Capstone Keynote and Innovation Award:The Story of MRI

PRESENTER AND RECIPIENT

Raymond Damadian, Chairman of the Board & Inventor of the MRI, Fonar Corporation

SESSION ABSTRACT

The story of MRI begins with the story of the original idea to transform a 2¼" test tube analyzer (NMR) into a scanner of the live human body, followed by the story of its indomitable first construction. It concludes with a presentation of MRI's newest revolutionary frontier: video visualization and quantification of the flow of the cerebrospinal fluid (CSF) by the FONAR UPRIGHT® MRI into and out of the brain and spinal column, and its pivotal role in surmounting today's neurodegenerative diseases, Multiple Sclerosis, Parkinson's, Alzheimer's, childhood autism, and amyotrophic lateral sclerosis (ALS).

INTRODUCTION

We talk a lot about innovation and disruptive innovation; but when we speak about the invention of magnetic resonance imaging (MRI), the term “disruptive innovation” is almost an understatement.

TAKE-AWAY

Innovation sometimes takes a lot of time, research, trial and error, and funding. But when real innovation happens, it changes everyone’s lives.

DEVELOPMENT OF THE MRI

Raymond Damadian: “I couldn’t get this question out of my head. How are we walking around like a human power plant? How do we do it? I spent years researching sodium and potassium ions on cells.”

“I proposed an idea that all tumors could be recognized, and proposed a tool that could scan the body. Having published this idea, I received a call about collaborating on an NMR apparatus project. We were able to measure in the amount of seconds what would normally take two to three days.”

We published our results in 1971: detection is hampered by a lack of contrast, and we could fix it. A year after we received a contract, we were able to detect tumors. In 1977 there was the first ever MRI scan. Visionary nonsense became a reality!

• 1980 – The first commercial scanner was in use. X-rays’ deficiency to successfully image the body’s soft-tissues was finally conquered! 
• 2001 – Introduction of the upright MRI – you can put the patient in virtually any position
• Upright MRI – The patient walks in and watches TV, can put patient in any position–a new revolutionary frontier
• Medical conditions such as multiple sclerosis and Parkinson’s disease can now be visualized
• In pediatric imaging with cerebral palsy – upright imaging will deliver important data

FINAL THOUGHT

The first innovation isn’t the end of the story; knowledge and insight gained from one innovative idea builds and enables further discovery: innovation is exponential.

Transformational Shift: New Business Models in Healthcare

 

PRESENTER
Greg Caressi
Senior Vice President,
Transformational Health
Frost & Sullivan

 

SESSION ABSTRACT
This discussion helped participants gain valuable insight into new marketplaces and implications across value chains. Examples of how transformation in healthcare can be leveraged to develop new business models were also presented. Participants examined top global case studies and utilized them to identify new channel partners, new customers, new convergence ideas and revenue streams across the entire ecosystem.

KEY TAKE-AWAYS:

• An assessment of the future success potential of current and emerging business models in the B2B and B2C segments across industries
• Identification of new partner networks, future customer segments and valuable revenue streams for your company
• Analysis of new product positioning, new value proposition through creation of a business model canvas

OVERVIEW

Healthcare is being transformed and new business models are evolving around six overall themes:

1. Building an Ecosystem
2. Moving from Product to Service
3. Decision Support
4. Integration Is King
5. Process Change
6. Mass Customization

Some key developments in new healthcare business models include:

• Artificial Intelligence solutions being used for workflow optimization (e.g., triage) purposes
• The use of social media, more on the consumer side than the institutional side, for purposes such as activity coaching
• The tendency to view market segmentation and/or fragmentation as an opportunity where one solution can be adapted across various stakeholders
• Enhanced patient comfort level with having their information reside in the cloud
• Consumer willingness to co-pay seems set at around $30-$50
• Genomics is one new area of innovation in business models; within 5 years it willbe considered ―malpractice not to use some genomics technologies, particularlyin oncology
• Intermountain Healthcare is one of the leaders in offering healthcare providers genomics testing
• IBM Watson is partnering with Memorial Sloan Kettering to leverage genomics and analytics
• The American Society of Clinical Oncology (ASCO) is partnering with Systems, Applications and Processes in Data Processing (SAP) to develop big data solution for oncologists nationwide
• Shared infrastructure platforms are being shared across practice groups

