Insights Series Issue 12: "The COVID-19 pandemic leads to a significant acceleration of digitalization in healthcare"

This paper provides the key steps a healthcare organization can take to accelerate digital transformation for success in the era of COVID-19 and beyond.

Insights Series Issue 12 digitalizing-healthcare The New Normal EB 32 07 EB 01 10900 10101100101501:001011 8 3 23 110121201911011011010010101 01 1001091910110010101010100 9D 011010010501190191101001011 11010110191101 1051010010101 60 01 1001061410110010101018100 911001011-1001015 1101101 1010010101 L This changes everything: The COVID-19 pandemic leads to a significant acceleration of digitalization in healthcare A thought leadership paper on “Digitalizing healthcare” 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 emerging 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 Executive summary The COVID-19 pandemic has placed unprecedented stress home monitoring, and digital communications. Healthcare on health systems around the world. It has also accelerated systems must prepare for this tectonic shift now, even as they adoption of digital technologies. We will see higher cope with the strains imposed by the COVID-19 pandemic. investments than pre-pandemic levels in digital technologies used for customer-engagement, care coordination, An effective shift towards building a digital enterprise enabling a remote workforce or telemedicine. Telemedicine, requires a commitment to manage data as a strategic asset. already undergoing rapid growth,1 has quickly become a Health systems have to integrate data from multiple key tool for both preliminary COVID-19 screening and sources, like wearables, imaging, diagnostic laboratory, also for non-urgent care and consultations. genetics, social determinants, and payors, on secure and easily accessible data platforms. Reliable and secure We expect that use of technology-based solutions will data together with advanced modeling and AI empowers continue to grow after the immediate threat of COVID-19 data-driven decisions within a health system – be it in has waned, as patients, providers, and payors alike discover the clinical or operational space, or even directly helping the benefits of Virtual Forward triage and eICUs, remote care, consumers to make the right decision in their care. How to build a digital enterprise 11011001101110011010 2010010000001110101011011200110011001000000110001001101001 -B 01101100110111001101110011101 LC S Manage data Empower data-driven Connect care teams Build a learning as a strategic asset decisions and patients health system V By managing data as a strategic asset, providers will gain telemedicine, and secure knowledge exchange will strengthen unprecedented insight into clinical and non-clinical processes. They bonds between patients and care teams. A cultural shift to a digital will be able to leverage powerful analytical tools, including AI mindset, coupled with new technology, will enable development of technologies, to improve decision making. Virtual access, a continuously improving learning health system. 3 Issue 12 · Siemens Healthineers Insights Series But data and digital technologies can be also used to better measures toward continually optimizing, expanding and connect care teams and patients, bridging the physical advancing enterprise performance. The learning health separation between them and unifying fragmented systems system will be better prepared for both “routine” care and of care. Along these lines, healthcare providers will embrace for extraordinary circumstances like COVID-19. the concept of “moving information, not patients.” Home monitoring and secure tele-consultation technology Digital transformation of healthcare is inevitable; COVID-19 will enable some patients to receive hospitalquality has merely sped up the timeline and underscored the care at home; this shift to home care will be enabled by need. This transformation isn’t easy; challenges to successful digital decision support tools that can more accurately digital transformation include low quality of data, an identify candidates for home-based outpatient care. inability to securely and conveniently access operational Through remote care and telehealth, patients will gain and clinical data, low interoperability of systems, and more transparency into their own care, and become more the fragmented care systems in place in many countries. active participants in their care, as well as in the prevention The greatest challenge, though, may stem from a lack of disease. of understanding of the ongoing commitment that is necessary for successful digital transformation. COVID-19 Similarly, healthcare enterprises will learn how to extend has highlighted some of these challenges, but it has the reach of their expert clinicians through services also spurred healthcare enterprises to meet these challenges like teleradiology, which will give remote locations and head-on as part of a comprehensive response to the standalone imaging clinics access to teaching hospital- pandemic. quality care. Clinicians will be able to collaborate and share information productively in virtual spaces, reducing