BioIT World 2011 eHealth


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  • BioIT World 2011 eHealth

    1. 1. eHealth<br />Chris L. Waller, Ph.D.<br />1<br />
    2. 2. The global health and life sciences market is a large, complex and highly fragmented.<br />While “data” is flowing freely through the system unabated, an “information” gap has formed.<br />Providers<br />Payers<br />Regulators<br />Policy<br />Makers<br />Accreditation<br />Entities<br />Govt. Programs<br />Diagnostic Services/<br />GCRCs<br />Employers<br />Regulations<br />Applications and Approvals<br />Licenses<br />Licensed Health Prof’nals<br />Consumers/<br />Patients<br />$<br />Coverage<br />Health Plans/<br />Care<br />Premium $<br />Health Delivery Systems/<br />Facilities<br />$<br />$<br />$<br />Carve<br />Outs<br />(PBMs, <br />others)<br />“orders”<br />Products<br />Pharmacies<br />Pharma.<br />(including Biotech) <br />Medical<br />Products<br />Contract<br />Services<br />Nursing and Home Health<br />Global Insurers<br />Distributors<br />Info<br />Companies<br />Generic Mfgs.<br />Products<br />The Worldwide Healthcare Ecosystem<br />
    3. 3. What is Happening in HIT:<br />Growing HIT Momentum in the US<br />Selected Critical <br />Developments<br />Projected Timeline<br />2001<br />2002<br />2003<br />2004<br />2005<br />2006<br />2007<br />2008<br />2009<br />2010<br />2011<br />2012<br />2013<br />2014<br />2015<br />MMA mandates federal eRx standards by 2009<br />Healthcare Reform Enacted. $35B alloc. to HIT<br />Pressure to Accelerate<br />June 2005 AHIC & RFPs Announced<br />Pressure to Accelerate<br />Mar 2001 Landmark IOM study “Crossing the Quality Chasm” identifies rampant errors and urges HIT<br />Dec 2003<br />MMA becomes law. Pfizer leads successful effort to block federal eRx mandate, but timetable is set to drive eRx standards process<br />Jul 2004ONCHIT releases strategic framework for NHII<br />ARRA: majority of Americans use EMRs by 2015<br />Kerry Pledge: 100% EHR use by 2008<br />Pressure to Accelerate<br />June 2004<br />RAND study estimates that Americans receive only 55% of recommended care and proposes HIT- based solutions<br />Apr 2004 Presidential Executive Order sets EHR adoption goal, and appoints Dr. David Brailer to lead the Office of the National HIT Coordinator (ONCHIT)<br />Note: ONCHIT = Office of the National Health Information Technology Coordinator NHII = National Health Information Infrastructure<br />MMA = Medicare Modernization Act<br />
    4. 4. HITECH<br />The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology.  <br />DIVISION A: TITLE XIII—HEALTH INFORMATION TECHNOLOGY<br />Subtitle A—Promotion of Health Information Technology<br />PART 1—IMPROVING HEALTH CARE QUALITY, SAFETY, AND EFFICIENCY<br />PART 2—Application and use of adopted health information technology standards; Reports<br />Subtitle B—Testing of Health Information Technology<br />Subtitle C—Grants and Loans Funding<br />Subtitle D—Privacy<br />PART 1—IMPROVED PRIVACY PROVISIONS AND SECURITY PROVISIONS<br />PART 2—RELATIONSHIP TO OTHER LAWS; REGULATORY REFERENCES; EFFECTIVE DATE; REPORTS<br />DIVISION B: TITLE IV—MEDICARE AND MEDICAID HEALTH INFORMATION TECHNOLOGY; MISCELLANEOUS MEDICARE PROVISIONS<br />Subtitle A—Medicare Incentives<br />Subtitle B—Medicaid Incentives<br />Subtitle C—Miscellaneous Medicare Provisions<br />
    5. 5. eHealth at Pfizer (2010)<br />We developed a capability called eHealth, which is a group that focuses on thinking about the convergence of healthcare and information technology. <br />Over the last nine months, we’ve made three investments in companies that are in the e-Health space: Private Access, Keas, and Acacia Living. All three are focused on driving consumer outcomes-based healthcare. They’re in the vein of personalizing medical treatment, health and wellness; and they’re in the vein of decentralizing health and wellness so that consumers are more responsible and more engaged, as well as their communities and caregivers.<br />Another capability is looking at complex partnerships between large players effecting healthcare to solve very complex problems requiring multi-player solutions. So, we’ve been building the capability to think about multiple-player collaboration and business models. One of the investments that we made in the last nine months is Private Access. It is enabling a collaborative model, which addresses clinical trial improvement through building an eco-system across the industry, bringing multiple stakeholders, government, private sector, and society together in a coherent and consolidated way.<br />From an interview with Usama Malik.<br />
    6. 6. eHealth Steering Committee<br />WWS&I<br />WWBD<br />WW BT<br />WW Policy<br />Technology Strategy<br />Strategy Setting<br />Search & Evaluation<br />US Policy Strategy<br />Technology Standards<br />Program Management<br />Due Diligence<br />US Advocacy<br />Technology Evaluation<br />Business Architecture<br />Deal Negotiation<br />Intl. Policy Strategy<br />Technology Architecture<br />Alliance Management<br />Investment Management<br />Intl. Advocacy<br />Technology Delivery<br />
    7. 7. eHealth: Convergence of Healthcare and Technology<br />Patient-centric<br />Provider-centric<br />Care provision augmentation<br />Health & Wellness Consumer Electronics <br />Business<br />Diversification beyond Pharma<br />New Product and Services<br />Health & Wellness Self-Management Services<br />Clinical Decision Support Aids<br />Uses of Clinical Data for R&D<br />Adverse Event Reporting Utility<br />Health Economics Analytics<br />Business Innovation within Pharma<br />Clinical Data Flow and Uses<br />7<br />
