The conference program lists title of my talk as “The Future of Healthcare Publishing”, but I’ve modified the topic to “Publishing for e-Patients” to make it more relevant to this audience – and to shorten it to fit in a 15 minute timeslot. There is a lot to cover; can only give a brief overview today, but hope to put developments in the e-Patient segment into context of other changes that are occurring in healthcare publishing.
These are the major themes of this talk: 1) ePatients as both providers and consumers of health content. As consumers that are seeking more indepth info than can readily be found, they are driving up demand for healthcare information. 2) ePatients also produce content: through social networking sites, through record-keeping, and even passively through monitoring devices, for instance. More data are being captured, there is more demand for information from emerging e-patient segment opportunity for publishers to create information products for the e-patient community. 3) Major theme throughout the publishing industry: Once in digital form, content becomes “data” and can be programmed and analyzed. My company calls this turning information into “data that can do stuff”. Digitizing content has the long-term effect of commoditizing the content that can be reproduced digitally. Even clinical decisions can be commoditized as rules of diagnosing and treatment are programmed and information sources are embedded into the clinical tools.But, first, we’ll put this segment of health content in context.
This is the last intro slide– and the most text-heavy of all! 1) You can look up more info on HCA and its parent company ICG online to find more info about us. Check me out on at healthcontentadvisors.com where I write my blog or on LinkedIn. I’ll just mention that I’ve be publishing and marketing online content since 1985 and have witnessed the progression of content + IT in other industries, such as financial services. 2) Next slide will present the view of entire health content segment.3) Again, I’ll reinforce the theme of how IT advancements and increased adoption of health IT create new data that can be tracked and mined in both clinical and administrative applications.
Don’t worry, this slide is intended only to illustrate the complexity of sector.Many stakeholders (I sometimes call them the 5Ps) . Traditionally, linear segmentation: that is, research info was published for specific end-user market, with just occasional and minimal cross-promotion (e.g., news of results from major research studies published in newspapers). Far more cross-over opportunities exist in today’s environment. In part, a function of widespread availability of info and the tools to find and use the info. Intermediaries play a more important role in healthcare and health publishing than in most other industries.
Industry diagram with focus on ePatient segment. Big question: how traditional medical information for professionals and other new digital sources of health data can be packaged for e-Patients. Also, stresses how e-Patients themselves are “producers” of content and there is a feedback loop. Motivated, educated ePatients research and record relevant data to share with their physicians and with others.Role of intermediaries changes with new developments, but there is always a role for value-added intermediaries that can adapt information to add efficiency and added-productivity that leads to better outcomes. E.g., Hope – created tool to search for grants. Added value beyond pointing people to the right info, she created a tool with ScanGrants.Final point: Patients are consumers of information from all of the sources. Increasingly more info is available to patients via distribution channels other than their physician. But, intermediaries still exist, and often the intermediaries subsidize the cost of providing the info. Channels are shifting and becoming bi-directional. Lots of moving parts. Lots of opportunities to disrupt!
Generic diagram that illustrates the effect of IT on content. Convergence of C+IT enables passive content to become active (and do stuff!).
More detail for healthcare industry on this slide. 1) Standalone reference required interrupting workflow and often required an intermediary.2) Content + tools is a big improvement, especially when well-designed for users’ application. E.g. ePrescribing; specialized databases with images. 3) Embedding in workflow ensures that appropriate standards are followed and can provide a record of transactions, events, outcomes for further analysis. E.g., appropriate doses are calculated automatically. Word of caution: professional should always be able to verify or change parameters.
