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The Biggest Opportunities in Digital Health 
from an American’s Viewpoint 
By Shahid N. Shah 
www.HealthcareGuy.com 
@ShahidNShah
This and many of my other presentations are available at 
http://www.SpeakerDeck.com/shah 
@ShahidNShah 
shahid@shah.org 
www.netspective.com 2
@ShahidNShah HealthcareGuy.com 
Who is Shahid? 
• 25+ years of software engineering and 
multi-site healthcare system deployment 
experience 
• 20+ years of technology management 
experience (government, non-profit, 
commercial) 
• 15+ years of digital health, healthcare IT 
and medical devices experience (blog at 
http://healthcareguy.com) 
Author of Chapter 13, “You’re 
the CIO of your Own Office” 
www.netspective.com 3
@ShahidNShah HealthcareGuy.com 
Top killers in 1900 
Pneumonia 
and influenza 
TB 
Diarrhea and 
enteritis 
Top killers today 
Heart disease Cancer 
Chronic lower 
respiratory 
diseases 
Infectious diseases used to kill us… 
…but what’s left seem only to be “manageable” not easily “curable” 
Per 100k population, Historical Statistics of the United States, Millennial Edition 
www.netspective.com 4
@ShahidNShah HealthcareGuy.com 
From cures to management… 
…young people don’t dye of diseases often now 
Death by age group, 1900 Death by age group, Today 
http://siteresources.worldbank.org/INTHSD/Resources/topics/Health-Financing/HFRChap1.pdf 
www.netspective.com 5
@ShahidNShah HealthcareGuy.com 
We’ve seemingly accepted lack of cures… 
The Shift 
The clinical model is shifting away from 
treatment of chronic conditions and 
focusing more on prevention, wellness, 
obesity intervention, behavior and 
lifestyle modification. 
Objectives 
• Keep people out of the hospital ($$$) 
• Keep people from their docs ($$) 
• Keep people off drugs ($) 
• Keep people at home 
Implications 
Clinical operations are shifting to hospital and 
physician ‘centered’ services that will rely heavily 
on health information technologies to monitor, 
coordinate, and manage care. 
• Successful Transition in Care resulting in 
Reduced Hospital Readmission Rates 
• Proactive population management 
• Patient engagement and collaboration 
• Disease prevention through wellness and 
obesity management 
• Chronic disease management 
• Care coordination and collaboration 
• Metrics and analytics 
www.netspective.com 6
@ShahidNShah HealthcareGuy.com 
Patient populations need different Digital Health 
Prevention Management 
• Obesity Management 
• Wellness Management 
• Assessment – HRA 
• Stratification 
• Dietary 
• Physical Activity 
• Physician Coordination 
• Social Network 
• Behavior Modification 
• Education 
• Health Promotions 
• Healthy Lifestyle Choices 
• Health Risk Assessment 
• Diabetes 
• COPD 
• CHF 
• Stratification & Enrollment 
• Disease Management 
• Care Coordination 
• MD Pay-for-Performance 
• Patient Coaching 
• Physicians Office 
• Hospital 
• Other sites 
• Pharmacology 
• Catastrophic Case 
Management 
• Utilization Management 
• Care Coordination 
• Co-morbidities 
26 % of Population 
4 % of Medical Costs 
35 % of Population 
22 % of Medical Costs 
35 % of Population 
37 % of Medical Costs 
4% of Population 
36 % of Medical Costs 
Source: Amir Jafri, PrescribeWell 
www.netspective.com 7
The digital enterprise 
is revolving rapidly 
based on key trends, 
health systems’ 
evolution, and IT’s 
evolution 
Key Industry 
Trends 
. 
Health System 
Evolution 
IT Systems 
Evolution 
IT Role 
Evolution 
Fee For Service, Shared Risk, 
Bundled Payments, etc. 
PRESENT 
Value, Care Management, 
Population Management 
FUTURE 
Full Risk, Integrated Health 
Plan & Care Delivery 
System 
Personalized Medicine, 
Wellness Management 
PAST 
Fee For Service 
Volume/Episodic Care 
Integrated Healthcare 
Integrated 
EHR 
Integrated Healthcare 
Health Information 
Exchange (HIE) 
Network 
Enterprise Data 
Warehouse (EDW) 
Patient 
Engagement 
Integrated Healthcare 
Advanced 
Informatics 
Mobile Health 
Ecosystem 
Connected 
Care 
Wellness 
Personalized 
Medicine 
Management 
Multi-Specialty Care 
Clinic & Hospital 
Ancillary Systems 
(Lab/Rad/Pharmacy, etc.) 
