Med Device Vendors Have Big Opportunities in Health IT Software, Services, and Data Management,


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If you’re in the medical device manufacturing or hardware sales business your revenue growth (CAGR) is under pressure like never before. You’re being asked to do more with less but you’re probably going to find that hard to accomplish because of one or more of the following challenges:

* Longer product development timelines caused by more FDA and other government regulations
* Increased demand by customers to have your devices deliver user experiences that are more like “consumer” devices such as cell phones and tablets
* Lower margins as a reaction to commodity competition (your sensor hardware business will be commoditized faster and faster over time)
* More complex and longer sales cycles because devices are now being approved for sale not by facilities and clinical executives alone but increasingly by CIOs and IT teams
* Increased cost of risk management and compliance caused by connectivity requirements

Any one of these challenges is difficult to meet but these days you’re probably being asked to meet more than one simultaneously. The solutions are not simple but the good news is that medical device manufacturers have many revenue generation opportunities today that can fund the new strategic imperatives you’ll need to put into place to meet the challenges listed above.

This briefing, presented by Netspective CEO Shahid Shah, describes some of the opportunities and how device vendors can take advantage of them.

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Med Device Vendors Have Big Opportunities in Health IT Software, Services, and Data Management,

  1. 1. Device Vendor Opportunities in Health IT Data Management Data is becoming currency and device vendors shouldn’t let health IT software firms own or control it By Shahid N. Shah, CEO
  2. 2. NETSPECTIVE Who is Shahid? • • • • 20+ years of software engineering and multidiscipline complex IT implementations (Gov., defense, health, finance, insurance) 12+ years of healthcare IT and medical devices experience (blog at 15+ years of technology management experience (government, non-profit, commercial) 10+ years as architect, engineer, and implementation manager on various EMR and EHR initiatives (commercial and non-profit) Author of Chapter 13, “You’re the CIO of your Own Office” 2
  3. 3. NETSPECTIVE What you’ll learn in this briefing Data from devices is too important to be left to others Background • • • • A deluge of healthcare data is being created as we digitize biology, chemistry, and physics. Data changes the questions we ask and it can actually democratize and improve the science of medicine, if we let it. While cures are the only real miracles of medicine, big data can help solve intractable problems and lead to more cures. Healthcare-focused software engineering is going to do more harm than good (industry-neutral is better). Key takeaways • • • • Applications come and go, data lives forever. He who owns, integrates, and uses data wins in the end. Data from devices is too important to be left to software vendors, managed service providers, and system integrators. There’s nothing special about health IT data that justifies complex, expensive, or special technology. Spend freely on multiple systems and integration-friendly solutions. 3
  4. 4. NETSPECTIVE Manufacturer’s have a great deal to worry about Your customer, competitors, and industry are all shifting Customer is trapped by their EHR vendors Device vendors aren’t benefiting from industry trends Customer base has shifted from clinical to clinical + IT + system integration Clinical customer goals have shifted from basic automation to advanced process optimizations Device manufacturer’s access to regulated IT and system integration skills is limited Struggling to find new revenue sources as hardware is commoditized 4
  5. 5. NETSPECTIVE Healthcare Industry / Market Trends Major market and regulatory trends that are causing customers and competitors to shift Device manufacturers must become experts on all of these terms PPACA ACO PCMH “Affordable Care Act” “Accountable Care Org” “Medical Home” Health Home mHealth MU “Meaningful Use” PCPCC “Patient Centered Care” 5
  6. 6. NETSPECTIVE NEJM believes doctors are trapped by EHRs Don’t buy the argument that the “enterprise EHR” should maintain / own / manage all data It is a widely accepted myth that medicine requires complex, highly specialized information-technology (IT) systems. This myth continues to justify soaring IT costs, burdensome physician workloads, and stagnation in innovation — while doctors become increasingly bound to documentation and communication products that are functionally decades behind those they use in their “civilian” life. New England Journal of Medicine “Escaping the EHR Trap - The Future of Health IT”, June 2012 6
