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TRANSCRIPT
Making Care Mobile:
Shifting Perspectives on theVirtualization of Health Care
www.pwc.com/ca
CIO Connect BreakfastJune 11, 2013
Agenda
1
2
Key Trends Shaping Healthcare
Making Care Mobile: Study Highlights
PwC
3 A Possible Future…
4 Moving Your Organization Forward
Slide 2
Key Trends Shaping Health Care
PwC Slide 3
Health Care in Canada: We are Tracking Four KeyInnovation Trends
Focus on “Frequent Flyers” (Health Links) as a Solution to Integration
• The 1% who account for a third of healthcare dollars
• Create more efficient and accountable care paths
• Integrate and standardize care; more efficient usage of resources
Activity-Based Payments (QBP)
• Identify the leading practice treatment pathways for specific diagnosis
1
2
PwC
• Identify the leading practice treatment pathways for specific diagnosis
• Funding based on that pathway and a fixed prices for services model which allows for innovation
• Allows funder to pay for what they want (and not what they don’t want)
Digitization Continues and Morphs into mHealth
• eHealth is currently providing little or no core support for hospital system upgrades
• Fast-changing environment threatens centrally planned models
• mHealth is a huge new factor in the last three years
Continued Model of Care: Innovation shifts to Virtual Care
• Advances in technology are enabling “care anywhere” networks
• Smart phones and tablets are being used as an educational platform in Medical School
3
4
Slide 4
Making Care Mobile: Shifting perspectiveson the virtualization of health care
Highlights and Key Findings
PwC Slide 5
Making Care Mobile: Shifting Perspectives on the Virtualizationof Health Care
• Report explores Canadians’ attitudes towards pertinentissues in the health care industry
• Provides analysis of what citizens expect decision makers tokeep in mind when thinking of the future of health care inCanada
Goal of the report
PwC
Canada
• What improvements are citizens looking for in health care?
• What channels are citizens using to access health care andinformation now, and in the future?
• What innovations are citizens ready to use that can makehealth care delivery more efficient?
• What are the future possibilities in health care delivery?
Key Questions
www.pwc.com/ca/virtualcare
Slide 6
Nearly 2,500 Canadians helped us address the central question:“What does the future of health care delivery look like?”
• 2,413 Canadians participated over 3 week period
Methodology
PwC
• Research was conducted through interactive online‘Choicebook’ where respondents:
• Learned about vHealth and mHealth
• Explored important questions related to key issues
• Reviewed advantages, disadvantages and trade-offsinvolved in scenarios
• Thought through and identified what services theywould like to use in the future
www.pwc.com/ca/virtualcare
Slide 7
Mobile devices and virtualization of care make it possible to provideand receive health care treatment and preventative services outside oftraditional care settings.
Mobile health and virtual health tools may include:
• remote patient monitors
video conferencing
Making Care Mobile
PwC
• video conferencing
• online consultations
• personal healthcare devices
• smartphone or tablet apps
• wireless access to patient records and prescription applicationsusing a cellphone, smartphone or wireless tablet
Slide 8
vHealth and mHealth are related, but different
PwC Slide 9
What are Canadians Saying?
• Canadians are aware of the challenges andgrowing demand facing our health caresystem
• Canadians are gaining comfort interactingonline, and see mHealth solutions as a way toaddress concerns
Perspectives on our Healthcare System...
PwC
address concerns
• Overall, respondents are satisfied with healthcare quality they receive
• However, respondents indicate that there arekey areas for improvement related toimproved access to health care providersthrough the use of more moderncommunication channels
Slide 10
Canadians are interested in mHealth tools that canimprove access to a doctor and health information…
34%34%of patientsreport that
What would be the main motivation for youto use mHealth services and applications?
PwC
report thatconvenientphysicianaccess wouldmotivate themto adopt amHealthservice or app
Slide 11
… such as apps for secure access to personal health info,scheduling & communication with health care professionals
70%70%are interestedin apps that
Which of the following mHealth apps/serviceswould you be interested in using?
64
70
Apps or services that help me schedule medical appointments
Apps or services that help me securely access my healthinformation, such as lab results or immunization history
Co
nn
ec
tC
on
tro
l
PwC
in apps thatprovide secureaccess topersonalhealthinformation(such as labresults)
7
31
41
44
48
50
63
64
No Answer
Apps or services that help me manage my own wellbeing bygathering data automatically
Apps or services that help me securely access a familymembers health information, such as lab results or
immunization history
Apps or services that work with my medical devices to senddata on my condition to my doctor
Apps or services that help me manage my own wellbeing
Apps or services that gather general information onhealthcare, such as illnesses or medications
Apps or services that help me communicate better with healthcare professionals
Apps or services that help me schedule medical appointments
Slide 12
Co
nn
ec
tC
on
tro
l
Most Canadians would use secure email for non-urgent health concerns
79%79%of patientsindicate that
PwC
indicate thatthey woulddefinitely , orprobably, usesecure emailfor non-urgenthealthconcerns
Slide 13
There is latent demand amongst Canadians formobile-enabled prescription renewal services
83%83%of patientssurveyed
PwC
surveyedwoulddefinitely, orare likely to,use onlineprescriptionrenewalservices
Leading the Way: More than 50% of Walgreensonline prescription refills done through mobile device(vs.10% three years ago). Walgreens is refilling oneprescription per second on a mobile device.
