24 th July 2007 HL7 Conference London. Dr Lester Russell. Chief Medical Officer. NHS Account Fujitsu Services

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1 24 th July 2007 HL7 Conference London Dr Lester Russell Chief Medical Officer NHS Account Fujitsu Services Fujitsu Services 20

2 We're here to make a dent in the universe. Otherwise, why even be here? Steve Jobs, CEO Apple Inc 2 Fujitsu Services 2007

3 24 th July 2007 HL7 Conference London Why are we doing this? How are we doing? Where are we going? Fujitsu Services 20

4 24 th July 2007 HL7 Conference London Why are we doing this? How are we doing? Where are we going? Fujitsu Services 20

5 Fujitsu Services 2007

6 Fujitsu Services 2007

7 Fujitsu Services 2007

8 Fujitsu Services 2007

9 850,000 Fujitsu Services 2007

10 10 Fujitsu Services 2007

11 What did he say? 11 Fujitsu Services 2007

12 Paper mountain 12 Fujitsu Services 2007

13 13 Fujitsu Services 2007

14 The Problem 14 Fujitsu Services 2007

15 Projected Cost Growth in Healthcare in the US Richard Hillestad, Ph.D., RAND Corporation 4.5 Annual health expenditures ($trillions) $2.1 Trillion(100%) 10 Years Official CMS projection of healthcare cost growth Year 15 Fujitsu Services 2007

16 UK Health Expenditure m NHS Total Year Sources: ONS, OHE 16 Fujitsu Services 2007

17 Health productivity the critical quotient max 17 Fujitsu Services 2007

18 Health productivity the critical quotient max $ 18 Fujitsu Services 2007

19 Health productivity the critical quotient max 19 Fujitsu Services 2007

20 Health productivity the critical quotient max 20 Fujitsu Services 2007

21 24 th July 2007 HL7 Conference London Why are we doing this? How are we doing? Where are we going? Fujitsu Services 20

22 Electronic Booking Bookings Made Using Choose and Book 2,500,000 2,000,000 Bookings 1,500,000 1,000, ,000 0 Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- 07 Months Fujitsu Services 2007

23 Electronic Prescriptions GP Sites GP Practices Operating the Electronic Prescriptions Service Jun- Jul- Aug- Sep- Oct- Months Nov- Dec- Jan- 07 Fujitsu Services 2007

24 Electronic Prescriptions Prescription Messages Issued Electronically 12,000,000 Messages Issued 10,000,000 8,000,000 6,000,000 4,000,000 2,000,000 0 Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- 07 Month Fujitsu Services 2007

25 Map of Medicine deployments Map of Medicine Deploym ent - Southern Cluster Deployed Projected Jul- Aug- Sep- Oct- Nov- Dec- Jan-07 Feb-07 Mar-07 Apr-07 May-07 Jun-07 Jul Fujitsu Services 2007

26 Digital X-Rays Live PACS Systems Live PACS Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- 07 Months Fujitsu Services 2007

27 PACS Data Store Cumulative Images June 2007 SC - Stored Images Cumulative 195,000, ,000, ,000, ,000, ,000, ,000, ,000,000 90,000,000 75,000,000 60,000,000 45,000,000 30,000,000 15,000, /04/ /05/ //2005 /07/ /08/ /09/ /10/ /11/ /12/ /01/20 15/02/20 19/03/20 20/04/20 22/05/20 23//20 25/07/20 26/08/20 27/09/20 29/10/20 30/11/20 01/01/ /02/2007 /03/ /04/ /05/ //2007 Date 27 Fujitsu Services 2007 Images

28 GEYMS CT Typical pre PACS workflow Patient Registered Previous Exams hung in Reading Room Patient Data Re-Entered at Acq Device Exam Performed Develop Film Quality Assurance Hang Films Radiologist Dictate & Un-hang films Transcribe & Report approved Send Films & Report to Referring Clinician Retrieve Films & Report from Referring Clinician Re-assemble Film Jacket Return Films to File Room 28 Fujitsu Services 2007

29 GEYMS CT Typical post PACS workflow Patient Registered Exam Performed Quality Assurance Radiologist Read Dictate & Approve Referring Clinician Accesses Report and Films 29 Fujitsu Services 2007

30 PACS What difference does it make? We've used PACS to completely change the way we re working. Dr Michael Creagh, Lead Radiologist, Ashford St Peter s 30 Fujitsu Services 2007

31 NHS Account - achievements to date 1.2 million people benefiting from NHS CRS in the South of England SHAs 100% deployment milestone of PACS and RIS reached in March 2007 Over 190 million diagnostic images stored in Fujitsu s UK data centres - increasing at over 3 million images/week Over 7 million patient examinations stored in Fujitsu s UK data centres All 5 clusters now running with NHS Connecting for Health Service Desk provided by Fujitsu 31 Fujitsu Services 2007

32 24 th July 2007 HL7 Conference London Why are we doing this? How are we doing? Where are we going? Fujitsu Services 20

33 Exponential advances in technology It took us 15 years to sequence HIV. We sequenced SARS in 31 days. Ray Kurzweil 33 Fujitsu Services 2007

34 edoc Doctors use ancient tools, memorize symptoms and solutions..and a half-way decent search engine can leave them in the dust. Andrew Kessler, in The End of Medicine: How Silicon Valley (and Naked Mice) will Reboot your Doctor 34 Fujitsu Services 2007

35 edoc Google aids doctors diagnoses BBC News 10 th November 20, 35 Fujitsu Services 2007

36 36 Fujitsu Services 2007

37 From Personalized Disease to Personalised Medicine Top Down Approach Patient Bottom Up Approach Physiology???? Metabonomics Proteomics Genomics 37 Fujitsu Services 2007

38 Personalised Medicine Sisters lose stomachs to avoid cancer Radical bid to beat inherited disease The Sunday Times, 12 th November 20 Two sisters in their early twenties have had their stomachs removed to protect themselves from a fatal inherited disease. Lisa and Ruth Bendle took the decision because they carry a defective gene that caused fatal stomach cancer in their father, cousin and grandmother. As technology to identify the risk of inherited cancer genes develops, more people will face such decisions. Doctors have already identified inherited forms of bowel, kidney and pancreatic cancer. 38 Fujitsu Services 2007

39 From medical records to EHR Potential benefit Paper records Medical records & microfiche Systematic scanning Scanned & archived documents Selective scanning Indexed document storage Multimedia integration Coded electronic documents Fully web enabled Virtual shared EHR Scale of integration 39 Fujitsu Services 2007

40 The Continuum of Care NHSD OoH GP Amb/999 A&E Hospital ward ISTC WIC MIU/ATC Pharmacy Patien t GP SC GP MH MW HV PN DN Fujitsu Services 2007

41 Broad, Deep and Longitudinal Lifestyle Data Time Locations of Care Bio Data 41 Fujitsu Services 2007

42 A patient s view 42 Fujitsu Services 2007

43 The more technology the better. Better than the old ways - definitely. Margaret Goodwin, Patient. 43 Fujitsu Services 2007

44 44 Fujitsu Services 2007

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