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Improve Your Health? Bringing Healthcare Home Disrupting Healthcare Transforming Healthcare

The Digital Pulse of Global Healthcare Connected Care

SAP Digital ReportPart 3

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The Pulse of Digital Disruption

The Role of the Internet of Things (IoT) in Healthcare

When was the last time you visited a doctor or went to the hospital? What if you could receive the necessary advice and treatment from home and avoid visiting a healthcare facility altogether? That’s already happening in many areas.

The role of technology in healthcare is changing dramatically. It’s affecting patient wellbeing and treatment, practitioner access to healthcare data, and pharmaceutical and research developments worldwide. It is transforming healthcare in multiple ways, from the wearable device on your wrist to the most sophisticated multi-million dollar machines in world-class hospitals.

While healthcare technology has already made incredible advancements, digital transformation of the healthcare industry is still in its infancy, and the possibilities and opportunities of the Internet of Healthcare Things (IoHT) are astounding.

This material is an opportunity to learn about the changing healthcare landscape from some of the top companies in the technology and consulting industries today. It is produced by SAP, and includes a compilation of insight and thought-leadership perspectives from a variety of industry-leading SAP partners, including Accenture, Hewlett Packard Enterprise (HPE), Infosys, Intel, Lenovo, and TCS.

Two previous eBooks from SAP; Digital Disruption: How Digital Technology is Transforming Our World, and The Digital Economy: Reinventing the Business World, focus on the multiple factors driving digital transformation and how to become a digital enterprise and succeed in the digital economy.

In this eBook, Connected Care: The Digital Pulse of Global Healthcare, we will focus on one of the most far-reaching industries to be altered by digital technology: healthcare.

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Wearable Technology The Internet of Healthcare Things (IoHT) is already infiltrating people’s lives in subtle ways. This chapter will address what advancements have already been made with wearable technology, and what could lie ahead for healthcare innovation.

Bringing Healthcare HomeThe IoHT can connect patients at home directly to medical help 24/7, without having to visit a healthcare facility. What risks and benefits does connected care present? Learn about the IoHT and its potential impact on patients, society, and the healthcare system.

Disrupting Healthcare Business ModelsDisruption of the healthcare system is forcing many companies to change their strategy and implement new business models to accommodate digital technology. Discover what this looks like.

Transforming Healthcare in a Digital WorldThe IoHT will eventually touch the lives of millions of healthcare patients worldwide. Learn what this could mean for you and your business as digital technology dramatically alters global healthcare.

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Our exploration of technology’s role in healthcare will cover the following areas:

The Internet of Healthcare Things

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Connected CareWearable Technology

What are ‘Wearables’?

Wearable devices that monitor and transmit personal activity or medical data are driving a revolution in connected healthcare. Devices that range from fitness trackers to hospital respiratory sensors are enabling healthcare providers to identify and respond to patients’ needs in real time.

These devices – often called ‘wearables’ – also encourage patients to monitor their own progress and become more engaged in their health, which can improve quality of life, extend healthy lifespans, and reduce treatment costs for healthcare providers.

Wearable devices use connected sensors to collect and transmit information. The proliferation of connected sensors is generating terabytes of data, which can be monitored to enable preemptive treatment. Analysis of the data is also helping to identify new relationships between genetics, medical treatments, and patient outcomes.

So what is driving this move toward connected care and what can consumers, healthcare providers, pharmaceutical companies, and insurers do to capitalize on it?

Connected patients are disrupting traditional approaches to healthcare. #SAPConnectedHealthcare SAP Digitalist Magazine, Connected Health: 4 Trends Shaping the Future of Digitized Healthcare

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Wearable Technology Bringing Healthcare Home Disrupting Healthcare Transforming Healthcare

Forces Behind the Growth of Connected Care

Hospitals and clinics have been swamped with electronic devices for years, but a number of factors have triggered the recent demand for wearable devices:

Escalating Healthcare Costs. Healthcare spending in developed countries is skyrocketing thanks to aging populations and chronic lifestyle diseases. The majority of health expenditure is on avoidable problems such as high blood pressure, type 2 diabetes, and high cholesterol. Governments are looking to wearable devices and other mobile technologies to help stem this cost escalation.

Accountable Care. In the United States, physicians and healthcare providers are being encouraged to provide accountable care: the best course of treatment delivered in the most efficient way. As a result, healthcare organizations are actively searching for technologies that can help achieve this. By deploying connected, wearable devices, patients’ vital signs can be monitored remotely and medical crises can often be pre-empted – reducing costly visits to medical facilities.

The Internet of Healthcare Things (IoHT). The miniaturization of electronics and their falling cost has led to an explosion of tiny sensors

being embedded into all sorts of medical devices and even the human body. The integration of data from these sensors with information from other mobile health technologies is referred to as the ‘Internet of Healthcare Things’ (IoHT).

Big Data. New technologies are providing better ways of handling the mass of data being generated by the IoHT. In-memory computing solutions can now crunch massive amounts of information in real time, and data mining technologies are helping to identify links between patient information and treatment outcomes. Rather than being overwhelmed by the data, life sciences and pharmaceutical organizations are now looking for ways to capitalize on it.

Discover more about the future potential of the IoHT in the Hewlett Packard Enterprise (HPE) article, Leveraging The Internet Of Healthcare Things (IoHT).