This slide represents the progression of health content over the past 50 years. We’ll go through it very quickly. Can discuss in the lunch time discussion group in more detail.Print: Print-based periodicals, textbooks, reference works, newsletters, pamphlets, etc. Long publishing cycle.Digital: Early online A&I databases. Special search language required; costly; marketed only to information specialistsAnalysis Tools: Bookmarks, bibliographic tools, more sophisticated taxonomy tools, federated search. Contextual Info: Tools to improve findability & precision (semantic search); wiki-type shared repositories; instant feedback.Workflow solutions: Content is embedded in workflow; research is automated to enhance productivity & efficiency. C+IT = data that do stuffKey points: IT, WWW, Web 2.0 has enabled cheaper better faster publishing, which has resulted in wider distribution of even specialized info (long tail, if you will). Only recently been seeing results from the interactive capabilities of the Internet—collaboration, real time publishing.Important point: evolution doesn’t mean that the next stage replaces the previous stage. Rather, they all co-exist but strengths of relationships change over time. For instance print, which once was the center focus of publishing, can take on a new role when clinical tools become the focus. Print can be used to promote, document, alert, and provide narrative that helps explain the workings of the tools.
Okay, we’ve arrived at the present time, where demand and supply of healthcare info is growing fast. ePatients and Participatory Medicine (a much preferred term to CDHC, IMO) are gaining traction and attention as an important and early-adoptor segment for new types of healthcare information. Former consumer health sources and patient education sources aren’t sufficient (hold up Health Insurance for Dummies as an example). There’s still a need for lowest common denominator instructions, but research-savvy ePatients want access to more indepth info. Just today, life sciences search and research provider, DeepDyve, has announced a new model that makes scholarly journal content more readily available to anyone. A Netflix-like rental model, with costs of $0.99 for online access to a fulltext article, and subscription rates that lower the per-article “rental” costs. It’s a start…Elsevier MedCounselor: Packaged for pharmacists, but also includes a patient module: http://www.goldstandard.com/ViewPress.aspx?ID=134. Drug and drug interaction data.2) Supply: PWC calls it secondary data from health IT. We call it healthcare data analytics. Patients are recording their own data through patient community sites such as Cure Together and PatientLikeMe, through PHRs, and passively through digital devices & EHRs.
Just a list of some new terms that represent new sources of supply of healthcare data:Patient-generated data: correlations, longer-term outcomes, ability to track more variables in complex statistical models. Examples include structured sites like PLM, broader adoption of PHRs will lead to creation of huge repositories of data. Post marketing studies will enhance RCT for drugs and devices. Also, Pharma is facilitating the creation of patient-generated data through their own patient community sites. With Pharma as the “publisher”, the roles between traditional publishers and marketers/advertisers blurs. I’ve been commenting on this trend for over six years and have seen many examples of disruption. Classified advertising is one obvious example, where advertising is the content and IT allowed eBay and Craigslist to disrupt the newspaper business model.
Last slide. The content value pyramid is another representation of the evolution of content+IT. IT helps add value to content and it also commoditizes the basic levels of content as these less-customized sources of content become cheaper, easier, faster to produce, distribute and share. Result: ever increasing supply of data. Tools to manage & mine data become more important. “Curators” are needed to distinguish quality content from fraudulent content. Transparency of the sponsor is critical. Close with some questions: Who will be the new intermediaries? how will roles change? Who will own the data and stand to benefit from it?
Thank you for your attention. Contact me if you have more questions.
ePatientConnections2009 Health Content for ePatients
e-Patients Increase Supply & Demand for Health Content<br />D ↑ e-patients are Web-savvy and aware of online sources, but often hit <br /> pay walls and other hurdles when seeking medical research info.<br />S ↑ Electronic records provide hugely expanded universe of outcomes and transactions data (tests and test results, Rx fulfillment, patient history, payment records)<br />S ↑ IT plays fundamental role in transforming production & consumption of health content. Over time, IT drives down cost of once pricey assets & expertise.<br />Janice McCallum<br />Health Content Advisors<br />
What is Health Content?<br /><ul><li>Health Content Advisors (HCA) is a division of InfoCommerce Group (ICG), a consulting group that provides strategic market analysis and business model optimization services to B2B publishers with emphasis on “data” publishers. HCA provides same services to entire “health content” industry.
