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Telehealth DPS LECTURE – HEALTHCARE 2020. ” “ An exciting new area for disruptive innovation is likely to come from a focus on holistic patient care with.

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Presentation on theme: "Telehealth DPS LECTURE – HEALTHCARE 2020. ” “ An exciting new area for disruptive innovation is likely to come from a focus on holistic patient care with."— Presentation transcript:

1 Telehealth DPS LECTURE – HEALTHCARE 2020

2 ” “ An exciting new area for disruptive innovation is likely to come from a focus on holistic patient care with an emphasis in life-long well-being. The convergence of medical and information technologies will be facilitated by a much more informed patient population that will expect much more than a pill. They will expect an integrated patient solution that will address the underlying disease and improve their life. M IGUEL B ARBOSA, P H.D, VP AT J ANSSEN R ESEARCH &D EVELOPMENT – P HARMA V OICE M ARCH 2013 Patients are becoming smarter, expect higher quality care, and will be more conscious about health decisions they make.

3 Context  13+ years Life Sciences experience  Director, R&D Customer Success at Veeva  Enterprise Program Director at NextDocs  Head of Global Regulatory Systems at Genzyme  Passionate about the future of Health Care  Future of Clinical Trials and Regulation  Transforming Life Sciences IT  Patient Engagement and Behavioral Change  Mobile Technology Connect: P: 781-375-8070 E: ryan-ennis/5/816/706

4 Agenda  Telehealth – Definitions and Key Concepts  Health Care 2020  Trends – Opportunities and Barriers  Examples  AMAA

5 What is Telehealth?

6 Telehealth “The use of digital technologies to deliver medical care, health education, and public health services, by connecting multiple users in separate locations. Telehealth services consist of diagnosis, treatment, assessment, monitoring, communications, and education. It includes a broad range of telecommunications, health information, videoconferencing, and digital image technologies.” - The Center for Connected Health Policy Telehealth services have been traditionally delivered in three main ways: Video conferencing Remote patient monitoring Store & forward technologies

7 Is a lot more than just Telehealth….  Telemedicine is the delivery of health care services by providers with the intention of providing diagnosis, treatment and prevention, research and evaluation, and continuing education.  mHealth is the use of mobile-based (smart phones, etc..) applications in health care.  eHealth is the use of internet-based (or internet accessible) applications in health care.

8 Spectrum of Telehealth Clinical Telehealth  Telehealth is used to replace or add to existing clinical services that plan to diagnose and/or treat patients.  These services are typically highly customized and regulated, and the scrutiny of information and outcomes is quite high. Consumer Telehealth  Focused on the wellness and preventive aspect of healthcare.  Unlike the clinical side, these services and products are more standardized and less regulated, with ease of use being paramount.

9 Telehealth is simultaneously Broadening and Focusing the health care industry Capabilities, Applications, Solutions, Reach Protocols, Technologies, Standards, Best Practices

10 Health Care 2020

11 The Provider Fee-For-Service has been replaced by Outcome-based care Consolidation of Practices and Integrated Delivery Networks Change-adverse doctors and medical professionals have mostly retired. Just-in-Time Knowledge management Customer Engagement and Experience Healthcare Population Solutions (Protocolization) High Velocity Change Refresh of knowledge base every 18 months

12 The Payer Critical role in the middle of everyone Business model in question Cost Containment Increased focus on quality data Partnerships Public Health focus

13 The Drug Manufacturer Several Brand-Name Pharmaceutical companies don’t develop products any more. Comparative studies have changed everything. Clinical trials in a bag Developing and Emerging Markets Direct customer engagement to develop brand loyalty Patent Cliffs, M&A We’ve moved all regulated systems into the cloud. We finally just moved to Windows 8

14 The Device and Software Manufacturer Regulation has consolidated solutions and players…. for now. We still haven’t figured out how to make money off of mobile apps. Data is increasingly shared, mined, and monetized The SmartPhone becomes the Tricorder Med-Device is HUGE Mobile Apps for customer engagement are critical to Brand success UI/UX is life or deathIts all in the cloud

15 The Patient We are ePatients Sensors everywhere Apps for everything Focus on behavioral change Social networks New relationships Holistic health management Greater role in facilitating care DATA IS EVERYWHERE!!!

16 The System Health Care is now primarily PROACTIVE vs REACTIVE Fee-For-Service has been replaced by Outcome-based care The Walmarting of Healthcare Change-adverse doctors and medical professionals have mostly retired. Medical Tourism is no longer a threat to the patient or provider Information is easier to collect, analyze, and share Consumer Engagement Drives Demand Developing nations create demand for non-developed- nation solutoins The Shadow Healthcare System emerges…


18 Of US adults are caregivers for a sick adult or child Up from 30% in 2010 39% Of US adults keep track of at least one health indicator, such as weight, diet or exercise 69% Of US adults have at least one chronic condition 40% of US adults with 1 condition are trackers 60% of US adults with 2+ conditions are trackers 45% Specific consumers are most influential Source(s): Pew Internet Research, 2013

19 Developing Nations are not out of scope No access to clean drinking water 700m No access to toilets 2.5b Global cellphone penetration 96% Cellphone penetration in developing countries 89.4%

20 A necessity for the future of life sciences companies As life sciences companies adopt a patient centric model, they need to differentiate themselves on value, not on the medicine itself. This is most relevant in highly competitive spaces such as diabetes or cholesterol therapies. Telehealth will enhance the connection between patient and provider, helping to improve the collection of data to optimize therapies, and strengthen the connection between companies and consumers. Self- Empowerment Self-Fulfillment Attachment Emotional Branding

21 Health Information is Disconnected  There should exist a standardized infrastructure to enable a regional, and national environment for connected health information.  The lack of standards and interoperability among systems makes widespread connectivity difficult, impeding clinician access to real-time data for medical decision-making.  If a patient walks across the street to a different hospital, there is a high likelihood that his or her care will start from the ground up, as any documentation from another system would be inaccessible.