The pharmaceutical firm AstraZeneca is helping to fund Ampaths’ HIV control efforts in Kenya, in exchange for data that it can use in drug development. The Economist Intelligence Unit, Power to the Patient: How mobile technology is transforming healthcare.

$7 trillion U.S. spent annually on private and public healthcare globally.

per year SAP Radio, The Future of the Future – Connected Care: Can Wearable Tech Improve Your Health?

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Wearable Technology Bringing Healthcare Home Disrupting Healthcare Transforming Healthcare

Wearables Today

Wearable sensors can be broadly split into two categories:

1. Personal wellness devices help consumers get fit and avoid lifestyle diseases. Fitness trackers that monitor daily exercise, heart rate statistics, and sleep patterns are among the most popular devices in this category. Users can collect their own data and track their progress, which serves as a source of inspiration for improvement. The format of these wearables varies – from wrist bands to shirts and even smart tattoos that measure the level of lactic acid in an athlete’s sweat.

2. Medical Grade Devices are wearable technologies that can provide clinically relevant data points and insights in or outside of traditional healthcare settings. These include:

• Biosensors: worn or embedded, these can detect and transmit data on physiological changes including blood pressure, heart rhythm and brainwaves. By using these sensors remotely, patients’ vital signs can be monitored without requiring them to visit already overloaded hospitals and health clinics.

• Nanochips: ingestible or implantable, these can detect tumors, antibody signals and type 1 diabetes. Ingestible sensors are also being incorporated into medication that, once swallowed, emits a signal helping to track patient adherence to prescribed dosages.

The Benefits of Wearable Technology

Medical Insight from Big Data. Health data from wearable sensors and other mobile devices can now be combined with data from genome studies, electronic medical records, treatment outcomes and clinical trials. Big Data technology can then reveal connections between these data sets to achieve groundbreaking insights into human health and disease. Here are a few examples:

• Researchers can further improve patient outcomes and identify high-risk populations through sophisticated data analysis.

• Pharmaceutical Research and Development (R&D) labs can use clinical trial data to measure drug efficacy.

• Healthcare providers can use statistics to determine the effectiveness of prevention programs.

Sales of fitness wearables are forecast to grow by almost 30 percent between 2015 and 2017. #SAPConnectedHealthcare Gartner, Worldwide Wearable Devices Sales to Grow

To learn more about wearable sensors, read the HPE article, Emerging Technology in the Internet of Healthcare Things (IoHT).

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Wearable Technology Bringing Healthcare Home Disrupting Healthcare Transforming Healthcare

Personalized Medicine. Every individual is different, and yet doses of medication have historically been based on an average of averages. Now thanks to Big Data, life sciences companies and hospitals can create more effective personalized treatments. By accessing and analyzing numerous sources of information – genome studies, treatment outcomes, electronic medical records (EHRs) and clinical trials – healthcare professionals can gain the insight they need to create personalized treatments.

Patient Engagement. Patient engagement is likely to be one of the greatest benefits to come from the use of wearables. With direct access to data tracking their progress, patients will be motivated to take greater charge of their own wellbeing. Furthermore, readmission to healthcare facilities is often caused by people not complying with their medication regimes. Connected devices can remind patients to take their medicine, do their exercise, and eat regularly.

Cost reduction. In addition to the cost benefits of greater patient engagement, wearables that monitor vital signs can help to pre-empt medical crises and enable timely interventions. This in turn reduces costly hospital stays. Remote sensors in wearables and other mobile devices will also take the place of equipment currently located in overloaded hospitals, doctors’ offices, and laboratories, further reducing medical costs.

Learn more about the future of connected health in the SAP Digitalist Magazine article, Connected Health: 4 Trends Shaping The Future of Digitized Healthcare.

Big Data will enable true personalization of care. #SAPConnectedHealthcare

Share This Infosys, Perspective: Higher Outcomes, Lower Costs: 5 Smart Pills for the Life Sciences Industry

By 2019, one of the most common functions of wearables and other mobile health devices will be enabling patients to participate proactively in their own care. The Economist Intelligence Unit, Power to the Patient: How mobile technology is transforming healthcare.

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Wearable Technology Bringing Healthcare Home Disrupting Healthcare Transforming Healthcare

Wearables Worldwide

In the western world, wearables are reducing the burden on existing hospitals and clinics, but in some developing countries, wearable technologies are enabling health services in the absence of medical infrastructure. This is likely to have profound implications for the future of health services in underdeveloped countries.

This issue is addressed in The Economist Intelligence Unit whitepaper, Power to the Patient: How mobile technology is transforming healthcare. It states that in developing countries, mobile technologies could allow health agencies to avoid the cost of traditional infrastructure built by the developed world, just as mobile phones have averted the need to build landline telephone networks.

Khushi Baby is one example of this mentioned in the SAP Radio show, Connected Care. Khushi Baby is a system for tracking vaccinations based on patients wearing a digital necklace. Health workers can scan a patient’s chip, without needing connectivity to a central database, and can read, act upon, and update the health record, enabling reach in even the most isolated, rural communities of India.

Pharmaceutical companies have a clear opportunity to play a greater role in delivering a better experience for patients, improving clinical outcomes, and reducing the total cost of care. The Economist Intelligence Unit, Power to the Patient: How mobile technology is transforming healthcare.

