Set the framework– Value vs. CostTHE ENVIRONMENT- World of increasing volatility – trying to better manage its inequity and variabilityFour points that relate directly to global healthcareHealthcare has several resonating trends, but the fundamental threat is global healthcare’s economic sustainability. Ontario numbers. How do you embark on the path of high cost technology innovation in the face of that threat?Access: 2B people globally have inadequate access to healthcare – does a high cost device move that dial? Does that device provide them any potential benefit?The mobile, connected world. Reversing trend of the hospital centric world. In the patient centred world, the hospital will go to the patient not vice versa. What are the technologies that will support that – are they big, high cost devices or ubiquitous, intelligent, connected, low cost devices?Changing view of the world “globalization” which everyone believed was the same thing (product) to be driven globally. Introduce concept of “Reverse Innovation” . Quote from Jeff Immelt: “ GE is literally reversing its traditional business model. Rather than follow its historical path of developing high-end products and adapting them for emerging markets, GE is developing local technologies in these regions and then distributing them globally.”Ex: GE Healthcare’s Mac 400 electrocardiogram machinewas developed in India and China. GE Healthcare made further improvements to the breakthrough technology and this year brought the new model, the Mac 800into the U.S, where it is finding new applications, such as at accident sites.Bring it back to VALUE VS. COST debate. - Cost can’t be more than the extracted value of the medical device and the solution it can provide.- Concept of Value VS. Cost is evaluated so differently evaluated around the world – problem statements and thresholds not the same. Think about this in the context of developed markets where access is good and emerging markets where access is poor. Value and cost in these contexts have very different interpretations. 3 Main Points today:Be local with a view to global impactFill a Need, Don’t create oneBigger is NOT always better
Healthcare challenges are the same around the world- access, quality and cost.Examples:- X-Ray systems (Africa) are powered by solar panels—no energy infrastructure in place for electrical power source.- Where could we do that? What about the challenges of delivering healthcare to remote communities? Economic realities – commodities economy, resources in the north where there are not people, have to create communities and there is no community without healthcare.Fertile ground for the imagineer and entrepreneur. Strong public policy underpinning, clear economic drivers and most importantly the opportunity of transferability to countries like India, Brazil, Russia and the African continent.Canada has a respected public healthcare system applicable to most of the rest of the world, talent for innovation and economic wherewithal to blaze the trail
To be precise – fill a healthcare economic need don’t create a healthcare economic problem. Otherwise it’s another cost the healthcare system can’t handle.This requires a significant amount of external focus to understand the healthcare market you are trying to serve. Example- Aging population in Canada Understand the external market—growing demographic and geographic trends in Canada.
Growth in seniors account for half of the total population growth in the next 4 decades.Demographic Trend:2/3 of the people who have ever lived to the age of 65 are alive today. In 2001, ~4 million Canadians were over the age of 65, and in 2041, it is expected that ~9 million will be.Not just managing a disease, it is the comorbidity, management of several concurrent conditions associated with aging*In 1950= 2,000 centennarians around the Globe. Today, there are 5,000 in Canada alone.With people living longer, we are just not concerned with people trying to manage an aging condition or disease at home; it is the comorbidities, the management of multiple, concurrent processes that we are facing.From the Public Health Agency of CanadaThere will not be enough hospital beds to address acute care for our aging population—need to address this challenge by bringing healthcare support into the home.SPEAK TO HUMAN DIMENSION—stress the importance for seniors living an independent life at home—SOME STATS TO HELP SUPPORT THIS POINT INCLUDE—It is estimated that the annual cost for fall related injuries in seniors over the age of 65 years in Canada is approximately $2.8B. Falls cause more than 90% of all hip fractures in seniors and 20% die within a year of the fractureFrom the CADTH – Environmental Scan – Initiatives for Healthy Aging in Canada – Issue 17 – March 2011During hospitalization, the elderly patient often experiences reduced mobility and activity levels. Functional decline, including changes in physical status and mobility, has been identified as the leading complication of hospitalization for the elderly.16 The hazards of bed rest during hospitalization are well established and include immobility, accelerated bone loss, dehydration, malnutrition, delirium, sensory deprivation, isolation, sheering forces on the skin, and incontinence - Reducing Functional Decline in Hospitalized Elderly Ruth M. Kleinpell, Kathy Fletcher, Bonnie M. JenningsWhat will it take to solve an issue like this? Coordination of care providers along the care continuum.ehealth integration to the EPR and capacity to data mine to drive improvement in patient safety and qualitySuite of devices & technology that will enable coordinated care and independent living for the elderlyAgain white space with strong economic and public policy alignment and first mover capacity to innovate for a global market.
