HCLT Whitepaper: Healthcare Ecosystem


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http://www.hcltech.com/healthcare/overview~ Healthcare Ecosystem

Never before has the healthcare industry offered so much hope amid so much uncertainty. In the last decade, we have seen the unlocking
of the human genome, which has put personalized and predictive medicine within reach for the first time in history. Advances in biomedicine and pharmaceuticals are achieving unprecedented
success against formerly intractable diseases. And the next generation of information technology is sparking innovation across the healthcare value chain.

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HCLT Whitepaper: Healthcare Ecosystem

  2. 2. 2EMPOWERING THE NEW HEALTHCARE ECOSYSTEMToday, the healthcare industry finds itself on the threshold of anew era in which key stakeholders, empowered by technology,are breaking down barriers and redefining what’s possible inmedical care. Find out how IT is shaping this new healthcareecosystem.A NEW ERANever before has the healthcare industry offered so much hope amidso much uncertainty. In the last decade, we have seen the unlockingof the human genome, which has put personalized and predictivemedicine within reach for the first time in history. Advances inbiomedicine and pharmaceuticals are achieving unprecedentedsuccess against formerly intractable diseases. And the next generationof information technology is sparking innovation across thehealthcare value chain.Yet we are also living in a time of great economic and social upheaval,with healthcare businesses and organizations contending withextraordinary new financial, demographic, and regulatory pressures.A challenging global economy continues to strain the bottom lines ofproviders, payers, and pharmaceutical companies - not to mentionthe businesses and taxpayers who ultimately foot the bill. What’smore, the economics of healthcare are set to become even tougher inthe years ahead as aging populations in industrial countries place newdemands on both private and public healthcare systems.Tighter finances and thinning margins have made cost cutting andoperational efficiency a top priority across the healthcare supplychain. It has also fueled innovation, with stakeholders ranging fromhospitals and insurance companies to drug companies andpharmacies learning to exploit “Health IT” to become leaner andmore agile without compromising the end goal: patient care. Indeed,Health IT is quickly turning into a competitive differentiator,helping healthcare organizations attract new patients and planmembers with more personalized services and rich health-information resources.In the U.S., the convergence of medical advances, technologyinnovations, and policy shifts are rewriting the rules of a $2.5 trillionindustry that makes up an astonishing 17.3% of the nation’seconomy.1 When President Obama signed the Patient Protection andAffordable Care Act in March 2010, an entire industry was mobilizedby the prospect of serving 32 million newly insured people. A yearbefore, the Health Information Technology for Economic andClinical Health (HITECH) Act-part of the 2009 economic stimulusprogram2 - poured billions of dollars into the development ofelectronic medical records (EMRs).© 2011, HCL Technologies. Reproduction Prohibited. This document is protected under Copyright by the Author, all rights reserved.
  3. 3. 3EMPOWERING THE NEW HEALTHCARE ECOSYSTEM In the U.S., the convergence of medical advances,technology innovations, and policy shifts are rewriting the rulesof a $2.5 trillion industry that makes up an astonishing 17.3% ofthe nation’s economy.These new programs come with sticks as well as carrots, and the newera of healthcare will be marked by a ratcheting up of regulatoryrules, mandates and penalties designed to cut fraud and waste andjumpstart new solutions such as health information exchanges.Similar government initiatives are reshaping the healthcare landscapeof Europe, Asia and other developed economies around the world.What does this all mean for industry stakeholders? At a minimum,stakeholders will need to prepare for a world of escalating complexityand volatility. Navigating this new environment won’t be easy. Itwill call for flexible strategies that can evolve in step with thechanging economic, technological, and regulatory landscape. It willcall for smart investments in technology - ones that emphasizeinteroperability, scalability, and cost-effectiveness. And it will callfor strategic partnerships to help stakeholders thrive in the newhealthcare ecosystem. Navigating this new environment won’t be easy. It will callfor flexible strategies that can evolve in step with the changingeconomic, technological, and regulatory landscape.THE NEW HEALTHCARE ECOSYSTEMWho are the stakeholders in the new ecosystem? At the highest level,we all are. Anyone who seeks medical care as a patient has a vestedinterest in the healthcare system. So the architecture of the newhealthcare ecosystem begins with the patient—the first “P” in whatwe call the “6 Ps” of healthcare, as shown in the figure on the nextpage.The following key stakeholders populate the rest of the ecosystem:?Providers - doctors, nurses, therapists, hospitals, physician groups, clinics and other medical professionals and organizations that provide medical care to patients.?Payers - health insurance companies that cover the cost of medical care, as well as businesses, organizations, and individuals who either directly pay for care, or pay for insurance coverage.?Pharmaceutical companies - makers of drugs prescribed by© 2011, HCL Technologies. Reproduction Prohibited. This document is protected under Copyright by the Author, all rights reserved.
