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eHealth Business
Opportunities in the
United States
1
David Whitlinger
Executive Director
New York eHealth
Collaborative
New York eHealth Collaborative (NYeC)
2
Not-for-profit organization working to improve healthcare for all New Yorkers
through health information technology.
• Promote the adoption and use of electronic health records.
• Build the Statewide Health Information Network of New York (SHIN-NY): A
secure network for sharing electronic medical records across the state.
• Create an ecosystem fostering innovation by leveraging the massively
valuable clinical data stored in the SHIN-NY.
• Develop policies and standards in conjunction with industry stakeholders.
• Through the HEAL grant program,
the NY State Department of
Health helped create 9 RHIOs in
New York.
• The total investment since 2006 is
$943 million (public and private
sources).
• Each RHIO has built a local
network of stakeholders including
hospitals, practices, long term
care, and payers and is actively
connecting participants in its
region to enable sharing of data.
• All the RHIOs together form
the SHIN-NY, the largest HIE
in the USA.
3
SHIN-NY: the Network of Major
Healthcare Providers within New York
SHIN-NY PARTICIPANTS
• 197 hospitals (84%)
• 50,000 providers
• 7MM patients
Our Vision
4
Health IT tools enable collaboration between patients, providers, public
health agencies, and payers. They improve quality of care, efficiency, and
patient satisfaction.
• No single entity can deliver this set of tools alone.
• It will take an ecosystem working together.
• And this ecosystem needs a basic infrastructure to build upon.
A universally accessible, reliable, public utility of clinical health information on
every New Yorker for every New Yorker.
Snapshot of the U.S. Market
5
U.S. Population
• 319 million
Health Expenditures
• U.S. $3.2 trillion (For context, the entire GDP of France is US $2.7 trillion)
• 22% of U.S. GDP
Funders/Payers
U.S. healthcare is financed, or paid for, in a variety of ways:
• A majority have health insurance coverage as a benefit from their employment.
• Military personnel and their dependents, as well as veterans, are provided health care
coverage through the federal government.
• Older Americans are provided care through Medicare.
• Low income individuals receive health care assistance through Medicaid.
• Individuals may pay directly for services received.
Key Healthcare Trends in the U.S.
6
Healthcare Reform: the Patient Protection and Affordable Care Act (ACA)
Signed into law in March, 2010. The ACA Expands Access to Care:*
• 16.4 million uninsured gained health insurance between the Marketplace, Medicaid
expansion, young adults staying on their parents plan, and other coverage provisions.
• 35% reduction in uninsured as of March 2015.
• 5.7 million young adults (aged 19-25) stayed on a parent’s plan until age 26.
However, employer-provided insurance remains our nation’s health insurance bedrock,
despite the alternatives offered by the ACA.
With only some exceptions, employers continue to provide their employees with
insurance and in many instances are the leading innovators in devising high-quality, lower-
cost care.
*http://obamacarefacts.com/2015/03/16/obamacare-enrollment-numbers-as-of-march-2015/
Key Healthcare Trends in the U.S.
7
Shift in Payment and Care Models
The ACA’s incentives, along with the soaring cost of care of Medicare and Medicaid, is pushing the
market to emphasize value and outcomes, compared with the outdated focus on volume.
• Insurers are focused on health outcomes for patient populations.
• Providers are changing how they care for patients through new delivery networks.
• Pharmaceutical & medical device companies are changing their investment and product
development strategies.
Delivery System Reform Incentive Payment (DSRIP)
$6 billion program to transform New York State’s Medicaid program to increase sustainability, better
coordinate care, and improve health outcomes of approximately six million Medicaid beneficiaries.
• Key goal of the program is to reduce avoidable hospital use by 25 percent over five years.
• Program will require previously disparate networks of providers to work together in Performing
Provider Systems and deliver population-based healthcare.
• Implementation of innovative strategies and technology solutions in patient engagement, care
coordination, and provider workflow is key to success.
Key Healthcare Trends in the U.S.
8
New Models Require New Tools…Resulting in Unprecedented Investment & Innovation
Health organizations are aware of the need for substantial investments in new
technologies beyond legacy solutions if they are to address the challenges and
opportunities presented by the shift toward patient-centric and value-based care.
2014 was a landmark year for health technology investment in the U.S.
Funding in 2014 more than doubled from last year with $6.5B invested compared to
$2.9B in 2013.
