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

3962189473d062fdc76ce9a07cbe89fd?s=47 Shahid N. Shah
September 18, 2014

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

This was presented at the Digital Health Summit Turkey 2014 in Istanbul. It is an American healthcare expert's viewpoint on what should matter to Turkey based on lessons from the USA. Designed for a mixed audience of providers, pharma, and bio entrepreneurs and executives.


Shahid N. Shah

September 18, 2014


  1. The Biggest Opportunities in Digital Health from an American’s Viewpoint

    By Shahid N. Shah @ShahidNShah
  2. 3 @ShahidNShah 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 Author of Chapter 13, “You’re the CIO of your Own Office”
  3. 4 @ShahidNShah 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
  4. 5 @ShahidNShah Death by age group, 1900 Death

    by age group, Today From cures to management… …young people don’t dye of diseases often now
  5. 6 @ShahidNShah 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
  6. 7 @ShahidNShah 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 22 % of Medical Costs 35 % of Population 37 % of Medical Costs 4% of Population 36 % of Medical Costs Source: Amir Jafri, PrescribeWell
  7. 8 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 Integrated Healthcare Ecosystem Multi-Specialty Care Clinic & Hospital Integrated Healthcare System Source: Bruce Metz, CIO, Lahey Health
  8. 9 @ShahidNShah 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
  9. 10 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
  10. 11 @ShahidNShah Data changes the questions we ask

    Simple visual facts Complex visual facts Complex computable facts
  11. 12 @ShahidNShah 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
  12. @ShahidNShah 13 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
  13. 14 @ShahidNShah Opportunities in health information networks

  14. 15 @ShahidNShah Opportunities in care facility decentralization Source:

    Jason Hwang, Innosight, via Jeff Selberg of IHI
  15. 16 @ShahidNShah Opportunities in consumer payment changes

  16. 17 @ShahidNShah 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
  17. 18 @ShahidNShah 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
  18. 19 @ShahidNShah Needed: Consumerization of physiologics….

  19. 20 @ShahidNShah Needed: Consumerization of labs / genes

    Labs on chips Personal Genomics
  20. 21 @ShahidNShah Needed: Consumerization of monitoring

  21. 22 @ShahidNShah Needed: diagnostic quality mHealth

  22. 23 @ShahidNShah Needed: predictive analytics

  23. 24 @ShahidNShah Needed: care team integration HEALTHCAR E

  24. 25 @ShahidNShah Needed: automated diagnostics

  25. Thank You Visit E-mail Follow @ShahidNShah Call