Health 2.0 Coming Soon to a Lab Near You

8/14/2019 Health 2.0 Coming Soon to a Lab Near You

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Health 2.0?

Coming to a Lab Near You!

Presentation at

Lab Info Tech

Scott Shreeve, MD

Crossover Healthcare

April 10, 2008


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Licensed under the Creative Commons Attribution-Share Alike 2.5 License.

Developed 2006 by Crossover Healthcare with input from numerous public sources.

Presentation

Introduction

1.0 First Generation

2.0 Next Generation Web 2.0

Health 2.0

Lab 2.0

X.0 Into the Future


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Scott Shreeve, MD

Board Certified Emergency Medicine Physician

Co-Founder of Medsphere Systems Corporation First ever enterprise open source electronic health record First commercial implementations of VistA outside of the VA

Helped create/promote concept of Health 2.0 Advisory board member, panelist, author, blogger, speaker

Crossover Healthcare Entrepreneur in Residence Next generation health care finance and delivery


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1.0 First Generation


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Laboratory Testing Market

Market Size 2007

Health Care = $2,200 billion

Diagnostic Services = $ 150 billion

Laboratory Services = $ 45 billion1

Ambulatory Lab Services = $ 12 billion2

Quest = $ 7 billion

Lab Corp = $ 4 billion

Physician Labs = $ 1 billion

1 2007 4Q 10Ks filed by LabCorp and Quest Diagnostics

2 Est from Dark Report Editor in private communication March 15, 2008
http://www.darkreport.com/http://www.darkreport.com/


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Ambulatory Lab Services Market Assumptions1

Lab Corp and Quest = 280M tests

Combined market share = 71.4%

Total Market = 392M tests

~2.5% were paid by patient = ~9.8M tests

Grows to 5% over next 5 yr =~19.6M tests

Average revenue/requisition= ~$35.712

Market size = $700M market

1 2007 4Q 10Ks filed by LabCorp and Quest Diagnostics

2 LabCorp 10K indicates that average rev/req of patient pay = ~$ 158.94


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Relative Growth Opportunities

~10% Annual Growth Rate ~20% Annual Growth Rate

06 07 08 09 10Ambulatory Lab Market

475M

450M

425M

400M

375M

06 07 08 09 10Consumer Paid Lab Tests

20M

18M

16M

14M

12M


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WTF?: DTC, DAT, and CDH

CLIA

Federal oversight of accuracy and reliability of laboratory results

Regulates at the laboratory level; not physician or consumer

States

Regulates physician licensure and general commerce

Unwarranted Variation between and within all 50 states

Consumerism

Direct To Consumer (DTC) how most services are marketed

Direct Access Testing (DAT) initiated by patient

Part of the larger Consumer Directed Health (CDH) movement


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2.0 Next Generation


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The World is Changing

If MySpace were a country, it would be the 11th largestin the world behind Mexico. (Techcrunch, 2007)

50% of all healthcare consumed is UGC (Jupiter, 2007)

There are more visits by the same users in a month onDaily Strength than on WebMD

The Machine is Us/ing Us
http://www.youtube.com/watch?v=6gmP4nk0EOE&eurl=http://www.youtube.com/watch?v=6gmP4nk0EOE&eurl=


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Web 1.0

Hype Cycle

The bursting bubble was part of a natural technical revolution

Shakeout allows ascendant technology to emerge

First Generation Initial content

Static websites

Personal home pages Email and online forums

First electronic transactions

Proprietary business models


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Web 2.0

Gravitational Core Concepts

1. The Web as a Platform

2. Harnessing Collective Intelligence

3. Data is the Next Intel Inside

4. End of the Software Release Cycle

5. Lightweight Programming Models

6. Software Above the Level of a Single Device

7. Rich User Experiences


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Web 2.0


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Health 2.0

First Echos on the Web


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Health 2.0



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Health 2.0



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Health 2.0



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Scott Shreeve, MDMatthew Holt

Dueling Perspectives

Health 2.0 isj ust a term

describing healthcare use of

Web 2.0 t echnology(search,

wikis, blogs, video, online

communities, mash-ups, etc.)

Health 2.0 is a descriptive of a

broader movement toward next

generation healthcare and not just

descriptive of the t echnology

enabling the movement!


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Commonality of Perspectives

1. Transparency

2. Users in control

3. Timely, personal, relevant

information

4. Aggregate, Analyze, Advise

5. Imminent Reform


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The continuum of Health 2.0

Use of Web2.0technologies for

patients and

physicians to

communicate and

investigate withoutconnecting to the

health care systems

Tools andcommunities created

as part of Web2.0 in

health care, then start

becoming connected

to the system (i.e.people use them to

create appointments,

conduct transactions)

Reform in paymentstructures,

transparency, and

technology produces

change in delivery

structure and processaround chronic care

treatment, excellence

centers for particular

procedures, etc.

All the data collectedin a combination of a,

b & c produces leaps

ahead in the process

of care and eventually

in drug and procedurediscovery.

User-

generated

health care

Users connect

to providers

Partnerships

to reform

delivery

Data drives

discovery

San FranciscoSeptember 20, 2007

San DiegoMarch 3-4, 2008

San FranciscoSeptember 2008


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Technology + Reform

= Health 2.0


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Health 2.0: Changing Relationships


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Health 2.0: Changing Relationships

Passive Patients Engaged Consumer Engaged, Educated, and Empowered

Doctor Demigod Physician Advisors Cost/Quality, outcomes focused, and service oriented

Insurance Adversary HealthPlan Advocate Transparent, advocacy, and proactive

System Generated User Generated The Cathedral vs. The Bazaar

The journey is just beginning . . .


