ET SYSTEME ÉLECTRONIQUE DE GESTION D’INFORMATION META BASE DE DONNÉES ET SYSTEME ÉLECTRONIQUE DE GESTION D’INFORMATION MÉDICALE ET DE SANTÉ CENTRÉE SUR LE PATIENT META BASE DE DONNÉES ET SYSTEME ÉLECTRONIQUE DE GESTION D’INFORMATION MÉDICALE ET DE SANTÉ CENTRÉE SUR LE PATIENT 2005 © medXchange Copyright Steve Roessingh 2001

Fournir des services de plus haute qualité Objectifs Clés Qualité des services médicaux Permettre des soins médicaux de haute qualité Données médicales du patient complètes et fiables Fournir des services de plus haute qualité Standardisation (dossier électronique, process qualité) Rationalisation des soins médicaux Permettre aux professionnels de santé d’être plus efficaces Réduction des coûts 2005 © medXchange

Aujourd‘hui: Échange des données médicale et le patient 2005 © medXchange

Échange des données médicale: medXchange et le positionnement du patient 2005 © medXchange

Dossier Médical Électronique Intégré - Une base puissante pour des nouvelles strategies de santé 2005 © medXchange

Meta banque de données centrée sur le patient HUB Meta Database 2005 © medXchange

Meta banque de données centrée sur le patient Profile d’Implant Dossier de Santé Personnel Dossier Médical Médecin Clinique Carte Optique Résultats Laboratoire Dossier Médical Spécialisé Carte Dentale Médicaments Distribuer Électronique Intégré medXchange proposes an information system that centralizes key health and medical data of the individual and manages the interfaces to distributed sources of specialized health and medical data. (e.g. Interfaces to Health Insurance information, Hospital records, specialized Clinical data servers, Clinical Laboratories etc.). medXchange also proposes a number of centralized data bases and applications to support the physician in Evidence Based Medicine, EBM and Therapy Planning and Disease – Case Management. 2005 © medXchange Copyright Steve Roessingh 2001

Meta banque de données centrée sur le patient Dossier Médical Médecin Dossier Médical Spécialisé Dossier Clinique Meta Banque de Données Résultats Laboratoire Médicaments Distribuer Donné Donné medXchange proposes an information system that centralizes key health and medical data of the individual and manages the interfaces to distributed sources of specialized health and medical data. (e.g. Interfaces to Health Insurance information, Hospital records, specialized Clinical data servers, Clinical Laboratories etc.). medXchange also proposes a number of centralized data bases and applications to support the physician in Evidence Based Medicine, EBM and Therapy Planning and Disease – Case Management. Résultat Résultat Carte Optique Carte Dentaire D M E I Profile de Santé Register d’Implant 2005 © medXchange Copyright Steve Roessingh 2001

Coût de santé - realité I: Explosion des coûts 2005 © medXchange

Santé realité II Redondance 1. Médecin de famille: Examen physique et laboratoire Résultat 1 2. Médecin specialiste: Examen physique et laboratoire Résultat 2 3. Hôpital: Examen physique et laboratoire Résultat 3 2005 © medXchange

Administration lourde Santé - realité III: Administration lourde 1. Médecin de famille: Examen physique et laboratoire 2. Médecin specialiste: Examen physique et laboratoire 3. Hôpital: Examen physique et laboratoire Laboratoire Assurance Patient 2005 © medXchange

Une approche Innovante de la Gestion de Santé Centralisation des données confidentielles Documentation médicale Dossiers fiables et exploitables Interface avec les systèmes d’information des cliniques (Laboratoire, Radiologie etc.) Gestion des cas et des maladies Lignes directrices pour la bonne pratique médicale Historique des profils PATIENT Interactivité des systèmes „medXchange“ provides secure communication between the individual, the healthcare professional, the hospital and clinic and the Health Insurer. The following services are offered: Personal health information and proactive health programs for the individual. The update of individual medical information by the Healthcare Service Provider. (Family doctor, specialist, therapist, nurse, hospital and clinic). Link to individual clinical medical records. Link to individual health insurance information and coverage. Statistical analysis and data mining on health information 2005 © medXchange Copyright Steve Roessingh 2001

Médical & Santé MÉDICAL SANTÉ Information médicale issue de sources existantes (examen détaillé, tests, médication, traitement, etc.) Lignes directrices personnalisées pour la bonne pratique médicale Médecine basée sur l’évidence (EBM) SANTÉ Information générale sur la santé de l’individu (historique, allergies, immunisations, environnement, habitudes, etc.) Over 40% of health and medical problems are caused by an individuals’ lifestyle and influenced by factors such as smoking and drinking habits, amount of weekly exercise, sleep (or lack of it), stress, living environment, etc. Health information and management is considered to be the actual and historical information about a persons lifestyle and other factors influencing his health or preventive health actions he has taken. This information greatly assists the physician in determining the cause of a medical condition, the diagnosis and the best treatments to prescribe. Medical information and management is based on scientific or Evidence Based Medicin such as accurate description in medical terms of symptoms, diagnosis, treatments, lab test and examination results, prescriptions etc. An accurate Health and Medical documentation of the individual is required in order for the healthcare service provider to be effective and deliver a high quality of healthcare treatment. 2005 © medXchange Copyright Steve Roessingh 2001

