Trends Driving Growth and Innovation in the
Healthcare Industry
AHA Health Tech Forum
September 29, 2014
Six Big Themes for the New Healthcare Economy
Themes
Modernizing Care
Delivery
Role of New
Participants
– Clinical practice is moving
– The emergence of IT
based tools and services is
witnessing the rise of a
new breed of competitors.
from intuition based decisions
to more analytics and data
based approaches.
Rethinking the
Customer
– Patients are no longer
going to be passive
participants in the process.
Companies Revamping
Strategies
– Many industry participants
as currently structured can
not maintain viability without
significant changes to their
business model.
Who Pays?
-The spiraling costs of care to
government and private payors is
forcing the launch of new methods
and models for payment of
healthcare services and products.
New Partnerships
– An industry that historically
operated in distinct silos is now
being forced to integrate, and
thus leading to firms seeking
new types of partnerships and
collaborations.
Source: Frost & Sullivan analysis.
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Healthcare Re-imagined
In Person
In Home
Preventive
Precision
Reactive
Semi-reactive
Predictive
Prescriptive
Break-Fix
Connected
Monitored
Streaming
Source: Frost & Sullivan
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Care Delivery Transformation: Acute Care to Prevention
Track, Predict, Intervene, Manage
•Early identification and prevention
Prevention/Wellness
•New models of care delivery to improve:
• Collaboration among providers
• Patient knowledge, self-help and health
Size of Impacted Population
$$
Goal:
Keep
People
Healthy
Longer
Healthy /
Well
•Increase intervention
• Higher touch at lower cost
Goal:
Manage
or Mitigate
Risk
At Risk
Disease/Care
Management
Goal:
Diagnose
and
Reduce
Treatment
Delay
Undiagnosed
Goal:
Move to
More
Interaction
and SelfMgmt
Chronically Ill
Managed
Continuum of Care
Goal:
Manage
Chronically Ill
Unmanaged
Goal:
Quality of
Life
End of
Intervention
Source: Frost & Sullivan
4
Leveraging Big Data to Improve Health, Reduce Costs
EHR / EMR
Remote
monitoring
mHealth apps
Genomic data
Email, text
messages
Microbiomic
data
Clinician notes
Metabolomic
data
Claims data
Biometric sensors
Photos, video
Actionable
Insights
Analytics
Published
research
Social media
Normalization of Data, NLP, Integration
Imaging files
Process,
Behavior
Change
Source: Frost & Sullivan
5
Population Health Management Leverages Shifts in IT
Cloud
Measure
Outcomes
Define Population
AUTOMATED &
ONGOING
Cloud
Social
Media
Mobility
Manage
Care
•
•
•
•
Data Integration
Analysis
Reporting
Communications
and Alerts
Identify
Care Gaps &
Stratify Risks
Big
Data
Cloud
Big
Data
Engage
Patients
Social
Media
Mobility
Cloud
Source: The Institute for Health Technology Transformation, 2013; and Frost & Sullivan
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Hurdles to Reaching the Promise of Digital Health
DATA
We are
creating
millions of
useful data
points,
from a wide
variety of
sources…
INTEGRATION
ANALYTICS
…But the data is
provided in
separate
solutions which
prevent getting a
holistic view of
the patient.
FREEING DATA
AND
INTEGRATING
DATA ARE KEY
Predictive
analytics has
arrived…Natural
language
processing will
become a
commodity…
…But working with
only part of the
data
PROCESS
CHANGE
Analytics alone
cannot transform
healthcare.
Analytics need to
create actions.
Culture change,
behavior change,
process changes
are hard to
execute.
Source: Frost & Sullivan
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Redefining Stakeholder Roles in Healthcare
Patients:
Physicians:
Active
Passive
Individual
Team
Pharma:
Blockbuster
Drug
Care Providers:
Breadth
Targeted
of
Care
Services
Models
Care Coordinators:
Therapeutic
Soluton
Secondary
Role
Primary
Role
Medical Device
Companies:
Procedure
Value
Based
Based
Insurers:
Administrative
Analytic
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Competitive Success Factors Change Who Will Win
Last Decade
Current Decade
Next Decade
Integrated platforms to
provide comprehensive
continuum of care. Focus on
quality of life.
Companies that understand
consumer behavior, needs,
and pain points.
Success
Drivers
Technologies geared
towards extending life
Technology to improve
outcomes and mitigate
risk
Types of
Companies
Who Excel
Companies that
advanced standard of
care.
Companies that could
make treatments safer
and easier to perform.
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Business Models Must Adapt
Frugal innovation, tiered product
markets
US to be a net importer
of medical technology?
Start with the need, not with the
technology
Look beyond your core customer
base
Tiered
solutions
Know when to fold
Applying techniques from other
industries to healthcare
Savings through
process
improvement
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Leveraging mHealth to Reduce Avoidable Medical Costs
Key Pain Points Addressed by Current mHealth Technologies
Annual Cost to US
Healthcare System
mHealth
Technology
~ $300 billion
• Help patients track the timing & dosage of their medicines
• Help providers gain more insight into patients’ conditions &
behavior to offer the right treatment & advice
• Provide information on side effects, benefits, etc.
~ $45 billion
• Collect data through an application which keeps consumers
engaged with the help of games, content and interaction
• Flag potential health problems and figure out exactly which
people on the medical team they need to see
Unnecessary
visits to doctors
~ $125 billion
• Provide information to patients by allowing them to pose
health related questions to a network of physicians
• Teleconsultations to screen, advise
Missing critical
warning signals
~ $7 billion
• Allow doctors to remotely monitor the vital signs of hospital
patients and at home through sensors/devices
~ $100 billion
• Allow people to track calories through weight-control
applications
• Prompt people to set reasonable goals, exercise, and count
calories
Patients don’t
follow their
prescriptions
Patients don’t
give doctors
enough
information
Unhealthy
diet & lack of
exercise
•
Source: mHealth report published by PwC,
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Direct To Consumer Models
Consumer
Analytics



  
Convenience
• Breaking down “bricks and
mortar” approach to healthcare
• Diagnosis, testing and treatment
in the home
Engagement
• Shared-decision making
• “I want all my information in
one place so my community
has access”
Personalization
• Preference-based
care vs. evidencebased care
• Customized approach
to communication
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Contact Info
Greg Caressi
Senior Vice President
Healthcare & Life Sciences
(+1) 650 475-4555
gcaressi@frost.com
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