Možnosti rozvoje nových modelů péče MUDr. Pavel Kubů Intel World Ahead Program Healthcare CEE Education CZ&SK
Healthcare Costs Rising Worldwide Western Europe $2 200 $2 000 $1 800
United States
$1 600 2010 2011 2012 2013 2014 2015
2010 2011 2012 2013 2014 2015
$3 300
…
$1,654Bn $1,713Bn $1,783Bn $1,867Bn $1,964Bn $2,075Bn
$2 800
Asia-Pacific
$2 300 2010 2011 2012 2013 2014 2015
…
2010 $3,305Bn 2011 2012 2013 2014 2015 $2,394Bn $2,555Bn $2,726Bn $2,905Bn $3,098Bn
$1 700 $1 500 $1 300
Rest of World
$1 100 $900 2010 2011 2012 2013 2014 2015
$1 100
2010 2011 2012 2013 2014 2015
$1 000 $900
…
$1,081Bn $1,179Bn $1,296Bn $1,438Bn $1,608Bn $999Bn
$800 $700 $600 2010 2011 2012 2013 2014 2015
2010 2011 2012 2013 2014 2015
…
$667Bn $707Bn $755Bn $813Bn $883Bn $966Bn
Source: Frost & Sullivan Decision support database 2010
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Health IT Spending on the Rise Western Europe $19 $19 $18 $18 $17
United States
$17 2010 2011 2012 2013 2014 2015
$59
2010 2011 2012 2013 2014 2015
$54 $49
…
$17Bn $18Bn $19Bn
$44
Asia-Pacific
$39 2010 2011 2012 2013 2014 2015
2015 2010 2011 2012 2013 2014
…
$56Bn $40Bn $43Bn $47Bn $50Bn $53Bn
$15
$13
Rest of World
$11 2010 2011 2012 2013 2014 2015
$9
2010 2011 2012 2013 2014 2015
$8
…
$11Bn $12Bn $13Bn $14Bn $15Bn
$7 $6 2010 2011 2012 2013 2014 2015
2010 2011 2012 2013 2014 2015
…
$6Bn $7Bn $8Bn
Source: IDC Projections
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Genome Sequencing Costs Are Plummeting
$1,000 Genome
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Intel Across Healthcare
Computing Innovation for Billions of People Worldwide Across Continents Across Care Continuum Across Computing Experience
Innovation
Healthcare Solutions
Health IT
Powering the Health Workforce
• R&D • People-centered research • Ecosystem support
• Security & risk management • Intel®-powered medical imaging & devices • Health information exchange
• Performance‡ • Security • Manageability
• Mobility • Cloud & datacenter • World health and nontraditional health workers
Initiatives • Age friendly cities • Coordinated care • Mobilizing health workers • Personalized medicine • Personal wellness
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Intelligent Systems – Healthcare Imaging
Diagnostics
Therapeutic
Fitness
• CT/PET
• ECG
• Infusion pumps
• Ultrasound
• Patient monitoring
• Defibrillators
• Fitness equipment
• Bedside terminals
• ICD communicators
• MRI • Digital x-ray
• Retinal scanner
• Healthcare kiosks
• Ventilators
• Restorative therapy
For more…
www.intel.com/healthcare/devices
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Ecosystem Support People-centered Research Global leadership in research organizations. Social science fieldwork in more than 1,000 homes, 100 clinics, and 20 countries.
Standards Intel supports healthcare and government leaders in developing policies and standards that promote the effective use of healthcare information technology.
Policy Engaged in health reform and public policy in more than a dozen countries, collaborating with governments to address critical issues such as payment reform and the adoption of technology standards for healthcare.
Trusted Advisor Intel is a thought-leader and trusted advisor to governments and healthcare partners around the world, collaborating on care redesign, business models, and policy changes to achieve successful healthcare transformation.
For more…
www.intel.com/healthcare/policy
7 * Other names and brands may be claimed as the property of others.
Convertible Form Factors for Healthcare Convertible / Ultrabook™ device
Not a convertible… but a slate
is a device that provides an uncompromised tablet experience, with integrated keyboard* and seamlessly converts from tablet/touch to a familiar PC experience for productivity
“Slates that offer keyboards as an accessory”
Convertible form factor examples Sliders
Flip
Detachable*
Swivel
* “Detachable” devices are devices that a user can mechanically attach to use in hybrid mode, but can also detach for a tablet/slate mode (key word is mechanics – aftermarket, Bluetooth, or similar keyboards are not defined as hybrids).
