ICT

Syed Tirmizi, MD

Which Health IT Application Do You Think Has Had the Greatest Effect on Boosting Patient Care?

Redefining Health Care Application of the best models to the production of healthcare

services. Interoperability for the harmonization of healthcare

information systems. Healthcare information systems. IT-based tracking of clinical work flow/patient flow and

equipment in hospitals. Utilization of mobile phones for the promotion of health. Prevention of chronic illnesses by means of information

technology.  Increasing the citizens’ motivation for self-care.

Clinical Decision SupportRationale - 1 CDS demonstrated to be effective in a number of settings

over the past 30-40 years Impact

best practices error reduction pay for performance cost effectiveness chronic disease management prevention biosurveillance etc.

Yet slow dissemination and adoption

Clinical Decision Support Rationale - 2 A number of barriers can be cited

including technical, organizational, cultural, and financial As a result, much reinvention of the wheel Will only get worse

More info available Informed consumer

Health care knowledge, provider performance data More complexity

genomics, competing technologies/workup strategies, targeted therapies

cost and time pressures, pay for performance

History of collaboration efforts AHCPR, other consensus panels

Yet difficulty operationalizing, too generic EBM, Cochrane Collaboration

Knowledge but not executable Guidelines.gov

Not curated, most not executable Arden Syntax

Widely used, but highly proprietary Requires host-specific customization of all rules CPMC (California Pacific Medical Center) site lists ~240 rules, but not updated since

1997 GELLO

New expression language, but implementations just emerging, no content libraries IMKI (Institute for Medical Knowledge Implementation)

Effort to form consortium of vendors, professional societies, and academic medical centers

Failed due to lack of willingness to contribute content

The CK-Collab approach Stimulate sharing by

Identifying high impact need(s) Developing high quality knowledge resources Demonstrate a workable model for collaboration

Lead by example

Show effectiveness

A Roadmap for National Action on Clinical Decision Support

AMIA White paper, June 13, 2006

Prepared by:Jerome A. Osheroff, MD, Jonathan M. Teich, MD,

Blackford F. Middleton, MD, Elaine B. Steen, MA,

Adam Wright,

Don E. Detmer, MD, MA

A Multi-Stakeholder Effort CDS / informatics

pioneers Providers:

academic / community centers

Patient / consumer advocates

HIT / CDS vendors Payers Consulting firms

Healthcare quality & safety experts

Legal / policy experts

Standards organizations

Government ONC, AHRQ, NIH,

VA, CMS, FDA, NLM, IOM, CCHIT

The Goal

“to ensure that optimal, usable and effective clinical decision support is widely available to providers, patients, and individuals where and when they need it to make health care

decisions.”

Enhanced Health and Healthcare Through Enhanced Health and Healthcare Through CDSCDS

BestKnowledgeAvailable

WhenNeeded

HighAdoption &

EffectiveUse

ContinuousImprovement

of Knowledge

& CDS Methods

Pillars of CDS

Critical Tasks

Identify NextSteps

AddressLegal,

Regulatory& Financial

issues

GeneralizeLessonsLearned

ImplementDemonstration

Projects

ShowFeasibility,Scalability,

Value

PromoteDisseminationand Adoption

StakeholderDiscussions

RoadmapExecutionSteeringGroup

Technical Requirements & Architecture

Goal: Identify specific technical requirements and processesSome issues to consider Kinds of tools and resources needed to facilitate group collaborative content

management Open vs. proprietary tools, environments Portal development Knowledge representation Standards What to do when no suitable standards exist Support for editing, review and update Ontologies, indexing support

Can CK-Collab tools and knowledge management be adapted for individual organizational use?

Instrumentation and data capture (metrics) for evaluation What will be required to facilitate institution adoption and adaptation of

content, receive and install updates, identify issues and measure usage?

