healthcare unwiredfiles.meetup.com/1582256/healthcare unwired - 102510 - meetup.pdf · personal...

Healthcare Unwired

October 26, 2010

Personal Health Meetup

Agenda

Session topics

• Introduction

• The Survey

• Business Models

• Key Obstacles

• Case studies

• What this means for your business

• Q & A

2


Introduction

3


Healthcare unwired is the most comprehensive mobile health research to date by HRI

• Interviewed 35 industry leaders including:

Aetna

Sprint

Merck SeronoSafeway

Kaiser PermanenteQualcomm

Best BuyCenter for Connected Health

PNC Mount Sinai

Patient Keeper

• HRI commissioned an online survey in the summer of 2010 of 2,000 consumers and 1,000 physicians regarding their use and preference of mobile technologies in the United States

FCC

West Wireless Health Institute


How is mobile health defined?

The ability to provide and receive healthcare treatment and preventative services outside of traditional care settings.

Mobile health tools can include

• remote patient monitors

• video conferencing

• online consultations

• personal healthcare devices

• Health information/services delivered via other channels e.g. retail

• wireless access to patient records and prescription applications using a cellphone, smartphone or wireless tablet

Slide 5


“The basic phenomena [of mobile health] is a very powerful machine that is always networked and on the person. The key difference is on the person. Right now, mobile activities are concentrating on extending the range of existing applications.”

-- John Glaser, former chief information officer, Partners Healthcare


The survey

7

September 24, 2010

• The data• Explore consumer and clinicians’ propensity to

leverage non-traditional care channels• Explore preferences and wants of key

demographics• The context

• Access is key


Access will be the key issue of this decadeOrganizations need to engage in new models of care delivery

8

Get

Efficient

Reward

Innovate

Team Access

• Increase patient throughput by decreasing unnecessary visits through technology

• Redefine the effectiveness of DM programs

• Flow with traffic – bring access to patients

• Shift emphasis to 1st miles of health and give people “sidewalks” to guide them

• Create innovation challenges as learning opportunities that are measured and rewarded

• Transform physician/patient workflow

• Anticipate payment changes to bundled pmts for hospital and physicians

• New revenue models, new incentive structures to innovate

• Understand changes in definition of performance, measure it, manage it

• Revitalize healthcare workforce and move to team care

• Adopt flexible models of care

Source: PwC Health Research Institute Jammed Access Report


Accessing providers is a particular challenge for Medicaid patients

9

Percentage of consumers with an ED visit in the last 12 months by insurance type

20%

15%

21%

44%

28%

0%

10%

20%

30%

40%

50%

Uninsured Employer sponsored insurance

Individual health insurance

Medicaid Medicare

Source: PwC HRI Consumer Access Survey, 2009


Medicaid patients text the most among insured and uninsured

10

Text message usage by insurance type

Source: PwC HRI Mobile Health Consumer Survey, 2010

79%

74%

68%

65%

63%

45%

43%Medicare

Veterans' health

No insurance

Individual policy

Employer-sponsored

Tricare

Medicaid


Chronic care drives the soaring needs curve

• Patients typically enter the health system when an accident occurs or an illness is diagnosed

• The needs curve soars and patients don’t have a comprehensive guide to navigate the system

• Chronic care viewed as the hardest to obtain among emergency care, urgent care and preventive care

11

What consumers value most based on health status

Source: PwC Consumer Access Survey, 2009

0%

10%

20%

30%

40%

Exercise/staying fit

Eating healthy Managing stress Access support groups

Lifestyle information (e.g.

nutrition)

Understanding treatment options

Quick access care

Second opinions by specialists

Transportation to appointments

Access to life needs (e.g. groceries)

Cost of care

Healthy Sick/Injured Chronic Illness


Percentage of physicians who said they’ve been reimbursed for nontraditional care channels

The growth area for mobile is in chronic condition management and preventative care

Slide 12

Source: PricewaterhouseCoopers HRI Physician Survey, 2010

14%

7% 6%

12%

5%

5%

2%

2%

6%

5%

5%

2%

3%

3%

2%

3%

Chronic condition management

Preventative care Wellness maintenance Acute care

Phone Telehealth Email Text

Personal Health Meetup 13

88% of physicians want patients to

track/monitor their health at home.

