geneva, switzerland, 26-27 april 2012 continua health alliance beyond the four walls of traditional...
TRANSCRIPT
Geneva, Switzerland, 26-27 April 2012
Continua Health AllianceBeyond the Four Walls of Traditional
Healthcare
Charles Parker, Executive Director, Continua Health Alliance
Joint ITU-WHO Workshop on e-Health Standards and Interoperability
(Geneva, Switzerland, 26-27 April 2012)
Geneva, Switzerland, 26-27 April 2012 2
Continua Health Alliance
Continua is a not-for-profit (U.S. - 501c6) association focused on the development of interoperability standards for personal connected health devices. Continua also works as a trade association to enable adoption and knowledge sharing within providers, policy/regulatory bodies, payers, vendors and consumers.
Continua was founded in June 2006Main location in Portland, OR with offices in Austin, TX , Brussels and TokyoCurrently, Continua has 240 member organizations
Main results to date:Involvement in EC-funded and International
projects
Smart Personal Health 2010/11: Interoperability recommendationsRenewing Health large scale pilot 2010-13:Telemedicine RCTs in nine EU regionseHealth Governance Initiative 2011-14:coordinates eHealth in EU starting with common approach to electronic identification Japanese Government – requirement for use in Sendai Earthquake refugee campsUS Veterans Program – requested requirement for new vendor procurement
Geneva, Switzerland, 26-27 April 2012 3
Future activities
Momentum thematic network 2012-14:Developing a blueprint for deploying telemedicine in regular healthcareeHealth Innovation 2011-1014:Developing roadmap for integrated and interoperable eHealth services Advisory roles in other large scale pilots for integrated care and telemedicine (2013-?)Participation in thematic network to provide a technological base for large-scale deployment of innovative services (2013-?)Leadership roles in US led Health Information ExchangeWork with GSMA on deploying as a standard for Mobile Operators internationally
Geneva, Switzerland, 26-27 April 2012 4
Challenges, lessons learned
Long lead times for initial development of Guidelines to productsInteroperable devices often not available on local marketsPrice often primary driver of eHealth procurementLegal uncertainty for procurers mandating standards complianceReimbursement issues with providersUncertain regulatory models
Geneva, Switzerland, 26-27 April 2012 5
Contact details for further info
Charles Parker, [email protected] to:[email protected] Web Address
www.continuaalliance.org
Geneva, Switzerland, 26-27 April 2012 6
[Optional]Additional slides
Geneva, Switzerland, 26-27 April 2012 7
Executive Summary
In this new era of changing healthcare models and the potential for governments to further institute reimbursement change, where are the new opportunities? How do we reach new consumers and engage them?
An opportunity exists with personal connected health. Continua Health Alliance is a not-for-profit (501c6) association focused on the development of interoperability standards for personal connected health devices. Continua also works as a trade association to enable adoption and knowledge sharing within providers, policy/regulatory bodies, payers, vendors and consumers. The discussion will cover the questions of new business models, workflow changes, consumer engagement models, business partner opportunities and new revenue streams.
8
About Continua Health Alliance:
Continua Health Alliance is an international not-for-profit industry organization dedicated to establishing guidelines for combining and applying existing standards to personal connected health products and services. Continua makes a transition from the personal connected health marketplace to a marketplace of interoperable devices that facilitate better care, empower consumers, improve outcomes and lower overall healthcare costs possible. With more than 240 member companies around the world, Continua is comprised of technology, medical device and healthcare industry leaders as well as service providers dedicated to making personal connected health a reality. .
9
Beyond the Four Walls of Traditional Healthcare
Today
Current rates of adoption are low in the home space – less
than 7%
Primary use of the technology is limited to Post-acute
recovery with some Aging at Home programs
Personal use is not integrated with clinical data
Only limited trials of data flowing into Medical Records in US
(outside of the Veteran’s Health deployments)
Why?
Some opportunities10
11
Cancers, mental disorders and diabetes are projected to grow the fastest, even though they are currently not the highest in prevalence
Source: Milken Institute
62%
54% 53%
41% 39%
31% 29%
0%
10%
20%
30%
40%
50%
60%
70%
Cancers Mental Disorders Diabetes Heart Disease Hypertension Pulmonary Conditions Stroke
Projected Rise in Cases by 2023, by Chronic Disease
Projected rise In
population(19%)
Confidential – This information was prepared by PwC for the Continua Health Alliance board of directors and is restricted to that use and cannot be copied or shared without prior written consent of PwC.
