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What’s next for healthcare
information technology innovation?
Vanderbilt Healthcare Conference 2012
Shahid N. Shah, CEO
NETSPECTIVE

Who is Shahid?
•
•
•

•

20+ years of software engineering and multisite healthcare system deployment
experience
12+ years of healthcare IT and medical
devices experience (blog at
http://healthcareguy.com)
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 nonprofit)

www.netspective.com

Author of Chapter 13, “You’re
the CIO of your Own Office”
2
NETSPECTIVE

What’s this talk about?
Questions answered

Key takeaways

• What does innovation in
healthcare mean?
• Where are the major areas
in healthcare where
innovation is required?

• Understand PBU: Payer vs.
Benefiter vs. User
• Understand why healthcare
businesses buy stuff so you
can build the right thing

www.netspective.com

3
NETSPECTIVE

What I mean by “innovation”

Innovation in healthcare is especially hard to define given the wide variety of constituencies

For this presentation, we’ll assume that “innovation” means
either:
a) You have made the job of identifying, diagnosing,
treating, or curing diseases faster, better, or cheaper for
clinicians through the use of information technology (IT)
OR

b) You have made the job of self-diagnosing, self-treating,
or preventing diseases and improving overall wellness of
patients through the use of IT
www.netspective.com

4
NETSPECTIVE

What Is the Business of Health Care?

What business are you in? The Emergence of Health as the Business of Health Care

• It's always better to define a business by what
consumers want than by what you can produce or
build
– For example, whereas doctors and hospitals focus on
producing health care, what people really want is health

• In the future, successful doctors, hospitals, and health
systems will shift their activities from delivering health
services within their walls toward a broader range of
approaches that deliver health.
Source: http://www.nejm.org/doi/full/10.1056/NEJMp1206862
www.netspective.com

5
NETSPECTIVE

PBU: Payer vs. Benefiter vs. User

If you don’t understand the exact interplay between PBU your product will fail

The person or group that
actually uses the product.

User

The person or group
that benefits most
from the use of the
product.

www.netspective.com

Benefiter

Payer

The payer is the
person/entity
that writes the
check for your
product.
6
NETSPECTIVE

What problem will you be solving?
Focus on jobs that need to be done, not what you want to build

Improve
medical
science?

Improve access
to care?

Reduce costs?

Improve
therapies?

Improve
diagnostics?

Improve drug
design?

Improve drug
delivery?

Create better
payment
models?

www.netspective.com

7
NETSPECTIVE

How to identify the best opportunities
From “Jobs to be Done” to the “Five Cs of Opportunity Identification”
Circumstance

• The specific
problems a
customer
cares about
• The way they
assess
solutions

Context

• Find a way to
be with the
customer
when they
encounter a
problem and
• Watch how
they try to
solve it

Compensating
behaviors

Constraints

• Develop an
innovative
means around
a barrier
constraining
consumption

• Determining
whether a job
is important
enough to
consider
targeting
• One clear sign
is a customer
spending
money trying
to solve a
problem

Criteria

• Customers
look at jobs
through
functional,
emotional,
and social
lenses

Source: http://blogs.hbr.org/anthony/2012/10/the_five_cs_of_opportunity_identi.html
www.netspective.com

8
NETSPECTIVE

Do you have ideas in payment design?
Payment models going fee for service to outcomes-driven care

The business needs

The technology strategy

• Quality and performance
metrics
• Patient stratification
• Care coordination
• Population management
• Surveys and other directfrom-patient data collection
• Evidence-based surveillance

•
•
•
•
•
•
•
•

www.netspective.com

Aggregated patient registries
Data warehouse / repository
Rules engines
Expert systems
Reporting tools
Dashboarding engines
Remote monitoring
Social engagement portal for
patient/family
9
NETSPECTIVE

Can you repurpose or enhance health data?
Try to use existing data to create new diagnostics or therapeutic solutions

Economics

Administrative

www.netspective.com

Phenotypics

Behavioral

Biochemical

Genomics

Proteomics

IOT sensors

10
NETSPECTIVE

Some stuff not to focus on

Incremental innovation is easier, disruptive innovation is probably more useful

• Don’t go for simple incremental innovation if
you can be bold and disruptive
• Don’t look at mHealth, look at mobility in
healthcare
• Don’t look at apps, look at entire systems

www.netspective.com

11
NETSPECTIVE

Forget mobile apps, focus on health IOT
• With all the attention being paid to mHealth
there’s been an useless focus on mobile apps
• For the mobile apps, instead focus on
mobility in healthcare through “health
internet of things (IOT)” and self-care
technologies
www.netspective.com

