rainer herzog healthcare consulting itu expert group meeting on m-health rainer herzog healthcare...
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Rainer Herzog Healthcare Consulting
ITU Expert Group Meeting on M-Health
Rainer Herzog Healthcare ConsultingGeneva, September 25-26, 2012
Success Stories and Country Case Studies
Rainer Herzog Healthcare Consulting
Sustainable M-Health – much more than technology
Rainer Herzog Healthcare Consulting
M-health is the most rapidly expanding market for ICT
solutions
Source: Roland Berger Consultants, 2009
E-/m-health market forecast for the EU
(billions of Euros)
+105%
+38%
Rainer Herzog Healthcare Consulting
Stakeholders
Health informatics system integrators
Healthcare staff
Other staffPhysicians
Biotech
Equipment manufacturers and vendors
Pharmacies
Regulators
Governments
Regulators
Employers
Insurance companiesGovernments
Patients or “customers”
Payers
Ambulatory care
Home care
Caregivers
Telecom Vendors + Operators
Patients
Healthcare delivery
Suppliers
Address the right stakeholders in the value chain
Rainer Herzog Healthcare Consulting
The winning combination for sustainable m-health implementation
IC Technology Organizational Development
Business Development
& Strategy
Policy & Regulatory
Sustainable Implementation
Rainer Herzog Healthcare Consulting
Quantification of variables
Impact „conservative“
Impact „realistic“ Impact „ optimistic“
I. Savings in total healthcare spending
5% 15% 20%
II. Savings in total number of medical interventions
5% 10% 20%
III. Reduction in average cost of a medical intervention
15% 20% 30%
IV. Degree of health resource utilization
10% increase 20% increase 30% increase
V, Savings in cost of adverse drug / tretament events
2% of hospital admissions
4% of hospital admissions
5% of hospital admissions
Identify the right business variables and estimate the m-health impact
Rainer Herzog Healthcare Consulting
Ericsson Mobile Health – EMH version 3.0 overview
ECG 3/6/12 lead
Communication Device
PEFSpO2
Blood pressure ECG 1 lead + event recorder
Operator
EMH Back-end system
EMH Clients
Digital Weight Scale
Source: Ericsson
Rainer Herzog Healthcare Consulting
Health kiosks in occupational health
Healthcare solution in SaaS
Health Service Provider (TPA)
Individual Enterprises
Provide solution in SaaS modelProvide medical services to Enterprises (3500 companies, 5 million lives)
”Health Room” for employeesROLE
ASSE
TS
NEE
DED
•Application in cloud
•Operations resources
•Mediassist education
•Medical staff
•Health Service Packages
•Training/Education
•Patient Unit
•Health Room facilities
•Trained personnel
Booking
Remote Monitoring
Video Conferencing
Patient Records
Source: Ericsson
Solution Provider
Rainer Herzog Healthcare Consulting
Remote monitoring after myocardial infarction – key processes
Contact Center (Support and Procedures)
City Hospital
Patient
Payer / Insurer
Day-to-day monitoring and consulting according to schedule.
First-line patient support.
Initiation of emergency processes according to protocol
rules. Data analysis.
Discharge, inclusion and training of patients. Decision on
monitoring schedule.
Regular review and follow-up of patients‘ condition. Collection and input of medical data. All
according to protocol.
Training. Second-line technical support 8/5
CET. Operation, hosting, maintenance.
Provision of EMH equipment. Exchange of equipment
(warranty terms).
Training of hospital staff. Referral of patients to hospital staff in case of needed medical intervention according to protocol rules.
Overall project management.
Connectivity (SIM cards) for EMH
equipment. Additional network services
(t.b.d.)
Input to pilot protocol, especially health-economic endpoints.
Participation in data analysis. Preparation of every-day-use-
case.