TAKE-AWAY

• 64% of patients would see a doctor via video
• Access and convenience is more important to patients than physical contact, many are also very unconcerned with having their information in the cloud
• Price points are similar for most available options (makes things easier)
• You can adapt one technology and one solution to many different stakeholders

ACTION ITEM

• Strive to change consumer attitudes towards healthcare delivery
  
  

BEST PRACTICE

• Reimburse only for the best pathway of healthcare delivery
• Artificial Intelligence (AI) is used for determining models and learning from them
• Find an enterprise based analytics solution located within a clinical setting
• Speed up ingestion and analytics of data
• Find the balance between one on one and subscription based model
• Retail clinics have an opportunity to provide a positive impact for minor issues
• A lot of different parts when it comes to chronic care leads to new models,
• While many in the field are reducing interaction with it, the FDA is still a central player; you need to worry about the FDA
• The first conflict point will probably be provider-payer not consumer-payer
• Cloud is the new change that has to happen, there is just too much data to house physically

FINAL THOUGHT

With the coming influx of technology and the growing consumer adoption rate, you need to really position yourself within the field and make use of the tools and analytics that are becoming increasingly more available. Cloud storage and the upcoming use of AI to help interpret all of this data in a meaningful way will be the key to success.

Ask The Experts! Panel Discussion Wearables: We Can Measure, But Can We Monetize?

 


Moderated by
Elisabeth George
Vice President - Global Government Affairs,
Standards & Regulations
Philips Healthcare





SESSION ABSTRACT
Wearables are an integral part of consumers’ well-being. Consumers are captivated by the idea of wearables but do they hold longevity and how can the healthcare community benefit from this fascination for true success?  

KEY TAKE-AWAYS

• A framework to identify what a wearable is and why it’s needed in today’s continuum of healthcare
• Insights on benefits and risks – consumers, economic and clinical outcomes
• Critical factors to sustainability of wearables and identify potential ways to solve

OVERVIEW
A diverse group of industry professionals discussed how wearable health products support patients' needs today and how they will do so in the future.  Although wearables are in a period of experimentation, next steps include bringing data to an A.I. application on smart phones, getting wearables devices into the right hands, getting people to engage with the devices, and then getting important data…not for your company, but for your customer.

Key insights about the multibillion dollar wearables market include the importance of integrating these devices into the consumer’s lifestyle and updating them to be waterproof and stay charged.

Wearables and other consumer technologies have disrupted the payment and reimbursement model.  Also, in the developing world, there is enormous market potential for wearables, but price and infrastructure are barriers.  Infectious disease and infant mortality are much higher concerns in the developing world.  Yet, the current thinking concerning this technology seems more focused on the developed world. This stratification, as well as other issues were discussed during the following question and answer session:

Question: How do you see wearables impacting patients’ lives now and for the future?

Mathew Diamond – We need to make patient support effortless in terms of design and patient experience, we need devices that don’t require charging, and are waterproof, which will help with adherence and compliance issues. Wearables companies have partnered with companies like Speedo and Victoria’s Secret to remove the burden from individuals by utilizing the clothing and apparel they already wear and the lifestyles they currently lead.  Miniaturization puts us on the brink of something revolutionary in terms of the use and practicality of wearables. The regulatory environment also encourages innovation in this area.