Spitex Rehabilitation Continuité des Soins Médecin Patient Médecin Spécialiste Deuxieme Opinion HIN Hôpital & Clinique Spitex Rehabilitation Laboratoire Distribution Médicaments D M E I 2005 © medXchange Copyright Steve Roessingh 2001

de Gestion Électronique de Santé individuelle” VISION “Système européen de Gestion Électronique de Santé individuelle” Le Fournisseur Européen de: Gestion du Dossier Médical Électronique Integré & des prescriptions Plate-forme de réseaux internationaux de médecins Bibliothèque des implants médicaux Assistance (centre d’appels médicaux & études cliniques) Accès au dossier de santé de l’individu par l’entreprise Gestion de santé de l’individu Our vision is to create Electronic Health Management Services and Electronic Medical Records for every European. Our Vision is also to: Be the preferred partner for Health Insurance Companies to provide Personal Health Management Solutions and Electronic Medical Records to their customers. Provide Medical and Practice Management Services for every Private Practice Physician Provide Corporate Health Support for every major European Company. Provide Electronic Support for every European Clinical Trial and Medical Research Program 2005 © medXchange Copyright Steve Roessingh 2001

Notre clièntele: le patient Assureurs de Santé / Santé Publique Intégration des produits & services existants Services médicaux innovateurs et interactifs Professionels de Santé Groupement médical Médecins généralistes et spécialisés Hôpitaux, Cliniques, Rehab, Spitex Médecine du Travail Conditions de travail Professions Études cliniques et médicales Suivi des traitements Industrie pharmaceutique Bibliothèque des implants médicaux Détail des implants médicaux Fabricants d’ implants The European medXchange market has been defined as several distinct segments grouped into 4 business units. Health Business to address Health Insurance Companies and Public Health sales. Medical Business aimed at Medical groups and hospital and clinic sales. Corporate Business focussed on Corporate Health Plan and Affinity Group sales. Pharma Business focussed on clinical studies for Pharmaceutical Companies and Clinical Research Organization. 2005 © medXchange Copyright Steve Roessingh 2001

Applications & prestations CORPORATE Analyse des risques de santé / lieu de travail Analyse des risques de santé / professionnels Suivi & historique des implants médicaux Documentation des implants & plannification IMPLANT Gestion des données d’études cliniques Bibliothèque des prescriptions PHARMA Documentation médicale & santé indviduelle Programmes de santé pro-actifs HEALTH Documentation médicale et ordonnance Gestion de maladies, plannification de thérapies MEDICAL 2005 © medXchange Copyright Steve Roessingh 2001

Dossier Médical Électronique Intégré D M E I Médical Médecin Dossier Médical Spécialisé Dossier Clinique Résultats Laboratoire Médicaments Distribuer Donné D M E I Donné medXchange proposes an information system that centralizes key health and medical data of the individual and manages the interfaces to distributed sources of specialized health and medical data. (e.g. Interfaces to Health Insurance information, Hospital records, specialized Clinical data servers, Clinical Laboratories etc.). medXchange also proposes a number of centralized data bases and applications to support the physician in Evidence Based Medicine, EBM and Therapy Planning and Disease – Case Management. Résultat Résultat Carte Optique Carte Dentaire Profil de Santé Registre d’Implant 2005 © medXchange Copyright Steve Roessingh 2001

Dossier Médical Électronique Intégré D M E I = I E M R Interoperabilité logique 2005 © medXchange

Exemples des applications Carte Optique Carte Dentaire Carte des Allergies Orthopédie Cardiologie Néphrologie medXchange has developed a number of applications that have been extensively tested in Switzerland. The Optic and Dental Card applications have been launched in Switzerland and are actively being marketed with healthcare industry partners. The other applications have been extensively tested by physicians and will be launched this year. 2005 © medXchange Copyright Steve Roessingh 2001

