Your SlideShare is downloading. ×
mHealth Israel conference, UnitedHealth Group, Dr. Pramod Gaur, VP TeleHealth: Trends & Opportunities in US TeleHealthcare
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

mHealth Israel conference, UnitedHealth Group, Dr. Pramod Gaur, VP TeleHealth: Trends & Opportunities in US TeleHealthcare

479

Published on

Presentation by Dr. Pramod Gaur, VP TeleHealth, UnitedHealth Group at the mHealth Israel conference, October 7th, 2013 in Tel Aviv. Title of the presentation is "Trends & Opportunities in US …

Presentation by Dr. Pramod Gaur, VP TeleHealth, UnitedHealth Group at the mHealth Israel conference, October 7th, 2013 in Tel Aviv. Title of the presentation is "Trends & Opportunities in US TeleHealthcare"

Published in: Health & Medicine, Business
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
479
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
23
Comments
0
Likes
1
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. Trends & Opportunities in US TeleHealthcare Pramod K. Gaur, Ph.D. Vice President – TeleHealth UnitedHealth Group Monday, October 7, 2013, Tel Aviv, Israel Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 1
  • 2. Agenda  Introduction – Background  mHealth Definition and Market Segmentation  Why mHealth is Important?  Obamacare  Stakeholders in US Healthcare Ecosystem  mHealth Enabled Total Population Management  Stay Healthy - Diabetes Example  Get Healthy -Telemedicine Example  Living with Illness - RPM Example  Opportunities to Improve Total Population Management Using mHealth Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 2
  • 3. A Fortune 25 Health and Wellbeing Company Mission: Help People Live Healthier Life Role: Help Make Health Care Work Better for Everyone Health Benefits Health Services Employer & Individual Medicare & Retirement Community & State Military & Veterans OptumHealth OptumInsight OptumRx Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 3
  • 4. American Telemedicine Association: SIG or Chapter Name: mHealth – Chair(s): Steven Dean – Vice Chair: Pramod Gaur, PhD – Past Chair: Sunil Hazaray – SIG Executive Committee Members: Rob Williams MD, Napoleon Monroe, Bree Holtz, Mohit Kaushal MD, Hon Pak MD Mission The mission of the mHealth group is to enhance access to health care through innovative mobile technologies, including phones, tablets, applications (apps), sensors, and supporting infrastructure. The mHealth group represents academia, government, healthcare, and industry. The group’s mission would be to promote dialogue between all stakeholders, to improve the understanding and use of mHealth platforms, and to provide guidance to the ATA Board of Directors regarding mHealth. Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 4
  • 5. American Telemedicine Association: mHealth SIG Objectives for 2013-14 Keep a dialogue with the FDA Conducting a half-day education course at the ATA annual meeting Facilitate quarterly webinars Continue outreach and partnerships with other professional organizations (e.g., HIMSS) Develop Practice Guidelines for mHealth Peer-review of ATA conference abstracts Increase SIG membership Update mHealth reference paper Subgroup Activity – Medication Management Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 5
  • 6. Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 6
  • 7. mHealth – Definition Defined broadly, mHealth is the ability to allow patients and providers to easily and quickly connect and exchange health data via information communication technology from anywhere at anytime to facilitate continuum of care delivery at lower costs, and improve outcomes. mHealth Applications and Technologies: 1. Remote Patient Monitoring (RPM): Consumer (home) setting to professional – use of telemetry for store and forward data (vital signs, images, surveys, etc.) to a centralized health data management application. Remote professional monitors patient vital/behavior data and intervenes as necessary. 2. Telemedicine: Use of real time video and/or audio technology for medical encounter in a professional to professional or professional to patient setting. This may be used with or without telemetry. 3. mHealth: Telemedicine/RPM with the use of mobile (cellular or Wi-Fi) technology. Applicable with common off the shelf mobile products. Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 7
  • 8. Why Important? Professionally Entered Patient Data M-Health fills an important gap in a patient’s medical record that exposes health/social aspects in consumer’s life at home, work, or while on the road Regulatory Compliant M-Health Capability Hospital Record Pharmacy Record Self Entered M-Health Record Doctor’s Office Record Lab Results Record Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 8
