20131125 e health_introductie

eHealth, changing the value proposition
in Healthcare

Transform to the power of digital

Personal introduction

Henk E. Bakker <henk.bakker@capgemini.com>
– Principal consultant for IT in Healthcare
• Capgemini Consulting Services NL

– Background
• Information Manager in several hospitals
• National Project leader of ICT program of the DBC project
• Project leader of National Electronic Medication Record project
• 25 years of industry experience
http://www.linkedin.com/pub/henk-bakker/4/280/95a
@henkebakker

Copyright © 2011 Capgemini Consulting. All rights reserved.

Agenda

Why eHealth?
Definition of eHealth and telemedicine
eHealth from a patient perspective
eHealth business models
Acceleration of eHealth implementations


3

Healthcare systems are under pressure
Chronic conditions increasingly pressurize health systems…


5

In particular the accessibility, affordability and quality of care are challenged due to….

Budget cuts
Improved ‘diagnostic’
technologies

Ageing
population /
growing
demand

Innovation in
medication
technology

Future of
Healthcare

Shrinking and
changing professional
workforce

Privacy,
Security and
Patient
Consent

Increasing
service
expectations
Private
competitors


The prevalence of chronic diseases is increasing rapidly: Some figures for the
Netherlands

Now

in 10-20 years

Diabetic

450.000

1.100.000

Alzheimer’s

120.000

500.000

Total Hip
Knee

It will become75.000
a
18.000
gigantic challenge !!!
24.000

55.000


In order to remain viable or to regain viability, hospitals must realise
efficiency gains of 15-20% over the next years and sustain themselves through growth

Care

Characteristics of Demand
Ageing
Demanding care consumer
New diseases
More demand caused by
better supply

Demand

How can we
close the gap?

Government
Response

Characteristics of Supply
Decreasing workforce
No increase of care capacity
Cost containment
2000

2010

Supply

2020

2030

Year

Challenge for the Hospitals


The challenge: a paradigm shift from cure to care (quality of life)

To Care

From Cure
Restore to health

Ability to do things independently

Restore to health

Prevention

Passive patient

Active patient

Expert

Counsellor

Intramural

Extramural

Institute

Process

Fragmentation

Integration

Monodisciplinary

Multidisciplinary

trade

Evidence based

Proactive
Reactive

eHealth is no other care, but it is designed differently

Tele Treatment
eConsult
Professional and Patiënt

Telemonitoring

Self Service
Patiënt

eConsult
Professional and Professional

Self diagnosis
and Prevention

Electronic Health Record and
Personal Health Record
Alerts and Signalling


eHealth is…..

Applications for the patient
Applications that support the interaction between patient and healthcare provider
(telemedicine)

– Applications for the healthcare professional itself
– Applications for the management of care continuity (information exchange of one
provider to another)
– Applications for the governance of care

eHealth is often seen as "the application of ICT in Healthcare”;
However eBusiness or eCommerce in Healthcare is more applicable

The potential of eHealth is enormous

Increases efficiency

Is economically
interesting

Supports early
warning

Can be
anonymous

eHealth contributes to:
Health benefits (quality and gained lifetime)
Increases
self-reliance

Social well being (longer in their own living environment, contact with peer
groups)

Increases the
accessibility

Efficiency of care and of processes (productivity)
Reducing labour issues

eHealth promotes :
Empowerment of clients (they take their own responsibility)
Opportunities for providers to meet customer needs

Is 24/7 available

Health benefits
(quality and gained
lifetime)

Contributes to the
quality of care

eHealth is about substitution of care provisioning, not about more healthcare

eHealth from a patient perspective
Realisation of the paradigm shift by eHealth

The Healthcare Provider - Patient Relationship shifts Fundamentally ....…

Patient Centric
Care

Patient – Value
determines
choices

Patient
Engagement
Healthcare
delivery costs
and efforts

Patient
Awareness
Efficiency, patient
satisfaction, and
quality are key
indicators for
success

Provider
Driven

Developing

Care Providers
embrace PatientValue and
stimulate Patient
Centric Care

Patients are
involved in
healthcare services
development and
take responsibility
for sustainable
solutions