Maulik D. Majmudar, M.D. – Currently, the most widely used wearable technologies are limited to wellness applications, such as activity and sleep tracking. However, wearables can impact patient’s lives in a much more significant manner by providing real-time monitoring and/or feedback with actionable insights. Maulik’s organization attempts to address the problem by focusing on validation and implementation of technology-enabled solutions to establish the evidence necessary to drive sustainable clinical adoption. According to Maulik, the most important thing is to foster collaborative alliances among stakeholders such as provider organizations, payers, pharmaceutical companies and start-ups to accelerate the translation of novel technologies into real world clinical practice.

Robert Kaul – His company is on the forefront of “Star Trek” tricorder technology.  Their product monitors vital functions such as resting heart rate and blood pressure on a continuous basis.  Part of the challenge of this technology is patient usability/consumer friendliness. An issue: Large corporations are reluctant to invest in new technology without assurance of reimbursement.

Brian Markwalter – We are in a period of heavy experimentation on the part of companies as diverse as L’Oréal, a cosmetics company, and medical technology companies.

Jay Rajda – In terms of value creation, one problem is how to separate out chronic-condition applications from lifestyle applications such as weight loss in the area of wearables.  There’s no clear answer as yet as to how to monetize the data derived from wearables as opposed to care management programs.

Bakul Patel – The FDA is concerned with the entire healthcare ecosystem, but it is less concerned with regulating wearables as activity-tracking devices than is the private sector.  The FDA is more concerned with data security issues around connectivity and intended use.

TAKE-AWAY

• 50% of medical costs come from 5% of patients (usually serious chronic conditions)
• If there's evidence of value creation, funding will come
• Given high deductible health plans, subscription services may be viable
• If it's going to be valuable for the consumer, then they'll contribute to the cost
• There's a sharp difference between wellness application and preventative application
• Those with chronic conditions deserve to have the same level of consumer experience
• Try to gather enough evidence of efficacy to gather the payers
• When there's evidence of value creation, things will absolutely change
• Implications right now are too US-centric, which is only a small part of the world population,  there's a lot more market potential
  

FROM A GLOBAL PERSPECTIVE

• Wearables will have a much bigger and faster impact globally once the breakthrough comes; the need is greater there
• Awareness and cost are the issue right now along with infrastructure
• Other diseases are also the focus globally at the moment
• Wherever you have a cell phone you can have one of these devices, but you need a value based version of them
• Right now where technology is, it’s all about activity tracking, but there's so much more available

FROM A COLLABORATION PERSPECTIVE

• The biggest thing to focus on is formal collaboration alliances: Providers, payers, pharma, and start-ups all have to team up to tackle this issue
• Distribute and target the right segments and right population to develop programs with all of this data to create value
• Improve targeting and distribution of these devices
• There are responsible ways to use these tools that we have to come up with as an industry
• Reduce time from conception to getting to consumer

FINAL THOUGHT
While the wearable market has been in a boom recently, we need to worry that the bubble won't pop by finding new innovative ways to use and interpret wearables. Aim for expanding the market globally; just because it's harder for non-US populations to adopt doesn't mean that the biggest market share should be ignored, find a way to reach this global market and increase your customer base.

New Products and New Opportunities in Precision Health: Population Health Management and Personalized Care

PRESENTER
Greg Caressi
Senior Vice President,
Transformational Health
Frost & Sullivan




SESSION ABSTRACT
Riding the hype wave, hundreds of companies are labeling their products as population health management solutions. Reaching population health goals, however, requires a focus on the individual, in terms of health data, analytics and individual intervention techniques, technology, motivation and interactions. Much has been written about personalized medicine in the pharmaceutical sector, but personalization also applies to many factors impacting health outside of the healthcare system, and a better grasp of ways to interact with each of us as consumers making choices of providers or payers, as customers making choices regarding diet, fitness, etc., and as members of a social group.

How can we expand our thinking about how we can interact with individuals to meet population health goals of better outcomes, lower costs, and better experience with the healthcare system and with our health? This panel included views from across the healthcare ecosystem designed to provoke thought on new opportunities to interact with individuals to offer more personalized approaches to health and healthcare.