Find out more about the technology used by Khushi Baby by watching this Unicef video.

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Wearable Technology Bringing Healthcare Home Disrupting Healthcare Transforming Healthcare

The Challenges Ahead for Wearables

Healthcare organizations are gearing up to capitalize on the opportunities of wearables, and they’re learning to deal with a few challenges along the way. Some of the obstacles include:

Pharmaceutical Side Effects. Pharmaceutical companies have been pursuing opportunities in wearables and mobile health by creating devices and apps that track diseases and outcomes or help manage conditions like diabetes. However, patients have shown limited interest in these new offerings unless there is evidence of their benefits.

To gain the trust of patients, pharmaceutical companies must make apps and devices that are useful, reliable, and can be shown to make a difference. The Economist Intelligence Unit, Power to the Patient: How mobile technology is transforming healthcare.

Getting to Grips with Big Data. While many health organizations have been aware of the potential of Big Data, some are still working out how to derive value from it. Some examples include:

• Health care providers are developing Big Data analytics competencies in response to the flood of data from sensors and other equipment. In particular, they are looking into the interfaces and integration strategies needed to bring actionable insights to the point of care.

• Personalized medicine has caused an explosion in the amount of data that pharmaceutical companies must analyze across multiple formats. Companies that can validate the quality of data and extract relevant information will have a significant competitive advantage, with the ability to exploit new findings in R&D projects.

Ensuring Patient Engagement. While wearables are helping to motivate younger patients to take charge of their wellbeing, many health providers still find it challenging to engage the elderly. Wearables alone may not be enough. We’ll learn more about ensuring patient engagement despite demographic differences in Chapter 2.

Making Connected Care Real

Wearable Technology Helps Fight Diabetes Learn how a mobile app can help doctors easily monitor their patients’ blood sugar levels and activity levels without seeing them face-to-face.

Advancing Personalized Healthcare Find out how SAP is using Big Data analytics and in-memory computing to help advance personalized healthcare treatment.

Customized Cancer Treatment Discover how technology used for personalized care can help improve treatment for cancer patients.

The Promise of Real-time Health Systems

Despite the challenges, the benefits and promise of wearable technology is driving healthcare providers to continue exploring new opportunities. Existing electronic health record (EHR) systems only collect clinical data about patients while they are in medical facilities. Now, with new technologies available, sensor data collected from wearables can be combined with EHR systems, to create Real-Time Health Systems (RTHSs). RTHSs provide better situational awareness of the patient’s health condition between hospital or clinic visits, where there are gaps between EHR-recorded episodes of care. The article by HPE, Leveraging The Internet Of Healthcare Things (IoHT), states that the RTHS is not inventing something new, but it’s leveraging and converging emerging technologies that currently are not effectively connected.

Learn more about the use of wearables in the SAP Radio show, Connected Care: Can Wearable Technology Improve Your Health?

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Connected CareBringing Healthcare Home

The Future of Healthcare: Preventive Care and Personalized Medicine

We are at the dawn of a fundamental new approach to healthcare: preventive and personalized healthcare. A new focus on wellness and pre-empting medical problems is replacing the reactive approach of treating illnesses when they arise. The Internet of Things (IoT) is a crucial driver behind this change.

Technology-based preventive care is changing the way healthcare works for patients of all ages. For today’s tech-savvy younger people, new technologies and a proactive attitude about health are shifting the emphasis to wellness programs that encourage fitness and responsible lifestyles, thereby reducing the incidence of chronic disease.

The elderly will benefit from preventive care as well, as remote monitoring via the IoT can spot health problems before they become critical, allowing aging patients to remain in their own homes longer.

Technology-based preventive care creates vast amounts of data, which is being analyzed by pharmaceutical and life science researchers in a race to develop truly personalized medicine. Big Data and predictive analytics are key technologies underpinning their research.

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Higher Expectations of Healthcare

As patients become increasingly proactive in their own health, they will develop new expectations. The SAP Digitalist Magazine article, 3 Main Contributing Factors To The Adoption Of Personalized Medicine, examines the impact of this on doctors and other caregivers, who will need to:

• Provide more data-driven, personalized care than they have in the past.

• Be open to patients becoming more actively engaged in shared decision-making.

• Provide visibility into patient data and key health indicators.

As healthcare shifts from reactive to preventive treatment, traditional healthcare will change significantly, with many facets of healthcare and wellness collaborating via technology.

Younger Generations Taking Ownership of Their Health

Tech-based healthcare enables younger generations to develop more healthy lifestyles than the elderly population. The SAP Radio show, IoT and Healthcare: Bringing IT Home, Part 2, identifies some key differences for younger generations:

• They are keen to take responsibility for their own health and want a more equal relationship with their caregivers.

• They are more likely to pursue fitness regimes and healthy lifestyles.

• They are interested in using the latest technology and gadgets to support their fitness and health.

The desire to take responsibility for their own wellness is making this segment of the population open to innovative tools and programs that encourage better health. New apps and wearables like fitness trackers allow users to increase their understanding of their health and fitness. This knowledge can lead to behavioral changes, which can reduce poor habits that lead to obesity and other chronic illnesses.