Enduring value-generating partnerships between healthcare information loss during care transitions, and without providers and medtech companies can help provider the time, expense, and – in the age of COVID-19 – the risk organizations leverage technology to upgrade their of travel. Throughout these changes, data security and organizations both in the near term, to better cope with patient confidentiality must be preserved. the urgency of the pandemic, and in the long term, by investing in strategic digitalization efforts. In collaboration The digital transformation can be only successful and with medical technology partners, healthcare enterprises sustainable if healthcare leaders move beyond adopting can create more value for stakeholders and deliver technology solutions and begin to transform their meaningful improvements in clinical and financial outcomes. institutions into learning health systems. This is a vital development for the future of healthcare, and one that will prepare providers to respond to new COVID-19 outbreaks or other infectious disease events. How? By including data and technology that is easy to use and frees up the time of caregivers, by establishing an organization committed to digital transformation, and by rigorously measuring and disseminating patient outcomes. Measuring outcomes is the basis for course correction and makes it possible to scale the right Siemens Healthineers Insights Series · Issue 12 4 The challenge COVID-19 has accelerated digitalization trends Telemedicine has been in the spotlight due to the COVID-19 Remote monitoring has also emerged as a driver of positive pandemic and the social distancing measures put in health and financial outcomes. For example, remote place by governments around the world. But a movement monitoring of implanted cardioverter defibrillators is a cost- toward digitally-enabled remote care had been slowly effective way to reduce morbidity and mortality.6 Other taking shape and gathering momentum before the benefits of remote patient monitoring include delivery pandemic struck. of health data to clinicians in real time, improved quality of life for patients, and reduced healthcare costs.7 A review of U.S. claims data revealed that use of telehealth services increased by 624% from 2014 to 2018, albeit from a low baseline rate.1 Remote monitoring was also The need for strategic digital transformation on an upward trajectory, with Grandview Research projecting (pre-COVID-19) an annual growth rate of When the safety concerns that are driving the current 13.5% through 2026.2 meteoric rise in telehealth utilization subside, patients’ expectations for telehealth quality will rise, and they will COVID-19 has indeed changed the face of medicine flock to healthcare providers who deliver a high value Telehealth became the norm virtually overnight at many patient experience. “As a provider, you have to get it right institutions; one institution reported an increase in the first time. If a patient has a poor initial telemedicine the share of telehealth visits from <1% of total visits to experience with a provider, no matter how good the 70% of total visits, reaching more than 1000 video care they provide is, the patient is going to go somewhere visits per day in just 4 weeks.3 else,” said Asif Shah Mohammed, who leads the Washington, DC office of ECG Management Consultants. Digitally-enabled care delivers positive outcomes The time has come to think about how to implement telehealth services ranging from outpatient care to Overall, there is substantial evidence that home-based sophisticated telesurgery services in an effective, patient- telemedicine reduces care costs in a number of chronic centric way. conditions including congestive heart failure and diabetes.4 When done well, telemedicine can also deliver But digital transformation of a healthcare enterprise goes patient satisfaction that is at least equivalent to well beyond the kinds of decentralized care that have in-person care.5 There will always be a role for in-person risen to prominence during the COVID-19 pandemic. Indeed, care, but the benefits of telemedicine and remote telehealth and remote monitoring services can be monitoring point to sustained growth in their utilization seen as the merely the tip of the iceberg that is digital in the coming years. transformation. 5 Issue 12 · Siemens Healthineers Insights Series Digitalizing healthcare requires profound changes in the way healthcare systems operate. This change begins ? What has changed: with prioritizing collection and analysis of validated data • Widespread adoption of telemedicine on both the individual and population level. Provider and remote care experiences organizations will need to make substantial investments • Move toward decentralized in IT infrastructure and digital tools to remain competitive. care accelerated • Key among these investments is adoption of AI-powered Decentralization of testing and greater emphasis on point of clinical decision support tools, which can enable datadriven care solutions decision making among clinicians, administrators, and • Remote workforce enablement, e.g., even patients. remote