Karen Taylor, Deloitte. Presentation at Health-Tech Innovation LAB Connected Health Conference...

Connected HealthHow technology is transforming patient care today and tomorrow

Karen Taylor

18 September 2015

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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/

http://www.deloitte.co.uk/centreforhealthsolutions

http://blogs.deloitte.co.uk/health/

Centre for Health Solutions3

How technology and cross industry working are transforming patient care today and tomorrow

Healthcare and Life science predictions 2020

Disrupting traditional healthcare and life science industries

How digital technology is transforming patient care today

Our industry is changing quickly – requiring a bold response that is often difficult to implement

What we know today and estimate about tomorrow

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2. 2015 Global Life Sciences Sector Outlook, Deloitte DTTL, 20143. Informa Plc Market Line Extracted 181014

5

Patients becoming more like consumers Informed and demanding patients are now partners in their own healthcare

• 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

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Healthcare delivery systems in 2020

• 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 models2020 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

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Wearables and mHealth applications in 2020

• 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

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In last 5 years healthcare systems in most countries have come under increasing pressure in terms of costs, funding, demand, supply, access and expectations

Escalating healthcare costs

Increasing carecomplexity

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

10Deloitte Global Mobile Consumer Survey, 2015

Source: UK edition, Deloitte Global Mobile Consumer Survey, May-Jun 2013 & May - Jun 2014Base: 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

Laptops Smartphone Tablet eReader Smart watches Fitness bands0%

20%40%60%80%

100%76%

62%

36% 29%

1%

75% 70%50%

31%

1% 2%

79% 76%60%

31%

2% 4%

2013 2014 2015

Pene

tratio

n ra

te

Laptops Smartphone Tablet eReader Smart watches Fitness Band0%

5%

10%

15%

20%

25%

30%

16%

23%

14%

8%

3%

15%

25%

19%

5% 4% 5%

16%

26%

19%

4%6% 6%

Pene

tratio

n ra

te

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?

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Bio-sensing wearablesFunctionality is expanding and use is becoming increasingly unobtrusive

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

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Tackling the barriers to the uptake of digital healthIn 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 2014

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

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Connected patients: shifting the balance of powerDigital technology empowers people to understand and manage their own health and the health of others

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

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Connected providers: transforming ways of workingGP 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

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 providersAiredale 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

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Connected providers: transforming home and community care

Supporting prevention, early intervention & early discharge from hospital

Supporting care at home – COPD

Used by 150 patients40% 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/ day60% 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

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Future developments in digital healthThe rise of TEC is enabling new entrants to better understand customer requirements and enter the provider market as stand-alone providers or partners

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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Karen Taylor, Deloitte. Presentation at Health-Tech Innovation LAB Connected Health Conference...

Healthcare

Transcript of Karen Taylor, Deloitte. Presentation at Health-Tech Innovation LAB Connected Health Conference...