Insights Series Issue 10: "Remote work for healthcare professionals"

This thought leadership paper offers five steps healthcare providers can and should take to implement remote work within their organizations.

Insights Series Issue 10 transforming-care-delivery The New Normal XI Remote work for healthcare professionals: From a stop-gap measure to a lasting transformation A thought leadership paper on how to ‘Transform care delivery’ SIEMENS Healthineers Preface The Insights Series The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. The Series explores emerg- ing issues and provides you with practical solutions to today’s most pressing healthcare challenges. We believe that increasing value in healthcare – delivering better outcomes at lower cost – rests on four strategies. These four principles serve as the cornerstones of the Insights Series. Expanding Transforming Improving Digitalizing precision care patient healthcare medicine delivery experience The New Normal The New Normal is a special edition of our Insights Series focusing on the COVID-19 pandemic. This series provides recommendations on how to confront the current SARS-CoV-2 outbreak and its implications, as well as strategies and ideas on how to emerge from the current crisis stronger, more resilient, and better prepared to address the healthcare challenges that lie ahead. Please visit Paper Remote work for healthcare professionals Executive summary As the healthcare sector works to transform care delivery in the wake of the current pandemic, what lessons can The ongoing challenge of transforming hospitals and other caregivers learn? What are the most care delivery has been given new urgency effective ways to take advantage of the opportunities presented by remote work in the long term? What are the and heightened importance as a result of dimensions of remote work and where in the healthcare the COVID-19 pandemic. sector can it achieve the greatest impact? Caregivers across the globe have struggled to treat those These are some of the questions addressed in this paper. infected by SARS-CoV-2, while at the same time protecting It looks at real-world examples of how remote work their own health and that of other patients, often with currently functions, and provides clear recommendations stretched resources, uncertain public health guidelines, on how it can contribute to more effective care delivery dramatically increased caseloads, and in highly stressful in all types of healthcare organizations – insights that are working conditions. particularly valuable at this transformational moment. If there is a thin ‘silver lining’ to the coronavirus outbreak, The paper concludes that the benefits of remote work can it is that this unprecedented challenge has produced be significant, for employers, employees, and for patients. remarkable examples of frontline innovation, creative A deeper understanding of these benefits provides a com- solutions for a more efficient allocation of resources, pelling argument for why remote work solutions should and new approaches to patient care. be integrated into the plans and infrastructure of health- care providers. Many industries and sectors have been transitioning to- ward increased remote work over the past years, supported by technology that allows employees, suppliers, custom- ers, and others to perform their work, regardless of where COVID-19 has accelerated the adoption they are physically located. Yet healthcare has been slow to of remote work solutions adopt this growing trend. Acceleration COVID-19 has changed that. Remote work in the health- care sector has emerged as one of the most effective ways to mitigate coronavirus infection rates, access neces- sary medical expertise, maximize resources, streamline treatment of patients, and allow employees to continue working even when under quarantine and forced to re- Slow adoption main at home. Before March 2020 Siemens Healthineers Insights Series · Issue 10 3 Remote solutions ... bridge distances ... ... Near meters Far kilometers Introduction The COVID-19 pandemic has shifted the transition to remote work into overdrive. TIME magazine called the The COVID-19 situation has resulted in emerging phenomenon “The world’s largest work-from- extraordinary changes in the way we shop, home experiment,” pointing out that as a result of the coronavirus outbreak working from home is “no longer a work, consume entertainment, socialize, privilege, it’s a necessity.”³ Data also illustrates the enormity and communicate. Because of mandatory of the recent changes. During the early weeks of the pan- restrictions on travel and group gatherings, demic, the daily time spent on Microsoft Teams Meetings many workplaces have been profoundly (an online communications platform) increased almost eightfold, from 560 million minutes on March 12 to 4.1 affected, with ‘remote work’ becoming billion minutes in April, 2020.