HEALTHINFORMATIONEXCHANGE                                    Sumit K Jha                                    jhasumit@gmail...
Flow of the Presentation   HIE Definition   HIE Stakeholders   Stakeholder Interaction   Value Proposition for HIE Sta...
Definition of HIE   HIE is a platform through which an entity can provide data    aggregated from its Telemedicine center...
HIE Stakeholders                    Healthcare          Pharma / Surgical                    Providers              compan...
Stakeholders involved                                              Healthcare               Pharma / Surgical             ...
Interaction Details – Healthcare Seeker                                   Healthcare ProvidersIndividual:Demographic Segme...
Interaction Details - Others                                            Healthcare                Pharma / Surgical       ...
HIE Value Proposition                                                          Healthcare                    Pharma / Surg...
HIE Value Proposition                                                          Healthcare                    Pharma / Surg...
Stakeholders Contribution to HIE                                                  Healthcare                  Pharma / Sur...
HIE is projected to acquire critical mass by 2015Type                  Stakeholders             Stakeholder paying to HIE ...
Appendix
Learning from NoMoreClipboard                                                                   …1/3NoMoreClipboard Overvi...
Learning from NoMoreClipboard …2/3NoMoreClipboard Milestones   NoMoreClipboard.com is integrated on the Google Health pla...
Learning from NoMoreClipboard …3/3NoMoreClipboard Innovations The NoMoreClipboard FroozHIE tool is a user-friendly, inter...
Lessons from Google’s failure   Google also proved that a consumer PHR service requires widespread, aggressive advertisin...
Lessons from Google’s failure   At the opening Google decided that they would support CCR (Continuity of Care Record) fro...
A word or two of caution        "The HIE market is extremely volatile," states Lynne A. Dunbrack, program director, IDC H...
Thank You
Upcoming SlideShare
Loading in …5
×

Health information exchange

912 views

Published on

Business and revenue model definition for Healthcare business platform

Published in: Business
1 Comment
0 Likes
Statistics
Notes
  • Be the first to like this

No Downloads
Views
Total views
912
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
33
Comments
1
Likes
0
Embeds 0
No embeds