Source: PwC Health Research Institute Physician Survey, 2010

Physicians prefer this as well


But individuals with chronic illnesses are less/ unlikely to leverage mobile health technologies

Slide 14

Likelihood of individuals, by chronic illness status, incorporating an app into their mobile phone to track their health

No chronic illness35%Chronic illness 28%

Source: PwC Health Research Institute Consumer Survey, 2010


Consumers want health plans to help reduce costs

15

Source: PwC Consumer Access Survey, 2009

How health plans can improve access to healthcare for consumers

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Better online information

Stop denying care

Improve access (e.g. next available appointment)

Eliminate referrals / pre-authorizations

Provide larger in-network selection

Expand benefits (e.g prevention, drugs)

Reduce costs


Research shows mobile health saves money

Slide 16

1. Max E. Stachura, MD, and Elena V. Khasanshina, MD, PhD. “Telehomecare and Remote Monitoring: An Outcomes Overview.” The Advanced Medical Technology Association, October 31, 2007, accessed July 29, 2010, http://www.advamed.org/NR/rdonlyres/2250724C-5005-45CD-A3C9-0EC0CD3132A1/0/TelehomecarereportFNL103107.pdf .

2. Cleveland Clinic/Microsoft Pilot Promising; Home Health Services May Benefit Chronic Disease Management.” March 1, 2010, accessed on August 25, 2010, http://my.clevelandclinic.org/media_relations/cleveland_clinic_pilot_with_microsoft_promising.aspx .

3. John G.F. Cleland, MD, Amala A. Louis, Alan S. Rigby, PhD, Uwe Janssens, MD, Aggie H.M.M. Balk, MD, and others. “Noninvasive Home Telemonitoring for Patients with Heart Failure at High Risk of Recurrent Admission and Death,” Journal of the American College of Cardiology 45,no.10 (2005): 1654.

Where What Result

Diabetes Pennsylvania Post discharge remote monitoring

42% drop in overall cost per patient1

Cleveland Cell phone size wireless transmitter transferring vital signs to electronic health record

71% increase in number of days between office visits2

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 visits3

Chronic obstructive pulmonary disease

Canada Remote monitoring of patients with severe respiratory illness

Reduced hospital admissions by 50%; acute home exacerbations by 55%; hospital costs by 17%1

Personal Health Meetup 17


One-third of physicians surveyed said they make decisions based on incomplete information.

What do physicians want?


Physicians want to perform more tasks wirelessly

Slide 18

86%83% 74%

63% 60%58%

AccessEMRS

Prescribemeds

Monitor patientsin hospital

Initiate/trackreferrals

Communicatewith patients

Monitorpatientoutside hospital



What do consumers want?

Slide 19

Source: PwC HRI Consumer Survey, 2010

20%: Monitor fitness/ wellbeing:

18%: Have doctor monitor condition from afar

11%: Monitor previous condition

51%: I would not buy mobile health technology


Approximately 40% of consumers said they would be willing to pay for remote monitoring devices and a monthly service fee to send data automatically to their physicians.

HRI estimates the annual consumer market for mobile/remote monitoring devices to be $7.7 to $43 billion

20

Source: PwC HRI Mobile Health Consumer Survey, 2010

* 41% of consumers willing to pay for a monthly subscription

The market is big and growing

40%* 3%$15–19

$20–30


Business Models

21

September 24, 2010


New business models will have different goals to address customer pain points

22

Operational/clinicalFocuses on internal operations of an organization – running and growing the business (e.g., financial, clinical performance, customer experience).

Goal: TransactionEnable the exchange or query of information to accomplish discrete tasks

Goal: KnowledgeProvide new information for decision-making

Goal: CommunicationEnable dialogue or information dissemination

Goal: IntegrationUnify services, products and/ players to form a whole solution

Source: PwC Health Research Institute

ConsumerPhysician

Health systemHealth insurer

EmployerPharma/device

InfrastructureFocuses on securing, connecting and speeding up health-related information exchange (e.g., platforms, software, bandwidth).