⁴, ⁵ Many of the recent changes the new normal for countless employees are likely to have an enduring impact. A Gartner, Inc. survey across the globe. of 317 CFOs and financial leaders conducted in late March 2020 revealed that 74% will move at least 5% and 48% will In some lines of work – professional or administrative move at least 10% of their previously on-site workforce to services, for example – this transition to remote work permanently remote positions post-COVID-19.⁶ has been relatively seamless and the current shift can be seen as the continuation of a trend that has been gaining traction for several decades. As connectivity has increased, so too has the ability of many workers to do their jobs from locations outside their offices – with clear and obvious benefits for both employees and their employers. Research suggests that remote work can result in better employee morale, heightened productivity, less absenteeism, and greater workplace satisfaction.¹, ² 4 Issue 10 · Siemens Healthineers Insights Series and are scalable ... 010110100011101 010110100011 0101110100011 One–One One–Many Many–Many Implications for healthcare collaboration with others has, in the past, presented greater obstacles. However, as technology evolves, In the healthcare sector, however, the shift these obstacles have crumbled. to remote work raises different questions Today, remote work in a healthcare context can and presents different challenges. How effectively connect: can healthcare workers continue to work • Workforce with workforce at peak efficiency during a time of social • Workforce with patients distancing? Can the needs of patients The scalability of remote-work technologies is also a vital factor, enabling contact not only between small be satisfied remotely? Can the level of groups of people but also among larger groups. precision required when analyzing test results or images be maintained? Can the In this paper we look at both the why and the how. barriers of time and distance be safely We argue that working remotely can significantly strengthen healthcare in three fundamental ways: overcome when life-and-death decisions workplace safety can be improved; capacity constraints are being made? can be overcome; and efficiency and productivity can be enhanced. In addition, we will analyze both dimensions of At the outset, it is important to distinguish between remote work – workforce-workforce and workforce-patient “remote work” and “working from home.” For the purposes as well as the technologies that support these types of – of this analysis, we treat working from home as a subcate- remote work. gory of the broader phenomenon of remote work. Remote solutions can bridge long distances of many kilometers, but can also be crucial over short distances of even just a few meters. In the current healthcare context, this type of remote work is of particular relevance: this way of work- ing can help to maintain a safe distance from potentially infected patients, reducing risk and eliminating the time, effort, and cost associated with hygiene protocols (e.g., putting on personal protective equipment (PPE)). Individual activity is the most obvious example of work that can easily be performed remotely. An employee working on a project independently can do so with full productiv- ity and efficiency from home, from a hotel room while travelling, or from virtually any remote location, provided the necessary connectivity is in place. Work that demands Siemens Healthineers Insights Series · Issue 10 5 How healthcare providers Much attention was given to the shortages of ventilators can benefit from remote work in certain hard-hit areas during the pandemic, but another dimension of this issue that received less attention was shortages of qualified ventilator technicians. As Eric Toner Improving workplace safety from the Johns Hopkins Center for Health Security noted, “In a severe pandemic, we certainly could run out of venti- The clearest benefit of remote work was brought into lators, but a hospital could just as soon run out of respira- sharp focus during the COVID-19 outbreak: remote work tory therapists who normally operate these devices.”⁸ protects healthcare workers from infection. The COVID-19 pandemic placed unprecedented demands on healthcare The use of remote workforce outside the hospital can infrastructure across the globe. Frontline caregivers were help to overcome this critical shortage. Remote solutions often exposed to SARS-CoV-2, and in many locations this can connect healthcare workers with different tasks and risk was exacerbated by shortages of PPE. Especially in contribute to achieving the right balance. Specialists in areas where the pandemic struck early, we saw doctors low-demand areas could, for example, provide virtual and nurses falling ill and dying. In Spain, approximately consultations and support colleagues in areas with higher 14% of COVID-19 cases in the beginning of April were demand.⁹ Some quarantined employees with mild symp- medical professionals.⁷ Enabling employees to perform toms could have worked from home, while in isolation.