12
Hypertension has the highest cost to employers, followed closely by cancers
Source: Milken Institute
The economic cost resulting from employees and their caregivers missing work days (“absenteeism”) or showing up but not performing well (“presenteeism”). This economic impact of chronic diseases is estimated at over $1 trillion annually
Lostproductivitydefinition:
$280 $271
$171
$105 $105 $94
$22
-
50
100
150
200
250
300
Hypertension Cancers Mental Disorders Diabetes Heart Disease Pulmonary Conditions Stroke
Lost Productivity, by Chronic Disease (US$B)
Confidential – This information was prepared by PwC for the Continua Health Alliance board of directors and is restricted to that use and cannot be copied or shared without prior written consent of PwC.
-
10
20
30
40
50
60
-
10
20
30
40
50
60
70
80
90
100
Cardiovascular diseases
Cancers Mental disorders Osteoarticular diseases
COPD and asthma
Hypertension Diabetes Kidney Disease Stroke Epilepsy Maternal-Fetal Health
# of
Pati
ents
(mill
ions
)
Tota
l Exp
ense
(US$
B)
Total US Treatment Expenses ($B) and Number of Patients (millions)
Total Expense ($B) # of patients (millions)
13
Although cardiovascular diseases result in the greatest treatment expenditures, stroke has the highest cost on a per-case basis
Source: US Department of Health and Human Services
4,114 4,661 1,908 1,625 1,155 858 2,169 4,680 5,113 3,303 1,959 Treatment Expense Per Patient ($)
Confidential – This information was prepared by PwC for the Continua Health Alliance board of directors and is restricted to that use and cannot be copied or shared without prior written consent of PwC.
14
Cost components vary greatly by disease; the large share of hospitalization costs for cardiovascular diseases offers a great cost reduction opportunity
Source: US Department of Health and Human Services
95.6
72.2 72.1
57.0 53.7
47.4 45.9
19.9 18.8
8.2
2.7
0
10
20
30
40
50
60
70
80
90
100
Cardiovascular diseases
Cancers Mental disorders
Osteoarticular diseases
COPD and asthma
Hypertension Diabetes Kidney Disease Stroke Epilepsy Maternal-Fetal Health
US Total Medical Expenses -- by Disease by Type of Service (US$B)
Home Health
Prescribed Medication
Emergency Room
Inpatient
Outpatient or Office Visit
Confidential – This information was prepared by PwC for the Continua Health Alliance board of directors and is restricted to that use and cannot be copied or shared without prior written consent of PwC.
15
Per-patient medical expenses also indicate that a large portion of stroke expenses are attributed to home health, indicating a potential mHealth area of opportunity
Source: US Department of Health and Human Services
4.1
4.7
1.9
1.6
1.2
0.9
2.2
4.7
5.1
3.3
2.0
-
1
2
3
4
5
6
Cardiovascular diseases
Cancers Mental disorders
Osteoarticular diseases
COPD and asthma
Hypertension Diabetes Kidney Disease Stroke Epilepsy Maternal-Fetal Health
US Average Medical Expenses Per Patient -- by Disease by Type of Service (US$000s)
Home Health
Prescribed Medication
Emergency Room
Inpatient
Outpatient or Office Visit
Confidential – This information was prepared by PwC for the Continua Health Alliance board of directors and is restricted to that use and cannot be copied or shared without prior written consent of PwC.
