Personalized Public Health Campaigns

Personalized Public H l h P l d P bl Health Campaigns pg Executive Summary October 2005 Giordano Beretta, Henry Sang Gi d B tt H S Publishing Systems & Technologies Department Imaging Systems Laboratory, HP Labs

Basic problem • Dependency of a family solely on their doctor d t causes costly i ffi i tl inefficiencies i • Thesegross inefficiencies can be reduced by timely and appropriate education in healthy life style habits and prevention 3 October 2005 2

goal • To create a money-making venture around the medical i d t di l industry 3 October 2005 3

value proposition: help people help themselves Leverage patient records • − public h lth monitoring of di bli health it i f diseases − on-going follow-up to medical problems − patient specific medical alerts (vaccinations, checkups,…) Leverage HP’s personalized publishing • Data mining and campaign optimization − variable content publishing capabilities − automated workflow systems − high volume, high quality printing capabilities − existing partners − Leverage the public’s demand for self-help • − increased demand for accurate and timely information −ddesire to pro-actively h l themselves and their families l help h l dh f l 3 October 2005 4

basic concept: high value & high volume • 392 printed health and fitness newsletters • currently more than 1 billion pages per year − potentially 115,904,641 housing units * 12 issues/year * 8 pages/issue = 11 126 845 536 pages/year /i 11,126,845,536 / • 2004 health insurance coverage (Census Bureau) − 245 3 million (84.3%) people have health insurance 245.3 (84 3%) − 45.8 million do not have health insurance − number of people covered by g pp y government health programs increased between 2003 and 2004 from 76.8M (26.6%) to 79.1M (27.2%) • i di indirect t savings i 3 October 2005 5

planned capital purchases over next 5 years (% CFOs responding) 0 10 20 30 40 50 60 70 80 digital radiology systems 72 computerized physician order entry 64 systems major IT system 61 increase ER capacity i i 51 increase OR capacity 50 convert semi-private rooms to private 36 add computer in patient rooms 25 new hospital 23 source: Healthcare Financial Management Association, March 2004, p.8 3 October 2005 6

funding sources for health services and supplies expenditures private health insurance 37% out-of-pocket payments 14% o e p va e u ds other private funds 4% state & local funds 13% federal funds 32% Source: Centers for Medicare and Medicaid Services, 2004c 3 October 2005 7

206 HMO medical centers with 751 establishments source: U.S. Census Bureau Statistics of U.S. Businesses: 2001. HMO medical centers United States 500+ employees py 45 100-499 employees 29 20-99 20 99 employees 21 10-19 employees 15 5-9 5 9 employees l 18 1-4 employees 53 no employees 25 0 100 200 300 400 500 600 firms establishments 3 October 2005 8

print: demographic data can be exploited for custom publishing • newsletters are PR material or bait for demographic data • control points: data modeling, publishing, VDP production • integration: complex application yields opportunities for C&I • managed services: small publishers lack IT skills • hosting: p g publishers may want not to deal with IT y issues • utility data center: data mining and layout requires large resources 3 October 2005 9

newsletter circulation data Tufts University Health and PacifiCare HealthBeat 2,959,400 250,000 Nutrition Letter American Institute for Cancer 1,600,000 Harvard Health Letter 226,000 Research Newsletter Mayo Cli i H l h L M Clinic Health Letter 750,000 750 000 Cancer Care Health Monitor C C H lhM i 210,000 210 000 Diabetes Health Monitor 528,717 Harvard Heart Letter 115,000 Arthritis Health Monitor 460,788 Harvard Mental Health Letter 52,363 Johns Hopkins Medical Letter: p 425,000 425 000 AIDS Clinical Care Newsletter 32,000 32 000 Health After 50 Harvard Women's Health 400,000 The Nation's Health 31,000 Watch UCB Wellness Letter 350,000 Fibromyalgia Network 20,000 3 October 2005 10

newsletter pages per year Mayo Clinic Health Letter 72,000,000 Harvard Health Letter 21,696,000 Johns Hopkins Medical 40,800,000 Harvard Heart Letter 11,040,000 Letter: Health After 50 Harvard Women's Health 38,400,000 The Nation's Health 6,200,000 Watch Harvard Mental Health Diabetes H lth Monitor Di b t Health M it 38,067,624 38 067 624 5,026,848 5 026 848 Letter Cancer Care Health Monitor 37,800,000 Fibromyalgia Network 4,800,000 AIDS Clinical Care UCB Wellness Letter 33,600,000 3,072,000 Newsletter TOTAL Tufts Health and Nutrition 24,000,000 336,502,472 Letter this table 3 October 2005 11