Slide 14
Virtual assessments via apps are good options inthe right situation…
52%52%of patientsindicate that
15%
20%
21%
36%
None of the above
You use an app for an initial assessment
You send it to your doctor using an app
Doctor takes the photo and communicates withdermatologist
Canadians were comfortable with virtual mole assessment appscenario – although, at this time, most prefer doctor-controlled option.
PwC
indicate thatfaster access tocare is theprimaryappeal ofvirtualassessment
1%
8%
No answer
Not sure
Slide 15
... Canadians told us they are ready for virtualmonitoring for chronic conditions…
79%79%of Canadiansindicate that
Most Canadians indicated they would be comfortablehaving a chronic condition monitored virtually...
36%
43%
10%
5%
4%
Yes, definitely
Probably
Not likely
Definitely not
Not sure
PwC
indicate thatthey arecomfortablewith virtualmonitoring forchronicconditions
4%
2%
Not sure
No answer
... and 62% of caregivers indicated that virtual healthcare would help them to provide care for someoneelse (e.g. parent/ child)
Slide 16
… And virtual visits for post-surgical follow-up.
54%54%of Canadiansindicate that
24%
43%
17%
11%
5%
Yes, definitely
Probably
Not likely
Definitely not
Not sure
The majority of Canadians indicated they would becomfortable having post-surgical follow-up visitdone by video conference.
PwC
indicate thatvirtual visits,homemonitoring,and virtualwards are goodcare deliveryoptions
5%
0
Not sure
No answer
Slide 17
Canadians want more opportunity to engage in their healthcare – the convenience of virtual monitoring offsetsconcerns related to risk of exposed personal data.
46%46%of Canadians
PwC
of Canadiansrankedconveniencehigher thanprivacy whenconsideringvirtualmonitoringtrade-offs
Respondents expect privacy to be addressed as tablestakes. However, privacy concerns must be balancedwith innovation in service delivery.
Slide 18
Doctors and patients all over the world not only believe thevirtualization of health care is coming, but that it willimprove the delivery of care when it does.
PwC
For the Canadian health care sector to remain competitiveas a leader in medical services, new delivery methodsneed to be explored and implemented
Slide 19
A Possible Future…
PwC Slide 20
We need to construct the Apps Formulary
Take 2 Apps and
Tech RxApps Pharmacy not Apps Store
PwC
Take 2 Apps andCall Me in theMorning
Apps Formulary
AliveCor Cardiac
Withings Blood Pressure
bant Diabetes
Pain Squad Pain Mgmt
MyIBD Crohn’s Disease
UK (Cambridge Healthcare): “Europe’s First Health-App Store” developing certification process for apps itsells.US (Happtique): market-leader in health appspublished set of standards to certify apps operability,privacy, security, content reliability
Slide 21
We need a process and standards for selection,and a taxonomy for regulation of apps
Front ofStore
Over theCounter
Criteria for evaluation include:
• Operability
PwC
Counter
Prescription
ControlledSubstance
• Operability
• Privacy & Security
• User Data Safeguards
• Functional Validation
• Clinical Efficacy
Slide 22
Front of store apps are mHealth ‘vitamins’ thatsupplement a healthy lifestyle
Front ofStore
Over theCounter
Fitness and Health• Fitbit
• Nike+ Fuelband
• MyFitnessPal
PwC
Prescription
ControlledSubstance
• Sleep Cycle Alarm Clock
Wayfinding Apps• BC Health Service Locator App• Hamilton Health Sciences App• Alberta Health Services App
Slide 23
Fitbit –Helps you achieve your fitness goals
Front ofStore
PwC
Fitbit – Flex
• Measures data such as the number ofsteps and distance walked, stairs climbed,calories burned, activity duration andintensity as well as sleep quality.