The ability for patients to take more responsibility for their health and the promotion of preventive measures will shape the future of healthcare. TCS, Leveraging the Internet of Things to Revolutionize Healthcare and Wellness

The outcome of care greatly depends on patients’ behavior when they leave the doctor’s office. Physicians have no control over their patients’ habits such as smoking, exercise, or healthy nutrition. SAP Digitalist Magazine, 3 Main Contributing Factors To The Adoption Of Personalized Medicine

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elderly, it can provide opportunities for preventive care through the remote monitoring of other health indicators, such as vital signs.

Remote Patient Monitoring (RPM)

Numerous research projects are underway to improve Remote Patient Monitoring (RPM), such as sensors that can remotely monitor a patient’s heart condition in real time to pre-empt heart attacks. Thanks to real-time monitoring, doctors can remotely assess changes in their patients’ conditions.

According to the SAP Digitalist Magazine article, Evolving Healthcare Technology With Internet of Things, monitoring such vital signs as blood sugar, heart rate, and blood chemistry enables problems to be spotted quickly. Doctors can then prescribe healthcare interventions at the beginning stages of a problem, often early enough to prevent further damage.

The Challenge of Engaging the Elderly

Elderly patients take up the lion’s share of healthcare spending. In addition to the inevitable problems associated with aging, unhealthy lifestyles have resulted in chronic diseases that worsen with age.

While younger generations are taking a proactive interest in their healthcare, the elderly are much harder to engage. As identified in Lenovo’s article, The Promise and Pain Points of Patient Engagement, many elderly patients tend to be comfortable with the traditional model of patient – doctor communications, where the patient is obedient and the doctor has authority. This approach does not generally encourage patients to take a proactive interest in their own health.

The elderly also tend to be less familiar with technology, and may be unwilling, or unable, to handle the fitness devices and gadgets that are motivating younger people to manage their own wellness. Nonetheless, while the IoT may not necessarily lead to healthier behavior in the

The average Medicare patient has five chronic conditions and sees nine different doctors any given year. #SAPConnectedHealthcareShare This

SAP Radio, IoT and Healthcare: Bringing IT Home, Part 2

Find out more about how the IoT is changing healthcare by reading the Lenovo article, The Promise and Pain Points of Patient Engagement.

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How RPM will Change Society

RPM is likely to have a profound impact not just on healthcare but on society as a whole. The SAP Radio show, IoT and Healthcare: Bringing IT Home, Part 1, examines the following changes:

• The elderly will be able to live in their own homes longer because remote monitoring will delay moves to nursing homes or hospitals.

• It will be easier for relatives and other remote caregivers to keep track of their relatives’ health from a distance.

• Healthcare should cost less, because issues will be addressed before they become acute, leading to fewer hospital visits for the elderly.

One key challenge is the loss of manual dexterity suffered by many elderly, which can make it difficult for them to handle and attach sensors. Medical device companies that are conscious of this difficulty are developing contact-free, continuous monitoring solutions such as sensors that can be placed in beds or chairs.

How RPM will work

The Infosys whitepaper, Digital Healthcare Ecosystem, outlines how remote patient monitoring will work:

• Health data captured from IoT devices will be synced to a cloud infrastructure.

• Healthcare providers’ systems will be given access to this data via secure web services.

• The healthcare provider will then perform Big Data analytics to identify consumers at risk that require immediate attention.

• The patients’ profiles will then be highlighted on relevant caregivers’ dashboards so they can attend to those patients quickly.

Remote health monitoring will soon be the norm for aging populations in the Western World. #SAPConnectedHealthcare Share This

Infosys, Perspective: Higher Outcomes Lower Costs: 5 Smart Pills for the Life Sciences Industry

Discover more about digital technology changing the dynamics of the healthcare industry in the Infosys whitepaper, Digital Healthcare Ecosystem.

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The Big Data Challenge

Analyzing medical data to identify more effective treatments is forecast to save billions of dollars in healthcare costs in the U.S. alone. With such promise, why is this data analysis not being used to its full potential? The problem lies in the volume and disparate nature of health data. In the article, Drawing Connections Between Interoperability and the IoT, Lenovo recognizes that the disjointed interoperability of many of today’s

The Promise of Personalized Medicine in Preventive Care

Constant monitoring of vital signs over the IoT is causing an explosion in biometric data. Researchers are combining this with genetic data, clinical medicine, and epidemiology – the patterns, causes, and effects of health and disease in defined populations – to better understand the relationships between external factors and human biology.

This will ultimately lead to truly personalized medicine and treatments that will be far more effective in preventing disease than they are today. Big Data and predictive analytic technologies are playing a key role in this work.

Personalized medicine focuses on analyzing a person’s genome, environmental, social, biometrical, and religious influencers and determining a treatment for the individual based on that data. SAP Digitalist Magazine, 3 Main Contributing Factors To The Adoption Of Personalized Medicine

Learn how data can help identify effective treatment with personalized healthcare in the SAP video, Pinpointing Treatment with Data.

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How Technology Can Help

Some of the following key technologies are helping to crack the Big Data challenge in healthcare:

• In-memory computing enables the ability to combine and analyze large amounts of data in real time.

• Predictive analytics software is making sense of previously hard-to-obtain or non-existent behavioral, psychosocial, and biometric data.

• Platforms for personalized medicine applications are enabling the processing and real-time analysis of medical Big Data from various sources, in a single system.