Content Resources & ApproachGoal: Identify specific content resources, approach to management, with focus on

diabetes Some issues to consider What knowledge is included and how do we decide (priorities)?

e.g., Order sets group interaction tables, dose modifications for age, renal insufficiency alerts reminders guidelines, pay for performance metrics, quality benchmarks

Editing and review process How indexed and organized?

Use of ontologies and controlled vocabularies How is it updated, how often, what triggers it? How deep is the knowledge in the various organizations and where will CK-Collab

get it, if not available from members. How would participants use it in their organizations?

Content matched to capabilities of systems How and when do we want to move to additional foci other than diabetes? Data capture (metrics) for evaluation

“Clinical Reminders” Performance Measures

1. Clinical Reminders Real time decision support Targeted to specific patient cohort Targeted to specific clinic/clinicians

2. Reminder Dialogs Standard documentation Capture of data (MDS, Health Factors, encounter data, etc)

3. Reminder Reports Performance improvement/scheduled feedback Identification of best practices Targeting low scorers for educational intervention Patient recall if missed intervention

What the Clinician Sees…

ATHENA Hypertension Advisory:BP- Prescription Graphs

ATHENA HTN Advisory

BP targets

Primaryrecommendation

Drugrecommendation

Clinical Clinical requirementsrequirements

Diabetes Patient Dialog for processing multiple reminders:

• Diabetic Foot Care Education• Diabetic Foot Exam• Diabetic Eye Exam• Recommended Labs• Other Health Activities

Acquisition of health data beyond care delivered exclusively through VHA

Standardized Data Elements

Links Reminder

With Actions

With Documentation

The Challenge & The Opportunity

Source: World Health Organization; McKinsey

• Worldwide today:• 1 billion adults overweight• 860 million chronic disease patients• 600 million elders age 60 or older

• 75-85% of healthcare spending is on chronic disease management

• 200K hospitals, 18M hospital beds

Health & WellnessOne billion adults overweight world wide

Healthyfamily

Glucosemeter

Pedometer

Blood-pressure

Cuff

MedicationTracking

DigitalHome

In the future…• Extension of healthcare

system into the home• Initial triage of conditions

• Vital signs• Images• Email / chat / video

• Appointment scheduling

Health & Wellness• Weight loss• Fitness• “Worried Well” vital sign

monitoring:• Weight• Blood pressure• Glucose• Cholesterol• Activity level

• Personal Health Records

Internet

Weight lossWeight lossand fitnessand fitnesscoachingcoaching

HealthcareHealthcareProfessionalsProfessionals

PersonalPersonalHealthHealthRecordRecord

WeightScale

Fitnessequipment

DigitalHome

Disease Management860 million chronic disease patients world wide

Pedometer

Blood-pressure

Cuff

MedicationTracking

PersonalHealthSystem

Disease Management• Vital sign monitoring (RPM)• Medication reminders and

compliance• Utilize home network to

locate devices in logical places:

• Scale in bathroom• Pill minder in kitchen• BP cuff in living room

• Trend analysis and alerts• Email, chat, video • Appointment scheduling

CellPhone

PulseOx

Weight

PC• Chronic disease

• Post trauma

• Pre-op

Internet

FamilyFamilycarecare

giversgivers

DiseaseDiseasemanagementmanagement

serviceservice

PersonalPersonalHealthHealthRecordRecord

Implant

HealthcareHealthcareproviderprovider

Fitnessequipment

DigitalHome

PersonalHealthSystem

CellPhone

PC

Internet

FamilyFamilycarecare

giversgivers

ElderlyElderlymonitoringmonitoring

serviceservice

DietDiet&&

wellnesswellnessservicesservices

DiseaseDiseasemanagementmanagement

service, service, healthcarehealthcareproviderprovider

Elderly Monitoring600 million elderly individuals world wide

Aging Independently• An adult child helping their

elderly parents age gracefully in their own home.