Enterprise Resource 
Planning (HR, GL, SCM) 
Revenue 
Cycle 
System 
Hospital EHR 
Ambulatory EHR 
Patient Access 
Installer Integrator Enabler Innovator 
Source: Bruce Metz, CIO, Lahey Health 
www.netspective.com 8
@ShahidNShah HealthcareGuy.com 
Opportunities in Data Comprehension 
What does 
it mean? 
How do I 
use it? 
•Must be continuously 
recomputed 
•Difficult today, easier tomorrow 
•Super-personalized 
• Prospective 
• Predictive 
Bio IT and 
Genomics 
Secondary 
Aggregation 
Social Interactions 
Biosensors 
•Can be collected infrequently 
•Personalized 
• Prospective 
•Potentially predictive 
•Digital 
•Family history is easier 
Phenotypics 
Primary Data 
Collection 
•Continuously collected 
•Mostly Retrospective 
•Useful for population health 
• Part digital, mostly analog 
•Family History is hard 
Admin 
Data 
Collection 
• Business focused data 
•Retrospective 
• Built on fee for service models 
• Inward looking and not focused 
on clinical benefits 
www.netspective.com 9
Hardware Software 
Data 
Medical Hardware 
IoT Sensors 
Consumer Hardware 
Health Records 
Payments 
Pharma / Clinical Trials 
Labs / Imaging 
Health Info Exchg 
Med Devices 
Compliance 
Provider Engagement 
Care Coordination 
Marketing IT 
Patient IT 
Social Media 
Health Literacy 
Retail purchases 
Behaviors 
Bioinformatics 
Retrospective 
Prospective 
Integration 
Comprehension 
Tools, Storage, Services 
Science, Discovery 
Research 
Digital Chemistry 
Consent 
Provider Stature 
Ratings/reviews 
www.netspective.com 10
@ShahidNShah HealthcareGuy.com 
Data changes the questions we ask 
Simple visual facts Complex visual facts Complex computable 
facts 
www.netspective.com 11
@ShahidNShah HealthcareGuy.com 
Data can change medical science 
The old way 
Identify problem 
Ask questions 
Collect data 
Answer questions 
The new way 
Identify data 
Generate questions 
Mine data 
Answer questions 
www.netspective.com 12
@ShahidNShah 
HealthcareGuy.com 
Opportunities in Accountable Tech 
What customers want and what we create are not aligned 
Cost per patient per 
procedure / treatment 
going up but without 
ability to explain why 
Cost for same 
procedure / treatment 
plan highly variable 
across localities 
Unable to compare 
drug efficacy across 
patient populations 
Unable to compare 
health treatment 
effectiveness across 
patients 
Variability in fees and 
treatments promotes 
fraud 
Lack of visibility of 
entire patient record 
causes medical errors 
www.netspective.com 13
@ShahidNShah HealthcareGuy.com 
Opportunities in health information networks 
www.netspective.com 14
@ShahidNShah HealthcareGuy.com 
Opportunities in care facility decentralization 
Source: Jason Hwang, Innosight, via Jeff Selberg of IHI 
www.netspective.com 15
@ShahidNShah HealthcareGuy.com 
Opportunities in consumer payment changes 
www.netspective.com 16
@ShahidNShah HealthcareGuy.com 
Opportunities in new approaches to care 
General 
Wellness 
Specific 
Prevention 
Self Service 
Physiologics 
Self Service 
Monitoring 
Self Service 
Diagnostics 
Care Team 
Monitoring 
Care Team 
Diagnostics 
Healthcare 
Professional 
Monitoring 
Healthcare 
Professional 
Diagnostics 
Hospital 
Monitoring 
Hospital 
Diagnostics 
www.netspective.com 17
@ShahidNShah HealthcareGuy.com 
Opportunities in externalization of Digital Health 
Inside-out focus Outside-in focus 
Patients 
External 
HCPs 
HCP and 
Staff 
Evaluators 
Internal 
business 
users and 
HCPs 
IT 
Personnel 
Unsophisticated and less agile 
focus 
Sophisticated and more agile 
focus 
HCPs = healthcare providers 
www.netspective.com 18
@ShahidNShah HealthcareGuy.com 
Needed: Consumerization of physiologics…. 