No notes for slide

Health information exchange

  1. 1. HEALTHINFORMATIONEXCHANGE Sumit K Jha jhasumit@gmail.com Business Idea Commercialization
  2. 2. Flow of the Presentation HIE Definition HIE Stakeholders Stakeholder Interaction Value Proposition for HIE Stakeholders Contribution by Stakeholders Commercials for HIE
  3. 3. Definition of HIE HIE is a platform through which an entity can provide data aggregated from its Telemedicine centers and also facilitate one-to-one or one-to-many exchange/s of healthcare related information among the following stakeholders commercially and non-commercially:  Healthcare Seekers  Healthcare providers  Pharma / Surgical companies  Pharmacies/ Chemists  Wellness providers  Insurers  Government  NGOs  InstitutesInteractions among and with Government, NGOs and Institutes are critical but will remain mostly non-commercial on the HIEplatform
  4. 4. HIE Stakeholders Healthcare Pharma / Surgical Providers companies Pharmacies/Healthcare Seeker Chemists NGOs Government Institutes Insurers
  5. 5. Stakeholders involved Healthcare Pharma / Surgical Pharmacies/ Healthcare Seeker Providers companies Chemists Individuals (Rural, Urban  Integrated Delivery Networks  Surgical instruments Pharmacieshealthcare seekers)  Hospitals  Drug manufacturers  Wholesalers Corporate (through  Nursing homesreimbursement model of  Device manufacturers  Individualhealthcare delivery)  Clinics  Chains  Diagnostic centers/ Pathology labs  Hospital owned 108 services Wellness providers AYUSH Fitness centers Skincare & Dermatology Institutes Insurers Government  Medical & dental colleges  Health Insurers  Central government NGOs  Pharmacy colleges  State government  Agents  Regulatory bodies i.e. MCI  R$D Institutes  Wealth planners NGOs  WHO  UNICEF  World Bank  ADB
  6. 6. Interaction Details – Healthcare Seeker Healthcare ProvidersIndividual:Demographic Segment • Tele-Medicine Clinics• Urban• Semi-Urban • Private Doctors• Rural • Specialist Doctors • Specialty Hospitals CommercialIncome-Group Segments: • Emergency Services Interactions• High Income Group• Middle Income Group Pharmacy / Chemists• Low Income GroupCoverage Segment: Insurance Companies• Covered with Insurance• No Insurance Government AgenciesCorporate Segment: Non-Commercial Interactions• Reimbursed Healthcare• Company Provided healthcare NGOs
  7. 7. Interaction Details - Others Healthcare Pharma / Surgical Pharmacies/ Healthcare Seeker Providers companies Chemists Healthcare providers  Healthcare Seekers  Healthcare providers  Healthcare Seekers Pharmacies/chemists  Insurers  Pharmacies/ chemists  Healthcare providers Insurance Companies  Pharma/ surgical companies  Government  Pharma / Surgical Government  Pharmacies/Chemists companies  Institutes  Government  Government  NGOs Wellness providers Healthcare SeekersPharmacies Institutes Insurers Government  Healthcare providers  Healthcare Seekers  NGOs NGOs  Pharma/surgical companies  Institutes  Healthcare providers  Healthcare Seekers  Government  Government Healthcare Seekers  Healthcare providers Healthcare providers  Pharma/ surgical companies Pharma/ surgical companies  Pharmacies/ Chemists Government  Insurers
  8. 8. HIE Value Proposition Healthcare Pharma / Surgical Pharmacies/ Healthcare Seeker Providers companies Chemists Access to care  Improve care quality  Increase volume  Greater access to the Reduce care/insurance cost  Access to EMR  Improve service market Improve services  Drug research & information  Increase direct sales  Product knowledge Support health of family members  Knowledge sharing  Accelerate clinical trials at  Procurement/ inventory Improved healthcare awareness lower cost planning  Technological advancements  Access to end-consumer and  Increased visibility impacting market intelligence top-line Wellness providers  Access to competition focus  Tie-ups with other areas Access to a more organized stakeholdersplatform to showcase their  Greater access to the marketcapabilities Easier access to customer Institutes Insurers Governmentbase  Clinical trials and studies  Increase membership by  Improve wellbeing- Social targeted marketing mandate NGOs  Research feed  Better & transparent funding  Direct sales  Use data to refine the course Government focus and budget  Reduce care costsallocation material  Easier claim settlement  Improve reach & access Opportunity to tie-up with the best fit  Funding/sponsorship  Informed premiumcare providers or pharmacies calculation  Improve services Attracting private/public  Reduce fraud & abusefunding/sponsorship  Better product design
  9. 9. HIE Value Proposition Healthcare Pharma / Surgical Pharmacies/ Healthcare Seeker Providers companies Chemists Access to care  Improve care quality  Increase volume  Greater access to the Reduce care/insurance cost  Access to EMR  Improve service market Improve services  Drug research & information  Increase direct sales  Product knowledge Support health of family members  Knowledge sharing  Accelerate clinical trials at  Procurement/ inventory Improved healthcare awareness lower cost planning  Technological advancements  Access to end-consumer and  Increased visibility impacting market intelligence top-line Wellness providers  Access to competition focus  Tie-ups with other areas Access to a more organized stakeholdersplatform to showcase their  Greater access to the marketcapabilities Easier access to customer Institutes Insurers Governmentbase  Clinical trials and studies  Increase membership by  Improve wellbeing- Social targeted marketing mandate NGOs  Research feed  Better & transparent funding  Direct sales  Use data to refine the course Government focus and budget  Reduce care costsallocation material  Easier claim settlement  Improve reach & access Opportunity to tie-up with the best fit  Funding/sponsorship  Informed premiumcare providers or pharmacies calculation  Improve services Attracting private/public  Reduce fraud & abusefunding/sponsorship  Better product design