patient monitoring, remote operation of devices • True, sustainable digital transformation goes beyond Recognition of need to become a datadriven enterprise adopting new tools and technologies. It requires a culture change and re-orientation around more data-driven care models. Simply digitalizing current processes and procedures won’t be enough; healthcare providers, med tech companies, government agencies, payors and patient advocates will have to work together to sustainably deliver seamless digitally enabled care across a wide variety of care settings. Realigning organizations around data-driven, digitally enabled processes and care models is paramount to the long-term success of healthcare enterprises. The following pages include some key steps healthcare organizations can take to accelerate digital transformation for success in the era of COVID-19 and beyond. Siemens Healthineers Insights Series · Issue 12 6 The solution Key steps toward digitalizing healthcare 1 Manage data as a strategic asset defining data models managed by data governance departments. Both clinical data and operational data Data is the foundation of a digital healthcare enterprise. should be collected with specific goals in mind. Innovative Data has become a hospital’s most valuable asset – and institutions like Mount Sinai Health System in New York one of the most challenging to manage. Providers have taken up this challenge. Mount Sinai recently struggle with setting a strategic direction and collecting named its first Chief Data Officer, a move that will promote the right data from fragmented data sources with low data access and sharing, and innovation throughout interoperability. Analyzing poor-quality data may result in the organization. The creation of a comprehensive imaging conclusions that are ineffectual or incorrect. Healthcare research warehouse to give researchers access to systems should follow four steps to fully leverage data: imaging and EHR data on more than a million patients is The first step is to set a data strategy including the representative of Mount Sinai’s drive to leverage the identification of clinical and operational use cases and power of clinical data.8 Reliable and secure data as basis for better decision making Reasons data is not fully leveraged: E Limited strategic Limited data Low-quality Fragmented sources/ direction access data low interoperability Steps to create smart data management: O Set data strategy Capture data Validate data Connect data Reliable and secure data and establish securely and via automated via secure accessible for better clinical and V governance automatically clean-up platforms & EHRs operational decisions 7 Issue 12 · Siemens Healthineers Insights Series A key barrier to digitalization is the act of data entry itself. Capturing data securely and validating data ? What has changed: automatically is the next step in managing data as a • Pressing need for institution-wide strategic asset. Some institutions are piloting use of voice data strategy assistants to simplify and automate data entry. Others, • Increased volume of data generates more like Bumrungrad International Hospital in Bangkok, equirements for validation and security • are working with partners to automate integration of Drive for secure connections to data to nform clinical and operational decisions multiple data sources in order to develop personalized treatment regimens.9 Collecting data is only half of the story. That data has to be connected to secure and easily accessible data platforms from fragmented sources – Community Health Systems, a leading operator of general acute care hospitals in the U.S, is increasing interoperability and patient data access by making user-friendly digital health records available via mobile devices at more than 100 affiliated hospitals in the U.S..10 Around the world, health systems are devising novel ways to integrate accurate data from fragmented sources and use it to create a holistic understanding of their patients and their enterprise in order to inform clinical and operational decisions. This drive to manage data as a strategic asset is no mere trend – it is a crucial step to ensure long-term viability of healthcare enterprises. Siemens Healthineers Insights Series · Issue 12 8 Since launching an initiative that combined IT solutions with lean management principles, Health First has seen a 300% increase in adult transfers, and a 37% decrease in time from ED admission and hospital bed occupancy. 