Dr. Dr. h.c. Monika Lehnhardt

Moscow, May 1st, 2012

Scalability of post-operative care

for CI recipients

Situation Analysis

World population is growing World population is ageing Technological advances at an increased speed Open, easy, cost free access to information via Internet Participative decision making in health care Incidence of deafness unchanged Quality of life an important factor Need for life-long care for CI recipients indisputable Economical constraints

Consequences

Indication broadening constantly (e.g. elderly population,￭ severely hearing impaired, single sided deafness …)

Awareness of availability of effective treatment for deafness spreading (candidates, parents, children of parents searching in the￭ Internet for objective information and exchange experience on Social

Platforms) Self-confidence of candidates and their spokesmen improving based

on acquisition of knowledge and social interaction

Increasing number of CI candidates every year

Germany now 20 k – in three years 60 kWorldwide estimate now 240 k – in three years 720 k

Dramatic / exponential growth of existing CI recipients pool demanding life-long care

Would seriously damage the validity of CI as a cost effective and beneficial treatment for the deaf

Lack of trained personnel (training is time consumingand expensive, equipment is also expensive, requiresadditional space, which is difficult to create)

Options

Do nothing = unacceptable

Add personnel and equipment = unrealistic

Change the structure of the care-giving system fundamentally =

(John Niparko, G.O’Donoghue, 2008)

the evident solution

Expand service of CI manufacturers not economical

Accept the challenge and adapt the business model =

=

Options

Scalability is the Solution

a) achieve the same results with less effort

e.g. mobile working stations, less office space, people working from home, people with no fixed salary working on project basis, eliminate higher costs for printed media

by (partly) replacing them with digital information

b) achieve more /better results with the same effort

Definition:

Economy of scale = Adaptability of costs in relation to turnover =

reduction of fixed costs

Scalability successfully implemented

SKYPE (developed in Estonia) : people establish their own telephone base

Facebook: > 600 Million users

cost free, as efficient as Windows from Microsoft

Scalable software for hospital management suitable for highly varying numbers of patients

Cloud computing in health care –see SynXplatform presented by Microsoft in March 2011

Scalability of production

Introduction of automated processes to reduce manual work and herewith risk of human failure to improve the reliability of devices and reduce cost of production

Scalability in CI surgery

Techniques have changed significantly over the last 28 years

incision size, flap shape, approaches, insertion of the electrode array, suturing, imaging techniques, computer aided surgeryTime for surgery reduced from 3 hours to 1 ½

In the future possibly robots will “do the job” faster and more reliable

(David Proops, Suzdal, December 2011)

Application of scalability conceptin post-operative care for CI-recipients

Registration Online

￭ no need of manually filling in cards, mailing, collecting, copying…

￭ Central Computing of data at an independent organization to get reliable statistics about CI recipients (e.g. Switzerland, Belgium, Netherlands, Austria, UK)

Application

cooperation between clinic/operating room and fitting centre

experienced expert maneuvers the software programme on the hardware of the less experienced in another location

fitting of new speech processor via Internet connection between the experienced and less experienced audiologist

of scalability conceptin post-operative care for CI-recipients

Upgrades

Tele-fitting sessions

Share intra-operative measurement data to create first maps

Application

CI systems will report about their functionality and about eventual problems online and will receive online instructions how to fix the problem or suggest competent resources where to find a solution

of scalability conceptin post-operative care for CI-recipients

Failure Reporting Online

Exchange of experience amongst experts and parents in LiveOnline Rooms across countries and language barriers e.g. PORA! Training programme for Russian speaking therapists

Voskresnyj Poldnik – Sunday meetings for Russian speaking parents

Application of scalability conceptin post-operative care for CI-recipients

Re(Habilitation) Online

of scalability conceptin post-operative care for CI-recipients

Application

Online consultation of surgeons, therapists and other experts for parents seeking advice

Continue Conferences LiveOnline

Weblogs – Interactive Communication – Presentations –

Preparation of next conference

Increase the sustainability of conferences

by continuing in the Internet environment

Conclusion

Have the experts not waste their time in extensive and expensive travelling, in working with instruments and equipment, applying mainly their manual skills, but have them spend quality time in talking with their clients / patients to improve the level of care and with colleagues on an intra- and interdisciplinary basis to develop new ideas how to improve medical treatments for people in need.

Apply scalable processes and services to free human resources and have them concentrate on providing what can only be provided by human beings

EMPATHY

Thank you for your attention and please feel free to comment

in my personal weblog

www.monika-lehnhardt.net