Connect, Engage and Take Decisions

Opportunities and Challenges of Telemedicine Implementation

Lars Kalfhaus | Oslo, 03. November 2014

The Market …

Now is the time!(?)

The Telemedicine Promise & Challenges

The Market …

Telemedicine

eHealth

mHealth

mHealth = Telemedicine reloaded

Worldwide Market Size and Growth

research2guidance; March 2013

(US$ millions)

research2guidance; March 2013

Main Professional and non-Professional Target Groups

Market Potential by Therapeutic Area

research2guidance; March 2013

Commissioner Tonio Borg, 04 April 2014IDF, Diabetes Atlas 6th edition, 2013Research2guidance; March 2013Internal data

€0,4 bnmHealth Market

• mHealth market by

2017: €5,7 bn

• Preventable costsfrom better chronicdisease managementand efficiency gains:

> €140 bn (in 2013)

2013

Market Potential revisited

Now is the time!(?)

Josep Valor; IESELars Kalfhaus (for QS)

Fundamental Global Trends

Fundamental Global Trends - SOCIAL

SOCIAL

Fundamental Global TrendsFundamental Global Trends - SOCIAL

Fundamental Global Trends

250,000 members

Fundamental Global Trends - SOCIAL

Fundamental Global TrendsFundamental Global Trends - SOCIAL

Fundamental Global Trends

MOBILE

Fundamental Global Trends - MOBILE

Devices Regions

Fundamental Global Trends – BIG DATA

BIG DATA

Fundamental Global Trends – BIG DATA

Fundamental Global Trends – BIG DATA

Fundamental Global Trends – BIG DATA

US Department of LabourWipro Applying Thought

Fundamental Global Trends – QUANTIFIED SELF

QUANTIFIED SELF

Fundamental Global TrendsFundamental Global Trends – QUANTIFIED SELF

Fundamental Global TrendsFundamental Global Trends – QUANTIFIED SELF

With theinstalled base of medical devices

Today > 500.000data points

ThisWeek

> 3.500.000data points

… Norway

Nothing new for people with diabetes!

The Telemedicine Promise & Challenges

No Significant Improvements in Diabetes Management

Diabetes related drugs and medical

devices

320 OADs

10 GLPs

150 Insulins

> 200 Med. Dev.

… despite access to and availability of innovative pharmacological treatment options

Severe

Moderate

Mild

General Population

x2

x6

x24

Kaiser PermanentePlan de Chronicos Navarra

• Promote health living, prevention and good health

• Avoid disease progression and comorbidities

• Find adequate balance and tools for integrating self-care and professional care

Costs

Cost Burden as a Consequence of Suboptimal Diabetes Management

Value =Health outcome

Cost of delivering the outcome

• Prevention

• Early detection

• Quality of Life

• Prevention of complications

• Less hospitalization

• Slower disease progression

• Faster recovery

• Fewer recurrences ...

… the enabling technology platform

Michael Porter; Redesigning Helathcare

The Promise of Telemedicine

Better health is the goal, not more or less treatment

Access, equity, quality and cost effectiveness

Michael Porter; Redesigning HelathcareGlobal Observatory for eHealth Series – Volume 2; who.int

The Goal

Personalized Diabetes Management Cycle – Enabled by Technology

Ceriello et al; Diabetes as a case study of chronic disease management with a personalized approach: the role of a structured feedback loop; Diabetes Res Clin Pract. 2012 Oct

Key Considerations

… on the way to fully capture the Telemedicine promise

Business Telemedicine Legal

Organizational

Political

Business Considerations …

• Glocalization

• Interoperability

• Co-creation

• Integration

• Pricing and revenue models

New Business Models needed

PWC – EIU; mHealth

Organizational Considerations …

Organizational Considerations …

• Process and cultural change on how care is delivered

• Alignment of KPIs and incentive schemes for healthcare workers

• Development and acceptance of new study designs (beyond classical clinical evidence) to assess effectiveness

• Willingness to engage in co-creation and overcome classical barriers and role definitions between stakeholders

• Build confidence and trust between all stakeholders

• Coherent policy making that encourages competition centered around patient value over the entire care cycle

Political Considerations …

• Data protection, patient safety and privacy is a top priority

• Regulatory aspects: Medical Devices (classes) boundary between MD and non regulated products – interoperability between the two

… technology changes faster than legal and regulatory framework

Changes in contractual framework especially public sector procurement and tender legislation

Legal Considerations …

• The business potential of Telemedicine could be far greater than generally estimated

• It will require (and enable) fundamental restructuring of healthcare delivery

• Co-creating and collaboration between stakeholders will be key in a value-creation approach on what the technology should accomplish

To Sum Up …