Consumer products and servicesServices related to individuals that span across health/ fitness, preventive care, acute care and chronic care (e.g., apps, fitness devices and games, personal sensors/ monitoring).


Key Obstacles

23

September 24, 2010


Healthcare Unwired is not without challenges

• Adoption

• Channels – direct vs. indirect

• Propensity - demographics

• Security/Privacy

• More points of data interception

• More integration/players

• Data needed for rich functionality

• Device limitations

• Operations

• Beyond the device

• ‘Sea of Red’

24


Case Studies

25

September 24, 2010


Case Study: Hawaiian health plan members embrace online physician consults

Hawaii Medical Service Association generated over 1000 encounters in the first five months of their Online Care program.

26

September 24, 2010

Average session time 10.3 minutes

Peak times 43% of consultations occur between 8am and 4pm. Another 43% of

consultations occur between 8pm and 12am.

Demographics The most common user is female (63%) between the ages of 26 and 45.

Demand for services • 79% of consultations are for primary care physicians.

• Upper respiratory and infections are the most common issues raised by

patients.

• Other common issues include cough, nausea, urinary tract infections,

strep throat, acute conjunctivitis, fever and diarrhea.

• The tool is also being used by physicians to manage chronic disease

with established patients.

User satisfaction • 85% of consumers rate their experience as “excellent” or “good”

• 89% of physicians rate their experience as “excellent” or “good”

Source: PwC Health Research Institute Jammed Access Report


Case study: Hospital creates and spins off mobile platform app for accessing medical records

• Business challenge: Enhance the physician/clinician experience and increase their ease of access to patient information

• Collaborators: Mount Sinai technology team and physicians

• Solution: Mount Sinai Hospital in Toronto developed VitalHub, an iPhone application portal that connects physicians to 66 other applications within its hospital. Mount Sinai spun out the intellectual property of VitalHub into a separate external company with plans to offer the platform model to other institutions on a commercial basis.

27

“How do we help our clinicians that are going to multiple places for locating information? We go to them.” -- Teek Dwvedi, CIO, Mount Sinai Hospital

Lessons learned:

• Focus on the physician experience from a clinical point of view, not from a technology system point of view

• Observe physicians in their daily routine to understand workflow

• Make existing applications/systems easier to use – make them simple and natural so clinicians can focus on their patients

• Require minimal or no training for new applications


Case Study: Pharma company uses Bluetooth and nurse reminder calls to boost adherence of injectables

28

Merck Serono: “Intelligent care” using mobile healthto reinvigorate pipeline and generate

patient outcomes

Personalized Systems-based Value driven

Outcomes:

• Sales growth in a declining, off-patent brand• Sales force reduction• Smaller administrative costs with improved margins

• Enhanced patient outcomes at lower cost• Better clinical integration• More care provided in home settings at lower cost

Screening

Molecular diagnosticscreening to ID

patients who couldbenefit

Inject drug

Through easypoddevice; recordsnumber of dosesadministered

Nursenotification

Call center interveneswhen notified bydevice about patientnon-compliance

EHRintegration

EHR integrationof patientinformation

Value-basedreporting

Reporting to payer,demonstratingpatient complianceand improved patientoutcomes


Case study: Health system, retailer, wireless company team to improve palliative care

• Business challenge: Enable patients in pain to record and communicate pain while resting at home or any location

• Collaborators: Meridian Health System, Cypak, Best Buy

• Solution: iMPak’s Health Journal for Pain, an electronic diary patients use to track pain. Physicians download information during office visits, or patients can download it at home into a web portal or personal health record.

Lessons learned:

29

“As a health system, our job is to take care of people. We need to come up with strategies to get service fees and technology prices down. Our challenge is to think about how to manage an increasing patient population without building new buildings.”

– Sandra Elliott, Meridian Health System

Partner with those who see patients

as consumers

Create a flexible

platform with the future in

mind

Focus product development on the most critical pain

point


What this means for your business

30


Understanding where physicians and consumers meet will help organizations identify value

Slide 31

Nontraditional appointments

Doctors and consumers are open to nontraditional

appointments (e.g., phone conversations, online visits, and

communication through secure online portals).

