"How compe**ve dialogue will take VGR into the future of Digital Pathology” 6 years into 20 minutes Mikael Wintell CMIO BFR/Patos Västra Götalandsregionen My goal with todays talk Our imaginaon is the only limit to what we can hope to have in the future & People are very open-minded about new things as long as they´re exactly like the old ones! Charles Frankling Keering (1876-1958) Avoid Agenda • Goal • Background • Why now • The choice, Compete4ve Dialogue • The process • Conclusion/Dialogue – Outcome (as of today) – Soluon? Västra Götalandsregionen • Bildades 1999 • Budget 2011: 42,3 miljarder kr • Över 50 000 anställda • 49 kommuner • Folkmängd: 1,5 miljoner • Avstånd nord-syd: 300 km • Avstånd öst-väst: 250 km Västra Götalandsregionen Bengtsfors Strömstad • 17 sjukhus Dals-Ed Åmål Bäckefors Gullspång • 29 röntgenavdelningar Tanum Mellerud • 5 externa leverantörer av radiologi Färgelanda Töreboda Munkedal MariestadKarlsborg • 4 patologi laboratorier Götene Sotenäs Uddevalla Lidköping Skövde Tibro – Vänersborg SU / SÄS / NU och SkaS ( Unilabs) Grästorp Skara Lysekil Trollhättan Vara Hjo • 130 vårdcentraler Orust Lilla Edet Essunga Falköping Tidaholm • 168 folktandvårdkliniker Tjörn Stenungsugn VårgårdaHerrljunga Ale Alingsås Kungälv Lerum Borås Ulricehamn Öckerö Partille Bollebygd Göteborg Härryda Mölndal Skene Tranemo Svenljunga = sjukhus Goal • Op4mize the possibilies for the staff, meboxing • Informaon tranparenses, No informaon lock in, system independent • Go from New Public Management to Value based healthcare • Focus shi from system/equipment governance to Paent and Medicine • Use the new legal Procurement Act to become more innovave • Make our region act as one for the paents, equal quality of care • Op4mize the ”turn around mes” within pathology • One speaking partner many possibilies (Consorum) Background New Public Management to Value Based Healthcare Why Now 1(4) Lack of Patologists, BMA (BioMedicine Analy4cs) and not acceptable TAT:s Why now 2(4) ILC overview and Big Data from the cradle– (Proactive,ER, Rehab, Aging)-- to the grave Health Management data Sick--- (Trauma, cardio etc.. ) ---Well Disease Management IN-EPR, Simulations, Diagnosdriven- OUT Workflow management HERE -Patients, Staff, equipment-THERE Medical interaction Utilization management Why Now 3(4) Key Challenges for Healthcare Organizations § Continually improving the Quality of Care • Ever growing volumes of information § Growing aging population – cost burdens • Data often “hostage” to specific applications § Accurate information – when and where it’s & storage islands needed • Contain costs – “do more with less” § Meeting regulatory compliance requirements • Integration, Interoperability & Legacy Data § Creating a single master EPR from multiple challenges disparate sources (both clinical and non- • Managing increasing complexity clinical) • Freedom of choice – applications & § Focus on cost of care and reporting across the infrastructure (without Vendor Lock-in!!) enterprise § Improving Healthcare workflow Why Now 4(4) Economy Traditional care based on our history Euros Primary focus, to take care when things already have become a fact Reactive Care Costs Collaborative Healthcare sharing information Partnership between public and private 1950 1990 201? healthcare providers Proactive Care Compe*ve dialogue A process where you set aside the technical focus and instead boost the focus of the required func4onality within the domain but also that domains responsibility within the Enterprise In a dialogue, you together with the actors goes from an overall conceptual solu4on to a disnct managed service with the required content and func4onali4es Will take some 4me and effort but the result is all worth it if you choose wisely CD is not the salvator for every purchase (complex, not out of the box products, longme contracts) SERVICE Trust Value PATOS The process • BP0, BP1, Project direcves 2014 • CD Starts 1/10 – 2014 • Tenders 27/7-2015 • Evaluaon 4/8-2015 • Decision 3/9-2015 • Contract date 1/10-2015 • Due Diligence 1/10- 30/11-2015 • Start av PATOS 1/12-2015 CD chronology– Contract period (Managed Services) • Managed Services • FLA Planing Pilot Implemenaon • Slide with one R&D column and picture CD Parallell syndrome Contractperiod 24 pt CD start Contract date Delivery starts up During the whole contractperiod the maincontractor will deliver the requirements as a managed service. Conclusion/Dialogue 17 Outcome • Freedom of choice – applications & infrastructure (without Vendor Lock-in!!) • VGR set up a request for services and not a technical solution, that means that innovations still can live within the legal requirements • Always be ahead of “new” technologies (Consortium) • Long-term contracts, where you start in some details but soon will go into principles, agreed up on. • Change management, NOT an IT-project What we want to achieve with Digital Pathology • Process oriented Digital Pathology, not just within Dept. of Pathology but within the Enterprise • VS • Instead of Image Management Pathology within an applicaon Why is it so important for us Healthcare- providers to achieve a transparent informaon workflow? Response to early detection and risk factors Health authorities • Education • Early screening programs? • Identification & monitoring of risk groups • Investing in information lifecycle • Medication Management The individual • Know your family medical history • Life style changes (diet & exercise) • Personalized decision support Risk quantification New information management infrastructure • Standards • Data mining • Interoperable systems • Ethics & security Predicting your medical future: Information Knowledge Early Health A Convergence of Need Policy Management Evidence based How to harvest more • Post health care precise and better genomic research information and then reprocess it Clinical Practice, Audit & Clinical trials Governance recruitment 23 Summary "How compe**ve dialogue will take VGR into the future of Digital Pathology” • That the technical solution is only a peripheral challenge • Instead the central challenges are to create and implement a – heterogeneous information model Services driven – new workflowStarts andOct new 1th 2015 ways of organizing principles work and people • will10 + 10 leadManaged toYear cultural Contract effects that needs to be negotiated and managed - ChangeChange Management Managementnego4ated Innovaons by From ref. to report and everything between Manage Services (VGR:Staff, Physical locaons, Med Response) Partnership-”Patos” 25 And remember! ” This is not the end, it is not even the beginning of the end, it is only the end of The beginning” – Sir Winston S. Churchill Digital Pathology But everybody will be a part of it ! .