• Customized software applications support experts in the analysis of huge amounts of data.

health systems leaves much of technology’s potential unfulfilled. It states that combining health data is a major challenge because:

• The volume of health data being generated by the IoT is huge. Combining it with highly complex genomic data, electronic medical records (EMR), and other clinical data is a major challenge.

• Health data is held in diverse repositories distributed between pharmaceutical companies, life sciences organizations, and healthcare systems.

• Data is often in different formats including images, video, text, numerical data, paper, electronic records, or multimedia, which makes it difficult to combine.

U.S. healthcare savings per year

billion

SAP Digitalist Magazine, Can Big Data Analytics Save Billions In Healthcare Costs? Source: McKinsey Global Institute

$300Big Data analytics enables:

U.S. healthcare expenditures

Learn more about Big Data's potential in healthcare in the article, Understanding The Body With Smart Data: In-Memory Technology In Personalized Medicine.

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Data Privacy Solutions

So the big question is: how do we protect our health data while still making it available to support critical health and research advancements? Some measures to consider include:

• Creating a clear set of privacy guidelines and security rules that adequately safeguard all personally identifiable medical data.

• Leveraging existing data privacy best practices and knowledge from other industries.

• Establishing secure technology platforms that can scale to handle massive amounts of data while also keeping it secure.

Medical Data Privacy

The growing volume of personal health data being collected by the IoT raises the question of how to secure the data as it is transferred and stored across the spectrum of care.

The SAP Digitalist Magazine article, The Risks, Challenges, And Rewards Of Ensuring Medical Data Privacy, explores the vulnerability of different types of medical data to theft. It points out that activity and health data may be less attractive to criminals than the social security numbers, home addresses, and phone numbers that may be associated with those medical records.

There is also the question of personal sensitivity to data privacy. Intel’s Healthcare Innovation Barometer Infographic, reveals that many people are willing to share their personal health data anonymously to lower the cost of healthcare. They also feel comfortable with primary care doctors reviewing their medical history and information. However, they’re less likely to react positively to the idea of others – such as employers, insurance companies, or malicious hackers – accessing the same information.

Find out what information people are willing to share to improve healthcare with Intel’s Healthcare Innovation Barometer Infographic.

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Transforming Healthcare

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The Rewards of Technology-based Preventive Care and Personalized Medicine

While there are some Big Data challenges in healthcare as mentioned, the potential rewards can already be seen, and show astounding promise for the future. Combining and analyzing biometric, genetic, and clinical data is already leading to groundbreaking advances in medicine, for example:

• A comprehensive picture is being developed of individual and genetic characteristics, biological relationships, and information about the therapies available worldwide.

• For the first time, clinicians are using drug response analysis to incorporate findings from past cases of chemotherapy prognosis for use with current cases.

• Analysis is underway into the complex causes of chronic heart failure and how these causes interact. In the future, physicians will be able to make better predictions about the possible course of the disease and therapeutic successes.

Listen to more in-depth healthcare technology discussions on the SAP Radio shows, IoT and Healthcare: Bringing IT Home, Part 1 and Part 2.

Making Connected Care Real

EarlySense Improves Lives with High Tech Sensors Discover how EarlySense is making preventive care a reality using the SAP HANA Cloud Platform.

Heidelberg University Hospital Takes Advantage of Connected Care See how Heidelberg University Hospital uses a mobile app to monitor the health of maternity patients to reduce risks throughout their pregnancies.

How Data Turned a Doctor Into a Hero Learn how data has historically helped pinpoint causes and treatments for disease, and how technological advancements can amplify Big Data’s potential in healthcare treatment.

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Connected CareDisrupting Healthcare Business Models

How the Internet of Things is Changing the Healthcare Industry

Traditional healthcare models are under pressure on a global scale. In the industrialized world, aging populations and chronic diseases have caused soaring treatment costs. Governments are introducing new policies to stem the rise in health spending and improve healthcare outcomes. This is having a ripple effect on other players in the healthcare industry including insurers, healthcare providers, and pharmaceutical companies, who are being pressed to rethink their business models.

In the developing world, the healthcare challenges are very different. Millions of people are still affected by infectious diseases such as tuberculosis, malaria, and HIV-AIDS. With limited healthcare infrastructure and large rural populations, governments and agencies are looking for better ways to manage population health.

The Internet of Things (IoT) is providing innovative ways of responding to these critical healthcare challenges. Healthcare providers, insurers, and the pharmaceutical industry (pharma) are rushing to harness the IoT and other modern technologies in order to drive insight from data and reimagine the way they operate.

At the same time, entirely new business models are starting to emerge within the healthcare industry as organizations form new alliances to meet these challenges and opportunities.

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1. Healthcare Providers: Feeling the Pressure to Change

Under pressure from new affordable health reimbursement models, U.S. healthcare providers are seeking ways to make their services more effective and efficient.

Electronic Health Records (EHRs)

One way to improve efficiency is to ensure that up-to-date patient health records are available at the point of care – whether that’s at a hospital, a doctor’s office or a retail medical clinic. Electronic Health Records (EHRs) enable this capability; however, many healthcare providers are still saddled with paper-based patient medical records. This compounds the complex challenge of integrating a patient’s records and data, which may be dispersed across various hospitals, doctors’ offices, retail clinics, and IoT monitoring systems.

