Harnessing Disruptive Technology in Healthcare

Transcription

1 Harnessing Disruptive Technology in Healthcare Case study in home healthcare point-of-care testing Dr. Malcolm Luker, VP & General Manager, Philips Home Clinical Monitoring The King s Fund Seminar April 30, 2013

2 Drawing on broad & deep clinical insights 190 million+ patients 190 million+ monitors patients monitored with Philips last year monitored with Philips patient monitors last year 4 million+ people sleep and breathe easier using our sleep aids 840,000 patients charted per year via IntelliSpace Critical Care software 390 million enterprise imaging studies archived, comprising 10 petabytes of storage 500 Ambient Experience installations globally enhance patient experience 1 million+ AEDs save lives in shops, schools, airports throughout the world 40 million babies come into the world every year with our fetal monitors We make a difference to millions of people across the continuum of care

3 Wireless data: a disruptive technology in healthcare Home Hospital Disruptive benefits Anytime: 24/7 always on information; facilitates early diagnosis/prevention Telehealth Centre Disruptive challenges Data overload: How can the right data be found to make the right clinical decisions? Anywhere: Information from any location Clinician/care provider coordination: Wireless data cuts across functional silos Patient empowerment: Enables home healthcare with focus on prevention Patient engagement: How do we ensure patients comply with therapies?

4 Case study: Remote Patient Monitoring (RPM) in oncology: Chemotherapy Adverse Events & Hospitalisation 4

5 The issue: Unplanned hospital admissions: challenge to payers / clinicians 5,135,794 emergency hospital admissions in England in 2009/10 Hospital Episodes Statistics (HES) 37% increase in emergency hospital admissions over last 10 years For cancer patients haematological, lung and urological tumours are highest users of emergency cancer bed days Resources and references

6 The approach monitoring White Blood Count in home to reduce chemotherapy adverse events: avoid hospital admissions Monitoring WBC during course of Chemo cycle ANC decrease and nadir duration are dependent upon therapy, dose and route of administration 7-14 days post chemotherapy * References by Gary Lyman Recovery period also dependent on regimen and patient status WBC indicates: when ready for treatment early recovery enables earlier scheduling for next course Detection of rapid fall in WBC: enables intervention with growth factors Depth of fall in WBC: if too low enables intervention with IV antibiotics avoid infection and hospitalisation (10-20 day length of stay) if too shallow - surrogate indication of whether chemotherapy having an effect.

7 Drivers impacting uptake of disruptive technology Example: RPM with Cancer Patient / care provider Clinician Home care Payer Technology

8 Drivers impacting uptake of disruptive technology Example: RPM in home healthcare Patient / care provider Is the patient motivated to test at home? Payer Home care Is the patient capable of carrying out the test? Will the patient understand the testing and monitoring regime? Does testing fit in with the patient s life style? Clinician Can issues seen with home vital signs monitoring be minimised? Is bi-directional connectivity to clinician (plus interpretation) an issue? Technology

9 Drivers impacting uptake of disruptive technology Example: RPM in home healthcare Patient / care provider Does RPM at home address clinician s needs? Clinician Does RPM free up clinician s resources? Home care Does clinician believe RPM results as reported by the patient? Is the RPM assay clinically accepted in the medical community? Does the clinician want to see all the data or just exceptions reports? Is the clinician able to provide feedback to their patients? Payer Technology

10 Drivers impacting uptake of disruptive technology Example: Point-of-care-testing in home healthcare Patient / care provider Is the RPM biomarker assay recognised? Does the Hospital laboratory endorse it? Will the testing be reliable & reproducible? What QC is involved? What feedback does the patient get that testing is OK? Payer Home care Connectivity: Mobile or home-based? What training is required / ease of use / plug & play? What fail safe / error codes? Portability & durability? Clinician Technology

11 Drivers impacting uptake of disruptive technology Example: RPM in home healthcare Patient / care provider Who pays for new care pathway? Home care Clinician Has the use of home testing been proven clinically & at what cost? What are the outcomes: benefits to payer and patient? Will it reduce my costs and/or improve patients quality of life? What is my investment cost payback time: Patients changing insurers < 3 years in USA No payback if > 2 years Benefit now or in next budget year? Payer Technology

12 Could RPM of cancer patients be cost effective/clinically valid? Economic model: Care pathway generated from Leeds PPM electronic patient data base (500K pts) Identified care states and incidence + costs Generated health economic model by Oxford University Health Economics > HCM monitoring provides a positive cost effective and improved care Leeds PPM Breast Cancer EC 90: Care States More costly / Less effective More costly / More effective Less costly / Less effective Less costly / More effective

13 Case study: RPM with patients on chemotherapy Have shown: Patients can reliably us in the home Clinicians endorse approach Technology works Laboratory support Cost effective But... Still need to find who pays & how (budget) How implemented (who owns process in NHS?) 13

14 The QIPP Agenda

15 Potential benefits of successful implementation

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