The document discusses the importance of business modeling in the implementation of eHealth technologies, emphasizing user-centered design and stakeholder involvement. It details the challenges faced in the implementation of these technologies, including the need for sustainable revenue models and support from various stakeholders. An example case of teledermatology illustrates the application of business modeling and the collaborative process necessary to meet stakeholder values and technical requirements.

1. Business Modelling to advance the development
and implementation of eHealth technologies
Maarten van Limburg, MSc, BEng
Elly Kloeze, MSc
30 November 2010, Maastricht

2. MAARTEN VAN LIMBURG, MSC, BENG
 Background in Business IT and Innovation Management
 MSc project: Business model for a Dutch PHR service
 PhD Student: “eHealth Business Modelling”
 Eursafety Health-net project
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3. IN THIS TALK
 Why the implementation requires attention
 Explanation on business models and business modelling
 Why business modelling in eHealth
 Introduction of CeHRes Roadmap
 Example case: Business Modelling for a teledermatology project
 Current projects and future research
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4. IMPROVING eHEALTH TECHNOLOGIES
 More focus on how to improve eHealth technologies
 User-/Human-Centered Design
 Involving the users of the technology
 Improving usability
 eHealth technologies reflect users needs and behaviour better
 Persuasive technology
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5. IMPLEMENTATION OF eHEALTH TECHNOLOGIES
 Implementation of eHealth technologies still problematic:
 eHealth technologies don’t catch on in practice
 Lacking support from insurance companies, health professionals, etc
 No self-sustaining revenue model
 Fragmented – difficult to scale up
 Too technology-driven
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6. STAKEHOLDERS
 There are a lot more parties involved than just users
 For the implementation the stakeholders are relevant
- health insurance companies
- healthcare organizations
- healthcare professionals
- government
- ...
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7. STAKEHOLDERS
 Stakeholders aren’t neccesarily users of the technology
 “Anyone who affects or gets affected by the technology” (Freeman)
 Stakeholder types: policymakers, vendors, insurers, healthcare
organizations and providers, home care, employers and patients (Cain)
 Every eHealth technology will have its own, specific stakeholder network
(sometimes also refered to as ecosystem)
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8. STAKEHOLDERS EXPECT VALUE
 Stakeholders expect certain benefits in return for participating in the
eHealth technology.
 “one good turn deserves another” (Proverb)
 Something valuable
 How can we make the implementation value-driven?
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9. BUSINESS MODELS
 “a business model is the rationale of how an organization creates,
delivers and captures value” (Osterwalder)
 Used in strategic management to assess innovations
 Basis for implementing an eHealth technology:
 Assessing the implementation a priori
 Guideline for operationalizing the technology in practice
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10. COMPOSING A BUSINESS MODEL: CANVAS
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11. BUSINESS MODELLING
 Involving stakeholders in composing the business model, they need to
accept the implementation after all.
 Discovering what value they want
 Consensus, finding a fit (HOT-fit)
 Co-creation
 Continuous process
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12. SO WHY BUSINESS MODELLING IN EHEALTH?
 As said, it can help the implementation:
 Sustainability
 Cost-effectiveness
 Holistic approach
 Value-driven
 Co-creation and collaboration
 Flexible and reflective
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13. DEVELOPING IS IMPLEMENTING
 Makes the whole development process value-driven
 If stakeholders find something valuable, make it, implement it
 And if they don’t, don’t!
 Implementation influences development
 Development influences implementation
 The environment determines, not only one party (outside-in)
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14. DEALING WITH MULTIDISCIPLINARITY
 eHealth is multidisciplinary (Pagliari)
 Brings different types of stakeholders together
 Diverse values
 “Value” can act as a common ground:
 # of patients
 $$$
 Quality
 Work to a consensus or fit
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15. STAKEHOLDER NETWORK BECOMES A PLATFORM
 Multidisciplinary nature means that collaboration is important
 Getting the group who need to eventually collaboration together whilst
implementing
 If it doesn’t work now, it won’t work later either
 Finding the context of the problem
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16. OPENNESS
 Collaboration requires openness
 Open business models (Chesbrough)
 Disease Management -> Organizational barriers fade
 Willingness to co-create
 Using standards
 Avoid problems from fragmentation
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17. FLEXIBILITY AND EVALUATION
 Formative evaluation
 A business model grows:
 Discovery driven (McGrath)
 Evaluate assumptions
 Environment is dynamic
 Summative evaluation
 Technologies and implementations aren’t forever
 Still feasible/sustainable/cost-effective? Or re-design?