• Basic life monitoring as appropriate (ADL):

• Bed pressure (sleep)• Bathroom sensor• Gas / water sensor• Emergency sensor

• Vital sign monitoring (RPM)• Medication reminders and

compliance• Trend analysis and alerts• Email, chat, video • Appointment scheduling

• Independent living

• Chronic disease

HomeAutomation& Control

Pedometer

Blood-pressure

Cuff

MedicationTracking

PulseOx

Weight

Implant

Fitnessequipment

The Continuum of Care

AmateurAmateurAthleteAthlete

Diet/FitnessDiet/FitnessFocusedFocused

WorriedWorriedWellWell

Elderly LivingElderly LivingIndependentlyIndependently

ChronicChronic Patient Patient

AcuteAcuteRecoveryRecovery

InfantInfant

CONTINUUM of LIFE

CONTINUUM of CARE GIVERS

Doctor/NP/NurseDoctor/NP/NurseHomeHome

NursingNursingProfessionalProfessional

The FamilyThe Family

FitnessFitnessWellnessWellness

CoachCoachNew ParentsNew Parents

The Continua Health Alliance will enable a personal health eco-system that empowers individuals & families to better manage their own health and wellness across the

continuum of life and care methods.

Personal Health Eco-system

CONNECTIVITY

Ethernet

SENSORSAGGREGATIONCOMPUTATION

SERVICES

Diet orFitnessServiceMICS / MEDS

DiseaseManagement

Service

PersonalHealth

RecordService

ImplantMonitoring

Service

HealthcareProviderService

PC

PersonalHealthSystem

CellPhone

Set Top Box

Aggregator

N E

T W

O R

K (P

OT

S, C

ellular, B

B)

GlucoseMeter

Pedometer

Blood-pressure

MedicationTracking

Fitnessequipment

WeightScale

PulseOximeter

Spirometer

Bed / ChairSensors

ImplantMonitors

BabyMonitors

PERS

ConsumerElectronics

Homesensing &

control

Guidelines Certification Logo

HomeAutomation& Control

• GUIDELINES:Continua member companies will select connectivity standards and publish Guidelines for strict interoperability.

• CERTIFICATION & LOGO:Continua will establish a certification program with a consumer recognizable logo signifying the promise of interoperability with other certified products.

An Aging Services Context

• Multiple wireless strategies can be affordably deployed today and are leveraged by a variety of devices to enable activity-appropriate use at the point of care across all care settings.– Empowered Workers– Empowered Consumers (patients)– Empowered Environments

Uses: The Empowered Worker

• Supporting Effective Relationships at the point of service– Balancing relationships and tasks

• Personalized documentation• Decision support = relationship support• Goal: open shared use of any technology

• Case Study– Strategic use of device types for supporting

relationships• kiosk, handheld, laptop, voice device

Uses: The Empowered Consumer

• Supporting rich engagement of consumers with their life and context– The legacy consumer environment

• TV and Phone

– Emerging possibilities• Convergence of tv, phone and computer• Social Networking• Convergence of gaming and therapy

– The Personal Health Record as a shared repository of resident story, goals and choices.

Uses: Empowered Environments

• Automating routine monitoring and documentation to promote safety and quality of life.

• The Legacy Environment– Proprietary single-point monitoring– Multiple systems

• Nurse call, wandering, fire safety, access and identity• Location & asset monitoring, energy management• Voice, radio, paging

– Each system has similar components• Sensors, distribution (wired/wireless), data collection point• Analysis engine to generate alerts, communications & dashboards

• Opportunities & Possibilities– Integrated, Standardized, Interoperable system(s) – Automated monitoring provides increased opportunity for

relationship-centered service

Technology: Devices

• Traditional PC & Laptop

• Phone & Communication Devices

• Handhelds

• Kiosks

• Tablets and other Form Factors

• Appliances– Cameras, gaming, etc.

• Tags

Scenario: Teleputer

• The empowered worker uses a teleputer to converge communications, documentation, notification, and decision support.

Scenario: Location

• Empowered Environments log activities, generate alerts, and supports independence.

