the biggest opportunities in digital health for turkey's medical sector

The Biggest Opportunities in Digital Health from an American’s Viewpoint

By Shahid N. Shahwww.HealthcareGuy.com

@ShahidNShah

www.netspective.com 2

This and many of my other presentations are available at

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@ShahidNShah HealthcareGuy.com

Who is Shahid?

• 25+ years of software engineering and multi-site healthcare system deployment experience

• 20+ years of technology management experience (government, non-profit, commercial)

• 15+ years of digital health, healthcare IT and medical devices experience (blog at http://healthcareguy.com) Author of Chapter 13,

“You’re the CIO of your Own Office”

http://healthcareguy.com/



Top killers today

Heart disease CancerChronic lower

respiratory diseases

Top killers in 1900Pneumonia

and influenza TB Diarrhea and enteritis

Infectious diseases used to kill us……but what’s left seem only to be “manageable” not easily “curable”

Per 100k population, Historical Statistics of the United States, Millennial Edition



Death by age group, 1900 Death by age group, Today

From cures to management……young people don’t dye of diseases often now

http://siteresources.worldbank.org/INTHSD/Resources/topics/Health-Financing/HFRChap1.pdf





We’ve seemingly accepted lack of cures…

The Shift

The clinical model is shifting away from treatment of chronic conditions and focusing more on prevention, wellness, obesity intervention, behavior and lifestyle modification.

Objectives

• Keep people out of the hospital ($$$)

• Keep people from their docs ($$)• Keep people off drugs ($)• Keep people at home

Implications

Clinical operations are shifting to hospital and physician ‘centered’ services that will rely heavily on health information technologies to monitor, coordinate, and manage care.

• Successful Transition in Care resulting in Reduced Hospital Readmission Rates

• Proactive population management• Patient engagement and collaboration• Disease prevention through wellness and

obesity management• Chronic disease management• Care coordination and collaboration• Metrics and analytics



Patient populations need different Digital Health

• Obesity Management• Wellness

Management

• Assessment – HRA• Stratification• Dietary• Physical Activity• Physician

Coordination• Social Network• Behavior Modification

• Education

• Health Promotions

• Healthy Lifestyle Choices

• Health Risk Assessment

• Diabetes• COPD• CHF

• Stratification & Enrollment

• Disease Management• Care Coordination• MD Pay-for-

Performance• Patient Coaching

• Physicians Office• Hospital• Other sites• Pharmacology

• Catastrophic Case Management

• Utilization Management

• Care Coordination• Co-morbidities

Well Patient At Risk Chronic Care Acute Treatment

Prevention Management

26 % of Population

4 % of Medical Costs

35 % of Population


35 % of Population


4% of Population


Source: Amir Jafri, PrescribeWell


The digital enterprise is revolving rapidly based on key trends, health systems’ evolution, and IT’s evolution

Key

Ind

ustr

y

Tren

ds

.

Healt

h

Syste

m

Evolu

tion

IT

Syste

ms

Evolu

tion

IT R

ole

Evolu

tio

n

Fee For Service, Shared Risk, Bundled Payments,

etc.Value, Care Management, Population Management

PRESENT

Full Risk, Integrated Health Plan & Care Delivery System

Personalized Medicine, Wellness Management

FUTURE

Fee For Service

Volume/Episodic Care

PAST

Integrated EHR

Health Information

Exchange (HIE)

Enterprise Data Warehouse

(EDW)Patient

Engagement

Mobile Health

Connected Care

Wellness Manageme

nt

Advanced Informatics

Personalized Medicine

Ancillary Systems (Lab/Rad/Pharmacy,

etc.)