⁹ In tasks remotely can help to mitigate the risk of infection. addition, remote assistance could bring expertise to where it is needed, giving support and confidence to those in Helping to overcome capacity constraints particularly challenging environments. During the COVID-19 pandemic, we saw many examples of Enhancing efficiency and productivity an enormous gap between workforce supply and demand. Particularly in pandemic hotspots, the demand for health- A more general and overarching benefit of remote work is its care workers often far exceeded usual capacities. Sudden contribution to greater efficiency and productivity. Remote rises in hospitalization rates led to an increased demand work can significantly reduce an employer’s overhead costs for workforce while, at the same time, healthcare providers as many employees are no longer working on-site. Studies were struggling with a decreasing number of employees. also suggest that productivity and quality are enhanced by Those who were quarantined were not able to provide such working arrangements. The output of employees work- support even if they were asymptomatic or had only very ing remotely can be increased by more than 4% and quality mild symptoms. In addition, the physical and mental strain defects can be reduced by as much as 40%.¹⁰ that overworked staff were under may have contributed to treatment errors because of fatigue. In many jurisdictions, Additional benefits for employees include the reduction or retired doctors and nurses were asked to resume service. elimination of long and time-consuming commutes. Days can be planned with greater flexibility (e.g., for those with competing commitments such as family obligations), fewer distractions, and less stress. 6 Issue 10 · Siemens Healthineers Insights Series Benefits These kinds of flexible arrangements also contribute to Improving improved employee morale, more successful recruitment workplace safety of new and geographically diversified talent, and better staff retention. Studies suggest that more than half of employees would change jobs for one that offered more workplace flexibility, and that employee turnover could be reduced by as much as 12%.¹⁰ And for more than 71% of employees, the ability to work remotely could make the difference in choosing one employer over another.¹¹ The corresponding benefit to employers is thus even more substantial, allowing them to hire the best employees, no Helping to overcome matter where they are.¹² capacity constraints Enhancing efficiency and productivity Siemens Healthineers Insights Series · Issue 10 7 01011010000101111010100001010111000011101 01011010000101111010100001010111000011101 1 Remote solutions connect workforce with workforce 8 Issue 10 · Siemens Healthineers Insights Series How remote solutions can be comprehensive and precise, enabling the remotely con- applied in healthcare nected colleague to not only offer an educated opinion but also giving them access to all of the patient’s infor- mation (e.g., data, scanned images, etc.) in real time. 1 Workforce-workforce The remote specialist can thereby provide insights as accurately as if she were standing at the patient’s bed- Transforming care delivery in a way that improves patient side. The benefits of this type of remote connectivity are outcomes requires meaningful coordination and collabora- valuable in many medical situations, but particularly so tion between caregivers and other healthcare profession- in times of crisis or uncertainty. Other types of external als. Remote solutions, using today’s technologies, can more expertise or assistance can also be made more accessible, effectively connect healthcare workers. These workforce- for example work with suppliers can be performed with- workforce solutions allow healthcare workers to share out the necessity of on-site visits, thereby reducing the expertise, engage in joint decision-making, schedule number of outside people entering hospital premises. and perform administrative and planning tasks remotely. The performance and condition of medical devices can Contact with partners outside the healthcare organization be monitored proactively, preventive maintenance can can also be enhanced, e.g., communication with public be carried out remotely, and software updates and health authorities in times of crisis, with service providers, upgrades can be installed without the need for a tech- or academic organizations. nician to be on-site. Accessible expertise Collaborative decision-making During times of exceptionally high workload with limited Perhaps the single most important aspect of workforce- capacities, or shortages of qualified workforce, remote workforce interaction during a time of crisis or uncertainty solutions connect employees and provide an easy and is joint decision-making. During the initial weeks of the flexible way to share expertise within an institution or to SARS-CoV-2 outbreak, there was a profound absence of access expertise from outside the institution. For example, certainty about basic medical issues including how the technologies exist to allow experienced employees working virus was transmitted and risks of infection among certain remotely to support less experienced on-site workers with populations. Being able to consult with colleagues is vital the operation of medical devices via chat, voice, or video. at a time