TELEWORK IN MEDICINE AND BUSINESS

ROSAS ROSAS CONSULTANCY & MANAGEMENTCONSULTANCY & MANAGEMENT

INTRODUCTION ROSAS• COMPLETED MISSIONS ABOUT MANAGEMENT IN:

☛ OPERAHOUSES OF CHELYABINSK (OERAL) AND RIGA (LATVIA), ☛ THE THEATRE OF KURGAN (OERAL), ☛ THE CULTURAL DEPARTMENTS OF GORLOVKA (DONBAS) ☛ SOUTH-SULUWESI (INDONESIA) FOR THE LOCAL GOVERNMENT OF GOWA

• CONSULTANCY FOR DUTCH COMPANIES• INTERIM-MANAGEMENT• DEVELOPING OF SOFTWARE• ORGANIZING MANAGEMENTS COURSES• TEACHING TEACHERS (DIGITAL DRIVER LICENCE)• TRADE (IMPORT AND EXPORT)

CONTENT OF PRESENTATION

• THE FIRST LARGE SCALE TELEMEDICINE TRIAL – ZHU LING’S CASE

• THE BIRTH OF HON IN 1995• TRENDS IN BUSINESS• HEALTH CAST 2010• DUTCH STUDIES TELEMEDICINE• THE FUTURE CARE CONSUMER• PRACTICAL EXAMPLES (COMMERCIAL AND

NON COMMERCIAL)

The First Large-Scale International Telemedicine Trial

to China: ZHU Ling's Case

ZHU Ling's Case

• On April 10, 1995, a SOS e-mail message was sent from Peking University through the Internet to ask for help for a young female university student, ZHU Ling, suffering an unknown but severe disease.

• The message was widely spreaded and since then one has received over 2,000 e-mail replies from 18 countries and regions and the Internet has played a very important but complicated role in Zhu Ling's life

ZHU Ling's Case• Dr.Shunwei Li,

Chairman of Dept. of Neurology at PUMC, made a conjecture of thallium poisoning. But his guess was not put to scientific test and soon was denied by some famous toxicologists in Beijing. Since then, they had not considered that possibility

• 84 persons worldwide made the correct diagnosis by themselves or by their friends who were consulted in the order of being received by Beijing University

• ZHU Ling had a thallium poisoning

THE BIRTH OF HON IN 1995

• 64 telemedicine experts gathered together in Geneva on an invitational conference “The use of the internet for telematics in healthcare”

• They founded the “Health on the Net Foundation”(HON)

• The foundation has a highly qualified and highly respected medical site: www.hon.ch

HEALTH ON NET FOUNDATION (HON)

• HON Code of Conduct (HONcode) for medical and health web sites

• 2.800 e-health sites adhere the Honcode

TELEMEDICINE

• Telemedicine definition:

Delivery of health services via remote telecommunications. This includes interactive consultative and diagnostic services.

• Also used terms: telehealth, online health and e-health

TRENDS IN BUSINESS

• GLOBALISATION• NEW TECHNOLOGY• SERVICE ORIENTATION• NEW RELATIONS

BETWEEN ORGANISATION AND EMPLOYEES

• EMPLOYABILITY• ORGANISATIONAL

CHANGE

NEW TECHNOLOGY

• MORE AND SMALLER COMPUTERS:• 80% OF WORK WITH COMPUTERS• ROBOTISATION• USING COMPUTERS FOR

COMMUNICATION• INTERNET, INTRANET, EMAIL• DATABANKING: NEW INFORMATION

FEEDBACK SYSTEMS, KNOWLEDGE MANAGEMENT

• NEW FORMS OF COLLABORATION USING COMPUTERS

HEALTHCAST 2010

• International study of Price Waterhouse Coopers

• Key point is the empowerment of the consumer/patient

• Empowerment thanks to the increasing acces to the telemedicne internet sites

• New technology will be focussed on self diagnoses, self care and home care

• Other international surveys confirm the trends

DUTCH STUDIES

• 3 STUDIES:

• 1. National Board of Health and Care, 2. The Association of Dutch Hospitals 3. The State institute for Health and

Enviroment

• In all studies is the key issue the increasing main role of ICT in health and care

DUTCH STUDIES

• The National Board of Health and Care is focussed on the internet

• Use the possibilities of e-health to deliver care of high quality, easy accessable and cost effectivity

DUTCH STUDIES

• The study of the Assiciation of Hospitals is concentrating on the hospital of the future

• Here are the key factors: telemedicine can contribuate to solve problems in care, like hospital waitinglists and lack of personal

DUTCH STUDIES

• The report of the State Institute voor Health and Enviroment has a high expectation about telemedicine and telecare in home care

• Specialy in optimising the efficiency

DUTCH STUDIES

• Main problem for future is the ageing of the population and the lack of (qualified) personal

• The demand for care increases in 2010 for 30 % and the supply (of personal) will decrease with 2 % per year

• So there are high hopes, that better, cheaper and more effective care are under reach.

DUTCH STUDIES

• Telemedicine will play a main role

• The patient will be better served

• The care is moving to the home of the care demander

• The comsumer/patient has a mighty weapon: the internet

• The main issue is the standarisation and the quality of the information

• The example of HON is one of the best

TECHNOLOGY PULL AND PUSH

• ICT-businesses are pushing supply

• Huge market potentials

• In 2005 30 Milliard Euro

• Technology pull is about about the demand in the market

• In the Dutch studies one sees telemedicine as an answer on shortage problems and about organizitional matters

THE FUTURE CARE CONSUMER

• The consumer/patient will act as a good informed and self-assured demander in de health market

• 5 trends are to be highlighted

THE FUTURE CARE CONSUMER

• The patient wants to be interdependent of the doctor

• The internet will be used for a second opinion, self diagnose and self care

• The patient will push doctors to improve their medical skills

• The patient shall push the pharma branche for better drugs

• The patient demands an increasing quality garantee of medical service

EXAMPLES IN PRACTICE

• Commercial• Philips Medical

Systems

• Non commercial

STATE OF THE ART MEDICATION

• Healt Base is an impressive databank with medical and pharmaceutical info

• Sources: national and international files (like WHO)

• Constant input from GP and Pharmacists

• 1390 GP, 701 Pharmacies, 200 local health servers

PROTECTION OF PATIENT

• Drugs can cause side effects

• In the medicom software is implemented a warning system against this effect

EXAMPLE• A patient has an allergy• The GP provides a presciption for terfenadine for

this allergy• The patient also has a irregular heart beat• The cardiologist provides a presciption for

verapamil• The pharmacist queries the database and sees

that the combination of the 2 drugs can cause a very dangerous disturbing of the heart beat

• He contacts the GP immediately and together they decide to provide another save drug for the allergy

THE HARDWARE

THE HARDWARE

• City of Goirle• 20.000 inh.• 6 practices (8 GP)• 2 pharmacies• Patient gets a

discription for a drug from the GP, enters the pharmacy which already has an on line copy and takes the drugs home

PERSONAL HEALTH INFORMATION SYSTEM

• The GP is storing the data of the patient in a electronic file

• This file is in principle accessable for the medical specialist in the hospital

• Patient is directed by the GP to a specialist• Specialist informs the GP about the care

program• When the GP is on leave the substitute can

access the file

TELEWORK IN MEDICINE AND BUSINESS

ROSAS ROSAS CONSULTANCY & MANAGEMENTCONSULTANCY & MANAGEMENT