KEY TAKE-AWAYS

• Insight into the solutions applied today and what is in development
• Examples of where the gaps are and what still needs to be addressed
• A framework of how we can change the approach of tour organizations to make personalized care and precision health the norm (or do we need to)?
• Critical factors and opportunities that will move the needle in applying personalization to meet health and healthcare goals

Questions and Answers with the Panelists
Q: How to get (medical) devices into the hands of patients?

A: Clint McClellan, co-founder of the Qualcomm Health initiative, advocates lowering the price of devices such as blood-pressure monitoring instruments for customers.  Cory Wiegert, a former internist now focused on forming partnerships between health providers and individuals, emphasized concerns about data rights and consent. Kripa Gaonkar, a Senior Research Manager at Ascensia (formerly Bayer) spoke about challenges relating to the integration of data customization regarding, for example, diabetes. Jeff Zigler of St. Jude‘s brought a cardiologist‘s perspective to the discussion, and spoke about compliance concerns with regard to HIPPA.

What are some of the things that are working? What are some of the things that are not working?

Kripa Gaonkar addressed the need for cultural changes within organizations, for
keeping users pro-active and engaged. Connecting about appointments via mobile devices is one way to do this.

Cory Wiegert stressed that data is meaningless unless it is put to some concrete use.

Michael Swiernik, M.D., of Kaiser Permanente talked about physician pushback around incorporating even more data into already overcrowded schedules. He stated that data must be paired with clinical guidelines that take the guesswork out of medical procedures. He also talked about rolling out protocols to care managers and directors rather than just nurses, as a way of increasing patient engagement. Swiernik reminded the panel that, for some patients who may not wish technology to replace human interaction, a visit to a healthcare facility is a form of meaningful social engagement in and of itself. Also, older patients tend not to favor mobile applications.

Q: What are the potential benefits versus the liabilities of mining patient data?

A: Clint McClellan said that one barrier is the question of consent and intent. At
present, certain data sets may not lawfully be combined due to concerns with PHI. On the other hand, there are liability concerns arising from the non-use of patient-provided data.

Swiernik spoke about how to reconcile the way data gets collected in ―front-end‖ day-today care, versus how that data gets used later for research purposes. He spoke about the need to collect a broader pool of patient data in order to make it useful and he emphasized the use of predictive analytics.

Cory Wiegert‘s perspective on the collection of data in clinical trials focused on enabling whatever is appropriate to the trial. He also spoke about digital patient recruitment concerns. What are the incentives for study subjects to participate? Per Wiegert, patients must clearly understand what they‘ve signed up for. Regarding how to change the payment structure and what roles patients, providers and payers should play, he brought up two key issues: 1. Who gets paid? and 2. What‘s in it for whom?

Clint McClellan emphasized that it is no longer about cutting costs, it is about managing the inflation curve.

Q: Moderator Greg Caressi asked the panelists for closing remarks regarding gaps and opportunities.

Jeff Zigler said that solutions vendors have a key role in closing gaps in clinical
consensus.

Clint McClellan stressed the importance of engaging patients about what they have been doing to improve and maintain their own health and why.

Kripa Gaonkar agreed on the importance of giving patients incentives to be more engaged with their health care management.

Cory Wiegert stressed that challenges and opportunities lie in getting to know patients as individuals, and what the cost savings are to those patients as individuals.

Michael Swiernik talked about the social determinants of health, about barriers patients face in taking advantage of the health care system, and about why some people fall through the cracks.

