healthcare unbound state of the union opening keynote presentation july 2006 boston, ma vince...
TRANSCRIPT
Healthcare UnboundState of the Union
Opening Keynote Presentation
July 2006 Boston, MAVince Kuraitis JD, MBA
Better Health Technologies, LLCwww.bhtinfo.com (208) 395-1197
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Agenda
I. “Remarkable” Events Of the Past YearII. Everything You Know is Wrong
What You Think You “Know”A. The killer app for HU technologies is chronic disease management B. Providers, especially physicians, are technology curmudgeonsC. HU is about Home Sweet HomeD. A $34 B HU market by 2015? No way!
The “Truth” revealedA. B. C. D.
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“Remarkable” Events Of The Past Year
• Continua created through Intel’s leadership• Medicare pilot/demo projects launched
– Medicare Health Support (MHS)– Care Management for High Cost Beneficiaries (CMHCB)
• American Health Information Community (AHIC) breakthrough projects launched
– Secure messaging – Personal Health Records
• Industry consolidation– DM: Matria acquires CorSolutions; Healthways acquires Lifemasters– Philips acquires Lifeline
• Physicians (AAFP and ACP) endorse the “medical home” model• Qualcomm announces plans for a healthcare MVNO• SPAN study finds: DM + RPM > DM alone• UK – National framework agreement for telecare achieved • VeriChip announces IPO plans• California enacts the Tom Cruise Ultrasound Bill• ....and many others
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II.
Rethinking assumptions...
...which have created conventional wisdom
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A) The killer app for HU
technologies is chronic disease
management
The “Truth”Hospital-At-Home (HAH)
Promises to Be the Biggest Disruption of All!
What You Think You “Know”
$34 B Market for Healthcare Unbound Technologies
$0
$10
$20
$30
$40
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
ADL/elder Chronic Acute
Total
Acute
Chronic
ADL/elder $0.35
$US(billions)
$0.37 $0.47 $0.59 $0.73 $0.98 $1.2 $1.6 $2.0 $2.4 $3.0 $3.7
$0.10 $0.13 $0.22 $0.38 $0.65 $1.2 $3.8 $12.1 $23.1 $26.3 $25.7 $26.7
$0.00 $0.00 $0.00 $0.00 $0.01 $0.02 $0.65 $2.0 $3.6 $3.5 $3.0 $3.2
$0.45 $0.50 $0.69 $0.97 $1.4 $2.1 $5.7 $15.7 $28.7 $32.3 $31.7 $33.6
(Numbers have been rounded)
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Hospital at home is defined as a service that provides active treatment by health care
professionals, in the patient's home, of a condition that otherwise would require acute hospital in-
patient care, always for a limited period.
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While there is some overlap....
Disease/condition management is mostly about avoiding hospital care (and other
high-cost care)
HAH is mostly about substituting for hospital care
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Hospital-at-Home -- Background
• Concept emerged in the 1960s• Significant research/literature base
– Almost all outside of U.S.– Cochrane review– Hopkins as only U.S. project– Irony
• HAH definition varies• NOT based on leveraging technology• But, HAH can be turbocharged with technology
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Elaborate Proof of a Hypothesis.....
The Willie Sutton Theory of Hospital-At-Home
Projected 2014 U.S. Annual Hospital Costs = $1 Trillion
Projected HU 2015 market of $34 B = 3.4%
Outside the U.S. ....
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HAH Driving/Restraining Forces
Cost reduction opportunity
Hospital safety/error issues
Concerns over hospital acquired infections
Patient preference for home
Benefit structures & incentives
Advancing tech allows for safe care in home
Potential burden on caregivers
Risk of HAH being viewed as a reincarnation of managed care
Physician concerns and inconvenience?
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Call to Action
The U.S. needs to join & advance the world dialogue
about hospital-at-home
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B) Providers, especially
physicians, are technology
curmudgeons
The “Truth”
Providers are beginning to see the light...
What You Think You “Know”
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Primary Care Physicians Endorse the Medical Home Model
The American College of Physicians position paper on the Advanced Medical Home describes that key elements of a revised reimbursement system should include compensation for:
b) adoption and use of health information
technology for quality improvement; c) provision of enhanced communication access such as secure e-mail and telephone consultation; d) remote monitoring of clinical data using technology; and e) pay-for-reporting or pay-for-performance. (p.8)
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Don’t Count Providers Out Yet
• DM companies and health plans were winners of the Medicare Health Support pilot project awards (MMA §721)
• But, Medicare has many provider based experiments in the works– Care Management for High Cost Beneficiaries demo– Medicare Health Care Quality Demonstration (MMA §646) – Medicare Care Management Performance Demonstration
MMA (§649) – others?
• Keep an eye on provider initiatives outside the U.S.
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C) Healthcare Unbound is about Home Sweet Home
The “Truth”
The Who had it right...HU is about “going mobile”
What You Think You “Know”
Let’s look at a prehistoric HU hieroglyphic
from 1999 ...what’s
wrong with this picture?
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Mobile/Wireless Apps – the Next Wave of Technology Disruption
[Forrester, June 2004]
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The Disconnect
Chronic Disease/Condition Management is migrating– From a clinical based model – Toward a behavior change model
How can you optimize behavior change without 24x7x365
connectivity to the patient?
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Implications
• We have underestimated the impact of mobile/wireless technologies for HU
• We need to reframe the UI debate– From: Competition among specialized home devices
vs. PCs vs. TVs vs. other– To: Integration and interoperability to achieve 24x7x365
connectivity
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The “Truth”
$34 B under sizes the HU market.
D) A $34 B HUmarket by 2015?
No way!
What You Think You “Know”
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There Must Be Very Good Times Ahead, Right?
x HU
Wrong! Near-term, HU is at the peak of inflated
expectations.
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Summing Up the Truths (Long-term)
A. Hospital-At-Home (HAH) promises to be the biggest disruption of All!
+B. Providers are beginning to see the light...
+C. The Who had it right...HU is about “going mobile”
=D. $34 B under sizes the HU market
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Long-term....A (Not So) Rhetorical Question
If we can spend $1 Trillion a year in the U.S. to care for people in buildings where– There is a high risk of infection– 98,000 people die annually due to medical errors– The cost of care is higher than anywhere else– People don’t want to be
Why would we spend only 3.4% as much ($34 B) to care for people in their
homes and communities?
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APPENDIX
• Creating value for patients and shareholders• Strategy, business models, partnerships• Disease/care management and e-health • Consulting/Business Development
• E-Care Management News– Complimentary e-newsletter– 3,000+ subscribers in 27 countries worldwide– Subscribe at www.bhtinfo.com/pastissues.htm
Better Health Technologies, LLC
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BHT Clients
Pre-IPO CompaniesHealthPost
Cardiobeat
HomMed
EZWeb
Sensitron
Life Navigator
Medical Peace
Stress Less
DiabetesManager.com
CogniMed
Caresoft
Benchmark Oncology
SOS Wireless
Click4Care
eCare Technologies
The Healan Group
FitSense Technology
Established organizationsSamsung Electronics, Seoul
Intel Digital Health Group
Medtronic
Philips Corporate Strategy Group, Amsterdam
Siemens Medical Solutions
Joslin Diabetes Center
Sears Methodist Retirement System
National Rural Electric Cooperative Association
Disease Management Association of America
Blue Cross Blue Shield of Massachusetts
PCS Health Systems
Varian Medical Systems
VRI
Washoe Health System
S2 Systems
CorpHealth
Physician IPA
Centocor
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