top 10 canada health innovations 2011

Copyright © 2011 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture.Copyright © 2011 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture.

Insight Driven Health

Top 10

Healthcare Game Changers Canada’s Emerging Health Innovations and Trends

Copyright © 2011 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture.

The time has come for healthcare

transformation in Canada…

From health reform and skyrocketing costs to consumer expectations and technology advances,

healthcare in Canada is undergoing significant transformation. The entire health community from

private providers and public health organizations to patients themselves is feeling the impact and

looking for new outcomes.

What emerging trends and innovations are driving Canada’s healthcare transformation—

from today and into tomorrow? And what organizations are leading the way to change?

Accenture works across the global health community helping our healthcare clients achieve high

performance by using knowledge in new ways to deliver more effective, efficient and affordable

healthcare with Insight Driven Health. Our thought leaders have drawn on this experience—along

with our work with health organizations in Canada—to provide our insights on the Top 10 Healthcare

Game Changers to watch.

Take a moment to explore our future vision for the nation’s healthcare landscape. Discover a range

of technology-driven, information-powered trends—including organizational and structural

reinvention, new options for providers and care delivery and innovative consumer empowerment

tools and approaches. While each is unique, together, they will contribute to a new model of Insight

Driven Health for Canada.

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Canada’s Top 10 Healthcare

Game Changers

Healthcare CloudsTaking health records off the mainframe

Health AnalyticsData insight into action

New Payment ModelsToward outcomes-based funding

Tablet Computing The key to health IT adoption

mHealth

The rise of the mobile health consumer

Social NetworkingPatient-connected online communities

Point-of-Care DiagnosticsDe-centralizing the centralized lab

Hospital at HomeHome is where the care is

Regionalization 2.0

Aggregate then integrate

Exporting HealthNew pursuit of commercial opportunities

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1 Healthcare Clouds

The Internet and cloud computing will take health records off the mainframe

for secure and unprecedented access to health stakeholders anywhere in

the world.

Taking Health Records off the Mainframe

Today. Electronic health records today are most often housed on

siloed, institutional databases that do not facilitate easy information

access for cross-organizational data sharing and are not available

to patients and consumers.

Tomorrow. Part of the utility computing trend, healthcare clouds will

push the trend away from large monolithic systems to point-of-care

systems. Clouds are secure Internet-based platforms used to link,

access, store and manage health information. Healthcare clouds

will help providers access and store information in more efficient,

flexible and secure ways while helping save money—driving the

push toward physician electronic medical records. For patients and

consumers, healthcare clouds will be a platform for personal health

records, offering new access, control, visibility and convenience.

While clouds are focused on information, services may also be

delivered over these emerging health care platforms.

Leading the Way. Microsoft HealthVault is an online health

information storage tool with services for consumers and providers.

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2 Health Analytics

Data Insight into Action

Today. Current systems typically measure healthcare

as a series of transactions rather than a process that

may or may not be executed as designed. To reach the

next level of quality and innovation in care delivery,

practitioners require a comprehensive set of facts

around healthcare delivery including compliance with

every aspect of the protocol and care outcomes.

Tomorrow. Canada’s growing network of electronic

medical records lays the groundwork for advanced

analytics. Together, advanced analytics and new data

visualization techniques will help unlock the power of

data to drive more informed decision making and,

ultimately, higher quality, lower cost care—from public

health monitoring and prevention to the treatment of

chronic illnesses.

Leading the Way. GE is a leader with data visualization

projects in its groundbreaking Healthymagination effort.

NHS Evidence provides access to a wide range of

health information to deliver quality care.

Visualizing and

comparing

hospital

performance

Visualizing future

chronic care costs

in the future by

geography

Access to health

information to deliver

high quality care

New ways of

presenting

lab data

With more health data at their fingertips, decision makers will rely on

analytical capabilities to evolve to the next level of healthcare delivery.

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3 New Payment Models

Toward Outcomes-Based Funding

Today. Fee-for-service is the principal method of

remuneration for more than 70 percent of physicians in

Canada.1, 2 Only a minority are paid by salary, capitation or

alternative payment plans. Hospital funding is based mainly

on global budgeting. None of these methods are linked to

service quality or outcomes.

Tomorrow. The convergence of health reform, new data

availability and access, and the push to lower healthcare

costs will drive the shift toward outcomes-based funding in

Canada and globally. New funding models will be linked to

meeting specific targets, adjustments for patient case mix

and other measures related to achieving quality outcomes.

Leading the Way. In Canada, there are new payment

model pilot projects underway. There are also initiatives

focused on intermediate steps such as “patient-based

payments.” While there are no clear leaders globally,

Sweden, Geisinger Health System and Blue Cross Blue

Shield of Massachusetts have value-based purchasing

mechanisms in place.

Hospital Funding in Canada

100%

80%

60%

40%

20%

0%

“Fixed”

block

funding

“Variable” case complexity adjustment

Current

“Variable”

outcome-

linked

funding*

“Fixed” block

funding

Case

complexity

adjustment

Per-patient

funding

Future?