Subsector $ Invested # Deals
Big Data/Analytics $1.46B 90
Population Health $1.14B 33
Navigating the Care System $974MM 52
Diagnostics $962MM 60
Consumer Health $880MM 69
Key Healthcare Trends in the U.S.
9
The Consumerization of Healthcare
• The patient as the consumer is an emerging force of change in healthcare.
• Patients expectations are starting to change…that their experience as patients
resemble that of their other consumer experiences: on-demand, digitally enabled,
user-friendly interfaces, clearly defined pricing, and a wide selection of product
options.
• In addition, they’re more actively participating in their health through the explosion of
wearable tech, mobile apps, social communities.
Health Tech in New York
10
New York Continues its role as a Leading Hub for Health Tech Innovation
• U.S. $722 MM was invested in 44 New York health tech companies in 2014.
Notable New York Health Tech Companies
Health IT Marketplace Gaps
11
• Broader access to patient information by all of the healthcare providers contributing
to a patient’s care.
• Secure methods for sending health information between healthcare organizations.
• Notification, alerting, and monitoring – the ability to proactively manage patient care
via real time events.
• Cross community care plan management tools for teams of providers and family care
givers.
• Patient access to their own health information and engaging consumer-level health
tools.
• Analytics to help manage and measure the healthcare system – you can’t change what
you can’t measure.
Intensive, five-month program run by NYeC and the Partnership Fund for NYC for
early- and growth-stage digital health companies that are developing cutting edge
technology products for healthcare providers in the areas of care coordination, patient
engagement, and workflow management.
Program Highlights
• 33 pilots launched with healthcare providers
• The companies created over 120 new high tech jobs in New York State
• Participants have raised an additional $54 million from outside sources; Two
companies were acquired within 6 months of graduating the program
12
NY Digital Health Accelerator
The ability of the participants to engage directly with the
senior leadership of a broad network of 23 healthcare
provider organizations in New York for mentorship and
pilot programs.
PROGRAM’S
UNIQUE
FEATURE
INVESTORS
SPONSORS
13
Digital Health Accelerator Network
ANALYTICS
14
Digital Health Accelerator Portfolio
PATIENT
ENGAGEMENT
CARE
COORDINATION
DRIVING HEALTH
TECHNOLOGY ADOPTION
Assists healthcare
providers in the adoption
of EHRs and innovative
technology solutions.
INDUSTRY EXPERTISE
Understands the
processes, policies, and
politics of working with
provider organizations.
NY DIGITAL HEALTH ACCELERATOR
Leads one of the largest
funded Health IT accelerators
for growth-stage health tech
companies.
ECOSYSTEM
DEVELOPMENT
Cultivates relationships with
providers, entrepreneurs,
investors, and government
through a number of programs,
initiatives, and events.
STATEWIDE HEALTH INFORMATION NETWORK
OF NEW YORK (SHIN-NY)
Manages the nation’s largest public
HIE containing millions of clinical records.
15
Catalyzing Innovation Through Expertise
and Relationships
We Want to Hear from You!
16
Reach out to us if you’re looking to make connections in
New York State.
www.nyehealth.org
New York eHealth Collaborative
@NYeHealth
facebook.com/NYeHealth
Appendix
17
Partnerships are Key to Thriving
18
• The health sector is proving to be highly adaptive to disruption and innovation. Joint
ventures, open collaboration platforms, and non-traditional partnerships are leading
towards new competitive strategies.
• Many traditional healthcare companies may find tremendous value in partnering with
new entrants that are disrupting the health system with new care delivery and
payment models.
• Incumbent health businesses will face mounting pressure from competitors that are
already engaged in industry-defining relationships.
• E.G. Walgreen’s partnership with blood test innovator Theranos to bring new
affordable testing services to Walgreen’s stores. Not only are Theranos’ tests low cost
(50% of the cost of Medicare reimbursement rates or less) and covered by major
insurance carriers, but test results can also be made available in hours, accelerating
diagnosis and treatment decisions.
Partnerships are Key to Thriving
19
Partnerships are Key to Thriving
20
To thrive in this hypercompetitive new environment, the most
successful companies will work together on innovative products
and services and seek expert partners to help fill the gaps in their
businesses.

