The document discusses the transition from fee-for-service to fee-for-value in healthcare and the benefits of integrated care. It presents Agfa's maturity model and the HIMSS Continuity of Care model for assessing levels of integration. The models outline a step-by-step approach to transitioning from simple messaging to full integrated care through collecting and semantically enhancing data across the care continuum to support clinical decisions, reminders and prevention. This enables a new business model and quality-driven delivery focused on outcomes rather than volume to improve patient outcomes and reduce costs through eliminating waste.

1. 1
Agfa HealthCare 360°
Our Roadmap to integrated care and 360° patient insight

2. 2
Agenda
 Healthcare is changing
 Fee for service versus Fee for value
 Benefits of integrated care, i.e. chronic disease management
 Agfa Maturity model / HIMSS Continuity of Care model
 Economics in a changing environment
 Step-by-step approach
 New quality driven business model enabled by IT
 Value for Stakeholders
 Patients
 Providers
 Payers

3. 3
Healthcare costs in selected OECD countries

4. 4
Hospital admission rates – a comparison
0
5
10
15
20
25
30
35
40
2006 2007 2008 2009 2010 2011
0
50
100
150
200
250
300
350
400
USA
Germany
UK
France
Brazil

5. 5
Chronic Disease Management: Cost & Quality

6. 6
Outcomes based payments require integrated care

7. 7
Integrated Care is here to stay
 Care Coordination shows
results
 Initial results of accountable
care organization show double
digit cost reduction and quality
improvement
 Shift from acute care to
preventive care
 More prevention saves cost
 Less revenue for Hospitals
(fewer acute care episodes),
more revenue for GPs and
Specialists (more preventive
care)
 .
The end of the fee for service era?

8. 8
Agfa Maturity Model
Maturity
Level
Objectives Characteristics
1 Messaging • Simple pnt-to-pnt messaging (e.g. email) to send orders and to receive results (push only – the data is
stored in the edge systems)
2 Sharing • Query and retrieve results, stored at different locations (push-pull model, central / federated data
storage ). Example XDS
• Data is structured and non-structured with various levels of data quality
• Tracking of orders / referrals (status monitoring, task management)
3 EHR • Use semantics (e.g. NLP, master data, tagging) and data quality management mechanisms (e.g.
validation, normalization) to ensure that the data is structured and of guaranteed data quality
(complete, consistent and correct)
• Provide longitudinal view on clinical results of patients (virtual patient record), stored at different
locations
• Support secure electronic communication (e.g. chat, secure email) among different members of care
team
• Access to clinical guidelines in applications
• Provide patient level alerting
4 Analytics • Provide outcome reporting (KPIs) and dashboards on financial, operational, clinical level
• Search and navigate through the data in interactive way
• Support secondary data usage for clinical trials
5 Smart Care • Improve clinical outcome and reduce clinical risk by using Clinical Decision Support mechanism (e.g.
reasoning, predictive analytics) for ordering, diagnosis and treatment planning
• Generate knowledge from information (e.g. using predictive analytics, community authoring)
• Integrate high variety of data sources, including sensors, genomics
6 Integrated
Care
• Support clinical pathways (process workflow) for disease / health management
• Create patient/case centric virtual care teams using advanced collaboration tools (e.g. forums, social
media,
• Provide population level alerting
HIE
EHR
Agfa
360

9. 9
HIMSS Continuity of Care Model
= Level 1
AGFA
Model
= Level 2
= Level 3
~ Level 4
~ Level 5
= Level 6

10. 10
Step-by-Step Transition
An economically viable way to transition
from status-quo to state-of-the-Art

11. 11
Quality driven delivery model

12. 12
Data progression enables integrated care

13. 13
5 steps to integrated care; value @ every step

14. 14
Value creation

15. 15
Summary
 Integrated Care is promising
 Can improve outcomes by supporting a holistic, 360° view of the patient
 Can reduce cost by eliminating waste & redundancy, prevention of
escalations
 New generation of Health IT can support Integrated care
 Collect and aggregate data across the care continuum
 Semantically enhance data
 Support clinical decisions, reminders, & prevention
 New Business model
 From fee-for-service (volume oriented) to
 fee-for-value (outcomes oriented)
 Patient Engagement
 Patient is involved and informed to better manage health outcomes
 Governments and Payers are important
 Create & funds standards, infrastructure to enable transition

16. 16
Questions & Comments
Joerg.schwarz@agfa.com