© PA Knowledge Limited 2014
1
DEPLOYING DIGITAL
HEALTH TECHNOLOGY
AT SCALE
dHealth 2014
George MacGinnis
1 April 2014
© PA Knowledge Limited 2014
2
PA has considerable recent experience in delivering
digital health initiatives
A top-tier ph...
© PA Knowledge Limited 2014
3
Diabetes: Most NHS costs wasteful,
says Diabetic Medicine
The majority of NHS spending on di...
© PA Knowledge Limited 2014
4
Many people experience unwanted or avoidable care encounters
• High costs and poor accessibi...
© PA Knowledge Limited 2014
5
PA sees 3 key themes emerging that are critical for this change:
• Creating and deploying
st...
© PA Knowledge Limited 2014
6
Attention focuses on coordinated care to improve quality and outcomes
The Patient
A Patient ...
© PA Knowledge Limited 2014
7
‘Paying for cures’ means understanding the impact of each
intervention on the individual lev...
© PA Knowledge Limited 2014
8
Digital health introduces a new dynamic in fielding solutions
New paradigms challenge the tr...
© PA Knowledge Limited 2014
9PPT presentation template V1-12.ppt
Developing new digital health markets
© PA Knowledge Limited 2014
10
The pace of innovation is moderated by the complexity involved
There is a significant drive...
© PA Knowledge Limited 2014
11
Reform is driving providers along a staged move to new models
Maximizing efficiency
of curr...
© PA Knowledge Limited 2014
12
Exploiting the dynamics of different markets
There are opportunities to build business aris...
© PA Knowledge Limited 2014
13
Regional differences exist, creating opportunities for new offerings
Regional differences i...
© PA Knowledge Limited 2014
14
Competitors or collaborators:
New entrants challenge current notions of the market
Healthca...
© PA Knowledge Limited 2014
15
Implications for deployment at scale
© PA Knowledge Limited 2014
16
There is an essential tension between ambition and capability
Growing services means gettin...
© PA Knowledge Limited 2014
17
Beware – some business models are barriers to scale
Give me all your data
Our business is r...
© PA Knowledge Limited 2014
18
Closing thoughts
Changes in healthcare are challenging established concepts of who the cust...
© PA Knowledge Limited 2014
19
Telehealth: Catholic Health Initiatives
Please find me a
physician more
prepared to move
wi...
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dHealth 2014, George MacGinnis, PA Consulting

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dHealth 2014, George MacGinnis, PA Consulting