Protection des Données Médicals Traitement des données personnelles Droit d’acces Exactitude des données Anonymat des données Secret professionel Personal health data should only be stored on the express consent of the individual and the healthcare professional. This health data is stored in such a manner that it contains no nominative information and cannot be traced to the individual. The individual should be able to directly or indirectly access his own medical data unless restricted by the Healthcare Professional. The individual owns, and should be able to manage and control all information within his/her health record with the input of a healthcare professional for medical credibility and accuracy. Registered healthcare professionals with the express permission of the individual should enter all medical data. The individual should be able consult his own medical information and request the healthcare professional for any rectification of inaccurate medical data in the case of a contest. The individual can authorize any participating Healthcare Professional to access and update his medical data. This includes a replacing Healthcare Professional, a Healthcare specialist or a Healthcare Professional in another geography or country. Medical data should not be nominative and is only identifiable by codes known only to the individual and the healthcare professional of choice. Medical data can only be disclosed with the express permission and under control of the individual. Anonymous medical data is processed for statistical and research purposes. Medical data and statistics cannot be linked to an individual. 2005 © medXchange Copyright Steve Roessingh 2001

Technologie: Gestion de santé Securisée Standard SmartCard “access key” USB Key Access management Access tracking The information within medXchange applications, other than information strictly limited to emergency situations, does not contain any nominative data such as name, address or any other identifying information in order to ensure anonymity. medXchange has implemented a number of unique features to provide secure access, manage, track and certify medical information. Access to patient medical records is only through the Physician and Patient Smart Card, Password - User ID or through Patient Recognition. Certain data may only be entered and updated by accredited healthcare professionals. All updates are recorded and tracked to ensure medical credibility. Medical data is flagged to indicate that an accredited healthcare professional has certified it. Changes to the individual’s record are tracked and an electronic notification of such changes is sent to the individual. Medical approval status Electronic change notification 2005 © medXchange Copyright Steve Roessingh 2001

Respect des Normes & Standards Hopitaux Universitaires Suisses “Standard de Qualité pour les Dossiers Électroniques Patient” Normes Européennes des Protections des Données NRC Recommandations “Protecting Electronic Health Information” HIPAA Security & Privacy Standards „medXchange“ complies with the strictest data protection laws and regulations covering the protection of personal health and medical data. The „medXchange“ services implementation complies with and exceeds the U.S. National Research Council (NRC) recommendations for “Protecting Electronic Health Information”. Positive opinions have been received by the Swiss Federal Data Protection Commissioner and CNIL, the French Data Protection Commission. The „medXchange“ services are also expected to comply with the U.S. proposed HIPAA security and privacy standards and the Patient’s Bill of Rights. 2005 © medXchange Copyright Steve Roessingh 2001

Plate-forme médecin Accès réseaux PC Windows & Navigateur Internet Mini CD sauvegarde locale “PC de Poche” avec SmartPad Lecteur de carte a puce Carte a puce/USB Key médecin Carte a puce/USB Key patient Connexion Internet VPN HIN Health Information Network Accès réseaux An integrated Physician platform is offered to Healthcare Professionals based on a standard PC with Microsoft Windows, an Internet Browser and CD reader. For online access a SmartCard reader, an Internet Connection and optionally a simple digital camera “WebCam” with a Facial Recognition system is provided. Mobile computing is also available to the physician with a “hand-held” or “palm” computer coupled with a SmartPad for taking clinical notes. Mobile telephones with an Internet connection may be used for online access to the medXchange services. 2005 © medXchange Copyright Steve Roessingh 2001

Interfaces pour une interoperabilité technique Plate-forme médecin PC Windows & Navigateur Internet Mini CD sauvegarde locale “PC de Poche” avec SmartPad Accès réseaux Vito Data Kis klin.Inform.system Laborat.Unilabs Connexion Internet smart card, e-eprica, USB Key HIN Health Information Network An integrated Physician platform is offered to Healthcare Professionals based on a standard PC with Microsoft Windows, an Internet Browser and CD reader. For online access a SmartCard reader, an Internet Connection and optionally a simple digital camera “WebCam” with a Facial Recognition system is provided. Mobile computing is also available to the physician with a “hand-held” or “palm” computer coupled with a SmartPad for taking clinical notes. Mobile telephones with an Internet connection may be used for online access to the medXchange services. Interfaces pour une interoperabilité technique 2005 © medXchange Copyright Steve Roessingh 2001

Dossier Medical Électronique Intégré risques associés minimisés L’accès 24h/24 7j/7 (24/7) aux données médicales clés dans le Dossier Medical Électronique Intégré permet au médecin un traitement optimal du patient. examens et traitements médicaux dupliqués risques associés minimisés 2005 © medXchange Copyright Steve Roessingh 2001

Dispersed Information Hospitals Physician Health Insurers Consulting Physician Laboratories Pharmacy Clinics Rehabilitation Patient Even though in theory and legally all his health and medical data belong to the individual, this data is distributed and often not readily accessible between the physician, consulting physician, hospital, clinic, laboratory, healthcare professionals and several other sources. This distribution and fragmentation of individuals’ health and medical information often leads to: Incomplete or erroneous diagnosis. Unnecessary examinations and tests Superfluous treatments and medications Additional medical administration time and costs Lack of accurate documentation in malpractice suits 2005 © medXchange Copyright Steve Roessingh 2001