Bigger doesn’t mean better. There … I said it without any gratuitous attempts at low humor.Look at this picture. If I’m an Alberta rigger in Fort Mac, where the gas is reasonable, driving over the tundra to the mine every morning, that Hummer is looking pretty good. But if I’m a Parisian, paying through the nose for gas, trying to find a parking space St. Germain des Pres … thanks very much, I’m taking the Smart car. Canada is a high end healthcare system—we have a healthy appetite for new, sexy, bleeding edge. We believe in the relationship between higher end technology and better patient care…..and sometimes it delivers…but many other times lower cost, simpler technology can provide more VALUE to the healthcare system (increase access, quality and reduce costs).We need to change how the Innovation community thinks about healthcare technology. Why are simpler lower cost solutions not worthy of our interest? Are they too straightforward? Not fun … not sexy enough? The mismatch is that this is REALLY sexy to the global healthcare market, and there are a staggering number of instances of simple, low cost technologies delivering significant value.2 EXAMPLES-
EXAMPLE 1- VSCAN:Visualization tool: ultrasound imager, pocket size, light, easy to use/fastDocking & Gateway: Docking with PC link to other customers’ PC tools, charger station, access to remote GE serviceWeb Portal: customer registration, device activation, online education, basic knowledge, support and helpVscan is a lower cost medical device, small, smart and fills an unserved need in emerging markets.. $200 K Ultrasound vs. $8K VscanSmall…smart…high tech, provide bedside care to patients. Think about its role in the physical exam. Now we can look inside the body to better inform and diagnose.Look at the stethoscope … its making a point. How would you recognize a doctor today. Tomorrow will it be hand held ultrasound?EXAMPLE 2- ENITS:Since the end of June 2010, 140 acute care hospitals now have access to the new Emergency Neurosurgery Image Transfer System (ENITS)ENITS, a project launched by eHealth Ontario, enables emergency department physicians to provide CT images digitally to an on-call neurosurgeon for assessment when a patient presents with head trauma. This GE technology now connects hospitals and medical centers throughout Southwestern Ontario (SWO), Canada, enabling the sharing of health data across the region. $35 million dollars in savings for a low cost six figure solution model. London innovation, but now applicable across Canada.BOTH EXAMPLES SHOW HOW YOU GET THE VALUE, NOT THE COST
So What1. Bigger isn’t always better – in fact bigger starts with more strikes against it. At best, this case could be argued equally as Bible or Bunk.Link between Innovation & Commercialization – we spend $42B annually in this province on Healthcare. I hope I’m not alone in thinking that for a $42B spend, maybe we should expect more than just good healthcare. Maybe we should expect some job creation and padding of the corporate tax base.Public Policy – it’s a powerful lens to bring to the evaluation of a concept. A great indicator of the appetite for a solution that will inform any question of cost vs value and the tolerances involvedNeed to work in a collaborative model. Healthcare is more complex than ever. Lots of different stakeholders with different need and agendas
5. Healthcare is a lot bigger and different than just Canada and we need to think more globally about how Canada can play a critical role in innovating here for the rest of the world.
Measuring Value ofMedical InnovationPeter RobertsonVP & General Manager, GE Healthcare CanadaSaturday, June 11, 2011
General ElectricA heritageof innovation 2 GE Healthcare 6/11/2011
General Electric todayEnergy Infrastructure Technology Infrastructure GE CapitalEnergy HealthcareOil & Gas Aviation Home & Business Solutions, MediaPower & TransportationWater
GE Healthcare$17 billion global business unit ofGE53,000 employeesworldwide$1 billion+/yearinvestment in R&DCore strengths inbio-sciences,technology, business 4 GE Healthcare 6/11/2011
healthymagination $6 billion commitment to making health sustainable
Canada’s Aging Population Growth in seniors account for half of the total population growth in the next 4 decades. In 2001, ~4 million Canadians were over the age of 65, and in 2041, it is expected that ~9 million will be. Remote Communities will triple in their aging population by 2021.1 Health Canada2 Public Health and Safety Canada3The Rising Tide: The Impact of Dementia in Canada.10