Scenario: Social Gaming

• Empowered consumers embrace interactive multi-media devices that integrate social communities, cognitive stimulation and entertainment.

(Tribune photo by David Trotman-Wilkins) Feb 9, 2007

Continua Health Alliance Objectives

• GUIDELINES: Developing design guidelines to build interoperable sensors, home networks, health compute platforms, and health & wellness services.

• CERTIFICATION & LOGO: Establishing a product certification program with a consumer recognizable logo signifying the promise of interoperability with other certified products.

• FDA & EU REGULATIONS: Collaborating with government regulatory agencies to provide methods for safely and effectively managing diverse vendor solutions.

• REIMBURSEMENT: Working with leaders in the healthcare industries to develop new ways of addressing the costs of providing personal health systems.

Chronic Disease Management

OverviewDM Megatrends

1) The DM Opportunity is Huge!

2) The DM is Complex

3) 2008 Could Be a Breakout Year for Remote Patient Monitoring (RPM)

4) What’s Missing in the Market? Large Scale Platforms/Projects. A) Health Plans

B) Medicare DM Demos

C) Medical Home model

D) PHRs/Google Health

E) Mobile Platforms, e.g., Lifecomm

F) Hospital at Home

5) “Behavior Change” is Becoming the Holy Grail

6) Next Generation Technologies: “You Ain’t Seen Nothing Yet”

7) Will the DM Community Be Leaders or Laggards in the Race to Interoperability?

1) The DM Opportunity is Huge!

$34 B Market for Healthcare Unbound Technologies

$0

$10

$20

$30

$40

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

ADL/elder Chronic Acute

Total

Acute

Chronic

ADL/elder $0.35

$US(billions)

$0.37 $0.47 $0.59 $0.73 $0.98 $1.2 $1.6 $2.0 $2.4 $3.0 $3.7

$0.10 $0.13 $0.22 $0.38 $0.65 $1.2 $3.8 $12.1 $23.1 $26.3 $25.7 $26.7

$0.00 $0.00 $0.00 $0.00 $0.01 $0.02 $0.65 $2.0 $3.6 $3.5 $3.0 $3.2

$0.45 $0.50 $0.69 $0.97 $1.4 $2.1 $5.7 $15.7 $28.7 $32.3 $31.7 $33.6

(Numbers have been rounded)

2) The DM is Complex

Two Seemingly Contradictory Statements

Diseases/conditions

x

Value propositions

x

Technologies

x

User environments

=

Thousands of Potential Applications

So Why Is Uptake of Technology in DM Taking Time? Do the Math.

© www.bhtinfo.com

Technology ConvergenceCONSUMER TECH

INFRASTRUCTURE

Internet

Smart houses

Personal communications devices -- PDAs, cell phones, etc.

Broadband -- cable, DSL, satellite

Digital cameras, video

Wireless -- 802.11, Bluetooth, RFID, etc.

Voice recognition

etc.

eHEALTH APPLICATIONS Electronic Health Records (EHRs)

Personal Health Records (PHRs)

Remote patient monitoring

Fitness/wellness/prevention

Self care support

Physician/patient secure messaging

Home telehealth/telecare

Decision support systems

e-Prescribing

e-Disease Management

e-Clinical Trials

Predictive modeling

Computerized Physician Order Entry

Quality evaluation web sites

Patient reminder systems

etc.

