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Digital Health: Understanding the
healthcare and technology challenges
Andy Wilkins
Independent healthcare consultant
1
My health Background Highlights
NHS
• Co-authored “Digital First” report for NHS England
• Co-authored “The Future’s Digit...
Agenda
1. Background
2. Healthcare market size and trends
3. Digital healthcare challenges
4. Key opportunity areas
Andy W...
Healthcare $6.5tn – welcome to biggest show on earth!
Total spend on healthcare is almost 10% of OECD GDP!
• Around 70% of...
Why are health costs continuing to rise?
1. Rise in Chronic disease
(Lifestyle related)
• Obesity (26%)
• Diabetes (5.5%)
...
Today most healthcare spend is focused on sickness..
Healthy/low
risk At risk
High risk
Chronic Disease
early stage
Acute ...
Wholescale business model change is required…
350m consults/yr
£50/consultation
£25/consultation
Nursing care
Innovation n...
“You‘ve got to start with the customer
experience and work back toward the
technology - not the other way around.”
Steve J...
Understanding what patient experiences to create is not easy….
What?
Who?
When? 9
Designing Digital healthcare solutions
Understand the ecosystem context
• Who are the players and what does good look like...
Modifying behaviour is harder than the technology!
11
Mental
Physical
Environment
Financial
Social
Life
satisfaction
Intel...
The explosion of wearable sensors will create a revolution through
passively recording and monitoring health & physiologic...
There are ecosytem barriers to widescale adoption…
Wellness Prevention
(at risk)
Diagnosis Treatment
Medical device, pharm...
Opportunity Areas
Andy Wilkins – Health 2.0
1. Aged Care
2. Outpatient care
14
Senior person
Their family &
support network
Aging Journey End of life
Their medical
provider
Self sufficiency
Reliance on...
• The Royal Free Hospital serves 500k outpatients per year
• They new their patient experience was poor
• We were asked to...
Deep dive patient research which enabled us to identify
over 400 needs along a structured customer journey
Backstory Appoi...
Research revealed that the patient journey is broken with
many disconnected experiences – lots of opportunity!
PRE-CONSULT...
Research from Kaiser Permanente shows that outpatients
spend 0.01% of their time with doctors & 99.99% on their own
PRE-CO...
PRE-CONSULTATION POST CONSULTATIONCONSULTATION
Referral DischargePre-appt Travel Arrival Clinic time travel Post-appt
My L...
I will leave you with an important medical tip…
“Never under any circumstances take a sleeping
pill and a laxative on the ...
2222
Thank you…..
Andy Wilkins
+44 (0) 7713 266626
andrew.wilkins@btinternet.com
Andy Wilkins – Health 2.0
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Andy Wilkins Presentation IoT Midlands Oct 2014

Presentation from IoT Midlands Meet Up in Oct 2014. The meet-up focused on IoT applications in Healthcare.

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Andy Wilkins Presentation IoT Midlands Oct 2014

