Page 1Healthcare Sector – Global Capabilities Healthcare Sector Global Capabilities InterSystems...

Healthcare Sector – Global Capabilities

Healthcare Sector

Global Capabilities

InterSystems Symposium 2009

Hluboka nad Vltavou, Czech Republic

8thd – 9th of June 2009

2Healthcare Sector – Global Capabilities

• 60% of the English population will use healthcare systems installed and operated by CSC

• 70% of the hospital beds in Denmark are supported by systems designed, built and operated by CSC

• CSC has built two of the largest healthcare claims data warehouses in the United States

• CSC’s proprietary DirectConnect software supports one of few financially viable health information exchanges in the United States

• In 2007, CSC served 14 of the top 20 global pharmaceutical companies and more than 300 hospitals globally

Healthcare Sector Highlights

Healthcare sector is a principle CSC operating unitHealthcare sector is a principle CSC operating unit

Healthcare Sector Overview


Switzerland

India

U.S.UK

Hong Kong

Denmark

Netherlands

Belgium

• $1.4 billion in world wide healthcare revenue

• 6000 people serve our healthcare clients world wide

• Services include consulting, systems integration, information technology outsourcing and business process outsourcing

• Engagements range in size from 10’s of thousands to billions of dollars

• Contract durations extend up to 10 years

• Our customers receive the highest quality of services at the lowest possible cost

Provider

Payer

Life Sciences

Public Sector Agencies

Austria

France

We have a global presence and relevant services


Slovakia


Our clients span the health services continuum



Healthcare Sector has experienced a 13.5% CAGR since 2005

Geography

Americas; 606; 35%

EMEA, 639 36%

NPS, 50029%

RevenueBillions of Dollars

13.5% CAGR



Creation of National Information Infrastructure (called Aorta) for patient information to hospitals, pharmacies and general practitioners.

Built “LSP” system selected on the basis of: Rapid development timescales (using CSC C-Rup process and Rational Requisite Pro); Scalability through use of Inter Systems ensemble products and virtualisation; and,

Data management strategy with need for 10 year traceability

Contract award November, 8th 2005 – 1st system delivery31 January 2006.

Significant healthcare engagements in Europe

ScandinaviaScandinaviaScandinaviaScandinavia BelgiumBelgiumBelgiumBelgiumNetherlandsNetherlandsNetherlandsNetherlands EnglandEngland EnglandEngland

2003 - Awarded a $1.7BN share of NHS National Programme for IT. CSC led alliance also wins $347.5M diagnostic imaging contract with the NHS.

2006 – Extended relationship by adding the North East and Eastern clusters - $3.73BN over 9 years

CSC now responsible for 60% of UK population within the Connecting for Health programme

IT Outsourcing

Largest healthcare company in Scandinavia employing over 300 people

Services include: application development; systems integration; systems operations and consulting

Products include:• Hospital Information

Systems • Clinical Systems• Laboratory Systems• Home Care Records• Health Insurance Systems

70% of hospital beds in Scandinavia are supported by CSC products

Consulting on platform of common services (“Portalhealth”)

Design/build of key data warehouses:•clinical records (200 hospitals)•Hospital cost/funding analysis•psychiatric records

Medega Project - a nationwide application which helps organising the ‘Doctors on Duty’ activities

Maintain Carenet – A Communication platform trough gateways for invoicing of medical care between Hospitals and Insurers

Developing conceptual design for an entitlement card to enable reimbursement of healthcare services

Capabilities


IntegrityLife

Sciences

State and Local State and Local GovernmentGovernment

State and Local State and Local GovernmentGovernment

CSC’s services in the United States public sector

Payers

Health Research and Health Research and IT SupportIT Support

Health Research and Health Research and IT SupportIT Support

Vaccine Program Vaccine Program ManagementManagement

Vaccine Program Vaccine Program ManagementManagement

Provider & Public Health

Black Lung Claims Processing

Medicare A/B Claims ProcessingMedicare Part D Insurance and Claims processingClinical data AbstractionSoftware Development

