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20131125 e health_introductie
- 2. Personal introduction
Henk E. Bakker <henk.bakker@capgemini.com>
– Principal consultant for IT in Healthcare
• Capgemini Consulting Services NL
– Background
• Information Manager in several hospitals
• National Project leader of ICT program of the DBC project
• Project leader of National Electronic Medication Record project
• 25 years of industry experience
http://www.linkedin.com/pub/henk-bakker/4/280/95a
@henkebakker
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 3. Agenda
Why eHealth?
Definition of eHealth and telemedicine
eHealth from a patient perspective
eHealth business models
Acceleration of eHealth implementations
Copyright © 2011 Capgemini Consulting. All rights reserved.
3
- 5. Healthcare systems are under pressure
Chronic conditions increasingly pressurize health systems…
Copyright © 2011 Capgemini Consulting. All rights reserved.
5
- 6. In particular the accessibility, affordability and quality of care are challenged due to….
Budget cuts
Improved ‘diagnostic’
technologies
Ageing
population /
growing
demand
Innovation in
medication
technology
Future of
Healthcare
Shrinking and
changing professional
workforce
Privacy,
Security and
Patient
Consent
Increasing
service
expectations
Private
competitors
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 7. The prevalence of chronic diseases is increasing rapidly: Some figures for the
Netherlands
Now
in 10-20 years
Diabetic
450.000
1.100.000
Alzheimer’s
120.000
500.000
Total Hip
Knee
It will become75.000
a
18.000
gigantic challenge !!!
24.000
55.000
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 8. In order to remain viable or to regain viability, hospitals must realise
efficiency gains of 15-20% over the next years and sustain themselves through growth
Care
Characteristics of Demand
Ageing
Demanding care consumer
New diseases
More demand caused by
better supply
Demand
How can we
close the gap?
Government
Response
Characteristics of Supply
Decreasing workforce
No increase of care capacity
Cost containment
2000
2010
Supply
2020
2030
Year
Challenge for the Hospitals
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 9. The challenge: a paradigm shift from cure to care (quality of life)
To Care
From Cure
Restore to health
Ability to do things independently
Restore to health
Prevention
Passive patient
Active patient
Expert
Counsellor
Intramural
Extramural
Institute
Process
Fragmentation
Integration
Monodisciplinary
Multidisciplinary
trade
Evidence based
Proactive
Reactive
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 11. eHealth is no other care, but it is designed differently
Tele Treatment
eConsult
Professional and Patiënt
Telemonitoring
Self Service
Patiënt
eConsult
Professional and Professional
Self diagnosis
and Prevention
Electronic Health Record and
Personal Health Record
Alerts and Signalling
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 12. eHealth is…..
Applications for the patient
Applications that support the interaction between patient and healthcare provider
(telemedicine)
– Applications for the healthcare professional itself
– Applications for the management of care continuity (information exchange of one
provider to another)
– Applications for the governance of care
eHealth is often seen as "the application of ICT in Healthcare”;
However eBusiness or eCommerce in Healthcare is more applicable
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 13. The potential of eHealth is enormous
Increases efficiency
Is economically
interesting
Supports early
warning
Can be
anonymous
eHealth contributes to:
Health benefits (quality and gained lifetime)
Increases
self-reliance
Social well being (longer in their own living environment, contact with peer
groups)
Increases the
accessibility
Efficiency of care and of processes (productivity)
Reducing labour issues
eHealth promotes :
Empowerment of clients (they take their own responsibility)
Opportunities for providers to meet customer needs
Is 24/7 available
Health benefits
(quality and gained
lifetime)
Contributes to the
quality of care
eHealth is about substitution of care provisioning, not about more healthcare
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 14. eHealth from a patient perspective
Realisation of the paradigm shift by eHealth
- 15. The Healthcare Provider - Patient Relationship shifts Fundamentally ....…
Patient Centric
Care
Patient – Value
determines
choices
Patient
Engagement
Healthcare
delivery costs
and efforts
Patient
Awareness
Efficiency, patient
satisfaction, and
quality are key
indicators for
success
Provider
Driven
Developing
Care Providers
embrace PatientValue and
stimulate Patient
Centric Care
Patients are
involved in
healthcare services
development and
take responsibility
for sustainable
solutions
Emerging
Near Maturity
Patient
manages
Personal
Health
Innovative
Maturity/time
…towards a service orientated model, developed for the patient, influenced by the patient and in
which the patient is actively engaged
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 16. Adoption of digital technologies has become mainstream and the pace is drastically
increasing …
2 billion people connected to the Internet
Broadband penetration is exceeding 85% from
2012 in developed countries(1)
CONNECTIVITY
Access shifting from the wide-open web to
semi-closed platforms: apps, social media…(2)
5 billion mobile phone subscribers in 2010
Accelerated pace of
adoption
Time needed for “mass adoption”
(50 million users)
Mobile Internet access globally outperforming
desktop access in 2014(3)
68 y.