like this, to ensure that information is as current Physicians dealing with new or challenging medical issues as possible and to allow new insights to be shared quickly. can get a second opinion from a colleague in another Tele-conferencing tools enable a fast and encrypted country, or remotely brief their teams before a complex exchange of patient data, and by sharing a common tool, surgical procedure. Family doctors, meanwhile, can reach experts across different locations can analyze data and out to the appropriate specialists for help in answering decide on next steps. For example, radiologists can share, questions or tackling complicated clinical cases. This interpret, and discuss clinical images remotely to ensure was possible previously, by telephone for example, but a correct and quick diagnosis. This shared decision-making today’s technologies make such consultation far more can also extend across various specialties. Siemens Healthineers Insights Series · Issue 10 9 01011010000101111010100001010111000011101 01011010000101111010100001010111000011101 2 Remote solutions connect workforce with patients 10 Issue 10 · Siemens Healthineers Insights Series Efficient planning and coordination Accurate monitoring Administrative and planning matters are perhaps the best Remote patient monitoring has the potential to dramati- example of where remote work can be utilized effectively. cally transform care delivery, improving access to care for Many non-patient-facing administrative tasks and func- patients, increasing workforce productivity, and optimizing tions can be performed off-site (e.g., accounting, human clinical operations. The overall result: improved patient resources, legal, medical records, marketing). Fleet manage- outcomes. ment tasks such as performance and maintenance manage- ment can also be done remotely via online platforms. Especially for chronic conditions, remote monitoring can be a highly effective way for healthcare providers to In addition, teams can be coordinated remotely. better manage diseases. Research shows that remote care Management and administration tools can be used by management programs can have a positive impact on the department heads regardless of where they are physically number of unplanned hospital readmissions,¹³ on mortal- located. Scheduling can be done on platforms accessible ity,¹³ overall costs, and patient experience.¹⁴ to anyone, anywhere. Continuing education programs and training seminars can be assigned and performed remotely, For physicians, remote patient monitoring technologies and their completion tracked. Training, for example, can be enable them to track patient data outside the healthcare delivered online to individuals and groups through video provider’s setting and while seamlessly connected with tutorials and webinars. Virtual classrooms and workshops other members of the patient’s care team and other can connect healthcare workers with teachers or trainers, experts. In the event of deviations or abnormalities, care while offering convenient flexibility in terms of location. teams are notified automatically, and care teams can reach out directly to patients via dedicated apps or video chat. 2 Workforce-patient Such solutions are also scalable. Large numbers of patients can be monitored at the same time, allowing care teams to The more interesting challenges arise when patients better manage large patient populations. Interoperability are involved. Providing effective care is of course the of different EMRs across several sites is also feasible. first priority of any type of health service; this cannot be compromised. Additionally, the patient experience, Precise diagnosis an increasingly important aspect of healthcare delivery, must also be considered. The workforce-patient rela- For many patients, receiving a correct and timely diagnosis tionship is an area with tremendous potential for new is a complex process. Getting to see a doctor can mean a approaches that allow healthcare workers to remotely long wait for an appointment, followed by lengthy periods interact with patients along the entire patient pathway of time in crowded waiting rooms. During the COVID-19 from monitoring, to diagnosis, to therapy. pandemic, mobility restrictions, quarantines, and simple fear of infection exacerbated these difficulties. Tele-visit services can provide an easy and elegant solution. Siemens Healthineers Insights Series · Issue 10 11 Remote solutions can work between two sites at opposite ends of a large hospital, or across distances of hundreds of kilometers The transformation made possible by telehealth switches physical, speech, occupational, and respiratory therapy. the interaction between doctor and patient from face-to- In the field of mental health and psychiatry, studies indi- face to online. Diagnosis and dialogue become available cate an exceptionally high degree of patient satisfaction. through one tool at the patient’s fingertips. Post-diagnosis, Telepsychiatry patients felt that they could present the the remote caregiver can direct the patient to an on-site same information via telehealth as in person (93%), were healthcare provider for further consultation, if required. satisfied with their sessions (96%), and were comfortable Alternatively, treatment programs and online prescriptions talking (85%).