newsletter subscription income/a Harvard Mental Health Diabetes Health Monitor $22,047,499 $3,770,136 Letter Mayo Clinic Health Letter $20,250,000 Harvard Heart Letter $3,680,000 Harvard Women's Health AIDS Clinical Care $12,800,000 $3,488,000 Watch Newsletter J Johns Hopkins Medical p $10,200,000 $10 200 000 The N ti ' Health Th Nation's H lth $1,550,000 $1 550 000 Letter: Health After 50 UCB Wellness Letter $9,800,000 Fibromyalgia Network $500,000 TOTAL Tufts Health and Nutrition $101,413,635 $7,000,000 Letter this table Harvard Health Letter $6,328,000 3 October 2005 12

patient handouts • 500# gorilla: Krames − part of the international MediMedia conglomerate f − sister company publishes Harvard newsletters − known more for breath than depth − 300,000 customers, 80% of US hospitals • expensive ($2 each) • has PoD solution Krames On-Demand 3 October 2005 13

Components of gross domestic product, product 2003 (total = $11 trillion) Sources: Bureau of Economic Analysis, Medicare Other Auto 3.8% Defense 4.5% Food 9.7% Housing 10.9% Health 15 3% 15.3% Health is the largest sector of the U.S. economy 3 October 2005 14

Economic health and burden of chronic disease in $ billion, 2004 billion 400 350 300 250 200 150 100 50 0 diabetes cardio cancer tobacco obesity Source: CDC 3 October 2005 15

today s today’s system • what is counted? − publishers give f free issues to medical offices ff • makemoney by using feedback mechanisms and data d t aggregation t create d ti to t demographic d t hi data − sell or rent address lists − targeted inserts in envelopes − permission based mailing of adverts for pharmaceuticals and medical services − campaigns t i targeting each patient over th course of a ti h ti t the f disease, adapting the message to the disease’s course • difficulty in assessing true market size in dollars 3 October 2005 16

opportunities • mainmessage: convert some of the health care money t savings via prevention to i i ti − Fortmann data • li t list of sources of i f f income/money pools and how bi / l dh big they are • direct money pools: subscription, info, pre-op, etc subscription info pre op etc. • indirect / leverage: reduce health cost 3 October 2005 17

newsletter players today • in the US there are two distinct ecosystems served by the b th same set of publishing companies: t f bli hi i − wellness newsletters • no medical liability • leveraged on the supplement industry • gather demographics via round-tripping • heavy content reuse • shake-out in industry − patient information •lleverages on same content corpus tt • clinician bears full responsibility • clinician generally unhappy with what they have 3 October 2005 18

wellness newsletter ecosystem government agency government medical group agency commercial hospital h it l customers content providers Medicare insurance non-profit … … partners government consulting agency school of data center professional fi l medicine di i HP business society experts international self-help organization call center organization … … print service provider data center suppliers production call center … role will become supplier/partner, not competitor 3 October 2005 19

best ecosystem for HP redo in terms of new slide “today’s system” above • build up for strategy, i.e., move money and capture 20% • wellness newsletters are printed in high volume on light • paper − it is hard to compete on price with gravure and offset on large runs p patient information • − can benefit from print-on-demand − clinicians are unhappy with current state − pages have high value pg g business challenge: the same group of people owns the • content opportunity: h b d newsletters hybrid l • 3 October 2005 20

leverage • what HPL technologies can we leverage on? − optimized production processes − campaign management − document analysis and automatic layout − print optimization − general digital publishing know-how complexity low high 3 October 2005 21

divisional customers opportunity for IPG to enter • the digital press application data center, market hosting opportunity for C&I to enter pp y • the health care vertical printers, supplies market contributes to the goal of • achieving estimated 10 C&I integration, billion Indigo pages/year domain comsulting managed services (propritery, (propritery S/W, systems, associated 3 October 2005 22

pilot • want reference customer, marketing tool, and shake our the product • hospitals and large HMOs in need of branding • partner must b experienced i patient i f t t be i d in ti t information ti − what works and what does not? − what is ethical? − HIPAA • must also partner with a content creator − content i expensive is i • need also funding − insurance company? 3 October 2005 23

special customers • Department of Veterans Affairs − mandate to providing f federal benefits to veterans and f their families − about a quarter of the nation s population, approximately nation's 63 million people, are potentially eligible for VA benefits and services − 2004 spending was $63.5 billion $63 5 • Kaiser Permanente − Nation's largest HMO 8 2 million members in 2003 Nation s HMO, 8.2 − Kaiser Foundation Health Plans and Hospitals, Permanente Medical Group • both may be able to self-fund 3 October 2005 24