12
NETSPECTIVE

Healthcare Industry Fallacies
• Healthcare folks are neither technically challenged nor
simple techno-phobes (they’re busy saving lives)
• Most product decisions are no longer made by clinical
folks alone, CIOs are fully involved
• Complex, full-featured, products are not easier to sell
than simple, stand alone tools that have the capability
of interoperating with other solutions are
• Hospitals will not buy unless one proves value.
• Selling into doctors offices is not easy.
www.netspective.com

13
NETSPECTIVE

What makes your products successful
•
•
•
•
•
•
•
•
•
•
•

Easy to explain
Defendable and differentiated
Attractive partnership opportunities
Word of mouth opportunity
Potential for PR
Scaleable staff and systems
Scaleable product — build once, sell many times
Uncomplicated
Focused
Sales model is scaleable and predictable
Own relationship with and information about customers

www.netspective.com

14
NETSPECTIVE

Why healthcare businesses buy stuff

Healthcare businesses have complex buying processes – figure out why and what they buy

Increase
revenue
(topline)

Maintain
capabilities

Reduce costs
(bottomline)

Attract new
patients

Increase staff
productivity

Find your
reason

www.netspective.com

15
NETSPECTIVE

The Customer Relationship

If you can’t figure out why they buy, see if any of the things below make sense

Customer Gives
You Get
•
•
•
•
•
•
•
•

Money
Time
Energy
Commitment
Referrals
Past experience
Expectations
Knowledge

www.netspective.com

You Give
Customer Gets
•
•
•
•
•
•
•
•

Product
Price
Value
Convenience
Selection
Service
Warranty
Brand
16
NETSPECTIVE

Defining your customer is really hard

Don’t focus on market segmentation, but do try to figure out who your customer is

Target health
sector?

Number of
employees?

Annual sales
volume?

Geography?

Number of
hospital beds?

Number of
patients?

Type of
patients?

The list goes on
and on…be
specific!

www.netspective.com

17
NETSPECTIVE

Health technology sector has many ups and downs
Make sure you understand where your product fits in the hypecycle

Source: Gartner; “Hype
Cycle for Healthcare
Provider Applications and
Systems, 2010”
www.netspective.com

18
Visit
http://www.netspective.com
http://www.healthcareguy.com
E-mail shahid.shah@netspective.com
Follow @ShahidNShah
Call 202-713-5409

Thank You

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What’s next for healthcare information technology innovation?