  4. 4. 4EMPOWERING THE NEW HEALTHCARE ECOSYSTEM doctors and healthcare providers; pharmaceutical companies sell approximately $300 billion worth of products in the U.S., and $650 billion worldwide.?Pharmacies - a sometimes overlooked player in the healthcare ecosystem, pharmacies represent a $277 billion industry in the U.S., often providing critical guidance to patients.?Policymakers - government agencies and industry organizations that set healthcare policy, write and enforce regulations, and oversee industry standards.THE 6 PS OF THE NEW HEALTHCAREECOSYSTEMUNIQUE ROLES, SHARED INTERESTSIn the past, these stakeholders occupied distinct niches in the overallhealthcare ecosystem. Their roles were completely clear, in partbecause interfaces between stakeholders were either weak ornonexistent. Payers before the advent of managed services, forexample, stayed largely uninvolved in medical management;pharmacies, lacking the enterprise software and networks to link toproviders and payers, served as passive dispensers of medicine;providers, for their part, occupied “silos” of their own, lacking themeans to track patients from place to place, or automated systems tooffload the burden of paperwork.The new paradigm reflects a “systems thinking” view of an industrywhere the walls separating stakeholders are steadily crumbling -where the success of one depends on the success of others, and wherenew business models of coexistence and co-development are rapidlybecoming the norm. That’s partly due to new government© 2011, HCL Technologies. Reproduction Prohibited. This document is protected under Copyright by the Author, all rights reserved.
  5. 5. 5EMPOWERING THE NEW HEALTHCARE ECOSYSTEMregulations that have opened up vast flows of information betweenpatients, providers and payers - and throughout the ecosystem; andpartly the result of runaway medical costs, which have spurred theentire complex to live within its means. That priority demands morecollaboration, more information sharing, more interoperability, andmore integration. In short: more convergence.This new ecosystem presents tremendous opportunities for creatingvalue when stake-holders learn to grasp the full potential oftechnology- and policy-driven convergence. In this new era, we seestakeholders coalescing around a common goal: delivering bettercare, to more people, at a reasonable cost. Getting there will requirevision, skill, and the confidence to invest in innovation. What is clear,also, is that information technologies, services, and solutions willplay a central role in this value-creation process.THE TECHNOLOGY EDGEHistorically, healthcare has been slow to embrace informationtechnology. “The healthcare industry…is where most of corporateAmerica was a decade or more ago in adopting Internet-stylecomputing,” writes Steve Lohr in the New York Times. “There areinnovators, intriguing experi-ments and lots of interest, but thetechnol-ogy hasn’t yet gone mainstream.” But the situation is rapidlychanging, he adds, and “only the pace of the shift is in question.” 3In truth, information technology has been transforming healthcareorganizations for more than a decade, albeit in low-profile venueslike hospital back offices, where enterprise resource planning (ERP)systems have been installed to automate billing and other revenue-cycle functions. Today, healthcare organizations large and small areequipping themselves with enterprise systems and solutions tooptimize tasks ranging from claims processing and patientadmissions to workforce management and regulatory compliance.Pharmaceutical companies, meanwhile, are investing heavily in IT tospeed drug development and testing programs.Far from a trivial development, the growing adoption of Health IThas generated enormous value for organizations. Among otherinitiatives, strategic outsourcing and selected business-processpartnerships are generating immense value to healthcarestakeholders, translating into billions of dollars in bottom-linesavings across the industry. The move is letting healthcareorganizations spend less on tasks that fall outside their corecompetency and transfer more resources to areas that matter most,such as clinical care, scientific research, and healthcare education.© 2011, HCL Technologies. Reproduction Prohibited. This document is protected under Copyright by the Author, all rights reserved.