Enterprise Resource Planning (HR, GL,

SCM)

Revenue Cycle

Ambulatory EHR

Hospital EHR

Patient Access

Enabler InnovatorInstaller Integrator

Integrated Healthcare Network

Integrated Healthcare Ecosystem

Multi-Specialty Care Clinic & Hospital

Integrated Healthcare System

Source: Bruce Metz, CIO, Lahey Health

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&docid=c-u8AVVvYHb78M&tbnid=Svm26vQEWp1TiM:&ved=0CAUQjRw&url=http://www.designyourway.net/blog/misc/how-to-look-for-the-best-website-builder/&ei=VntaU6v7H7XIsATMvoGgCw&bvm=bv.65397613,d.aWc&psig=AFQjCNEpSUjVSplRxwLNmzaE614xbUsaRw&ust=1398525065303745








Opportunities in Data Comprehension

What does it mean?

How do I use it?

•Must be continuously recomputed

•Difficult today, easier tomorrow

•Super-personalized•Prospective•Predictive

Bio IT and Genomics

Secondary Aggregation

•Can be collected infrequently

•Personalized•Prospective•Potentially predictive•Digital•Family history is easier

Phenotypics

Primary Data Collection

•Continuously collected•Mostly Retrospective•Useful for population health•Part digital, mostly analog•Family History is hard

Admin Data

Collection

•Business focused data•Retrospective•Built on fee for service models

• Inward looking and not focused on clinical benefits

Biosensors

Social Interactions


Data

Medical Hardware

Consumer Hardware

Health Records

Patient IT Social Media Health Literacy Retail purchases Behaviors

IoT Sensors

Hardware Software

Pharma / Clinical Trials

Labs / Imaging

Payments

Bioinformatics

Health Info Exchg

Provider Engagement

Care Coordination

Compliance

Marketing ITRetrospectiveProspective

Med Devices

Integration

ComprehensionTools, Storage, Services

Science, Discovery

Value

Creation Research

Consent

Digital Chemistry

Provider Stature

Ratings/reviews



Data changes the questions we ask

Simple visual facts Complex visual facts Complex computablefacts



Data can change medical science

The old way

Identify problem

Ask questions

Collect data

Answer questions

The new way

Identify data

Generate questions

Mine data

Answer questions

Less Med Expertise

Quicker hypotheses

Lower costs

Fail Fast

Medical Expertise

Time Consuming

High costs

OldNew

@ShahidNShah


HealthcareGuy.com

Opportunities in Accountable Tech

Cost per patient per procedure / treatment going up but without

ability to explain why

Cost for same procedure /

treatment plan highly variable across localities

Unable to compare drug efficacy across

patient populations

Unable to compare health

treatment effectiveness

across patients

Variability in fees and treatments promotes fraud

Lack of visibility of entire patient record causes medical errors

What customers want and what we create are not aligned



Opportunities in health information networks



Opportunities in care facility decentralization

Source: Jason Hwang, Innosight, via Jeff Selberg of IHI



Opportunities in consumer payment changes



Opportunities in new approaches to care

General Wellness

Specific Prevention

Self Service Physiologics

Self Service Monitoring

Self Service Diagnostics

Care Team Monitoring

Care Team Diagnostics

Healthcare Professional Monitoring

Healthcare Professional Diagnostics

Hospital Monitoring

Hospital Diagnostics



Opportunities in externalization of Digital Health

PatientsExternal HCPs

HCP and Staff

Evaluators

Internal business

users and HCPs

IT Personn

el

Unsophisticated and less agile focus

Sophisticated and more agile focus

Inside-out focus Outside-in focus

HCPs = healthcare providers



Needed: Consumerization of physiologics….



Needed: Consumerization of labs / genesLabs on chips Personal Genomics



Needed: Consumerization of monitoring



Needed: diagnostic quality mHealth



Needed: predictive analytics



Needed: care team integration

HEALTHCARE PROVIDER

PATIENT/ CONSUME

R

HOSPITALFAMILY

CAREGIVER

ALTERNATE SITE OF CARE

Care Team

CALL CENTERS AND REMOTE SUPPORT



Needed: automated diagnostics

Thank You

Visit http://www.netspective.com http://www.healthcareguy.comE-mail [email protected] @ShahidNShahCall 202-713-5409

the biggest opportunities in digital health for turkey's medical sector

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