The Enterprise vs the Consumer Patient July 2013

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Presented at BYOD - Bring Your Own Doctor, July 17 · 2:00 PM, Centre for Global eHealth Innovation, R. Fraser Elliott Building, 4th Floor, Toronto, Ontario, Canada

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The Enterprise vs the Consumer Patient July 2013

  1. 1. The Enterprise vs. the Consumer Patient Martin Sumner-Smith, PhD 17 July 2013 Event: BYOD – Bring You Own Doctor Toronto
  2. 2. About me Martin Sumner-Smith, PhD Academic – Biotechnology – Bioinformatics – Enterprise – Advisory 1970’s 1980’s 1990’s 2000’s 2010’s
  3. 3. “One of the key drivers for the future lies in using information to create more personalised care and standardisation at the same time. We are witnessing the ‘industrial revolution’ of healthcare, enabled by IT” – PA Consulting
  4. 4. Your interface to healthcare…
  5. 5. Then: Patients completely dependent on doctor
  6. 6. Now: Patients access information
  7. 7. Soon: Patients generate data
  8. 8. Patients gain expert interpretation of data
  9. 9. Doctor-tech in 2012 “Just under one-third of doctors reported emailing with patients in 2012, up from 27% five years earlier, according to annual studies of more than 3,000 doctors conducted by Manhattan Research, a health-care market- research firm. Those texting rose from 12% in 2010 to 18% in 2012.” http://online.wsj.com/article/SB10001424127887324373204578376863506224702.html
  10. 10. Physicians resist patient access to data • “The ultimate one was when the American Medical Association lobbied to deny patients access to their genomic data without a doctor. • But the AMA also conducted a survey of their own people – US doctors, 10,000 of them – and 90 percent said they have no comfort whatsoever in dealing with genomic data.” Eric Topol, 2012 http://www.theatlantic.com/health/archive/2012/03/destroying-medicine-to-rebuild-it-eric-topol-on-patients-using-data/254215/
  11. 11. Thought experiment: How much data does your doctor have about you (in GB)?
  12. 12. There are more than 300 EHR vendors
  13. 13. What other organizations have health records?
  14. 14. http://www.philblock.info/hitkb/e/elements_of_a_typical_EHR_system.html
  15. 15. http://braintertainment.blogspot.ca/2009/04/implementing-security-and-iam-for-ehrs.html
  16. 16. EHRs are examples of enterprise software sold by complex systems vendors
  17. 17. Enterprise software characteristics • Large scale • Highly complex • Slow and expensive to implement • Customized in almost every instance • Extremely hard to replace/displace • Often co-existing with comparable/competitive systems in large organizations
  18. 18. Slide 20 Complex-Systems vs. Volume Operations Complex Systems Volume Operations Sweet Spot Sweet Spot Complexity Volume Effectiveness Small Business Societal Projects Societal Entitlements Enterprise Consumer
  19. 19. Slide 21 Complex Systems vs. Volume Operations Complex Systems Volume Operations Sweet Spot Sweet Spot Complexity Volume Effectiveness Small Business Societal Projects Societal Entitlements Enterprise Consumer Polarization The middle ground is hard to occupy
  20. 20. Enterprise organizational behaviour
  21. 21. Slide 23 People Silos
  22. 22. Slide 24 Content Silos
  23. 23. Slide 25 Process Silos
  24. 24. Other Silos • Semantic • Technology etc.
  25. 25. The information is about the patient, not for the patient
  26. 26. Patient supplied data are conspicuously absent in these designs and implementations
  27. 27. Where do patient data go?
  28. 28. • Portals for each device or app • EHR • Consolidated vaults • Or consumer-managed X?
  29. 29. Benefits of data consolidation: Synergy “At 8:03am you used your asthma puffer while entering the MaRS concourse, walking at a moderate pace towards the Tim Horton’s after an unusually long subway ride. Your pulse was 110, blood pressure 135/80, temperature 37.2, blood glucose…”
  30. 30. “Based on data collected to date I estimate that there is 78.9% probability of an allergen to which you react present at the following locations…”
  31. 31. Established Healthcare Institutions Patient/Consumer ?

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