¹⁵ for self-treatment can be provided. Robotic surgery is a further step along the telehealth In such a model, distance becomes irrelevant. Remote continuum, expanding the field into tele-treatment. Some solutions can work between two sites located at various types of procedures are now performed robotically, with ends of a large hospital complex, or across distances of physicians viewing the patient on monitors and precisely hundreds of kilometers. Both can be highly advantage- controlling surgical tools or therapeutic devices through ous – to patients and to physicians. a control console from a distance. As these technologies advance, the distances can also increase, helping to The operation of medical devices that play an essential improve access to care and helping to reduce time to role in diagnosing patient conditions (e.g., CT scanners) treatment. can also be performed remotely, with tablets or remote controls. The flexibility this gives healthcare providers is This could be especially helpful in geographic areas where significant. And – although those features were originally shortages of highly skilled specialists may exist, and for designed to permit caregivers to be close to patients – in emergent procedures, such as heart disease and ischemic the current circumstances, the safety and hygiene benefits stroke, where time to treatment is critical. Endovascular are significant, allowing caregivers to remain at a safe telerobotic systems are one example of a technology that distance from potentially infected patients. could enable remote interventions from a control room next door or from kilometers away.¹⁶ Effective therapy In 2018, in Ahmedabad, India, five patients underwent Therapy usually requires some type of interaction between an elective percutaneous coronary intervention procedure caregiver and patient. However, these interactions do not performed robotically by a physician more than 30 km necessarily have to be in person. away.¹⁷ Whether the surgeon is several meters from the patient, in an adjacent room, or kilometers away, the Telehealth services can be utilized to allow caregivers to advantages are significant. Barriers to care are overcome, provide patients with live, interactive advice, answering time is saved, and by reducing person-to-person contact questions and discussing options, even when neither the safety of caregivers is enhanced by limiting their patient nor caregiver are in a traditional healthcare facility. exposure to potential infections as well as radiation from Some types of therapy particularly well suited to tele- imaging devices. health communication include behavioral, mental health, 12 Issue 10 · Siemens Healthineers Insights Series Conclusion Technological concerns, however, should not serve as an impediment. Recent technological advances have created The benefits of remote work are significant remarkable new opportunities and flexibility, permitting healthcare workers to embrace remote work and ensuring for patients, for employers, for health- that patient needs are met. The COVID-19 pandemic has – care employees, and for business partners. made the advantages of remote work even more appar- An understanding of these benefits ent, highlighting issues of safety both for patients and for provides a compelling argument for why frontline healthcare providers. remote work solutions should be integrated In order for healthcare providers to capitalize on the tran- into the strategic plans, infrastructure, and sition to remote work, we recommend that the following workflows of healthcare organizations. five steps be applied and followed: 1. Make the transition to remote work a central The healthcare sector has, however, been slow to part of your overall strategic plan embrace this growing trend. This is a consequence of Healthcare providers should give priority to remote work numerous factors, including financial and legal issues. solutions in their strategic planning. Strategic investments Capital expenditures for bricks and mortar must be re- will pay off in future. Remote work must be understood couped. Reimbursement guidelines for services rendered as a comprehensive and enduring part of the transforma- remotely remain unclear in many jurisdictions. In addition, tion of healthcare, not simply a short-term response to there are difficult legal and regulatory issues that must be COVID-19. resolved. In the U.S., for example, prior to the pandemic a ‘virtual’ physician providing remote advice had to be 2. Identify functions and positions where remote licensed not only in the state where he or she was located, work can leverage maximum benefits but in every state from which a patient called. Look at tasks from the perspective of patients, employees, and providers. The issue is not just about realizing cost Demographic, cultural, and technological factors also play savings. Ask: where can remote work solutions improve a role. Some demographic