The Biggest Opportunities in Digital Health for Turkey's Medical Sector

The Biggest Opportunities in Digital Health
from an American’s Viewpoint
By Shahid N. Shah
www.HealthcareGuy.com
@ShahidNShah

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www.netspective.com 3
@ShahidNShah HealthcareGuy.com
Who is Shahid?
• 25+ years of software engineering and
multi-site healthcare system deployment
experience
• 20+ years of technology management
experience (government, non-profit,
commercial)
• 15+ years of digital health, healthcare IT
and medical devices experience (blog at
http://healthcareguy.com)
Author of Chapter 13, “You’re
the CIO of your Own Office”

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Top killers today
Heart disease Cancer
Chronic lower
respiratory
diseases
Top killers in 1900
Pneumonia
and influenza
TB
Diarrhea and
enteritis
Infectious diseases used to kill us…
…but what’s left seem only to be “manageable” not easily “curable”
Per 100k population, Historical Statistics of the United States, Millennial Edition

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Death by age group, 1900 Death by age group, Today
From cures to management…
…young people don’t dye of diseases often now
http://siteresources.worldbank.org/INTHSD/Resources/topics/Health-Financing/HFRChap1.pdf

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We’ve seemingly accepted lack of cures…
The Shift
The clinical model is shifting away from
treatment of chronic conditions and
focusing more on prevention, wellness,
obesity intervention, behavior and
lifestyle modification.
Objectives
• Keep people out of the hospital ($$$)
• Keep people from their docs ($$)
• Keep people off drugs ($)
• Keep people at home
Implications
Clinical operations are shifting to hospital and
physician ‘centered’ services that will rely heavily
on health information technologies to monitor,
coordinate, and manage care.
• Successful Transition in Care resulting in
Reduced Hospital Readmission Rates
• Proactive population management
• Patient engagement and collaboration
• Disease prevention through wellness and
obesity management
• Chronic disease management
• Care coordination and collaboration
• Metrics and analytics

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Patient populations need different Digital Health
• Obesity Management
• Wellness Management
• Assessment – HRA
• Stratification
• Dietary
• Physical Activity
• Physician Coordination
• Social Network
• Behavior Modification
• Education
• Health Promotions
• Healthy Lifestyle Choices
• Health Risk Assessment
• Diabetes
• COPD
• CHF
• Stratification & Enrollment
• Disease Management
• Care Coordination
• MD Pay-for-Performance
• Patient Coaching
• Physicians Office
• Hospital
• Other sites
• Pharmacology
• Catastrophic Case
Management
• Utilization Management
• Care Coordination
• Co-morbidities
Prevention Management
26 % of Population
4 % of Medical Costs
35 % of Population
35 % of Population
4% of Population
Source: Amir Jafri, PrescribeWell

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The digital enterprise
is revolving rapidly
based on key trends,
health systems’
evolution, and IT’s
evolution
Key Industry
Trends
.
Health System
Evolution
IT Systems
Evolution
IT Role
Evolution
Fee For Service, Shared Risk,
Bundled Payments, etc.
Value, Care Management,
Population Management
PRESENT
Full Risk, Integrated Health
Plan & Care Delivery
System
Personalized Medicine,
Wellness Management
FUTURE
Fee For Service
Volume/Episodic Care
PAST
Integrated
EHR
Health Information
Exchange (HIE)
Enterprise Data
Warehouse (EDW)
Patient
Engagement
Mobile Health
Connected
Care
Wellness
Management
Advanced
Informatics
Personalized
Medicine
Ancillary Systems
(Lab/Rad/Pharmacy, etc.)
Enterprise Resource
Planning (HR, GL, SCM)
Revenue
Cycle
Ambulatory EHR
Hospital EHR
Patient Access
Enabler Innovator
Installer Integrator
Integrated Healthcare
Network
Ecosystem
Multi-Specialty Care
Clinic & Hospital
System
Source: Bruce Metz, CIO, Lahey Health

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Opportunities in Data Comprehension
What does
it mean?
How do I
use it?
•Must be continuously
recomputed
•Difficult today, easier tomorrow
•Super-personalized
•Prospective
•Predictive
Bio IT and
Genomics
Secondary
Aggregation
•Can be collected infrequently
•Personalized
•Prospective
•Potentially predictive
•Digital
•Family history is easier
Phenotypics
Primary Data
Collection
•Continuously collected
•Mostly Retrospective
•Useful for population health
•Part digital, mostly analog
•Family History is hard
Admin
Data
Collection
•Business focused data
•Retrospective
•Built on fee for service models
•Inward looking and not focused
on clinical benefits
Biosensors
Social Interactions

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Data
Medical Hardware
Consumer Hardware
Health Records
Patient IT
Social Media
Health Literacy
Retail purchases
Behaviors
IoT Sensors
Hardware Software
Pharma / Clinical Trials
Labs / Imaging
Payments
Bioinformatics
Health Info Exchg
Provider Engagement
Care Coordination
Compliance
Marketing IT
Retrospective
Prospective
Med Devices
Integration
Comprehension
Tools, Storage, Services
Science, Discovery
Research
Consent
Digital Chemistry
Provider Stature
Ratings/reviews

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Data changes the questions we ask
Simple visual facts Complex visual facts Complex computable
facts

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Data can change medical science
The old way
Identify problem
Ask questions
Collect data
Answer questions
The new way
Identify data
Generate questions
Mine data
Answer questions

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@ShahidNShah
HealthcareGuy.com
Opportunities in Accountable Tech
Cost per patient per
procedure / treatment
going up but without
ability to explain why
Cost for same
procedure / treatment
plan highly variable
across localities
Unable to compare
drug efficacy across
patient populations
Unable to compare
health treatment
effectiveness across
patients
Variability in fees and
treatments promotes
fraud
Lack of visibility of
entire patient record
causes medical errors
What customers want and what we create are not aligned

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Opportunities in health information networks

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Opportunities in care facility decentralization
Source: Jason Hwang, Innosight, via Jeff Selberg of IHI

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Opportunities in consumer payment changes

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Opportunities in new approaches to care
General
Wellness
Specific
Prevention
Self Service
Physiologics
Self Service
Monitoring
Self Service
Diagnostics
Care Team
Monitoring
Care Team
Diagnostics
Healthcare
Professional
Monitoring
Healthcare
Professional
Diagnostics
Hospital
Monitoring
Hospital
Diagnostics

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Opportunities in externalization of Digital Health
Patients
External
HCPs
HCP and
Staff
Evaluators
Internal
business
users and
HCPs
IT
Personnel
Unsophisticated and less agile
focus
Sophisticated and more agile
focus
Inside-out focus Outside-in focus
HCPs = healthcare providers

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Needed: Consumerization of physiologics….

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Needed: Consumerization of labs / genes
Labs on chips Personal Genomics

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Needed: Consumerization of monitoring

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Needed: diagnostic quality mHealth

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Needed: predictive analytics

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Needed: care team integration
HEALTHCAR
E PROVIDER
PATIENT/
CONSUMER
HOSPITAL
FAMILY
CAREGIVER
ALTERNATE
SITE OF
CARE
Care Team
CALL CENTERS AND
REMOTE SUPPORT

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Needed: automated diagnostics

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Thank You
Visit
http://www.netspective.com
http://www.healthcareguy.com
E-mail [email protected]
Follow @ShahidNShah
Call 202-713-5409

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The Biggest Opportunities in Digital Health for Turkey's Medical Sector

The Biggest Opportunities in Digital Health for Turkey's Medical Sector

Shahid N. Shah

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