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Smart Healthcare: Digitization transforming health(care)
Hans HofstraatVice President, Philips ResearchMember Supervisory Board, EIT HealthJune 2, 2016
March 05, 2014 Philips Design Confidential2
Macro trends driving healthcare needs
Increase in life expectancy
100% increase 1 out of 2 Shortage of
+ 18 years 0.2 doctors and 2 healthcare workers per 1,000 people in sub-Saharan African
German hospitals makes a loss
90,000+physiciansin the US by 2020
From 11% in 2000 to 22% in 2050
of # of people >60
Between 1950 and 2050, globally
246 million people with diabetes, increasing to 380m in 2025
Private Healthcare growing fastest in
Emerging Markets
March 05, 2014 Philips Design Confidential3
Healthy life expectancy by gender
Source: KSH Statisztikai Tükör, Egészséges várható élettartam, 2015
Hungary:• Women: 60,5 years• Men: 59,2 years
Best results:• Women: 72,2 years
(Norway)• Men: 71,9 years
(Malta)
About 10 years shorter than life expectancy
March 05, 2014 Philips Design Confidential4
Need for transformation of Health(care)
Meaningful solutions to deliver better care at lower costs
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Need for transformation of Health(care)
Digital Healthcare
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Digital technologies enable new solutions and services
Internet of Things Big data Virtual physiological human
Data analytics & semantic reasoning
Computational physiology & biophysical modeling
Machine to machine communication & control
The digital revolution will enable industrialization and personalization of care across the continuum
Connectivity and digital shifting value from devices to software and services
March 05, 2014 Philips Design Confidential8
From products to solutions on a common platform
Our journey
Hardware
Software
Services
HSDP
Solution components
Value migration to more software, services and solutions; from Philips and partners
HSDP is not the solution, it is the platform for interoperable solutions
Seamless User
Experience
Partner components
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Building integrated solutions on top of HSDP
Philips and3rd Party HardwareSoftware Services
Seamless user experience
Consumer & Professional healthcare functionality (API)
Collaboration cloud
Connected device cloud
Secure data cloud
Identity and permission control
HealthSuiteDigitalPlatform
Data layer: user – device – health records
Cleaning
Integration
Analysis
Interpretation
Acquisition
The data lifecycle
Hardware infrastructure
Platforms& tools
Advancedalgorithms
From descriptive to prescriptive applicationsClinical application requires validation
• How to achieve best outcome?• Which actions to take?• What will happen if?
Prescriptive
• What will happen next?• Why will it happen?
Predictive
• What happened?
Descriptive
Adva
nced
An
alyti
cs
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What are we talking about?Data Challenges
o Volume Handling terabytes of data
o Velocity Do processing of data streams, do real-time analysis
o Variety Integrate structured and unstructured data,
multimodal, complex datao Veracity
Deal with authenticity, trust, uncertainty, provenanceo Valuation
From big data analytics to meaningful innovations
March 05, 2014 Philips Design Confidential14
Big data in Philips
6,000,000 patients monitored in their
homes every day
18 petabytes of imaging study data managed for healthcare providers
250 million appliancessold each year making homes healthier
Hundreds of thousands of people tracking their health with ActiveLink®
Last year 6.5 millionpeople improved their oral health with our oral healthcare products
101million lives improved globally through access to diagnostic X-Ray
275 million patientstracked with our patient monitors in 2014
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Big data in Philips
6,000,000 patients monitored in their
homes every day
18 petabytes of imaging study data managed for healthcare providers
250 million appliancessold each year making homes healthier
Hundreds of thousands of people tracking their health with ActiveLink®
Last year 6.5 millionpeople improved their oral health with our oral healthcare products
101million lives improved globally through access to diagnostic X-Ray
275 million patientstracked with our patient monitors in 2014 VOLU
ME
March 05, 2014 Philips Design Confidential16
Healthcare Smart Maintenance
Philips sells medical imaging systems (CT, MR, iXR, etc.), often with service contracts.