  7. 7. NETSPECTIVE Trend Goal: Patient Engagement How does your device help customers engage with their patients? Superb Access to Care Patient Engagement in Care Clinical Information Systems •Patients can easily make appointments and select the day and time. •Waiting times are short. •eMail and telephone consultations are offered. •Off-hour service is available. •Patients have the option of being informed and engaged partners in their care. •Practices provide information on treatment plans, preventative and follow-up care reminders, access to medical records, assistance with self-care, and counseling. •These systems support high-quality care, practice-based learning, and quality improvement. •Practices maintain patient registries; monitor adherence to treatment; have easy access to lab and test results; and receive reminders, decision support, and information on recommended treatments. Source: Health2 Resources 9.30.08 7
  8. 8. NETSPECTIVE Trend Goal: Coordinated Care How does your device help customers coordinate care across their partners? Care Coordination •Specialist care is coordinated, and systems are in place to prevent errors that occur when multiple physicians are involved. •Follow-up and support is provided. Team Care •Integrated and coordinated team care depends on a free flow of communication among physicians, nurses, case managers and other health professionals (including BH specialists). •Duplication of tests and procedures is avoided. Patient Feedback •Patients routinely provide feedback to doctors; practices take advantage of low-cost, internetbased patient surveys to learn from patients and inform treatment plans. Publically available information •Patients have accurate, standardized information on physicians to help them choose a practice that will meet their needs. 8
  9. 9. NETSPECTIVE Why care about MU? If you’re not talking about MU you’ll find it harder to get in the door “Enable significant and measurable improvements in population health through a transformed delivery system.” 2011 2015 MU Stage 1 MU Stage 2 MU Stage 3 No Impact 2013 Indirect Impact: Start planning for MU Direct Impact: Device integration proposed 9
  10. 10. NETSPECTIVE There’s money in MU Devices can and should be “MU capable” 10
  11. 11. NETSPECTIVE Fit into CIO’s strategic framework In the future your devices won’t be sold into customers without CIO approval Source: The Advisory Board 11
  12. 12. NETSPECTIVE Implications of health IT trends PPACA ACO Software Regulated IT and Systems Integration Services MU Health Home PCMH mHealth DATA Evidence Based Medicine Comparative Effectiveness 12
  13. 13. NETSPECTIVE Don’t give up data to others without a fight Software vendors, systems integrators, and others don’t have your best interest in mind Device Teaming Cloud Services Patient Self-Management Platforms SSL VPN Patient Context Monitoring Device Gateway (DDS, XMPP ESB) , Device Data Data Transformation (ESB, HL7) Remote Surveillance Management Dashboards HIT Integration Report Generation Device reimbursement Enterprise Data RCM, Financials, EHRs Device Management Cross Device App Workflows Device Utilization Device profitability Alarm Notifications Device Inventory 13
  14. 14. NETSPECTIVE New revenue centers in software and services Build the right roadmap so that you don’t leave new revenue on the table 2 year ranking comparison of Top 30 HIT firms by offering type. Pure play firms are failing behind 100% Focus on Services and Solutions is the way to go 80% 60% Up % of all firms by 40% offering Down Flat 20% Ranking YoY 0% Hardware Software Services Source - The 2012 Healthcare Informatics 100 ranks the leading 100 vendors by revenues derived from healthcare IT products and services earned in the U.S. 14
  15. 15. Start small but think big Market your devices as data generators that can help change medical science
  16. 16. NETSPECTIVE We’re digitizing biology Last and past decades Digitize mathematics Digitize literature Digitize social behavior Predict human behavior Gigabytes and petabytes This and future decades Digitize biology Digitize chemistry Digitize physics Predict fundamental behaviors Petabytes and exabytes 16
  17. 17. NETSPECTIVE We’re just getting started Will you be ready for the coming data deluge and can you differentiate your device? Social Interactions Biosensors Economics Phenotypics Since 1970, pennies per patient Since 1980s, pennies per patient • Business focused data • Retrospective • Built on fee for service models • Inward looking and not focused on clinical benefits • Must be continuously collected • Mostly Retrospective • Useful for population health • Part digital, mostly analog • Family History is hard Genomics Since 2000s, started at $100k per patient, <$1k soon • Can be collected infrequently • Personalized • Prospective • Potentially predictive • Digital • Family history is easy Proteomics Emerging • Must be continuously collected • Difficult today, easier tomorrow • Super-personalized • Prospective • Predictive 17