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18. CEHRES ROADMAP
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19. CEHRES ROADMAP - INSTRUMENTS
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20. BUSINESS MODELLING INSTRUMENTS
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21. ELLY KLOEZE, MSC
 Background in Health Science & Policy
 MSc project: Business model for a Teledermatology project
 Researcher on business modelling for diabetic foot care and Pal4.
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22. EXAMPLE CASE: Teledermatology
 Using CeHRes Roadmap for a teledermatology (TD) eHealth technology
 Tele-diagnostic device chronic wounds
 Automated diagnosis
 Wound evolvement
Problem Stakeholder Design Scenarios
identification analysis requirements Infrastructure
wound care
Stakeholder- Values Technical
mapping feasibility Business
Functional
model
requirements
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23. CONTEXTUAL INQUIRY
 First indication stakeholders
 Focus group
 Problem statement (step 1)
 General solutions (step 2)
 Contribution of technology (step 3)
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24. VALUE SPECIFICATION
 Definitive stakeholders project
 Stakeholder interviews (n=11):
 Determine values
 A value = “something that is beneficially and desirable for a
stakeholder.”
 Determine attributes (how to realize values?) and requirements
(specification of attributes)
 Rank the values, attributes and requirements (1-5)
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25. ATTRIBUTES & REQUIREMENTS
 Example of scored attributes and requirements
 Nine overview schemes per stakeholder
 Program of functional stakeholder requirements
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26. ATTRIBUTES & REQUIREMENTS
 Example of scored attributes and requirements
 Nine overview schemes per stakeholder
 Program of functional stakeholder requirements
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27. Functional requirements
 high performance quality camera and technical system
 objectifying shape, surface, depth, color, total size
under leg, temperature, wound edge conditions
 providing images
 involve patient by technique and results
 sharing a portal between health care providers
 more alignment chain of care
 transparency and uniformity of communication
 financial support
 integration with wound score sheets
 store history and additional disorders patient
 work on behalf of standard protocol
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28. DESIGN
 More specific information about the characteristics of the design and
format of the TD device
 Examples: handy, disinfection option, stand alone device etc.
 Match stakeholder requirements with technical requirements
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29. OPERATIONALIZATION
 Different scenarios:
 Role of the TD service provider
 Scenario 1: the General Practioner (GP) takes an image of the wound
and sends the image to the dermatologist
 Scenario 2: the home care nurse takes an image of the wound and
send the image to the GP
 Interaction networks
 Who pays for which service? Who benefits? Who have a contract with
whom?
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30. WHICH SCENARIO SUITS BEST?
 Validation of the interaction
networks:
 Different stakeholders
 Brainstorm session technology
provider TD device
 Scenario 2 is preferable:
 the economics of scale
 wound care structure
improves:
 nice tool for communication
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31. BUSINESS MODEL FOR SCENARIO
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32. BUSINESS MODEL FOR SCENARIO
How technology fits in
business model of partner
(Openness)
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33. SUMMATIVE EVALUATION
 Can take place after the TD device is deployed
 Test first prototype in clinical setting
 Test advanced prototype
 Results unknown for now
 Robustness roadmap
 Reflect on participatory development process
 Cost effectiveness
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34. CURRENT PROJECTS AND FUTURE RESEARCH
 Different case settings:
 Eursafety Health-net
 Personal Assistant for life (PAL4)
 Diabetes Interactive Education Program (DIEP)
 Refine and test roadmap, improve robustness
 Added value for the development of eHealth technologies
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35. THANK YOU
E-mail : a.h.m.vanlimburg@utwente.nl
: e.kloeze@utwente.nl
www : www.ehealthresearchcenter.org
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