Emerging Trends and Opportunities in Telehealth -- A Global Scenario


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Frost & Sullivan Healthcare Program Manager E.Sujith gave this presentation at the Medical Informatics World Conference 2013 in Boston: http://www.medicalinformaticsworld.com/

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Emerging Trends and Opportunities in Telehealth -- A Global Scenario

  1. 1. Emerging Trends and Opportunities in TelehealthA Global ScenarioBy Sujith EramangalathApril 2013Boston
  2. 2. © Frost & Sullivan 2013In collaborationwith …2Contents1. Overview of Telehealth2. Market Dynamics3. Market Opportunities4. Telehealth Matrix5. Business Models6. Case Studies
  3. 3. © Frost & Sullivan 2013In collaborationwith …Forces and Factors Shaping Evolution of Healthcare3Molecular andPersonalized MedicineAccess, Cost & Qualityof CareProficient Use ofInformationProcessesPeopleTechnologyLeading change to the future of sustainable healthcare
  4. 4. © Frost & Sullivan 2013In collaborationwith …Evolving Phase of Phase of Healthcare Delivery and Management4mTrac -UgandaWeqaya Program –Abu DhabiWelldoc-Alere-AT&T Partnership
  5. 5. © Frost & Sullivan 2013In collaborationwith …5The EU is providing a strong push towards home care to achieve an improvementin Quality of Life, while reducing the Cost of CareQUALITYOFLIFECOST OF CARE PER DAY$1 $10 $100 $1,000 $10,000IndependentHealthy LivingCommunityClinicDoctor’sOfficeChronic DiseaseManagementHOME CAREAssisted LivingNursing HomeINSTITUTIONAL CARESpecialty ClinicCommunity HospitalACUTE CAREICUA singleEuropeaninformationspaceInclusion, betterpublic services& quality oflifeInnovationandinvestmentin researchi2010 InitiativeSource: Frost & Sullivan. Adapted from European CommissionShifting the Model of Care Provision in Europe
  6. 6. © Frost & Sullivan 2013In collaborationwith …6RemoteMonitoringmHealthGeneralHealthcare ITVideoTelemedicine• ProfessionalApps• Wellness Apps• Fitness Apps• TextingInformationalServices• Video DiagnosticConsultation• RemoteDoctor/SpecialistServices• DistanceLearning/Simulation• Retail Telehealth• Teleimaging• Departmental• Electronic HealthRecords (EHR)• Health InformationExchange (HIE)• Patient Portals• Hosted CloudInfrastructure• Home Healthcareand DiseaseManagementMonitoring• Activity Monitoring• DiabetesManagement• Wellness Programs• Remote CardiacServices• PERS• MedicationManagementConnected Health Ecosystem – Market Segmentation
  7. 7. © Frost & Sullivan 2013In collaborationwith …7MarketDriversMarketRestraints1-2 years 3-5 years 6-10 yearsIncreasing demand due to increase in chronicillnesses.Government support in terms of funds to movetowards effective operation of healthcare systemEurozone crisis leading to drop in healthcarebudgetsIncreasing hospital expenses, forcing patient’s toswitch to affordable remote monitoring options.Lack of information on funding/reimbursement practices deter manypotential users from adopting this systemLack of common European standardsmaking the regulatory environmentunfavorable for growthImpact: High Medium LowTelehealth Market: Key Market Drivers and Restraints (Europe), 2012-2020Source: Frost & Sullivan analysis.Europe Telehealth Market Dynamics
  8. 8. © Frost & Sullivan 2013In collaborationwith …8United States Telehealth Market DynamicsTelehealth Industry: Key Market Drivers and Restraints, North America, 2013–2017Misinformation and overall confusion in theindustry restrains growth.General unknowns facing users concerninglicensing, regulatory issues, and privacy slowsdown the industry.Difficulty in using telehealth with traditionalpredominant payment models hinders adoption.1–2 years 3–4 years 5th yearThe continued need for better access to care forpatients, remote specialists, and increased workflowefficiencies enable industry growth.The continued investment by major providers like theVA and OTN* in telehealth promotes acceptance.Advances in technology allowing greater capabilitiesfor telehealth encourages growth.Patients’ increasing interest in investing in their ownhealthcare drives revenue.MarketDriversMarketRestraintsImpact: High Medium Low