© www.bhtinfo.com

Focal Points for ConvergenceHome Networks, Smart Phones, EHRs, PHRs

PHR/EHRSmart

Phone

HomeNetwork

CONSUMER eHEALTH

Role of IT in Disease Management

Patient Facing

DM Provider Facing

Patient-provider communication tools (IVR, email)

MonitorEngage Intervene

Educate, Coordinate, TreatIdentify, Validate, Stratify, Enroll

Call center

Personal Health Record

Predictive modeling

Remote monitoring (biometric, tele-monitoring)

Personal assessment tools

Educational tools (websites, audio library)

Electronic Medical Record

Decision support tools (CDSS)

Outcomes, Feedback, Follow-up

Clinical integration tools

Disease registry

3) 2008 Could Be a Breakout Year for Remote Patient Monitoring

(RPM)

2008 Could Be A Breakthrough Year For RPM

• Continua begins to address major challenges– Interoperability of devices

– Pricing (indirectly)

• But other challenges remain– IT/integration

– Reimbursement/business model

– Licensure/regulatory issues

...but Consider the Systemic Barriers

• Reimbursement

• HIPAA: Privacy/confidentiality issues

• Physician workflow

• Technology maturity– Infrastructure

– Bandwidth

– Interoperability/Standards

– Friendly user interfaces

4A) The Cats are Herding:Medical Home Model Gaining Momentum

The Medical Home Incorporates Disease/Care Management Tech & Apps

• Proposed payment framework for the Medical Home model includes $$ for:– coordination of care

– health information technology

– secure e-mail and telephone consultation;

– remote monitoring of clinical data using technology.

4B) PHRs & Google Health

• 2 models of PHRs– Stand alone

– Tethered: typically to a health plan, provider, employer

• Each has challenges

• The “populating the PHR with data” problem

• 200 PHRs on the market

• Generations of PHRs– 1st generation: PHR as “APPLICATION” -- an online repository of

personal health information (PHI)

– Next generation – PHR as PLATFORM

Source: Markle Foundaton A Common Framework for Networked Personal Health Information, 2006. See also: RWJF Project HealthDesign A New Vision for Personal Health Records, May 2007

Google Health– A Next Generation PHR(detective work and tea leaf reading)

• The Current Market Structure for Personal Health Information (PHI). Your PHI is– Scattered everywhere

– Not in standardized formats suitable for a global information economy

• GH’s Anticipated Technology Model – Patient centric

– A personal health URL

– Automated data mechanisms to gather and store PHI

– Interoperable technical standards: XML and the Continuity of Care Record (CCR) standard

– A user interface

– Appropriate security and confidentiality measures

– Value added functionality (over time)

• Three Potential Leverage Points– A GH platform could simultaneously create AND dominate next

generation PHRs.

– Google Health promises to overcome the “populating the PHR” challenge

• Automated data feeds

• The Continuity of Care Record standard as the MP3 of PHI

– Potential for rapid, dramatic network effects

4C) Mobile Platforms, e.g., Qualcomm’s sponsorship of LifeComm

The Disconnect

Chronic Disease/Condition Management is migrating– From a clinical based model

– Toward a behavior change model

How can you optimize behavior change without 24x7x365 connectivity to the patient?

4D) Hospital at Home

• Portland Veterans Administration Hospital

Gives Acutely Ill Homecare Option

To Free Up Valuable Beds

Care Is Brought to Patient;

An Alternative for Elderly

Current DM/Tech & Apps Are A Collective Platform to Support HAH

• EHRs

• Telemedicine

• Niche apps

• Remote Patient Monitoring

• Disease Management

• Personal Health Records

• Mobile telehealth

• Health 2.0

• Etc

Hospital At Home

5) “Behavior Change” is Becoming the Holy Grail

63

The Holy Grail: Changing behavior to prevent disease

Behavioral Risk Factors

ChronicCHF

Clinical Risk Factors

Our Future1994-98 1998-2002 Current

Interactive Data Systems

• All of the above plus more real time two way remote interaction between pts., disease managers, and MDs (e.g. interactive TV, implantable devices, PDAs, cell phones, other wireless technologies)

Copyright © LifeMasters Supported SelfCare Inc. 2004 All Rights Reserved.

Behavior Change: Carrots vs. Sticks?

6) Next Generation Technologies: “You Ain’t Seen Nothing Yet”

The Next Generation of DM TechnologyWhen the Technology is Just “There”

“Ubiquitous Health”

“Sense and Simplicity”

“Pervasive Computing”

7) Will the DM Community Be Leaders or Laggards in the Race

to Interoperability?