a win-win proposition • patients get guidance towards a healthier life • insurance companies save money when their members need less services • medical services grow because − patients are happier and recommend it − can live on the fi d i li th fixed income th get f they t from i insurances • HP makes a step towards − th goal of achieving 10 billi I di pages/year the l f hi i billion Indigo / − enters a new vertical in which it has no presence − does good for society g y 3 October 2005 25

a win-win proposition ALTERNATE Win for HP customers in health care industry • − Hi h value services th t should i High l i that h ld increase wellness of th i patients ll f their ti t − Potentially reduce health costs owing to early intervention Win for patients p • − More informed health information allowing self help − Mechanism to seek additional information Win for industry • − New services and printing opportunities Win for HP • − New product and services opportunity for HP in digital publishing − High value, high volume opportunity for Indigo division for printing and supplies pp − Leverages on HP’s core competencies 3 October 2005 26

next step • recommendations on how to go forward − need help f from a business development specialist − find an interested divisional partner − work with a sales or C&I person (we are interacting directly with customers, but do not yet make a sale) − get a second meeting with Palo Alto Medical Foundation and VA Palo Alto Health Care S t d P l Alt H lth C System − form a team of technology providers 3 October 2005 27

go/no go decision • should it live or die? −ffinancial data is OK − interest is strong • what ht is involved f th pilot? ii l d for the il t? − need help from business development specialist − need to develop connections within HP − line up resources to provide the technology • this proposal exploits the insurance vector − it is a financial business and that organization is probably the best partner 3 October 2005 28

technological impact • technology requirements − high performance custom printing on digital press and f laser printer (for point of contact handouts) − optimized production processes − campaign management − document analysis and automatic layout − print optimization • potential research vectors: − automatic l i layout i the DFE in h − new digital publishing paradigms − new campaign management strategies 3 October 2005 30

data to date • notbeing a player in the health vertical made it particularly h d to get d t b ti l l hard t t data, because we could not ld t get introductions •h how we did it − searching on the Web − scouting patient libraries − interviewing health sector decision makers for patient information − i t i i content providers interviewing tt id − lots of cold calls, with great help from the HP library 3 October 2005 31

Importance of branding Do you think the certification and/or accreditation of medical Web sites may reduce the issues listed above? Yes No Undecided Source: 8th HON Survey, Health On the Net Foundation, May-June 2002 3 October 2005 32

Internet is not trusted In your opinion, what is the most critical issue facing the Internet and especially the medical Internet? A ccuracy o f info Trustwo rthness Finding info /Navigatio n A vailability Junk Spam Subscriptio n P o rno graphy P rivacy Equal access Co st A dvertising B andwidth Regulatio n Security A ccessibility Co pyrights Censo rship Legality No respo nse Source: 8th HON Survey, Health On the Net Foundation, May-June 2002 3 October 2005 33

Wellness newsletter cost example Assumptions: • − 4 pages − 1,000 identical copies − Prepared by M.D. and staff Research, writing & editing text $500 Layout, design & graphics $400 Printing, paper & f ldi P i ti folding $450 Envelopes $100 Postage $350 Addressing, inserting, sealing & affixing postage $250 Total $2,040 , Source: Patient News Publishing, Niagara Falls 3 October 2005 34

Traditional workflow academic paper online content conference wellness newsletter medical writer editorial WHO/CDC board medical writer patient bulletin editor medical writer patient information press release online content news article wellness vs. $: board prestige salary subscriber medical info UC B k l Berkeley Belvoir M di B l i Media Medline Plus M dli Pl healthy h lth example: Harvard University Health vs. Medline vs. sick 3 October 2005 35

Clear return on investment • Claims by contents provider Healthwise − One client reported saving $34.5 million in 30 months with Healthwise information − 23% of respondents reported avoiding an unnecessary visit to the doctor − 15% avoided an unnecessary visit to the emergency room − Another survey showed 87% of the respondents were more satisfied with their health plan as a result of participating i a H lth i program ti i ti in Healthwise source: http://www.healthwise.org/mhb_employers.aspx 3 October 2005 36

Alternate uses training Puerto Rico health card materials wellness newsletter clinic staff bios medical group post visit info sheet publisher institution info content repository in-depth info insurance admission info Medicare/Medicaid clinician’s update hospital surgery i f info therapy info self-help group 3 October 2005 37

Personalized Public Health Campaigns

by Giordano Beretta on Jan 08, 2009

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Personalized Public Health Campaigns — Presentation Transcript