2 Empower data-driven decisions Operational decision support spans asset and fleet management (e.g., enterprise-wide utilization, protocol, Longitudinal patient and person data together with image management) to workforce and workflow enterprise-wide, real-time operational data is the basis management (e.g., workload balancing and aggregated for better decision making in health systems. Collecting scheduling systems) to hospital and enterprise performance and connecting high quality validated data enables systems enabling centralized oversight for integrated development of three types of decision support tools: patient journey management. Health systems like Health clinical, operational and consumer. First, in Brevard County, Florida, are reaping benefits from technology solutions that help them make datainformed Clinical decision support tools help health systems make decisions. Since launching an initiative that combined sense of the deluge of clinical and operational data IT solutions with lean management principles, Health First they are confronted with. According to BJ Moore, Chief has seen a 300% increase in adult transfers, and a Information Officer of Providence St. Joseph Health, “ 37% decrease in time from ED admission and hospital … we can… use AI and machine learning to identify precursors bed occupancy.14 for diseases” by parsing the volumes of medical data now available from imaging, genomics, health records, remote monitors and wearables, and other sources.11 AI is also useful in non-clinical contexts as well. Sheba Medical Center, near Tel Aviv, Israel, has developed AI-based tools with its technology partners to detect the presence and severity of coronavirus infection via sound and odor.12 AI-powered tools are currently being developed and used to benchmark insights, provide clinical decision support and to optimize workflows. It is even possible that AI could play a role in detecting infectious disease outbreaks and preventing them from developing into pandemics. Success in this role depends on global cooperation to collect and share validated, trustworthy data.13 9 Issue 12 · Siemens Healthineers Insights Series Consumer decision support will become increasingly important in the future. Mobile-based tools like ? What has changed: e-scheduling systems, which patients use to book their • Data-driven decisions more important appointments and get access to diagnostics and treatment, than ever in COVID-19 pandemic and will passively adapt and refine their behavior based on future infectious disease events • patients’ preferences. The next level in consumer decision AI-enabled technology will help predict and control future outbreaks support will be active decision support, like health informatics • Development of more health informatics apps and dashboards for personal health data. In the apps and dashboards for personal health near future, predictive wellness coaches may provide data management continuous advice to help patients adopt customized healthy behaviors using life-long patient data to prevent sickness. Stakeholders will come to expect this kind of tailored support, so it is vital that healthcare enterprises begin creating the tools and systems necessary to support it. Digital simulations and AI support better decision making Transform data … into insight for better decision making … Longitudinal patient and person data $ 00100000 00010000 01000110 Enterprise-wide, real-time, operational data Clinical decision support Consumer decision support Operational decision support • Prediction of intervention • E-scheduling systems • Asset and fleet management + • Therapy decision support • Personal health informatics • Workflow and workforce mgmt. • Chronic disease management • Predictive wellness coach* • Enterprise performance systems * This feature is based on research, and is not commercially available. Due to regulatory reasons its future availability cannot be guaranteed. Siemens Healthineers Insights Series · Issue 12 10 3 Connect care teams and patients The most important stakeholders are patients, hospital physicians, primary care physicians and other Health systems struggle with fragmented systems of referrers. Healthcare providers will increasingly engage care. Interoperability between hospital and primary care patients outside traditional healthcare settings, e.g., via physicians’ data is often lacking. As a result, information teleconsultations and remote monitoring. during care transactions can be lost, access to the right clinician at the right time is variable, and patient data is Mercy Health, which serves four states in the American not fully leveraged when developing care plans. Midwest, is a pioneer in advanced telehealth, with an eICU program that achieves outcomes like reduced mortality The COVID-19 pandemic presents a challenge to forging (25% lower than APACHE predictions) and shorter hospital connections between patients and their care teams. stays. The eICU is part of a comprehensive virtual care Digitalization can help connect caregivers and patients center that serves as the hub for 75 telemedicine services.15 for better coordination and knowledge sharing while Innovations like this will continue to pay dividends after strengthening integrated care across the health system. the initial threat from COVID-19 has waned. Towards effective integrated care and care continuity Patients • Enable patient self- management via health and wellness platforms • Expand telehealth and home monitoring Hospital physicians Central, smart platform Primary care physicians Support caregivers Real time, secure information flow Foster knowledge with remote assistance, exchange via data physician and staff sharing, patient and e-learning physician portals Secure digital front door Expanded patient access (e.g., via e-booking systems) 11 Issue 