disrupt, collapse and transform - aventri€¦ · next generation healthcare: percentage of...
TRANSCRIPT
Rhenu Bhuller
Senior VP, Healthcare
Disrupt, Collapse and Transform
Trends Driving Growth and Innovation in the
Healthcare Industry
2
Diminishing Returns on Healthcare Spend
Health care
costs
constitute
increasing
proportions
of the GDP
In 31 of the past
40 years, health
care costs
increased faster
than economy.
30% increase in
personal income is
offset by 76% increase
in health care costs for
the last decade
An estimated
$750 B in
healthcare
spend is on
avoidable
expenses.
Source: IOM, Frost & Sullivan
3
There will be a lot more elderly people and comparatively
fewer young people to care for them by 2050
Next Generation Healthcare: Percentage Split of
Population, Global, 2000
Populationat or above60
Rest of thepopulation
11% Of the world’s
population was
at or above 60
in 2000
Next Generation Healthcare: Percentage Split of
Population, Global, 2020
22% Of the world’s
population will
be at or above 60
by 2020
0%
5%
10%
15%
20%
1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050
Pe
rce
nta
ge o
f P
op
ula
tio
n
Next Generation Healthcare: Percentage of Population by Age, Global, 1950-2050
Percentage of Population <5 Percentage of Population >65
Source: World Health Organization (WHO); Frost & Sullivan
4
Chronic disease patients account for the vast majority
of healthcare spending in the US
• Source: Partnership for Solutions. Chronic Conditions: Making the Case for Ongoing Care (Sep 2004), Frost & Sullivan analysis
Chronic Disease Cost Burden in the US
Chronic
Disease
Patient
Healthy
Person
5X
($6,032)
X
($1,206)
Comparative Healthcare Coverage Costs ($ per annum)
Chronic Disease Spending (spend on chronic diseases as % of total)
% of Medicare
spending 99%
83%
% of total public
and private
healthcare
spending
75%
% of Medicaid
spending
People with chronic conditions are the most frequent users of health care in the U.S.
91% of all
prescriptions
filled
76% of all
physician
visits
81% of hospital
admissions
5
Long-
term
Care
Hospital
Care
Staged and episodic disease management is becoming
increasingly unviable
Disease
Predisposition Early Onset
Symptomatic
Disease
Presentation
Advanced
Disease
Progression
End Stage
Wellness/ Prevention Measures
Medical Therapy (Rx) Administration
Procedural Intervention
Surgical
Intervention
Diagnostics Tests
Monitoring (Periodic & Continuous)
Primary
Care
Self
Care
•Prevention
possible
•Individual
awareness
low.
•Indicators
overlooked
•Clinical
guidance &
support
limited.
•‘Individual’
becomes
‘patient’.
• Symptoms
managed
with
therapeutics.
•Treatment
options
varied.
•Patient
uncertainty
high
•High costs of
care
•Cure often
‘worse’ than
disease.
6
Stakeholder roles in healthcare will need to be redefined
Patients:
Physicians:
Pharma:
Care Coordinators:
Medical Device
Companies:
Care Providers:
Payors:
Passive Active
Block-
buster
Niche-
buster Secondary Primary
Procedure
Based
Value
Based
Breadth
Of
Services
Targeted
Care
Models Admini-
strative Analytic
Decision
Maker
Collaborator
7
Healthcare delivery systems need stronger emphasis on
home and community care
Tertiary
Care
Center
General
Hospital
Primary
Care
Provider
Community
Care Center
Home
Care
Vo
lum
e o
f C
are
Next Generation Healthcare: Care
Delivery Structure, Global
Care Delivery Re-Engineering – Emergence of
Community Wellness Hubs
Components
• Home healthcare
supported by care-givers
and technology
• Life Enhancement Centres
(LEC) – flexible facilities
focused on improving life
style management. Could
support physician offices,
diagnostic labs, specialty
clinics, fitness centres,
cooking classes, etc.
