the digital transformation in healthcare services is...
TRANSCRIPT
THE DIGITAL TRANSFORMATION IN
HEALTHCARE SERVICES IS
CHALLENGING NEW BUSINESS MODELS
Luís Velez Lapão, PhD, MSc
15th June 2016
Environmental
Data
Life Signals
INTEGRATED HEALTHCARE RECORDS
Biosensors
Genomic data
Biochips
DIGITAL TECHLOGY IS PUSHING HEALTHCARE...EUROPEAN COMMISSION STRATEGY IS BASED ON AN INTEGRATED NETWORK
OF SENSORS AND INFORMATION SYSTEMS
NEW EQUIPMENTS ARE ARRIVING… AND THEY ARE LEVERAGING THE CAPACITIES OF HEALTH PROFESSIONALS
LV Lapão 2014
…Professionals are also
changing behaviour
THE EFFECT OF DIGITALIZATION IN HEALTHCAREBudget limitations and the lack of a proper business-models are primary
reasons for unsuccessful implementation
For many decades most telemedicine/eHealth projects were mainly deployed
as pilot/research programs.
Although the hype and the proven fact that it adds both clinical and economic
value, the reality is that most cases did not reach routine-care, i.e.
transformation. Several reasons are recognized as being responsible for
that. Budget limitations and the lack of a proper business-models are
the primary.
The Momentum project, a thematic-network partially funded by the
European-Commission, coordinated by EHTEL, and with the involvement of
EHMA, has addressed this problem.
There is a need to developed new
business-models that better address the
digital transformation challenges of today.
Digital Technologies
Management/PatientKnowledge
Health Professionals’
Skills
SOCIETY CHANGE
HEALTHCARE SERVICES DIGITAL TRANSFORMATION
LV Lapão 2015
TELEMEDICINE’S WAVES OF DEVELOPMENT
First Wave Second Wave Third Wave
Timeframe
Emphasis
Scope
Nature
60’s-70’sEarly 90’sto present
Coming
decade
FeasibilityClinical
DevelopmentServices
Integration
Very limitedFringe
populationsMainstream
Care Delivery
Video links + Instrumentation + Informatics
&
Business Models
Product centred model…
…Patient centred model
HEALTHCARE SERVICES: PARADIGM CHANGE
mHEALTH MARKET IN 2015: 500 MILLION PEOPLE ARE
USING HEALTHCARE SMARTPHONE APPLICATIONS
AAL HEALTHCARE SERVICES MODEL
- Socio-Technological Systems
PEOPLE/CHRONIC PATIENTS
… Other Channels
Sensors 2.0
Interactions/Usability
Cloud
Automatic
Systems
Operador,
Nurse
Physicians
Service Management: QoS & SLA
Health Managers
Service Organization
Sales/Marketing/Financing/Cost Modelling
- Home assessment
& installation
- Help desk
(different clients)
Health Units
- IT Support &
Management
- Maintenance
- HR Qualifications
- Services Integration
- EHR Integration
- Services
Organization
- Clinical Governance
THE PROJECT “MOMENTUM”
A CIP ICT-PSP thematic network
Running from February 2012 until January 2015
The consortium: 21 organisations
Telemedicine associations / competence centres from
Denmark, United Kingdom, Estonia, Norway, Spain, France,
Sweden, Germany, Greece, Poland, Portugal and Switzerland
European stakeholder associations representing
Health professionals and health care organisations, health
insurers, technology vendors
A growing network of partners
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16
BUSINESS MODELS AND ORGANIZATION ARE KEY GO
FROM PILOT TO ROUTINE CARE …
A European Telemedicine
deployment Blueprint
THE CHALLENGE FOR DEVELOPING
eHEALTH AND TELEMEDICINE SERVICES
This is about changing from
Data to services
Data collection to data integration in processes
Tools to process redesign / new care pathways
If not, then one get the equation:
New Technology + Old System = New Old System
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TOOLS AND METHODS ARE REQUIRED FOR
DEPLOYING SERVICES
Impact assessment framework
The results and lessons learned from Renewing Health
The approach of United4Health and Engaged
Guidelines for large scale deployment
The blueprint of Momentum
Business development tool kit
Innovation Governance
…18
MOMENTUM STUDY DIMENSIONS
Strategy
& Management
Legal,
Regulatory&
Security
Organisation &
Change Mgmt.
Technical
&
Market relations
CRITICAL SUCCESS FACTORS
CRITICAL SUCCESS FACTORS FOR
DEPLOYMENT STRATEGYStrategy
& Management
Legal,
Regulatory&
Security
Organisation &
Change Mgmt.
Technical
&
Market relations
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1. Ensure leadership through a champion.
2. Create a community consensus on the
compelling need to address.
3. Define & Develop Business Model and Plan.
4. Put together the resources needed for
deployment.