  • 9. OBAMACARE 1. Access to Healthcare 2. Quality of Healthcare 3. Patient and Provider’s User Experience AFFORDABLE CARE ACT Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 9
  • 10. Key Stakeholders for US Healthcare System Patients Providers Consumers Doctors, Nurses Care Givers Therapists, Care Family Members Managers, etc. Payers Regulators Fed Govt. Healthcare Policy State Govt. FDA – 510(K) Employers HIPAA Insurance Co. Self Pay Transition from Pilot to Scalable and Sustainable Program Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 10
  • 11. PATIENTS/CAREGIVERS Technologies/Services Sought by Caregivers Source: Helpfulness of Caregiving Technologies, e-Connected Family Caregiver: Bringing Caregiving into the 21st Century Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 11
  • 12. PROVIDERS 1. Provider Institutions – Move Towards Integrated Health Delivery Networks (IDN) ‾ Primary Care ‾ Specialty Care ‾ Out Patient Clinics ‾ Transitional Care ‾ Home Care 2. Provider Professionals – Move Towards Group Practices ‾ Primary Care Physicians ‾ Specialty Care Physicians ‾ NP and PA Support ‾ Nurse Line (24/7 support line) ‾ Nutritionist Coaches ‾ Wellness and DM Coaches Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 12
  • 13. REGULATORS 1. Healthcare Legislation – Federal/State and Local 2. Medical Board – Each State has its own Medical Board 3. FDA ‾ Medical Device Act and Fees ‾ Mobile Health Guidance ‾ Mobile Healthcare Device ‾ Mobile App ‾ Mobile Health App 4. HIPAA 5. ICD-10 Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 13
  • 14. PAYERS 1. Federal Government – Medicare • • Traditional Medicare Managed Medicare 2. State Governments – Medicaid • • • Traditional Medicaid Managed Medicare Medicaid - Medicare Dual Eligible 3. Large Employers – Self Insured • ASO Contracts with Insurance Companies 4. Insurance Companies • Risk Based Policies for Individuals and Small Businesses 5. Self Pay – Consumers Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 14
  • 15. PAYMENT MODELS 1. Traditional Fee for Service 2. Capitated/Negotiated Rates • ACO • PCMH • Bundle Payment • Episode of Care 3. Employer Wellness/Prevention Incentives 4. Pre-Tax Spending Accounts • Health Savings Account • Flexible Savings Account 5. Over the Counter - Self Pay Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 15
  • 16. M-Health Innovation: Total Population Management Goal is to Improve Overall Health and Wellbeing of Populations and Individuals by Providing Comprehensive and Integrated Care Across the Care Continuum Stay Healthy Wellness and Prevention Care Mobile Health Goal Improve Overall Health and Wellbeing Living with Illness Chronic Disease End Of Life Care Remote Patient Monitoring Get Healthy Acute and Sub-Acute Care Telemedicine Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 16
  • 17. M-Health Enabled Stay Healthy: Helping people live healthier lives PAYERS ARE PAYING FOR THIS SEGMENT WITH DEMONSTRATED OUTCOMES Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 17
  • 18. M-Health for Get Healthy: Consumer to Physicians Via Two-Way Video, Secure Chat Or Phone CONSUMERS AND SOME PAYERS ARE PAYING FOR THIS SEGMENT WITH DEMONSTRATED OUTCOMES “The doctor will see you now” It’s time that technology allowed just that. • A technology for bringing healthcare services online • Live interaction between patients and available network physicians 9725551212 • Extends traditional healthcare into people’s homes • Upholds care continuity Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 18
  • 19. M-Health for Living with Illness: PAYERS ARE PAYING FOR THIS SEGMENT WITH DEMONSTRATED OUTCOMES Heart Failure Program Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 19
  • 20. Opportunities for mHealth Solutions Medication Related     Prescriptions aren’t filled Medication isn’t taken Overlap/confusion of medication Allergic reactions are not identified Logistics/Transport Related     No follow-up visit with PCP No transportation Can’t get appointment PCP is not notified of admission or discharge Support/Management Related  Patient health deteriorates  Lack of care giver support  Home not conducive to post acute environment Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 20
  • 21. THANK YOU Pramod K Gaur, PhD Vice President TeleHealth Optum, a UnitedHealth Group Company Rye Brook, NY 10573 Tel: 914-933-4610 pramod.gaur@optum.com Proprietary and Confidential. Do not distribute. Disclaimer - Contents of this presentation are the personal views of Pramod Gaur and not an official view of UnitedHealth Group or its affiliated companies 21

×