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The Transition to Health 2.0Health 1.0 Health 2.0

Zero Sum Competition --> Positive Sum Competition

Opacity --> Transparency

Integration --> Interoperability

Focus on Cost --> Focus on Value

Disease Care --> Health Care

Physician: Ultimate Authority --> Physician: Trusted Advisor

Patient : Passive Observer --> Patient: Engaged Consumer

Pay for Process --> Reward for Result

Culture of Denial --> Culture of Quality

Professional medical information --> Pervasive medical information

The Transi t ion t o Heal t h 2.0.This is a representative, but far from comprehensive, list of the characteristics of Health 2.0


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Health 2.0: Consumer Relationships

New Consumer Interactions with: Medical Providers

Medical Information Medical Search

Medical Finances

Medical Communities

Consumer becomes the central focus Gravitation core of health care interaction

Empowered to use information Accountable for health care status

Engaged in the care process


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Health Care Consumerism


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Personalized Search


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Active PHR Information


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Intelligent Communities

ll


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Intelligent Content

H l h 2 0 C i


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Health 2.0 Companies

Next generation health companies that leverage the

principles of openness, standards, andtransparency; utilize the technology tools of

collaboration, information exchange, and

knowledge transfer; and focuses on deliveringvalue-added services that empower health

participants (patients, physicians, providers, and

payers) with freedom, choice, and accountability

for health outcomes.

H l h 2 0 C i


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Direct access to care

Advisory Services

Collective Intelligence

Mash-up

Network Effect

Health 2.0 Companies

Sermo:


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Sermo:

Online Physician Community

Daily Strength:


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Daily Strength:

Online Health Community

Revolution Health:


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Revolution Health:

Healthcare Consumerism Portal

Vimo:


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Vimo:

Consumer Reports of Healthcare

Yelp:


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p

Community eReviews of Everything

HealthEquity:


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q y

Health and Wealth Advisory Services


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Lab 2.0

Health 2 0 in the Lab


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Health 2.0 in the Lab

Expanding Access to Laboratory Information Testing

Analytic Proteomic Genetic

Analytics Treatment triggers off of lab values

Reporting Education

Counseling Value added advisory services

Health 2 0: Genetic Testing


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Health 2.0: Genetic Testing

Protein blueprints with disease potential Recreational Genetics clinical implications?

Heavily regulated and highly political (GINA)

Health 2 0: Proteomic Testing


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Health 2.0: Proteomic Testing

Active proteins causing disease Breast, Ovarian, Prostate, etc

Consumers want access to these tests

Health 2 0: Analytic Testing


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Health 2.0: Analytic Testing

Basic body chemistry as a result of disease The foundation of diagnosis and relevant clinical information

In many ways considered the largest opportunity ($700M)

Health 2 0: Lab Analytics


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Health 2.0: Lab Analytics

Lab Testing information as therapeutic platform Electronically captured / stored information in PHR

Mined by analytic engines to create personalized messaging

Example: HealthEquity Elevated A1C triggers proactive response Creates opportunity for company to demonstrate value,

increase compliance, reduce costs, and improve health

Health 2 0: Lab Reporting


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Health 2.0: Lab Reporting

Reduce Complexity and Increase Understanding Utilize new media to help consumers more readily interpret

Create customized, professional report electronically

Example: Biophysical

Detailed report in easy to interpret graphical style

Health 2 0: Lab Counseling


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Health 2.0: Lab Counseling

Basic body chemistry as a result of disease The foundation of diagnosis and relevant clinical information

In many ways considered the largest opportunity ($700M)

Example: DNA Direct Realized that genetic testing would be commoditized

Built out a nation wide network of genetic counselors Their competitive differentiator is ability to effectively

advise consumers on clinical relevance of genetic testing


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DAT in Detail

Lab 2 0: DAT Overview


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Lab 2.0: DAT Overview

Lab 2 0: DAT Portal


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Lab 2.0: DAT Portal

Lab 2 0: DAT Process


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Lab 2.0: DAT Process

Lab 2 0: Account Creation


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Lab 2.0: Account Creation

Lab 2.0: DAT Orders


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Lab 2.0: DAT Orders

Lab 2.0: CA Protocol


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Lab 2.0: CA Protocol

Lab 2.0: DAT Transaction


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Lab 2.0: DAT Transaction

Lab 2.0: DAT DLO


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Lab 2.0: DAT DLO

Lab 2.0: Physician Oversight


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Lab 2.0: Physician Oversight

Lab 2.0: Results Release


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ab .0: esults elease

Lab 2.0: Personal Health Record


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Conclusion

Conclusion


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Web 2.0 is the evolving tools, technologies, andthemes of the post-bubble internet renaissance

Health 2.0 defines an emerging healthcaredelivery model of enabling technologies and the value-based reform initiative

Lab 2.0 will increasingly engage consumers byproviding comprehensive testing, improved analytics,enhanced reportingand value-add counselingservices

For more information


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CONTACT:

Scott Shreeve, MDCrossover Healthcare

[email protected]

ATTEND:

Consumer Health WorldMay 4-6, 2008Las Vegas, NV

www.consumerhealthworld.com


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Value Driven Health Care


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Technology + Reform = Health 2.0


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Health 2.0 Coming Soon to a Lab Near You

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