  9. 9. © Frost & Sullivan 2013In collaborationwith …9VideoTelemedicine11.4%mHealth17.5%HomeHealthcareand DiseaseManagementMonitoring11.0%RemoteCardiac ECG22.0%MedicationManagement1.0%PersonalEmergencyResponseSystems65.0%ActivityMonitoring1.0%RemoteMonitoring71.1%Remote Monitoring Vertical, PercentRevenue Breakdown, North America, 2012Important Segment CharacteristicsFactors AssessmentOpportunity Size($B, 2012)1.74Opportunity Size($B, 2017)2.83Base Year Growth (2012) 13.5%CAGR Growth Rate(2012–2017)10.2%Price Sensitivity 6Demand for Innovation 8The largest of the verticals, with both consumer and professional products andservices well represented.*Not included in breakdown chart are Diabetes Monitoring or Wellness SystemsNote: All figures are rounded. The base year is 2012. Source: Frost & Sullivan analysis.United States Telehealth Market Revenue Opportunities
  10. 10. © Frost & Sullivan 2013In collaborationwith …European Telehealth Market Opportunities10020406080100120The UnitedKingdomGermany France Italy Spain Scandinavia Benelux70.2 64.442.65014.7 17.834.4102.6 99.662.774.521.5 25.948.3Regional Market Revenue (2012 and 2015)2012 2015The United Kingdom is the largest market for telehealth in Europe, followed by Germany and Italy.Almost all European telehealth markets are likely to witness high growth, and increase their revenuesby two-folds in another five years. Adoption rates in all the countries are expected to increase rapidlywith growing awareness and public funding. The United Kingdom will continue to dominate thetelehealth market mainly due to early developments in the market and Government support. Othercountries are recently beginning to consider improving their investments into information andcommunication technology in the healthcare sector.Note: All figures are rounded. The base year is 2012. Source: Frost & Sullivan analysis.
  11. 11. © Frost & Sullivan 2013In collaborationwith …Telehealth MatrixTM—Top 20 Telehealth Markets11CustomerFocusProfessionalConsumerIndustry FocusInformationCommunicationTechnologiesHealthcareTraditional Healthcareand TelemedicineConsumer/Non-healthcareApproaching TelehealthCore TelehealthTelehealth Industry: Top 20 Telehealth Markets, North America, 2012HIECloudInfrastructureActivityMonitoringPatient PortalsFitness AppsRetail TelehealthWellnessProgramsTexting Services MedicationManagementTele-ImagingDistanceLearning/SimulationEHRProfessional AppsHome and DMMonitoringRemoteCardiacServicesPERSVideo ConsultationWellnessAppsDiabetesManagementRemote SpecialistServicesNote: The top five markets are in blue text boxes. Source: Frost & Sullivan analysis.
  12. 12. © Frost & Sullivan 2013In collaborationwith …12Business Model 1Integration into Health System StructuresSuppliersCustomersProvidersPayersEvidenceMedical ServiceFlow of Money Service is a logical extension ofportfolio Providers need to network withphysicians hub and spoke model – leastthreatPAYMENT One time capital investment by Provider Providers pay a license fee per patient Advantages in license fee conceptIMPLEMENTATION: Cash flow follows well established paths Assuming any services have been approved for re-imbursement Health authorities / Insurance can use existing structures to compensate providersExample – NHS UK
  13. 13. © Frost & Sullivan 2013In collaborationwith …13The key players involved in driving Telehealth come from different parts of thehealthcare ecosystemAlarm ManufacturersDevice ManufacturersIT Solutions ProvidersSocial Service ProvidersCall Centre CompaniesClinical Service ProvidersTelecomsNetwork ProvidersPayers/Health AuthoritiesHospitalsPhysician PracticesSystemsIntegratorsRegulatorsPatient GroupsServiceProviderCall Centre/ServiceProvidersNetworkOperatorsPatientHostingSocial CareNurse / DoctorGP surgeriesIntegration &ImplementationManagementMonitoring•Network service•Potential Point of sale1stline support2ndline support•HandsetManufacturer•SensorManufacturerProvidehardwareHealth Servicecouldpay for thesolutionSource: Frost & SullivanA complex marketplace: Complex Mix of Public and Private Entities
  14. 14. © Frost & Sullivan 2010In collaborationwith …14Business Model 2Combining Medical Service Provision and IT SupportSuppliersCustomersProvidersPayersMedical ServiceFlow of Money Supplier extends value chain andprovides medical services Also network with PrimaryPhysicians Specialised services may focuson chronic diseasesPAYMENT Capital investment by Customer Pay as you go model Efficient and reliable service (integrated) can result inoptimised work flow Decreased costs and improved profitsIMPLEMENTATION: Limited success due to patients’ reluctance to accept services Not delivered in the context of conventional healthcare systems and funding Providers may view such offerings as a threat and not co-operate
