1. Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross Blue Shield Association.
Consumer Centric Healthcare
Choice, Engagement, Experience
Leo Barella
Blue Cross Blue Shield of Michigan

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It’s a matter of choice….

3. Google answers to anything
The Consumerism Megatrend
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Implications on Healthcare
Americans Want Control
Control TV programming with TiVo
Seek employment through LinkedIn
Keep personal videos on Facebook
Maintain their music with iTunes
Buy & sell goods through eBay
Purchase stock over the internet
Bank electronically at ATMs
They don’t want limits, restrictions, waiting lines, or other barriers to their health

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7. The Old Paradigm: Treatment of Disease
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Time
DiseaseSeverity
Reactive Medial Care
Diagnose Disease: Treat Symptoms; Costly, Trial and Error Treatment
Diagnosis
Select Drug
Switch Drug
Switch Drug Again

8. How Do We Decide That a Drug “Works”
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CURE
NO EFFECT
SIDE EFFECT
SERIOUS SIDE EFFECT
CURE
NO EFFECT
SIDE EFFECT
SERIOUS SIDE EFFECT
A
B

9. Major Drugs Ineffective for Many
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10. Ineffective Therapies Can Cause Harm
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Adverse Effects
• Estimated 125,000 deaths per year (in 2014)
• 6th leading cause of death in the US
• Experienced by approximately 7% of patients (2.2 million)
per year
• Medication-related health problems account for an estimated 3-
7% of hospital admissions (Pirmohamed M, et al 2004)
• During their hospital stay, 15% of patients experienced
adverse drug reactions (Davies, et al 2009)
• Increased patient non-compliance

11. Personalized Medicine: Impacts Care
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~ 38 types of Leukemia
~ 51 types of Lymphomas
“Disease of the
Blood”
Lymphoma
Leukemia
Aggressive Lymphoma
Indolent Lymphoma
Chronic Leukemia
Acute Leukemia
Preleukemia
5 Year Survival
~0% 70%
Ries LAG, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, Mariotto A, Feuer EJ, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2002, National Cancer
Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2002/ Based on November 2004 SEER data submission, posted to SEER web site 2005
Source: Mara G. Aspinall, former President, Genzyme Genetics

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Personalized Medicine
“Products and Services that leverage the science of genomics and proteomics
(directly or indirectly) and capitalize on the trends toward wellness and
consumerism to enable tailored approaches to prevention and care.”
PricewaterhouseCoopers
The new science of personalized medicine

13. Cost Per Genome
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BENCHTOP
GENOME CENTER

16. Effective, Efficient Health Management
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Time
DiseaseSeverity
Predisposition Screening
Diagnosis/Prognosis
Right Drug Monitoring
Efficient Medial Care
Health Management; Molecular Screening, Early Detection; Rapid Effective Treatment; Improved Quality of Care

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Social Provider
Media Blog

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Social Provider
Media Blog

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$4,000
$79

20. Kolibree
Smart toothbrush BlueAnatomy
Smart scale
TotalECG®
Wireless 12 Lead ECG System
ClearProbe
Connected Ultrasound Device
NICaS
Non-Invasive Cardiac System
SpiroPerfect
Connected Spirometer
& Pulmonary Function Test
AMD
Telehealth Examination cameras
3M Littman
Connected Electronic
Stethoscope
WallDoc
Connected Integrated
Examination Station

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Massimo Radical 7
Handheld and portable pulse monitor
Kinsa
Smart thermometer
Withings
Smart blood pressure monitor
Luna
Bed sensor that tracks temperature and sleep
Mimo
Smart baby monitors
UP3, Basis & W/ME
General health trackers
Rejiva
Vital and bio snesor
CliniCloud
Smart home health kit including stethoscope,
thermometer and telemedicine

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25. It Will Largely Fall Onto the Healthcare Industry to Recognize the Value
of Predictive Analytics and Implement Critical Use Cases
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26. Beyond Regulation, the Biggest Risk to Predictive Analytics Being Used
in Healthcare is Adoption as Power Dynamics Shift
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Our question: Can user experience and design influence decision making so deeply as to be regulated?

27. New Data Streams, Including Those Direct From Patients, Are
Beginning to be Used by Companies for Predictive Analytics
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SO MUCH DATA
Percentage of venture-backed predictive analytics companies using various types of data (2011-Q3 2014)
SAM HO, M.D.
Chief Medical Officer, UnitedHealthcare
“Current data sets generally revolve
around claims but that’s going to be
changing with lots of clinical data and
transactional information with lifestyle
becoming more readily accessible”

28. Personalizing Care Through Predictive Analytics Represents a Significant
Opportunity to Reduce Costs in the Healthcare System
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$192B
OVERTREATMENT
• Eliminating care that cannot help
patients – care that outmoded,
supply-drive, and eschews science
• Restricting treatment and intervention
to the patients who will benefit based
on the individual and the context
$128B
FAILURES OF CARE DELIVERY
• Continuously studying care to identify
what works for whom and in what context
• Scaling best practices including preventive
care and early warning systems that
demonstrate effectiveness
$35B
LACK OF CARE COORDINATION
• Ensuring those at the highest risk of
costly medical episodes are identified,
monitored, and cared for between visits
and following hospitalization

29. Actionable lifestyle prescription for reducing risk of disease
Greater control & patient-centered access to medical records
Treatment decisions will be improved by patient education
Greater knowledge of one’s genetic risks
Changing Role of the Consumer (Patient)
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30. New ethical & legal issues/quandaries
Greater reliance on HIT for decision support
Improved care through use of aggregate patient data
Highly networked, team based care
Physician as manager, rather than repository of medical knowledge
Changing Role of the Health Care Provider
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31. Regulatory mandates could disrupt development budgets & market plans
“Personalization” of drugs will require partnering with diagnostics companies
Uncertain economics of drug development & commercialization
New Business Strategies for Pharma
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32. Increased need to demonstrate cost efficiencies
Proactive strategies to limit reimbursement
Increased pressure to change paradigm towards preventive medicine
Greater emphasis on clinical validity & utility of diagnostic tests
New Demands On and From Payers
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