1) CIHI National Physician Database 2008-2009; 2) Canadian Medical

Associationhttp://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Statistics/39-Chart-DistRemun.pdf)

Future payment models will be tied to quality and outcomes in a pay-for-

performance model that will ultimately replace output-based funding.

6

http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Statistics/39-Chart-DistRemun.pdf






4 Tablet Computing

The Key to Health IT Adoption

Today. Tablet computers have been well received by the

public. The healthcare community has shown interest in using

tablet computing to transform healthcare. Tablet computers

offer the advantage of ease of use, portability and long battery

life and allow users to have “visual” conversations with patients

for an engaging “user” experience.

Tomorrow. More than 60 percent1,2 of physicians have

expressed interest in using the iPad for healthcare purposes.

The combination of consumer and provider interest could drive

a preference for tablet computers over traditional computers.

Tablets could become an educational tool at the point of care

and a catalyst for increasing physician adoption of health care

IT.

Leading the Way. Stanford Medical School announced it will

provide all incoming students with an Apple iPad as part of a

trial to improve and transform medical education.3 Kaiser

Permanente, among other organizations, announced plans to

test the iPad for clinical use by physicians and nurses.

1) Business Wire. http://www.businesswire.com/news/home/20100204006741/en/Physicians-Purchase-iPad-60-Percent-Intrigued-Device

2) Morningstar;http://news.morningstar.com/all/business-wire/20110302005507/ipads-are-the-tablet-of-choice-among-us-physicians.aspx

3) Stanford : http://med.stanford.edu/ism/2010/august/ipad.html

Easy-to-use and portable, tablet computers will play a critical role in unlocking

clinical adoption of technology like physician electronic medical records.

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http://www.businesswire.com/news/home/20100204006741/en/Physicians-Purchase-iPad-60-Percent-Intrigued-Device













http://news.morningstar.com/all/business-wire/20110302005507/ipads-are-the-tablet-of-choice-among-us-physicians.aspx























http://med.stanford.edu/ism/2010/august/ipad.html


5 mHealth

The Rise of the Mobile Health Consumer

Today. Mobile technology and mobile apps have become a

part of everyday life for many people. Interest in health apps is

exploding with new applications released weekly (100+ percent

growth rate and 78 percent increase in total apps in six

months.1) Bant, developed in Canada, is one of the new class

of apps simplifying diabetes management. Users can record

their glucose readings, links to popular health accounts and

share information.

Tomorrow. More than 9 percent2 of Americans reported having

at least one health app on their smartphone in 2010. The

popularity—and consumer appetite for—mobile health apps will

continue to rise worldwide. These apps will become more

sophisticated, empowering consumers to change their

behaviours by making it easy to monitor health information.

Mobile apps will become another channel for providers to

interact in real time with patients.

Leading the Way. There are no clear leaders in the consumer

mobile app space, but Epocrates has been developing clinical

applications for several years.

1) MobiHealthNews: http://mobihealthnews.com/9396/number-of-smartphone-health-apps-up-78-percent/

2) Pew Internet & American Life Project, Mobile Health 2010: http://www.pewinternet.org/Reports/2010/Mobile-Health-2010.aspx

Health apps for mobile devices will empower healthcare consumers,

change their behaviors and drive new clinical management and

physician-patient interactions.

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http://mobihealthnews.com/9396/number-of-smartphone-health-apps-up-78-percent/















http://www.pewinternet.org/Reports/2010/Mobile-Health-2010.aspx







6 Social Networking

Patient-Connected Online Communities

Today. Patients are using the Internet and social

networking tools to connect with one another and to share

information about their health and healthcare

experiences.

Tomorrow. Moving beyond initial trends of connecting

and information sharing, the next wave of opportunity will

be around patients managing and “curating” healthcare

information via social networking sites. Consumers will be

able to access trusted sources and reliable information

that reflects patient needs. Social data on healthcare

(perception of care, treatment regime, experience, etc.)

will be a key part of this content.

Leading the Way. PatientsLikeMe.com is one of several

leading Web sites that has created an online community

for patients with similar diagnoses to help improve their

quality of life. Members can chart symptoms with tools

that collect outcomes-based patient data and share

experiences and resources with other patients and

partner healthcare stakeholders.

Social media/networking tools will make it easy for patients to connect and

share information, empowering them to take greater control of their health.

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7 Point-of-Care Diagnostics

De-centralizing the Centralized Lab

Today. The at-home pregnancy test was one of the first

mass market point-of-care tests (PoCTs). The test gave

women new control over their health information. Today,

newer and more accurate tests for other diagnoses and

monitoring of chronic conditions are available, bringing

new convenience, control and ease-of-use to consumers.

Recent advances toward “lab on a chip” allow for

thousands of tests to be run on just a few drops of blood.

