20131125 e health_introductie
DESCRIPTION
Introduction eHealth: why its important, definition, development and challenges to overcome.TRANSCRIPT
Transform to the power of digital
eHealth, changing the value proposition
in Healthcare
Copyright © 2011 Capgemini Consulting. All rights reserved.
Personal introduction
� Henk E. Bakker <[email protected]>
– Principal consultant for IT in Healthcare
• Capgemini Consulting Services NL
– Background
• Information Manager in several hospitals
• National Project leader of ICT program of the DBC project
• Project leader of National Electronic Medication Record project
• 25 years of industry experience
http://www.linkedin.com/pub/henk-bakker/4/280/95a
@henkebakker
Copyright © 2011 Capgemini Consulting. All rights reserved.
Agenda
Why eHealth?
Definition of eHealth and telemedicine
eHealth from a patient perspective
eHealth business models
Acceleration of eHealth implementations
3
Why is eHealth necessary?
4
Copyright © 2011 Capgemini Consulting. All rights reserved.
5
Healthcare systems are under pressure
Chronic conditions increasingly pressurize health systems…
Copyright © 2011 Capgemini Consulting. All rights reserved.
In particular the accessibility, affordability and quality of care are challenged due to….
Future of Healthcare
Budget cuts
Privacy, Security and
Patient Consent
Increasing service
expectations
Shrinking and changing professional
workforce
Ageing population /
growing demand
Innovation in medication technology
Private competitors
Improved ‘diagnostic’ technologies
Copyright © 2011 Capgemini Consulting. All rights reserved.
The prevalence of chronic diseases is increasing rapidly: Some figures for the
Netherlands
Now in 10-20 years
� Diabetic 450.000 1.100.000
� Alzheimer’s 120.000 500.000
� Total Hip 24.000 55.000
� Knee 18.000 75.000It will become a
gigantic challenge !!!
Copyright © 2011 Capgemini Consulting. All rights reserved.
In order to remain viable or to regain viability, hospitals must realise
efficiency gains of 15-20% over the next years and sustain themselves through growth
2000 2010 2020 2030 Year
Care
Demand
Supply
AgeingDemanding care consumerNew diseasesMore demand caused by better supply
Characteristics of Supply
Decreasing workforceNo increase of care capacityCost containment
How can we close the gap?
Characteristics of Demand
Challenge for the Hospitals
Government
Response
Copyright © 2011 Capgemini Consulting. All rights reserved.
The challenge: a paradigm shift from cure to care (quality of life)
From Cure
� Restore to health
� Restore to health
� Passive patient
� Expert
� Intramural
� Institute
� Fragmentation
� Monodisciplinary
� trade
To Care
� Ability to do things independently
� Prevention
� Active patient
� Counsellor
� Extramural
� Process
� Integration
� Multidisciplinary
� Evidence based
Reactive
Proactive
eHealth and telemedicine
Copyright © 2011 Capgemini Consulting. All rights reserved.
eHealth is no other care, but it is designed differently
Self Service
Patiënt
Telemonitoring
Tele Treatment
eConsult
Professional and Patiënt
Alerts and Signalling
eConsult
Professional and Professional
Electronic Health Record and
Personal Health Record
Self diagnosis
and Prevention
Copyright © 2011 Capgemini Consulting. All rights reserved.
eHealth is…..
– Applications for the healthcare professional itself
– Applications for the management of care continuity (information exchange of one
provider to another)
– Applications for the governance of care
Applications for the patient
Applications that support the interaction between patient and healthcare provider (telemedicine)
eHealth is often seen as "the application of ICT in Healthcare”;
However eBusiness or eCommerce in Healthcare is more applicable
Copyright © 2011 Capgemini Consulting. All rights reserved.
The potential of eHealth is enormous
� eHealth contributes to:
� Health benefits (quality and gained lifetime)
� Social well being (longer in their own living environment, contact with peer
groups)
� Efficiency of care and of processes (productivity)
� Reducing labour issues
� eHealth promotes :
� Empowerment of clients (they take their own responsibility)
� Opportunities for providers to meet customer needs
Increases efficiency
Increases
self-reliance
Supports early
warning Can be
anonymous
Health benefits (quality and gained
lifetime)
Increases the
accessibility
Contributes to the
quality of careIs 24/7 available
Is economically
interesting
eHealth is about substitution of care provisioning, not about more healthcare
eHealth from a patient perspective
Realisation of the paradigm shift by eHealth
Copyright © 2011 Capgemini Consulting. All rights reserved.