Cloud-based EHRs

In the whitepaper, Healthcare Insights: Top Trends Driving the U.S. Healthcare Industry, Infosys identifies the need for cloud-based EHRs that are more flexible and intuitive to allow those who collaborate through healthcare partnerships to access patient information anytime, anywhere, on any device.

To achieve this, EHR applications need to integrate information from across many systems, enabling doctors to have an overview of their patients as well as drill down to more specific care information.

Traditional Healthcare Under Pressure

The healthcare industry has long been characterized by a 3-pronged model:

1. Healthcare Providers: hospitals, clinics, and doctors delivering treatment and services.

2. Healthcare Manufacturers: pharmaceutical and other medical companies manufacturing medication and devices.

3. Healthcare Payers: typically governments and insurers who pay for medical services.

Healthcare Providers

Healthcare Manufacturers

Healthcare Payers

All organizations involved in healthcare – from government to pharma – are working to adapt to the new pressures on healthcare. Let’s take a closer look at each of these segments of the healthcare sector to see how they are dealing with the digital disruption in their industry.

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2. Healthcare Manufacturers: Rethinking the Pharmaceutical Industry

Pharmaceutical companies see the incredible potential of Big Data, and are striving to harness the IoT in a number of ways. In order to capitalize on IoT data, the pharma industry is embracing Big Data technology for the following reasons:

• Big Data solutions can process huge data sets in an extremely short time, as well as conduct data mining quickly and intelligently.

• In-memory computing opens up even more opportunities as different data formats, including unstructured text, can be consolidated easily and quickly from various sources.

Moving Beyond Medication

Pharma companies are attempting to improve customer service by moving beyond medicine and supplying personalized treatment solutions that include monitoring as well as lifestyle advice. Pharma companies have been quick to spot this opportunity and there are now hundreds of consumer health apps for chronic conditions.

Precision Medicine

In 2015, U.S. President Barack Obama announced the Precision Medicine Initiative – a new research effort aimed at revolutionizing how diseases are treated. Precision medicine involves classifying individuals into subpopulations that differ in relation to a particular disease, and then creating medication and treatment plans that suit each specific group.

Data Visualization for Improved Medical Decisions

Hospitals are increasingly becoming more integrated and are combining data about both prevention and treatment to provide patients with a comprehensive picture of their options. Visualizations that let patients see and consider the likely outcomes of surgery versus less invasive alternatives are helping them choose the best course of action given their specific circumstances. Healthcare providers should consider:

• Using Big Data technology to break down data silos and process data from many sources to improve health outcomes.

• Using data visualization to help doctors, surgeons, and patients make fact-based treatment decisions in real time.

Find out how EHRs can help healthcare providers make better decisions by reading the SAP Digitalist Magazine article, 3 Ways Big Data will Personalize Medicine.

Some hospitals operate as many as 500 dif-ferent systems, making data integration a big challenge. #SAPConnectedHealthcareShare This

SAP Digitalist Magazine, 3 Ways Big Data Will Personalize Medicine

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The SAP Digitalist Magazine article, Innovation in Healthcare: Who Cares?, explains how leading research institutions are leveraging Big Data to glean insights from patient data to deliver precision care.

Developing medication suited to targeted populations requires the collection of enormous volumes of data from a wide range of sources including DNA tests, clinical trials, and patient health records. Big Data analytics technology can then be used to analyze the data to reveal connections and patterns that enable the development of personalized precision medication.

Opportunities and Challenges for Pharma

The IoT also presents pharma with an enticing opportunity to gain a competitive advantage. If researchers and healthcare providers can share their data in collaborative projects, pharma companies can bring drugs to market faster.

Watch the SAP video, Big Data Will Help Save Lives, to find out how precision medicine can enhance cancer treatment.

Researchers, pharmaceutical companies, and academic institutions tend to protect proprietary data. But for personalized medicine to reach its full potential, these institutions must collaborate. SAP Digitalist Magazine, Precision Medicine: A New Social Contract for Healthcare

This presents some challenges, however, such as gathering data from disparate silos of medical information, as mentioned in Chapter 2. A further challenge is secrecy, as key players in the healthcare industry are not used to sharing their data.

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Developing Countries Fight Infectious Diseases

In developing countries, governments and government agencies are engaged in the fight against infectious diseases. A new, more holistic approach to healthcare is helping to improve population health in remote locations. By identifying risk factors up front, healthcare workers can intervene more proactively to stop the spread of disease. This new approach requires processing large volumes of data often from many different sources.

3. Healthcare Payers: Challenges Facing Governments and Insurers

Governments and Government Agencies

Governments across the world face the same fundamental healthcare challenge: how to maintain a healthy population in an affordable way. However, governments in the industrialized world face very different problems than those in developing nations.

Developed Countries Battle Healthcare Costs

The crisis of escalating medical costs in industrialized nations has been most acute in the United States, where healthcare spending is forecast to reach $4.78 trillion by 20211 and is almost double that of some European countries (as a percentage of GDP).2

The Affordable Care Act, which was passed in the U.S. in 2010 to address this issue, is re-shaping American healthcare and radically altering business models that previously had not changed in decades. The new affordable care mandate rewards outcomes and the value of treatment over volume, and is leading to a substantial restructuring of healthcare providers and insurance companies.