Emerging

Near Maturity

Patient
manages
Personal
Health

Innovative

Maturity/time

…towards a service orientated model, developed for the patient, influenced by the patient and in
which the patient is actively engaged

Adoption of digital technologies has become mainstream and the pace is drastically
increasing …

2 billion people connected to the Internet
Broadband penetration is exceeding 85% from
2012 in developed countries(1)

CONNECTIVITY

Access shifting from the wide-open web to
semi-closed platforms: apps, social media…(2)

5 billion mobile phone subscribers in 2010

Accelerated pace of
adoption
Time needed for “mass adoption”
(50 million users)

Mobile Internet access globally outperforming
desktop access in 2014(3)

68 y.

Phone

50 y.

Mobile already being the main device to access
the Internet in developing countries

Radio

38 y.

TV

22 y.

PC

MOBILITY

Plane

14 y.

Internet

7 y.

iPod

3 y.

Facebook

2 y.

People reading 10MB and hearing 400MB
worth of material a day(4)

DATA ABUNDANCE

User-generated content exceeding the amount
contributed by professional organizations(5)
Sources: (1) In-stat, June 10, 2008
(2) The Web Is Dead. Long Live the Internet, Wired, 2010
(3) Morgan Stanley, 2010
(4) The Economist, November, 2006
(5) Data Center of China Internet, 2010


… which leads to customers becoming more involved in the organization and getting
more influence on clientservices
‘Once upon a time’
Inspiration Orientation

Domain of “customers”

Demand

In the digital world
Service

Business scope

Inspiration Orientation

Demand

Service

Customer involvement
Increased business influence


17

Interaction with the healthcare professional: the Digital Outpatient Clinic


Patient Empowerment

• Personal health record
• Doctor visit sheet (summary)

• Self-diagnosis/triage based on decision trees
• Provide comparative Health information
• Prevention and lifestyle
• Mutual contact (Forum)
• Monitoring (engage your own care team)
• Information on research programs

HealthVault Personal Health Record (PHR) platform

Prevention

Convenience
Services

Entertainment
Pleasure
Services

Social
Networks

HealthVault
Patient
Empowerment

Self
management

Personal Health Information is not safety-critical
The information is owned and managed by the patient and
can be made available for use in a professional healthcare
setting
Healthcare professionals have strict guidelines in the usage
of patient-originated data
A conscious process of incorporation of personal health
information in the formal safety-critical systems and medical
decision support is the responsibility of all professional
healthcare provider organisations

Privately stored
public information on
health, care and
wellness

Personal wellness
data from the
citizens and their
wellness providers

Personal health data
from the citizen and
their health care
providers

An EHR supports the medical doctor, the PHR empowers the citizen

Creating a Healthcare Information Ecosystem

Professional Care

Electronic
prescriptions

Medical record

ECG monitor
Education and screening

Personal record

Lifestyle

Disease management
Donor register

Step counter

Fitness monitor
Healthcare spending
Bloodsugar monitor

Weight scales

Heartrate monitor

Epilepsy diary

Blood pressure
monitor
Red is a tool

Green is a device

Personal Health

Information sharing


eHealth business models
What is the value proposition?

eHealth is patient centered, but the patients don’t pay us ….

Patient

Payer
(Insurance)

Healthcare
Provider


From eHealth proposition to a sustainable business model
Resources

Offer

Customer

Co-creation

Partner
Network

Core
Capabilities

Customer
Relationship

Value
Configuration

Value
Proposition

Distribution
Channels

Cost
Structure

PROFIT

Revenue
Streams

(Financiële) Prestaties
Financial Performance

Customer
Segment

Bron: Vrij naar Alexander Osterwalder, Business Model Generation

With a business model an organization describes, what value they create for their clients, how these
services reach and support their customers, which resources should be used, with which third party
should be partnered and finally, how they will make money

Acceleration of eHealth implementations

Introduction of eHealth is going (too) slow

Health insurers (the payers) have so far ehealth approached competitively and achieved
some successes
But the Health insurers encounter barriers to further upscaling:
– Termination of a project when the grant money runs out
– The lack of a clear business case
– Uncertainty about the effectiveness and efficiency of eHealth applications
– Insufficient standardization and interoperability of eHealth applications
– Lack of funding and a structural wide purchasing

