INTEGRATED ELECTRONIC MEDICAL RECORD IEMR AND MEDICAL KNOWLEDGE

INTEGRATED ELECTRONIC MEDICAL RECORD IEMR AND MEDICAL KNOWLEDGE BASE 16 February, 2003 med. Xchange© 2003 Private & Confidential 1

Continuity of healthcare Physician Second Opinion Consulting Physician Patient Centric Integrated Electronic Medical Record Medical Call Center Hospital & Clinic Therapists 16 February, 2003 Laboratories Dispensed Medication med. Xchange© 2003 Private & Confidential 2

Continuity of Healthcare The treating physician, consulting physician, hospital and clinic, dentist, optician, laboratory, therapist and pharmacist can share relevant patient information and documentation. 16 February, 2003 med. Xchange© 2003 Private & Confidential 3

Continuity of Healthcare Enabling the rationalisation of the healthcare process Reducing unnecessary medical examinations Eliminate redundancy of prescriptions Reduce risk of medication interactions and negative reactions Optimizing the hospital process and reducing hospitalization Avoiding delays in diagnosis and treatments Faster and better medical care at reduced costs Reduce risk of malpractice 16 February, 2003 med. Xchange© 2003 Private & Confidential 4

Management of "Risk Patients" Case – Disease management l Using Evidence Based Medecin, EBM and good medical practice Interface or data migration out of other medical information systems l Bio-sensors, laboratories, hospitals l Specialised medical documentation (Orthopedic, cardiology, nephrology, radiology) 16 February, 2003 med. Xchange© 2003 Private & Confidential 5

Patient Centric Meta Database Medical Information & Images Physician Medical Record Clinical Medical Records Medical Call Center Laboratory Results Input Dispensed Medication Meta Database Output Health Profile Health Cards 16 February, 2003 IEM R Output Disease Profile med. Xchange© 2003 Private & Confidential Implant Register 6

Integrated Electronic Medical Record Intuitively understandable by healthcare professionals worldwide Multi Language Ergonomically structured to physicians working methods Easy to consult by patient 16 February, 2003 med. Xchange© 2003 Private & Confidential 7

Patient support applications: Examples General patient support Optic-Card Dental-Card Audio-Card Allergy-Cardio-Card Diabetes-Card Nephro-Card Orthopedic-Card 16 February, 2003 med. Xchange© 2003 Private & Confidential 8

Disease related & health profile Patient group profile IEMR contains patient medical & health data and documentation Patient disease related profiles are created through case – disease support applications (e. g. diabetes, nephrology, cardiology ) Patient health profiles are created through occupational health and human ability building applications Disease related profile Health profile Patient group profiles are created for statistical analysis of patient groups 16 February, 2003 med. Xchange© 2003 Private & Confidential 9

IEMR: Ergonomic Structured to follow the medical process and working methods of physicians Comprehensive and up-to-date medical data and documentation ü Personalised according to existing patient data 16 February, 2003 med. Xchange© 2003 Private & Confidential 10

IEMR: Disease related data: Example of diabetes patient Blood sugar Blood pressure Blood coagulation Medication Calorie intake Physical activity Comments and notes may be entered with each value on a chart 16 February, 2003 med. Xchange© 2003 Private & Confidential 11

IEMR: Patient Documentation Patient documentation in the Integrated Electronic Medical Record, IEMR may consist of: Physician notes, letters and text documents Laboratory test and examination results X-Rays, scans, MRI, ECG, angiography, Echocardiography, Audiometrie, Visual performance, fundus of the eye, EMG, NCV, other medical imaging, etc. 16 February, 2003 med. Xchange© 2003 Private & Confidential 12

IEMR: Monitoring a diabetes patient Key diabetes indicators monitored with daily / monthly profiles Each of 5 key values entered in simple numeric format ü Glucose ü Ketone ü Insulin dosage ü Calory intake ü Activity level 16 February, 2003 med. Xchange© 2003 Private & Confidential 13