The Healthcare Provider - Patient Relationship shifts Fundamentally ....…
Maturity/time
Healthcare
delivery costs
and efforts
Provider
Driven
Patient
Awareness
Patient
Engagement
Patient Centric
Care
Patient – Value
determines
choices
Developing Emerging Near Maturity
Efficiency, patient
satisfaction, and
quality are key
indicators for
success
Care Providers
embrace Patient-
Value and
stimulate Patient
Centric Care
Patients are
involved in
healthcare services
development and
take responsibility
for sustainable
solutions
Innovative
Patient
manages
Personal
Health
…towards a service orientated model, developed for the patient, influenced by the patient and in
which the patient is actively engaged
Copyright © 2011 Capgemini Consulting. All rights reserved.
Adoption of digital technologies has become mainstream and the pace is drastically
increasing …
� 5 billion mobile phone subscribers in 2010
� Mobile Internet access globally outperforming
desktop access in 2014(3)
� Mobile already being the main device to access
the Internet in developing countries
� People reading 10MB and hearing 400MB
worth of material a day(4)
� User-generated content exceeding the amount
contributed by professional organizations(5)
� 2 billion people connected to the Internet
� Broadband penetration is exceeding 85% from
2012 in developed countries(1)
� Access shifting from the wide-open web to
semi-closed platforms: apps, social media…(2)
Sources: (1) In-stat, June 10, 2008(2) The Web Is Dead. Long Live the Internet, Wired, 2010(3) Morgan Stanley, 2010(4) The Economist, November, 2006(5) Data Center of China Internet, 2010
CONNECTIVITY
MOBILITY
DATA ABUNDANCE
Accelerated pace of
adoption
Plane 68 y.
Phone 50 y.
Radio 38 y.
TV 22 y.
PC 14 y.
Internet 7 y.
iPod 3 y.
Facebook 2 y.
Time needed for “mass adoption”
(50 million users)
Copyright © 2011 Capgemini Consulting. All rights reserved.
… which leads to customers becoming more involved in the organization and getting
more influence on clientservices
17
Inspiration Orientation Demand Service
Customer involvement
Increased business influence
Business scopeDomain of “customers”
‘Once upon a time’ In the digital world
Inspiration Orientation Demand Service
Copyright © 2011 Capgemini Consulting. All rights reserved.
Interaction with the healthcare professional: the Digital Outpatient Clinic
Copyright © 2011 Capgemini Consulting. All rights reserved.
Patient Empowerment
• Personal health record
• Doctor visit sheet (summary)
• Self-diagnosis/triage based on decision trees
• Provide comparative Health information
• Prevention and lifestyle
• Mutual contact (Forum)
• Monitoring (engage your own care team)
• Information on research programs
Copyright © 2011 Capgemini Consulting. All rights reserved.
Personal Health Information is not safety-critical
� The information is owned and managed by the patient and
can be made available for use in a professional healthcare
setting
� Healthcare professionals have strict guidelines in the usage
of patient-originated data
� A conscious process of incorporation of personal health
information in the formal safety-critical systems and medical
decision support is the responsibility of all professional
healthcare provider organisations
HealthVault Personal Health Record (PHR) platform
An EHR supports the medical doctor, the PHR empowers the citizen
HealthVault
Personal health data from the citizen and
their health care providers
Personal wellness data from the
citizens and their wellness providers
Privately stored public information on
health, care and wellness
PreventionConvenience
Services
Social Networks
Entertainment Pleasure Services
Patient Empowerment
Self management
Copyright © 2011 Capgemini Consulting. All rights reserved.
Bloodsugar monitor
Lifestyle Disease management
Professional Care
Personal Health
Blood pressure
monitor
ECG monitor
Fitness monitor
Heartrate monitor
Green is a deviceRed is a tool
Weight scales
Step counter
Personal record
Donor register
Electronic
prescriptions
Information sharing
Healthcare spending
Epilepsy diary
Medical record
Education and screening
Creating a Healthcare Information Ecosystem
eHealth business models
What is the value proposition?
Copyright © 2011 Capgemini Consulting. All rights reserved.
Patient
Healthcare Provider
Payer(Insurance)
eHealth is patient centered, but the patients don’t pay us ….
Copyright © 2011 Capgemini Consulting. All rights reserved.
From eHealth proposition to a sustainable business model
(Financiële) PrestatiesBron: Vrij naar Alexander Osterwalder, Business Model Generation
Resources
Value Configuration
PROFIT
Distribution Channels
CostStructure
RevenueStreams
CustomerOffer
Financial Performance
CustomerRelationship
Value Proposition
CustomerSegment
CoreCapabilities
PartnerNetwork
Co-creation
With a business model an organization describes, what value they create for their clients, how these services reach and support their customers, which resources should be used, with which third party
should be partnered and finally, how they will make money
Acceleration of eHealth implementations
Copyright © 2011 Capgemini Consulting. All rights reserved.