1SAP infographic, Healthcare Starts with IT

2OECD, Focus on Health Spending, OECD Health Statistics 2015, July 2015 Watch the video, SAP Healthcare Reaches Underserved Communities, to find out how technology is improving wellness without healthcare infrastructure.

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Health Insurers

In recent years, the cost of health insurance has been escalating alongside the cost of healthcare. In response, insurance companies have started using IoT data to develop tailored insurance policies and pricing in order to win business. They are also encouraging health providers to use remote monitoring in order to stem the rise in premiums.

The IoT and Personalized Premiums

According to the Financial Times article, Medical insurance premiums set to soar in the UK, the cost of medical insurance in the United Kingdom is rising at four times the rate of inflation, and insurers are offering discounts to people willing to share their health and fitness data. Apparently people who walk 10,000 steps or more per day are perceived by some insurers to have a healthier lifestyle and are being offered lower premiums as a result.

Reaching More Patients with Technology

The SAP infographic, Healthcare Starts with IT, identifies some core technologies used when dealing with population health, modernized care, and precision medicine. It outlines how digital technology can improve many scenarios, including healthcare integration, up-front analysis, and in-the-field medical coordination in developing countries. In rural areas, technology can help in the following ways:

• Big Data combines and analyzes countless data points, giving real-time and predictive facts so that providers can prevent the spread of infectious diseases and treat conditions quickly.

• The Cloud provides a network to coordinate care among healthcare providers, government agencies, and non-governmental organizations (NGOs).

• Mobile monitoring over the IoT delivers the right medical information to the right person at the right time in remote rural locations, regardless of infrastructure.

Worldwide, communities are turning to technology to improve healthcare, especially in rural areas. #SAPConnectedHealthcareShare This

SAP TV, SAP Healthcare Reaches Underserved Communities

See the SAP infographic for a detailed look at how Healthcare Starts with IT.

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The Emergence of a New Order in Healthcare

The traditional lines of distinction in healthcare are starting to blur as healthcare providers, manufacturers, and payers adapt to meet today’s new focus on patient outcomes. Accenture identifies four emerging business models centered on value and patient outcomes in the article, Accenture Reveals Disruptive Forces Driving a New Order in the Healthcare Business Models.

1. Lean Innovators: Companies that combine expertise with efficient manufacturing and lean supply chains, challenging cost structures, productivity, and operating models.

2. Value Innovators: Product-centric companies that are scientific innovators largely focused on specialty therapeutics and the patient journey, using complementary services to improve outcomes for patients and health systems.

3. Around-the-Patient Innovators: Companies focused on improving patient and health systems by integrating therapeutics, devices, and services with clinical management processes.

4. New Health Digitals: Companies from within and outside the healthcare industry that are changing how and where patient care is delivered on a global scale or via large ecosystems of digital apps, technologies, devices, and the cloud.

The Infosys whitepaper, Digital Healthcare Ecosystem, identifies some key factors for insurers to consider when seeking a new approach based on IoT data:

• Access insightful health data, collected over the IoT, from consumers and healthcare providers.

• Create tailored insurance plans that provide lower premiums.

• Suggest healthcare insurance plans based on customers’ health conditions and lifestyles.

The Potential of Remote Monitoring

Insurers are also encouraging healthcare providers to use remote monitoring sensors in order to reduce costs. As the benefits of such devices emerge, insurance companies are looking at changing their reimbursement policies to ensure that healthcare monitoring is done in the patient’s own home whenever possible, rather than repeated expensive hospital visits. Transferring healthcare monitoring from hospitals to the home is disrupting traditional models of healthcare delivery.

Why should an insurer pay for an expensive ECG or ultrasound in a hospital, or for a visit to a doctor’s office, if cheaper mobile devices and remote consultations work just as well? Economist Intelligence Unit, Power to the Patient: How mobile technology is transforming healthcare

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Transforming Healthcare

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Collaborating to Survive Digital Disruption

Much of the business model transformation in the healthcare industry is the result of collaboration across industry boundaries, resulting in innovative new products combined with services to improve health and wellness outcomes. The Accenture article recognizes the new partnerships that are emerging, such as medical device and technology companies partnering with pharmaceutical firms; healthcare providers managing risk with life science companies; and payers teaming up with digital technology companies for clinical monitoring and advanced analytics services.

To thrive in this shifting environment, healthcare organizations should consider:

• Redefining their strategies and implementing new operating models to prepare for disruptive forces.

• Embracing new collaborative technologies and building value-enabling partnerships.

• Encouraging executives and leaders at all levels to think differently and act as integrators.

Only the most agile and quick-responding healthcare companies and life sciences organizations will survive the changing environment.

Accenture, Accenture Reveals Disruptive Forces Driving a New Order in the Healthcare Business Models.

Making Connected Care Real

Fast Access to Critical Patient Information See how SAP helps doctors at the Kardinal Schwarzenberg'sches Hospital view patient information, including X-ray images, on mobile devices at the patient's bedside.

Overcoming Big Data Challenges in Cancer Research Find out how the National Centre for Tumor Disease (NCT) conducts enhanced cancer research with the support of SAP technology.

Revolutionizing Healthcare with Genome Analysis Discover how Mitsui Knowledge Industry (MKI) is using SAP HANA in-memory computing to analyze DNA samples rapidly and precisely.