Fields of Medicine

• Curative Medicine• Preventive Medicine• Palliative Medicine• NBIC Therapeutic Medicine• NBIC Enhancement Medicine

NBIC-Medicine definition

• medical intervention at the molecular scale for curing disease or repairing damaged tissues, such as bone, muscle, or nerve. [i]

• the study of biotechnology, pharmacy and biosensors at the cellular level.[ii]

• the application of nanoscale principles to biomedical technology,

• the comprehensive monitoring, control, construction, repair, defense, and improvement of all human biological systems, working from the molecular level, using engineered nanodevices and nanostructures;

• the science and technology of diagnosing, treating, and preventing disease and traumatic injury, of relieving pain, and of preserving and improving human health, using molecular tools and molecular knowledge of the human body; [iii]

• the employment of molecular machine systems to address medical problems, using molecular knowledge to maintain and improve human health at the molecular scale.” [iii]

NBIC medicine

US NANOTECHNOLOGY HEALTH CARE PRODUCTS DEMAND(million dollars)

% Annual Growth

Item 2004 2009 2014

Nanotech Health Care Product Demand

906 6500 27700

Pharmaceuticals 406 3000 16600

Diagnostics 465 1100 2200

Medical Supplies & Devices

35 2400 8900

[i] US NANOTECHNOLOGY HEALTH CARE PRODUCT DEMAND TO REACH $6.5 BILLION IN 2009 <http://www.the-infoshop.com/press/fd29054_en.shtml>

NBIC-Medicine/NBIC-enhancement

Bionic Implants:

• “Couples' nervous system linked by implants in limbs. 06.07.2004 http://www.nzherald.co.nz/index.cfm?ObjectID=3576668

When Kevin Warwick lifted his finger, his wife Irena felt as if a bolt of lightning ran down her palm and into her own finger. In what they billed as the first direct link between nervous systems, the couple had electrodes surgically implanted in their arms and linked by radio signals to a computer. Blindfolded for the experiment, they could feel when their spouse's finger moved

• Bionic Ear: Cochlear Implants – Applications And Developments Utillising Nanotechnology http://www.azonano.com/details.asp?ArticleID=976

• Bionic Eyes for the Blind

http://www.seeingwithsound.com/retinal.htm; Bionic Eyes – Ceramic Microdetectors That May Cure Blindness http://www.azom.com/details.asp?ArticleID=1544; Bionic eye offers new window on the world, Sunday 10.10.2004, CET 04:53 http://www.swissinfo.org/sen/Swissinfo.html?siteSect=511&sid=4415302

NBIC-Medicine/NBIC-enhancement

Illustration by Illustration by DaniloDanilo DucakDucak

BY MIKE FILLONBY MIKE FILLON

THE NEW BIONIC MANTHE NEW BIONIC MAN

http://popularmechanics.com/science/medicine/1999/2/new_bionic_man/print.phtml

NBIC-Medicine/NBIC-enhancement

• Chips Coming to a Brain Near You - (Wired News – October 22, 2004)

In this era of high-tech memory management, next in line to get that memory upgrade isn't your computer, it's you.

• Theodore W. Berger, director of the Center for Neural Engineering at the University of Southern California, is creating a silicon chip implant that mimics the hippocampus, an area of the brain known for creating memories. If successful, the artificial brain prosthesis could replace its biological counterpart, enabling people who suffer from memory disorders to regain

the ability to store new memories. And it's no longer a question of "if" but "when." …

NBIC-Medicine/NBIC-enhancement

http://www.amputeehttp://www.amputee--coalition.org/communicator/vol2no3pg4.htmlcoalition.org/communicator/vol2no3pg4.html

The process termed "osseoperception" refers to the adjustment of the mind to an osseointegrated prosthesis. The implication is that bone-integrated prosthetic fixtures "communicate" with the mind, via numerous neural pathways, to promote near-normal function of the prosthetic limb and improved psychological acceptance. Beethoven, who held a pencil between his teeth and touched the pencil to the piano keys to help him "hear" the music, illustrates a primitive form of this concept. Similarly, patients can perceive their environment through their osseointegrated prosthetic device. A self-reported incident even describes a patient sensing, through his artificial leg, what type of subfloor was beneath a carpet.