  6. 6. 6EMPOWERING THE NEW HEALTHCARE ECOSYSTEMBeyond the administrative streamlining, Health IT has now movedto the forefront of medical best practice, giving providers theknowledge and tools to head off disease before it strikes, whileempowering patients with the resources to take charge of theirhealthcare and make smarter decisions from both a medical and costperspective.In these areas, Health IT’s strength lies in its power to distill massiveamounts of data from disparate sources, to provide mechanisms forfaster, better decision-making, and to open up new channels ofcommunications between patients, providers and payers. At the endof the day, enabling the predictive, preventive and participatoryapproaches to healthcare made possible by IT is expected to yield themost meaningful and lasting returns to the industry and society as awhole.EMERGING TRENDSThe tech-enabled future is already visible in several key trendsemerging now. Chief among them may be the accelerating adoptionof electronic medical records that share data across networks. EMRs -along with the closely affiliated EHRs (electronic health records) andPHRs (personal health records) - will soon become pervasive,boosted by nearly $20 billion dollars in government incentives aswell as advances in information security and portability that haveaddressed initial concerns about the concept. Nearly 200,000providers have already adopted EMRs, yet its potential forimproving patient health remains largely untapped.Healthcare will be more coordinated in the future, continuing a trendof “patient-centric” care that emphasizes preventive primary care andclose partnerships between patients and providers. Guided by sharedinformation, patients will move seamlessly between all types of care -givers in an integrated fashion, with each provider staying fullyinformed of the patient’s overall progress. Care coordination willdrive savings by improving medical outcomes and focusing care moreeffectively.Increasingly, evidence-based medicine will become the norm for thehealthcare profession. This methodology depends on analyzingmassive stores of data, including genomic and epidemiologicaldatabases, to refine diagnoses and set the best course of treatment foreach individual. The approach is one of the most reliable ways toimprove treatments and outcomes, which makes it an attractiveoption for every stakeholder in the industry.Information technology will enable healthcare to be delivered on a© 2011, HCL Technologies. Reproduction Prohibited. This document is protected under Copyright by the Author, all rights reserved.
  7. 7. 7EMPOWERING THE NEW HEALTHCARE ECOSYSTEMmore constant basis in the years ahead. Telemedicine will supportthat trend, enabling expert care to be delivered wherever the patientlives via broadband multimedia networks. Such technology bridgesvast distances in an instant, giving patients new options for homehealthcare and extending the specialized skills of experts to morepeople and geographies. Guided by shared information, patients will moveseamlessly between all types of caregivers in an integratedfashion, with each provider staying fully informed of thepatient’s overall progress.CONCLUSIONIn the new healthcare industry, stakeholders will continue to bechallenged by tough choices as they seek to deliver the highest level ofpatient care with limited economic and human resources. For thatreason, information technology will remain at the center of the newhealthcare ecosystem, helping stakeholders harness the power ofcollaboration and knowledge sharing to improve care, stretchbudgets, and spark innovation. Convergence will be a dominanttrend in this world, and the most successful stakeholders will be thosethat exploit the tremendous value potential of cross-boundaryintegration and innovative technology partnerships.ABOUT AUTHORFor more information about how HCL is enabling the future ofhealthcare, contact Pradep Nair, Senior Vice President -Healthcare Practice, HCL, at pnair@hcl.com.REFERENCE1 http://prescriptions.blogs.nytimes.com/2010/02/04/us-health-care-spending-rose-at-record-rate-in-2009/2 Also known as the American Recovery and Reinvestment Act(ARRA)3 “Health Care Industry Moves Slowly Onto the Internet,” SteveLohr, New York Times, April 5, 2009.© 2011, HCL Technologies. Reproduction Prohibited. This document is protected under Copyright by the Author, all rights reserved.
  8. 8. 8EMPOWERING THE NEW HEALTHCARE ECOSYSTEMABOUT HCLHCL TechnologiesHCL Technologies is a leading global IT services company, workingwith clients in the areas that impact and redefine the core of theirbusinesses. Since its inception into the global landscape after its IPOin 1999, HCL focuses on ‘transformational outsourcing’, underlinedby innovation and value creation, and offers an integrated portfolioof services including software led IT solutions, remote infrastructuremanagement, engineering and R&D services and BPO. HCLleverages its extensive global offshore infrastructure and network ofoffices in 26 countries to provide holistic, multi-service delivery inkey industry verticals including Financial Services, Manufacturing,Consumer Services, Public Services and Healthcare. HCL takes pridein its philosophy of ‘Employees First’ which empowers our 77,046transformers to create real value for customers. HCL Technologies,along with its subsidiaries, had consolidated revenues of US$ 3.5billion (Rs. 16,034 crores), as on 30 June 2011 (on LTM basis). Formore information, please visit www.hcltech.comAbout HCL EnterpriseHCL is a $6 billion leading global technology and IT enterprisecomprising two companies listed in India - HCL Technologies andHCL Infosystems. Founded in 1976, HCL is one of India’s originalIT garage start-ups. A pioneer of modern computing, HCL is a globaltransformational enterprise today. Its range of offerings includesproduct engineering, custom & package applications, BPO, ITinfrastructure services, IT hardware, systems integration, anddistribution of information and communications technology (ICT)products across a wide range of focused industry verticals. The HCLteam consists of 85,000 professionals of diverse nationalities, whooperate from 31 countries including over 500 points of presence inIndia. HCL has partnerships with several leading Global 1000 firms,including leading IT and technology firms. For more information,please visit www.hcl.com© 2011, HCL Technologies. Reproduction Prohibited. This document is protected under Copyright by the Author, all rights reserved.