Medicaid Claims Processing

Medicare FraudMedicare – Medicaid fraudProvider EducationData Quality Review

Medicaid Fraud

NEDSS Program DevelopmentMission SupportData Center Operation

Eclipsys CIS ImplementationMission Support

NHIN Prototype Development

Health Information Exchange

Biotechnology IntegrationScience Solutions management

AdvanceMedAdvanceMedAdvanceMedAdvanceMed Health System Health System SolutionsSolutions

Health System Health System SolutionsSolutions

Occupational Medicine

Capabilities


Supply Chain Supply Chain ManagementManagement

Supply Chain Supply Chain ManagementManagement

Planning and Planning and Operations Operations

ImprovementImprovement

Planning and Planning and Operations Operations

ImprovementImprovement

Patient Access andPatient Access andRevenue Cycle Revenue Cycle

ManagementManagement

Patient Access andPatient Access andRevenue Cycle Revenue Cycle

ManagementManagement

Healthcare Healthcare TechnologiesTechnologiesHealthcare Healthcare

TechnologiesTechnologies

Services to United States healthcare providers

Payer / Provider Connectivity Supply Chain

Savings program

Master Distributor Agreement

Strategic Planning

Economic Performance Improvement

Cerner Implementation

Eclipsys Implementation

Epic Implementation

Lawson ERP Implementation

Clinical Data Management

Health information Health information ExchangesExchanges

Health information Health information ExchangesExchanges

Clinical Data Exchange

Capabilities


Services to United States based commercial health insurance companies

Systems Systems IntegrationIntegrationSystems Systems

IntegrationIntegrationBusiness Business

IntelligenceIntelligenceBusiness Business

IntelligenceIntelligenceLegacy System Legacy System ModernizationModernization

Legacy System Legacy System ModernizationModernization

Business Process Business Process OutsourcingOutsourcing

Business Process Business Process OutsourcingOutsourcing

Blue Health Intelligence design development, implementation and operation

Data warehouse design development , implementation and operation

Website design development and deployment

CRM Planning and Implementation

Medicare Part D enrollment and claims processing

Claims System Implementation

Enterprise Billing System Implementation

Capabilities


Contracts and Contracts and PricingPricing

Contracts and Contracts and PricingPricing

CRM Strategy andCRM Strategy andImplementationImplementation

CRM Strategy andCRM Strategy andImplementationImplementation

Clinical Information Clinical Information WarehouseWarehouse

Clinical Information Clinical Information WarehouseWarehouse

Reg. Affairs, TechnicalReg. Affairs, TechnicalProcess Support,Process Support,ImplementationImplementation

Reg. Affairs, TechnicalReg. Affairs, TechnicalProcess Support,Process Support,ImplementationImplementation

Customer Master

CRM Strategy & Implementation

Health CareCompliance

Enterprise Content Enterprise Content ManagementManagement

Enterprise Content Enterprise Content ManagementManagement

LIMS SupportLIMS SupportLIMS SupportLIMS Support

Services to the life sciences industry

Capabilities


CSC licenses, installs and maintains its own proprietary healthcare software

Proprietary CSC Software

Software product Description

Clinical Suite Clinical Suite is an integrated software portfolio that supports a hospitals clinical and operating functions. Clinical Suite includes a hospital information system, a clinical information system, a laboratory systems and a home care records system

DirectConnect® DirectConnect® facilitates the exchange of claims data between healthcare providers and health insurers

FirstDoc FirstDoc is an enterprise content management system that facilitates the collection and management of documents needed by pharmaceutical manufacturers for regulatory compliance

HealthSpace Advisor HealthSpace Advisor is an internet based benchmarking tools that allows hospitals to assess how well they are using existing floor space in critical areas such as the emergency department, the operating theaters, and the intensive care unit

Capabilities


To establish CSC Healthcare Sector vertical as a world wide leader in the effective use of information to transform the healthcare industry through improved care delivery, decision making, and operating performance.