ACTION ITEM

• We need to get (medical) devices into people's hands and not just step counters
• We need devices that read blood pressure, sugar readings, weight, etc. but do so constantly like step counters do
• Devices that monitor throughout the entire day are needed Platform partners are needed
• Costs need to come down to deploy all of these devices

TAKE-AWAY

• Technology is about cost of course, but there's also context, correlation, and consent
• Individuals need to own data and be able to share it
• Data needs to be customized because each patient is different
• Allow providers better application of all of this data
• The industry as a whole needs to change its practice to adapt to all of this new data

BEST PRACTICE

• Culture change: Keep the user engaged
• Don't just keep the data, but use the technology for appointment reminders, etc. as well
• Saving trips for the patients means higher satisfaction from them, although older patients still prefer the social interaction
• Activity is both medicine and mood, so a general reading doesn't always give all of the relevant information needed
• Need to address a generational shift, most older patients have access to but won't download apps because they don't want to adapt to new technology
• There could also be legal problems if patient‘s miss data, so it's better for it to reach doctors first but always be available to the patient

ISSUES

• Kaiser's challenge right now is knowing why data was collected, because there's just too much data to sift through at the moment
• Need to find incentives for patients so that adoption rate increases

GAPS OR OPPORTUNITIES

• Closing the gap of the clinical consensus
• Collect the data, then find out how the patient feels
• How do you incentivize providers as well?
• Know each individual and let them know what you know about them
• Solve the issue of so many patients without care (due to income or location)

FINAL THOUGHT
While wearables have made a huge splash in the market, it's now time to focus on using them to the best of their ability. Don't just focus on step counts or data that's only collected once or twice a day, think about developing a wearable that reads multiple factors throughout the entire day so you can get a true idea about data averages and spikes that you might need to focus on. Incentivize the use and adoption rate of these wearables to consumers so that hopefully the industry can get a broader picture of current population health as well as individual care.

Transformational Shift: New Business Models in Healthcare

PRESENTER
Greg Caressi
Senior Vice President,
Transformational Health
Frost & Sullivan






SESSION ABSTRACT

This discussion helped participants gain valuable insight into new marketplaces and implications across value chains. Examples of how transformation in healthcare can be leveraged to develop new business models was also presented. Led by Senior Vice President Greg Caressi, participants examined top global case studies and utilized them to identify new channel partners, new customers, new convergence ideas and revenue streams across the entire ecosystem.

KEY TAKE-AWAYS: 

• An assessment of the future success potential of current and emerging business models in the B2B and B2C segments across industries 
• Identification of new partner networks, future customer segments and valuable revenue streams for your company 
• Analysis of new product positioning, new value proposition through creation of a business model canvas

OVERVIEW

Healthcare is being transformed and new business models are evolving around six overall themes:

1. Building an Ecosystem
2. Moving from Product to Service
3. Decision Support
4. Integration Is King
5. Process Change
6. Mass Customization

Some key developments in new healthcare business models include:

• Artificial Intelligence solutions being used for workflow optimization (e.g., triage) purposes
• The use of social media, more on the consumer side than the institutional side, for purposes such as activity coaching
• The tendency to view market segmentation and/or fragmentation as an opportunity where one solution can be adapted across various stakeholders
• Enhanced patient comfort level with having their information reside in the cloud
• Consumer willingness to co-pay seems set at around $30-$50
• Genomics is one new area of innovation in business models; within 5 years it will be considered “malpractice” not  to use some genomics technologies, particularly in oncology
• Intermountain Healthcare is one of the leaders in offering healthcare providers genomics testing 
• IBM Watson is partnering with Memorial Sloan Kettering to leverage genomics and analytics
• The American Society of Clinical Oncology (ASCO) is partnering with Systems, Applications and Processes in Data Processing (SAP) to develop big data solution for oncologists nationwide
• Shared infrastructure platforms are being shared across practice groups

TAKE-AWAY

• 64% of patients would see a doctor via video
• 70% of patients would rather have a video visit
• Access and convenience is more important to patients than physical contact, many are also very unconcerned with having their info on the cloud
• Price points are similar for most available options which makes things easier
• You can adapt one technology and one solution to many different stakeholders, so it's better to increase chances of success by going to a wider range of stakeholder groups

