the promise of integrated healthcare: health information systems
TRANSCRIPT
The Promise of Integrated Healthcare
How can Health Information Systems Help?
Bhargav Rajan, Research Analyst
Healthcare
July 31, 2014
© 2014 Frost & Sullivan. All rights reserved. This document contains highly confidential information and is the sole property of Frost & Sullivan. No part of it may be circulated, quoted, copied or otherwise reproduced without the written approval of Frost & Sullivan.
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Today’s Presenter
� Industrial experience in biomaterials, tissue engineering, wound healing, implants and devices
� Tracking emerging technologies, competitive benchmarking and opportunity landscape, with expertise in:
� Medical devices and imaging
� Clinical diagnostics
� Innovations in healthcare systems and delivery
� Frost & Sullivan research publications (Most recent):
� Innovations in Home Medical Devices & Integrated Healthcare (June 2014)
� Technologies Enabling Home Medical Devices & Integrated Healthcare (June 2014)
� Top Medical Technologies for 2014 (February 2014)
� Advances in Smart Pills (October 2014)
Bhargav Rajan, Research Analyst
Frost & Sullivan
Follow me on: (Connect with social media)
https://www.linkedin.com/pub/bhargav-rajan/17/339/ab7
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Focus Points
� What is integrated healthcare (IHC)?
� What are the different IHC models?
� What is the need for IHC?
� IHC adoption - Drivers and Challenges
� 4 Pillars of IHC
� Health information systems - introduction and segmentation
� HIS - Drivers and Challenges
� Global Mega Trends and collaboration potential
� Roadmap - What to expect from HIS
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Healthcare Consumerism – Patient or Consumer?
or
� Are healthcare end users “Patients” or “Consumers”?
� Patients: Passive, uninformed, hands-off - implies that they are taken care of,rather than being actively engaged in the healthcare process.
� Consumer: Actively engaged in healthcare process; demanding; “consumerexperience” from other industries; interactive process
� Reducing gap between patient and consumer
Integrated Healthcare (IHC): The design, management and delivery of healthservices so that clients receive and perceive a continuum of health promotion, healthprotection and disease prevention services, as well as diagnosis, treatment, long-termcare, rehabilitation and palliative care services through the different levels and sites ofcare within the health system and according to their needs – WHO 2013
� Importance of IHC:
� Patient-centric system
� Services across the continuum of care
� Efficiency and transparency in services
� Consumer demands: Round-the-clock services, convenience, flexibility, freedomand mobility
� IHC Enabling features
� IHC Drivers and challenges
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Changing Healthcare Trends
Sphere of Innovation
Focus
Approach
Information Exchange
Dispensation
Decision Making
Objective
Partnerships
Traditional Healthcare Systems Integrated Healthcare Systems
Provider-centric healthcare model Patient-centric healthcare model
One-size-fits-all treatment Customized and personalized treatment
Unidirectional, unstructured Bi-directional, organized
Centralized and hospital-based De-centralized and community-based
Physician-expertise driven model Healthcare analytics-driven model
Treatment of disease Prevention of diseaseE
me
rgin
g T
ren
ds
Individual, physician expertise Collaborative, consultative model
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How is IHC Delivered?
Integrated Healthcare
Physician Hospital Organization (PHO)
Management Service Organization (MSO)
Group Practice without Walls (GPWW)
Health Maintenance Organization (HMO)
Staff Model HMO Group Model HMO
Network Model HMO
Individual Practice Association Model
HMO
Ve
rtic
al In
teg
rati
on
Horizontal Integration
• Merging of organizations and teams thatare specialized in different services.
• Clumping together similar teams
• Merging physician practice with hospitals,payers, healthcare providers, informationtechnology support and other specializedservice providers.
• Improving efficiency, scope of services andfinancial consolidation.
• Merging or consolidation of organizations at asimilar or comparable levels of services.
• Example: Outpatient clinics across geographies inorder to create a network of such clinics.
• Expand presence/footprint
• Optimize resource utilization
• Financial strengthening
• Managerial challenges
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The 4 Pillars of IHC
Source: Marino DJ (2012); Frost and Sullivan
Integrated Care Systems
Leadership
• Governance
Body
• Compliance
• Business
model
• Work Culture
Allied
Incentives
Clinical
Programs
Technical
Infrastructure
• Physician
Engagement
• Staff Support
• Performance-
tagged
Incentives
• Disease
Management
• Palliative care
• Population
Health
Management
• Tools and
Devices
• Content
Digitization
• Network and
Connectivity
• Interfaces
•PACS•EHR, EMR
•CPOE, RCM•Rostering
•Cloud•IoT•Big Data
•Biometrics•RFID/NFC•Apps and
software• Integration
•PDA, phones•RPM devices•mHealth•Medical devices
Tools & Devices
Interfaces
Information Exchange
Network & Connectivity
Enabling Infrastructure
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What are Health Information Systems (HIS)?
