New business models in healthcare provision

  • 1,643 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
No Downloads

Views

Total Views
1,643
On Slideshare
0
From Embeds
0
Number of Embeds
1

Actions

Shares
Downloads
0
Comments
0
Likes
6

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. New business models in healthcare provisionDaan Giesen
  • 2. 1. Personal background2. A real-life story3. Traditional vs. new healthcare4. Evolving business models5. Value of business models6. Challenges, barriers & actions7. Future expectationsCONTENT
  • 3. 1. PERSONAL BACKGROUND• eHealth research for theEuropean Commissionon best practiceeHealth businessmodelsMOBILE HEALTH eCOMMERCEINNOVATION &BUSINESS MODELS• Research in Portugal onorganizationalconsequences of e-commerce• Business developmentwithin the largest e-tailer in the Netherlands• Primary focus oninnovation and newbusiness models andthe implications it hason organizations andsociety
  • 4. 1. Personal background2. A real-life story3. Traditional vs. new healthcare4. Evolving business models5. Value of business models6. Challenges, barriers & actions7. Future expectationsCONTENT
  • 5. 2. A REAL-LIFE STORYWHO IS VISITING A DOCTOR ORHOSPITAL MORE THAN ONCE A YEAR?
  • 6. • My brother Diederik• Diabetes Type 1• Insuline dependent• Injects ±6 times a day• Every 6 weeks to the hospitalWay of Working• Checks sugar level• Writes down his values• Adjust insuline levels• Inject insuline• Trial and error (how do I feelafter the injection?)2. A REAL-LIFE STORYDIABETES
  • 7. 1. Personal background2. A real-life story3. Traditional vs. new healthcare4. Evolving business models5. Value of business models6. Challenges, barriers & actions7. Future expectationsCONTENT
  • 8. 3. TRADITIONAL VS. NEW HEALTHCARERESEARCH CASE STUDIES• Identify the underlining business models ofsustainable mobile healthcare systemswithin four market segments identified inthe EU Lead Initiative• Extraction of best practices for makingmobile healthcare systems sustainablebeyond the pilot phase6 Case studies of sustainable mobile healthservices:•Situation of the system/service•Description of network and partners in themobile health value chain•Analysis on mobile health Business Model•Assessment of the Relative PerformanceCase studies:TelemedEscape (Italy)CUP Umbria (Italy)Tactive (the Netherlands)Naviva (the Netherlands)UCLH (UK)ALERT (Portugal)Source: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009
  • 9. 3. TRADITIONAL VS. NEW HEALTHCAREFROM TO• Professional centered• Effectiveness & efficiency• Opinion-based• Event• Organization• Structure• Clinical practice peripheral• Money-driven• Patient centered• Value• Evidence-based• Pathway• Network• System• Clinical practice central• Knowledge-drivenSource: RAND Europe, 2009What would the impact be on Diederik when you consider this change?
  • 10. 3. TRADITIONAL VS. NEW HEALTHCARE – BACK TO THE REAL-LIFE STORY• A hospital serves a target population of 2500 young people who need better access to information abouttheir diabetes condition• Government’s initiative: give young people the support they need• 85% of children and young people with Type 1 Diabetes do not have it under control• It is vital that they understand how much to take in order to regulate the level of blood glucose levels soas to have a normal healthy life• A cooperation between the national healthcare organization, hospital and IT partner designed andimplemented a mobile health technology in diabetes involving children and their parents• Specialist modems at home. These plug into blood sugar meters and automatically upload results• Results are available to clinicians and to a specialized team of nursesPossiblesolutionEnvironmentMain driversto changeBusinessModel• System gives access to data, which can be analyzed. Clinicians can proactively intervene, or simply callpatients to give advice or guidance• Creates better care, and ultimately lowering average blood glucose resulting in less complications andfewer costsKey SuccessFactorsBusinessModelSource: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009
  • 11. • Hospitals• Providing a solution in diabetes3. TRADITIONAL VS. NEW HEALTHCARE – DIABETES CARESource: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009SITUATION SOLUTIONMARKETSEGMENTGEOGRAPHICPOSITIONVALUEPROPOSITION• One hospital has several healthcareprofessionals• Provide care to young diabetics viaconsults, advice, recipes• Homecare remote monitoring system• Add value in the handling ofdiabetes• Usable and scalable to hospitals inthe region/country• Share data and insights on measures• Deliver a total solution for youngdiabetes patients in order to monitoran act on their disease
  • 12. 3. TRADITIONAL VS. NEW HEALTHCARE – DIABETES CARE VALUE CHAINHospitalHealthcareorganizationCliniciansSupport in diabetes Type I;Young patientsProvide diabetescare to clientsDiabetesnursesQuality & Control; SubsidyKnowledgeNeed-oriented diabetes assistanceFeedbackHomecareMonitoringsystemHealthcareorganizationIT serviceproviderMonitoring functionMonitoring functionClinicianshospitalDiabetesnursesQuality & Control; SubsidyKnowledgeNeed-orienteddiabetes assistanceIT KnowledgeDiabetes careknowledgeFeedbackIT partnerSystem/Service KnowledgeSource: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009SITUATION SOLUTION