Slide 24
Health services apps to enhance patient experience
Hamilton Health Sciences App Front ofStore
PwC
BC Health Service Locator App Alberta Health Services App
Slide 25
Front ofStore
Over theCounter
• My Heart&Stroke Health <30 Days
• MyNetDiary• Medication Reconcilliation
(MyMedRec)Withings (blood pressure tracking)
Over the counter apps may be dispensed after anassessment of the patient's needs
PwC
Prescription
ControlledSubstance
• Withings (blood pressure tracking)• Masimo – iSpO2 Device• Mood Watch• Education Apps
Slide 26
Withings– Blood Pressure Monitor
Over theCounter
WithingsBlood Pressure Monitor
PwC
Blood Pressure Monitor
• Monitors blood pressure andheart rate
• Attaches directly into anyiOS device
• Allows users to viewmeasurements, graphs andtrends over time
Slide 27
Masimo – iSpO2 Device
Masimo – iSpO2 Device
Over theCounter
PwC
• Accurate noninvasivemeasurement of bloodoxygenation, pulse rate andperfusion index
• Connects to any iOS device• Allows users to view
measurements, graphs andtrending over time
Slide 28
Patient / client / family education apps provide astandardized, yet tailored experience
Over theCounter
PwC
Education Apps
• Standardized, customizable approach to client/patient education inreal-time or asynchronous manner
• Teach-out, follow-up, triggered instructions for self-care
Slide 29
Prescription apps: plan of care written by physician orother health professional
Front ofStore
Over theCounter
Supported self-management• Diabetes – bant• Mental health - Lawson SMART
record• Asthma – breathe• MyIBD
PwC
Prescription
ControlledSubstance
• MyIBDPost-surgical patient follow-
up
• QoC
PHR / test results viewing
• Wellx
• MyChart
• InstantPHR
Slide 30
Lawson Supportive Mental AssessmentRehabilitation and Treatment (SMART)
Lawson SMARTRecord
Prescribed
PwC
Record
• Created for LawsonHealth ResearchInstitute, the LawsonSupportive MentalAssessmentRehabilitation andTreatment (SMART)record is an example ofa customized mentalhealth PHR, built usingthe instant PHR (iPHR)Toolkit. Slide 31
Wellx
Prescribed
PwC
Wellx
• Allows patients to easily and securely connect with their healthcare provider• Receive lab results• Refill prescriptions
Slide 32
breathe – Improved asthma control
Self
Management
Improved
Asthma Control
Improved
Health
Outcomes
Prescribed
PwC Slide 33
QoC Health Software
Prescribed
PwC
QoC Health Software
• Allows doctors tocommunicate with andmonitor their patients’progress as theyrecover from surgery.
Slide 34
Controlled apps: require close supervision ofmanagement and use
Front ofStore
Over theCounter
• Diagnostic testing and follow-up (m-CARDS)
• Remote Patient Monitoring(GE, Telus)
PwC
Prescription
ControlledSubstance
(GE, Telus)
• Electrocardiograms
• Ultrasounds
Slide 35
Mobile Cardiac Arrhythmia DiagnosticService (m-CARDS)
ControlledSubstance
PwC
m-CARDS
• Auto detect/ auto send wireless Event Loop Recorder (ELR) transmits ECGthrough BlackBerry Smartphone
• patients are taught to self “hook-up” using video instruction
Slide 36
AliveCor– iPhone Electrocardiogram
ControlledSubstance
PwC
AliveCor
• Instant, portable electrocardiogram (ECG) rhythms• Cleared by the FDA for sales in the USA to licensed medical professionals and
prescribed to patients
Slide 37
MobiSante – MobiUS
ControlledSubstance
MobiUS
PwC
MobiUS
• Cleared by the FDA in 2011,accurate and inexpensiveSmartphone-based ultrasoundimaging system
Slide 38
Moving Your Organization Forward
PwC Slide 39
Health care leaders should have four coreplanning assets for mHealth in 2013
Point of View on BYOD
Develop organizational point of view onBYOD based on review of currentoperating environment, organizationstrategy, IT strategy, and mHealthreadiness assessment.
Mobile StrategyRoadmap
mHealth opportunity matrix and high-level strategy roadmap with prioritizedopportunity areas for organization acrosskey stakeholders segments (characterizedby value proposition, high-level cost-benefit, and/or implementation effort).
PwC
MobileStrategy
Mobile ApplicationInventory
Inventory of all applications – currentmobile apps and those that may bemobilized in future – leading to alignmentof IT infrastructure with organizationalstrategic objectives. A critical step tomaximize return on IT investment.
benefit, and/or implementation effort).
Apps Formulary
Health care organizations need a deliverysystem to direct patients/clients to apps.Develop and publish an apps formularythat provides physicians and staff with listof applications for their clients/patientsthat have been approved for use.
Slide 40
Thank you
Will Falk
Managing Partner, Healthcare
416.687.8486
@willfalk
Mark Casselman
This content is for general information purposes only, and should not be used as a substitutefor consultation with professional advisors.
© 2013 PricewaterhouseCoopers LLP, an Ontario limited liability partnership. All rightsreserved.
PwC refers to the Canadian member firm, and may sometimes refer to the PwC network. Eachmember firm is a separate legal entity. Please see www.pwc.com/structure for further details.
Mark Casselman
Director
416.687.8480
@markcasselman