Improving maintenance can lead to substantial benefits:1. less unplanned downtime2. lower total cost of ownership
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data integration
live imaging systems log data
historical imaging systems log data
repositories
data analysis
predictive & decision
modeling
maintenance alert & action
business value
From reactive to predictive service using big data
Healthcare Smart Maintenance
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Big data in Philips
6,000,000 patients monitored in their
homes every day
18 petabytes of imaging study data managed for healthcare providers
250 million appliancessold each year making homes healthier
Hundreds of thousands of people tracking their health with ActiveLink®
Last year 6.5 millionpeople improved their oral health with our oral healthcare products
101million lives improved globally through access to diagnostic X-Ray
275 million patientstracked with our patient monitors in 2014
VELOCITY
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From real-time data to actionable insights
Real-time data
Data-driven insights
Actions suited to your needs
March 05, 2014 Philips Design Confidential2020
Big data in Philips
6,000,000 patients monitored in their
homes every day
18 petabytes of imaging study data managed for healthcare providers
250 million appliancessold each year making homes healthier
Hundreds of thousands of people tracking their health with ActiveLink®
Last year 6.5 millionpeople improved their oral health with our oral healthcare products
101million lives improved globally through access to diagnostic X-Ray
275 million patientstracked with our patient monitors in 2014
V A R I E T Y
March 05, 2014 Philips Design Confidential21
10-50% overtreatment & difficult to assess response3
Cancer Care is facing many challenges that drive up costs and impact outcomes
Sub-optimal decision in diagnosis and treatment planning…
...Complications and readmission
25% of decisions are sub-optimal1
…Incorrect or over-treatment…
…Low productivity …
15-30% of clinician time can be saved2
20-30% readmission rates4
PreventionHealthy living Diagnosis Treatment Home careHelp people to live a
healthy life in a healthy home environment
Enable people to manage their own health
Ensure first time right diagnosis with personalized and adaptive care pathways
Enable more effective therapies, faster recovery
and better outcomes
Support recovery and chronic care at home
1. American health and drug benefits (ASCO) 2013, JAMA Intern Med, 20152. International Journal of Health Services - 20153. The Definition of “Cancer” May Be Narrowed to Prevent Overtreatment of Harmless Tumors - 20134. NICE study in UK - 2009, “Emergency Room Visits and Hospital Admission Rates After Curative Chemotherapy for Breast Cancer”
Journal of Oncology Practices, 2015
The role of integrated information solutions will be critical in addressing these challenges.
Cancer mortality rate
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Definitive DiagnosticsImaging Precision biopsy Digital pathology Genomics
Detection, Localization and Staging
Targeted MR/ultrasound biopsy
Digitization of tumor analysis
Personalized therapy by identifying cancer pathways
Imaging Targeted biopsy Digital pathology Genomics
Integration of precision diagnostics and therapy decisions
Integrated Prostate CancerSolution‘Dashboard’
ResearchPrototype
Urologist / Oncologist
(Metastatic Prostate Ca)
Urologist / Risk Scoring
Very low risk / Low risk
vs.