Case – disease support: Disease related profile A disease related profile of key medical indicators (e. g. blood sugar, blood pressure, insulin intake etc. ) can be established and followed over a day, weeks, months or years. 16 February, 2003 med. Xchange© 2003 Private & Confidential 14

Knowledge Base Patient Support Applications Evaluation of patients with high health risks or chronic illnesses Occupational health risk assessment Patient rehabilitation and behavioural support Clinical studies 16 February, 2003 med. Xchange© 2003 Private & Confidential 15

Patient data creation Structured IEMR data Library of templates Yes / No question templates Evaluation templates 16 February, 2003 med. Xchange© 2003 Private & Confidential 16

Patient data creation Structured IEMR data Measurement and value templates 16 February, 2003 med. Xchange© 2003 Private & Confidential 17

Knowledge Base: Rules Defined by experts Formulas applied to patient data Library of rules and formulas 16 February, 2003 med. Xchange© 2003 Private & Confidential 18

Disease and health risk analysis Disease related and health profiles Analysis of key medical risks l Supports case – disease management Analysis of overall health risks l Occupational health programs l Pro-active health programs l Behaviour support programs 16 February, 2003 med. Xchange© 2003 Private & Confidential 19

My. Habit: Human Ability Building Information Technology Evidence based guidelines for healthier lifestyle Behaviour support tailored to individual health profile Online support and feedback Monitoring and feedback of treatment adherence 16 February, 2003 med. Xchange© 2003 Private & Confidential 20

Healthcare sectors Risk Patients Personal Health Management Medical Registers Occupational Healthcare Consumer Protection 16 February, 2003 Integrated Electronic Medical Record med. Xchange© 2003 Private & Confidential Clinical Studies 21

Data Protection & Access Management EC Health Card or USB Key “access key” Patient controls access to record Certain data updated by patient Medical data certified by physician All data traced to source Physician can restrict access to data Physician & Patient notified of updates 16 February, 2003 med. Xchange© 2003 Private & Confidential 22

Healthcare Professional Platform Windows PC & Internet Browser CD Reader “Hand Held” Computer with Smart. Pad Online Access Internet connection Professional Health Key Patient Health Key 16 February, 2003 med. Xchange© 2003 Private & Confidential 23

Healthcare Rationalization Patient Greater medical security – one IEMR Improved healthcare treatment Improved quality of healthcare Optimization of healthcare services u u Early warning system in case of problems with medical implants and drugs Supervision of compliance with medical regulations 16 February, 2003 med. Xchange© 2003 Private & Confidential 24

Healthcare Rationalization Physician 30% reduction of patient history research time 20% reduction in patient diagnosis time 20% reduction of medical exams and tests Hospital & Clinic 50% efficiency of patient admission processing time 20% reduction of medical exams and tests 30% efficiency in diagnosis time for emergencies 16 February, 2003 med. Xchange© 2003 Private & Confidential 25

Healthcare Rationalization Occupational Health 30% reduction of workplace health risk 20% reduction of occupational health risk Health Insurers 40% decrease in patient audit costs 10% reduction of malpractice claims 10% reduction of medical costs 16 February, 2003 med. Xchange© 2003 Private & Confidential 26

Healthcare Rationalization General Healthcare 20% reduction of disease emergency treatments 25% reduction of medical exams and tests 30% risk reduction of medications Clinical & Medical Studies 20% shortening of time to detect problems 40% clinical study infrastructure cost reduction 30% reduction of data gathering and reporting costs 16 February, 2003 med. Xchange© 2003 Private & Confidential 27

The IEMR & Medical Knowledge Base ü Designed by physicians for physicians ü Complete patient medical data and documentation ü Follows physician working methods ü Patient disease support and profile ü Patient pro-active health support and profile ü Disease and health risk analyis 16 February, 2003 med. Xchange© 2003 Private & Confidential 28