Our definition on “health content” includes all content produced by all health industry stakeholders: (more next slide)
Effect of IT on health industry will lead to an avalanche of new data sources that can serve as raw data for new information tools. Challenge rests on turning all that data into reliable, usable information, or what we refer to as “data that do stuff”. </li></ul>Janice McCallum<br />Health Content Advisors<br />
Janice McCallum Health Content Advisors<br />Today’s Talk Focuses on Producing Content for e-Patients and New Sources of Data Produced by e-Patients<br />Primary Sources Intermediaries End-Markets<br />Health and Life Science<br />Publishers <br />(journals, books, <br />cme)<br />Research Institutions<br />Articles, conf. presos.<br />Physicians, Clinicians<br />Researchers<br />Pharma<br />Clinical Trials,<br /> Drug Info<br />Medical Communications <br />Agencies<br />Payers<br />Search Engines, <br />Text Mining/Analytics,<br />Aggregators<br />Patients, <br />Patient Advocates, <br />e-Patients<br />Providers<br />Directory info<br />Librarians, Patient<br />Advocates,<br />Patient Navigators<br />Patients<br />User-generated, <br /> PHRs<br />Payers, Pharma<br />Consumer Media <br />Companies<br />EHRs, PHRs<br />
The fundamental trend in medical information content: moving to“data that do stuff”<br />Point of care workflow solutions<br />Standalone Reference Content<br />Content integrated with tools<br />Janice McCallum<br />Health Content Advisors<br />
Evolution from standalone content resource to point of care decision tools and workflow solutions<br />Reference works<br />Library resources<br />Specialized online <br />reference works <br />available at (or near)<br />point-of-care.<br />Integrated point-of-care data; clinical decision tools<br />Janice McCallum<br />Health Content Advisors<br />
Evolution of Health Publishing<br />Read Search Navigate Connect Do <br />Collabor-ation tools; integration across collections.<br />Workflow solutions<br />Info needs to be pushed.<br />Provides “peek” into full article. <br />.<br />Navigation <br />tools to sort through large and varied collections<br />Janice McCallum<br />Health Content Advisors<br />
New Research and Publishing Opportunities in Healthcare Information Market<br />Demand from e-Patients<br />Medical reference databases re-packaged for e-patient segment:<br /> Examples:DeepDyve medical research engine with Netflix content rental model – announced today!<br /> Elsevier’s MedCounselor module for consumers.<br />Supply from e-Patients<br />Healthcare Data Analytics: <br /> Organize and mine data content that is byproduct of digital record keeping.<br />. Examples: Aetna, athenahealth, Cerner, Cure Together, MedMining, PLM, Safeway, Virgin Healthmiles. <br />Janice McCallum<br />Health Content Advisors<br />
Emerging Trends <br />Supply-side<br />Infodemiology: Extracting patterns from search behavior, e.g., Google Flu Trends<br />Patient Generated Data: Expanded definition includes any and all patient- generated data that can be mined and analyzed.<br />Healthcare Data Analytics: Data mining; developing new statistical techniques for <br /> medical studies that deal with large universes of outcomes data.<br />Personalized medicine: genomic data will increase amount of data by order of<br /> magnitude.<br />Social Pharma: Social Pharmer group that studies new ways for pharma <br /> companies to interact with consumers online.<br />Janice McCallum<br />Health Content Advisors<br />
Where are Opportunities?<br />New information sources (supply) from e-Patients drive need for services that organize, cleanse, design, aggregate, integrate, market, sell, analyze and report healthcare data. <br />Demand from e-Patients drives need for more medical information directed at educated non-specialist audience.<br />$64K Question: Can traditional medical publishers make the transition or will new players outside of publishing (e.g., Health IT vendors and pharma/device companies, e-Patient groups) take the lead in providing health content for emerging markets?<br />Janice McCallum<br />Health Content Advisors<br />Content Value Pyramid<br />
Now It’s Your Turn: Q&A<br />Janice McCallum<br />Health Content Advisors<br />For more on Health Content Advisors, see<br />www.healthcontentadvisors.com<br />Twitter: @janicemccallum<br />Email: firstname.lastname@example.org<br />617.529.2594 (mobile)<br />