  1. 1. Digital Health: Understanding the healthcare and technology challenges Andy Wilkins Independent healthcare consultant 1
  2. 2. My health Background Highlights NHS • Co-authored “Digital First” report for NHS England • Co-authored “The Future’s Digital” mental health report for NHS Confed + NHS England • Co-authored mHealth report for NHS England • Innovation model recommendations for NHS/private sector collaboration • Patient Experience research & innovation report for Royal Free Hospital Private Sector • Diabetes Patient & clinical needs research & report for Sanofi Aventis • Health market assessment & recommendations for O2 Health • Interim head of eHealth strategy for Bupa – Corporate employee health & wellbeing service design (behaviour change) - Bupa – Market needs analysis for pregnancy and early stage motherhood – Bupa – Market opportunities analysis for aged care – Bupa Care Homes Andy Wilkins – Health 2.0 2
  3. 3. Agenda 1. Background 2. Healthcare market size and trends 3. Digital healthcare challenges 4. Key opportunity areas Andy Wilkins – Health 2.0 3
  4. 4. Healthcare $6.5tn – welcome to biggest show on earth! Total spend on healthcare is almost 10% of OECD GDP! • Around 70% of health costs are due to preventable conditions • Controlling healthcare costs is one of the biggest challenges for 21C! Andy Wilkins – Health 2.0 4
  5. 5. Why are health costs continuing to rise? 1. Rise in Chronic disease (Lifestyle related) • Obesity (26%) • Diabetes (5.5%) • Heart disease (4.4%) • Cancer • Mental health 2. Aging populations • Longer life spans • Changing demographic mix 3. Rise in medical costs • Medical technology • New treatments Andy Wilkins – Health 2.0 5
  6. 6. Today most healthcare spend is focused on sickness.. Healthy/low risk At risk High risk Chronic Disease early stage Acute Disease Chronic Disease Progression End of Life care Healthcare Cost CostValue 20% of population generate 80% of healthcare costs Healthcare Status Preventing sickness Treating sickness Andy Wilkins – Health 2.0 6
  7. 7. Wholescale business model change is required… 350m consults/yr £50/consultation £25/consultation Nursing care Innovation needed to transfer diagnostics & treatments to lowest cost point of delivery Increasing cost & finite resources 42.5k GPs 358 NHS hospitals356k Nursing/ Healthcare visitors 80m consults/yr £250/consultation 60 Million People Traditional healthcare Primary care Secondary care Digital healthcare mHealth Opportunity• Telehealth • Monitoring • Personalised medicine • Preventative care Smartphones & IoT Monitoring Devices Electronic Health Records & Care Pathway workflow Andy Wilkins – Health 2.0 7
  8. 8. “You‘ve got to start with the customer experience and work back toward the technology - not the other way around.” Steve Jobs Technology as an enabler not a solution - Apple Andy Wilkins – Health 2.0 8
  9. 9. Understanding what patient experiences to create is not easy…. What? Who? When? 9
  10. 10. Designing Digital healthcare solutions Understand the ecosystem context • Who are the players and what does good look like for them? • How will they measure success? Understand the Patient’s context • What value will they get from the solution (could be different from clinician’s) • In what contexts will this be used? • Do you understand the patient journey – physical, cognitive and emotional • What usability issues need to be considered Understand the clinical context • What are the outcomes that define success? – Clinical outcomes – Care pathway measures – Economic – Technical Wellness Prevention (at risk) Diagnosis Treatment Healthcare providers & Regulators Healthcare Payers & Insurers Lifestyle, Fashion & Wellbeing brands Health Service Providers Andy Wilkins – Health 2.0 10
  11. 11. Modifying behaviour is harder than the technology! 11 Mental Physical Environment Financial Social Life satisfaction Intellectual BehaviourChangeStrategies Personal Wellbeing • Diet & nutrition • Exercise • Substance abuse • Disease management • etc • Mental health • Stress • etc There is now compelling evidence to show that people do not make rational decisions to improve their health & wellbeing…. mHealth providers need to use new techniques MINDSPACE Messenger We are heavily influenced by who communicates information Incentives Our responses to incentives are shaped by predictable mental shortcuts such as strongly avoiding losses Norms We are strongly influenced by what others do Defaults We go with the flow or preset options Salience Our attention is drawn to what is novel & seems relevant to us Priming Our acts are often influenced by sub conscious cues Affect Our emotional associations can powerfully shape our actions Commitment We seek to be consistent with our public promises and reciprocate acts Ego We act in ways that make us feel better about ourselves Andy Wilkins – Health 2.0
  12. 12. The explosion of wearable sensors will create a revolution through passively recording and monitoring health & physiological data Primary Care A&E Secondary Care Nursing Care Health information Public Health Pharmacists Social Care Health Insurance 3rd Sector Support Fragmented data held by health system silos The transactional patientThe quantified selfHealth & Wellbeing Behaviour Tracking Physiological Tracking EHR My data Andy Wilkins – Health 2.0 12
  13. 13. There are ecosytem barriers to widescale adoption… Wellness Prevention (at risk) Diagnosis Treatment Medical device, pharma & content providers Developers & ICT industries Digital Health Solutions Healthcare providers & Regulators Healthcare Payers & Insurers Lifestyle, Fashion & Wellbeing brands Lack of mHealth skills Health Service Providers Constraints & Enablers 13