CRITICAL SUCCESS FACTORS FOR
ORGANIZATIONAL CHANGE
5. Involve health care professionals and decision-
makers.
6. Involve patients: “Patient at the centre of the
service”.
7. Prepare and implement a change management plan.
Strategy
& Management
Legal,
Regulatory&
Security
Organisation &
Change Mgmt.
Technical
&
Market relations
22
Strategy
& Management
Legal,
Regulatory&
Security
Organisation &
Change Mgmt.
Technical
&
Market relations
CRITICAL SUCCESS FACTORS FOR LEGAL,
REGULATORY AND SECURITY COMPLIANCE
8. Establish the conditions under which the service
is legal, ethical, privacy and security experts.
9. Seek for relevant legal and security operational
guidelines to help setting the service up
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Strategy
& Management
Legal,
Regulatory&
Security
Organisation &
Change Mgmt.
Technical
&
Market relations
CRITICAL SUCCESS FACTORS FOR
TECHNOLOGY DECISIONS AND PROCUREMENT
10. Ensure that the IT and eHealth infrastructures
needed are in place;
11. Ensure that the technology is user-friendly,
using processes required to monitor the service.
12. Guarantee that the technology has the potential
for scale-up (i.e., “think big”), maintaining good
procurement practices.
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• Business plan will help to define clearly the TM service objectives and value for each stakeholder.
- All the costs are also analyzed and a cost-benefit analysis is done to check for the validity of the investment required;
- Additionally a timetable is defined and validated by all stakeholders (including patients and health professionals);
HYPOTHESIS:
PREPARE AND IMPLEMENT A BUSINESS PLAN
IS THE MOST SIGNIFICANT CRITICAL SUCCESS
FACTOR FOR TELEMEDICINE TO GO
FROM PILOT TO ROUTINE CARE
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CHARACTERISTICS OF A BUSINESS PLAN
Written business plan describes:
new telemedicine service (access, information flow,
people required, patients, etc.),
business model (resources used, payments, incentives,
service levels, etc.),
Competition analysis,
projections and milestones, and
analysis of the market
Engage health professionals, managers, technicians,
and patients (e.g., testing usability and validating
requirements)
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BUSINESS PLAN: What is It?
• Still many AAL/telemedicine ventures fail to grow beyond the initial
pilot stage.
• It is important to study the business models of successful telemedicine
ventures can help develop business strategies for upcoming ventures.
• We use Osterwalder's "Business Model Canvas” to describe business
models.
• The business models can be compared to draw inferences and
lessons regarding their business strategy and contextual factors that
influenced it.
• A business strategy is clearly necessary for the development of the
next generation of AAL/telemedicine ventures to be economically
sustainable and to successfully address local healthcare challenges.
AAL/TELEMEDICINE BUSINESS MODELS
Business Model Canvas
THE MOST FREQUENT AAL/TELEMEDICINE
FAILURE REASONS WERE IDENTIFIED
• Lack of clear objectives (confusion between services and
technology);
• Lack of leadership and coordination;
• Lack of proper business and service training;
• Lack of business models (benefits estimation, incentives,
reimbursing schema, etc.);
• Lack of integration with the routine services.
Additionally, it was found that this is both a private and public
health services phenomenon, as it is an European problem.
• From the successful cases analysed there are mainly two
different situations:
• the TM services is the continuity of previous services: only using
TM to extend it, like radiology/haemodialysis; or,
• TM services is integrated in healthcare networks simply
assumed as beneficial. The existence of a business plan or
reimbursing schemes supporting the decisions are rare;
• Most of the TM project coordinators believe in their “non-
existent” business-models, probably feeling that with
more time and experience an “innovative business-model”
will emerge
HOWEVER, I ALSO FOUND SOME MISSLEADING
INTERPRETATIONS OF THE REALITY
MOMENTUM HAVE SHOWN THE IMPORTANCE OF
MANAGEMENT, LEADERSHIP AND BUSINESS MODELS
IN THE DEVELOPMENT OF TELEMEDICINE SERVICES
- However, are we sure to have the managers with the
right skills to address the challenges of launching
TM services?
- Are business-models incorporating real value?
- How can TM make it possible?
Discussion
IN CONCLUSION
• We are learning a lot about telemedicine deployment from the information collected through questionnaires and from the stakeholder groups
• But we still lack more information to know if the highlights are correct
• The MOMENTUM Blueprint will not be the solution that truly escalates telemedicine deployment, but the MOMENTUM blueprint will be a…
valuable contribution and tool to maximise the current “momentum” for telemedicine deployment in Europe.
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Strategy
& Manageme
nt
Legal,
Regulatory&
Security
Organisation &
Change Mgmt.
Technical
&
Market relations
Thank you!
Obrigado!
WHO Collaborating Center for Health Workforce, Policy and PlanningInstituto de Higiene e Medicina Tropical
Universidade Nova de Lisboa