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Consumer centric healthcare workshop
Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit health insurers licensed by the Blue Cross Blue Shield Association. The document discusses how consumers want more choice and control over their healthcare, moving away from a reactive treatment model towards proactive health management. It argues that personalized medicine using genomic data and predictive analytics can improve outcomes by matching patients to effective treatments while reducing costs through more efficient care delivery.
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Consumer centric healthcare workshop
- 1. Blue Cross BlueShield 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
- 2. 2 It’s a matterof choice….
- 3. Google answers toanything The Consumerism Megatrend 3 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 7 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 WeDecide That a Drug “Works” 8 CURE NO EFFECT SIDE EFFECT SERIOUS SIDE EFFECT CURE NO EFFECT SIDE EFFECT SERIOUS SIDE EFFECT A B
- 9. Major Drugs Ineffectivefor Many 9
- 10. Ineffective Therapies CanCause Harm 10 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: ImpactsCare 11 ~ 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
- 12. 12 Personalized Medicine “Products andServices 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
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- 16. Effective, Efficient HealthManagement 16 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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- 20. Kolibree Smart toothbrush BlueAnatomy Smartscale 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
- 21. 21 Massimo Radical 7 Handheldand 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 LargelyFall Onto the Healthcare Industry to Recognize the Value of Predictive Analytics and Implement Critical Use Cases 25
- 26. Beyond Regulation, theBiggest Risk to Predictive Analytics Being Used in Healthcare is Adoption as Power Dynamics Shift 26 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 27 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 ThroughPredictive Analytics Represents a Significant Opportunity to Reduce Costs in the Healthcare System 28 $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 prescriptionfor 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) 29
- 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 30
- 31. Regulatory mandates coulddisrupt development budgets & market plans “Personalization” of drugs will require partnering with diagnostics companies Uncertain economics of drug development & commercialization New Business Strategies for Pharma 31
- 32. Increased need todemonstrate 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 32
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