  10. 10. Stakeholders Contribution to HIE Healthcare Pharma / Surgical Pharmacies/ Healthcare Seeker Providers companies Chemists Generic personal information  Location List of products  Location Medical Records  Service provided  Patent information  Demographic profile of their region Healthcare provider information  Doctor information  Research  Product sales information Healthcare spending behaviour  Patient records  Formulations  Preferred healthcare providerPayment for Services availed  Diagnosis best practices/  Technological advancements knowledge  Drug efficacy Wellness providers  Healthcare spending Alternative & economic behaviourtreatment Care for lifestyle diseases Institutes Insurers Government  Clinical trials and studies  Insurance schemes  Demographic information (Census, UID) NGOs  Research  Insurance coverage  Development Schemes  Courses offered  Medical history Profiles- focus areas  Funding  Claims history  Consultation papers Knowledge  Client list Epidemics Plans & funding
  11. 11. HIE is projected to acquire critical mass by 2015Type Stakeholders Stakeholder paying to HIE For transacting with Individuals Healthcare Providers Commercial Healthcare Providers Individuals Pharmacies & Chemists Pharmacies & Chemists Wellness care providers Wellness care providers Healthcare Providers Individuals Insurers Individuals Pharmacies & Chemists Pharma & Surgical Companies Healthcare Providers Government Wellness care providers Individualscommercial Non- Institutes Insurers Individuals NGOs Pharma & Surgical Companies Pharmacies & Chemists Revenue in INR Crores 2012 2013 2014 2015 Individuals 5.2 12.3 30.1 95.6 Healthcare Providers 2.9 7.1 18.1 61.4 Pharmacies & Chemists 0.9 2.0 4.7 13.2 Wellness care providers 0.3 0.6 1.6 4.8 Insurers 0.3 0.9 2.3 7.0 Pharma & Surgical 0.6 3.3 13.2 55.0 Companies Total Revenue Projection 9.7 26.3 70.0 237.0
  12. 12. Appendix
  13. 13. Learning from NoMoreClipboard …1/3NoMoreClipboard Overview The founders of NoMoreClipboard got their start in healthcare IT when they created one of the first commercially viable health information exchanges in the United States. The wires and pliers effort required to connect hospitals, physicians and other healthcare providers embedded the importance of practical and affordable interoperability into our organizational DNA. This same team developed a web-based electronic health record platform widely used by physicians, Fortune 500 companies operating on-site health clinics and safety net healthcare providers. In 2003, NoMoreClipboard was formed as a separate legal entity to provide consumers with a portable, patient-managed personal health record platform designed to interoperate with virtually any other healthcare IT application. NoMoreClipboard is built on a robust electronic health record architecture developed for clinicians – with a consumer-friendly user interface. While much of the underlying clinical functionality is "turned off" for consumer use, it can be enabled for enterprise clients. NoMoreClipboard is recognized as one of the top personal health records on the market, based largely on our ability to help consumers compile, manage and share personal health information with physicians and other care providers. NoMoreClipboard is able to deliver PHR data directly from the application in a format that integrates with existing provider workflow. PHR data can be delivered electronically using secure, interoperable data standards, or on the specific paper registration forms used by each individual provider. Physicians receive information that is more legible, accurate and complete – improving communication and coordination of care, and reducing medical errors and unnecessary costs.
  14. 14. Learning from NoMoreClipboard …2/3NoMoreClipboard Milestones NoMoreClipboard.com is integrated on the Google Health platform, enabling Google Health users to deliver their health information and medical records to physicians without electronic connectivity NoMoreClipboard.com has a strategic relationship with Microsoft HealthVault, enabling consumers to compile, manage and share health records, delivering data from HealthVault to care providers Howard University Hospital is providing diabetes screening and treatment on a mobile van that visits the Washington D.C. community – after the visit, the Howard EMR populates a NoMoreClipboard.com PHR account NoMoreClipboard.com collaborated with NCHICA and IBM to demonstrate PHR interoperability as part of the Consumer Access to Clinical Information use case at the National Health Information Network (NHIN) demo sponsored by HHS Medicare beneficiaries in Arizona and Utah can populate their NoMoreClipboard.com accounts with CMS claims data as part of a the Medicare PHR Choice Pilot program Indiana University students can create an IU branded PHR and send their information to the campus student health center – information from NoMoreClipboard.com populates existing health center registration forms NoMoreClipboard.com serves as the consumer gateway at the 2009 HIMSS Interoperability showcase in Chicago Bon Secours Health System in Virginia is offering a branded version of the NoMoreClipboard.com PHR to its patient population as part of an online patient portal offering- Meridian Health in New Jersey is also offering a branded PHR to its patients – the PHR will include integration with innovative home monitoring devices including MDMouse
