smart healthcare – hogyan pörgeti fel az it az egészségügyet – hogyan válik a bigdata a...

1

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


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


Need for transformation of Health(care)

Meaningful solutions to deliver better care at lower costs

http://www.google.nl/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&docid=6ZWQwF-LmAG_3M&tbnid=LaT0IsXfDxYSTM:&ved=0CAUQjRw&url=http://connectingdirectors.com/articles/41287-cremations-past-and-future-canas-centennial-convention&ei=6A5-U_jZMeaNywP354CYDg&bvm=bv.67229260,d.bGQ&psig=AFQjCNEZGJJUbzrQkrxIJodOrTH1Q7Hr8A&ust=1400856630885200


Need for transformation of Health(care)

Digital Healthcare

http://www.google.nl/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&docid=6ZWQwF-LmAG_3M&tbnid=LaT0IsXfDxYSTM:&ved=0CAUQjRw&url=http://connectingdirectors.com/articles/41287-cremations-past-and-future-canas-centennial-convention&ei=6A5-U_jZMeaNywP354CYDg&bvm=bv.67229260,d.bGQ&psig=AFQjCNEZGJJUbzrQkrxIJodOrTH1Q7Hr8A&ust=1400856630885200


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


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


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


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


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


Big data in Philips


homes every day






275 million patientstracked with our patient monitors in 2014 VOLU

ME


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


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


Big data in Philips


homes every day







VELOCITY


From real-time data to actionable insights

Real-time data

Data-driven insights

Actions suited to your needs


Big data in Philips


homes every day







V A R I E T Y


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


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

24

Integrated Prostate Cancer Suite

ProstAid

26

Big data in Philips


homes every day







V E R A C I T Y

Veracity: authenticity, trust, uncertainty, provenance

DATA

Analytics engines

DECISIONS

?

Is this data reliable?


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

19


Big data in Philips


homes every day







V A L U E


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


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!


It’s not just technology

Prof. Lajos Mocsai, Testnevelesi Egyetem

smart healthcare – hogyan pörgeti fel az it az egészségügyet – hogyan válik a bigdata a...

Health & Medicine