  14. 14. Opportunity Areas Andy Wilkins – Health 2.0 1. Aged Care 2. Outpatient care 14
  15. 15. Senior person Their family & support network Aging Journey End of life Their medical provider Self sufficiency Reliance on supporting services Living at home Support at home Assisted living Care home Digital & Telehealth service opportunities Market opportunity – 10m 65+ 2. Medical Support – managing my condition 3. Wellbeing Support – living well 1. Care Support – looking after myself There are huge opportunities in aged healthcare Andy Wilkins – Health 2.0 15
  16. 16. • The Royal Free Hospital serves 500k outpatients per year • They new their patient experience was poor • We were asked to research the patient journey & make recommendations The Royal Free Hospital in NW London The Royal Free has an ambition to become a world class hospital Players in the healthcare system are now aware they need radical change in order to achieve their objectives Andy Wilkins – Health 2.0 16
  17. 17. Deep dive patient research which enabled us to identify over 400 needs along a structured customer journey Backstory Appointment journey How they felt about their experiences What else could make a difference Patient Interviews1. Conduct patient interviews & observations Contexts Functional needs Emotional needs Wider support needs 2. Interview analysis to extract needs & experiences Contexts Functional needs Emotional needs Widersupport needs Contexts Functional needs Emotional needs Wider support needs Contexts Functional needs Emotional needs Wider support needs Contexts Functional needs Emotional needs Wider support needs Contexts Functionalneeds Emotionalneeds Wider supportneeds3. Collate multiple interviews to build end to end outpatient experience journey 4. Analyse patient experience needs to create solution ideas Over 400 needs Andy Wilkins – Health 2.0 17
  18. 18. Research revealed that the patient journey is broken with many disconnected experiences – lots of opportunity! PRE-CONSULTATION POST CONSULTATIONCONSULTATION Referral DischargePre-appt Travel Arrival Clinic time travel Post-appt Visit a GP due to health issue Obtain a referral Find out more about my condition Prepare for my appt Travel to my appt Arrive at hospital Determine location, proceed to clinic Arrive at clinic, register for appt Wait for appt Meet doctor for appt Test / procedure Obtain advice / follow on appt Onward travel Manage condition Obtain a discharge Significant numbers of patients are being referred unnecessarily clogging up the system Patients need and want more information to help them plan & prepare for their appointment visits There are multiple issues around directions, travel planning & parking that cause significant frustration & difficulty to patients who are ill First impressions are chaotic and unwelcoming and hospital navigation is confusing Waiting is key frustration for patients with many clinics offering a dingy, overcrowded & poor experience Testing & consultation procedures often involves more waiting & queuing Consultation templates of fixed lengths often lead to rushed appointments & patients feeling unable to express themselves or unclear on doctor explanations & instructions Limited information & support for ongoing patients leads to poorer condition management & outcomes + greater readmission rates Inconsistent discharge procedures lead to unnecessary follow ups that further clog the system Overbooking leads to significant delays in availability and appointment choices impacting patient outcomes and convenience Andy Wilkins – Health 2.0 18
  19. 19. Research from Kaiser Permanente shows that outpatients spend 0.01% of their time with doctors & 99.99% on their own PRE-CONSULTATION POST CONSULTATIONCONSULTATION Referral DischargePre-appt Travel Arrival Clinic time travel Post-appt My Life 1. Visiting the hospital 2. Managing with a medical condition Patients receive minimal support at the time they most need it! This is where health happens! Andy Wilkins – Health 2.0 19
  20. 20. PRE-CONSULTATION POST CONSULTATIONCONSULTATION Referral DischargePre-appt Travel Arrival Clinic time travel Post-appt My Life 1. Visiting the hospital Understanding & ownership of my condition • Understanding my condition/ treatment • Personalising my care plan • Taking ownership of my condition/ self management Managing my treatment & my condition • Support for managing my condition • Obtaining support from family for managing my condition • Support from other patients for managing my condition • Monitoring my condition Obtaining support from my doctor & care team • Communication access to my doctor & clinic teams Carrying out tests & obtaining supplies • Undertaking repeat tests & procedures • Obtaining repeat medical supplies Support for medical queries and emergencies • Medical queries • Emergency support Managing & coordinating my appointments• Coordinating & managing my hospital appointments Huge “white spaces” exist in the patient’s world where personalised info & tools would provide significant help & improved outcomes 2. Managing with a medical condition Andy Wilkins – Health 2.0 20
  21. 21. I will leave you with an important medical tip… “Never under any circumstances take a sleeping pill and a laxative on the same night.” Andy Wilkins – Health 2.0 21
  22. 22. 2222 Thank you….. Andy Wilkins +44 (0) 7713 266626 andrew.wilkins@btinternet.com Andy Wilkins – Health 2.0

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Presentation from IoT Midlands Meet Up in Oct 2014. The meet-up focused on IoT applications in Healthcare.

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