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eHealth business opportunities and things to consider when entering the USA market

  • 1. eHealth Business Opportunities in the United States 1 David Whitlinger Executive Director New York eHealth Collaborative
  • 2. New York eHealth Collaborative (NYeC) 2 Not-for-profit organization working to improve healthcare for all New Yorkers through health information technology. • Promote the adoption and use of electronic health records. • Build the Statewide Health Information Network of New York (SHIN-NY): A secure network for sharing electronic medical records across the state. • Create an ecosystem fostering innovation by leveraging the massively valuable clinical data stored in the SHIN-NY. • Develop policies and standards in conjunction with industry stakeholders.
  • 3. • Through the HEAL grant program, the NY State Department of Health helped create 9 RHIOs in New York. • The total investment since 2006 is $943 million (public and private sources). • Each RHIO has built a local network of stakeholders including hospitals, practices, long term care, and payers and is actively connecting participants in its region to enable sharing of data. • All the RHIOs together form the SHIN-NY, the largest HIE in the USA. 3 SHIN-NY: the Network of Major Healthcare Providers within New York SHIN-NY PARTICIPANTS • 197 hospitals (84%) • 50,000 providers • 7MM patients
  • 4. Our Vision 4 Health IT tools enable collaboration between patients, providers, public health agencies, and payers. They improve quality of care, efficiency, and patient satisfaction. • No single entity can deliver this set of tools alone. • It will take an ecosystem working together. • And this ecosystem needs a basic infrastructure to build upon. A universally accessible, reliable, public utility of clinical health information on every New Yorker for every New Yorker.
  • 5. Snapshot of the U.S. Market 5 U.S. Population • 319 million Health Expenditures • U.S. $3.2 trillion (For context, the entire GDP of France is US $2.7 trillion) • 22% of U.S. GDP Funders/Payers U.S. healthcare is financed, or paid for, in a variety of ways: • A majority have health insurance coverage as a benefit from their employment. • Military personnel and their dependents, as well as veterans, are provided health care coverage through the federal government. • Older Americans are provided care through Medicare. • Low income individuals receive health care assistance through Medicaid. • Individuals may pay directly for services received.
  • 6. Key Healthcare Trends in the U.S. 6 Healthcare Reform: the Patient Protection and Affordable Care Act (ACA) Signed into law in March, 2010. The ACA Expands Access to Care:* • 16.4 million uninsured gained health insurance between the Marketplace, Medicaid expansion, young adults staying on their parents plan, and other coverage provisions. • 35% reduction in uninsured as of March 2015. • 5.7 million young adults (aged 19-25) stayed on a parent’s plan until age 26. However, employer-provided insurance remains our nation’s health insurance bedrock, despite the alternatives offered by the ACA. With only some exceptions, employers continue to provide their employees with insurance and in many instances are the leading innovators in devising high-quality, lower- cost care. *http://obamacarefacts.com/2015/03/16/obamacare-enrollment-numbers-as-of-march-2015/
  • 7. Key Healthcare Trends in the U.S. 7 Shift in Payment and Care Models The ACA’s incentives, along with the soaring cost of care of Medicare and Medicaid, is pushing the market to emphasize value and outcomes, compared with the outdated focus on volume. • Insurers are focused on health outcomes for patient populations. • Providers are changing how they care for patients through new delivery networks. • Pharmaceutical & medical device companies are changing their investment and product development strategies. Delivery System Reform Incentive Payment (DSRIP) $6 billion program to transform New York State’s Medicaid program to increase sustainability, better coordinate care, and improve health outcomes of approximately six million Medicaid beneficiaries. • Key goal of the program is to reduce avoidable hospital use by 25 percent over five years. • Program will require previously disparate networks of providers to work together in Performing Provider Systems and deliver population-based healthcare. • Implementation of innovative strategies and technology solutions in patient engagement, care coordination, and provider workflow is key to success.
  • 8. Key Healthcare Trends in the U.S. 8 New Models Require New Tools…Resulting in Unprecedented Investment & Innovation Health organizations are aware of the need for substantial investments in new technologies beyond legacy solutions if they are to address the challenges and opportunities presented by the shift toward patient-centric and value-based care. 2014 was a landmark year for health technology investment in the U.S. Funding in 2014 more than doubled from last year with $6.5B invested compared to $2.9B in 2013. Subsector $ Invested # Deals Big Data/Analytics $1.46B 90 Population Health $1.14B 33 Navigating the Care System $974MM 52 Diagnostics $962MM 60 Consumer Health $880MM 69
  • 9. Key Healthcare Trends in the U.S. 9 The Consumerization of Healthcare • The patient as the consumer is an emerging force of change in healthcare. • Patients expectations are starting to change…that their experience as patients resemble that of their other consumer experiences: on-demand, digitally enabled, user-friendly interfaces, clearly defined pricing, and a wide selection of product options. • In addition, they’re more actively participating in their health through the explosion of wearable tech, mobile apps, social communities.