Phone
50 y.
Mobile already being the main device to access
the Internet in developing countries
Radio
38 y.
TV
22 y.
PC
MOBILITY
Plane
14 y.
Internet
7 y.
iPod
3 y.
Facebook
2 y.
People reading 10MB and hearing 400MB
worth of material a day(4)
DATA ABUNDANCE
User-generated content exceeding the amount
contributed by professional organizations(5)
Sources: (1) In-stat, June 10, 2008
(2) The Web Is Dead. Long Live the Internet, Wired, 2010
(3) Morgan Stanley, 2010
(4) The Economist, November, 2006
(5) Data Center of China Internet, 2010
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 17. … which leads to customers becoming more involved in the organization and getting
more influence on clientservices
‘Once upon a time’
Inspiration Orientation
Domain of “customers”
Demand
In the digital world
Service
Business scope
Inspiration Orientation
Demand
Service
Customer involvement
Increased business influence
Copyright © 2011 Capgemini Consulting. All rights reserved.
17
- 18. Interaction with the healthcare professional: the Digital Outpatient Clinic
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 19. Patient Empowerment
• Personal health record
• Doctor visit sheet (summary)
• Self-diagnosis/triage based on decision trees
• Provide comparative Health information
• Prevention and lifestyle
• Mutual contact (Forum)
• Monitoring (engage your own care team)
• Information on research programs
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 20. HealthVault Personal Health Record (PHR) platform
Prevention
Convenience
Services
Entertainment
Pleasure
Services
Social
Networks
HealthVault
Patient
Empowerment
Self
management
Personal Health Information is not safety-critical
The information is owned and managed by the patient and
can be made available for use in a professional healthcare
setting
Healthcare professionals have strict guidelines in the usage
of patient-originated data
A conscious process of incorporation of personal health
information in the formal safety-critical systems and medical
decision support is the responsibility of all professional
healthcare provider organisations
Privately stored
public information on
health, care and
wellness
Personal wellness
data from the
citizens and their
wellness providers
Personal health data
from the citizen and
their health care
providers
An EHR supports the medical doctor, the PHR empowers the citizen
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 21. Creating a Healthcare Information Ecosystem
Professional Care
Electronic
prescriptions
Medical record
ECG monitor
Education and screening
Personal record
Lifestyle
Disease management
Donor register
Step counter
Fitness monitor
Healthcare spending
Bloodsugar monitor
Weight scales
Heartrate monitor
Epilepsy diary
Blood pressure
monitor
Red is a tool
Green is a device
Personal Health
Information sharing
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 23. eHealth is patient centered, but the patients don’t pay us ….
