telehealth defined, explained and explored
TRANSCRIPT
Telehealth Defined, Explained and
Explored
Zachary Bujnoch Frost & Sullivan Senior Industry Analyst
Telehealth
Sanjay Bahel Infosys Client Partner
Medical Devices
June 14, 2011
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Today’s Presenters
Zachary Bujnoch,
Senior Industry Analyst, Telehealth
Frost & Sullivan
Sanjay Bahel,
Client Partner, Medical Devices
Infosys
3
Focus Points
Telehealth Defined
Telehealth Matrix and Spectrum
Telehealth Explained
Challenges
Telehealth Explored
Case Studies
Infosys Focus Point
Topic
4
Poll Question
What is your overall opinion on the state of Telehealth?
• Highly Favorable – What’s the hold-up? Telehealth programs
should be in every state along with intense Federal support
• Moderate – There have been some positive outcomes; I still want
to slowly introduce telehealth programs and concepts, observing
results
• Cautious – I need to see some substantial and straight forward
cost savings before I give my full support of telehealth
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Telehealth – Healthcare’s Road to the Consumer
• Remote Monitoring
• Disease
Management
• Wellness Systems
• Activity Monitoring
• Medication
Dispensing
Telepresence
Visual Collaboration
Teleradiology
Distance
Learning/Simulation
e-Health
m-Health
Personal Health Records
(PHR)
Mobility
Home
Health
Video Tele-
health
IT Enabled
Solutions
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Telehealth Matrix
Customer
Focus
Professional
Consumer
Industry Focus
Information
Communication
Technologies
Healthcare
Traditional Healthcare
and Telemedicine
Consumer/Non-healthcare
Approaching Telehealth
Core Telehealth
Source: Frost & Sullivan.
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Telehealth Matrix Discussion
Professional
ConsumerInformation
Communication
Technologies
Healthcare
Traditional Healthcare
and Telemedicine
Consumer/Non-healthcare
Approaching Telehealth
Core Telehealth
Source: Frost & Sullivan.
Y Axis – User Focus
The higher vertically on this axis
the more focus the market has
on high end professional
markets
The lower vertically on this axis
the more the market is focused
consumer driven offerings
X Axis – Industry Focus
Moving left horizontally on this axis increased the focus on the
information communication technologies (ICT) industry
Moving left horizontally on this axis increased the focus on the
traditional healthcare industry
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Telehealth Matrix Discussion
Professional
ConsumerInformation
Communication
Technologies
Healthcare
Traditional Healthcare
and Telemedicine
Consumer/Non-healthcare
Approaching Telehealth
Core Telehealth
Source: Frost & Sullivan.
Core Telehealth (Medium)
Here is largely where the
opportunities for revenue
growth healthcare
transformation reside.
Solutions in this area provide
significant healthcare to
patients with minimal
involvement by trained
healthcare professionals. Consumer/Non-healthcare Approaching Telehealth (Light)
This area contains offerings heavily focused around fitness
and wellness with almost no healthcare professional
involvement.
Traditional Healthcare and Telemedicine (Dark)
The area of traditional healthcare and telemedicine is heavily professional and healthcare focused, and primarily
focuses using “tele” applications to extend traditional healthcare services over a distance.
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Telehealth Matrix – Telehealth Markets
Customer
Focus
Professional
Consumer
Industry Focus
Information
Communication
Technologies
Healthcare
Traditional Healthcare
and Telemedicine
Consumer/Non-healthcare
Approaching Telehealth
Core Telehealth
Source: Frost & Sullivan.
EMR/EHRHIE
Tele-pharmacy
Remote Video
Consultation
Simulation/
training
Mobile Health
Software
Mobility/Tablets
Mobile Info Gathering
& Delivering
Patient Portals
Wellness Systems
Health Coaching
Remote Vital Signs
PERS
Activity Monitoring
Wellness Apps
Tele-Imaging
ECG Monitoring
Sleep Apnea
Fitness Apps
PHR
Diabetes
Monitoring
Robotic
Telepresence
Mobile Telemedicine
Medication
Dispensing
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Professional HC Consumer
Telehealth Professional vs Consumer Spectrum
• Understanding who the customer is, is essential in assessing a client on this spectrum
• Understanding where your solution is or wants to be, is essential in understanding the value of a product
Reimbursed
FDA Approval
Direct Payment
Source: Frost & Sullivan.
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Professional HC Consumer
Telehealth Technology Spectrum
• Technology is an enabler for success, but the tipping point for
success is increasingly becoming exceptional sales support,
partnerships, and being service oriented
Reimbursed
FDA Approval
Direct Payment
Source: Frost & Sullivan.
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Market Challenges
1 How do you reimburse for diverse, complicated systems?
2 Various complicated regulating bodies possibly in conflict
3 How do you change behavior and the unique needs for the elderly
4 How does this make me a better doctor?
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User Implementation Challenges
1How do you keep your technology up to date and functional in the
fast moving information and communication technology world?