Source: Ericsson
Mobile Network Operator
Solution Provider
Rainer Herzog Healthcare Consulting
Content:1. SMS Quiz text 2. SMS answer, e.g ”D”3. SMS response (link-SMS) - Provide jpg-pictures
You are about to order your beverage for lunch -Which of the following would be your healthiest choice? A. Soft drinkB. Mixed fruit drinkC. Energy drinkD. Water
Functionality:-SMS-request
-SMS-subscribe-SMS answer handling
- User database- SMS-Quiz database
Health campaigns for behavioral & lifestyle changes
Messaging Platform
(hosted service)
Source: Ericsson
1. SMS Quiz to registered users
2. SMS Answer
3. SMS Reward
Rainer Herzog Healthcare Consulting
• Patient Messenger Service
Patient / User
• Content• Content Analysis
SMS / MMS
Reply
Rewards
Mobile Operator
Service Provider
Content Provider
• Sponsoring of Preventive Health
Campaign
Healthcare Payer (e.g. Insurance)
• Health Clubs• Dietary Centers• Health Food
• Sports Equipment
Other Sponsors
• Prevention• Motivational
Wellness
Health campaigns for behavioral & lifestyle changes
Source: Ericsson
Rainer Herzog Healthcare Consulting
• Listlessness
• Missing social environment
• Drug side effects
• Slow onset of therpay success
• Direct patient contact and motivation
• Interaction and patient dialogue
• Continuous patient monitoring
• Continuous patient feed back
Barriers for therapy success
Factors for therapy success
Missing Compliance
Terminaton of Therapy
Patient compliance in Schizophrenia and Bipolar Disease
Rainer Herzog Healthcare Consulting
Messaging solution to improve patient compliance
• The solution is based on SMS messaging• Patients using a particular drug will receive SMS messages up to 4 times daily at
predefined times: SMS drug reminder („Please remember to take your drug“) SMS drug check („Have you taken your drug?“) with a Yes/No answer
requested SMS well-being check („How are you feeling today?“) with a multiple choice
answer requested SMS motivational / fun message („Well done“)
• Patients who do not answer will be flagged and brought to the attention of the doctor for special follow-up
• A web-based user-interface is avaiable where doctors can easily follow up and monitor patients as well as include new ones
• A web-based user-interface for system managers is available
Rainer Herzog Healthcare Consulting
Patient compliance – pilot trial summary
• 71% of compliant responses (to >10,000 messages)
• The technology was well accepted and performed perfectly
• More than 50% of the physicians felt that the system enhanced patient compliance
• 43% of Physicians used the system more frequently than required by the protocol – even from home
• Most would recommend the system to patients
Rainer Herzog Healthcare Consulting
Vision – an integrated m-health service platform
Patie
nt d
omai
nSe
rvic
e Pl
atfor
m P
rovi
der
Serv
ice
Prov
ider
Dom
ain
Medical Devices / Equipments
Data Collection,
Normalization, Translation
Storage
Device Mgmt
SIM Mgmt
M2M PLATFORM
Analytics
Policy
Provisioning
Subscription
Mgmt
Id Mgmt
Security
Payers
HealthcareProviders
Nurses &Health Coaches
Comm
unication services
Communication Service Delivery platform
Basic
CommunicationCharging / Billing
Business Process
IntegrationConferencing
Presence Scheduling
Application Platform
Portals AnalyticsPatient
Mgmt
Claims Mgnt Rules Apps
RulesService
Orchestration
M-Health Service Platform
Rainer Herzog Healthcare Consulting
Preconditions for a successful m-health implementation
• Properly address the value chain: – Who are the main stakeholders driving implementation – Who enjoys the benefits – Who holds the funds– Who has the power to facilitate implementation
• Establish a sound business model for all value chain members• Come up with end-to-end solution and service offerings:
– Processes and wokflows – Change management needs– System integration architecture– Legal and policy framework
• Generate sound validation data and involve clinicians in defining validation goals and endpoints
Rainer Herzog Healthcare Consulting
Contact
Rainer HerzogHealthcare ConsultingMail: [email protected]: +49 178 534 0067