Karen Taylor - Deloitte, slides from Connected Health 2015 Title: How Technology is Transforming Patient Care Today and Tomorrow

1. Connected
Health
How technology
is transforming
patient care
today and
tomorrow
Karen Taylor
18 September 2015

2. 2
Publications
Deloitte UK Centre for Health Solutions
Established November 2011 to generate insights and thought leadership based on the key
trends, challenges and encourage collaboration across the health value chain, connecting
the public and private sectors; health providers and purchasers; and consumers and
suppliers.
www.deloitte.co.uk/centreforhealthsolutions
blogs.deloitte.co.uk/health/

3. How technology and cross industry working are
transforming patient care today and tomorrow
Centre for Health Solutions3
Healthcare and Life science predictions 2020
Disrupting traditional healthcare and life science
industries
How digital technology is transforming patient care today

4. Our industry is changing quickly – requiring a bold response that is often
difficult to implement
What we know today and estimate about tomorrow
4
2. 2015 Global Life Sciences Sector Outlook, Deloitte DTTL, 2014
3. Informa Plc Market Line Extracted 181014

5. Patients becoming more like consumers
Informed and demanding patients are now partners in their own
healthcare
5
• Individuals are better informed about their own
genetic profile, their health status and risks.
• Informed consumers demand specific treatments
and the best services.
• Fully engaged with the ‘quantified self’ & prevention
agenda and use information and data to get best
treatments.
• Increasing number of people comfortable
consulting with a doctor or other HCP through
video or skype
• Consumer access to EHRs continues to
increase
• Increasing number of Government initiatives to
empower patients via digital - increase in on-
line patient communities PatientsLikeMe over
300,000 members/ 2,300 conditions.
• In UK still only small % people engaged
• UKs 100,000 genome project; growth in
precision medicine, 23andMe actually
advertising on UK TV
• Insurance companies/employers providing
incentives that reward good behaviour
• Clinicians are becoming more actively
engaged (Dr Now; Babylon)
2020 prediction
Today’s evidence

6. Healthcare delivery systems in 2020
6
• The home is where much of the standard TEC care
takes place.
• Specialist hospital treatment is reserved for trauma
and emergencies – electives largely day surgery.
• Many doctor–patient contacts are now virtual and
informed with real world evidence.
• New funding models including year of care, pooled
budgets capitation, etc.
• PatientKnowsBest ‘patients own their own
healthcare information and decide who they
share it with
• Increasing number of GPs using telephone
triage and eVisits - Kaiser number “e-visits”
has grown from 4.1 million in 2008 to
12 million in 2014.
• New provider models /entrants ( Walmart,
Apple, Google, Pharma)
The era of digitised medicine - new ideas drive new models
2020 prediction
• Home monitoring of patients with LTCs (COPD
and Diabetes leading way) – but also home
administration of insulin/ warfarin/ chemotherapy
• ACOs with vertically integrated care and care
pathways designed around the patient
overcoming silos - New models of care being
piloted (FYFV)
Today’s evidence

7. Wearables and mHealth applications in 2020
7
• Affordable wearables shape the quality of life
of the 2020 consumer, monitoring & managing
their condition.
• Seamless integration of information from
different devices provide comprehensive view
• New clinician/ patient partnerships based on
more equitable relationships, co-creation and a
focus on prevention.
• Venture funding of biosensors and wearable
technology continues to increase
significantly
• mHealth market revenue reached USD 2.4bn
in 2013 and is projected to grow to USD
26bn by the end of 2017
• Consumer engagement with their own data is
starting to improve medication adherence
and management of chronic disease
Measuring quality of life not just clinical indicators
• Proliferation in health apps and wearables (6%
adult population) with Apple watch latest
gimmick?
• Accuracy and interoperability between devices/
analysis tools still to be addressed
• 50% of people who download apps say its to
improve understanding of own health and well
being
2020 prediction
Today’s evidence

8. How technology and cross industry working are
transforming patient care today and tomorrow
Centre for Health Solutions8
Healthcare and Life science predictions 2020
Disrupting traditional healthcare and life science industries
How digital technology is transforming patient care today

9. In last 5 years healthcare systems in most countries have come under increasing
pressure in terms of costs, funding, demand, supply, access and expectations
9
Escalating
healthcare costs
Increasing care
complexity
A change in patient
Expectations
Evidence for use of
TEC services
• More expensive medicines
• Increasing demand for
diagnostics
• Increasing staff costs and
reducing supply
• Expanding funding deficit
• Aging population
• Rising prevalence of
multiple long term
conditions
• ‘high and increasing bed
occupancy and delayed
discharges
• Patients expect and
demand better quality
care - co-creation
• Support needs to be
patient-centred
• Desire to move to
outcome based/value
based funding
• Mobile and digitally enabled
technology increasingly
seen as a solution to
overcome todays challenges
improving:
‒ productivity
‒ efficiency
‒ cost ?
Why TEC is important and how it can help transform health and social care

10. Deloitte Global Mobile Consumer Survey, 2015
10
Source: UK edition, Deloitte Global Mobile Consumer Survey, May-Jun 2013 & May - Jun 2014
Base: All respondents, UK, 2015: 4,000, 2014: 4,000, 2013: 4,020
In 2015 Smartphone and tablet penetration in UK has continued to
increase, fitness bands and smart watches still very low penetration
N/A
76%
62%
36% 29%
1%
75% 70%
50%
31%
1% 2%
79% 76%
60%
31%
2% 4%
0%
50%
100%
Laptops Smartphone Tablet eReader Smart watches Fitness bands
Penetrationrate
2013 2014 2015
16%
23%
14%
8%
3%
15%
25%
19%
5% 4% 5%
16%
26%
19%
4%
6% 6%
0%
5%
10%
15%
20%
25%
30%
Laptops Smartphone Tablet eReader Smart watches Fitness Band
Penetrationrate
N/A
Q. Which of the following devices, if any, are you likely to buy in the next 12 months?
Q. Which, if any, of the following devices do you own or have ready access to?