  18. 18. NETSPECTIVE Data changes the questions we ask Simple visual facts Complex visual facts Complex computable facts 18
  19. 19. NETSPECTIVE Implications for scientific discovery The old way Identify problem Identify data Ask questions Generate questions Collect data Mine data Answer questions The new way Answer questions 19
  20. 20. NETSPECTIVE We’re in the integration age We’re not in an app-driven future but an integrationdriven future. He who integrates the best, wins. Source: Geoffrey Raines, MITRE 20
  21. 21. Don’t become a commodity sensor company Educate your customers about the importance of medical device data
  22. 22. NETSPECTIVE Obvious sources of data Your device data needs to fit in and integrate across a wide variety of existing customer data Clinical systems Consumer and patient health systems Core transaction systems Decision support systems (DSS and CPOE) Electronic medical record (EMR) Managed care systems Medical management systems Materials management systems Clinical data repository Patient relationship management Imaging Integrated medical devices Clinical trials systems Telemedicine systems Workflow technologies Work force enabling technologies 22
  23. 23. NETSPECTIVE Architect for next generation sources of data Your device data needs to fit in and integrate across a wide variety of new sources of data Clinical trials data (failed or successful) Secure Social Patient Relationship Management (PRM) Patient Communications, SMS, IM, E-mail, Voice, and Telehealth Patient Education, Calculators, Widgets, Content Management Blue Button, HL7, X.12, HIEs, EHR, and HealthVault Integration E-commerce, Ads, Subscriptions, and Activity-based Billing Accountable Care, Patient Care Continuity and Coordination Patient Family and Community Engagement Patient Consent, Permissions, and Disclosure Management 23
  24. 24. NETSPECTIVE Your device is a great source of data Understand how your data compares to other data sources Patient Source Self reported by patient Health Professional Observations by HCP Labs & Diagnostics Specimens Medical Devices Real-time from patient Biomarkers / Genetics Specimens Errors High Medium Low Low Low Time Slow Slow Medium Fast Slow Reliability Low Medium High High High Kilobytes Kilobytes Kilobytes Megabytes Gigabytes Gigabytes Gigabytes Uncommon Uncommon Discrete size Streaming size Availability Uncommon Common Somewhat Common 24
  25. 25. NETSPECTIVE Application focus is biggest mistake The customer needs are changing from simple automation to complex process improvements Application-focused IT instead of Data-focused IT is causing business problems. Silos of information exist across groups (duplication, little sharing) Clinical Apps Billing Apps Lab Apps Other Apps Healthcare Provider Systems Patient Apps Partner Systems Poor data integration across application bases 25
  26. 26. NETSPECTIVE The Strategy: Modernize Integration Be sure you fit into your customer’s data architecture and governance needs Need to get existing applications to share data through modern integration techniques Clinical Apps NCI App Billing Apps Lab Other Apps Apps NEI App Healthcare Provider Systems Patient Apps NHLBI App Partner Systems Master Data Management, Entity Resolution, and Data Integration Improved integration by services that can communicate between applications 26
  27. 27. NETSPECTIVE Data-centric device architecture Extensibility and adaptability will be key in a data-centric world 5 Device Components • Presence • Messaging • Registration • JDBC, Query Sensors Storage Event Architecture Display 6 App #1 App #2 Plugins 4 Location Aware Connectivity Layer (DDS, HTTP, XMPP) 3 Device OS (QNX, Linux, Windows) 3rd Party Plugins Web Server, IM Client 1 7 Plugin Container 2 Security and Management Layer 27
  28. 28. NETSPECTIVE Ensure your devices fit in a modern IT architecture Don’t give up your device data to others without a fight Device Teaming Cloud Services Patient Self-Management Platforms SSL VPN Patient Context Monitoring Device Gateway (DDS, XMPP ESB) , Device Data Data Transformation (ESB, HL7) Remote Surveillance Management Dashboards HIT Integration Report Generation Device reimbursement Enterprise Data RCM, Financials, EHRs Device Management Cross Device App Workflows Device Utilization Device profitability Alarm Notifications Inventory 28
  29. 29. Visit E-mail Follow @ShahidNShah Call 202-713-5409 Thank You