12 · Siemens Healthineers Insights Series Digitalization can help connect caregivers and patients for better coordination and knowledge sharing while strengthening integrated care across the health system. Through digital technologies, it is possible for clinicians Connecting patients and care teams: to provide care at a distance. Some specialties, including Telesurgery radiology and pathology, have already adopted technology to enable consultations from a distance. Telesurgery Telesurgery relies on robotic technology and broadband has become a viable way of providing access to highly internet connectivity to enable surgeons to perform specialized care from a distance. These applications procedures from a distance. While telesurgery systems of telehealth allow specific clinical expertise to be shared have been on the market for the better part of two decades, across a wider area, and help providers deliver vital services the technology is maturing, with much improved latency to remote or less developed areas where healthcare and new innovations like haptic feedback giving surgeons infrastructure is lacking.16 a more “live” experience while operating robotic systems remotely.17 Connecting patients and care teams: In these and many other specialties, tele-practice capabilities Teleradiology help deliver high quality care to more patients. Standardization of image formats and the near-ubiquity of broadband internet connections have made teleradiology New paradigm for data security an established practice in both industrialized nations and patient privacy and developing countries. With radiologists in short supply, teleradiology brings continuous radiology coverage to However, the promise of telemedicine and other forms of even smaller or remote locations, allowing more patients remote care and monitoring must be balanced with to benefit from specialist care. the need for patient privacy and security. Government agencies in the U.S. issued a number of HIPAA waivers in In addition, teleradiology services allow staff to perform the wake of the COVID-19, which had the effect of complex or highly specialized scans that may not easing the sudden transition to telemedicine. The waivers otherwise be available in their institutions by leveraging made it easier for patients and physicians to communicate expert knowledge digitally. via existing, generally non-HIPAA-compliant platforms.18 Siemens Healthineers Insights Series · Issue 12 12 This allowed healthcare providers to deliver telehealth services via Apple FaceTime, Facebook Messenger, ? What has changed: Google Hangouts and other consumer communications • Social distancing strains connections platforms. But these waivers do not free providers between patients and caregivers from their responsibilities to protect sensitive patient data. • Acceleration of technology solutions will The rapid increase in use of telemedicine services have positive impact on patient-caregiver relationship and patient experience highlights the importance of data security, and the sheer volume of data that must now be protected will provide a new challenge to healthcare systems. In the post- COVID-19 world, it will be vital for healthcare enterprises to develop and implement sound strategies for data security based on an increasing volume of telehealth and remote monitoring data. Partnerships with companies that understand the unique data security needs of health systems may help many institutions adapt more rapidly to this new normal. Finally, digitalization can help forge stronger, more productive connections within care teams and groups of colleagues. Health systems can foster knowledge exchange among primary care physicians and other referrers via data sharing, patient and physician portals. Far from the early days of online message boards, these virtual workspaces provide secure, user-friendly environments for far-flung clinical teams and colleagues to share best practices, increase productivity, and tackle complex problems. Extending the reach of clinical experts will be of paramount importance for health systems in the near future. 13 Issue 12 · Siemens Healthineers Insights Series Measuring outcomes is the basis for course correction and makes it possible to scale positive changes toward continually optimizing, expanding and advancing enterprise performance. 4 Build a learning health system Rigorous measurement and secure sharing of patient outcomes is the crucial third step of the learning cycle. Sustaining the digital transformation is a challenge for Multi-year patient data, PROMS data, social many health systems primarily because of a lack of determinants, and patient preferences all must be commitment to both digital transformation and a culture measured and tracked over time.22, 23, 24 And most of continuous improvement. These obstacles can be importantly, a learning health system should make overcome through the creation of a learning health outcomes transparent throughout the health system, system (LHS). using patient outcomes dashboards (for each clinician) that are regularly shared and reviewed inside the A LHS leverages data and user-centric technology and