  • 10. Health Tech in New York 10 New York Continues its role as a Leading Hub for Health Tech Innovation • U.S. $722 MM was invested in 44 New York health tech companies in 2014. Notable New York Health Tech Companies
  • 11. Health IT Marketplace Gaps 11 • Broader access to patient information by all of the healthcare providers contributing to a patient’s care. • Secure methods for sending health information between healthcare organizations. • Notification, alerting, and monitoring – the ability to proactively manage patient care via real time events. • Cross community care plan management tools for teams of providers and family care givers. • Patient access to their own health information and engaging consumer-level health tools. • Analytics to help manage and measure the healthcare system – you can’t change what you can’t measure.
  • 12. Intensive, five-month program run by NYeC and the Partnership Fund for NYC for early- and growth-stage digital health companies that are developing cutting edge technology products for healthcare providers in the areas of care coordination, patient engagement, and workflow management. Program Highlights • 33 pilots launched with healthcare providers • The companies created over 120 new high tech jobs in New York State • Participants have raised an additional $54 million from outside sources; Two companies were acquired within 6 months of graduating the program 12 NY Digital Health Accelerator The ability of the participants to engage directly with the senior leadership of a broad network of 23 healthcare provider organizations in New York for mentorship and pilot programs. PROGRAM’S UNIQUE FEATURE
  • 14. ANALYTICS 14 Digital Health Accelerator Portfolio PATIENT ENGAGEMENT CARE COORDINATION
  • 15. DRIVING HEALTH TECHNOLOGY ADOPTION Assists healthcare providers in the adoption of EHRs and innovative technology solutions. INDUSTRY EXPERTISE Understands the processes, policies, and politics of working with provider organizations. NY DIGITAL HEALTH ACCELERATOR Leads one of the largest funded Health IT accelerators for growth-stage health tech companies. ECOSYSTEM DEVELOPMENT Cultivates relationships with providers, entrepreneurs, investors, and government through a number of programs, initiatives, and events. STATEWIDE HEALTH INFORMATION NETWORK OF NEW YORK (SHIN-NY) Manages the nation’s largest public HIE containing millions of clinical records. 15 Catalyzing Innovation Through Expertise and Relationships
  • 16. We Want to Hear from You! 16 Reach out to us if you’re looking to make connections in New York State. www.nyehealth.org New York eHealth Collaborative @NYeHealth facebook.com/NYeHealth
  • 18. Partnerships are Key to Thriving 18 • The health sector is proving to be highly adaptive to disruption and innovation. Joint ventures, open collaboration platforms, and non-traditional partnerships are leading towards new competitive strategies. • Many traditional healthcare companies may find tremendous value in partnering with new entrants that are disrupting the health system with new care delivery and payment models. • Incumbent health businesses will face mounting pressure from competitors that are already engaged in industry-defining relationships. • E.G. Walgreen’s partnership with blood test innovator Theranos to bring new affordable testing services to Walgreen’s stores. Not only are Theranos’ tests low cost (50% of the cost of Medicare reimbursement rates or less) and covered by major insurance carriers, but test results can also be made available in hours, accelerating diagnosis and treatment decisions.
  • 19. Partnerships are Key to Thriving 19
  • 20. Partnerships are Key to Thriving 20 To thrive in this hypercompetitive new environment, the most successful companies will work together on innovative products and services and seek expert partners to help fill the gaps in their businesses.

Editor's Notes

  1. 4.7 overall title/heading more in the middle, away from top logo - center
  2. Per discussion, don’t change layout, work on box only; ok to make type a little smaller IF needed. 4.7 too square – look at Dave’s ppt; rounded corners – echo the circle e more
  3. 4.7 overall title/heading more in the middle, away from top logo - center
  4. Green b/c of accelerator logo 4.7 – too sq/too jarring needs more designed look; too much green
  5. Missing logos tk Monday. Ok to make investors and sponsors’ logos smaller.
  6. Great graphic as is.