Intermediate / high risk
Pathologist / Tumor ID and Grading
Radiologist / Urologist (Precision) Biopsy
Urologist / Diagnosis
Prostate cancer diagnostic & treatment flowDeath due to other reason
Death due to prostate cancer
Surgeon / Rad Onc (low risk)
Surgeon / Rad Onc (Intermediate / high risk)
Active Surveillance
BrachyTherapy
Wait & check
Prostatectomy
Roboticprostatectomy
Wai
t & c
heck
External BeamRadiation Tx
protons
Wai
t & c
heck
Treatment selection
no c
ance
r rec
urre
nce
no c
ance
r rec
urre
nce
no cancer recurrence
Lymph nodedissection
Hormone Tx + External Beam
Operation + External Beam
External Beam / protons
Surgery
HormoneTherapy
Wai
t & c
heck
Wait & check
local with extended disease (> T2b Mx Nx)
metastasis (T4 M1 N1)
no c
ance
r rec
urre
nce
HormoneTherapy
ChemoTherapy
Wait & check
repeatbrachy
oper
ate
met
asta
sis
cancerrecurs
canc
er
met
asta
sis
Cancer recurs
Cancer recurs
no cancer recurrence
Cancer metastasis
metastasis
(locally) advanced
Can
cer r
ecur
s
surgery
Rad
iatio
n
met
asta
sis
Both tests not suspicious
(Regular) PSA & DRE
DRE abnormal, PSA low: BPH,
infection, cancer
DRE abnormal, PSA high
Biopsy
Template Biopsy
Tumor -
Biopsy not done
Targeted Biopsy
mp MRI
TRUS
Pathology
Tumor +
Low grade
Intermed grade
high grade
Minor decision point (requires a local solution) Major decision point (requires an integrated solution)
localized
No of biopsies
Patie
nt
pref
eren
ce
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Integrated Prostate Cancer Suite
ProstAid
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Big data in Philips
6,000,000 patients monitored in their
homes every day
18 petabytes of imaging study data managed for healthcare providers
250 million appliancessold each year making homes healthier
Hundreds of thousands of people tracking their health with ActiveLink®
Last year 6.5 millionpeople improved their oral health with our oral healthcare products
101million lives improved globally through access to diagnostic X-Ray
275 million patientstracked with our patient monitors in 2014
V E R A C I T Y
Veracity: authenticity, trust, uncertainty, provenance
DATA
Analytics engines
DECISIONS
?
Is this data reliable?
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Patient / device authentication and data quality
Home Hub
GP RecordTelehealth record
MD1
Biometric authentication Data + SigK
Data + SigK
Bob
Data + SigK
REFERENCES:• Sokratis Vavilis, Nicola Zannone, Milan Petkovic: Data reliability in home healthcare services. CBMS 2013: 377-380 • Jorge Guajardo, Muhammad Asim, and Milan Petković, Towards Reliable Remote Healthcare Applications Using Combined Fuzzy Extraction,
(Information Security and Cryptography), Springer, 2010
K BobMD1
Data + Quality indicationPAL1050
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March 05, 2014 Philips Design Confidential2929
Big data in Philips
6,000,000 patients monitored in their
homes every day
18 petabytes of imaging study data managed for healthcare providers
250 million appliancessold each year making homes healthier
Hundreds of thousands of people tracking their health with ActiveLink®
Last year 6.5 millionpeople improved their oral health with our oral healthcare products
101million lives improved globally through access to diagnostic X-Ray
275 million patientstracked with our patient monitors in 2014
V A L U E
March 05, 2014 Philips Design Confidential30
Valuation• From big data analytics to
meaningful innovation• Proven outcomes• Reimbursement (in the real world)!
Patient Monitoring in the ICU today
Digital monitoring platform: • All basis measurements
plug and play
Transforming from “box” to smart solutionWearable sensing, smart alarms, clinical decision support, tele-ICU
• Mobile• Low acuity• Older• Chronic• Co-morbidities • Personalized
therapy• Therapy
effectiveness
• Shortage of staff
• Less trained staff
• e-ICU
Physiological background knowledge
Alarm management and
pathophysiological state description
Physicians and nurse
Clinical observations laboratory results, etc.
Contextual interpretation
Vital sign monitoring
Therapeutic actions
Signals
Patient
From ICU towards Ubiquitous Monitoring
ECG, Respiratory Rate, Blood Pressure, Oxygen Saturation, Temperature, etc.
Respiration Rate, Heart Rate, Activity, Posture, more prone to artifacts
Sports, work, sleep …
ICU
General wardRespiration Rate and Heart Rate should be monitored
Similar to general ward, but the subjects are more mobile
Home care, telemedicine
FitnessWellbeing
Critical care ICU population
Everyone
Acute care
All hospital patients
Disease management
A first step: IntelliVue Guardian SolutionAutomated Early Warning Scoring1 in General Wards
Cableless SpO2
Cableless NBP
Cableless Respiration / Pulse
IntelliVueMP5SC
Spot-check monitors
IntelliVueCableless
Measurements
IntelliVue Guardian Software
1 Early warning score is based on Heart Rate, SpO2, Systolic Blood pressure, Temperature, Respiration rate, Consciousness level
Time window where trend analysis could have
predicted the deterioration
Alarms on the general ward?
