SIEMENS

Anyone concerned with healthcare finances should review the figures published in the OECD’s 2011 healthcare report. These include statistics that show how frequently medical services, such as office visits and magnetic resonance imaging (MRI) examinations, are provided. And the evidence is clear. In most countries, these services are being used more and more every year. This is a welcome development, since it is an indicator of improved healthcare. On the other hand, each additional examination, each blood test, and each fluoroscopy adds to costs.

While developing countries and emerging markets are confronted with the challenge of providing basic medical care to growing populations, industrial nations face the challenge of providing healthcare to a rapidly aging population. Although less than one in six people are older than 65 today, by 2050 the equivalent figure will be one in four. And UN figures indicate that the population in less developed countries will also have aged substantially by then. This trend is of particular concern in China, where the number of people over 65 is expected to triple to about 330 million by 2050.

How IT Improves Services. Despite extreme differences, the basic challenge is the same in all countries: how to improve the quality of medical care while reducing costs. The answer to this question lies in our ability to address several key areas: preventive care, early detection, personalized therapies, and process optimization. Information technologies (IT) and the Internet will play a key role in all of these.

Indeed, this trend is already starting to emerge in some countries. In Denmark, for instance, 97 percent of all prescriptions are issued electronically and doctors and patients communicate via e-mail in 60 percent of all medical offices — as digital aftercare. In Sweden, Iceland, and the Netherlands, doctors and patients are gaining experience in the remote medical monitoring of patients with chronic conditions. Current data, such as a patient’s weight, blood pressure and blood oxygen level, are transmitted to the physician via e-mail or telephone.

In the U.S., the first promising trials are under way for providing overweight patients with a robot that helps them achieve a healthier lifestyle. In this approach, a patient answers a robot’s questions about weight, nutrition and exercise — by means of a computer screen built into a robot. A computer collects and analyzes this data, and the robot then issues recommendations concerning nutrition and exercise in a gentle voice.

Behind information technology innovation in healthcare is the growing need on the part of large hospitals and laboratories to optimally utilize personnel and equipment. One such facility is the Würzburg University Clinic, one of Germany’s top hospitals. A total conversion of the clinic’s diagnostic radiology department from zero to 100 percent digital in 2004 amounted to “a quantum leap,” says Prof. Dietbert Hahn, Director of the clinic’s Institute of Roentgen Diagnostics. As a result, all X-ray findings at the clinic are now distributed electronically rather than on paper or film.

To further improve the efficiency and speed of its processes, in 2011 the clinic introduced Siemens’ syngo.plaza, an agile picture archiving and communications system (PACS) for routine clinical reading. The product supports loading performance of up to 200 images per second. It also supports central application management to reduce complexity and costs.

To understand the system’s benefits, consider the following example: To analyze the condition of a patient with severe multiple injuries might require hundreds of images, which used to take several minutes to download from a medical records server to the diagnosing physician’s workstation. Now, however, it might take only seconds thanks to syngo.plaza. Medical team meetings often address the X-ray images of more than 20 patients. As a result, professionals now save considerable time, which can be used to evaluate images rather than waiting for downloads.

In the U.S., the Department of Radiology at the Marshfield Clinic in the state of Wisconsin has shown how IT systems can reduce costs while also improving patient care. Marshfield comprises two hospitals and 54 satellite facilities at locations throughout Wisconsin. The radiology department at the main location in Marshfield provides services to all affiliated facilities and handles up to 500,000 MRI and X-ray cases annually. To provide swift diagnostic evaluations, even during peak periods, the clinic’s management came up with a solution that allows all authorized radiologists to view images at any radiology workstation (assuming all prerequisites are met). As a result, radiologists at nine locations, including one that is about 3,700 miles away in Hawaii, now use syngo.plaza to store, process, and make images available at any time to the widely scattered satellite facilities.

It’s not just radiologists who are saving time now. Marshfield’s IT department also benefits because it can service the Windows-based syngo.plaza faster and more effectively, whereas the old system was Unix-based and only a few IT employees were qualified to work with Unix. Since many software systems used in hospitals around the globe also run on Windows, it’s much easier now to connect seamlessly with other networks, servers, and clinical systems. What’s more, for the advanced development of its image evaluation systems, Siemens has chosen a client-server architecture that makes it possible to install software updates centrally rather than having to update every workstation individually. This reduces maintenance costs substantially.

To further optimize working procedures, Siemens has developed software that can significantly increase patient throughput for magnetic resonance imaging systems. The software helps ensure that the table supporting the patient is swiftly moved into the optimal position for the required examination. In difficult cases — for instance when children can’t remain motionless or seriously ill patients can’t hold their breath long enough — the software provides predefined proposals to the radiologist in order to complete the procedure as efficiently, thoroughly, and swiftly as possible.

Rapid Error Detection. As is the case with all hospital departments, preventing errors is a top priority, and the clinical lab is no exception. Here, managers see an urgent need for systems that can automatically detect contaminated samples or chemical reactions that have gone wrong during a test. This was revealed in 2010 by a survey of 230 laboratory directors in the U.S. and Europe that was conducted by Siemens Healthcare Diagnostics.

The second-highest priority is the ability to graphically visualize different laboratory processes on a monitor in order to swiftly locate the origin of a problem. To fulfill these needs when developing new laboratory systems, Siemens experts have examined automation systems widely used in industrial and energy applications. In those industries, even highly complex systems such as power plants can be managed via functions displayed on a screen. In place of error messages with long columns of numbers that first need to be tediously analyzed, such monitoring systems display a graphic image of the affected part, such as a faulty valve. Improvements along these lines could soon come to hospital labs.

Web-based services are also becoming very useful in clinical systems. Such services are widely used in industry, for instance, to allow global collaboration between departments separated by great distances. Similarly, the days when radiologists have to sit down at a hospital workstation to evaluate images will soon be over. In an era in which imaging centers and hospitals are looking to provide high-quality care for more patients, an application such as syngo.plaza helps radiologists and clinicians to expand their services to virtually any location, all while having access to a wide range of functionalities.

Other IT applications could go a step further — right into “the cloud,” thus eventually making it possible to store medical records on a server that a user could theoretically access from any PC worldwide via the Internet. For example, in order to transmit medical data to a hospital, IT systems could be linked via a secure connection to data centers. Such systems could learn from each case and from each other as best practices crystalize from data. In other words, the greater the number of hospitals participating, the larger the database related to a given topic. The goal all physicians share — to have more time for their patients — might then be much closer to realization.