The future of healthcare

A modern industrial revolution:

Connected Health as a driver of improved outcomes and economic growth

George MacGinnis

8th May 2013

© PA Knowledge Limited 2012.

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Growing old – More and more

people live to be 100

According to a British survey we have more

chances of reaching the biblical age of a hundred

than we did many years ago. The survey says that

a girl born in the U.K. today has a 30% chance of

becoming a centenarian and a boy has a 25%

chance of reaching this age.

Superbugs threaten to render antibiotics useless, warns WHO

There is a global crisis in antibiotics caused by

rapidly evolving resistance among microbes

responsible for common infections that threaten to

turn them into untreatable diseases

Margaret Chan, Director General of the WHO. 16 Mar 2012

Rates of Chronic Disease Expected to Rise Sharply A new report released by the Partnership to Fight Chronic

Disease, “…expected to continue to rise due to several

factors, including childhood obesity, poor lifestyle choice, and

lack of access or emphasis on preventative care, posing

significant problems for the U.S. healthcare system.

Diabetes: Most NHS costs wasteful, says Diabetic Medicine

The majority of NHS spending on diabetes is avoidable, says a report in the journal Diabetic Medicine. It suggests that 80% of the NHS's £9.8bn annual UK diabetes bill goes on the cost of

treating complications

BBC 25 April 2012

10 Top-Selling Drugs

Coming Off Patent

Ten of the world's top-selling prescription drugs

are about to get cheaper.

Over the next 17 months, the patents on

brand-name medications like the cholesterol-

lowering drug Lipitor and the blood thinner

Plavix will expire, opening the door for generic

versions that could cost up to 80 percent less.

ABC News July 25, 2011

© PA Knowledge Limited 2012. CONFIDENTIAL - between PA and J&J Ortho Clinical Diagnostics

Many people experience unwanted or avoidable care encounters• High costs and poor accessibility may mean putting off seeking care when

early intervention would be better• Many chronic patients are poorly served by care in hospitals – yet for many

that is where they end up• Systems often reward activity regardless of the overall outcomes

Infectious diseases1900-1950

Episodic care1950-2000

Personalised care 2000-

Health needs are evolving yet services have been slow to catch up


Telehealth: Catholic Health Initiatives

Please find me a physician more prepared to move with the times”Quote from an 85 year old patient whose

rheumatology physician refused to do a

teleConsult with her at Thayer County

Critical Access Hospital, Nebraska

requiring her to make the 2.5 hrs.

journey into St Elizabeth’s Medical

Center in Lincoln, Nebraska


PA sees 3 key themes emerging that are critical for this change:

• Creating and deploying stratified medicine

• Challenging established structures through commercial model innovation

• Including greater patient insight

• Changing reimbursement to reward population health

Delivery of more effective patient outcomes based on the integration of new technologies, business models and partnerships

Patient Centric Healthcare

• Removing cost and improved access to new models of healthcare delivery.

• Patients becoming active partners in care management

• Accessing new data and information

• Developing eHR, medical devices, virtual health and wider technical infrastructure

Effective use of connected technologies is enabling a shift from

curative/reactive healthcare to prevention and health management

Intelligent Health

Delivering health reforms to create healthier communities and

maintain universal access

Healthcare Reforms

• Keeping universal access affordable

• Re-organising health services around people’s needs and expectations

• Securing healthier communities


Attention focuses on coordinated care to improve quality and outcomes

The Patient

A Patient Centric perspective provides the driver for growth in the connected health market

Acute care provided in more

specialised hospitals

Where possible, care moves

closer to the patient

Improved self care and prevention to stem rising demand


‘Paying for cures’ means understanding the impact of each intervention on the individual level

Improving outcomes involves:

• Better targeting through personalised medicine and care packages

• Maximising efficacy by understanding adherence and effect for each patient

• Ensuring best clinical practice is applied

Information drives performance and opens the way for innovative new approaches

http://images.google.com/imgres?imgurl=http://www.medisave.co.uk/images/m5i.jpg&imgrefurl=http://www.medisave.co.uk/popup_image.php/pID/269&h=178&w=210&sz=6&tbnid=i8cxZ-zXNQwJ:&tbnh=84&tbnw=99&start=3&prev=/images?q=blood+pressure+monitor&svnum=100&hl=en&lr=lang_en&newwindow=1&safe=off