HR Alarm limit = 110
Time (Hrs)
Start of deterioration
Alarms triggered
Alarms only warn you when the deterioration has already happened.On General Ward, with slow deteriorating patients, we would lose hours of valuable time if we rely on alarms.
– Christopher Subbe, MD
Celebration HealthA premier healthcare facility in Orlando, Florida (part of Adventist Health)
* Stephen Knych MD, et al. Implementation of a Multi-System Solution to Identify the Clinical Deterioration in Patients on the Medical Surgical Unit. National Patient Safety Conference, 2013.
A 92% improvement in notification time was demonstrated between the recognition of clinical deterioration and activation of the Rapid Response Team. The actual data revealed improvement from a pre-implementation time of 19.6 hours (SD 1020 min) to 1.47 hours (SD 153 min) from vital sign instability to Rapid Response Team activation (P<.001). The decrease of the standard deviation also indicates a more uniform process of RRT activation.
Hospital-to-Home care delivery
Total cost reduction$27k/patient/year
Care coordination and remote patient monitoring for improved outcomes
…enabling programs to achieve relevant financial and clinical improvements1 Applications on HealthSuite Digital Platform…
eCareCoordinator for clinicians• Population health management and care
coordination• Remotely monitors patients’ vital signs
and health status• Monitors hundreds of patients
simultaneously and prioritizes need of care through data analytics
eCareCompanion for patients• Enables real-time communication with
care team• Health coach to patients with chronic
conditions like heart disease, diabetes, COPD, cancer
1 Source: LeadingAge CAST Report, Provider Case Studies 2013
2 Emergency Department
-38%
With solution
Baseline
-67%
Baseline With solution
Hospital visits ED2 visits
Less days in a hospital10.2/patient/year
Together with all stakeholders we can create solutions for better healthcare and for better health: quality of life
Clinical breath and depth of
experience
Expertise in actionable information
from data, leveraging the population, tailored
to individuals
Consulting, services and new business
models
Partnered for results
Innovative solutions that solve the most pressing challenges in healthcare today
EIT Health is supported by the EIT, a body of the European Union
EIT Health:a powerful alliance forhealthy living and active ageing
Our mission:EIT Health promotes entrepreneurship
and innovates in healthy living and active ageing, with the aim to
improve quality of life and healthcare across Europe.
EIT Health: leveraging the potential
One of the largest healthcare initiatives worldwide with more than 130 leading organisations, covering all areas of healthcare.
Industry
Public
University
Research
EIT Health• invests in Europe’s best
entrepreneurial talents and creative minds
• fosters the development and commercialisation of smart product and service solutions
4343
A strong partnership across Europe
Menno KokInterim CLC Director Belgium/Netherlands
CLC UK/Ireland
CLC FranceCLC Spain
CLC Belgium/Netherlands
InnoStars
CLC Germany
CLC Scandinavia
4444
A strong partnership across Europe
Menno KokInterim CLC Director Belgium/Netherlands
CLC UK/Ireland
CLC FranceCLC Spain
CLC Belgium/NetherlandsCLC Germany
CLC Scandinavia
InnoStars
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Take aways• We are in the midst of the digital revolution in health(care),
fueled by data.
• We are transforming now into a software and service company, on top of our strong base in hardware.
• Innovation needs to be more iterative, continuous and multidisciplinary. A user experience centric innovation approach facilitates this; Co-Create!
• Europe has a great opportunity to make healthcare systems more efficient and effective; if we all collaborate on a common platform and close the gaps.
• We are all architects of an interconnected and consistent health continuum; Collaborate!
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It’s not just technology
Prof. Lajos Mocsai, Testnevelesi Egyetem
March 05, 2014 Philips Design Confidential47