Opportunities in the New World of Connected Health


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Frost & Sullivan 2013 Australia ICT Outlook Briefing

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  • The last major evolution in healthcare was heavily driven by the simple fact that significant road systems were put into place in the early 1900s thereby enabling patients to reach treaters and vice versa. We currently find ourselves in a second evolution in healthcare, and again, it is all about new roads. However, this time around, the roads are digital and even beyond that, in the cloud. Preventative (rather than reactive) healthcare issues, such as obesity, are among the most prevalent issues that we face today. Fortunately, new technology is allowing healthcare providers and patients to connect in new and exciting ways, thus making significant strides in addressing the current preventative healthcare crisis. This evolution changing the way we practice healthcare today and how it will evolve in future.
  • The use of information technologies in healthcare environments is not a new phenomenon. During the 1970s and 1980s, expressions such as "medical informatics" and "healthcare informatics" were common in the healthcare industry. As communications technologies became more ubiquitous, their role in healthcare grew in importance. Currently, terms such as e-health and mobile health (m-health) are becoming common. We aim to join those twoterms and talk about "connected health". Rather than propose an abstract definition of "connected health", we list the types of services that are a part of the connected health market. This grouping is reflective of the European Commission European Lead Market Initiative in eHealth.■ Clinical Information Systems (CIS): Specialised tools for health professionals in healthcare service provision organisations such as hospitals (such as computer-assisted diagnosis, information systems and medical imaging); Tools for primary care providers such as general practitioners (GPs) and pharmacies■ Secondary Usage Non-clinical Systems (SUNCS): Systems for health education and prevention such as online portals and Internet-based information services; Solutions for public health data analysis for research purpose; Solutions for management systems such as billing systems, administrative tasks andsupply chain management■ Telemedicine (TM): Solutions that enable remote patient monitoring, teleradiology, teleconsultation and other forms of telecare■ Integrated Health Clinical Information Network (IHCIN): Systems that enable distribution of health records such as e-prescriptions and e-referrals
  • Other global examples: T-Mobile’s CardioMessenger Service in Germany helps perform remote cardiac monitoring. This involves the patient’s heart device (a pacemaker or implantable cardioverter defibrillator (ICD)) sending regular messages to an external device, which in turn forwards the data to a central database through the GSM network so that a physician can evaluate it.Homemonitor by Telenor in Norway has different sensors wirelessly connected to a medical alert system. Sensors are present for fall detection, location detection and identifying moisture levelsNational Taipei University of Technology (NTUT) and Taichung Hospital are working on an ambulance-support Emergency Response system, which will entail a wireless sensor system to enable the transmission of patient parameters to the emergency wards of hospitals while patients are en route.SK Telecom’s Mobile Health Assistant in South Korea links smartphones of doctors to the EHR systems of hospitals. Physicians can then view patient records on their smartphones
  • The mobile health market in APAC is expected to comprise almost 30% of the global market and reach US$ 6.8 billion, corresponding to mobile health spend per capita of about US$ 1.6, by 2017. The mobile health market opportunity in APAC will be driven by the eastern region, in particular China with 37% share of the market and Japan with 21% share of the market. India with 8% market share and Australia with 6% market share.Wearable devices long been a panacea for the telecoms industry, but it is the medical industry, rather than consumer, that is driving the market.A study by IMS Research shows far more manufacturers in the field of medical wearable technology than consumer products. The firm’s research found some 32 vendors producing kit in what it terms healthcare and medical devices – double the number manufacturing in the infotainment sector.The second largest category also has a focus on healthcare. According to IMS, there are 20 manufacturers producing equipment for the fitness and wellbeing market. Industrial and military applications rank last, with eight vendors.Wearable devices in the infotainment sector have yet to prove their usefulness when compared to smartphones and mobile applications. “Consumers may question the value of smart watches or smart glasses if they cannot do anything that their smartphone cannot do – apart from being wearable.”It forecasts 170 million such devices will ship in 2016, as more big-name companies get on board. However, success will depend on the size of the devices, how invasive the kit is, and its ability to measure multiple parameters and provide automated feedback
  • Through usage of mobile phone or personal digital assistant(PDA) servers : •Patients have immense possibilities for adequate recordings of biomedical signals at home that includes: Glucose analysis, Respiratory parameters, Blood pressure measurements, and electrocardiogram(ECG) recordings •The measuring equipment being mobile facilitates the biomedical recordings to be stored as a fragment of the electronic health record(EHR) in a database •Ensures secure communication with digital ID in the subscriber identity module(SIM) card •Involves use of encrypted virtual private network(VPN) tunnels for secure data transfer •Many mobile medical devices are now connected to medical information technology networks and information technology(IT) networks are these days remotely accessible through the medical devices--This stands out as a desirable developmental trend. •The storage capacity, faster computing speeds, ease of use, and portability render mobile devices an optimal solution in terms of diagnosis and monitoring of chronic conditions. •With mobility being discussed as a prominent theme and a top takeaway from health IT conference (HIMSS12’), many vendors are focused upon an iPhone or an iPad app. design and healthcare providers are realizing the need to manage the ‘BYOD’ (bring your own device) trend in hospital settings.