Tomorrow. PoCTs will continue to simultaneously drive

consumer empowerment and improve care with the ability

to provide reliable and “instantaneous” results without the

need for a large centralized lab. This transformation can

also play a role in lowering healthcare costs.

Leading the Way. There is no clear leader in this area

today, but pharmaceutical companies are already making

significant investments in new PoCTs. $0

$50

$100

$150

$200

$250

$300

$350

$400

2003 2005 2007 2009 2011 2013 2015 2017 2019

Millions

Total PoCT Spending in Canada, 2003-2013

POCT spending in Canada estimated based on 1) Point of Care Diagnostic Testing Sector Trends

http://trimarkpublications.ecnext.com/coms2/summary_0230-4082_ITM?referid=3470&gclid=CLKh-IjWkZsCFSAhDQodGFEZpg and 2) Point of Care testing established world-wide: Tran

NK, Kost GJ. Worldwide point-of-care testing: compendiums of POCT for mobile, emergency, critical, and primary care and of infectious diseases tests. Point of Care: The Journal of

Near-Patient Testing & Technology 2006;5:84-92. using official US/Canada exchange rates and OECD health expenditure reports

“Point-of-care” and “lab on a chip” testing technologies will transform

diagnostic services and de-centralize the lab.

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http://trimarkpublications.ecnext.com/coms2/summary_0230-4082_ITM?referid=3470&gclid=CLKh-IjWkZsCFSAhDQodGFEZpg






8 Hospital at Home

Home is Where the Care is

Today. Looking to control healthcare costs and provide

quality, effective care, there is a push to deliver more

services within the home for patients whose diagnoses

meet certain eligibility requirements. Advances in

technology allow for remote monitoring and delivery of

services without the need to stay in an acute care facility.

Tomorrow. Technology advances will continue to enable

more hospital at home options for diagnostics, the care of

chronic conditions and post-surgical recovery. This trend

is key in lowering hospital admissions and costs,

eliminating hospital-acquired infections and supporting

the patient’s comfort and the physical and mental well

being so essential to recovery.

Leading the Way. Kaiser Permanente is emphasizing the

“home hospital” as a method of providing flexible, patient-

centered and cost-effective care. Ontario Telemedicine

Network is one of the world’s largest telemedicine

networks.

Advances in remote-monitoring technologies will transform healthcare

delivery, driving the rise of at-home care options for eligible patients.

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9 Regionalization 2.0

Aggregate then Integrate

Today. The clear need to lower healthcare costs in the

wake of an unprecedented global health reform mandates

has sparked moves toward the regionalization of

healthcare. The overall aim is to achieve true integration.

Already, regional integrated care networks are emerging

to drive new efficiencies and economies of scale.

Tomorrow. The emergence of these larger regional

systems along a centralized governance model and

stable funding will continue to enable better integration.

Key benefits will include the consolidation of systems,

standardization of care protocols and the development of

shared service models or managed services contracts.

Leading the Way. In Canada, Alberta Health Services is

an example of this trend. And in the United States,

Geisinger Health System is a regional integrated network.

The push to deliver better, more cost-effective healthcare will lead to the

emergence of “super regions” in order to truly integrate care and services.

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10 Exporting Health

New Pursuit of Commercial Opportunities

Today. Healthcare organizations outside of Canada are

entering new markets—foreign markets in particular—in

an attempt to generate new revenue. Opportunities

include partnerships, licensing deals, expansion into new

markets and commercialization of IP.

Tomorrow. While the need to generate new revenue will

continue to drive this trend, other factors such as the

need to develop new skills, maximize existing resources

and build a healthcare brand will come into play.

Leading the Way. The Swedish government has

announced plans to export its model of healthcare and

will partner with private sector firms to pursue

opportunities aggressively.

The University Health Network and the Cleveland Clinic

are both exploring private, for-profit initiatives to generate

new revenue sources.

$0

$20

$40

$60

$80

$100

$120

$140

$160

$180

$200

1975 1985 1995 2005

Billio

ns

Private Spending Public Spending

1 Figures for 1975 through 2005 taken from National Health Expenditure Trends 1975-2005 (NHET), published by the Canadian Institute for Health Information (CIHI).

To pay for rising healthcare costs, public health organizations will become

more entrepreneurial and pursue and export commercialization opportunities.

Health Expenditures in Canada, 1975-20101

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What Do You Think?

• Today. Which trends do you see influencing your

organization today?

• Tomorrow. Which trends do you think will have the most

impact on your organization in the next two years?

• Business. What trends do you think best align with your

short and long term business objectives?

• Environment. What other healthcare trends are you

tracking today?

• Challenges. Do you have any concerns about how these

trends will impact your organization and its stakeholders?

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For more information

To learn more about these healthcare game changers—and how they

might impact your organization, please contact:

Sanjay Cherian

Health Industry Lead, Canada

[email protected]

416-641-3718

http://www.accenture.com/insightdrivenhealth

15

http://www.accenture.com/insightdrivenhealth

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