Patient
Payer
(Insurance)
Healthcare
Provider
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 24. From eHealth proposition to a sustainable business model
Resources
Offer
Customer
Co-creation
Partner
Network
Core
Capabilities
Customer
Relationship
Value
Configuration
Value
Proposition
Distribution
Channels
Cost
Structure
PROFIT
Revenue
Streams
(Financiële) Prestaties
Financial Performance
Customer
Segment
Bron: Vrij naar Alexander Osterwalder, Business Model Generation
With a business model an organization describes, what value they create for their clients, how these
services reach and support their customers, which resources should be used, with which third party
should be partnered and finally, how they will make money
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 26. Introduction of eHealth is going (too) slow
Health insurers (the payers) have so far ehealth approached competitively and achieved
some successes
But the Health insurers encounter barriers to further upscaling:
– Termination of a project when the grant money runs out
– The lack of a clear business case
– Uncertainty about the effectiveness and efficiency of eHealth applications
– Insufficient standardization and interoperability of eHealth applications
– Lack of funding and a structural wide purchasing
Embedding eHealth in organizational processes and changing the daily practice of healthcare
professionals appear to be the most important critical success factors
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 27. Two dimensions spell out four different types of digital maturity
•
•
BEGINNERS
Fashionista have implemented or experimented with many
DIGIRATI
Digital Intensity
FASHIONISTAS
Beginners
do very little with advanced digital capabilities,
although they may be mature with more traditional
applications such as ERP or electronic commerce. Although
companies may be Beginners by choice, more often than not
they are in this quadrant by accident.
sexy digital applications. Some of these initiatives may create
value, but many do not. While they may look good together,
they are not implemented with the vision of gaining synergies
among the items.
CONSERVATIVES
•
Conservatives
•
Digirati
Transformation Management Intensity
favor prudence over innovation. They
understand the need for a strong unifying vision as well as for
governance and corporate culture to ensure investments are
managed well. However, they are typically skeptical of the
value of new digital trends, sometimes to their detriment.
truly understand how to drive value with digital
transformation. They combine a transformative vision, careful
governance and engagement, with sufficient investment in
new opportunities.
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 28. Digital Leaders show common patterns: the Digital DNA
Focus
Investments on
where they
choose to Excel
Digitally
Invest 100% in
transformation
management
Digital
Leaders
Combine Digital
Capabilities to
Exploit Synergies
Use Digital
Technologies to
Transform their
Business Models
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 29. Our two-year research program with MIT provides some useful pointers for successfully
executing a digital transformation
Conducting a digital (eHealth) transformation requires taking action in four key areas:
framing, investing, engaging, and sustaining.
Sustain the Transformation
Frame the Digital Challenge
• Build Capabilities
• Measure & Monitor
Sustain Frame
• Understand the impact
• Assess Digital Maturity
• Develop & Align around a
Vision
Engage Focus
Engage the Organization
• Signal and Mobilize
• Govern across silos
• Evolve Culture/ adapt Work
Practices
Focus Investments
• Invest in Digitally-Enabled
Initiatives
• Adapt your Business Model
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 30. We discovered that many common perceptions about digital transformation were
actually myths, which can lead executives to make unfortunate and costly decisions
“Many common
perceptions about digital
transformation are
actually myths
Fortunately, our global
survey of nearly 400 large
firms, supplemented by
157 in-depth interviews
with senior executives in
more than 50 large
companies, provides factbased answers”
Myth
Reality
Digital is primarily about the customer
experience
Huge opportunities exist also in efficiency,
productivity & employee leverage
Digital primarily matters only to
technology or B2C companies
Opportunities exist in all industries with
no exceptions
Let 1000 flowers bloom; bottom-up
activity is the right way to change
Digital transformation must be led form
the top
If we do enough digital initiatives, we will
get there
The how of transformation is more
important for driving overall performance
Digital transformation will happen despite
our IT
Business/IT relationships are key, and in
many companies they must be improved
Digital transformation approach is
different for every industry and company
Digital Leaders exhibit a common DNA
In our industry we can wait and see how
digital develops
There are digital leaders outperforming
their peers in every industry today
Copyright © 2011 Capgemini Consulting. All rights reserved.
- 31. Critical Success Factors for eHealth up scaling
eHealth is an issue for board members:
It is about organizational strategy, not IT.
The perception of the professionals:
eHealth should be given a place in the “hearts” and “minds” of healthcare professionals
Funding:
From projectfunding, subsidies to structurally embedded in the healthcare funding system
Business as Usual:
Application of eHealth should be part of the (development of) regular daily care
Future proof:
“Is Cloud technology a Game Change? Business says Yes; IT says No!”
(Andy Mulholland, Capgemini CTO)
The acceptance of digital services in the private sector in most EU countries makes it likely that
many other basic conditions for up scaling of eHealth are properly fulfilled
Copyright © 2011 Capgemini Consulting. All rights reserved.