The Uberfication of Canadian Healthcare
Vincent Ng Health Business Consulting Senior Manager, TELUS Health June 7, 2016
Today is not about “Uber for healthcare”
2
What do these
disruptive companies
have in common?
It’s about the “disruption” of healthcare
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Unbundle & Commodify Integrate & Value Capture
Production Subscriptions &
Distribution Viewers
Business models disrupt, not technologies
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Source: Ben Thompson (https://stratechery.com/2015/netflix-and-the-conservation-of-attractive-profits)
Bundled Unbundled
Taxis Cabs Dispatch Hailing & Payment Riders
Unbundle & Commodify Integrate & Value Capture
Dispatch Hailing & Payment Riders
Networks Content Production Subscriptions &
Distribution Viewers
Cars
Content
Uber lowers transaction and distribution costs
…to optimize the utilization of an underused resource
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Passenger Driver
Convenience
Safety
Trust
Healthcare
This is a common path to disruption
Rooms
Servers
Identity
Constrained Resource
Private Homes
Amazon’s Servers
Facebook Profile
Under-utilized Resource
6
HC Providers’
Attention
Patients and
Caregivers’ Attention
Societal trends exacerbating the constraint
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“On
Demand”
Everything on demand is expected
Internet &
Mobile
Health vs.
Healthcare
Healthcare is just one determinant of health
People/companies will pay for wellness
Behaviours and near-medical grade biometrics
can be tracked 24/7/365
High-quality, “free” video is always available
Uberfied healthcare unbundles Attention
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1. Consumers (i.e. not just patients) are the end users
2. Enabled by smartphones, suppliers of Attention are unbundled
and expanded to alleviate the Attention constraint
3. Consumers are triaged for the right type and supplier of Attention
Bundled Unbundled
Current Attention HC Pros Access Patients
Unbundle Integrate & Value Capture
“Uberfied” HC Pros Access Consumers
Attention
Doctors’ medical expertise is essential, and
cannot be replaced, but is insufficient
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Different suppliers of Attention are appropriate for
different situations Doctors
Allied Health Professionals
Coaches, Caregivers, Peers
Self (apps, wearables)
Different ways of delivering Attention are appropriate
for different interventions Video vs. in-person
Synchronous vs. asynchronous (text, email)
Person vs. algorithm (checklist, chatbot)
Integrate Access to triage consumers
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Triage consumer for the appropriate type(s) of
Attention with the appropriate supplier(s)
Deploy personalized Chronic Disease
Management or Wellness programs at scale
Traditional business functions of CDM can be
unbundled and commodified
Enable self-booking of appointments/interactions
or self-enrollment into programs
…and to better capture consumer data to
improve experience
11
Consumers (i.e. not yet “patients”) are the users
Individual habits/data tracked on smartphones
can be aggregated to provide predictive power
and personalized recommendations
Technology and support enables consumers to
also be suppliers of Attention (self-management)
But does
“Uberfied”
healthcare
actually exist?
5 “Rights” of Uberfied healthcare
1. Right intervention, by the
2. Right person, for the
3. Right problem, through the
4. Right medium, at the
5. Right time.
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Uberfied future is here, just unevenly
distributed
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1. Ginger.io
2. Sherpaa
3. Propeller Health
4. Omada Health
5. Chrono Therapeutics
Common Themes
1. Target specific patient populations for intensive management
2. Smartphone-enabled
3. Different suppliers of Attention for different situations
4. “B2B” strategy (plan sponsors)
5. Leverage “Pay for Value” movement
Ginger.io provides personalized mental health care through a smartphone app
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Source: www.ginger.io
1. Assigns a coach to talk (chat or
phone) and create a personalized
care plan
2. Provides self-care tools 24/7
3. Includes a licenced therapist for video
visits
4. Sends basic information from
smartphone (e.g. movement, calling,
texting frequency) to enable check-ins
5. Shares information with a physician to
support informed prescribing
Sherpaa is a U.S. online physician practice for large employers
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Source: www.sherpaa.com; https://medium.com/tincture/a-311-for-healthcare-is-the-future-fee8934ada34
1. Access first begins online – “Health 311
Operators” use algorithm to route the case
to the most appropriate health professional
2. Three types of health pros in the practice:
Virtualists, IRLists, Care Coordinators
3. Virtualists, IRLists diagnose & make care
plans; Care Coordinators execute and
support
4. Patients always routed to the same team to
maintain continuity
5. Communications 95% asynchronous, 5%
synchronous
Final Words
1. The smartphone era is driving the demand for Attention in
healthcare, a constrained resource
2. Uberfication unbundles and expands the suppliers of Attention to
relieve the constraint
3. Early examples of Uberfied healthcare exist – they focus on
Chronic Disease Management
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Questions
More Examples of Uberfied Healthcare
Delivery
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Propeller aims to improve chronic respiratory disease management
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Source: www.propellerhealth.com
1. Users attach a sensor to the top of their
inhalers and then use inhalers as usual
2. Sensor records when inhaler is used to
monitor symptom triggers, provide
adherence reminders
3. Clinical studies demonstrate Propeller
users have more than 2X higher
adherence rates, better asthma control
4. U.S. plan sponsors and healthcare
providers have deployed Propeller
programs
Omada’s “Prevent” is a CDC-recognized Diabetes Program designed for quick launch
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Source: www.omadahealth.com
1. Identifies plan members most at risk and
launches campaign to sign them into the
program
2. Participants receive wireless digital scales,
pedometers, wearables directly
3. Each participant is paired with a personal
health coach and online peer group for
feedback, support and accountability
4. Participants track food, activity and weight
and receive weekly lessons
5. 80% of participants complete the program
Chrono Therapeutics provides personalized behaviour support to help smoking cessation
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Source: www.chronothera.com
1. Users provided with a wearable pod that
adheres to the skin (like a nicotine patch)
2. The pod times the release of nicotine to
when smokers have strongest cravings
3. The pod has embedded sensors to
monitor when, where, how often nicotine
is delivered and provides insights back to
the user and to a coaching app
4. The coaching app uses the data to tailor
the content and timing of coaching advice
to the patient