  • 1. What’s next for healthcare information technology innovation? Vanderbilt Healthcare Conference 2012 Shahid N. Shah, CEO
  • 2. NETSPECTIVE Who is Shahid? • • • • 20+ years of software engineering and multisite healthcare system deployment experience 12+ years of healthcare IT and medical devices experience (blog at http://healthcareguy.com) 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 nonprofit) www.netspective.com Author of Chapter 13, “You’re the CIO of your Own Office” 2
  • 3. NETSPECTIVE What’s this talk about? Questions answered Key takeaways • What does innovation in healthcare mean? • Where are the major areas in healthcare where innovation is required? • Understand PBU: Payer vs. Benefiter vs. User • Understand why healthcare businesses buy stuff so you can build the right thing www.netspective.com 3
  • 4. NETSPECTIVE What I mean by “innovation” Innovation in healthcare is especially hard to define given the wide variety of constituencies For this presentation, we’ll assume that “innovation” means either: a) You have made the job of identifying, diagnosing, treating, or curing diseases faster, better, or cheaper for clinicians through the use of information technology (IT) OR b) You have made the job of self-diagnosing, self-treating, or preventing diseases and improving overall wellness of patients through the use of IT www.netspective.com 4
  • 5. NETSPECTIVE What Is the Business of Health Care? What business are you in? The Emergence of Health as the Business of Health Care • It's always better to define a business by what consumers want than by what you can produce or build – For example, whereas doctors and hospitals focus on producing health care, what people really want is health • In the future, successful doctors, hospitals, and health systems will shift their activities from delivering health services within their walls toward a broader range of approaches that deliver health. Source: http://www.nejm.org/doi/full/10.1056/NEJMp1206862 www.netspective.com 5
  • 6. NETSPECTIVE PBU: Payer vs. Benefiter vs. User If you don’t understand the exact interplay between PBU your product will fail The person or group that actually uses the product. User The person or group that benefits most from the use of the product. www.netspective.com Benefiter Payer The payer is the person/entity that writes the check for your product. 6
  • 7. NETSPECTIVE What problem will you be solving? Focus on jobs that need to be done, not what you want to build Improve medical science? Improve access to care? Reduce costs? Improve therapies? Improve diagnostics? Improve drug design? Improve drug delivery? Create better payment models? www.netspective.com 7
  • 8. NETSPECTIVE How to identify the best opportunities From “Jobs to be Done” to the “Five Cs of Opportunity Identification” Circumstance • The specific problems a customer cares about • The way they assess solutions Context • Find a way to be with the customer when they encounter a problem and • Watch how they try to solve it Compensating behaviors Constraints • Develop an innovative means around a barrier constraining consumption • Determining whether a job is important enough to consider targeting • One clear sign is a customer spending money trying to solve a problem Criteria • Customers look at jobs through functional, emotional, and social lenses Source: http://blogs.hbr.org/anthony/2012/10/the_five_cs_of_opportunity_identi.html www.netspective.com 8
  • 9. NETSPECTIVE Do you have ideas in payment design? Payment models going fee for service to outcomes-driven care The business needs The technology strategy • Quality and performance metrics • Patient stratification • Care coordination • Population management • Surveys and other directfrom-patient data collection • Evidence-based surveillance • • • • • • • • www.netspective.com Aggregated patient registries Data warehouse / repository Rules engines Expert systems Reporting tools Dashboarding engines Remote monitoring Social engagement portal for patient/family 9
  • 10. NETSPECTIVE Can you repurpose or enhance health data? Try to use existing data to create new diagnostics or therapeutic solutions Economics Administrative www.netspective.com Phenotypics Behavioral Biochemical Genomics Proteomics IOT sensors 10
  • 11. NETSPECTIVE Some stuff not to focus on Incremental innovation is easier, disruptive innovation is probably more useful • Don’t go for simple incremental innovation if you can be bold and disruptive • Don’t look at mHealth, look at mobility in healthcare • Don’t look at apps, look at entire systems www.netspective.com 11
  • 12. NETSPECTIVE Forget mobile apps, focus on health IOT • With all the attention being paid to mHealth there’s been an useless focus on mobile apps • For the mobile apps, instead focus on mobility in healthcare through “health internet of things (IOT)” and self-care technologies www.netspective.com 12
  • 13. NETSPECTIVE Healthcare Industry Fallacies • Healthcare folks are neither technically challenged nor simple techno-phobes (they’re busy saving lives) • Most product decisions are no longer made by clinical folks alone, CIOs are fully involved • Complex, full-featured, products are not easier to sell than simple, stand alone tools that have the capability of interoperating with other solutions are • Hospitals will not buy unless one proves value. • Selling into doctors offices is not easy. www.netspective.com 13
  • 14. NETSPECTIVE What makes your products successful • • • • • • • • • • • Easy to explain Defendable and differentiated Attractive partnership opportunities Word of mouth opportunity Potential for PR Scaleable staff and systems Scaleable product — build once, sell many times Uncomplicated Focused Sales model is scaleable and predictable Own relationship with and information about customers www.netspective.com 14
  • 15. NETSPECTIVE Why healthcare businesses buy stuff Healthcare businesses have complex buying processes – figure out why and what they buy Increase revenue (topline) Maintain capabilities Reduce costs (bottomline) Attract new patients Increase staff productivity Find your reason www.netspective.com 15
  • 16. NETSPECTIVE The Customer Relationship If you can’t figure out why they buy, see if any of the things below make sense Customer Gives You Get • • • • • • • • Money Time Energy Commitment Referrals Past experience Expectations Knowledge www.netspective.com You Give Customer Gets • • • • • • • • Product Price Value Convenience Selection Service Warranty Brand 16
  • 17. NETSPECTIVE Defining your customer is really hard Don’t focus on market segmentation, but do try to figure out who your customer is Target health sector? Number of employees? Annual sales volume? Geography? Number of hospital beds? Number of patients? Type of patients? The list goes on and on…be specific! www.netspective.com 17
  • 18. NETSPECTIVE Health technology sector has many ups and downs Make sure you understand where your product fits in the hypecycle Source: Gartner; “Hype Cycle for Healthcare Provider Applications and Systems, 2010” www.netspective.com 18