Embedding eHealth in organizational processes and changing the daily practice of healthcare
professionals appear to be the most important critical success factors

Two dimensions spell out four different types of digital maturity

•

•

BEGINNERS

Fashionista have implemented or experimented with many

DIGIRATI

Digital Intensity

FASHIONISTAS

Beginners

do very little with advanced digital capabilities,
although they may be mature with more traditional
applications such as ERP or electronic commerce. Although
companies may be Beginners by choice, more often than not
they are in this quadrant by accident.

sexy digital applications. Some of these initiatives may create
value, but many do not. While they may look good together,
they are not implemented with the vision of gaining synergies
among the items.

CONSERVATIVES
•

Conservatives

•

Digirati

Transformation Management Intensity

favor prudence over innovation. They
understand the need for a strong unifying vision as well as for
governance and corporate culture to ensure investments are
managed well. However, they are typically skeptical of the
value of new digital trends, sometimes to their detriment.

truly understand how to drive value with digital
transformation. They combine a transformative vision, careful
governance and engagement, with sufficient investment in
new opportunities.


Digital Leaders show common patterns: the Digital DNA

Focus
Investments on
where they
choose to Excel
Digitally

Invest 100% in
transformation
management

Digital
Leaders
Combine Digital
Capabilities to
Exploit Synergies

Use Digital
Technologies to
Transform their
Business Models


Our two-year research program with MIT provides some useful pointers for successfully
executing a digital transformation
Conducting a digital (eHealth) transformation requires taking action in four key areas:
framing, investing, engaging, and sustaining.

Sustain the Transformation

Frame the Digital Challenge

• Build Capabilities
• Measure & Monitor

Sustain Frame

• Understand the impact
• Assess Digital Maturity
• Develop & Align around a
Vision

Engage Focus
Engage the Organization
• Signal and Mobilize
• Govern across silos
• Evolve Culture/ adapt Work
Practices

Focus Investments
• Invest in Digitally-Enabled
Initiatives
• Adapt your Business Model


We discovered that many common perceptions about digital transformation were
actually myths, which can lead executives to make unfortunate and costly decisions
“Many common
perceptions about digital
transformation are
actually myths
Fortunately, our global
survey of nearly 400 large
firms, supplemented by
157 in-depth interviews
with senior executives in
more than 50 large
companies, provides factbased answers”

Myth

Reality

Digital is primarily about the customer
experience

Huge opportunities exist also in efficiency,
productivity & employee leverage

Digital primarily matters only to
technology or B2C companies

Opportunities exist in all industries with
no exceptions

Let 1000 flowers bloom; bottom-up
activity is the right way to change

Digital transformation must be led form
the top

If we do enough digital initiatives, we will
get there

The how of transformation is more
important for driving overall performance

Digital transformation will happen despite
our IT

Business/IT relationships are key, and in
many companies they must be improved

Digital transformation approach is
different for every industry and company

Digital Leaders exhibit a common DNA

In our industry we can wait and see how
digital develops

There are digital leaders outperforming
their peers in every industry today


Critical Success Factors for eHealth up scaling

eHealth is an issue for board members:
It is about organizational strategy, not IT.
The perception of the professionals:
eHealth should be given a place in the “hearts” and “minds” of healthcare professionals
Funding:
From projectfunding, subsidies to structurally embedded in the healthcare funding system
Business as Usual:
Application of eHealth should be part of the (development of) regular daily care
Future proof:
“Is Cloud technology a Game Change? Business says Yes; IT says No!”
(Andy Mulholland, Capgemini CTO)

The acceptance of digital services in the private sector in most EU countries makes it likely that
many other basic conditions for up scaling of eHealth are properly fulfilled

20131125 e health_introductie

Recomendados

Recomendados

Más contenido relacionado

La actualidad más candente

La actualidad más candente (20)

Similar a 20131125 e health_introductie

Similar a 20131125 e health_introductie (20)

Último

Último (20)

20131125 e health_introductie