organization. frees clinicians from repetitive or time-consuming low-value tasks. Team-based care and care automation Measuring outcomes is the basis for course correction technologies, for example, enable distributed care and makes it possible to scale positive changes toward delivery and automation of routine tasks, and deliver continually optimizing, expanding and advancing simple, intuitive user experiences. enterprise performance. Patient and family engagement can give the right insights for setting up enterprise Further, a learning health system requires leadership buy-in learning programs using improvement and evaluation with joint targets, aligned incentives, and a commitment trainings (e.g., lean, 6-sigma, qualitative, quantitative).25 to transformation. Building the right organizational structures, including a dedicated team to support evaluation Geisinger Health System (GHS) in Northeastern Pennsylvania and learning activities throughout the organization, is embodies the concept of a learning health system. another important lever for the shift to learning health GHS employs a system-engineering approach to continuously systems.19, 20 Institutions like Memorial Sloan Kettering reduce variability and increase efficiency. Real world Hospital, Kaiser Permanente, and Mayo Clinic have results include an algorithm that proactively identifies demonstrated their commitment to ongoing digital patients at high risk to miss an appointment. These transformation by appointing their first Chief Digital Officers, patients receive a phone call prior to their appointment, a position that existed in only 6% of top global companies resulting in a 24% decrease in no-shows.24 as recently as 2016.21 The goal of these high profile organizational changes is to leverage digital technology to deliver more convenient, personalized, and affordable care. Siemens Healthineers Insights Series · Issue 12 14 Fostering a culture of improvement What is a learning How do you create a learning health system? health system? A healthcare system that 1 Leverage data and technology performs interventions, Data and Organizational (e.g., decision support, care automation) measures outcomes and technology structures course corrects based on 2 Build organizational structures evaluation of outcomes. 1 2 (e.g., value realization office, leadership buy-in) 4 3 3 Measure patient outcomes Correction Outcomes (e.g., PROM*, transparency on outcomes) and scale measurement 4 Course correct and scale (e.g., enterprise-wide learning program) Degree of learning This approach of continuous learning and refinement will be vital to success in combating future outbreaks of ? What has changed: COVID-19 or other infectious diseases. A culture that adapts • Health systems must be ready to pivot quickly to new data, especially in the face of a novel pandemic response rapidly in response to pathogen, will be better prepared for both typical clinical new data and analysis • challenges and future pandemics than one that pivots Culture of continuous improvement will remain after COVID-19 threat wanes more slowly. 15 Issue 12 · Siemens Healthineers Insights Series Conclusion Digitalization is critical to success in managing COVID-19 Siemens Healthineers is committed to forming enduring, and other infectious disease outbreaks. Many of the performance-based Value Partnerships with healthcare trends and technologies we have seen emerge during providers. These Value Partnerships can include everything this pandemic – like telemedicine – have been developing from imaging and diagnostic fleet updates to healthcare for years, but have been thrust into the limelight since IT to financing to process optimization consulting. Perhaps the emergence of the novel coronavirus. most importantly, Siemens Healthineers has the know-how and experience to guide healthcare enterprises through Some processes and procedures were hastily adopted digital transformation with strategic consulting to set because of the pandemic, leaving substantial room for a course for success, and change management and improvement. It is vital for healthcare institutions to operational consulting services to keep the institution consider long-term, strategic digital transformation now, and its staff on that course. in order to better serve patients in the future. Because of the scope and complexity of digital transformation in healthcare, partnerships between healthcare provider organizations and industry are vital to success. Medtech partners with broad and integrated healthcare portfolios hold particular advantages for healthcare enterprises that are ready to embrace digital transformation. Siemens Healthineers Insights Series · Issue 12 16 References 1. Viles E. Use of telehealth rapidly 9. Koh D. Bumrungrad International partners 17. Choi PJ, Oskouian RJ, Tubbs RS. increased according to FAIR Health with BC Platforms to offer personalised Telesurgery: Past, Present, and Future. report. State of Reform, July 2019. healthcare solutions for patients. Cureus. 