  15. 15. © Frost & Sullivan 2010In collaborationwith …15Business Model 2 - ExampleBringing it All Together: Leveraging the Reach of TelecomsSuppliers (Vendor + Telecoms Player)CustomersPhysiciansPayers / ProvidersMedical ServiceFlow of MoneyVendor has partnered withdevice/sensor manufacturers. Itpromotes its own mobile devices.Its preferred route to market isthrough telecoms operators/systems integrators such as T-systems, BT etc. Vendor does notapproach hospitals / providersdirectly.CHALLENGES TO IMPLEMENTING THIS MODEL: Vendor may be limited to the reach of the Telecoms operators / systems integrators Direct revenues to vendor will be sale of its mobile devices and infrastructure services Revenue gains will only be in high volume cases or in the long runThe solution envisages sensor devices forphysiological monitoring, mobiledevices, infrastructure support, traffichosting by telecoms player on GPRSplatform, call centre support by telecomplayer, clinical support on case by casebasis. Each RPM client is considered aUNITMed Call CentresVendor
  16. 16. © Frost & Sullivan 2013In collaborationwith …16Business Model 2 - ExampleSelling into Medical Call CentresEquipment Suppliers (Aerotel)CustomersProvidersPayersMedical ServiceFlow of MoneyCall Centres + TelecomsEquipment VendorAerotel Medical Systems follows abusiness model of selling monitoringdevices to medical call centres. Thesecall centres are business entities inthemselves as they are contracted byNHS or hospitals in the public orprivate system. The call centre mayhave associations with telecomscompanies and clinicians.CHALLENGES TO IMPLEMENTING THIS MODEL: Aerotel is limited to the reach of the call centres for volume purposes Aerotel does not interact directly with patients or clinicians Direct revenues to Aerotel will be sale of its mobile monitoring devices and services Revenue gains will only be in high volume cases or in the long runThe solution envisages monitoring deviceswith bluetooth capability byAerotel, traffic hosting through landlineand cellular networks, call centre withbasic clinical support. Telecoms vendorsare involved with call centres
  17. 17. © Frost & Sullivan 2010In collaborationwith …17Business Model 3Managed Care ApproachSuppliersCustomersProvidersPayersMedical ServiceFlow of Money Payers provide health service Taking on Financial Risk during careProvision Suitable for Disease managementconceptsPAYMENT Efficient and reliable service (integrated) can result inoptimised work flow Decreased costs and improved profits Focused on specific medical risksIMPLEMENTATION: Legal constraints Opposition by healthcare Providers Focused on costly chronic diseases
  18. 18. © Frost & Sullivan 2013In collaborationwith …18Business Model 3 - ExampleHealth Hero Network+Sananet + MeavitaCustomersLocal HospitalsInsurance CompaniesIPTV Service Offering by Health Hero Network & Sananet in NetherlandsSananet identifies new and potentialtarget customers for Health HeroNetwork. The company hasdeveloped an IPTV platform in linewith the MOTIVA system from PhilipsMedical. They have tied up with alocal cable service provider calledMeavita that markets this service inthe form of an additional module inthe set top box they sell.CHALLENGES TO IMPLEMENTING THIS MODEL: Sananet offers the solution to the cable provider at a license fee for the software and the content Cable provider gets paid by the insurance provider which collects premiums from the patient Sananet anticipates an installed base of 20,000 patientsHealth Hero Network develops a vitalsigns monitoring appliance called ‘HealthBuddy’. To enter the European marketthey have entered into marketinglicenses with Sananet in the Netherlands.
  19. 19. © Frost & Sullivan 2013In collaborationwith …Challenging Questions for the Telehealth Market19• Who will fund services?• How can consumers be educated to use these services?• How do we encourage healthcare professionals (hospital personnel,GPs, and pharmacists) to promote Telehealth usage? What type ofsystems of incentives do we need?• Is there a role for the pharmaceutical industry?• Should governments continue to drive and lead the adoption ofTelehealth? To what extent? How?
  20. 20. © Frost & Sullivan 2013In collaborationwith …Contact Details20Britni MyersSenior ExecutiveFrost & SullivanP: 210.477.8481E: britni.myers@frost.com