2 How to you train users and then keep that user up to date?
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Telehealth Market Case Studies –
Remote ECG (MCOT/ACT)
Overall Market Characteristics
• Mature, traditional HC market
• Direct reimbursement
• Highly competitive market
• New telehealth technologies
(MCOT/ACT) utilize the continuous
monitoring of Holter and the extended
time period and mobility of event
Note: All figures are rounded; the base year is 2009.
Source: Frost & Sullivan
Key Take Aways
• Moving traditional healthcare markets to telehealth is
possible and profitable, but requires extensive
experience and expertise in healthcare systems and
reimbursement
• New telehealth products and services created
significant upselling opportunities and growth
Remote ECG Key Metrics
• Revenue grew 57% from 2005 to 2010 in ECG
Event Monitoring due to the introduction of
MCOT and ACT services
• Price points for MCOT/ACT were over four
times traditional event monitoring services
when first introduced and are still more than
double in 2010
• Obtained CPT code for MCOT/ACT in 2009
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Telehealth Market Case Studies – Personal
Emergency Response Services (PERS)
Overall Market Characteristics
• Non-traditional HC market
• Out of pocket consumer costs
• Direct customer focused market
• New, more sophisticated monitoring
technologies are generating new
growth by justifying higher price
points
Note: All figures are rounded; the base year is 2010.
Source: Frost & Sullivan
PERS Key Metrics
• The largest of all telehealth markets
in revenue
• Consistent double digit revenue
growth
• Increasing price points due to
increasing inclusion of more
advanced telehealth technologies
Key Take Aways
• Adopting consumer service models to telehealth is possible
and sustainable through healthcare referrals and “fear”
based marketing but heavy use of traditional consumer
tactics will limit opportunities in healthcare applications
• New telehealth products and services created significant up
selling opportunities and growth
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What is Remote Health Monitoring?
Source: Adapted from Center of Technology and Aging
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Infosys Remote Health Monitoring Solution
Infosys Digital Smart
Home Gateway
Infosys Health
Management PlatformWeb Portal
(Information Access) Source: Adapted from
Center of Technology and Aging
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Infosys Digital Smart Home Gateway
Economical
• Low power consumption
• Small form factor
• Embedded wired and wireless and technologies
Configurable
Gateway
• Configurability -from disease specific state to wellness
• Remote Updates
Tracking Health
Readings
• Convenient Tracking of Health Data
• Interface with several Patient-worn devices
Designed For
Compliance
• Standards
• Regulatory
• FCC
• ROHS (Hazard)
• Environment and Noise compliance
A Dynamic and Intelligent Medical Devices Gateway. Providers can interact and customize therapies to
patient’s specific need.
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Health Management Platform and Web Portal
Device
Manufacturers
• Device Monitoring
• EMR / PHR Interoperability
• Remote Programming
Payers
• Integrated view for care plan manager
• Create new health plans
• Incentive calculation
Pharmaceutical
• Medication Compliance Management
• Disease management services
Providers
• Physician portal to view integrated device data
• Rule based Clinical Alerts
• E-Consultation with Patients
Other Features
• Customizable Branding
• SaaS based offering
• Integration with social media sites (Facebook / Twitter, etc.)
Interoperability Layer
Payer Health Vault /
GoogleHealth / Dossia Clinical Data Repository EMR / EHR
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CASE STUDIES
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US Cardiovascular Solutions Company: Design
and Development of Remote Monitoring Solution
Situation:
Pioneer in wireless cardiovascular solutions
focused on digital healthcare through the
confluence of medical devices,
telecommunication and IT sought to develop a
system for remote patient monitoring
Business Value:
Allowed the client to focus on more strategic
aspects of their business - Algorithms
Supported creation of key elements of the
design history and other documentation
required for FDA approval
Infosys Solution:
A physiological monitoring device attached to
the patient that talks to a gateway over Bluetooth,
which transfers data using wireless
communication or ZigBee
Development of key system components,
enabling the monitoring of vital patient
parameters remotely
Develop complete solution for the gateway
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Global Sleep Apnea Devices Company:
Patient Data Management Solution
Situation:
A leading manufacturer of products for the
diagnosis and management of sleep-disordered
breathing solutions sought to re-architect and
develop a system for patient data management
system
Business Value:
Expedite product introduction to market by
creating a global, flexible, platform based
architecture
Significant reduction in development and
testing costs to support any new device family
without requiring major system changes and
testing effort
Supported in achieving the US FDA for 510(k)
clearance for the product
Infosys Solution:
This product is used to collect patient data
remotely and transmit it using cellular network
interface or standard telephone line
Solution definition for a flexible platform based
architecture enabling the verification of patient
compliance and diagnosing Apnea and Hypopnea
via clinical reports
New product design, development, verification
and validation testing
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Poll Question
What are your organizations plans to develop a Remote Health
Management Solution?
• Currently have a Remote Health Management solution
• Planning within the next 12 months
• No plans
• Not applicable
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