• Community Hospital
Stakeholders
• Governments
• Insurance
companies
• Private
healthcare
providers
• Patients and
care-givers
Source: Healthcare Design; Frost & Sullivan analysis
2050
2010
8
Wearable Devices Media Wellness Devices Smart Living
Connected Accessories
- PC Watches
Bluetooth Shirts
Smart Appliances
Connected Home
Devices
Holographic TVs
3D Immersive
Theatre
Sports Accessories –
Digital Helmets
Mobile Health - Hand
Bands
Augmented Reality
Contact Lens
Smart Thermostats
(Nest)
Flexible Media
Devices
Wireless embedded
medical sensors
Enter the age of Healthcare Consumerism
9
Creating a world of seamless collaboration
Image source: Med Tech Insider, Aurametrix, Xcluesiv, The University of Chicago Medicine, Engadget, Marathon Health
Source: Frost & Sullivan
Seamless information gathering, collation, analytics, and dissemination
10
Unleashing the power of Big Data
Imaging files
Published
research
EHR / EMR
Claims data
Genomic data
Remote
monitoring
mHealth apps
Biometric sensors
Social media
Discharge
summaries
Clinician notes
Photos, video
Registration
forms
Email, text
messages
Natu
ral L
an
gu
ag
e P
rocessin
g
An
aly
tics
Cues to
intervene
Patient
engagement
11
This will become a market for Data M
ark
et
Gro
wth
2008-2012
mHealth and Remote
Monitoring Devices
2012-2015
Integrated Disease
Management Solutions
2015-2020
Health Data Market
Time
Apple Healthbook
Source: Frost & Sullivan analysis
43% Of Americans aged 65+
were Facebook users
in 2013.
13% Of Americans aged 65+ were
Smartphone users in 2012, a growth
of 2% over the previous year.
12
Use of integrated monitoring solutions have had an
impact in lowering medical expenditures . . .
• Source: Deployment of an mHealth Patient Monitoring Solution for Diabetes — Improved Glucose Monitoring Leads to Reduction in Medical Expenditure (US
Endocrinology, Feb 2014), Frost & Sullivan Analysis
1st FDA-cleared glucose meter
launched in 2012 (Telcare)
Transmits automatically to a
HIPAA-compliant server
Wireless connectivity provided
for free
Combined with call center
based diabetes management
program
Returns clinical coaching and
guidance to the user
Priced comparably to traditional
glucose meters and test strips
(includes insurance coverage)
mHealth Monitoring Solution - Diabetes
US DIABETES
EXAMPLE
Enrolled and Used Program
$17,428
$14,044
19%
Enrolled and Did Not Use Program
$18,570 $18,852
2011 Average
Claim
2012 Average
Claim
2%
2011 Average
Claim
2012 Average
Claim
13
. . . But lack of business models which align the financial
incentives among stakeholders is a barrier
• Providers also
have to bear
mHealth and
health IT upfront
investments
mHealth Impact on Patients vs. Providers
Disease Where What Result
Diabetes Pennsylvania Post discharge
remote monitoring
42% drop in overall
cost per patient
Cleveland Cell phone size
wireless transmitter
transferring vital signs
to electronic health
record
71% increase in
number of days
between office visits
Congestive
heart failure
Trans-
European
Network-Home-
Care
Management
System
Remote monitoring of
patients who received
implantable cardiac
defibrillators
35% drop in inpatient
length of stay
10% reduction in
office visits
65% drop in home
health visits
COPD Canada Remote monitoring of
patients with severe
respiratory illness
Reduced hospital
admissions by 50%;
acute home
exacerbations by 55%;
hospital costs by 17%
Positive impact on
patients
But negative impact
on provider
revenues1
+
-
Source: “Mobility for connected health” (Accenture, May 2012), Frost & Sullivan analysis
14
Many needs many models – Moving from “Or” to “And”
Shared costs
and risks
15
Disrupt
16
Top Technologies
Web
Regenerative Medicine
Next-Gen Sequencing
Biomarkers
Personalized Medicine
Targeted Drug Delivery
Genetic Cosmetics
General Illumination LEDs
Energy Efficient Processors
Next-Gen Non-Volatile Memory
Smart Haptics & Touch
Flexible Electronics
OLED Displays
Carbon Fibers
Biocomposites
Superhydrophobic Coatings
Smart Packaging
Lightweight Composites
Polymer Chameleons
Alternative Feedstocks
Nanocoatings
CBRNE Detection
Energy Harvesting
Nanosensors
Ubiquitous Wireless
Sensors
Roll-to-Roll Manufacturing
3D Printing
Composites Manufacturing
Micromanufacturing
Remote Patient Monitoring
Surgical Robots
Interventional Radiology
Neuromodulation Technologies
Virtualization
Cloud Computing
Big Data Analytics
Semantic Search
Data Visualization
Context-Aware Mobility
Augmented Reality
In-Memory Computing
Information &
Communication
Technology
Health &
Wellness
Microelectronics
Materials & Coatings
Sensors & Controls
Medical Device &
Imaging Technology
Advanced Manufacturing &
Automation
Source: Frost & Sullivan
Key Technology Disruptions to Watch
17
Top 10 Disruptors in Med Tech
Frugal Innovation
Cloud
Big Data
Aging in Place
Regenerative
3D Printing
Private Labeling
Consumer Power
Optimizing Delivery
E-Commerce
18
Competitive Success Factors Change Who Will Win
Last Decade Current Decade Next Decade
Technologies geared
towards extending life
Technology to improve
outcomes and mitigate
risk
Integrated platforms to
provide comprehensive
continuum of care. Focus on
quality of life.