Introduction of eHealth is going (too) slow
� Health insurers (the payers) have so far ehealth approached competitively and achieved
some successes
� But the Health insurers encounter barriers to further upscaling:
– Termination of a project when the grant money runs out
– The lack of a clear business case
– Uncertainty about the effectiveness and efficiency of eHealth applications
– Insufficient standardization and interoperability of eHealth applications
– Lack of funding and a structural wide purchasing
Embedding eHealth in organizational processes and changing the daily practice of healthcare professionals appear to be the most important critical success factors
Copyright © 2011 Capgemini Consulting. All rights reserved.
Two dimensions spell out four different types of digital maturity
Transformation Management Intensity
Dig
ita
l In
ten
sity
BEGINNERS
• Beginners do very little with advanced digital capabilities,
although they may be mature with more traditional
applications such as ERP or electronic commerce. Although
companies may be Beginners by choice, more often than not
they are in this quadrant by accident.FASHIONISTAS
• Fashionista have implemented or experimented with many
sexy digital applications. Some of these initiatives may create
value, but many do not. While they may look good together,
they are not implemented with the vision of gaining synergies
among the items.CONSERVATIVES
• Conservatives favor prudence over innovation. They
understand the need for a strong unifying vision as well as for
governance and corporate culture to ensure investments are
managed well. However, they are typically skeptical of the
value of new digital trends, sometimes to their detriment.
DIGIRATI
• Digirati truly understand how to drive value with digital
transformation. They combine a transformative vision, careful
governance and engagement, with sufficient investment in
new opportunities.
Copyright © 2011 Capgemini Consulting. All rights reserved.
Digital Leaders show common patterns: the Digital DNA
Focus
Investments on
where they
choose to Excel
Digitally
Combine Digital
Capabilities to
Exploit Synergies
Use Digital
Technologies to
Transform their
Business Models
Invest 100% in
transformation
management
Digital
Leaders
Copyright © 2011 Capgemini Consulting. All rights reserved.
Our two-year research program with MIT provides some useful pointers for successfully
executing a digital transformation
Conducting a digital (eHealth) transformation requires taking action in four key areas:
framing, investing, engaging, and sustaining.
Frame
Frame the Digital Challenge
• Understand the impact
• Assess Digital Maturity
• Develop & Align around a
Vision
Focus
Focus Investments
• Invest in Digitally-Enabled
Initiatives
• Adapt your Business Model
Sustain
Sustain the Transformation
• Build Capabilities
• Measure & Monitor
Engage
Engage the Organization
• Signal and Mobilize
• Govern across silos
• Evolve Culture/ adapt Work
Practices
Copyright © 2011 Capgemini Consulting. All rights reserved.
We discovered that many common perceptions about digital transformation were
actually myths, which can lead executives to make unfortunate and costly decisions
Digital is primarily about the customer
experience
Digital primarily matters only to
technology or B2C companies
Let 1000 flowers bloom; bottom-up
activity is the right way to change
If we do enough digital initiatives, we will
get there
Digital transformation will happen despite
our IT
Digital transformation approach is
different for every industry and company
In our industry we can wait and see how
digital develops
Huge opportunities exist also in efficiency,
productivity & employee leverage
Opportunities exist in all industries with
no exceptions
Digital transformation must be led form
the top
The how of transformation is more
important for driving overall performance
Business/IT relationships are key, and in
many companies they must be improved
Digital Leaders exhibit a common DNA
There are digital leaders outperforming
their peers in every industry today
Myth Reality“Many common
perceptions about digital
transformation are
actually myths
Fortunately, our global
survey of nearly 400 large
firms, supplemented by
157 in-depth interviews
with senior executives in
more than 50 large
companies, provides fact-
based answers”
Copyright © 2011 Capgemini Consulting. All rights reserved.
Critical Success Factors for eHealth up scaling
� eHealth is an issue for board members:
It is about organizational strategy, not IT.
� The perception of the professionals:
eHealth should be given a place in the “hearts” and “minds” of healthcare professionals
� Funding:
From projectfunding, subsidies to structurally embedded in the healthcare funding system
� Business as Usual:
Application of eHealth should be part of the (development of) regular daily care
� Future proof:
“Is Cloud technology a Game Change? Business says Yes; IT says No!” (Andy Mulholland, Capgemini CTO)
The acceptance of digital services in the private sector in most EU countries makes it likely that many other basic conditions for up scaling of eHealth are properly fulfilled