convergence of medical devices, telehealth, and edisease management presented at saint ieee workshop...
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Convergence of Medical Devices, Telehealth, and eDisease Management
Presented at
SAINT IEEE Workshop on Global Telehealth/Telemedicine & the Internet
San Diego, CA January 9, 2001Vince Kuraitis JD, MBA
Principal, Better Health Technologieswww.bhtinfo.com (208) 395-1197
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Clicks and Bricks
InternetTechnology
Services/Bricks
500 100
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Presentation Overview
• Background and Terminology
• Emergence of Remote Monitoring
• Strategy and Business Model Design
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Background and Terminology
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Better Health Technologies
• Strategy, business models, partnerships• Disease/care management and e-health • Consulting/Business Development
• E-Care Management News– Complimentary e-newsletter– 2,500 subscribers in 27 countries worldwide– www.bhtinfo.com/pastissues.htm
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Recent BHT Clients• Pre-IPO Companies
– Life Navigator (remote monitoring connectivity and health intermediary services)– DiabetesManager.com (Internet diabetes DM)– CogniMed (highest cost/risk patient management software)– Caresoft (consumer focused DM)– Benchmark Oncology (oncology DM)– SOS Wireless (cellular phone technology)– Click4Care (Internet DM)
• Established organizations– Medtronic -- Neurological DM (medical devices/chronic disease solutions) -- Cardiac Rhythm Patient Management– Disease Management Association of America (trade association)– PCS Health Systems (PBM)– Varian Medical Systems (oncology equipment & systems)– VRI (behavioral health care management services)– Washoe Health System (integrated delivery system)– S2 Systems (medical transaction processing software)– CorpHealth (MBHO)– Physician IPA– Centocor (biopharma)
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5 %
4 5 %
5 0 % 3%
37%
60%
% of population % of claims
Distribution of Health Care Claims In A Population
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Cost Per ClaimantPer Yr.
0 10 20 30 40 50 60 70 80 90 100
$1,000
$0
$2,000
$3,000
$4,000
$50,000
$75,000
$100,000
Claimant Percentile
Distribution of Health Care Costs: Conceptualizing Population Health
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$$ Per ClaimantPer Yr.
0 10 20 30 40 50 60 70 80 90 100
$1,000
$0
$2,000
$3,000
$4,000
$50,000
$75,000
$100,000
Disease Management Services
2 Differing Approaches Emerging
eDM/eCare Management
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Differing Value Propositions
DM Services• Care Coordinator = 3rd Party• Cost containment• Save $$ short term on behalf
of health plan• Prevent unnecessary
hospitalizations and ER visits• Done “to” the patient• 5-10 top diseases• Local/regional focus
eDM/eCare Management• Care Coordinator = patient• Health care consumerism• Save $$ long term on behalf
of the patient• Optimize patient health status
• Done “by” the patient• 100+ conditions/diseases• Not geographically bound
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Emergence of Remote Monitoring
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• A Portable Cure: PDAs for drug research and prescriptions are getting attention
• Enhancing Patient Care: In-hospital wireless monitoring
• Freedom From Hospitals: Remote monitoring of chronic illnesses
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Types of Remote Patient Data
• Biometric– list
• Patient satisfaction• Subjective symptoms
– Pain– Fever– Shortness of breath– Etc.
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Characteristics of Remote Monitoring (RM) Data
• Real time• Multiple sources
– Across multiple devices– From the patient
• Subjective• Patient satisfaction• Passive (gathered by the device)
• Integrated with other data across multiple providers, e.g., EMR, lab, pharm, claims
• Longitudinal• Data warehouse, data mining opportunity
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Timing of Biometric Data
• Quarter-to-Quarter (q/q)• Month-to-Month (m/m)• Week-to-week (w/w)• Day-to-day (d/d)• Hour-to-hour (h/h)• Minute-to-minute (m/m)• Second-to-second (s/s)
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4 Cs of E-Health
Connectivity
Content Commerce
Care
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A Crude Map of the New World: eHealth & Care Management Framework
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A Crude Map of the New World: eHealth & Care Management Framework
PersonalOnlineMedical Record
eDisease Management
ElectronicMedical Record
DiseaseManagementOutsourcingServices Telemedicine
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Strategy and Business Model Design
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© www.bhtinfo.com11/21/00 Life Navigator, Inc. 4
Fragmented RM Market
Etc.
Providers
Employers
Consumers
DM/eHealth Vendors
HealthPlans
TelemedCompanies
MedicalDevice
Companies
eHealth
Internet Appliance
Wireless
Telecom
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LNI Value Proposition
Etc.
Providers
Employers
Consumers
DM/eHealth Vendors
HealthPlans
TelemedCompanies
eHealth
Internet Appliance
Wireless
Telecom
MedicalDevice
Companies
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Multiple Sources of Revenue
• Sponsorship Fees• Advertising• Health Data Fees &
Infomediary Sponsorships• Marketing & Product Launch
Fees• Pharmaceutical
Sponsorships• Clinical Trial Recruitment• Electronic Prescriptions• Pharmacy Sponsorships• Delivery of Health Care
• Directory Advertising (provider and non-provider)
• Consumer Advice and Research Services
• Online Disease Monitoring and Disease Management Services
• Disease Testing Services• 2nd and 3rd Opinions• E-mail Reminder Notices• Health Claim Assistance• Direct
Source: Business model for DiseasesRx.comhttp://corporate-partnering.com/names/clicks-to-bricks-business-model.htm
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InternetTechnology
Services/Bricks
500 100
Marginal Cost Per Unit of Service
Scaleability
Valuation
Operating Model
IT
Connectivity
Value Proposition
Geography
Close to zero High
Hi Lo
8-15 x Revenues 2-3 x Revenues (valid in 3/2000, not today!)
Web enabled tools Services
ASP Client/Server
Internet Fax, phone, mail
Ride the wave Identify leverage points
of health consumerism of behavior change
Ubiquitous Regional markets
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Key Questions to Consider
• Where are you today?• Where are you headed?
– Direction?– Speed?– Momentum?
• What is the optimal mix of bricks and clicks?• Are any extreme business models viable?• Where will contemplated capital investments move you?• Should you make or buy Internet technologies?
InternetTechnology
Services/Bricks
500 100
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