and social groups might be access, clinical outcomes, and satisfaction? How can re- unwilling to confront the challenges associated with new mote access expand our reach and broaden our catchment technologies; for these groups, the default is often to sim- area? How can remote work allow us to more effectively ply continue doing things as they were done in the past. utilize (and monetize) our expertise and assets? Perhaps the most difficult barrier to overcome is cultural. In many organizations there is a strong desire to maintain 3. Equip your institution with the right infrastructure traditional working arrangements and traditional concepts Realistically evaluate key issues including current financial of patient proximity. This inherent desire to maintain the conditions and capital investment requirements. Identify status quo can be difficult to overcome. opportunities for partnerships with external vendors based on quality, experience, and existing relationships. Siemens Healthineers Insights Series · Issue 10 13 And determine which hardware and software is required and whether existing equipment can be upgraded or updated. In addition, new functions and positions will have to be created and given the appropriate authority and resources to establish and manage a remote work infrastructure. 4. Create organization-wide capabilities and a culture that embrace remote work Cultural change and long-term investments in people’s education support the transition towards remote work. Successfully navigating this transition will require many employees to re-evaluate their roles and responsibilities and must be accompanied by future-oriented and modu- larized trainings that create a clear upskilling pathway. 5. Continually analyze, measure, and evaluate remote workflows Remote work must be understood along a continuum of both time and distance. Progress will at times be gradual and must be evaluated in an overall context. Foster opportunities for feedback, the sharing of best practices, and encourage continual improvement. Integrate remote workflows in everyday routines until they become habits. If these steps are applied, the transition to remote work can be a valuable part of every healthcare organization’s strategic plan, helping to achieve business objectives, prepare for future challenges, comply with rigorous safety and regulatory standards, and better meet the needs of patients and employees. Looking ahead, we believe that updates to functions, networks, and platforms will continue to advance rapidly, and that the growing role of AI will further contribute to greater insights and more precise care. 14 Issue 10 · Siemens Healthineers Insights Series Remote healthcare delivery – Your path forward 1 Make the transition to remote work a part of your strategic plan Q 2 Identify functions where remote work can leverage benefits 3 Equip your institution with the right infrastructure 4 Create remote work capabilities and culture 5 Analyze, measure and evaluate remote workflows Siemens Healthineers Insights Series · Issue 10 15 Suggested follow-up on • Siemens Healthineers Insights Series, issue 7: Do one thing, and do it better than anyone else • Siemens Healthineers Insights Series, issue 4: Achieve twice as much but only work half as hard • Siemens Healthineers Insights Series, issue 2: Culture of diversity, respect, and inclusion • Harvard Business Review: Transforming Care delivery to increase value The Siemens Healthineers Insights Series is our pre- eminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. It explores emerging issues and provides practical solutions to today’s most pressing healthcare challenges. All issues of the Insights Series can be found here: For regulatory reasons, the solutions described in this paper may not be commercially available in all countries and their future availability cannot be guaranteed. Remote telerobotic capabilities are largely under develop- ment and not commercially available. Their future avail- ability cannot be ensured. 16 Issue 10 · Siemens Healthineers Insights Series References 1 Kruse K. Top 10 Benefits of Working From Home 9 Angus D, Connolly M, Salita M. The shift to virtual care in (Survey Results). Forbes [Internet]. 2012 Dec 18 response to COVID-19 [Internet]. PwC. 2020 [cited 2020 [cited 2020 Jun 26]; Available from: Jun 26]. Available from: sites/kevinkruse/2012/12/18/benefits-working-from- coronavirus-covid-19/shift-virtual-care-response.html home/#7e3a1c9b1d4c 10 Farrer L. 5 Proven Benefits Of Remote Work For 2 Lister K. Latest Work-At-Home/Telecommuting/Mobile Companies. Forbes [Internet]. 2020 Feb 12 [cited Work/Remote Work Statistics [Internet]. Global Workplace 2020 Jun 26]; Available from: Analytics. 2020 [cited 2020 Jun 26]. Available from: laurelfarrer/2020/02/12/top-5-benefits-of-remote-work-for- companies/#23e74e6416c8 3 Banjo S, Yap L, Murphy C, Chan V. The Coronavirus 11 Owl Labs. State of Remote Work [Internet]. 2019. Available Outbreak Has Become the World’s Largest Work-From- from: Home Experiment. TIME [Internet]. 