Date post: | 17-Dec-2014 |
Category: |
Technology |
Upload: | shahid-shah |
View: | 232 times |
Download: | 0 times |
The Biggest Opportunities in Digital Health from an American’s Viewpoint
By Shahid N. Shahwww.HealthcareGuy.com
@ShahidNShah
www.netspective.com 2
This and many of my other presentations are available at
http://www.SpeakerDeck.com/shah
www.netspective.com 3
@ShahidNShah HealthcareGuy.com
Who is Shahid?
• 25+ years of software engineering and multi-site healthcare system deployment experience
• 20+ years of technology management experience (government, non-profit, commercial)
• 15+ years of digital health, healthcare IT and medical devices experience (blog at http://healthcareguy.com) Author of Chapter 13,
“You’re the CIO of your Own Office”
www.netspective.com 4
@ShahidNShah HealthcareGuy.com
Top killers today
Heart disease CancerChronic lower
respiratory diseases
Top killers in 1900Pneumonia
and influenza TB Diarrhea and enteritis
Infectious diseases used to kill us……but what’s left seem only to be “manageable” not easily “curable”
Per 100k population, Historical Statistics of the United States, Millennial Edition
www.netspective.com 5
@ShahidNShah HealthcareGuy.com
Death by age group, 1900 Death by age group, Today
From cures to management……young people don’t dye of diseases often now
http://siteresources.worldbank.org/INTHSD/Resources/topics/Health-Financing/HFRChap1.pdf
www.netspective.com 6
@ShahidNShah HealthcareGuy.com
We’ve seemingly accepted lack of cures…
The Shift
The clinical model is shifting away from treatment of chronic conditions and focusing more on prevention, wellness, obesity intervention, behavior and lifestyle modification.
Objectives
• Keep people out of the hospital ($$$)
• Keep people from their docs ($$)• Keep people off drugs ($)• Keep people at home
Implications
Clinical operations are shifting to hospital and physician ‘centered’ services that will rely heavily on health information technologies to monitor, coordinate, and manage care.
• Successful Transition in Care resulting in Reduced Hospital Readmission Rates
• Proactive population management• Patient engagement and collaboration• Disease prevention through wellness and
obesity management• Chronic disease management• Care coordination and collaboration• Metrics and analytics
www.netspective.com 7
@ShahidNShah HealthcareGuy.com
Patient populations need different Digital Health
• Obesity Management• Wellness
Management
• Assessment – HRA• Stratification• Dietary• Physical Activity• Physician
Coordination• Social Network• Behavior Modification
• Education
• Health Promotions
• Healthy Lifestyle Choices
• Health Risk Assessment
• Diabetes• COPD• CHF
• Stratification & Enrollment
• Disease Management• Care Coordination• MD Pay-for-
Performance• Patient Coaching
• Physicians Office• Hospital• Other sites• Pharmacology
• Catastrophic Case Management
• Utilization Management
• Care Coordination• Co-morbidities
Well Patient At Risk Chronic Care Acute Treatment
Prevention Management
26 % of Population
4 % of Medical Costs
35 % of Population
22 % of Medical Costs
35 % of Population
37 % of Medical Costs
4% of Population
36 % of Medical Costs
Source: Amir Jafri, PrescribeWell
www.netspective.com 8
The digital enterprise is revolving rapidly based on key trends, health systems’ evolution, and IT’s evolution
Key
Ind
ustr
y
Tren
ds
.
Healt
h
Syste
m
Evolu
tion
IT
Syste
ms
Evolu
tion
IT R
ole
Evolu
tio
n
Fee For Service, Shared Risk, Bundled Payments,
etc.Value, Care Management, Population Management
PRESENT
Full Risk, Integrated Health Plan & Care Delivery System
Personalized Medicine, Wellness Management
FUTURE
Fee For Service
Volume/Episodic Care
PAST
Integrated EHR
Health Information
Exchange (HIE)
Enterprise Data Warehouse
(EDW)Patient
Engagement
Mobile Health
Connected Care
Wellness Manageme
nt
Advanced Informatics
Personalized Medicine
Ancillary Systems (Lab/Rad/Pharmacy,
etc.)
Enterprise Resource Planning (HR, GL,
SCM)
Revenue Cycle
Ambulatory EHR
Hospital EHR
Patient Access
Enabler InnovatorInstaller Integrator
Integrated Healthcare Network
Integrated Healthcare Ecosystem
Multi-Specialty Care Clinic & Hospital
Integrated Healthcare System
Source: Bruce Metz, CIO, Lahey Health
www.netspective.com 9
@ShahidNShah HealthcareGuy.com
Opportunities in Data Comprehension
What does it mean?