Companies that
advanced standard of
care.
Companies that could
make treatments safer
and easier to perform.
Companies that understand
consumer behavior, needs,
and pain points.
Types of
Companies
Who Excel
Success
Drivers
19
Who’s At-Risk? Many Layers of Analytics In Preventive
Care
Reduce utilization
by ‘frequent flyers’
Avoid readmission
penalties
Avoid catastrophic events
in diagnosed patients
Better disease management
to reduce long term costs
Reduce the number who
develop chronic conditions
20
Collapse
21
Healthcare Re-imagined
In Person In Home
Prescriptive Reactive Semi-reactive
Monitored
Predictive
Preventive
Break-Fix Connected
Precision
Streaming
22
Business Model Focus Creates Higher Rate of Return
Strategy Process Product Delivery
Business model
Partnering Enabling process
Core process
Product performance
Product system
Service Channel Brand Customer experience
Cumulative Value Creation
Last 10 Years
Volume of Innovation Efforts
Last 10 Years Hi
Source: Doblin analysis, Doblin Inc.
Lo
Hi
Lo
23
Business Models Must Adapt
23
Yesterday Tomorrow?
Start with the need, not with the
technology
Look beyond your core customer
base
Know when to fold
Applying techniques from other
industries to healthcare
Frugal innovation, tiered product
markets
24
Direct To Consumer Models
Convenience Engagement Personalization
• Breaking down “bricks and
mortar” approach to healthcare
• Diagnosis, testing and treatment
in the home
• Preference-based
care vs. evidence-
based care
• Shared-decision making
• “I want all my information in
one place so my community
has access”
Consumer
Analytics
25
Transform
26
How Quickly Can We Move to N = 1?
“Within __ years, it will be
considered malpractice to
treat a patient without
consideration of their
individual genomic and
proteomic data”
27
Multiple Ways To Create Value for Multiple Stakeholders Moving from ‘or’ to ‘and’
28
Capturing the Value from Data Growth in Clinical Utility
Data Info Knowledge Clinical
Utility
• Beyond data integration
to clinical integration
• It’s not about the app, the
interface, or even the
analytics – it’s how
clinicians use the
knowledge
• The biggest gap to be
breached is not in
creating more data and
analytics, it is in
transforming the process
of providing healthcare
29
Bending the Cost Curve, Not Just the Payment Curve
• Device spend is less than 10%
of total healthcare spend, the
costs are not the device itself
as much as it is the cost of the
healthcare professional
resources
• Bring healthcare costs down
not only through lowering
device costs, but by reducing
hospital labor costs through
efficient use of resources
• Leverage artificial intelligence,
robotics, and connected
platforms to improve device
accessibility
Specialists
General Practitioners /
Hospitalists / Internal Medicine
Nurses
Patient Self Management
30
Changing Business Models
30
31
Questions to Consider?
What could the world of healthcare look like in the future?
What changes are threats?
What opportunities will result from the changing environment?
What is your gameplan?
Performance
Technologies
Markets
Customers
Collapse Converge
Partnerships
Value Finance
Delivery
Process
Brand Customer Experience
Channel
Business Model
Service Solutions
Unmet Needs
Efficiency
32
Target Markets
End User Need Global Appeal
Value Creation
White Space Partner or Alliance
Your Technology Play
Vectors
Evaluate your ability to disrupt or transform
The Issue Vector is a tool to provide a more structured approach to the brainstorming of strategic options. The Vector assumes that there are eight main categories of growth options into which any ideas can be mapped.
32
Vectors Competition
Exists
Vectors
33
"If change is happening on the outside faster than on the
inside the end is in sight.” Jack Welch
34
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