  • 13. 1. Personal background2. A real-life story3. Traditional vs. new healthcare4. Evolving business models5. Value of business models6. Challenges, barriers & actions7. Future expectationsCONTENT
  • 14. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELCUSTOMER/PATIENT SEGMENTSSource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 15. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELVALUE PROPOSITIONSSource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 16. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELCHANNELSSource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 17. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELCUSTOMER/PATIENT RELATIONSHIPSSource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 18. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELREVENUE STREAMSSource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 19. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELKEY RESOURCESSource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 20. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELKEY ACTIVITIESSource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 21. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELKEY PARTNERSSource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 22. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELCOST STRUCTURESource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 23. 4. EVOLVING BUSINESS MODELS – THE BUSINESS MODELA BUSINESS MODEL DESCRIBES THE RATIONALE OF HOW ANORGANIZATION CREATES, DELIVERS, AND CAPTURES VALUESource: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 24. THE BUSINESS MODEL OF DIABETES CAREKEYPARTNERSKEYACTIVITIESVALUEPROPOSITIONCUSTOMERRELATIONCUSTOMERSEGMENTSCHANNELSKEYRESOURCESCOSTSTRUCTUREREVENUESTREAMS• National HealthcareService (publiclyfunded)• Acquire knowledge &experience on diabetes• Consult diabetespatients• Provide diabetes care• Staff• Knowledge on diabetesType 1• Diabetes care• Need for assistanceduring Type 1 Diabetesdisease• Need-orientedrelationship• Diabetes nurses aschannel to providecare• Young patients /children with Type 1Diabetes• Desire knowledge andexperience arounddiabetes• Will need enoughinformation regardingthe diabetes disease• Personnel• Education & Training• Consultation fee (nr. of consults per patient at a clinician)• Fee per hour for delivered diabetes care• Connection with medicine provider (fee)Source: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 25. THE BUSINESS MODEL OF MOBILE DIABETES CAREKEYPARTNERSKEYACTIVITIESVALUEPROPOSITIONCUSTOMERRELATIONCUSTOMERSEGMENTSCHANNELSKEYRESOURCESCOSTSTRUCTUREREVENUESTREAMS• National HealthcareService (publiclyfunded)• IT partner• IT service provider• Healthcare network• Acquire knowledge &experience on diabetes• Consult diabetespatients• Provide diabetes care• Monitor diabetespatients• Data analysis andtreatment setup• Staff• Knowledge on diabetesType 1• Monitoring systems• Specialized modems• Diabetes care• Need for assistanceduring Type 1 Diabetesdisease• Remote managementmodel of care allowingpatients to care morefor themselves• Need-orientedrelationship• Monitoring relation;more care in hands ofthe patient• Diabetes nurses aschannel to providecare• Remote system• Data sharing through IT• Young patients /children with Type 1Diabetes• Desire knowledge andexperience arounddiabetes• Will need enoughinformation regardingthe diabetes disease• Model of care beyondDiabetes• Personnel• Education & Training• Service Setup• Hardware purchase• Maintaining process / service• Consultation fee (nr. of consults per patient at a clinician)• Fee per hour for delivered diabetes care• Connection with medicine provider (fee)• License system (beyond diabetes)Source: Adapted from Business Model Generation, Alexander Osterwalder & Yves Pigneur, 2009
  • 26. 1. Personal background2. A real-life story3. Traditional vs. new healthcare4. Evolving business models5. Value of business models6. Challenges, barriers & actions7. Future expectationsCONTENT
  • 27. 5. VALUE OF BUSINESS MODELSSource: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009STAKEHOLDER ASSESSMENT• Positions, attitudes, and beliefs about change can be understood in light of a group or individualbehaviors, reactions, and emotional responses• Culture, source of power, level of influence, and motivation for each stakeholder should be used todesign specific interventions to achieve proposed objectivesCliniciansClinicians Admin staffAdmin staff Pharm. &Lab StaffPharm. &Lab StaffPayorsPayorsSocial /CommunityWorkersSocial /CommunityWorkersIT StaffIT StaffPatientsPatients• Understanding how specific changes will affect stakeholders will inform the mobile health developmentteam on what interventions they will need to addressASSESS IMPACTS
  • 28. 5. VALUE OF BUSINESS MODELSPATIENT RELEVANCY MODEL OUTLINEDOMINATEThe supplier of choice (score 5)A mobile health system dominates when its usersnot only prefers it over the traditional healthcare,but will actively seek it outDIFFERENTIATEA preferred supplier (score 4)A mobile health service differentiates when theclient prefers its mobile health proposition overanotherPARITYOne of many acceptable suppliers (score 3)A mobile health service is at parity when its offersare similar to those delivered with traditionalhealthcare processesSource: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009ACCESS•Easiness in accessing and exploiting thefunctionalities for performing specific activities.PRODUCT•Level of performance and innovation brought bythe mobile health system in the delivery of aspecific healthcare servicePRICE•Value for moneySERVICE•Level of flexibility and scalability of the mobilehealth system to accommodate newfunctionalitiesEXPERIENCE/INTIMACY•Level of emotional connection with thehealthcare service