  1. 1. © PA Knowledge Limited 2014 1 DEPLOYING DIGITAL HEALTH TECHNOLOGY AT SCALE dHealth 2014 George MacGinnis 1 April 2014
  2. 2. © PA Knowledge Limited 2014 2 PA has considerable recent experience in delivering digital health initiatives A top-tier pharmaceutical company Policy and regulation for innovation in mobile health Establishing a pan-US virtual health services business unit Making Telehealth a reality – delivering a technology innovation programme Market entry strategy for connected health propositions Supporting development of the Irish connected health market Developing a drug- device mHealth service Adviser on implications of telehealth for revision to the EU Medical Device Directive Member – dallas interoperability steering group Delivering investments to promote innovative information sharing Leading global industry group work to identify need for new standards in connected health Adviser to a project developing innovative, low-cost telehealth Supporting delivery of successful telehealth initiatives for the NHS in Bexley, and Lewisham Global medical device company
  3. 3. © PA Knowledge Limited 2014 3 Diabetes: Most NHS costs wasteful, says Diabetic Medicine The majority of NHS spending on diabetes is avoidable, says a report in the journal Diabetic Medicine. It suggests that 80% of the NHS's £9.8bn annual UK diabetes bill goes on the cost of treating complications BBC 25 April 2012
  4. 4. © PA Knowledge Limited 2014 4 Many people experience unwanted or avoidable care encounters • High costs and poor accessibility may mean putting off seeking care when early intervention would be better • Many chronic patients are poorly served by care in hospitals – yet for many that is where they end up • Systems often reward activity regardless of the overall outcomes Infectious diseases 1900-1950 Episodic care 1950-2000 Personalised care 2000- Health needs are evolving yet services have been slow to catch up
  5. 5. © PA Knowledge Limited 2014 5 PA sees 3 key themes emerging that are critical for this change: • Creating and deploying stratified medicine • Challenging established structures through commercial model innovation • Including greater patient insight • Changing reimbursement to reward population health Delivery of more effective patient outcomes based on the integration of new technologies, business models and partnerships Patient Centric Healthcare • Removing cost and improved access to new models of healthcare delivery. • Patients becoming active partners in care management • Accessing new data and information • Developing eHR, medical devices, virtual health and wider technical infrastructure Effective use of digital technologies is enabling a shift from curative/reactive healthcare to prevention and health management Intelligent Health Delivering health reforms to create healthier communities and maintain universal access Healthcare Reforms • Keeping universal access affordable • Re-organising health services around people’s needs and expectations • Securing healthier communities
  6. 6. © PA Knowledge Limited 2014 6 Attention focuses on coordinated care to improve quality and outcomes The Patient A Patient Centric perspective provides the driver for growth in digital health Acute care provided in more specialised hospitals Where possible, care moves closer to the patient Improved self care and prevention to stem rising demand
  7. 7. © PA Knowledge Limited 2014 7 ‘Paying for cures’ means understanding the impact of each intervention on the individual level Improving outcomes involves:  Better targeting through personalised medicine and care packages  Maximising efficacy by understanding adherence and effect for each patient  Ensuring best clinical practice is applied Information drives performance and opens the way for innovative new approaches
  8. 8. © PA Knowledge Limited 2014 8 Digital health introduces a new dynamic in fielding solutions New paradigms challenge the traditional drug / medical device innovation model: • Technology innovation outpaces ability to gather traditional forms of evidence • Economics governed by service implementation rather than product design • Impact and risk is harder to assess in ‘preventative’ care Contrasting environments are reflected in two very different regulatory regimes which now have to work together Patient Centric Safety First Demonstrate efficacy ‘at least, do no harm’ Market Centric Maximize consumer value Foster competition ‘Just enough’
  9. 9. © PA Knowledge Limited 2014 9PPT presentation template V1-12.ppt Developing new digital health markets
  10. 10. © PA Knowledge Limited 2014 10 The pace of innovation is moderated by the complexity involved There is a significant drive for innovation: • Services that improve the efficiency of existing provision have an immediate case • Services that change the location of existing provision involve changing professional working practices, requiring investment in facilities and training. • Services that look to change the process of healthcare to achieve improved outcomes are likely to be disruptive to existing reimbursement, organizational and professional structures - and require significant reforms
  11. 11. © PA Knowledge Limited 2014 11 Reform is driving providers along a staged move to new models Maximizing efficiency of current operations Managing key business risks Optimising population health outcomes • Improving referral rates • Maximising clinical throughput • Reducing length of stay • Reducing re- admissions • Improving adherence • Patient-centric care package • Evidence based pathways • Payment for outcomes • Accountable care The challenge is developing capability ahead of the reforms
  12. 12. © PA Knowledge Limited 2014 12 Exploiting the dynamics of different markets There are opportunities to build business arising from: • Focusing on unregulated markets such as wellness • Identifying where the user is the payer and is able to pay • Looking at sectors that don’t need the same burden of proof • Targeting areas with strong clinical leadership • Building volume through consumerisation of medical offerings This challenges conventional paradigms for the spread of innovation – with the potential for reverse innovation spreading from emerging
  13. 13. © PA Knowledge Limited 2014 13 Regional differences exist, creating opportunities for new offerings Regional differences in need, reimbursement, regulation and infrastructure offer opportunities to incubate a business while waiting for reforms elsewhere US: Highly regulated. Hospitals have significant power. Policy is moving towards entitlement reform and providers looking to get ready for the future while maintaining revenues. Gulf: Emerging market for health infrastructure/ regulation. Mix of social provision & powerful consumer base including non- nationals. Growing markets in medical tourism. India: Relatively few regulatory restrictions: Strong growth of mobile technologies. High appetite for innovation. Powerful consumer base developing while also having pressing issues of access to basic care. Africa: Focus mainly on basic health needs: infectious diseases, childbirth and nutrition. Poor access to care, much of which is donor funded. Little regulation and significant supply chain issues. EU: Highly regulated. Public policy led health with significant variations. Some countries with a significant eHealth infrastructure.
  14. 14. © PA Knowledge Limited 2014 14 Competitors or collaborators: New entrants challenge current notions of the market Healthcare reform is attracting the attention of global players as connected health drives convergence between industries within healthcare: • Pharma – looking to find a new ‘value add’ • Mobile – opening up the last untapped enterprise market with capabilities in meeting consumer demand • Insurance – looking to move to new business models. • Media/Entertainment – bringing the customer revolution to healthcare • Utilities – moving to offer services enabled by smart metering Who will be the winners and losers in the battle for a consumer health brand?
  15. 15. © PA Knowledge Limited 2014 15 Implications for deployment at scale
  16. 16. © PA Knowledge Limited 2014 16 There is an essential tension between ambition and capability Growing services means getting three key aspects right: • Clarity on the focus of the service • Choosing an achievable scale to drive further adoption • Establish a platform for future growth – recognising that demands will change as services grow
  17. 17. © PA Knowledge Limited 2014 17 Beware – some business models are barriers to scale Give me all your data Our business is really integration I own the customer
  18. 18. © PA Knowledge Limited 2014 18 Closing thoughts Changes in healthcare are challenging established concepts of who the customer is and what they see as a value proposition: • Governments and payers are seeking to reward positive outcomes, shifting risk onto healthcare providers and their suppliers • The customer is changing and bringing more complex buying behaviours • Solutions, rather than products, will be the key to defining value propositions • Collaborations involving innovative commercial models will become an engine for growth • Early growth markets in connected health may not be the traditional innovators
  19. 19. © PA Knowledge Limited 2014 19 Telehealth: Catholic Health Initiatives Please find me a physician more prepared to move with the times” Quote from an 85 year old patient whose rheumatology physician refused to do a teleConsult with her at Thayer County Critical Access Hospital, Nebraska requiring her to make the 2.5 hrs. journey into St Elizabeth’s Medical Center in Lincoln, Nebraska

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