11. Bio-sensing wearables
Functionality is expanding and use is becoming increasingly unobtrusive
11
Hearing device to boost
hearing
Heart rate monitor patch
Wrist band that monitors
heart beat, blood
pressure, calories burnt
Insole sensor that
measures weight
bearing, balance and
temperature
Contact lenses that
monitor glucose levels
Smart pills that monitor
medication intaking
behaviours and body
response

12. Tackling the barriers to the uptake of digital health
In 2014 the European commission launched a stakeholder consultation that
identified the following barriers to wider digital health adoption
Source EC consultation on mHealth Green paper 201412
Barriers to
mHealth
adoption
Lack of data protection, privacy, and security standards
Concerns over patient safety, quality and liability and
need for a clear legal and regulatory framework
Limited cost effectiveness evidence
Lack of interoperability and interoperability standards
Inadequate funding or reimbursement models
Cultural resistance from healthcare providers

13. Connected patients: shifting the balance of power
Digital technology empowers people to understand and manage their own health
and the health of others
13
75 per cent of the UK population are going online for health information
• This can be an important enabler of self-management for patients with chronic
disease and provide vital support for a growing number of carers
• It is helping shift healthcare delivery, from a traditional paternalistic approach,
towards shared ownership
Traditional paternalistic model of care Empowered patient sharing ownership
Empowered
Doctor
Empowered
Patient
Empowered
Doctor
Empowered
Patient
Health tech
• Patient completely reliant on HCP to provide
information, diagnosis and referral
• Difficult for patients to navigate within and between
health and social care
• Interventions usually in response to physical
evidence from patient
• Fragmented commissioning limited patient choice
or financial incentives to prescribe mHealth
• Patients informed whenever & wherever using their
interoperable electronic health record
• Co-creation of care packages, proactive prevention
and rapid access to services
• Technology enabled supported discharge/ self
management
• New business models for commissioning TEC at
scale and delivering choice

14. Connected providers: transforming ways of working
GP practices have led the way in the move from paper to digital record-keeping but
they are still slow to adopt technology in their interface with patients
14
GPs were the first to adopt:
However: The full potential for technology to support primary care is widely under-developed
• Digital record keeping
• Email consultations
• Telephone appointments
& triage
• Text messaging
How TEC is benefitting providers
Airedale NHS Foundation Trust:
• 210 care homes
• 113 in discussion
Hospital
• 35% reduction in Hospital
admissions, A&E use fell by
53%, Hospital bed days
decreased by 59%• Telehealth hub accessed by
over 6,000 residents

15. Connected providers: transforming home and
community care
Supporting prevention, early intervention & early discharge from hospital
15
Supporting care at home – COPD
Used by 150 patients
40% savings compared to ‘usual care’ = £100,000
26% decrease in GP appointments
70% decrease in hospital admissions
86% reduction in local out of hours services
Virgin Care – a mobile working solution for nurse
community visits
Patient face-time increased by 29%
nurses were seeing ~ 2 more patients/ day
60% reduction in paperwork time
Home care TEC initiatives can support
people with LTCs
TEC can support community care staff and
improve services to patients
Wireless blood
pressure,
weight & pulse
monitors
Data stored in
patients
‘HomePod’
Data transferred to
physician who
responds
accordingly
Hospital
GP
Patient
Community Nurse

16. How technology and cross industry working are
transforming patient care today and tomorrow
Centre for Health Solutions16
Healthcare and Life science predictions 2020
Disrupting traditional healthcare and life science
industries
How digital technology is transforming patient care today

17. Future developments in digital health
The rise of TEC is enabling new entrants to better understand customer
requirements and enter the provider market as stand-alone providers or partners
17
Solutions that store and
integrate health & fitness data
Examples include:
• Apple HealthKit
• Google Fit
• Microsoft health vault
• PatientsLikeMe
Scope to use this technology to
allow health providers to receive
and transmit data from health
check-ups
Apple’s launch of ResearchKit in
which users decide if they want
to participate in a clinical trial and
how their data is shared
Medical Device/ diagnostic
technology
• Google are partnering with
Novartis, to develop smart
contact lenses, which can
monitor glucose levels and
transmit real time information to
a doctor
• Google are also working on a
nanoparticle pill that could
identify cancers, heart attacks
and other diseases before they
become a problem.
• IBM Watson partnering with
Apple, Johnson & Johnson and
Medtronic among others to
develop a health platform.
Pharma using technology to
aid care delivery
• Pharma among the most
active mHealth app publisher;
but impact is low – 12
companies have published
over 700 apps to educate
/assist or monitor treatment
compliance
• Pharma still clarifying ‘best fit’
within the digital health space
• Opportunities include
 online repeat
prescriptions
 tele-monitoring
compliance
 live dose adjustment
based on real-time
monitoring
 early diagnosis – early
prescription

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For further information contact: kartaylor@deloitte.co.uk