Healthcare Sector Objective

Healthcare Sector Vision


Healthcare activities in Europe

• The Netherlands – National Healthcare Switchboard

• The UK NHS Program

• CSC ScandihealthClinical Suite– Medical Record– Clinical Overview– ePrescription– Clinical PortalAccounting / Health Insurance

Agenda


The concept

HospitalHospital

LSP

PharmacistPharmacist PharmacistPharmacist

General PractitionerGeneral Practitioner

General PractitionerGeneral Practitioner

HospitalHospital

The Netherlands – National Healthcare Switchboard


Principles

• Patients’ information stays at the source

• The Dutch National Switchpoint is a pointer index

• The Switch Point also retrieves the information from the QHIS-ses and transfers the information to the requesting QHIS.

• Importance of authentication and autorization– privacy aspects– reliability of information (responsibility)– Citizen Service Number for patients identification– Unique Healthcare provider identification for doctors etc.

• Importance of logging

• The patient in the driving seat– final autorization of healthcare professionals by the patient– right to see logging information by law



IT-related principles

• HL7v3 messages – between QHIS-ses and the National Switch Point

• At the start: SSL handshake to exchange authentication information

• Currently: also using Digital Signing as means to exchange authentication information

• Certification/Qualification of Healthcare systems before connecting (Qualified Healthcare Information System)

• Certification/Qualification of network-service-providers before connecting

• Service Oriented Architecture aka Composite Application– at first focussing on information exchange



The NHS National Program (NPfIT)

• Aims to give healthcare professionals access to patient information safely, securely and easily, whenever and wherever it is needed.

• Started in 2003 by the NHS Information Authority. Transferred in 2005 to Connecting for Health, an agency of the Department of Health

• Links systems via broadband network delivering:

– Care Records– Electronic Appointment Booking– Electronic Prescriptions– Picture Archiving and Comms Systems

(PACS)– Supporting Systems

UK NHS Program


Program Background

• The National Programme For IT

• Run by NHS Connecting for Health – now moving to local ownership (NLOP)

• £12.4 billion investment

• IT focus is on transforming the way patient information is accessed, used and shared

• Service improvement focus is on improving access, increasing choice, reducing waiting times, reducing lengths of stay and increasing clinical safety across the patient journey

• Standard IT solutions are being developed

• Consistent ways of working are required

• CSC responsible for delivering the programme to 60% of the UK

NPfIT is the largest civil IT programme in Europe and a key enabler for transformation of health services

UK NHS Program


CSC Alliance: Scope of Services

North East / Yorkshire & Humberside

North West / West Midlands

East Midlands / East of England

London

South West / South East

CSC Alliance

CSC Alliance

Fujitsu Fujitsu

BTBT

CSC Alliance

CSC Alliance

CSC Alliance

CSC Alliance

• NWWM Cluster signed 23.12.03

• Delivery of Electronic Patient Record

• 10 year deal

• Contract Value $1.9bn

• No staff transition

• PACs signed mid 2004

• 10 year deal

• Contract Value $383m

• Renegotiated April 2006

• New Contract Value $400m

• NE & EEM Clusters agreed 29.9.06

• Ex Accenture TUPE circa 350 staff

• Transition complete 8th Jan 2007

• Increased TCV by $3.9bn

• Contract extended by 1 year

UK NHS Program


GP Systems

TPP SystmOneLorenzo GP

A&E

i.PM / EDIS

Maternity

Evolution

Laboratory

iSOFT iLab

Pharmacy

ASCribe / JAC

Theatre

ORMIS

PACS/ RIS

GE ,HSS

Electronic Patient Record

iSOFT i.EPR including:i.PM - i.CM - i.IE - Lorenzo

TPP SystmOne in Primary Care

Integration Bus

SeeBeyond e*Gate 4.5

Mental Health

i.PM and i.CM

Dental

SoE

Community Care

i.PMHSW and S1

(for child health)

Ambulance

Medusa

CSC Alliance Reference SolutionC

ore

Ad

dit

ion

al

= Superseded by PACS contract

UK NHS Program


CSC Scandihealth A/S

• Largest healthcare IT company in Scandinavia.