Rationalisation des Soins 30% Réduction des temps de recherche sur l’historique du patient 20% Réduction des temps de diagnostic 20% Réduction des examens et tests médicaux Médecins 50% Gestion & Administration du patient 30% Efficacité en temps de diagnostic d’urgence Hôpital & Clinique Advantages to the general healthcare system Through the availability of complete and accurate health and medical documentation of patients, the delivery of healthcare services can be rationalized thereby improving the quality and efficiency. This is particularly noticeable in the areas of emergency medical treatments, elimination of redundant medical exams and tests and less risks of contra-indications and negative reactions to medications and treatments. Key motivations for Healthcare Professionals Medical information management time and costs are reduced bringing greater efficiencies in researching patient medical histories and coming to a diagnosis. This allows the physician to reduce the time and his costs per consultation and frees up his resources to focus on treatments and consult more patients. Hospitals and Clinics use the medXchange to communicate and share medical and health insurance data enhancing the quality of healthcare and insurance services while optimizing costs. The Smart Card technology allows authentication of patient identity and immediate access to key health and insurance information. The medXchange services facilitate the implementation of comprehensive electronic patient and clinical records optimizing the management of patient related health and medical data. 2005 © medXchange Copyright Steve Roessingh 2001

Rationalisation des Soins 20% Efficacité de traitement des maladies d’urgence 25% Réduction des examens et tests médicaux 30% Réduction des risques liés aux médicaments Santé Générale 20% Raccourcir le temps de détection des problèmes 40% Réduction des coûts d’infrastructure 30% Réduction des coûts d’acquisition des données Étude Clinique & Médicale Advantages to the general healthcare system Through the availability of complete and accurate health and medical documentation of patients, the delivery of healthcare services can be rationalized thereby improving the quality and efficiency. This is particularly noticeable in the areas of emergency medical treatments, elimination of redundant medical exams and tests and less risks of contra-indications and negative reactions to medications and treatments. Key motivations for Healthcare Professionals Medical information management time and costs are reduced bringing greater efficiencies in researching patient medical histories and coming to a diagnosis. This allows the physician to reduce the time and his costs per consultation and frees up his resources to focus on treatments and consult more patients. Hospitals and Clinics use the medXchange to communicate and share medical and health insurance data enhancing the quality of healthcare and insurance services while optimizing costs. The Smart Card technology allows authentication of patient identity and immediate access to key health and insurance information. The medXchange services facilitate the implementation of comprehensive electronic patient and clinical records optimizing the management of patient related health and medical data. 2005 © medXchange Copyright Steve Roessingh 2001

Rationalisation des Soins 30% Réduction des risques de santé sur le lieu de travail 20% Réduction des risques de santé liés aux professions Médecine du Travail 40% Réduction en coûts d’audit du patient 10% Réduction des réclamations / accidents du travail 10% Réduction des coûts de soins médicaux Mutuelles Key benefits to Health Insurers By providing insured customers with comprehensive Electronic Medical Records, Health Insurers can directly gain efficiencies in the costs of customer medical claim audits and the investigation of alleged malpractice claims. Health Insurers benefit indirectly in an overal cost reduction of medical claims due to rationalization of the healthcare process. Key benefits to Corporate Health programs medXchange provides a number of medical applications and analysis programs to physicians to identify and track workplace health risks. The physician also has access to specific medical profiles to identify and track occupational health risk and provide better health counseling to employees. Benefits to Clinical Research medXchange provides pharmaceutical companies the data and information system support for patients and healthcare professionals participating in clinical and medical studies. The medXchange services for participating patients and healthcare professionals provide better and more efficient tracking and reporting of trials and studies. 2005 © medXchange Copyright Steve Roessingh 2001

Étude de rationalisation Example: Population of 5 Million 2005 © medXchange Copyright Steve Roessingh 2001

Implementation Example: Population of 5 Million 2005 © medXchange Copyright Steve Roessingh 2001

Return on investment Example: Population of 5 Million 2005 © medXchange Copyright Steve Roessingh 2001

Rationalisation des coûts Example: Population of 5 Million 2005 © medXchange

Meta banque de données centrée sur le patient access authorized by patient platform dedicated to healthcare professionals open standard for medical data exchange using existing technologies and investments 2005 © medXchange Copyright Steve Roessingh 2001

La meta-base de données centrée sur le patient Accès autorisé par le patient Plate-forme dédiée aux professionnels de santé Système ouvert à l’échange des données médicales Capitalisant sur les technologies et investissements existants 2005 © medXchange Copyright Steve Roessingh 2001