  15. 15. Learning from NoMoreClipboard …3/3NoMoreClipboard Innovations The NoMoreClipboard FroozHIE tool is a user-friendly, interoperable application that intelligently translates, compares and helps clinicians reconcile clinical patient data from disparate sources including PHRs, EMRs, HIEs and health care IT platforms such as Google Health and Microsoft HealthVault. Further, FroozHIE supports data between platforms utilizing different data standards including CCR, CCD, CDA and HL7. NoMoreClipboard forms definition technology enables practice-specific patient registration forms to be scanned and defined – matching the fields on paper registration forms with the contents of the NoMoreClipboard PHR. Clinical information is SNOMED-CT coded so that information in the PHR corresponds to matching questions on practice forms (e.g. CHF entered in the patient PHR automatically indicates a history of heart disease on the practice form). With this technology, physicians receive a printed version of their own forms that is more legible, accurate and complete than the same form filled out in a practice waiting room. NoMoreClipboard is able to create a branded patient portal experience that integrates the brand identity of the sponsoring organization with the benefits of the personal health record. Portals can incorporate additional functionality including secure messaging, appointment requests and prescription refill requests. NoMoreClipboard functionality can be tailored for enterprise level clients to automate health risk assessments, integrate with other applications, and incorporate organization- specific modules
  16. 16. Lessons from Google’s failure Google also proved that a consumer PHR service requires widespread, aggressive advertising. It will not spread virally, at least not at this nascent point in the PHR market. Google did not advertise the service widely, so hardly anyone realized Google Health existed. The few consumers who knew about it were not entranced, and did not recommend it to their friends. Google Health was too hard to use, too complicated. Then the PHR must be explained and advertised to consumers so they crave it. Given the lessons of Google’s failure, should we abandon visions of successful PHR systems for at least five years? The United States cannot afford that. There is little hope of controlling healthcare costs until we educate consumers about managing their health and dealing efficiently, as buyers, with physicians and hospitals. Consumers need their own health records on their own screens. They need help using those records with Internet tools and games, and on social networks ONC’s experiment with NwHIN (Nationwide Health Information Network) Direct may be the way for consumers to get copies of their data easily, and sooner rather than later. If hospitals and physicians were required simply to write to, and read from, a standardized central communications backbone, there would be hope that commercial PHR systems could succeed. The write-read backbone design relies on existing infrastructure and requires only the minimum standards necessary for the job. It is attractive because it is realistic using today’s technology, and because the “publish-subscribe” backbone can be made smarter and otherwise more capable over time.  As a bonus, that architecture makes it easy for patients to get digital copies of their records for hassle-free input to their PHRs. None of this is as fancy as pie-in-the-sky dreams of universal structured data interchange, semantic interoperability, or comprehensive metadata tagging. But it is possible to do in the short-term, affordable, acceptable to physicians and the rest of the health industry, and very much worth doing. Those are systemic lessons all of us can draw from Google Health’s demise. http://www.himss.org/ASP/ContentRedirector.asp?type=HIMSSNewsItem&ContentId=78818
  17. 17. Lessons from Google’s failure At the opening Google decided that they would support CCR (Continuity of Care Record) from ASTM and AFFP rather than the much more complex CDA/CCD from HL7. The CCR vs CCD debate has been one of the most controversial and long- standing arguments in Health IT. HealthVault, the Microsoft product which survives Google Health has always elected to support both standards. But Google insisted that the CCD standard was too complex, and not only insisted on CCR, but a smaller subset of that standard. http://www.fredtrotter.com/category/hie/
  18. 18. A word or two of caution  "The HIE market is extremely volatile," states Lynne A. Dunbrack, program director, IDC Health Insights, "and will change dramatically in the next 12–18 months as HIE technologies become a commodity and dominant players acquire their way into a crowded market currently made up of many small, privately held vendors.“March, 2010, IDC Health  “The exchanges could help consumers and small businesses compare competing health plans” and “they also could increase price competition by requiring health insurers to offer more standardized plans and by providing consumers with better information about what they are buying. HIEs are taking root across the country, despite technical, governance, institutional and funding challenges. Currently, there are more than 150 HIE projects in varying stages of maturity and employing several types of business models. Unfortunately, many of these HIEs may not exist long enough to realize their full potential because their business model is not financially sustainable. The key to sustainability is working with stakeholders to define and develop a business model that addresses the near term needs of individual stakeholders, yet is flexible enough to accommodate the diversity and evolution of these needs. Source: Deloitte Center for Health Solutions
  19. 19. Thank You

×