PUBLIC SECTOR USE OF THE CLOUD- BEAUMONT HOSPITAL

earsplittinggoodbeeInternet and Web Development

Nov 3, 2013 (3 years and 9 months ago)

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PUBLIC SECTOR USE OF THE
CLOUD- BEAUMONT HOSPITAL
Martin Mc Cormack
ICT Director , Beaumont Hospital
Healthcare ever more expensive, consumption growing...
US spend already $2.3T
Years
Dramatic increase in
health care costs
... that will be compounded
by boomers propensity to
consume
... that will be compounded
by boomers propensity to
consume
Per capita growth in hospital
spending (indexed)
43
29
18
0
1
2
3
21–30
31–50
51+
1987–98 per-capita growth (indexed)
(%)
Near term, technology and
price, NOT aging, will drive
cost increases
Near term, technology and
price, NOT aging, will drive
cost increases
Drivers of expected hospital
spending growth
1
43
29
18
10
100
0
30
60
90
120
Tec
hno
log
y
Hospital
i
n
fla
t
ion
Po
pul
ati
o
n
g
row
t
h
Age
ing
p
opulati
on
Total
5–9
20–24
30–34
40–44
45–49
55–59
65–69
80–84
70–74
85–89
100+
5
Male
Female
Long-term, aging will have
dramatic impact on
structure of cost and risk ...
Long-term, aging will have
dramatic impact on
structure of cost and risk ...
Population (%)
Age
Under 5
10–14
15–19
25–29
35–39
50–54
60–64
75–79
90–94
5
4
3
2
1
0
1
2
3
4
95–99
= 2000
= 2025
Aging
Boomers
Youth
Aging
boomers
Shrinking
youth
What could eHealth look like for citizens?
Today:
Mary in Dublin
Today:
Mary in Dublin

80 years old, severe
arthritis, on the waiting list
for a hip replacement but
hasn't heard anything

Officially 'fit' to live at home
but can't cook, go up the
stairs. Has a mixed bag of
drugs – some of which she
doesn't take

Receives a hot meal each
day, a bath once a week –
not coordinated

None of the people she
sees remember her
Emerging:
Karin in Sweden
Emerging:
Karin in Sweden
Future:
Claudette in France
Future:
Claudette in France

Uses a website designed to
help manage diabetes.
Uploads blood glucose
readings from
iPhone
and
receives advice based on
readings and her own
personal goals

Manages her record
on a
secure website – and includes
key interactions with
physicians

Her genetic profile is part of a
research
database and she
receives information on new
research relevant to her
condition

Has a chronic heart condition
but stopped taking her
medicine

Friend recently referred her to
site sponsored by a pharmacist
chain via
Facebook

Filled in a form online and had
an
online

chat
with a
Pharmacist about the results.
She received the summary by
e-mail
and clicked on a link for
a follow up visit with her Doctor
Source: BCG
What could eHealth mean for providers?
Today: Fragmented,
Some applications
Today: Fragmented,
Some applications
Emerging:
Interoperability
Emerging:
Interoperability
Future: Integral part of
care delivery
Future: Integral part of
care delivery

Significant reliance on paper
and patients to exchange
information

Patients repeat information –
often is re-keyed into different
systems

Tests are repeated because
information is not trusted

Interactions driven by a
fragmented chain of events,
organised around healthcare
providers

Focus is on disease

Increasing
exchange
of
information within hospitals
and between providers, eg

Discharge summaries

Lab Results

Prescription orders

Workflow within organisations
increasingly
automated

Maturing tools for
decision-
support
(eg, adverse drug
reactions, standard protocols)

Emergence of common
standards
and
certification

eHealth becomes an integral
part of the d
elivery model

A variety of
devices

capture
diagnostic and patient
information directly into EHR

Protocols are based on
evidence
of clinical outcome

Workflow
between
organisations enabled by
information exchange,
enabled by technical and
semantic interoperability

Focus is on
wellness
and
prevention
Source: BCG
Examples of the digital ecosystem in healthcare are
already present
Health Care Organisations
Digital
community
HCP2HC
P
C2C
C2HCP
HCP2C
Ecosystem of new hardware,
software and services