  • The Australian government spends close to AU$10 billion (US$10 billion) on aged care annually, an amount that is expected to grow at 5% CAGR through 2016 (excluding the impact of proposed reform initiatives). We estimate consumers contribute at least an additional US$3 billion in annual out-of-pocket costs. The market is broadly divided into two main categories: community care packages, which offer care at home to more than a million elderly Australians; and residential care, a segment comprised of roughly 1,200 service providers and 200,000 beds. We expect community care will grow as a proportion of the market; reflecting a global trend, Australians seek to stay in their homes as long as possible, entering care facilities only when all other options have been exhausted
  • Airtel is not the first to introduce a mobile health scheme in the country, a recent trend. Some months earlier, telecom operators Aircel and Idea had launched a similar service in association with the Apollo Hospital group-promoted Healthnet Global. Such tie-ups are increasingly seen as a good value addition for telecom companies and a business opportunity for healthcare providers.http://www.airtel.com/wps/wcm/connect/airtel.in/airtel.in/home/whats+new/mediphone
  • Recently, SAP made a partnership with Siemens with the purpose of providing the healthcare industry with an electronic medical record to be accessed in mobile devices. SAP has also partnered with Atos, intending to deliver a solution to track and trace medicines. SAP believes that its main differentiators are the company ecosystem and the great number of local and global partners; both elements contribute to the company performing highly in different industries, delivering adequate and innovative solutions.The healthcare industry faces the challenge of providing high quality services for a larger population and at the same time reducing costs. SAP aims at providing the healthcare industry with a portfolio that addresses these market needs. SAP has developed a specific costumer relationship management (CRM) solution for the healthcare industry. It also has a portfolio of solutions designed to help clients to manage financial processes, human resources, and other strategic activities. Moreover, SAP provides its customers with a Business Intelligence (BI) tool, which can also be used to manage sustainability along hospitals’ conventional processes. One relevant differentiator of the previously mentioned solution is its in-memory computing platform, HANA, which can make data processing almost 3.6 thousand times faster than conventional databases. Another solution is the business analytic technology (BA&T), a software for strategic planning and for real-time patient monitoring. The BA&T can be associated with other SAP solutions, enabling the development of a single platform able to communicate with other institutions and systems. SAP is also investing in electronic medical records to be accessed on mobile devices and as well as solutions for chronic disease monitoring
  • AT&T provides a wide range of solutions to healthcare organizations: Business continuity, Health information exchange, Infrastructure, Mobility, Security, Telehealth, Unified communications, mHealth, and Cloud-based healthcare solutions. AT&T’s mHealth solution is the opportunity closest to the patient/consumer and has received significant attention and resources from AT&T. AT&T has engaged Cisco, Polycom, Avaya, and AMD Global Telemedicine to deliver a variety of end-to-end telehealth solutions that include the necessary hardware, software, and network infrastructure to facilitate a turnkey application. Essentially, AT&T acts as an integrator and value-added reseller in this market segment.WellDocA strategic alliance to market and sell WellDoc’s mobile health (mHealth) solution to improve patient outcomes and reduce the cost of managing chronic diseaseseCardio DiagnosticsAT&T provides M2M wireless data and mobile connectivity for near real-time remote monitoring of cardiac patients, allowing them to recover at homeWallace WirelessOffering with AT&T a healthcare notification and pager replacement solution that allows hospital and healthcare organizations to reach healthcare workers and contractors regardless of the mobile device or carrier they useVitality GlowCapsThe partnership sends visual and audio reminders to patients to remind them to take their medicationAcuo TechnologiesWorking with AT&T to develop a cloud-based medical imaging storage solution to help healthcare solve storage challengesCisco SystemsProvides telepresence hardware for telemedicine applications