Nanomaterial Applications

• Many already on the market:– Cosmetics, sunscreen, sporting goods, stain-resistant clothing, electronics, sensors, anti-

microbial agents, paints, food supplements, …

• Coming Soon:– Pharmaceuticals – drug delivery– Tumor targeting cancer treatments– Artificial Bone composites– Catalytic materials (I.E. chemical spill clean-up), Industrial films, Building

materials/Insulation, many more

• Foreseeable Future:– Fuel Cells, Solar Cells, Batteries, nano-scale devices and machinery

Source: Nanotechnology Information Center, americanelements.com/nanotech.htm

Nanomaterial Economy Cont.

• A Sample of Industries Projected to Experience Economic Disruption (in Billions): – Healthcare: $1,700

– Electronics: $550

– Telecom: $550

– Plastics: $460

– US Chemical: $450

– Apparel: $182

– Pharmaceutical: $180

Source: Nanotechnow.com

Annual DoD Investment in Nanotechnology; 2006 estimated. (DoD

"Defense Nanotechnology Research and Development Programs", May 8, 2006)

NCI Nanotechnology Alliance: http://nano.cancer.gov/

Nanoparticle Probes

Antibody-labeled quantum dots traveled through the bloodstream to tumors in mice. The antibody then binds with proteins found on the surface of the tumor.

Mechanical Engineering and Medicine Produces Nano-Robotics

• Concept of Endoscopic Microcapsule

• Swallowable imaging ‘pill’ and new endoscopic instruments

Cancer Detection

• By injecting quantum dots into tumors, investigators have been able to image sentinel lymph nodes. These results could lead to a simple, non-invasive method for detecting metastasis.

• The investigators found that they readily observed the quantum dots moving out of tumors and into the lymph system.

Goals

• U.S. Health Care ICT market analysis for Finnish companies

• Network Finnish companies with marketing opportunities in the U.S

• Work with Finnish companies to maximize these opportunities

Opportunities sought

• R&D initiatives with Universities

• Demonstration projects

• Partnerships

• Licensing agreements

• Develop U.S.-based distribution options

• Sales

ICT company profile

• Established SME

• ICT solution is market ready

• ICT meets U.S. requirements

• Demonstrated interest in the U.S. market with ability to deliver with ongoing local support

• Technology has potential to succeed in the U.S. marketplace

Expected Outcomes

• The specific goal is to put companies in the position to either:– SEIZE A U.S. BUSINESS DEVELOPMENT OPPORTUNITY

OR

– EXECUTE A MARKET ENTRY INITIATIVE• Detailed U.S. Market Analysis

• Detailed market entry strategy

• U.S. specific business plan

• Consultants can assist companies with:– – Detailed Market Analysis– – Business Plans– – Funding Proposals– – Financing/Venture Capital– – Recruitment– – Partnerships– – Licensing & Regulatory requirements– – Product Development– – Marketing & Business Development

• Goal is for Finnish companies to establish a sustainable presence in the competitive U.S.

Consultant Services

Questions?

Syed Tirmizi

worldmed@gmail.com

FINLAND

Exhibitor Name

Biohit Oyj

Diagnostica Oy

Entre Marketing Ltd.

Fysioline Oy

Karstulan Metalli Oy

Medix Biochemica

Merivaara Corp.

Niva Medical Co.

Oriola Oy

Oy Medix Biochemica Ab

Pensi Rescue Oy

Planmeca - Planmed

Schering Oy

Sisu Medical Oy

Soredex

Wihuri Oy Wipak