Post on 20-Jan-2016
transcript
Overcoming Healthcare’s Last Mile Through mHealth
SolutionsmHealth Summit
November 2015Anne Katharine Wales
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1/3 of all health
expenditures will occur in emerging economies by 2022
Over the next two decades, the middle class is
expected to expand by another three Billion, coming almost exclusively from the emerging world
84% cell phone ownership in emerging and developing nations
Innovations in Healthcare is focused on identifying, scaling, and learning from innovative healthcare delivery solutions around the world
Nonprofit organization founded by Duke Medicine, McKinsey & Company, and the World Economic Forum and hosted at Duke.
Aims to improve health worldwide by supporting the scale and impact of promising innovations.
Supported by and collaborates with a global and diverse group of organizations that are committed to strengthening and increasing the scale of health innovations.
To date we support 55 healthcare innovators, with an average of $2M in annual revenue and 9 years in operations
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We have curated a network of 55 organizations that:
Provide significant improvements in cost, quality, and/or access, as measured against comparable solutions
Address critical health needs
Can be implemented via a sustainable business model
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Brazil India Kenya Mexico United States
Population 202 million 1.2 billion 45 million 123 million 318 million
GNI (per capita, PPP)
$15,900 $5,760 $2,890 $16,160 $55,860
Nurses (per 1K people)
7.6 1.7 0.9 2.5 9.8
Internet users (per 100 people)
57.6% 18 % 43.3 % 44.4 % 87.4 %
Rural Population 15 % 68 % 75 % 21 % 19 %
Health expenditure, total (% of GDP)
9.7 4.0 4.5 6.2 17.1
Three main causes of death
1. Heart disease
2. Stroke 3. Diabetes
1. Heart disease
2. Diarrheal diseases
3. Lung diseases
1. HIV2. Influenza3. Diarrheal
diseases
1. Heart disease
2. Diabetes3. Kidney
disease
1. Heart disease
2. Cancer3. Respiratory
disease
Out-of-pocket health expenditure (% of total expenditure on health)
29.9% 58.2% 44.6% 44.1% 11.8%
Radical healthcare innovation is cropping up differently in key markets, with important economic factors driving entrepreneurial opportunity
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• Get close to the patient (consumer) and follow their established behaviour patterns
• Borrow someone else’s assets
• Confront professional assumptions and ‘right-skill’ the workforce
• Standardize operating procedures wherever possible
• Reinvent the delivery model by using proven technologies disruptively
Across our network, we’re seeing innovators that focus on these opportunities utilizing key principles
Technology plays an incredible driving force in this innovation
Strategic Planning
Performance Management
Should I franchise to maximize my impact? Is acquisition the right path?
How can I collect data in a cost effective way to prove my impact? What about measuring clinical quality?
Product/ Service Innovation Development
What product changes should I make to best serve my customers?
Organizational Leadership & Talent
How do I hire, train and retain talented clinical staff?
Leveraging the Ecosystem What’s the best way for me to partner with a pharma company?
Funding & InvestmentHow can I best position my organization for a series A round? Are grants ever seen negatively by investors?
If healthcare innovators already exist in a proven way, why aren’t they scaling faster? What areas of support do they need to increase their impact?
1There is a need for more coordination between active parties across the system
2There is currently a mismatch between available capital and needs on the ground
Silos of investors
Hard for investors to work
with Foundation
s and Donors
Investment timeframes
are too short
Debt is unavailable or available
at crazy rates
The market is flooded
with early stage free
money
Banks don't
understand the
business models
Healthcare is too
political
Difficult to manage
regulatory environment
s
What’s stopping more investing in this space? Need for more coordination and availability of the right types of capital at the right time.
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Rural BoPUrban/peri-urban
middle-incomeUrban/peri-urban
high-incomeUrban/
peri-urban BoP
Delivery system
Medical Device & Supplies
Payment Systems
Mobile & Tech
Pharma
Inadequate volumeInfrastructurePrice sensitivity
Last mile distributionInadequate volumePrice sensitivity Last mile distributionInformation asymmetryPrice sensitivity Information asymmetryPrice sensitivity
Infrastructure AccessPrice sensitivity
Quality for costInfrastructurePrice sensitivity
Price sensitivity
Information asymmetryPrice sensitivity
Information asymmetryPrice sensitivity
AccessPrice sensitivity
Quality for costInfrastructure
Price sensitivity
Information asymmetryPrice sensitivity
Information asymmetry
Infrastructure
Su
b-s
ecto
rs
Populations
Logistics & Distribution
Last mile distributionInadequate volumeInfrastructure
InfrastructurePrice sensitivity
Infrastructure
GrantImpact capital
Traditionalcapital
Healthcare ventures respond to different market challenges- each requires a unique type of capital depending on population served
Implications for Innovators
Seeking Customer Revenue
Seeking Grant Funding Seeking Equity
• Demonstrate ease of use for all users (CEO, clinician, etc) with current workflow
• Low-up front cost• Understand all
unintended consequences
• Illustrate increased revenue
• Demonstrate increased ability to reach more patients with higher quality care or at lower costs
• Demonstrate ability to increase care for specific population segments
• Show clear customer growth
• Set and reach revenue milestones from a diversified set of payers
Spotlight on Relief Watch
Discussion:
For Innovators: What has been your biggest challenge on your path to growth? What types of resources or partners do you need (other than
funding?)
For Corporates: How are you engaging with emerging markets and does technology
play a role?
For Funders: Are you currently funding mHealth solutions? Grants? Equity? Given the many solutions currently in the market, what makes them
stand out to you?