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

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

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  2. 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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  3. www.netspective.com 4
    @ShahidNShah HealthcareGuy.com
    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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  4. www.netspective.com 5
    @ShahidNShah HealthcareGuy.com
    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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  5. www.netspective.com 6
    @ShahidNShah HealthcareGuy.com
    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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  6. www.netspective.com 7
    @ShahidNShah HealthcareGuy.com
    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

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  7. www.netspective.com 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

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  8. www.netspective.com 9
    @ShahidNShah HealthcareGuy.com
    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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  9. www.netspective.com 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

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    @ShahidNShah HealthcareGuy.com
    Data changes the questions we ask
    Simple visual facts Complex visual facts Complex computable
    facts

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    @ShahidNShah HealthcareGuy.com
    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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  12. @ShahidNShah
    www.netspective.com 13
    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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  13. www.netspective.com 14
    @ShahidNShah HealthcareGuy.com
    Opportunities in health information networks

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    @ShahidNShah HealthcareGuy.com
    Opportunities in care facility decentralization
    Source: Jason Hwang, Innosight, via Jeff Selberg of IHI

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    @ShahidNShah HealthcareGuy.com
    Opportunities in consumer payment changes

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    @ShahidNShah HealthcareGuy.com
    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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  17. www.netspective.com 18
    @ShahidNShah HealthcareGuy.com
    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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  18. www.netspective.com 19
    @ShahidNShah HealthcareGuy.com
    Needed: Consumerization of physiologics….

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  19. www.netspective.com 20
    @ShahidNShah HealthcareGuy.com
    Needed: Consumerization of labs / genes
    Labs on chips Personal Genomics

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  20. www.netspective.com 21
    @ShahidNShah HealthcareGuy.com
    Needed: Consumerization of monitoring

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  21. www.netspective.com 22
    @ShahidNShah HealthcareGuy.com
    Needed: diagnostic quality mHealth

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    @ShahidNShah HealthcareGuy.com
    Needed: predictive analytics

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  23. www.netspective.com 24
    @ShahidNShah HealthcareGuy.com
    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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  24. www.netspective.com 25
    @ShahidNShah HealthcareGuy.com
    Needed: automated diagnostics

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  25. 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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