• Revenue FY08: $ 73 M. Profit margin: 15%.

• 350 employees – with combination of clinical and IT education.

• Specialised in development of clinical and administrative Healthcare IT product (IPR) – and associated services (consulting, systems integration, outsourcing).

• Serving national, regional and local (municipality) clients.

Vision: Create the coherent healthcare society

Company Facts Perspective

CSC Scandihealth


International Product Suites

• Clinical Suite

• Patient Administrative System

• Laboratory System

• Home Care and Nursing Home Record

• Healthcare Portal

Company Facts Perspective

CSC Scandihealth


The Roles of CSC Clinical Suite

• Shared Patient Record

• Monitoring tool for clinicians

• Shared coordination tool for patient treatment and care

• Documentation tool for clinical units

• Clinical IT-workstation

• Clinical knowledge base

• Patient Administrative management tool

• Patient administrative workstation

• Production Management tool

CSC Scandihealth - Medical Record


• Interdisciplinary and team-oriented work processes at hospitals and other healthcare institutions

• Planning, reporting and evaluation directly in connection with the clinical work.

• Implementation of evidence based medicine

• Accreditation processes within healthcare institutions

• Quality measurement and improvement of clinical work

• Support both highly specialized university hospitals and generalized institutions

• Support the specific clinical settings and the specific professional

Business Architecture

Basic Business Principles



Clinical overview



The ePerscription Module

• The purpose is to support all of the clinicians activities regarding medication in one system.

• The goal is to enhance quality, security and efficiency in the treatment from initial referral to discharge including a print or electronic transfer of all prescribed medication.

• We call it a 'one-string' medication system, where both the prescription and the receipt for giving the medicationby the nurse, is documented in the same system.

• The system is interdisciplinary for doctors and nurses.

CSC Scandihealth - ePrescription


Clinical GuidelinesRecommended drugs

RegimesStandard prescriptions

Dispense medicine

Give medicine

Deviations

Assessmedicine

Discontinuemedicine

Prescribemedicine

Informationto the patient



Quality

• Drugs recommended by the local Medical board

• Standard assortment of drugs provided by the pharmacy

• Standard prescriptions (templates)

• Standard prescription sets (regimes)

• Documentation of allergic reaction to drug treatment

• Dose calculator



Drugs recommended by the local Medical board

Standard assortment of drugs provided by the pharmacy



Overview of current prescribed medicine



Economic and Finance Management

• Notus Healthcare: Health Insurance Solution– Accounting of private providers in Denmark– Activity based accounting

• Domus Healthcare– Inter-regional accounting– Accounting of activity based funding of hospitals – 85% fixed / 15% activity

financed

CSC Scandihealth – Finance Management


Clinical PortalOpen Clinical Workspace (OCW)

Aktuel patient kontekst

Patientliste

Modul område

Modul menu

Hoved menu

Aktuel patient kontekst

Patientliste

Modul område

Modul menu

Hoved menuOPUS Arbejdsplads

CSC Scandihealth – Clinical Portal

Main menuMain menu

Module menuModule menu

Module areaModule area

Patient in contextPatient in context

Patient listPatient list


• ”Open” – Framework with open interface. – Interfaces are documented and publicly available.

• ”Clinical” – Portal build around a central coordinated context sharing

module. (Based on HL7.org’s CCOW)

• ”Workspace” – Common Workspace that support the users various

applications and thereby cross-application tasks.– Can be customized per individual user.– Ensures Single Sign-on to all applications.

CSC Scandihealth

Open Clinical Workspace (OCW)


”Great Things In Small Packages”

OCWMobile

• Same portal concept as on the desktop

CSC Scandihealth


Thank You

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