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Connected CareTransforming Healthcare in a Digital World

The Role of IoT in Healthcare

The healthcare industry is in the midst of digital disruption. The Internet of Things (IoT) is driving a revolution in connected care: from supporting the development of precision medicine, to facilitating a preventive new approach to personalized healthcare.

The IoT and other digital technologies are presenting exciting new business opportunities, which traditional healthcare organizations are racing to meet. But they are not alone on this journey – innovative technology companies are also entering the healthcare space with completely new go-to-market strategies.

To survive in this disruptive market, healthcare organizations need to develop a highly patient-centric approach to meet the expectations of a new breed of digital consumers. They also need to learn how to innovate rapidly, requiring business agility that is made possible through the use of digital technologies.

Until recently, attempts at rapid innovation have been bogged down by the myriad of stakeholders, legacy systems, and regulations that are inherent to the healthcare industry. These have caused enormous complexity and have delayed or deterred attempts to build fully integrated digital healthcare systems.

Let’s explore how healthcare organizations can overcome these challenges by using new technologies to ride the wave of digital disruption rather than be left in its wake.

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This is a sure sign of digital disruption, and it’s putting pressure on existing healthcare organizations to become more agile and innovate faster. So what is the key to rapid innovation? The SAP eBook, Digital Disruption: How Digital Technology is Transforming our World, identifies digital technologies and collaboration as crucial for success.

Essential Digital Technologies

The pace of innovation has been accelerating exponentially across all industries, thanks to the potential that’s been unlocked by digital technologies. Health organizations recognize the importance of digital technologies and many have already deployed IoT, cloud, Big Data, analytics, and mobile initiatives.

However, over the last decade, investments in many e-health programs have delivered only modest returns. In the article, How Healthcare Systems

Maintaining Patients in the Digital Era

If healthcare organizations want to retain their patients, their services need to be more patient focused. In the age of digital transformation, consumers have become used to the convenience of digital networks and services in all areas of their lives, from checking bank balances and making purchases, to downloading movies. As patients bring similar expectations to healthcare, technology is necessary to meet those expectations.

Research done by Accenture for the Digital Health Tech Vision 2016 update, reveals that 7% of patients have switched healthcare providers due to poor customer experience. This switching translates to a loss of more than $100 million in annual revenue per hospital.

Innovate and Transform to Survive

While traditional healthcare organizations have been innovating to a degree, non-traditional players such as Google and Uber have been stepping onto the healthcare field with entirely new approaches to medical challenges.

Alphabet, the parent company of Google, is also

developing smart lenses that read glucose levels in tears

to avoid the inconvenience of blood monitoring.

Uber has entered the healthcare market by offering a mobile flu shot service from

registered nurses who will come to your door.

of healthcare executives say organizations are being pressed to evolve before they are disrupted. Accenture Digital Health Tech Vision 2016, Predictable Disruption

86%

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In the video, Digital Health Tech Vision 2016, Platform Economy, Accenture recognizes the problem of IT systems that are too complex for a single company to solve, and points out the need for architectures and platforms where a number of different technologies can work together from both a technical and a business perspective.

Can Become Digital-Health Leaders, McKinsey blames this on ambitious IT initiatives that have typically been beyond the scope of individual healthcare organizations. These initiatives have also struggled because of a vast array of legacy systems that have impeded data integration, as well as no suitable way to integrate data and enable collaboration between multiple healthcare stakeholders.

Collaboration through Digital Ecosystems

Innovative new business partnerships are key to agility. As the IoT provides connections to more and more objects and processes, healthcare organizations are starting to realize the potential of digital business networks. By collaborating and integrating with partners in a digital ecosystem, healthcare organizations can shape experiences and outcomes for their patients in ways that would have been impossible operating as a single entity.

of healthcare executives believe adopting a platform-based business model and engaging in ecosystems of digital partners are critical to the success of their business.Accenture, Digital Health Tech Vision 2016, Platform Economy

39% Watch Accenture’s Digital Health Tech Vision 2016, Platform Economy video to understand how healthcare platforms can accelerate innovation.

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The digital evolution of the healthcare industry may still be in its infancy, but it is growing at an astronomical rate as new advancements in technology quickly develop. Are you ready for the digital transformation of the global healthcare industry?

Take the next step to become a truly innovative player in healthcare.

The Secret to Healthcare Innovation: Connected Health Platforms

New platforms are now emerging that foster collaboration between different technologies and healthcare organizations to solve complex medical system challenges. In a recent Connected Health Platform announcement, SAP explains how these platforms can support a broad ecosystem of partners, including developers, researchers, and healthcare organizations. Connected via this technology, healthcare ecosystems will be able to accelerate the development and delivery of innovative, patient-centered solutions.

Numerous healthcare stakeholders can benefit from this development: from research organizations that need to make a universe of cancer treatment practices accessible to clinicians, to employers that can use health benefit platforms to engage employees and foster better healthcare decisions.

Creating a truly connected global healthcare ecosystem can improve patient outcomes and reduce costs. #SAPConnectedHealthcare SAP, Connected Health Platform announcement

Share ThisFind out how connected healthcare can drive better health outcomes in the SAP video, Patients Benefit from New Healthcare Platform.

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