  • Existing mHealth applications have shown that the combined use of a mobile network and connected device can greatly extend the reachability of healthcare platforms, and the potential for further development is huge. •The development of low-cost sensors as peripherals for smartphones is actively being pursued as it allows improved diagnosis outcomes to be achieved closer to the patient without the need for commuting to imaging center. •In the event of outbreaks of infectious diseases, mobile monitoring tools can enable patients to receive due medical assistance without the need to travel. •Within the next three to four years, remote diagnosis could begin to encompass prescription delivery on the basis of remote consultation. Scope to employ SMS-based review and authentication of prescriptions is promising. •Healthcare data collated from remote diagnosis can be combined with data interpreted from physician’ office consultation to augment epidemiological research findings
  • The growing coverage of mobile networks and the increasing number of active subscribers emerges to be a major driving force for mHealth interventions and the plethora of applications continues to increase in diversity with new innovations. Automated real-time blood glucose recording and diabetes management through mobile phones and software networks is an active area of research these days. Clinical findings revealed till date pinpoint towards mobile diabetes management systems as the highest growth potential sector presently and for the next four years. •Amongst the most promising mobile diabetes intervention systems designed, Telcare Inc.’ cellular-enabled blood glucose meter; AgaMatrix Inc.’ WaveSense diabetes manager; and WellDoc Inc. Diabetes Management (see picture) platform are noteworthy to mention. CARDIAC: With complexity increasing in chronic disease management on a daily basis, solutions which can improve outpatient care are becoming vital components of healthcare delivery. Mobile cardiac management is one area in which newer product offerings can make a true difference in the strengthening efforts geared towards public health surveillance with respect to cardiac diseases incidence worldwide. •Mobile cardiac monitoring solutions involving wireless cardiac telemetry systems targeting arrhythmic events and mobile electrocardiogram recorders(ECGs) have been demonstrated to significantly improve patient outcomes as a result of changes in patient management. •Prominent participants working towards bringing forward mobile cardiac monitoring tools as a valuable diagnostic tool ensuring patient safety includes: AliveCor Inc.’ mobile ECG; SHL Telemedicine’ Smartheart technology; Aventyn Inc.’ Vitalbeat patient monitoring system, to name a few… ASTHMA:Smartphone mobile applications that will allow people with asthma, their family, caregivers, and physicians to accurately and effortlessly manage their breathing distress symptoms is increasingly preferred. Mobile acoustic respiratory monitoring platforms that use mobile sensors and signal processing software to monitor changes in lung function and treatment response are sought-after platforms for ongoing asthma monitoring needs. •Wireless sensors attached to the inhalers, mobile applications, advanced analytics and feedback, all are observed to aid in achieving improved collection and interpretation of large amounts of patient data. •Key mobile asthma interventions that can remotely monitor asthma symptoms and improve adherence with controller medications are listed herewith: iSonea Limited’ AsthmaSense app. for smartphone users; Asthmapolis Inc.’ mobile sensor and mobile app. ; AsthmaWin’ digital mobile application for day-to-day management.
  • Opportunities in the New World of Connected Health

    1. 1. Opportunities in the New World of Connected Health Will this road lead to healthcare transformation? Rhenu Bhuller Vice President, Healthcare December 5th, 2012 #2013ictoutlook
    2. 2. Connected Health #2013ictoutlook
    3. 3. Megatrends Impacting the Entire Spectrum of Care A modern health care system is on the horizon, demanding a paradigm shift From... ...ToOne Size Fits All APPROACH Personalized MedicineFragmented, One-way INFORMATION FLOW Integrated, Two WayProvider Centric FOCUS Patient CentricCentralized, Hospital-based LOCATION Decentralized, Community-basedFragmented, Specialized TREATMENT Collaborative, Shared InformationProcedure-based REIMBURSEMENT Outcomes-basedTreating Sickness OBJECTIVE Preventing Sickness (Wellness) Source: Frost & Sullivan analysis. #2013ictoutlook
    4. 4. Shifting Emphasis From Acute Care to Prevention Track, Predict, Intervene, Manage Prevention/Wellness • Early identification and prevention • New forms of care delivery to improve collaboration among providers, patient knowledge, self-help and health • Increase coverage for those services which prevent Goal:Size of Impacted Population disease and improve health over long term; Keep People incentivize better chronic disease management Healthy Longer Goal: Disease/Care Manage Management or Mitigate Goal: Risk Diagnose and Reduce Goal: Treatment Move to Goal: Delay More Manage Goal: Interactio n and Informed Self- Decisions Mgmt Healthy/ ―At Risk‖ Undiagnosed Chronically Ill Chronically Ill End ―Worried Well‖ Managed Unmanaged of Life Continuum of Care Source: Frost & Sullivan analysis. #2013ictoutlook
