Patient Benefit Model could disrupt Healthcare

1. Patient Benefit Model could Disrupt
HEALTHCAREA Concept paper by Anantha Krishna
Healthcare Industry is on the brink of disruption; my view is that the
industry is due for a radical change in the way Healthcare is delivered.
Today the healthcare consumption lacks productivity, as 25% of the
healthcare dollar spent on non value adds for the patient and the
other 75% carry substantial optimization opportunities
https://www.ahip.org/health-care-dollar/
In the below picture I have outlaid how the data or physical value is
transferred across the value stream and how the costs are transferred
/ incurred currently. This reflects the dollar expenditure that I had
reflected on earlier.
This way the industry – though professes patient centricity, actually
embraces patient centricity term in a very subjective premise.
Specialist organizations term patients who peruse the products of the
providing company and not as a whole, that burden is left to the
country governments or the individuals themselves. This disparity can
be viewed in 2 ways If you look at the current disease burden across
the globe and the resultant Pharmaceutical research investment.
http://www.eoi.es/blogs/juancarlosgomezmartin/2014/01/08/the-pharmaceutical-
industry-a-key-player-in-development/
Most of the Pharmaceutical Industry is focused on the disease burden
in the developed world / or the Payor dominant markets.
My hypothesis is that this operating model is set to be disrupted, and I
propose a radically different model in the next column.
(The current proposal is focused on the US Pharmaceutical Market
model, I will follow this model with subsequent discussions for the
other markets as well).
My proposal is that the entire Industry be driven by Patients needs
and not by Insurance or Payor dominated markets. The following
would be my recommendation.
1. Bundle all patient data in to a blockchain model; the patient
has control of their data, completely mobile and transferable
on demand for a purpose relevant to the patient.
2. The patient uses this interface in all their dealing with the
healthcare delivery system, whether it is Doctors, Hospitals or
Pharmacies. All data is stored sequentially by occurrence and
the patient can give conditional access to the Health care
delivery model for historical validation.
3. The Hospital / Doctor then order / record / Prescribe on cloud
which automatically documents on to the patient data system
on block chain.
4. The healthcare delivery system sources diagnostics and
Pharmaceuticals using a supply chain.
5. What this does, very subtly, is then allow decoupling of a
Pharmaceutical companies into 2 virtual entities –
a) Research and development organization which can
freely collaborate with R&D of different Pharma
companies to share IP, collaborate on research or just
pool their respective library of data for the end
patient benefit.
b) Consolidate Manufacturing organization which can
license different IP’s for manufacturing and Supplying
based on demand from the health care delivery
system.
c) The above 2 set up can be subject to Regulatory
governance for the benefit of the patient and may
even enable the research organizations by free access
to anonymized patient data for even focused
research across all disease areas and not just the high
paying capacity markets focus.
d) This model disrupts the Pharmacy Benefits managers
who currently share 15 – 20 % of the US 1trillion
Healthcare market without great patient benefit.
One of the Prime activities that the Pharmaceutical organization
does today, and effectively differentiates them on, is their
marketing and sales. In the above model it leads to a completely
digital delivery of marketing and medical content to the Health care
Practitioners.
This model also has the potential of disrupting Healthcare data
providers like IQVIA or Symphony etc. as the Patient may choose to
share their data or not. However some anonymized data can be
freely opened to all companies to benefit patients through
research.
It could be extremely beneficial for small countries with limited
resources, low barriers for disruptive innovation with patient
benefit as the end goal.
I would like to call this the Patient Benefit Model.
This is a platform business model that Franz Kumli talks in his article
Healthcare 4.0 the Platform Business Model
Amazon, Berkshire and JP Morgan have got together to create an
organization headed by Atul Gawande who is to shake up the way
Healthcare functions if only for their employees at the moment.
But it is not a far stretch to take this to a small country with
sufficient political backing and strong governance in place, the
Patient Benefit model can be implemented.
I can be reached on rishikavitha@gmail.com for discussions on this
topic.