ACTION ITEM

• Change consumer attitudes towards healthcare delivery

BEST PRACTICE

• Reimburse only for the best pathway of healthcare delivery
• Artificial Intelligence (AI) is used for determining models and learning from them
• Find an enterprise based analytics solution located within a clinical setting
• Speed up ingestion and analytics of data
• Find the balance between one on one and subscription based model
• Retail clinics have an opportunity to provide a positive impact for minor issues
• A lot of different parts when it comes to chronic care leads to new models, possibly subscription based models
• While many in the field are reducing interaction with it, the FDA is still a central player; you need to worry about the FDA
• The first conflict point will probably be provider-payer not consumer-payer
• Cloud is the new change that has to happen, there is just too much data to house physically

FINAL THOUGHT

With the coming influx of technology and the growing consumer adoption rate, you need to really position yourself within the field and make use of the tools and analytics that are becoming increasingly more available. Cloud storage and the upcoming use of AI to help interpret all of this data in a meaningful way will be one key to success.









 

The Future of Consumer Health: Changing the Landscape of Healthcare

 


PRESENTER
Peter Antall, M.D.
Chief Medical Officer
American Well





SESSION

Telehealth is a well-established technology used to provide on-demand healthcare directly to a patient, wherever the patient is currently located. While these vendor-driven use-cases offer patients convenience, access and decreased cost, they generally are unable to address the larger issues of population health and coordinated care. The emergence of direct to consumer telehealth has not gone unnoticed by providers and hospital systems, who are now embracing telehealth as part of an overall strategy to become more consumer centric, to participate in the direct to consumer market and to cost-effectively care for their patient populations.

Telehealth-enabled health systems offer the promise of high-quality, coordinated care that is convenient, consumer-centric and leverages the ability to bring to bear virtual care teams around patients and populations. Best practices have also emerged that combine the experience and quality systems that exist in hospital systems with the technology and consumer facing expertise that exists at the vendor level.

KEY TAKE-AWAYS: 

• Insight into why direct to consumer telehealth programs are growing and thriving
• Examples of hospitals and provider organizations are embracing telehealth and why it's good for patients
• Best practices and evidence-based guidelines for telehealth
• Challenges and barriers that still exist for providers

This session defined telehealth and explored the current state of telehealth.  Antall predicted that healthcare that is not already online will be very soon. He also stated that although we are in a new connected age, that is not necessarily true for healthcare as online healthcare is still often a “hassle” for consumers compared to the ease of many other online tasks and transactions.

TAKE-AWAY

• Telehealth will continue to make a difference
• The healthcare future holds self-scheduling provider options and the ability to access  
• practitioners in an uber-like manner
• Consumers are realizing that telehealth is available, helpful, and convenient
• Because of increased demand, vendors are now creating supply
• Large integrated systems are coming into the game since the bigger vendors want to
• keep their patients
• Telehealth saves time which could help doctors and patients alike
• 57% of health providers are providing or willing to provide telehealth
• Telehealth can broker meaningful connections between providers and patients
• Telehealth is still a challenge for everyone, largely due to the fact that it is relatively new
• Consumerism is about making things seamless and easy: press a button, connect, and have a meaningful health visit

BEST PRACTICES IN TELEHEALTH

Telehealth is about:

• Interacting with patients wherever they are and patients being able to reach their health providers wherever they may be
• Placing choice in the patient’s hands and offering a focus on convenience for both patients and providers
• Moving beyond acute care and behavioral health to follow-up visit simplicity during post-op checks, etc.
• Keeping all data available so there's no issue with taking medicines without doctors knowing
• Average wait time is 3 minutes (data from last 3 years) this is unprecedented, especially since it's already available in 48 states