  • 29. 5. VALUE OF BUSINESS MODELS – MOBILE DIABETES CAREVALUE PROPOSITION BENEFITS Increased pro-active interventions Increased personal treatment protocols Less time needed to consult patients (nurses & clinicians) Less acute escalations and complications at patients, andtherefore less costs on their care Patients are more able to care for themselves, need lesshospitalization and have better long-term health outcomes.That saves money, saves limbs, and saves lives Less stress at patients / parentsSource: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009DOMINATE ON SERVICE•Increase quality of data•Improved immediacy & openness•Better access to informationDIFFERENTIATE ON EXPERIENCE•Increased moments of patient contact but withless effort•Data is more granular (less measures on HbA1c -Glycated Haemoglobin)•-1% in HbA1c leads to -30% complicationsPARITY•Transparency in diabetes process of youngpatients / children
  • 30. 5. VALUE OF BUSINESS MODELS – S-CURVETimeSpeed(time tomarket)Up scaling(time tovolume)Support costs(post launchinvestment)LaunchStart-up costs(prelaunchinvestment)Phase I: Idea Phase II: Design PilotPhase IV: UpscalingCumulativecash1234Phase III:ImplementationSource: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009
  • 31. 5. VALUE OF BUSINESS MODELS – MOBILE DIABETES CARE S-CURVESource: Capgemini Consulting & RAND Europe, eHealth Business Models EU Report, 2009TimeSpeed(time tomarket)Up scaling(time tovolume)Support costs€10 mioLaunchStart-up costs€100KPhase I: Idea Phase II: Design PilotPhase IV: UpscalingCumulativecash1234Phase III:ImplementationSavings per patientper year (€2200)Estimate saving inNL (€20 mio)
  • 32. 1. Personal background2. A real-life story3. Traditional vs. new healthcare4. Evolving business models5. Value of business models6. Challenges, barriers & actions7. Future expectationsCONTENT
  • 33. 6. CHALLENGES, BARRIERS & ACTIONS• Decline in available operational budget or re-allocation of funds towards other priorities• Complex national and international legislation• Lack of understanding of needs and interests ofhealthcare delivery staff and patientsINSIGHTS PRACTICAL ACTIONS• Research as an important factor in development• Build-up evidence to proof success• Use several phases to implement system• Do not forget security, privacy, and safety issuesCURRENTEUCHALLENGESSTAKEHOLDERBENEFITSEXPERIENCESUCCESSESEVALUATION• Affected healthcare professionals or independentresearchers are not involved in a systems’development and delivery• Comprehensive analysis of processes are affectedby mobile health• Involve different stakeholders throughout theprocess• Customize your treatments• Examine the operational processes• Research also the degree mobile health system usein the overall healthcare process• Mobile system development and implementation isexperienced as a large change with high costs• Increased stakeholder value is not guaranteed• Negative change to the healthcare service delivery• Funding is a large issue• Develop and implement through phases• Achieve cost-effectiveness• Increased value for stakeholders (soft KPI’s)• Dare to use new and innovative (or affiliate) businessmodels for funding• No ex ante/ex post baseline data available to assessfinancial and operational sustainability• Not able to go beyond the ROI• Stakeholder usability is not part of the developmentprocessEvaluate your mobile business model through:•Return On Investment / Cost effectiveness•Usability (patient/user perspective)•Soft KPI’s – treatment satisfaction
  • 34. 1. Personal background2. A real-life story3. Traditional vs. new healthcare4. Evolving business models5. Value of business models6. Challenges, barriers & actions7. Future expectationsCONTENT
  • 35. 7. FUTURE EXPECTATIONS• A champion in place who has all the necessary knowledge and drive to start a team and put this thingforward• The teams first job is to start building a business model• The team must think about the integration with the current organization• Developments from Silicon Valley (health apps on smartphones and additional products) and theincreasing focus of human beings on a healthier life result in more space for mobile health to rise• Due to regulation and the modus operandi the traditional healthcare companies work in, they will not beready yet for this paradigm shift• The key element in mobile health is DATA• How are you going to manage data and take care of the privacy and important information comingfrom those patients/clients?• Regulation on data and privacy is there, but not very clear and to-the-pointRegulationNecessaryconditionsSpace formobilehealth• There are some individuals coming together that are passionate enough to bring the system a step furtherinstead of talking about politics or other things.• These so-called start-up clubs will rise also within the mobile healthcare sector within the upcoming years.Key SuccessFactors
  • 36. CLOSINGANY QUESTIONS?
  • 37. CLOSINGTHANK YOU FOR YOUR ATTENTIONMUITO OBRIGADO PELA SUA ATENÇÃO