Beyond the Four Walls: Personal Connected Health
www.continuaalliance.org
16
17
“Our Mission is to establish an ecosystem of personal connected
health systems that empower individuals & organizations to better manage their health and wellness”
04/10/23 18
Goal: Realize Peak Health Potential Goal
Experience peak health potential throughout life for a high quality of life at minimal costs
RealityAverage individual is experiencing much less of full health potential than expected at a high financial & quality of life cost
CauseAdverse health events such as stress, poor nutrition, inactivity… are causing the population to fall away from their peak health potential
Adapted from Oregon Medical Labs
0 25 65
Age
Illness
Pre
-Illn
ess
Welln
ess
Unpredictable Health
Predictable (Rules-based) Health
DeatDeathh
60-80% LifestyleManagement
Modifiable lifestyle
Irreversible Disease state
Happening earlier in life
Hig
her $
$ C
osts to
All
Realize Peak Health Potential
19
The Goal: Improve Lifestyle Choices, Health
= Non Modifiable Contributors to Disease= Modifiable Contributors to Disease
Hu et al. Diet, lifestyle and the risk of type 2 Diabetes in women. NEJM 2001 Sep 13;345(11):790-7.Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000; 343: 16–22
A Solution: Personal Connected Healthcare
There is increasing evidence to support the value of remote monitoring for individuals with chronic conditions, including:
• 35-56% reduction in mortality; • 47% reduction in risk of hospitalization; • 6 days reduction in length of hospital admission
and • 65% reduction in office visits; • 40-64% reduction in physician time for checks and • 63% reduction in transport costs
(Cleland et al 2005; Lee R, Goldberg et al, 2003; Scalvini S et al., 2001; Elsner et al, 2006; Van Ginneken et al 2006)
20
Primary focus areasHealth & Wellness
Chronic Condition
Management
Living Independently
Longer
With a second separation and focus on non-regulated and regulated devices to ensure appropriate adoption
Already Complete: Interfaces & Standards
HealthRecordNetworkInterface
Personal Device
Weight Scale
Pulse Oximeter
Independent Living
Activity
Cardio / Strength
Medication
Adherence
Glucose Meter
Pulse /Blood
Pressure
Thermometer
Physical Activity
Peak Flow
AggregationManager
DeviceConnectivity
WideArea
Network(WAN)
Interface
TelehealthServiceCenter
HealthRecords
EHR
PHR
HIE
NHIN
CCD
PCD 01
22
HDP and LE
04/10/2323
Examples of Solutions implemented:
Aging Independently – Garfield Center:(Zigbee enabled living center)
Chronic ConditionOxygen level, Heart rate, Weight, Blood pressure
Activity MonitorsEnsure appropriate levels of activity
Gait monitorEnsure proper orientation and early stroke warning
Devices are wired for entire center. Individuals can move about the entire facility.
04/10/2324
Examples of Solutions implemented:
Veterans Administration: (45,000+ end users of technology)
Fixed system for deployment to chronic populationLargest deployment in the world
Health conditionsDiabetesHeart FailureHypertensionCOPD and Asthma
Published reports show savings of 53 to 85% over existing practice and treatments.
04/10/2325
Examples of Solutions implemented:
Sub-Saharan Africa (Maternal health):
Pulse/OximetersHeart rate
Blood PressurePre-eclampsiaHypertension
GlucometersMeasure for gestational Diabetes
ECGMobile platform
Devices are portable and can be shared
04/10/2326
Examples of Solutions implemented:
Japan Earthquake/Tsunami:
Personal Health RecordsAllows data to be shared quickly as residents are transferred/movedProvides an easy way to acquire data in single location
DevicesJapan has required devices to have standardized interfaces to allow easy implementationCan carry devices from different manufacturers and still acquire data
Standardization and Personal Health Record allows transfers of displaced to have records follow them.
04/10/2327
Examples of Solutions in development:
Organized Competition for engagement:
Studies repeatedly show that:Competition is highest driver In a group that is non-threateningGroup resultsSelf-insured employee activation
Can provide optimized resultsNear real-timeMultiple measurements for diversity
Can provide a safety measure in sportsSensor technology can be deployed for safety
Devices are portable and can be shared in situ
04/10/2328
Examples of Solutions in development:
Diagnostic Gaming:
Provide advanced platforms that:Can measure health of individualRecovery of individualProvide rehabilitative assistanceDetermine early signs of cognitive issuesCan measure a whole facility
Devices can be fit on individuals and can be re-used. Architecture allows standardized acquisition.
04/10/2329
Examples of Solutions:
Highly Mobile Platforms:(Emergency Response)
Personal Health RecordsAllows data to be shared quicklyProvides an easy way to acquire data in single location
Portable and unobtrusiveCan carry in pocket or “stuck on”Can carry devices from different manufacturers and still acquire data
Wireless setup and portable devices allowed quick dissemination and deployment
Key Points
The certified technology provides a standard based approach to collecting device data rather than having to manually input data.
Common tools for representing data
Many devices specializations defined
Can integrate technology into systems in an ad hoc manner
Technology can be repurposed quickly
Can be integrated into health records or set up for quick single issue management
Highly portable
Thank you!
For more information or to join Continua Health Alliance…
Sign up for our [email protected]
Visit our websitewww.continuaalliance.org