© PA Knowledge Limited 2014
1
WHAT’S DRIVING
UPTAKE OF DIGITAL
HEALTH AND CARE?
D14 – Digital Health and Care
George MacGi...
© PA Knowledge Limited 2014
2
PA has considerable recent experience in delivering
digital health initiatives
A top-tier ph...
© PA Knowledge Limited 2014
3
• What’s driving changes in economic
models
• Early movers
© PA Knowledge Limited 2014
4
Attention focuses on coordinated care to improve quality and outcomes
The Patient
A Patient ...
© PA Knowledge Limited 2014
5
Digital health introduces a new dynamic in fielding solutions
‘Digital’ challenges the tradi...
© PA Knowledge Limited 2014
6
Pursuing Digital Health
and Care implementations
as pilots or IT projects
fails to adequatel...
© PA Knowledge Limited 2014
7
Reforms are taking providers along a staged move to new models
• Improving referral
rates
• ...
© PA Knowledge Limited 2014
8
Finding early movers
© PA Knowledge Limited 2014
9
Designing for scale –
The pace of innovation is moderated by the nature of the change
There ...
© PA Knowledge Limited 2014
10
Designing for scale - An approach for large scale deployment
Background – a very large over...
© PA Knowledge Limited 2014
11
Making it easy to buy – the move towards ‘Paying for cures’
‘Paying for cures’ means unders...
© PA Knowledge Limited 2014
12
Making it easy to buy - A spectrum of product-to-service offerings
offers a route-map to se...
© PA Knowledge Limited 2014
13
Think about Digital Health in the context of a value-creating network, where cooperation
be...
© PA Knowledge Limited 2014
14
Exploiting the dynamics of different markets
There are opportunities to build business aris...
© PA Knowledge Limited 2014
15
Telehealth: Catholic Health Initiatives
Please find me a
physician more
prepared to move
wi...
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George MacGinnis, PA Consulting

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D14 Digital Health & Care Session Speaker

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George MacGinnis, PA Consulting

  1. 1. © PA Knowledge Limited 2014 1 WHAT’S DRIVING UPTAKE OF DIGITAL HEALTH AND CARE? D14 – Digital Health and Care George MacGinnis 30 May 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 • What’s driving changes in economic models • Early movers
  4. 4. © PA Knowledge Limited 2014 4 Attention focuses on coordinated care to improve quality and outcomes The Patient A Patient Centric perspective provides the driver for growth Acute care provided in more specialised hospitals Where possible, care moves closer to the patient Improved self care and prevention to stem rising demand
  5. 5. © PA Knowledge Limited 2014 5 Digital health introduces a new dynamic in fielding solutions ‘Digital’ challenges the traditional dynamics of the health market: • Technology innovation outpaces ability to gather traditional forms of evidence • Economics are governed by service implementation more than product features • Impact and risk is harder to assess, particularly 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’
  6. 6. © PA Knowledge Limited 2014 6 Pursuing Digital Health and Care implementations as pilots or IT projects fails to adequately account for the care delivery transformation
  7. 7. © PA Knowledge Limited 2014 7 Reforms are taking providers along a staged move to new models • 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 by • Designing for scale • Making it easy to buy • Joining a value network Maximizing Efficiency of Current Operations Managing Key Business Risks Optimising Population Health Outcomes
  8. 8. © PA Knowledge Limited 2014 8 Finding early movers
  9. 9. © PA Knowledge Limited 2014 9 Designing for scale – The pace of innovation is moderated by the nature of the change There is a significant drive for innovation in most healthcare systems but often limited capacity for change: • 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
  10. 10. © PA Knowledge Limited 2014 10 Designing for scale - An approach for large scale deployment Background – a very large overseas hospital provider, also interested in offering new models of care The challenge: A large portfolio of apparently successful pilots with no follow-on adoption. The Solution: A central digital health organisation to support local implementations, based around some guiding principles: • Technology is best bought centrally – to secure best deals, drive consistent standards, enable greater resilience and provide effective technical integration • Clinical services are best delivered within locally – so that the operating costs and benefits are managed within the same area • In additional to common technology platforms the central service should provide common operating procedures, training and accreditation to support local delivery
  11. 11. © PA Knowledge Limited 2014 11 Making it easy to buy – the move towards ‘Paying for cures’ ‘Paying for cures’ means understanding the impact of each intervention on the individual level. Typically this 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, and also requires whole new capabilities in the supply chain
  12. 12. © PA Knowledge Limited 2014 12 Making it easy to buy - A spectrum of product-to-service offerings offers a route-map to secure greater value as health systems evolve Classic ‘product’ play typically using a channel partner Managed service for supply, install and management solution. Managed clinical service including e.g. patient assessment. Often attractive to care providers Bundled clinical solution that provides commissioners / payers with a comprehensive solution Clinical care service with revenue linked to individual patient outcomes Maximizing Efficiency of Current Operations Managing Key Business Risks Optimising Population Health Outcomes Option1 Product Supply Option 2 dHealth as a Service Option 3 Clinical Fee- for-Service Option 4 Bundled Solution Fee- for-Service Option 5 Clinical Fee for Outcome
  13. 13. © PA Knowledge Limited 2014 13 Think about Digital Health in the context of a value-creating network, where cooperation between different players adds more value that can be achieved by any one of them on their own. In this context, purchasers are increasingly wary of some aspects of business models that marked the early stages of the development of the market Joining a value network – some business models are barriers to scale “Give me all your data” “Our business is really integration” “I own the customer”
  14. 14. © PA Knowledge Limited 2014 14 Exploiting the dynamics of different markets There are opportunities to build business arising from: • Targeting areas where strong clinical leadership can overcome reimbursement and evidence barriers • Looking at care sectors that don’t need the same burden of proof • Focusing on unregulated markets such as wellness • Identifying where the user is the payer and is able to pay • 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 economies
  15. 15. © PA Knowledge Limited 2014 15 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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