www.netspective.com 19
@ShahidNShah HealthcareGuy.com 
Needed: Consumerization of labs / genes 
Labs on chips Personal Genomics 
www.netspective.com 20
@ShahidNShah HealthcareGuy.com 
Needed: Consumerization of monitoring 
www.netspective.com 21
@ShahidNShah HealthcareGuy.com 
Needed: diagnostic quality mHealth 
www.netspective.com 22
@ShahidNShah HealthcareGuy.com 
Needed: predictive analytics 
www.netspective.com 23
@ShahidNShah HealthcareGuy.com 
Needed: care team integration 
HEALTHCAR 
E PROVIDER 
PATIENT/ 
CONSUMER 
HOSPITAL 
FAMILY 
CAREGIVER 
ALTERNATE 
SITE OF 
CARE 
Care Team 
CALL CENTERS AND 
REMOTE SUPPORT 
www.netspective.com 24
@ShahidNShah HealthcareGuy.com 
Needed: automated diagnostics 
www.netspective.com 25
Visit 
http://www.netspective.com 
http://www.healthcareguy.com 
E-mail shahid.shah@netspective.com 
Follow @ShahidNShah 
Call 202-713-5409 
Thank You

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The biggest opportunities in digital health for Turkey's Medical Sector

  • 1. The Biggest Opportunities in Digital Health from an American’s Viewpoint By Shahid N. Shah www.HealthcareGuy.com @ShahidNShah
  • 2. This and many of my other presentations are available at http://www.SpeakerDeck.com/shah @ShahidNShah shahid@shah.org www.netspective.com 2
  • 3. @ShahidNShah HealthcareGuy.com Who is Shahid? • 25+ years of software engineering and multi-site healthcare system deployment experience • 20+ years of technology management experience (government, non-profit, commercial) • 15+ years of digital health, healthcare IT and medical devices experience (blog at http://healthcareguy.com) Author of Chapter 13, “You’re the CIO of your Own Office” www.netspective.com 3
  • 4. @ShahidNShah HealthcareGuy.com Top killers in 1900 Pneumonia and influenza TB Diarrhea and enteritis Top killers today Heart disease Cancer Chronic lower respiratory diseases Infectious diseases used to kill us… …but what’s left seem only to be “manageable” not easily “curable” Per 100k population, Historical Statistics of the United States, Millennial Edition www.netspective.com 4
  • 5. @ShahidNShah HealthcareGuy.com From cures to management… …young people don’t dye of diseases often now Death by age group, 1900 Death by age group, Today http://siteresources.worldbank.org/INTHSD/Resources/topics/Health-Financing/HFRChap1.pdf www.netspective.com 5
  • 6. @ShahidNShah HealthcareGuy.com We’ve seemingly accepted lack of cures… The Shift The clinical model is shifting away from treatment of chronic conditions and focusing more on prevention, wellness, obesity intervention, behavior and lifestyle modification. Objectives • Keep people out of the hospital ($$$) • Keep people from their docs ($$) • Keep people off drugs ($) • Keep people at home Implications Clinical operations are shifting to hospital and physician ‘centered’ services that will rely heavily on health information technologies to monitor, coordinate, and manage care. • Successful Transition in Care resulting in Reduced Hospital Readmission Rates • Proactive population management • Patient engagement and collaboration • Disease prevention through wellness and obesity management • Chronic disease management • Care coordination and collaboration • Metrics and analytics www.netspective.com 6
  • 7. @ShahidNShah HealthcareGuy.com Patient populations need different Digital Health Prevention Management • Obesity Management • Wellness Management • Assessment – HRA • Stratification • Dietary • Physical Activity • Physician Coordination • Social Network • Behavior Modification • Education • Health Promotions • Healthy Lifestyle Choices • Health Risk Assessment • Diabetes • COPD • CHF • Stratification & Enrollment • Disease Management • Care Coordination • MD Pay-for-Performance • Patient Coaching • Physicians Office • Hospital • Other sites • Pharmacology • Catastrophic Case Management • Utilization Management • Care Coordination • Co-morbidities 26 % of Population 4 % of Medical Costs 35 % of Population 22 % of Medical Costs 35 % of Population 37 % of Medical Costs 4% of Population 36 % of Medical Costs Source: Amir Jafri, PrescribeWell www.netspective.com 7
  • 8. The digital enterprise is revolving rapidly based on key trends, health systems’ evolution, and IT’s evolution Key Industry Trends . Health System Evolution IT Systems Evolution IT Role Evolution Fee For Service, Shared Risk, Bundled Payments, etc. PRESENT Value, Care Management, Population Management FUTURE Full Risk, Integrated Health Plan & Care Delivery System Personalized Medicine, Wellness Management PAST Fee For Service Volume/Episodic Care Integrated Healthcare Integrated EHR Integrated Healthcare Health Information Exchange (HIE) Network Enterprise Data Warehouse (EDW) Patient Engagement Integrated Healthcare Advanced Informatics Mobile Health Ecosystem Connected Care Wellness Personalized Medicine Management Multi-Specialty Care Clinic & Hospital Ancillary Systems (Lab/Rad/Pharmacy, etc.) Enterprise Resource Planning (HR, GL, SCM) Revenue Cycle System Hospital EHR Ambulatory EHR Patient Access Installer Integrator Enabler Innovator Source: Bruce Metz, CIO, Lahey Health www.netspective.com 8