Using text

There may be opportunities to incorporate text messaging for

simple communications between the provider and consumer.

Administrative communications

Doctors and consumers are interested in using email to

communicate about administrative tasks (e.g., appointment

reminders), but doctors appear to be more eager.

Paying for mobile health

There is a consumer market for remote monitoring devices

that send data to the healthcare professional.

How consumers feel Summary How physicians feel

56% like the idea of remote

care and 41% would prefer to

have more of their care via

mobile

45% said Internet visits would

expand access to patients

27% said medication

reminders via text would be

helpful

31% said they use

or would like to use text for

routine administrative

communications

23% prefer providers

communicate by email for

appointment reminders/

simple communications

66% said they use

or would like to use email for

administrative

communications

40% said they would pay for

remote monitoring device

with a monthly service fee

57% said they want to

monitor patients outside the

hospital

Source: PwC HRI Mobile Health Consumer and Physician Surveys, 2010


Consider 10 steps to identify and execute against the healthcare unwired opportunity

Slide 32

• Identify the specific market segment

Customer

• Identify the current failures that mobile solutions can address

Pain points

• Identify how current processes/practices would change

Work flow

• Create a vivid visualization of value-added characteristics of the offering

Vision

• Identify, quantify, and measure the cost, convenience, confidence, and compensation of outcome improvements

Value proposition

• Identify existing platform or create new platform and partners

Platform

• Leverage existing or creating new payment options

Business model

• Design pilots, launch, and realize metrics and milestones

Develop and launch

• Mine real-time data and information to increase value

Data mining

• Expand the platform and business model to address larger and adjacent markets

Scale


Pharma/Device

• What types of adherence programs do you have in

place? Is mobile a part of your strategy in this area?

• What is your approach for extending the value of your

current products?

• How do you intend to maintain or increase market share

for products that are about to come off patent?

• How are you helping providers with their concerns on

patient medication compliance?

• How are you addressing security and privacy of health

information related to mobile health?

Employer

• Have you considered using mobile as a channel for

your health and wellness strategy?

• How are you engaging your employees in health

and wellness?

• In what way can your employees access care

without having to leave the worksite?

• How are you addressing security and privacy of

health information related to mobile health?

Slide 33

Payer

• What types of transactions do your members

currently use on your web that might be beneficial

to offer on a mobile platform?

• Have you considered incorporating mobile

communications into your disease management

efforts?

• How are you working with your employer

customers to manage the data of their employee

population?

• How are you addressing security and privacy of

health information related to mobile health?

Provider

• How are you incorporating mobile health into your

meaningful use of electronic health records (EHR)

strategy?

• How are you enabling physicians’ access to patient

information?

• What’s your approach on communicating with patients

regarding appointments and other administrative

matters?

• What is your strategy on increasing access for patients?

Is mobile health a part of that strategy?

• How are you addressing security and privacy of health

information related to mobile health?

Questions to consider when evaluating mobile health


Q & A

34

Thank you.

For more information

Preetham Peter, Director

Health Industries

703.863.5941

[email protected]

www.pwc.com/us/healthcare

www.pwc.com/us/hri

twitter.com/PwCHealth

This publication has been prepared for general guidance on matters of interest only, and does

not constitute professional advice. You should not act upon the information contained in this

publication without obtaining specific professional advice. No representation or warranty

(express or implied) is given as to the accuracy or completeness of the information contained

in this publication, and, to the extent permitted by law, PricewaterhouseCoopers LLP, its

members, employees and agents do not accept or assume any liability, responsibility or duty of

care for any consequences of you or anyone else acting, or refraining to act, in reliance on the

information contained in this publication or for any decision based on it.

©2010 PricewaterhouseCoopers LLP. All rights reserved. “PricewaterhouseCoopers” refers to

PricewaterhouseCoopers LLP, a Delaware limited liability partnership, or, as the context

requires, the PricewaterhouseCoopers global network or other member firms of the network,

each of which is a separate and independent legal entity.

healthcare unwiredfiles.meetup.com/1582256/healthcare unwired - 102510 - meetup.pdf · personal...

Documents