The Uberfication of Canadian Healthcare

Vincent Ng Health Business Consulting Senior Manager, TELUS Health June 7, 2016

Today is not about “Uber for healthcare”

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What do these

disruptive companies

have in common?

It’s about the “disruption” of healthcare

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Unbundle & Commodify Integrate & Value Capture

Production Subscriptions &

Distribution Viewers

Business models disrupt, not technologies

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Source: Ben Thompson (https://stratechery.com/2015/netflix-and-the-conservation-of-attractive-profits)

Bundled Unbundled

Taxis Cabs Dispatch Hailing & Payment Riders

Unbundle & Commodify Integrate & Value Capture

Dispatch Hailing & Payment Riders

Networks Content Production Subscriptions &

Distribution Viewers

Cars

Content

Uber lowers transaction and distribution costs

…to optimize the utilization of an underused resource

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Passenger Driver

Convenience

Safety

Trust

Healthcare

This is a common path to disruption

Rooms

Servers

Identity

Constrained Resource

Private Homes

Amazon’s Servers

Facebook Profile

Under-utilized Resource

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HC Providers’

Attention

Patients and

Caregivers’ Attention

Societal trends exacerbating the constraint

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“On

Demand”

Everything on demand is expected

Internet &

Mobile

Health vs.

Healthcare

Healthcare is just one determinant of health

People/companies will pay for wellness

Behaviours and near-medical grade biometrics

can be tracked 24/7/365

High-quality, “free” video is always available

Uberfied healthcare unbundles Attention

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1. Consumers (i.e. not just patients) are the end users

2. Enabled by smartphones, suppliers of Attention are unbundled

and expanded to alleviate the Attention constraint

3. Consumers are triaged for the right type and supplier of Attention

Bundled Unbundled

Current Attention HC Pros Access Patients

Unbundle Integrate & Value Capture

“Uberfied” HC Pros Access Consumers

Attention

Doctors’ medical expertise is essential, and

cannot be replaced, but is insufficient

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Different suppliers of Attention are appropriate for

different situations Doctors

Allied Health Professionals

Coaches, Caregivers, Peers

Self (apps, wearables)

Different ways of delivering Attention are appropriate

for different interventions Video vs. in-person

Synchronous vs. asynchronous (text, email)

Person vs. algorithm (checklist, chatbot)

Integrate Access to triage consumers

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Triage consumer for the appropriate type(s) of

Attention with the appropriate supplier(s)

Deploy personalized Chronic Disease

Management or Wellness programs at scale

Traditional business functions of CDM can be

unbundled and commodified

Enable self-booking of appointments/interactions

or self-enrollment into programs

…and to better capture consumer data to

improve experience

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Consumers (i.e. not yet “patients”) are the users

Individual habits/data tracked on smartphones

can be aggregated to provide predictive power

and personalized recommendations

Technology and support enables consumers to

also be suppliers of Attention (self-management)

But does

“Uberfied”

healthcare

actually exist?

5 “Rights” of Uberfied healthcare

1. Right intervention, by the

2. Right person, for the

3. Right problem, through the

4. Right medium, at the

5. Right time.

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Uberfied future is here, just unevenly

distributed

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1. Ginger.io

2. Sherpaa

3. Propeller Health

4. Omada Health

5. Chrono Therapeutics

Common Themes

1. Target specific patient populations for intensive management

2. Smartphone-enabled

3. Different suppliers of Attention for different situations

4. “B2B” strategy (plan sponsors)

5. Leverage “Pay for Value” movement

Ginger.io provides personalized mental health care through a smartphone app

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Source: www.ginger.io

1. Assigns a coach to talk (chat or

phone) and create a personalized

care plan

2. Provides self-care tools 24/7

3. Includes a licenced therapist for video

visits

4. Sends basic information from

smartphone (e.g. movement, calling,

texting frequency) to enable check-ins

5. Shares information with a physician to

support informed prescribing

Sherpaa is a U.S. online physician practice for large employers

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Source: www.sherpaa.com; https://medium.com/tincture/a-311-for-healthcare-is-the-future-fee8934ada34

1. Access first begins online – “Health 311

Operators” use algorithm to route the case

to the most appropriate health professional

2. Three types of health pros in the practice:

Virtualists, IRLists, Care Coordinators

3. Virtualists, IRLists diagnose & make care

plans; Care Coordinators execute and

support

4. Patients always routed to the same team to

maintain continuity

5. Communications 95% asynchronous, 5%

synchronous

Final Words

1. The smartphone era is driving the demand for Attention in

healthcare, a constrained resource

2. Uberfication unbundles and expands the suppliers of Attention to

relieve the constraint

3. Early examples of Uberfied healthcare exist – they focus on

Chronic Disease Management

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Questions

More Examples of Uberfied Healthcare

Delivery

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Propeller aims to improve chronic respiratory disease management

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Source: www.propellerhealth.com

1. Users attach a sensor to the top of their

inhalers and then use inhalers as usual

2. Sensor records when inhaler is used to

monitor symptom triggers, provide

adherence reminders

3. Clinical studies demonstrate Propeller

users have more than 2X higher

adherence rates, better asthma control

4. U.S. plan sponsors and healthcare

providers have deployed Propeller

programs

Omada’s “Prevent” is a CDC-recognized Diabetes Program designed for quick launch

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Source: www.omadahealth.com

1. Identifies plan members most at risk and

launches campaign to sign them into the

program

2. Participants receive wireless digital scales,

pedometers, wearables directly

3. Each participant is paired with a personal

health coach and online peer group for

feedback, support and accountability

4. Participants track food, activity and weight

and receive weekly lessons

5. 80% of participants complete the program

Chrono Therapeutics provides personalized behaviour support to help smoking cessation

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Source: www.chronothera.com

1. Users provided with a wearable pod that

adheres to the skin (like a nicotine patch)

2. The pod times the release of nicotine to

when smokers have strongest cravings

3. The pod has embedded sensors to

monitor when, where, how often nicotine

is delivered and provides insights back to

the user and to a coaching app

4. The coaching app uses the data to tailor

the content and timing of coaching advice

to the patient