THE FUTURE OF TELEHEALTH

• Rather than build a diffuse network, build a national medical group
• Build behavioral health and nutrition programs
• Operations and support: Running telehealth is different since there's a new learning curve
• The industry is working to develop dermatology, pediatrics, and hopefully post-op applications soon
• So many acute visits are usually reassurance only, so telehealth makes that easier
• Some worry that telehealth will take away patients, but that's not the case according to data
• Healthcare has to change and has to be able to facilitate the types of visits you would normally do
• Due to unused capacity of physicians, uber-like technology makes it easier to connect patients with available doctors
• There's a wealth of consumer biometrics in the cloud
• Collaborative care with full patient data for all health care providers who are working with the patient is the way to go, there needs to be a focus on centralized data
• The industry is slowly moving from consumer space to hospital setting
• 3 way video for multi-way conversation with patients (either another physician, caregiver, translator, etc.) will make things easier
• It's not just about the technology, that's just where you start.
• Need to think about workflow, staffing model, etc.
• Think about knowledge transfer, living documents, etc.
• Future is about reinventing how healthcare is delivered
• All consumers are patients and all patients are consumers
• The industry is starting work in the Medicaid space, we need a tool to democratize health care

FINAL THOUGHT

Clearly telehealth will be a game for the medical industry. Due to its increasing availability, ease of use, and convenience for both patient and practitioner, not only will it save everyone who uses it money, but time as well. Additionally, telehealth has the potential to make things much easier for family members to help and reassure patients by being there without actually physically being there. That is revolutionary.

Welcome to the World of Game Changing Healthcare Technologies

 

PRESENTER
Greg Caressi
Senior Vice President
Healthcare & Life Sciences
Frost & Sullivan





SESSION
Analyst Greg Caressi digs deeper into the changes happening within the medical technology market. The healthcare sector needs to extend beyond advancing clinical standards of care to address the high costs plaguing the industry. This can be attributable to catastrophic care bankrupting individuals and the health system; hospitals facing insolvency; the need to change processes of care delivery; and information systems and management not delivering appreciative value to clinicians. Following what the healthcare sector is doing to overcome these issues, Caressi identifies five transformations driving opportunities in healthcare:

• Wellness, prevention and reducing the impact of chronic disease
• Re-imagining care delivery and looking at the process of getting clients and care providers adjusted to implementing new technologies
• Facilitating a change from hospital-based consumer roles to consumer roles in smaller clinic environments.
• Moving from product to platform—selling technologies and solutions
• Patient-centered outcome models that add value while driving incremental and distinctive innovation

TAKE-AWAY
Identify key technologies impacting the industry of today as well as tomorrow. Focus on patient-centered, value-based models for efficient, cost-saving solutions

BEST PRACTICE
The following transformations become game-changers in medical technologies:
1. Innovating chronic care approach

• Improves outcomes, lowering system and per-member per-month (PMPM) cost
• Supports cost of care innovations and outcome-based incentives in vendor contracts.
• Extends solutions outside of the hospital setting
• Extends solution models to primary care, home-based interactions and IT solutions to identify and track at-risk individuals

2. Better use of staff

• Chronic disease management requires more interaction with patients at a lower cost, requiring the use of advanced technology and lower-cost clinical personnel
• Chronic disease management strategies: Rigorous process for patient management and care protocols
• Going digital: Preventive care and remote diagnostic models require the use of technology solutions to enable scalability
• Role of new participants
• Proactive patient interaction strategies, new tools and processes, and new vendor and stakeholder partners

3.  Re-imagining care delivery

• Scalability
• Capitated hi-quality care modules require financial viability.
• Department management
• New approaches to improve efficiency in surgical suite, catheterization lab, imaging services, infant / pediatric care, ER, etc.
• Decision support
• Automating non-critical decisions and documentation that take up significant time and add a resource burden
  

4.  Building the ecosystem

• Forming partnerships with a range of stakeholders, vendors, patients and families, analytics service providers, and supply chain
• Process change
• Care coordination and collaboration. Includes initializing artificial intelligence and automation to speed processes, digest information and reduce labor costs and human error
• New revenue focus
• Wellness services, direct contracting with employers and tech innovation co-development with vendors.