    5. 5. Settings for Care Provision Diagnostic Planned interventions SpecialistD Treatment centres Emergency care Specialist care centres Secondary care Complex diagnostic treatment Serving population of 250K, 500K Tertiary care & inpatient care and 1,000K on central city sites Resource centres Basic Diagnostic Services CommunityC Community hospitals Day interventions Community care centres Minor injuries Serving populations of 100K Nurse-led inpatient care In the heart of the community Intensive rehabilitation Chronic care management Surgeries Social care Health and SocialB Drop in centres Primary care Health and social care centres Healthy living centres Outreach care Close to home, serving populations Information and advice Of up to 10K Home Self care HomeA Nursing home Monitoring Pharmacy Automated treatment Cyber café Information and advice Health kiosk NHS Direct #2013ictoutlook
    6. 6. What Does This New Healthcare World Look Like?More emphasis on diagnosis, monitoring, Tighter cost constraints, declining preventative care = reimbursement, more expensive tools = INCREASED COLLABORATION BETTER FINANCIAL MANAGEMENT P4P, more public scrutiny, evidence- Greater info flows to support training, based medicine = supply chain, patient educationTRACK AND DOCUMENT OUTCOMES COMMUNICATIONS AND CONTENT #2013ictoutlook
    7. 7. The role of Health Data Analytics in the shift from treatment to preventionEnables hospitals Empowers usersto improve patient with key care and reduce knowledge needed costs for effective decision making #2013ictoutlook
    8. 8. Connected Health Ecosystem• Video Diagnostic • Home and Disease Consultation Management Monitoring• Remote Doctor/Specialist • Activity Monitoring Services Remote Monitoring • Diabetes Management• Distance • Wellness Programs Learning/Simulation • Remote Cardiac ECG• Retail Telehealth • PERS• TeleImaging IHCIN • Medication Management Telemedicine mHealth• Electronic Health • Professional Records (EHR) Apps• Health Information • Wellness Apps Exchange (HIE) General • Fitness Apps• Patient Portals Healthcare IT (CIS and • Texting• Hosted Cloud non-CIS) Informational Infrastructure Services Source: Frost & Sullivan analysis. #2013ictoutlook
    9. 9. Big Data—Data Explosion Drives the Need for PowerfulAnalytics Leveraged Across Disparate Data Sets Definition Key Trends―Big data‖ • Amount and movementterabyte to of digitized datapetabyte toexabyte- • Healthcare reformsized data. • Explosion of scientific informationSelect Vendors Core Solutions HealthcareHumedica providers will increasingly utilize advanced, cloud-based MinedShare, SaaS-based clinical, financial, operational intelligence solution; database technologies for patient care, surveillance management, and MinedStream; real-time predictive clinical financialEMC scientific research. Greenplum Unified Analytics Platform (database, computing, storage, and network)IBM IBM Content and Predictive Analytics for Healthcare; InfoSphere BigInsights Source: Frost & Sullivan analysis. #2013ictoutlook
    10. 10. Healthcare Cloud – What does it mean for Healthcareplayers? Scale Rapid Flexibility Provisioning Cloud Computing High Multi-tenancy Availability Pay as you Agility go #2013ictoutlook
    11. 11. Healthcare Cloud – Who is leading ? IBM Amazon Web services Salesforce Health cloud offering In 2009 , Salesforce announced equity investment in PracticeFusion, an EMR service provider that was Collaborati one of the first to offer free, ad Elasticity – supported physician EHRs to physician groups. ve Care Pay as you using go model Others Cloud Microsoft, Dell and GE Health are some of the other major players offering cloud computing services. Microsoft - leading the way on the policy front. Dell, GE Health and others - services such as EHRs, health information exchanges and PHRs. #2013ictoutlook
    12. 12. HCIT Market Overview #2013ictoutlook
    13. 13. In Asia, countries are at different stages of healthcare delivery which represent a different set of opportunities Image Electronic Resource Clinical Health Record Personal Management Electronic Management Decision (EHR) Health Medical Computer Support Record Patient Record Information (PHR) Financial Patient Management (EMR ) SystemsManagement Administration Administrative IT Solutions Clinical IT Solutions Integrated Healthcare Delivery Singapore China Thailand Malaysia Australia South Korea Taiwan Japan Source: Frost & Sullivan. #2013ictoutlook