2020 Feb 3 [cited 2020 Jun 26]; Available from: 12 Johnson C. 20 Reasons to Let Your Employees Work From work-from-home/ Home. Entrepreneur Europe [Internet]. 2015 Dec 14 [cited 2020 Jun 26]; Available from: 4 Spataro J. Remote work trend report: meetings. Microsoft article/253896 [Internet]. 2020 Apr 9 [cited 2020 Jun 29]; Available from: 13 Facchinetti G, D’Angelo D, Piredda M, Petitti T, Matarese remote-work-trend-report-meetings/ M, Oliveti A, et al. Continuity of care interventions for preventing hospital readmission of older people with 5 Spataro J. 2 years of digital transformation in 2 months. chronic diseases: A meta-analysis. Int J Nurs Stud. Microsoft [Internet]. 2020 April 30 [cited 2020 Jun 26]; 2020;101:1–10. Available from: blog/2020/04/30/2-years-digital-transformation-2-months/ 14 Gheorghiade M, Vaduganathan M, Fonarow GC, Bonow RO. Rehospitalization for heart failure: Problems and 6 Gartner Inc. Gartner CFO Survey Reveals 74% Intend perspectives. J Am Coll Cardiol. 2013;61(4):391–403. to Shift Some Employees to Remote Work Permanently [Internet]. 2020 [cited 2020 Jun 26]. Available from: 15 Urness D, Wass M, Gordon A, Tian E, Bulger T. Client Acceptability and Quality of Life – Telepsychiatry gartner-cfo-surey-reveals-74-percent-of-organizations-to- Compared to In-Person Consultation. J Telemed Telecare. shift-some-employees-to-remote-work-permanently2 2006;12(5):251–4. 7 Nugent C. “It’s Like Being a War Medic.” A Madrid Doctor 16 Zindel C. COVID-19: A healthcare executive’s perspective Speaks Out About Grave Shortages in Protective Gear. TIME on the transition to the new normal. LinkedIn [Internet]. [Internet]. 2020 May 2 [cited 2020 Jun 26]; Available from: 2020 May 11 [cited 2020 Jun 26]; Available from: linkedin. com/pulse/covid-19-healthcare-executives-perspective- transition-zindel/ 8 Akpan N. U.S. has only a fraction of the medical supplies it needs to combat coronavirus. National Geographic 17 Corindus. Corindus’ Technology Successfully Used in [Internet]. 2020 Mar 3 [cited 2020 Jun 26]; Available World’s First-in-Human Telerobotic Coronary Intervention. from: Press release [Internet]. 2018 Dec 6; Available from: america-has-fraction-medical-supplies-it-needs-to-combat- coronavirus/#close technology-successfully-used-in-worlds-first-in-human- telerobotic-coronary-intervention Siemens Healthineers Insights Series · Issue 10 17 Insights Series, issue 10 About the authors Dr. Herbert Staehr Dr. Ralf Meinhardt Vice President Senior Global Marketing Manager Global Head of Transforming Care at Siemens Healthineers Delivery at Siemens Healthineers Ralf Meinhardt engages in thought leadership activities Herbert Staehr is passionate about healthcare and, as for transforming care delivery. Prior to his role at global head of Transforming Care Delivery, drives activities Siemens Healthineers, he spent several years in the phar- to equip healthcare providers to deliver higher-value care. maceutical industry, consulting and scientific research. Prior to this position, he led Portfolio Development and Ralf Meinhardt holds a Doctor of Economics and Social Marketing within the Enterprise Services and Solutions Sciences degree from the University of Erlangen- business of Siemens Healthineers. Before joining Nuremberg. In addition, he holds a Master of Science Siemens Healthineers, Herbert Staehr worked with a major degree in Management and Bachelor of Arts degree in private hospital group in Germany in senior leadership Business Administration. He studied at the University of roles including serving as managing director of an acute Erlangen-Nuremberg and Indian Institute of Management, care and a post-acute care hospital. Earlier, he led the Bangalore (IIMB). His scientific background is in the field group’s Corporate Development department. He was of corporate strategy where he has authored several employed for several years in the Healthcare Consulting publications. practice of McKinsey & Company on various European and international assignments. Herbert Staehr holds a PhD in Healthcare Economics from the University of Hohenheim, Germany. He obtained a dual degree (Bachelor of Arts and Diplom-Betriebswirt) in International Business and Finance from the European School of Business, Germany, and Dublin City University, Republic of Ireland. 18 Issue 10 · Siemens Healthineers Insights Series At Siemens Healthineers, our purpose is to enable health- care providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experi- ence, all enabled by digitalizing healthcare. An estimated five million patients worldwide benefit every day from our innovative technologies and services in the areas of diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine as well as digital health and enterprise services. We are a leading medical technology company with over 120 years of experience and 18,500 patents globally. With about 50,000 dedicated colleagues in over 70 countries, we will continue to innovate and shape the future of healthcare. Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 913184-0 Published by Siemens Healthcare GmbH – Printed in Germany – 2007 · ©Siemens Healthcare GmbH, 2020

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