Intelligent health introduces a new dynamic in fielding solutions

New paradigms challenge the traditional drug / medical device innovation model:

• Technology innovation outpaces ability to gather traditional forms of evidence

• Economics governed by service implementation rather than product design

• Impact and risk is harder to assess in ‘preventative’ care

Contrasting environments are reflected in two very different regulatory regimes which now have to work together

Patient Centric

Safety First

Demonstrate efficacy

‘at least, do no harm’

Market Centric

Maximize consumer value

Foster competition

‘Just enough’

© PA Knowledge Limited 2012. PPT presentation template V1-12.ppt

Developing new Connected Health markets


The pace of innovation is moderated by the complexity involved

There is a significant drive for innovation:

• Services that improve the efficiency of existing provision have an immediate case

• Services that change the location of existing provision involve changing professional working practices, requiring investment in facilities and training.

• Services that look to change the process of healthcare to achieve improved outcomes are likely to be disruptive to existing reimbursement, organizational and professional structures - and require significant reforms

http://www.orthodoxherald.com/wp-content/uploads/parumala-cancer-centre-small.jpg


Reform is driving providers along a staged move to new models

Maximizing efficiency of current operations

Managing key business risks

Optimising population health outcomes

• Improving referral rates

• Maximising clinical throughput

• Reducing length of stay

• Reducing re-admissions

• Improving adherence

• Patient-centric care package

• Evidence based pathways

• Payment for outcomes

• Accountable care

The challenge is developing capability ahead of the reforms

* HAI = Healthcare Acquired Infections


Exploiting the dynamics of different markets

There are opportunities to build business arising from:

• Focusing on unregulated markets such as wellness

• Identifying where the user is the payer and is able to pay

• Looking at sectors that don’t need the same burden of proof

• Targeting areas with strong clinical leadership

• Building volume through consumerisation of medical offerings

This challenges conventional paradigms for the spread of innovation – with the potential for reverse innovation spreading from emerging


Regional differences exist, creating opportunities for new offerings

Regional differences in need, reimbursement, regulation and infrastructure offer opportunities to incubate a business while waiting for reforms elsewhere

US: Highly regulated. Hospitals have significant power. Policy is moving towards entitlement reform and providers looking to get ready for the future while maintaining revenues.

Gulf: Emerging market for health infrastructure/ regulation. Mix of social provision & powerful consumer base including non-nationals. Growing markets in medical tourism.

India: Relatively few regulatory restrictions: Strong growth of mobile technologies. High appetite for innovation. Powerful consumer base developing while also having pressing issues of access to basic care.

Africa: Focus mainly on basic health needs: infectious diseases, childbirth and nutrition. Poor access to care, much of which is donor funded. Little regulation and significant supply chain issues.

EU: Highly regulated. Public policy led health with significant variations. Some countries with a significant eHealth infrastructure.


Competitors or collaborators: New entrants challenge current notions of the market

Healthcare reform is attracting the attention of global players as connected health drives convergence between industries within healthcare:

• Pharma – looking to find a new ‘value add’

• Mobile – opening up the last untapped enterprise market with capabilities in meeting consumer demand

• Insurance – looking to move to new business models.

• Media/Entertainment – bringing the customer revolution to healthcare

• Utilities – moving to offer services enabled by smart metering

Who will be the winners and losers in the battle for a consumer health brand?


Closing thoughts

Changes in healthcare are challenging established concepts of who the customer is and what they see as a value proposition:

• Governments and payers are seeking to reward positive outcomes, shifting risk onto healthcare providers and their suppliers

• The customer is changing and bringing more complex buying behaviours

• Solutions, rather than products, will be the key to defining value propositions

• Collaborations involving innovative commercial models will become an engine for growth

• Early growth markets in connected health may not be the traditional innovators

• The UK and Ireland have a unique position as early adopters whose experience is shaping thinking globally

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The future of healthcare

Health & Medicine

Transcript of The future of healthcare