    14. 14. Key challenges faced by CIOs in Australian hospitals Key future drivers Priority areas for CIOs #2013ictoutlook
    15. 15. Areas of opportunity15 #2013ictoutlook
    16. 16. Telehealth Will be Enabled with Various DevicesTelehealth Video Monitors TV as Access Device Smartphones & Tablets• Act as home hub for plug-in • In place in nearly 100% • Widespread use among of various devices, support of households clinicians and consumers two-way communications • High penetration and • Easy to deploy and diffuse• Difficult to deploy and comfort with use by new applications and provision at large scale elderly population solutions• Will be displaced by • New capabilities with • Addition of mobility consumer devices motion sensing increases value of apps Source: Frost & Sullivan. #2013ictoutlook
    17. 17. The Mobile Health Market Fitness monitors Activity monitors #2013ictoutlook
    18. 18. m-Health . . . Potential efficiencies in the systemThe adoption of mobile healthcaretechnologies speeds up the process ofdelivering healthcare information andoutcomes. More advanced mobile phonetechnologies are enabling the prospects forfurther healthcare delivery #2013ictoutlook
    19. 19. Opportunities in aged care Australia is seeking to redesign its aged care system to meet challenges presented by the increasing demands of an ageing population, shifting consumer preferences and workforce shortages. #2013ictoutlook
    20. 20. Healthcare solutions provided by collaborations betweentelco and healthcare providers Airtel, India’s largest mobile phone operator, has recently tied-up with Religare Technologies, a company controlled by promoters of the Fortis hospital chain, to offer healthcare solutions and guidance over telephone. By paying an introductory tele- consultation fee of Rs 15 ($0.25 cents) a call, Airtel customers can get basic medical guidance on non-emergency health problems through this service, 24 hours, seven days a week. Airtel charges ~ $0.50 for this call. The service is based on a protocol developed by Medibank Health Solutions, Australia With a customer base of 173 million, Airtel’s latest value addition is expected to provide a productive platform for Religare to promote their e-health service. #2013ictoutlook
    21. 21. SAP’s focus on healthcare and its solutions portfolio SAP has been providing solutions for the healthcare industry for a long time. In 2012, the company elected healthcare as one of the five verticals that it would focus on. #2013ictoutlook
    22. 22. AT&T Key Value Propositions to Healthcare Stakeholders Hospitals Brand Equity Sales Force M2M Networking Technology Physician Offices AT&T mHealth Healthcare Platform Community OnlineApplicationDevelopers Web/Video/ Medical Audio ImagingConsumers Conferencing Storage and Mgmt Health Plans Wireless Cloud Services, Network, Managed Device Support Data and Services Voice Employers Services Source: Frost & Sullivan. #2013ictoutlook
    23. 23. Future Trends #2013ictoutlook
    24. 24. Mobile health continues to extend the reachability ofhealthcare platforms #2013ictoutlook
    25. 25. Advancements in mobile phone technologies are enablingprospects for improved healthcare delivery #2013ictoutlook
    26. 26. HCIT Will Include The Entire Continuum of Care Workplace Fitness, Healthy Villages Wellness: Rejuvenation, and Nutritional, Fitness, Beauty Centers Preventive WellnessMedical Wellness: Retirements Spa, Nutritional, Homes Rejuvenation, Rehabilitation Hospitality Wellness: Spa, Fitness Assisted Lifestyle Villages & Townships Health Institutional Management Community Primary Care Health Centers: Centre Day Care Preventive, Nutritional, Alternative Illness Home Care Hospitals: Acute & Chronic Care Mobile Clinics Age Sphere: Lifelong Continuum ―from womb to tomb‖ #2013ictoutlook
    27. 27. The Future of Healthcare . . . .Linking Stakeholders From Different Industries Assisted Lifestyle Retirement Homes Medical Spa Healthy Villages Preventive Wellness Wellness Villages Medical Wellness Healthcare Cosmetic Surgery Nutritional Primary Alternative Corporate Wellness Community Secondary Spa Fitness Tertiary Beauty Courses Nutritional Supportive Industries Education Hospitality #2013ictoutlook
    28. 28. Follow Frost & Sullivan on Facebook, LinkedIn,SlideShare, and Twitter http://www.facebook.com/FrostandSullivan http://www.linkedin.com/companies/4506 http://www.slideshare.net/FrostandSullivan http://twitter.com/frost_sullivan #2013ictoutlook
    29. 29. For Additional Information Donna Jeremiah Carrie Low Corporate Communications Corporate Communications Asia Pacific Asia Pacific +61 (0) 8247 8927 +603 6204 5910 djeremiah@frost.com carrie.low@frost.com Jessie Loh Corporate Communications Asia Pacific +65 6890 0942 jessie.loh@frost.com #2013ictoutlook