  • 9. @ShahidNShah HealthcareGuy.com Opportunities in Data Comprehension What does it mean? How do I use it? •Must be continuously recomputed •Difficult today, easier tomorrow •Super-personalized • Prospective • Predictive Bio IT and Genomics Secondary Aggregation Social Interactions Biosensors •Can be collected infrequently •Personalized • Prospective •Potentially predictive •Digital •Family history is easier Phenotypics Primary Data Collection •Continuously collected •Mostly Retrospective •Useful for population health • Part digital, mostly analog •Family History is hard Admin Data Collection • Business focused data •Retrospective • Built on fee for service models • Inward looking and not focused on clinical benefits www.netspective.com 9
  • 10. Hardware Software Data Medical Hardware IoT Sensors Consumer Hardware Health Records Payments Pharma / Clinical Trials Labs / Imaging Health Info Exchg Med Devices Compliance Provider Engagement Care Coordination Marketing IT Patient IT Social Media Health Literacy Retail purchases Behaviors Bioinformatics Retrospective Prospective Integration Comprehension Tools, Storage, Services Science, Discovery Research Digital Chemistry Consent Provider Stature Ratings/reviews www.netspective.com 10
  • 11. @ShahidNShah HealthcareGuy.com Data changes the questions we ask Simple visual facts Complex visual facts Complex computable facts www.netspective.com 11
  • 12. @ShahidNShah HealthcareGuy.com Data can change medical science The old way Identify problem Ask questions Collect data Answer questions The new way Identify data Generate questions Mine data Answer questions www.netspective.com 12
  • 13. @ShahidNShah HealthcareGuy.com Opportunities in Accountable Tech What customers want and what we create are not aligned Cost per patient per procedure / treatment going up but without ability to explain why Cost for same procedure / treatment plan highly variable across localities Unable to compare drug efficacy across patient populations Unable to compare health treatment effectiveness across patients Variability in fees and treatments promotes fraud Lack of visibility of entire patient record causes medical errors www.netspective.com 13
  • 14. @ShahidNShah HealthcareGuy.com Opportunities in health information networks www.netspective.com 14
  • 15. @ShahidNShah HealthcareGuy.com Opportunities in care facility decentralization Source: Jason Hwang, Innosight, via Jeff Selberg of IHI www.netspective.com 15
  • 16. @ShahidNShah HealthcareGuy.com Opportunities in consumer payment changes www.netspective.com 16
  • 17. @ShahidNShah HealthcareGuy.com Opportunities in new approaches to care General Wellness Specific Prevention Self Service Physiologics Self Service Monitoring Self Service Diagnostics Care Team Monitoring Care Team Diagnostics Healthcare Professional Monitoring Healthcare Professional Diagnostics Hospital Monitoring Hospital Diagnostics www.netspective.com 17
  • 18. @ShahidNShah HealthcareGuy.com Opportunities in externalization of Digital Health Inside-out focus Outside-in focus Patients External HCPs HCP and Staff Evaluators Internal business users and HCPs IT Personnel Unsophisticated and less agile focus Sophisticated and more agile focus HCPs = healthcare providers www.netspective.com 18
  • 19. @ShahidNShah HealthcareGuy.com Needed: Consumerization of physiologics…. www.netspective.com 19
  • 20. @ShahidNShah HealthcareGuy.com Needed: Consumerization of labs / genes Labs on chips Personal Genomics www.netspective.com 20
  • 21. @ShahidNShah HealthcareGuy.com Needed: Consumerization of monitoring www.netspective.com 21
  • 22. @ShahidNShah HealthcareGuy.com Needed: diagnostic quality mHealth www.netspective.com 22
  • 23. @ShahidNShah HealthcareGuy.com Needed: predictive analytics www.netspective.com 23
  • 24. @ShahidNShah HealthcareGuy.com Needed: care team integration HEALTHCAR E PROVIDER PATIENT/ CONSUMER HOSPITAL FAMILY CAREGIVER ALTERNATE SITE OF CARE Care Team CALL CENTERS AND REMOTE SUPPORT www.netspective.com 24
  • 25. @ShahidNShah HealthcareGuy.com Needed: automated diagnostics www.netspective.com 25
  • 26. Visit http://www.netspective.com http://www.healthcareguy.com E-mail shahid.shah@netspective.com Follow @ShahidNShah Call 202-713-5409 Thank You