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Perceptual Computing
Natural Intuitive Immersive
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Sociotechnical theory main principles 1. The interaction of social and technical factors creates the conditions for successful (or unsuccessful) organizational performance. This interaction consists partly of linear "cause and effect" relationships (the relationships that are normally "designed") and partly from "non-linear", complex, even unpredictable relationships (the good or bad relationships that are often unexpected). Whether designed or not, both types of interaction occur when socio and technical elements are put to work. 2. Optimization of each aspect alone (socio or technical) tends to increase not only the quantity of unpredictable, "undesigned" relationships, but those relationships that are injurious to the system's performance. Therefore sociotechnical theory is about joint optimization. They are usually based on designing different kinds of organization, ones in which the relationships between socio and technical elements lead to the emergence of productivity and wellbeing, rather than the all too often case of new technology failing to meet the expectations of designers and users alike. 10
Mýtus INDOŠ 2 se do zdravotnictví transformuje coby mýtus iZip 2 paradoxně označující odpor k povinnosti eRx. Pro obrovský kšeft na úkor lékařů a zdravotnictví sice nehlasoval nikdo z poslanců ČSSD a KSČM, ale když se k hlasům všech poslanců TOP 09 přidaly hlasy ODS (Hegerův zákon ale nepodpořili například premiér Nečas nebo exprimátor Bém) a LIDEM, pak stačila zrada 8 poslanců Věcí veřejných, kteří Hegerův návrh podpořili, ač se jinak tváří jako opozice, k zisku 101 a více hlasů k prosazení „IZIPU 2“. MUDr. Milan Kubek, prezident ČLK, mailing členům ČLK 20.2.2013 Povinné elektronické recepty ministr Heger prosadil - profesní likvidace lékařů seniorů, kteří nepracují na počítači
Koncepce eHealth nebo duplicitní součásti Health 2.0 infrastruktury? 1. výměna zdravotnické dokumentace 2. zdravotnický portál 3. manažerský informační systém 4. registr radiační zátěže Koncepce (lat. conceptio, početí)
pojetí, způsob výkladu, chápání, základní hledisko, vůdčí idea, myšlenková osnova, hlavní záměr či myšlenka 12
Korelace kvality nemocnic a spokojenosti zaměstnanců s NIS
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Healthcare Spending is Concentrated on Small Percentage of Population
Source: Kaiser Family Foundation calculations using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), Household Component, 2009.
For more…
www.intel.com/healthcare/coordination
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Coordinated Care
For more…
www.intel.com/healthcare/coordination
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Preventivní systém ITAREPS • ITAREPS (www.itareps.com) vyvinut Psychiatrickým centrem Praha. • Účastníci (pacient a rodinný příslušník) podávají týdně systému pomocí SMS strukturovanou zprávu o aktuálním zdravotním stavu. • Data jsou ukládána na centrální serveru, kde jsou automatizovaně vyhodnocena pomocí unikátního matematického algoritmu (Katedra kybernetiky ČVUT), který zhodnotí riziko výskytu relapsu onemocnění. • Blížící se relaps a nutnost farmakologické intervence program automaticky oznamuje ošetřujícímu lékaři pomocí e-mailu. • dokáže předpovědět hrozící relaps cca 7 týdnů před vlastní událostí, a to se srovnatelnými predikčními vlastnostmi, jaké má EKG v diagnostice akutního infarktu myokardu. 16
Preventivní systém ITAREPS Ekonomické aspekty • snižuje o 70% počty psychiatrických hospitalizací a hospitalizačních dnů • analýza nákladů a přínosů: •
každá koruna vložená do výkonů spojených s programem vyprodukuje celkem 2,90 Kč přímých hospitalizačních úspor
• modelace úspor: • • • •
reprezentativní průzkum v letech 20082009 programu by se zúčastnilo 60% oslovených pacientů s psychotickým onemocněním. extrapolace na celkovou populaci pacientů s psychózami v ČR (cca 100 tis. nemocných) po odečtení veškerých nákladů programu roční úspory 740 mil. Kč.
Současný stav • 900 pacientů od 2003 • funguje v ČR, SR a Japonsku, • 1.1.2012 byl projekt zařazen pod kódy 35201, 35203, 35205 do Seznamu zdravotních výkonů. • VZP odmítá kódy nasmlouvat a proplácet.
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Virtual Incubator for premature newborns •
Innovative Idea and Concept Development •
Petr Krcho MD, PhD
- Chief Physicians, Department of Neonatology Children’s Teaching Hospital Kosice
• POC goals • accelerate the availability, security and clarity of digitally stored data from critically ill newborn’s EMRs. • fast overview of USG and EMR documentation in critical situations for rapid onsite evaluation of the treatment efficiency.
• Technology: • Intel • Core i5, Xeon E3, HD Graphics 3000 • Centrino® Advanced-N 6230 with Widi Support • Samsung • XE700T1A Series 7 Slate PC, Flat Screen with Widi • Microsoft • Windows 8. Office 2010, Exchange Server, .NET • GE Healthcare • Digital USG
Virtualization transmits patient data to various devices according to provided intensive care setting and clinical team needs.
Clinical benefits • Virtualization of multimedia from medical diagnostics systems into a single screen increasing care efficiency and safety e.g. reduction of prescribed antibiotics due to improved monitoring processes. • Enabling remote diagnostics and treatment from senior doctors supporting junior physicians on duty, e.g. from home. • MPOC access to USG multimedia and EMR data improving decision making process in clinical teams during casuistic consultations. • Multimedia combined with clinical data increasing quality of medical students as well as junior physicians professional education.
Intel Across Healthcare: Learn More
www.intel.com/healthcare
[email protected] 20
