2. 1. Lack of entrepreneurial mindset
The size of the challenge, not the size of the kingdom
The new direction is the challenge, not the destination
Make the present model obsolete
Problem seeker, not problem solver
Questions not answers
Work from the challenge backward,
not capability forward
3. 2. A highly regulated ecosystem
Differs around the world
In US, shifting from FFS to value based
4. 3. A lack of patient awareness
Low health IQ
Low insurance IQ
Bad consumers of care
Bad judges of quality
Lack of transparent information to make choices
5. 4.Vested interests
There is nothing more difficult to take in hand, more
perilous to conduct, or more uncertain in its success,
than to take the lead in the introduction of a new order
of things. For the reformer has enemies in all those who
profit by the old order, and only lukewarm defenders in
all those who would profit by the new order, this
lukewarmness arising partly from fear of their
adversaries … and partly from the incredulity of
mankind, who do not truly believe in anything new
until they have had actual experience of it.
— Niccolo Machiavelli
6. 5. Consolidation
BIG MEDICINE v small medicine
Public systems v private systems
Market power
Threats to private practice
7. 6. Mass eCare
Scaling digital health adoption
Digital health gaps
8. 7.Finding leaderpreneurs
Knowledge technicians are dead and replaceable
Managers are not leaders
Leaders are not necessarily entrepreneurs
Entrepreneurs are not necessarily innovators
9. 8. Finding early seed sage capital
Changing financing models
Money, like people and technology, go where they are
treated best
11. 10. Defining and measuring value
The perceived difference in the mind of the user
between the tangible and intangible benefits-the
tangible and intangible costs when compared to other
offerings
Changing value factors
12. Solutions
Upside down organizational structure
Revised platforms and processes of care with
innovative business models; systems of systems
The right people in the right jobs of the future
Changing rules