2018;10(5):e2716. Published Accessed June 12, 2020 at Healthcare IT News. 2018 May 31. doi:10.7759/cureus.2716. Accessed June 12, 2020 at use-oftelehealth-rapidly-increased- 18. Health IT Security. Insights into HHS according-to-fair-health-report/ international-partners-bc-platformsoffer- COVID-19 HIPAA waivers and lasting 2. Grand View Research. Remote patient personalised-healthcare-solutions-patients. implications. Accessed June 12, 2020 at monitoring system market worth 10. Eddy N. Community Health Systems into-hhs-covid-19-hipaa-waivers-and- $1.8 Billion By 2026. March 2019. makes Apple Health Records available at lasting-implications. Accessed June 12, 2020 at 100 affiliated hospitals. Healthcare IT News. Accessed June 12, 2020 at 19. AHRQ. Baylor Scott & White Health: global-remote-patient-monitoring- building a foundation for continuous devices-market health-systems-makes-apple-health- improvement. Accessed June 12, 2020 records-available-100-affiliated-hospitals. at 3. Wosik J, Fudim M et al. Telehealth lhs/lhs_case_studies_bsw.pdf. transformation: COVID-19 and the rise 11. Gooch, K. Cleveland Clinic, Brigham, of virtual care. Am Medical Informatics Stanford & others name healthcare's 20. AHRQ. University of Utah Health: Association. 2020;27:957-962. most promising tech. Becker's Hospital creating a formula for value based care. Review. Accessed June 12, 2020 at Accessed June 12, 2020 at sites/default/files/wysiwyg/lhs/lhs_case_ 4. Michaud TL, Zhou J, et al. Costs of home-based telemedicine programs: a whitepapers/leidos-must-reads- studies_utah_health.pdf. systematic review. Int J Technol Assess ebook-jan-2020.pdf. 21. Landi H. Will the Chief Digital Officer Health Care. 2018;34(4):410–418. 12. Sheba Medical Center. Saving lives from Role be Key to Healthcare’s Future? COVID-19 is the latest mission of Israeli Accessed June 29 at hcinnovationgroup. 5. Sirintrapun SJ, Lopez AM. Telemedicine army’s R&D lab. Sheba Online. Accessed com/policy-value-based-care/ in cancer care. Am Soc Clin Oncol Educ June 12, 2020 at article/13030590/will-thechief-digital- Book. 2018;38:540–545. doi:10.1200/ saving-lives-fromcovid-19/. officer-role-be-key-to-healthcares-future EDBK_200141. 13. Agrebi S, Larbi A. Use of artificial 22. Beyer B. Martini-Klinik: patient-centred 6. Hummel JP, Leipold RJ, Amorosi SL, et intelligence in infectious diseases. outcomes data collection to improve al. Outcomes and costs of remote Artificial Intelligence in Precision prostate cancer care. Accessed June 12, patient monitoring among patients with Health. 2020;415–438. doi:10.1016/ 2020 at implanted cardiac defibrillators: An B978-0-12-817133-2.00018-5. klinik-patient-centredoutcomes-data- economic model based on the PREDICT 14. Blanchard JC, Rudin RS. Improving collection-to-improve-prostate-cancer-care/. RM database. J Cardiovasc hospital efficiency through data-driven 23. AHRQ. HCA: How a large healthcare Electrophysiol. 2019;30(7):1066–1077. management: a case study of Health system is looking beyond the electronic doi:10.1111/jce.13934. First, Florida. Rand Health Q. health record. Accessed June 12, 2020 7. Bogdanova H. Pros and cons of remote 2016;5(4):2. Published 2016 May 9. at patient monitoring. Health IT Outcomes. 15. Landi H. Mercy Health opens virtual lhs/lhs_case_studies_hca.pdf. Accessed June 12, 2020 at care center dedicated to telehealth. 24. Foley T, Fairmichael F. Site visit to Accessed June 12, 2020 at Geisinger Health System. The Learning cons-of-remote-patientmonitoring- 0001. Healthcare Project. Accessed June 12, 8. Kent J. Mount Sinai advances innovation news/13025782/mercy-healthopens- 2020 at with new chief data officer role. Health virtual-care-center-dedicated-to- section/evidence/40/63/site-visit-to- IT Analytics. Accessed June 12, 2020 at telehealth. geisinger-health-system. 16. Sankaye S, Kachewar S. Telepathology 25. AHRQ. Denver Health: how a safety net sinaiadvances-innovation-with-new- for effective healthcare in developing system maximizes its value. Accessed chief-data-officer-role nations. Australas Med J. June 12, 2020 at 2011;4(11):592–595. doi:10.4066/ files/wysiwyg/lhs/lhs_case_studies_ AMJ.2011.855. denver_health.pdf. 17 Issue 12 · Siemens Healthineers Insights Series Suggested follow-up on Digitalizing healthcare • Siemens Healthineers Paper Embracing Healthcare 4.0. Available at: news/embracing-healthcare-4-0.html • Jochen A. Werner on Digitalizing Healthcare and Smart Hospitals. Available at: siemens- Information: The Siemens Healthineers Insights Series is our preeminent H. 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: Contact: If you have further questions our would like to reach out to us, please do not hesitate to contact our expert directly: Ralph Wiegner, PhD Global Head of Digitalizing healthcare [email protected] Siemens Healthineers Insights Series · Issue 12 18 At Siemens Healthineers, our purpose is to enable healthcare providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experience, all enabled by digitalizing healthcare. An estimated five million patients worldwide every day benefit 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 9131 84-0 Published by Siemens Healthcare GmbH · Printed in Germany · 9424 0820 · ©Siemens Healthcare GmbH, 2020

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