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Making Care Mobile - PwC presentation at ATA Fall Forum, Toronto, September 10, 2013

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Will Falk of PwC Canada presents the shift to virtual care impacting healthcare delivery in Canada and the US at the ATA Fall Forum in Toronto, Canada on September 10, 2013.

Will Falk of PwC Canada presents the shift to virtual care impacting healthcare delivery in Canada and the US at the ATA Fall Forum in Toronto, Canada on September 10, 2013.

Published in: Health & Medicine, Business

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  • 1. Making Care Mobile: Shifting Perspectives on the Virtualization of Health Care ATA Fall Forum Luncheon Keynote Sept 10, 2013 @willfalk slides available on Twitter
  • 2. PwC Who I am Will Falk Managing Partner – Healthcare, PwC Canada Executive Fellow, Mowat Centre for Policy Innovation Adjunct Professor, Rotman School of Management william.f.falk@ca.pwc.com Twitter: @willfalk 2
  • 3. PwC Making Care Mobile: Shifting Perspectives on the Virtualization of Health Care • Report explores Canadians’ attitudes towards pertinent issues in the health care industry • Provides analysis of what citizens expect decision makers to keep in mind when thinking of the future of health care in Canada Goal of the report • What improvements are citizens looking for in health care? • What channels are citizens using to access health care and information now, and in the future? • What innovations are citizens ready to use that can make health care delivery more efficient? • What are the future possibilities in health care delivery? Key Questions www.pwc.com/ca/virtualcare 3
  • 4. PwC Making Care Mobile Shifting perspectives on the virtualization of health care More than 2,400 Canadians participated in our research to address the central question, “What does the future of health care delivery look like?” 4
  • 5. PwC Virtual assessments via apps are good options in the right situation… 52% of patients indicate that faster access to care is the primary appeal of virtual assessment 1% 8% 15% 20% 21% 36% No answer Not sure None of the above You use an app for an initial assessment You send it to your doctor using an app Doctor takes the photo and communicates with dermatologist 77% of Canadians were comfortable with virtual mole assessment app scenario – although, at this time, most prefer doctor-controlled option. 5
  • 6. PwC Canadians told us they are ready for virtual monitoring for chronic conditions… 79% of Canadians indicate that they are comfortable with virtual monitoring for chronic conditions Most Canadians indicated they would be comfortable having a chronic condition monitored virtually... 36% 43% 10% 5% 4% 2% Yes, definitely Probably Not likely Definitely not Not sure No answer ... and 62% of caregivers indicated that virtual health care would help them to provide care for someone else (e.g. parent/ child) 6
  • 7. PwC … and virtual visits for post-surgical follow-up. 54% of Canadians indicate that virtual visits, home monitoring, and virtual wards are good care delivery options 24% 43% 17% 11% 5% 0 Yes, definitely Probably Not likely Definitely not Not sure No answer The majority of Canadians indicated they would be comfortable having post-surgical follow-up visit done by video conference. 7
  • 8. PwC Q: Are mHealth and vHealth different? Consumer mHealth is exploding in part as a result 8
  • 9. PwC Telemedicine and mobility are coming together facilitating delivery of virtual care anywhere Telemedicine mHealth Virtual Care 9
  • 10. PwC 10 many small pilots 25% By 2020, more than 25% of care will be delivered virtually (with provider and patient in separate places). - Dr. Ed Brown, 2012
  • 11. PwC Virtual Health Care: We have been through similar shifts before… Inpatient Care Outpatient Care Virtual Care 1992… More people leave hospital after procedure than remain overnight 202X?… More virtual visits than physical visits Each transition involved people, process, and technology changes. Major shifts in how we organize our care delivery services and assets 11
  • 12. PwC Virtualization improves health system access, quality, productivity, and sustainability… Access Quality Productivity Sustainability • Deliver care over long distances • Reduced travel and wait times • Re-distribution of HHR – access to scarce specialties • Better waiting rooms • Auditability of decisions • Use of manufacturing, QI, and QA techniques • Lower infection rates/ Infection control • Automated scheduling • Elimination of “politeness time” • Asynchronous consultations • Ability to aggregate volumes • Avoidance of greenhouse gases • Ability to substitute lower cost care providers • Auction pricing mechanisms • Artificial Intelligence 12
  • 13. Specialists’ Offices Regional Hospitals On-Call Emergency Physicians Public Health Units Mental Health and Addiction Treatment Centres Primary Care Family Health Teams Community Hospitals Cancer Centres First Nations Communities Psychiatric Hospitals CCACs Mental Health Facilities Federal and Provincial Prisons Rural Nurse Practitioners Long-Term Care Homes Referring Clinician Consulting Clinician eReferral 4. eConsult (ask a question) 3. eConsult (full assessment) 2. Clinical Videoconference 1.Face-to-Face Provider to Provider: The Future
  • 14. PwC Virtual Care solutions will be segmented by cost of delivery, and offer benefits to specific segments 14 High cost solutions supported by high clinical value Cost-value tradeoff Cost level can only be supported using consumer electronics 10,000 01,000 001oo 010 Solutioncost/benefit($) Population (%) 5% 100%50%
  • 15. PwC Focusing on “frequent flyers” both helps and hinders developing an at scale virtual care system 1% 34% 5% 66% 10% 79% 50% 99% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Ontario Population Health Expenditure Figure 1. Health Care Cost Concentration: Distribution of health expenditure for the Ontario population, by magnitude of expenditure, 2007 $33,335 $6,216 $3,041 $181 Expenditure Threshold (2007 Dollars) Source: ICES 15
  • 16. PwC The drug delivery system may provide a model for the organization of apps and devices Take 2 Apps and Call Me in the Morning Tech Rx Apps Pharmacy not Apps Store Apps Formulary AliveCor Cardiac Withings Blood Pressure bant Diabetes Pain Squad Pain Mgmt MyIBD Crohn’s Disease 16
  • 17. PwC We need a process and standards for selection, and a taxonomy for regulation of apps Front of Store Over the Counter Prescription Controlled Substance Criteria for evaluation include: • Operability • Privacy & Security • User Data Safeguards • Functional Validation • Clinical Efficacy 17
  • 18. PwC Front of store apps are mHealth ‘vitamins’ that supplement a healthy lifestyle Front of Store Over the Counter Prescription Controlled Substance 18
  • 19. PwC Over the counter apps may be dispensed after an assessment of the patient's needs Front of Store Over the Counter Prescription Controlled Substance 19
  • 20. PwC Prescription apps: plan of care written by physician or other health professional Front of Store Over the Counter Prescription Controlled Substance 20
  • 21. PwC Front of Store Over the Counter Prescription Controlled Substance Controlled apps: require close supervision of management and use 21
  • 22. PwC Virtual care and Apps fulfillment is now a new class of service offerings Front of Store Over the Counter Prescription Controlled Substance In this stage of their development, the ‘prescription’ and ‘fulfillment’ of mHealth Apps need not be separated 22
  • 23. Thank you. @willfalk * slides available on Twitter This content is for general information purposes only, and should not be used as a substitute for consultation with professional advisors. © 2013 PricewaterhouseCoopers LLP, an Ontario limited liability partnership. All rights reserved. PwC refers to the Canadian member firm, and may sometimes refer to the PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details.