Networks of patients / family
members with similar
interests

Patients directly booking
appointments with GP /
hospital

Patients complete
assessment in community
and transfer to GP

New ecosystems for research
While healthcare has its unique challenges,
significant benefit in learning from other industries
Citizen


C2C
HCP2C

C2HCP

HCP2HCP



Source: BCG
Payers / Insurers
The Healthcare model of the future
Prenatal /
Birth
Healthy Life
and Prevention
Asympt-
omatic
Early Tx
Ongoing Tx
Late
Stage Tx
Biopharma /
MedTech
Providers
Evaluation
Pay for Performance
Benefits to Population
Targeted
product
information
New
Protocols
Government /
HSE
Information & workflow
Ethics
Privacy
Outcomes
Engagement &
ownership
New therapies
Evidence
Pay for
Performance
Transformation will require new capabilities from IT
Integrated
healthcare
Mobile
and
accessible
More
affordable
Customized/Personalized
Patient
centric
Clinical and Patient
Buy-In
Clear
value Proposition
New

Business Models
for Health
Care
Transformational Health
Transformational Health
Support new
business process
Proactively drive
innovation
Lower
TCO
A step-change in
user experience

including extending IT to Patients
Clinical & administrative
relationship management

Ability to assess and realise
benefits
More complex
sourcing
New skills and
capabilities
Key Themes for IT
Key Themes for IT
Source: BCG; IVI working group
Context for Beaumont Hospital
Always changing…
Attraction of cloud computing for Beaumont hospital

The business want invisible, foolproof and
cheap I.T

Cloud computing

I
ncreases capacity and adds
capabilities quickly without investing in
new infrastructure, training new
personnel, or licensing new software.

It extends IT's existing capabilities.

Shift from traditional computing to
virtualisation to private cloud aligned to
business strategy
How does one prioritise investment?

What processes are good enough?

What do we have to concentrate on straight
away?
IT Leadership and Governance
Business Process Management
Business Planning
Strategic Planning
Demand and Supply
Management
Capacity Forecasting and
Planning
Risk Management
Accounting and Allocation
Organisation Design and
Planning
Sourcing
Resource Management
Innovation Management
Performance and Quality
Management
Service Analytics and
Intelligence

Managing IT like a
business
Funding and Financing
Budget Management
Portfolio Planning and
Prioritisation
Budget Oversight and
Performance Analysis
Managing the
IT budget
Managing IT for
business value
Managing the
IT capability
Enterprise Architecture
Management
Technical Infrastructure
Management
People Asset Management
Intellectual Capital Management
Relationship Asset
Management
Research, Development and
Engineering
Solutions Delivery
Service Provisioning
User Management and Training
User Experience Design
Programme and Project
Management
Supplier Management
Value Chain Management
Capability Assessment and
Management
Total Cost of Ownership
Benefits Assessment and
Realisation
Portfolio Management
Investment Analysis and
Performance
ITG
BPM
BP
SP
DSM
CFP
RM
AA
ODP
SRC
REM
IM
PQM
FF
BGM
PPP
BOP
EAM
TIM
PAM
ICM
RAM
RDE
SD
SRP
UMT
UED
PPM
SUM
VCM
CAM
TCO
BAR
PM
IAP
SAI
Critical processes to assess maturity and value
delivered
Processes that are key to cloud adoption

Source: Gerry Conway, IVI
Our journey to the cloud
Phase one:
IT production
Development, test and IT-
owned applications
Phase two:
Business production
Mission critical
applications
Phase three:
IT as a service (ITaaS)
Managing IT as a
service
Lower IT costs
Improved quality of service
Greater IT agility
20
03
20
11
20
14
Simplicity, efficiency
Scalability, availability,
protection and security
Policy driven, fluid and
elastic, chargeback
capable
72%
Lessons learned

The cloud is taking us places we couldn’t go
before.

Resistance is natural.

Test, monitor and review security to ensure
confidence.

Transformation takes time.

Our legacy systems feel like cement shoes.