    8. 8. Data Analysis<br />Medical History<br />External Data (Labs, Other providers)<br />Presenting problem<br />Clinical & Claims Data<br /><ul><li>Clinical outcome
    9. 9. Cost effective
    10. 10. Drug safety
    11. 11. Epidemiology
    12. 12. Bio surveillance</li></ul>Patient<br />Physician<br />Pay forPerformance<br />Formulary/Individual Benefit<br />ConsumerScorecard<br />Robust Decision Support<br />PHRs<br />Protocol Modeling & Assessment, Site Selection, Patient Recruitment<br />RetrospectiveEvidence<br />PhysicianMetrics<br />PACeR and the HIT Pipeline for Research<br />Consumers, healthcare providers, policy makers and payers are leveraging HIT, particularly Electronic Health Records (eHRs), to analyze health data, contain healthcare costs, and improve quality of clinical care<br />The PACeR Collaborative was established to leverage the HIT Pipeline for Research<br />The Partnership to Advance Clinical electronic Research (PACeR) is a collaboration between Pfizer and other leading pharmaceutical companies, health technology vendors, New York-based academic medical centers, standards organizations, and regulators to build an advanced clinical research capability enabled by the re-purposing of electronic clinical care data. PACeR’s Primary Goals are:<br /><ul><li>To more rapidly, accurately, and efficiently identify and enroll patients appropriate for clinical trials
    13. 13. Establish a sustainable business framework and exchange where are all stakeholders realize economic benefit
    14. 14. Identify regulatory and legal issues, implications for business models, and data and systems necessary for success
    15. 15. Develop a practical, implementable, roadmap, addressing the requirements of all stakeholders</li></li></ul><li>PACeR - The Public-Private Partnership<br />
    16. 16. Keas Mission:consumersto take charge of their<br /><br />Keas: Empower Consumers<br />
    17. 17. Core solution<br />WellnessProgram<br />B. <br />Wellness “engine”<br />Complete health & wellness assessment under consent<br />1<br />2<br />Suggest interventions based on results<br />SMS<br />Track selected data (activity, weight, diet, stress, sleep time, work time, ... ) on defined intervals<br />3<br />Provide instant feedback, encouragement and guidance based on data<br />4<br /><ul><li>Share data within the online community,
    18. 18. Track own progress compared to others,
    19. 19. Challenge others
    20. 20. Participate in company wellness initatives</li></ul>5<br />A.<br /> Employee with wellness application<br />C. <br />“Wellness program site”<br />Activate coach service based selected criteria<br /><ul><li>Get called by coach to track progress or suggest additional activities
    21. 21. Contact coach proactively to get persolized support</li></ul>7<br />6<br />D. <br />Wellness coach<br />
    22. 22. Smoking Cessation Assistive Technology Experiment<br />Upload application to phone<br />Pfizer<br />Design smoking cessation program<br />Employee<br />Motivate, coach, support employee<br />Employer<br /><ul><li>Personalized content
    23. 23. Inspiration/reminders for quitting
    24. 24. Distractions for overcoming urges
    25. 25. Communities for support
    26. 26. Quitting advice dispensed on-demand
    27. 27. Financial and health incentive trackers
    28. 28. Progress tracking
    29. 29. Select employer partner to participate in the experiment
    30. 30. Demonstrate value of program to other employers to support reimbursement</li></ul>iPhone<br />Our Goal: <br />- Demonstrate Behavior Modification <br />- Improved Medication Adherence, Persistence, and Quit Rates<br />
    31. 31. Mobile Apps<br /><br />
    32. 32. eHealth Strategic Plan<br />
    33. 33. Summary of Pfizer’s HIT Efforts<br />Support and Transform Medical Practice<br />Adverse Drug Event Spontaneous Electronic Reporting (ASTER)<br />217 reports in 5 mons. vs. 0 (25% “serious”)<br />7x as much (structured) data as normal report<br />Support Patient-Centric Healthcare<br />Keas<br />Text4Baby<br />Nutrition, flu prevention, immunization, etc.<br />Free, 100,000 subscribers<br />G.C. Simon, AJMC-2010-08-0217<br />
    34. 34. Summary of Pfizer’s HIT Efforts<br />Improve Clinical Trials<br />Private Access<br />PACeR<br />Clinical Trial Atlas<br />Partnership with National Minority Quality Forum to collect and map trial data to demographics<br />Expedite Research<br />Connecting for Drug Safety Collaboration of the eHealthInitative<br />Safety Surveillance in electronic healthcare data<br />Observational Medical Outcomes Partnership (OMOP)<br />2 year pilot to develop methods to query databases to assess safety of drugs on market<br />G.C. Simon, AJMC-2010-08-0217<br />
    35. 35. Recommendations<br />Embrace and Fully Fund Public-Private Partnerships<br />Development of a National Clinical Trials Infrastructure<br />Development of Systems that Provide Selective Sharing of Electronic Health Data<br />Development of HIT Platforms that Allow Physicians Access to All Approved Options to Inform Decisions for Patients’ Health<br />Implement an Incentive Model that Encourages Sustained Investment in HIT<br />G.C. Simon, AJMC-2010-08-0217<br />
    36. 36. eHealth at Pfizer (2011)<br />Connected Health<br />Contact Usama Malik for more information<br />
    37. 37. Acknowledgements<br />David Leventhal<br />Chris Waller<br />Shaf Madina<br />Ben Bandaru<br />Mark Brincat<br />
    38. 38. Thanks<br />