How do I use it?
•Must be continuously recomputed
•Difficult today, easier tomorrow
•Super-personalized•Prospective•Predictive
Bio IT and Genomics
Secondary Aggregation
•Can be collected infrequently
•Personalized•Prospective•Potentially predictive•Digital•Family history is easier
Phenotypics
Primary Data Collection
•Continuously collected•Mostly Retrospective•Useful for population health•Part digital, mostly analog•Family History is hard
Admin Data
Collection
•Business focused data•Retrospective•Built on fee for service models
• Inward looking and not focused on clinical benefits
Biosensors
Social Interactions
www.netspective.com 10
Data
Medical Hardware
Consumer Hardware
Health Records
Patient IT Social Media Health Literacy Retail purchases Behaviors
IoT Sensors
Hardware Software
Pharma / Clinical Trials
Labs / Imaging
Payments
Bioinformatics
Health Info Exchg
Provider Engagement
Care Coordination
Compliance
Marketing ITRetrospectiveProspective
Med Devices
Integration
ComprehensionTools, Storage, Services
Science, Discovery
Value
Creation Research
Consent
Digital Chemistry
Provider Stature
Ratings/reviews
www.netspective.com 11
@ShahidNShah HealthcareGuy.com
Data changes the questions we ask
Simple visual facts Complex visual facts Complex computablefacts
www.netspective.com 12
@ShahidNShah HealthcareGuy.com
Data can change medical science
The old way
Identify problem
Ask questions
Collect data
Answer questions
The new way
Identify data
Generate questions
Mine data
Answer questions
Less Med Expertise
Quicker hypotheses
Lower costs
Fail Fast
Medical Expertise
Time Consuming
High costs
OldNew
@ShahidNShah
www.netspective.com 13
HealthcareGuy.com
Opportunities in Accountable Tech
Cost per patient per procedure / treatment going up but without
ability to explain why
Cost for same procedure /
treatment plan highly variable across localities
Unable to compare drug efficacy across
patient populations
Unable to compare health
treatment effectiveness
across patients
Variability in fees and treatments promotes fraud
Lack of visibility of entire patient record causes medical errors
What customers want and what we create are not aligned
www.netspective.com 14
@ShahidNShah HealthcareGuy.com
Opportunities in health information networks
www.netspective.com 15
@ShahidNShah HealthcareGuy.com
Opportunities in care facility decentralization
Source: Jason Hwang, Innosight, via Jeff Selberg of IHI
www.netspective.com 16
@ShahidNShah HealthcareGuy.com
Opportunities in consumer payment changes
www.netspective.com 17
@ShahidNShah HealthcareGuy.com
Opportunities in new approaches to care
General Wellness
Specific Prevention
Self Service Physiologics
Self Service Monitoring
Self Service Diagnostics
Care Team Monitoring
Care Team Diagnostics
Healthcare Professional Monitoring
Healthcare Professional Diagnostics
Hospital Monitoring
Hospital Diagnostics
www.netspective.com 18
@ShahidNShah HealthcareGuy.com
Opportunities in externalization of Digital Health
PatientsExternal HCPs
HCP and Staff
Evaluators
Internal business
users and HCPs
IT Personn
el
Unsophisticated and less agile focus
Sophisticated and more agile focus
Inside-out focus Outside-in focus
HCPs = healthcare providers
www.netspective.com 19
@ShahidNShah HealthcareGuy.com
Needed: Consumerization of physiologics….
www.netspective.com 20
@ShahidNShah HealthcareGuy.com
Needed: Consumerization of labs / genesLabs on chips Personal Genomics
www.netspective.com 21
@ShahidNShah HealthcareGuy.com
Needed: Consumerization of monitoring
www.netspective.com 22
@ShahidNShah HealthcareGuy.com
Needed: diagnostic quality mHealth
www.netspective.com 23
@ShahidNShah HealthcareGuy.com
Needed: predictive analytics
www.netspective.com 24
@ShahidNShah HealthcareGuy.com
Needed: care team integration
HEALTHCARE PROVIDER
PATIENT/ CONSUME
R
HOSPITALFAMILY
CAREGIVER
ALTERNATE SITE OF CARE
Care Team
CALL CENTERS AND REMOTE SUPPORT
www.netspective.com 25
@ShahidNShah HealthcareGuy.com
Needed: automated diagnostics
Thank You
Visit http://www.netspective.com http://www.healthcareguy.comE-mail [email protected] @ShahidNShahCall 202-713-5409