22 Medical image archives to increase by 20-40% a year BIG Data = BIG Growth 425k health providers in the US 36.6M, 2011 admissions to registered hospitals according to the American Hospital Association. Source: MedCity NewsMedCity News Today 80% of data is unstructured.

23 By 2015 the average hospital will generate 665TB a year. BIG Data = BIG Opportunity Xray 30mb Mammogram 12mb 3d MRI 150mb 3d CT Scan 1gb Source: MedCity NewsMedCity News By 2020 the amount of worldwide health care data is expected to grow to 50 times the current total to 25,000 petabytes Clouds roll in to handle stratospheric capacity needs, Healhcare IT News, October 2011

24 Mindsets Need to Change  The industry is focused on face-to-face care based only on tradition and fragmented delivery systems where real-time collaboration is impossible.  Coordination of care among diagnostic and therapeutic providers, inpatient and outpatient facilities and home care environments is unacceptably low – as is payer reimbursement for this level of interaction.  Providers today wrestle with financial, regulatory and operational challenges.

25 Everyone is involved in facilitating change  Companies must prove the benefits of their innovations in terms of health outcomes and economic benefits.  Policy makers and politicians need to ensure that regulations support future innovation.  Health care providers will have to focus on delivering services outside the hospital setting.  Payers need to provide reimbursement that reward innovation.  Patients need to take a more active role in managing their own health.

26 A Note on Privacy  If you are on Medicare or Medicaid, the government has your medical records.  Private payers have HUGE databases with your medical records.  EHR companies and pharmacies have your medical records.  Your data is being constantly de-identified, sold, re-identified and used to create new health care services for financial profit.  Once HIE’s officially become a reality, State and private agencies will also begin building their own repositories of medical records.


28 Examples of innovation  Intelligent Pills Deliver Medication to Specific Locations : Philips Research has developed an intelligent pill that can be programmed to deliver targeted doses of medication to patients with digestive disorders such as Crohn’s disease, colitis, and colon cancer. 1  Sensor Technology Tracks Medication Adherence : Proteus Biomedical is working on technology that incorporates a tiny sensor into pills for targeting medication adherence for organ transplants, cardiovascular disease, infectious diseases, diabetes, and psychiatric disorders. 2  Printing New Skin : Wake Forest University’s scientists have discovered how to apply ink-jet printer technology to ‘print’ proteins directly onto a burn victim’s body for faster and more thorough healing. 5  Video Games Hone Medical Student Decision-Making Skills : The University of Texas, Corpus Christi, and BreakAway Ltd., have developed a ‘serious’ video game that lets professionals and students practice on 3D video patients using the same interactive techniques and decision-making processes they would use with real patients.  Robot Care Givers : MIT’s “Huggable” teddy bear robot can serve as a medical communicator for children. Packed with electronic sensors and sensitive skin technologies, the robot can distinguish between cuddling for comfort or agitation by sensing the strength of the squeeze. 7

29 Continuous Professional Education QuantiaMD Website and mobile app that hosts interactive presentations on clinical and medical practice management. 500 QuantiaMD expert faculty members, who include physicians from academic institutions, group practices, and community medical centers. 160,000 registered users.

30 Patient Communities PatientsLikeMe Patient network to connect patients with others who have the same disease or condition and track and share their own experiences. Goal is to accelerate clinical research, improve treatments and patient care PatientsLikeMe research team has authored more than a dozen peer-reviewed published scientific articles Sells aggregated, de-identified data to pharmaceutical companies and medical device makers. 200,000 + registered users.

31 Clinical Trials in a Box  A patient walks into a doctor’s office  EMR tells doctor patient meets inclusion/exclusion criteria for trial  Doctor gives patient a box of validated medical devices  Connected Medical Devices  Patient Portal  CCR/CCD or Blue Button or HealthVault connectivity  Patient remains engaged with trial, gets better data

32 The PHR/UHR Problem  Evolving standards and frameworks….like CCR/CCD and BlueButton  A few dominant players….like Microsoft HealthVault and Dossia.  Challenges?  Opportunities?

33 EMR/EHR Data Mining  Tremendous potential for the future of clinical trials, evidence based care, and public health.  Challenges?  Opportunities?

34 Event Driven Technology  Technology helps providers connect, correlate, understand, and act upon information across systems,  Improves the coordination and visibility of patient care, gaining efficiencies, and reducing waste.  Real-time, event driven platforms enable provider organizations to manage massive volumes of data to:  Identify potential problems faster  Intervene proactively  Influence clinical and financial outcomes

35 Takeaways

36 We WANT to leverage information

37 There are new models and markets

38 Protocolization will increase

39 Integrated Care makes sense

40 There are new payment models



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