5. Changing customer roles

• Rethink the consumer: Beware of disruptions to business on a macro level.
• Identify the target: Rethink and expand target audience, also within same provider organization. Approaches to consider: adaptive and holistic care models.
• Value to individuals
• Patients are no longer passive participants. The patient may not be a direct consumer while still retaining the status of key user
• Role of new participants
• Extend reach to new competitors and partners as the value of analytics, customer relationship management, patient interaction, stakeholder collaboration and service delivery models increase.Provider consolidation
• Consolidation among providers is changing the volume and scale of relationships. Larger providers will likely look to scale back on number of vendors
• Viability of “As a Service” solution and smaller customers
• Small and mid-size providers will increasingly move to a pay-as-a-service model as vendors move toward service/solution models
  

6. Moving from product to platform

• Data vs. information: Value is not derived from data collection, but in the conversion to insight and change in behavioral process
• Security: Eliminate potential data leaks. Insecurity is one of the major impediments to large scale deployment of analytics and connected platforms
• Building the ecosystem: Forming partnerships with key stakeholders is critical
• Decision support: Automating non-critical decisions and documentation, and providing artificial intelligence support to make sense of increased volume of lower-value data
• Monetization strategies: Failure to define monetization models have become key factors behind majority of market exits
• Integration is king: Institutions and consumers will increasingly value integrative solutions that reduce fragmentation of information and processes

ACTION ITEM

The healthcare sector must implement methods of engaging the patient and initiating behavioral change. This will involve many partners and technologies outside of the industry itself. Healthcare will also need to better understand what the patient wants. There are many individualized and customer relationship solutions that must be cultivated.

Healthcare provider organizations are just now beginning to focus on the process of team-based care and learning how to put their staff to better use. Some models promote adding more staff at a lower cost but in the end, re-engineering healthcare means utilizing people in different ways and bringing in technology solutions to help reduce costs. Additionally, lower-paid staff isn't a practical solution to lower healthcare costs.

TAKE-AWAY
Create frameworks to track technologies and competitors in a converging world.

BEST PRACTICE

The last transformation--value-based/patient centered outcome-based models driving incremental and disruptive innovation--first surfaced in 2013. One model is the accountable care contract (ACO), authenticating the change of payments into the category of costs and recognizing that cost is now a potential savings. 

ACTION ITEM
Key lessons learned in recent years:

• ACOs are part of the shift from volume to added-value
• Medical technologies vendors would benefit from exploring outcome-based contracts with providers and payers

TAKE-AWAY
Insight into multi-billion dollar opportunities arises out of the serendipitous tech convergence with high-quality, lower-risk patient care.

BEST PRACTICE  

Technology adaptation will become more valuable when factored into an integrated model. The consumer is not the last evaluator. Committees are being formed to assess how an information solution can be a tool of change throughout organizations, not just a technology solution.
Risk-sharing drives partnerships so the model is no longer treating sickness but preventing it.
 

ACTION ITEM
Look at longer-term relationships and ecosystem partners both within and outside the healthcare sector. Technology companies need to restructure to address market disruptions.
Restructuring points include:

• Inevitable commoditization
• Broader portfolios provide greater flexibility for bundling
• Shredding products with low margins, high competition
• Own entire value chain
• Optimize distribution and sales channels 
• Tax inversion / financial tools

• Honing focus
• Streamline portfolio towards high value, high growth segments 
• Shift away from solutions anchored to fixed reimbursement levels 
• Align R&D, M&A strategies, internal competencies with core focus areas

• Expanding scope and scale
• Build information and services platform around products
• Develop offerings targeting entire disease continuum
• Tier solutions for different use cases, payment models
• Delineate luxury and base offerings (i.e. the Toyota-Lexus model)

FINAL THOUGHT
There are many ways healthcare technologies and direct care solutions can leverage innovation and create new thought around driving up value and lowering costs.