To be, or well be, II

Teknologiat osana palveluprosessin muutosta

Jaana Tuominen, GE Healthcare

GE Healthcare

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Technologies Bio-Sciences

Molecular Diagnostics

Information Technology

Pharmaceutical Solutions

Imaging and Intervention

GE Healthcare: A Unique Collection of Expertise…

…creating advanced diagnostics

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Need a fundamental change …

50% die after 1st heart attack

Heart DiseaseOne person in three

will have cancer

Cancer20% aged 75-84 suffer from

Alzheimer’s disease

Brain Disorders

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A new age of medicine

21st Century Personalized HealthcarePredict Diagnose Inform Treat

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If we can detect it here,

it may never appear here.

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Predict

See the future.Change the future.

Molecular understanding of diseases

A new generation of diagnostics

Identify the “genetic fingerprints” of disease

Predict disease before the onset

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Diagnose

The earlier you detect disease,the earlier you can deal with it.

Transformational medical imaging and medical diagnosticsVisualize and analyze disease at a molecular levelDiagnose disease more precisely – based on the individual patientImprove patient outcomes

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Inform

Enable better care through molecular knowledge.

Provide life-critical patient information – when, where and how it’s neededEmpower through information about “genetic signatures”Tailor treatment to the patientMonitor and manage the efficacy of personalized therapy

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Treat

Read the genes.Tailor the treatment.

Understand disease at a molecular level

Develop more targeted and effective therapies

Enable the development of new, more targeted drugs… faster

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GE Healthcare Vision

At GE Healthcare, We Strive to See Life More Clearly

We Help Predict, Diagnose, Inform and Treat So That Every Individual Can Live

Life to the Fullest

The Emerging Era of Chronic Disease

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Response Needed for a New Era

1900-1950 Era of Infectious Disease Care

1950-2000 Era of Acute Care

2000-2050 Era of Chronic Care

Era of Chronic Care requires collection and management of patient medical information outside of the traditional hospital setting.

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Population Managing Multiple DiseasesMedical progress often turns an acute condition into a chronic one. Ex: 40% decline in mortality from coronary heart disease since 1980, but more people are living with survival effects. A chronic condition lasts more than one year, limits a patient’s abilities and requires ongoing care. Chronic conditions include:

• Cardiovascular disease • Diabetes• Hypertension• End-stage renal disease (ESRD)• Chronic obstructive pulmonary disease (COPD)• Osteoporosis

• Arthritis• Some types of cancers• Asthma• Neurodegenerative disorders (Alzheimer’s, Parkinson’s, etc.)• Chronic pain• Stroke and other brain injuries

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Chronic Health Impact

0 20 40 60 80 100 120

Hospital Stays

InpatientAdmits

Home CareVisits

Physician Visits

EmergencyRoom Visits

Patients With Chronic Conditions Account For:

55%

66%

96%

60%

80%1.5

1.7

1.9

2.1

2.3

2.5

2.7

2.9

2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 2020

Mill

ions

of P

atie

nts

Supply

Demand

US Supply & Demand for Registered NursesPending Dr. & RN Shortage Rising Costs of Healthcare

Quality of Care Dilemma

$211$2 394

$4 701

$12 973

None Two Three Four

Medicare ExpendituresPer # of Chronic Conditions

• 60 Million Americans with 1 Chronic Disease

• 157 Million Americans with 1 by 2020

• Medicare Insolvency by 2019

• Direct Costs $510 Billion, to $1.07 Trillion, 2020

• 80% of Healthcare Costs on 20% of Population

• Chronic consuming 70% of Prescription Drugs

Ambulatory Care – to address chronic diseases

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Ambulatory Care

Chronic patient, managed at

home

Congestive Heart Failure

Ambulatory diagnostic device + connection to

physician & EMR

Asthma and COPD

Therapeutic dose monitoring

+

Address KeyDisease States… Ambulatory Monitoring…

Enables early intervention Improves patient outcomes Reduces hospitalization costs Increases Cost Savings Increases patient compliance Improves provider productivity Improves quality of life

MSU Telehealth Case Study:

Ambulatory Monitoring Solution reduced…

Total Bed Utilization 55%

CHF Patient Hospital Utilization 43%

Urgent Care Visits 35%

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Market Drivers• Aging population

• Acute conditions chronic conditionsAcute intervention managed care

• Increasing patient consumerism - “Worried well”

• Need for cost reductions in healthcare systems

• Changes in reimbursement to encourage outpatient care

• Improvement in communications access(Source: F&S 2004 US RPM)www.cybernetmedical.comwww.medscape.com

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Market Restraints• High cost and inflexibility of products

• Limited scope of reimbursement

• Documentation of outcomes

• Legal issues (e.g. state licensure issues)

• Lack of standardization of clinical protocols

• Privacy concerns

• Tight budgets with home health care

• Lack of physician acceptance (Source: F&S 2004 US RPM)www.cybernetmedical.comwww.medscape.com

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Product Needs• Low cost

• Flexibility

• Ease of Use (single button, voice prompts)

• Unbreakable

• Designed for home environment

• Communications requirements

Key CHF Parameters…

•Weight

•SPO2

•ECG

•Heart Rhythm

•Blood Pressure

•Drug Compliance

•Activity Level

•Nutrition/Diet

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Remote Patient Monitoring Overview

Sensing

• Smart alerts• Wireless platform • Information portal • Telecommunication

Information interface Customer interfaceData management

Non-professional caregivers

Professional caregivers

Alertee (e.g., FNP)

Physician

Data alert

Configured

Data

Data

EMR/ Patient dashboard

Central platform

Algorithm

Home hub

Data

Results

PC/TV

Network / DataPre-prosessing

•Novel algorithms, modeling

•Existing algorithms

•Decision Support

•Configurable Alerts

•EMR Integration•Patient Access

• Non-invasive sensors

• Novel Parameters

• Drug Compliance

•Patient Triage •Educate Patient•Engage Family

Patient

Remote monitoring and viewing – opportunities in the near future

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The story of Joe Doe

Telemetry patient John Doe is going to have a cup of coffee in the hospital cafeteria.

14:32:23

RN M. Smith receives the ‘ST high’ alarm in her PDA. She checks the snapshot, acknowledges the message and hurries to the patient.

14:32:28

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After examination she decides to consult Dr. S. Jones who is the physician in charge of John Doe.

14:33:32

The message shows the snapshot and RN Smith’s request for advice

14:33:55

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After looking at the John Doe’s snapshot and real-time and trended data, Dr. Jones gives care instructions to RN Smith

RN Smith makes the lab test order electronically with her PDA

14:35:12 14:36:38

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The lab results are ready and they are sent to Dr. Jones automatically by the system

Dr. Jones makes the drug order with his PDA, and sends it to RN Smith

15:17:09 15:17:09

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RN Smith receives the drug order and administers the drug in John Doe’s IV bag

RN Smith documents the drug treatment utilizing the bar code scanner that is built-in her PDA

15:21:17 15:22:50

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