Health Information Exchange
Non-Clinical Information Systems
Revenue Cycle Management
Rostering and Scheduling
Administrative Information
Systems
Clinical Information Systems
Laboratory Information System (LIS)
Operating Room Information Systems (ORIS)
Pathology Information Systems (PIS)
Radiology Information Systems (RIS)
Health Information System
Electronic Medical Records (EMR)
Patient Portals
Health Informatics
Picture Archiving and Communication System
Source: Frost and Sullivan analysis
• $46 bn revenue
loss (2012)
• US market size:
$12 bn (2012)
• CAGR: 4%
• $23 bn market
• CAGR: 5 - 7%
• NA ($9 bn), EU ($7
bn) and APAC ($8 bn)
• > $250 mn US market
• CAGR: ~22%
• ~300 companies; 10%
hospitals own system
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HIS – Market ForcesD
rive
rs
Driv
ers
Re
strain
ts
Re
strain
ts
Long term: 4-5 years
Short term: 1-3 years
Need for improved decision support and
analytics Cost reduction, elimination of redundancy
and manual processes
Emergence of integrated healthcare systems and new business models
Need for efficiency and flexibility in workflow
Lack of standardization Interoperability Budget Constraints
Source: Frost & Sullivan analysis
Rapid advances in IT and ICT technologies power innovations
in health infrastructure
End-user Compliance
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Alignment with Global Mega Trends
CustomerFocus
Professional
Consumer
Industry FocusInformation & CommunicationTechnologies
Healthcare
I
Video Conferencing
Personal Health Programs
Patient portals
Fitness apps Community programs
Digital ImagingEHR
Web-MD services
Wellness apps
Remote Patient Monitoring
Physician assist software
ePayment gateways
Remote Specialist Services Diagnostics
PACS
II
III IV
• Mega Trends: Mega Trends are global, sustained and macroeconomic forces of development that impact business,economy, society, cultures and personal lives, thereby defining our future world and its increasing pace of change.
Connectivity & Convergence - Future of Mobility - Social Trends - Beyond BRICS - New Business Models - Bricks & Clicks – Urbanization - Health, Wellness & Wellbeing
D540-TI 11
Technology RoadmapAdoption of Health Information Systems
2014 2018 2019
Patient Portals
Electronic Medical Records
Virtual Community Support Groups
Predictive analytics
Population health informatics
� Increasing adoption of non-clinical, financialand administrative workflow systems
� Early adoption of clinical informationsystems
� Complete transfer to ICD-10 coding systems� Further adoption of clinical information
systems� Creating of national and regional health
information repositories
� Use of health analytics in framing policies,creating infrastructure, distributing supplies
� Predictive analytics, epidemic control,preparing for seasonal diseases
� Personalized healthcare services
Source: Frost & Sullivan Analysis
2011 2015 2022
Administrative Workflow Systems
Revenue Management
Health and Wellness
Applications
Meaningful Use Stage 1: 2011Data capture and sharing
Meaningful Use Stage 2: 2014Advance clinical processes
Meaningful Use Stage 3: 2016Improved outcomes
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The Last Word – Can HIS Ensure IHC?
� Adoption potential:
• NA, EU, APAC, ME
� Kaiser Permanente (Oakland, CA) –
• Largest integrated healthcare institution
• > $4 billion in 10 years for HIS
• 9.1 million users � 34 mn test views; 3.6 mn appointments; 15 mn emails; 15 mn e-prescriptions
� Investments by IT giants – Microsoft, IBM, Dell, Google
• VC funding $1.2 bn (2012); $2.2 bn (2013); $900 mn (Q1 2014) � ~ $5 bn since 2010
• GE Healthcare $2 bn between 2013-2017 towards data analytics, HER
• Google Ventures: $130 mn Series B in Flatrion Health - Big data in cancer imaging and diagnosis
• IBM Watson: $23 mn Series C in Welltok – Social Health Management
� Incentives by governments:
• Meaningful Use program: Stage 1 (completed in 2011), Stage 2 (2012-2014), Stage 3 (2015 - )
• Financial incentives for meaningful use of health information systems
• Data acquisition � Clinical use � Analyticsa
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