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What’s next for healthcare information technology innovation?

Shahid N. Shah
November 16, 2012

What’s next for healthcare information technology innovation?

This is a summary of a talk I gave at the Vanderbilt Healthcare Conference 2012 in Nashville.

It focused on answering a couple of key questions:
* What does innovation in healthcare mean?
* Where are the major areas in healthcare where innovation is required?

And had a few key takeaways:
* Understand health tech buy fallacies
* Understand PBU: Payer vs. Benefiter vs. User
* Understand why healthcare businesses buy stuff so you can build the right thing

Shahid N. Shah

November 16, 2012
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Transcript

  1. What’s next for healthcare
    information technology innovation?
    Vanderbilt Healthcare Conference 2012
    Shahid N. Shah, CEO

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  2. NETSPECTIVE
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    Who is Shahid?
    • 20+ years of software engineering and multi-
    site healthcare system deployment
    experience
    • 12+ years of healthcare IT and medical
    devices experience (blog at
    http://healthcareguy.com)
    • 15+ years of technology management
    experience (government, non-profit,
    commercial)
    • 10+ years as architect, engineer, and
    implementation manager on various EMR
    and EHR initiatives (commercial and non-
    profit)
    Author of Chapter 13, “You’re
    the CIO of your Own Office”

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  3. NETSPECTIVE
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    What’s this talk about?
    Questions answered
    • What does innovation in
    healthcare mean?
    • Where are the major areas
    in healthcare where
    innovation is required?
    Key takeaways
    • Understand PBU: Payer vs.
    Benefiter vs. User
    • Understand why healthcare
    businesses buy stuff so you
    can build the right thing

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  4. NETSPECTIVE
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    What I mean by “innovation”
    For this presentation, we’ll assume that “innovation” means
    either:
    a) You have made the job of identifying, diagnosing,
    treating, or curing diseases faster, better, or cheaper for
    clinicians through the use of information technology (IT)
    OR
    b) You have made the job of self-diagnosing, self-treating,
    or preventing diseases and improving overall wellness of
    patients through the use of IT
    Innovation in healthcare is especially hard to define given the wide variety of constituencies

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    What Is the Business of Health Care?
    • It's always better to define a business by what
    consumers want than by what you can produce or
    build
    – For example, whereas doctors and hospitals focus on
    producing health care, what people really want is health
    • In the future, successful doctors, hospitals, and health
    systems will shift their activities from delivering health
    services within their walls toward a broader range of
    approaches that deliver health.
    What business are you in? The Emergence of Health as the Business of Health Care
    Source: http://www.nejm.org/doi/full/10.1056/NEJMp1206862

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    PBU: Payer vs. Benefiter vs. User
    Payer
    Benefiter
    User
    If you don’t understand the exact interplay between PBU your product will fail
    The payer is the
    person/entity
    that writes the
    check for your
    product.
    The person or group
    that benefits most
    from the use of the
    product.
    The person or group that
    actually uses the product.

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  7. NETSPECTIVE
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    What problem will you be solving?
    Improve
    medical
    science?
    Improve access
    to care?
    Reduce costs?
    Improve
    therapies?
    Improve
    diagnostics?
    Improve drug
    design?
    Improve drug
    delivery?
    Create better
    payment
    models?
    Focus on jobs that need to be done, not what you want to build

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    How to identify the best opportunities
    Circumstance
    • The specific
    problems a
    customer
    cares about
    • The way they
    assess
    solutions
    Context
    • Find a way to
    be with the
    customer
    when they
    encounter a
    problem and
    • Watch how
    they try to
    solve it
    Constraints
    • Develop an
    innovative
    means around
    a barrier
    constraining
    consumption
    Compensating
    behaviors
    • Determining
    whether a job
    is important
    enough to
    consider
    targeting
    • One clear sign
    is a customer
    spending
    money trying
    to solve a
    problem
    Criteria
    • Customers
    look at jobs
    through
    functional,
    emotional,
    and social
    lenses
    From “Jobs to be Done” to the “Five Cs of Opportunity Identification”
    Source: http://blogs.hbr.org/anthony/2012/10/the_five_cs_of_opportunity_identi.html

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    The business needs
    • Quality and performance
    metrics
    • Patient stratification
    • Care coordination
    • Population management
    • Surveys and other direct-
    from-patient data collection
    • Evidence-based surveillance
    The technology strategy
    • Aggregated patient registries
    • Data warehouse / repository
    • Rules engines
    • Expert systems
    • Reporting tools
    • Dashboarding engines
    • Remote monitoring
    • Social engagement portal for
    patient/family
    Do you have ideas in payment design?
    Payment models going fee for service to outcomes-driven care

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    Can you repurpose or enhance health data?
    Proteomics
    Genomics
    Biochemical
    Behavioral
    Phenotypics
    Economics
    Try to use existing data to create new diagnostics or therapeutic solutions
    IOT sensors
    Administrative

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    Some stuff not to focus on
    • Don’t go for simple incremental innovation if
    you can be bold and disruptive
    • Don’t look at mHealth, look at mobility in
    healthcare
    • Don’t look at apps, look at entire systems
    Incremental innovation is easier, disruptive innovation is probably more useful

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    Forget mobile apps, focus on health IOT
    • With all the attention being paid to mHealth
    there’s been an useless focus on mobile apps
    • For the mobile apps, instead focus on
    mobility in healthcare through “health
    internet of things (IOT)” and self-care
    technologies

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    Healthcare Industry Fallacies
    • Healthcare folks are neither technically challenged nor
    simple techno-phobes (they’re busy saving lives)
    • Most product decisions are no longer made by clinical
    folks alone, CIOs are fully involved
    • Complex, full-featured, products are not easier to sell
    than simple, stand alone tools that have the capability
    of interoperating with other solutions are
    • Hospitals will not buy unless one proves value.
    • Selling into doctors offices is not easy.

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    What makes your products successful
    • Easy to explain
    • Defendable and differentiated
    • Attractive partnership opportunities
    • Word of mouth opportunity
    • Potential for PR
    • Scaleable staff and systems
    • Scaleable product — build once, sell many times
    • Uncomplicated
    • Focused
    • Sales model is scaleable and predictable
    • Own relationship with and information about customers

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    Why healthcare businesses buy stuff
    Increase
    revenue
    (topline)
    Maintain
    capabilities
    Reduce costs
    (bottomline)
    Attract new
    patients
    Increase staff
    productivity
    Find your
    reason
    Healthcare businesses have complex buying processes – figure out why and what they buy

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    The Customer Relationship
    Customer Gives
    You Get
    • Money
    • Time
    • Energy
    • Commitment
    • Referrals
    • Past experience
    • Expectations
    • Knowledge
    You Give
    Customer Gets
    • Product
    • Price
    • Value
    • Convenience
    • Selection
    • Service
    • Warranty
    • Brand
    If you can’t figure out why they buy, see if any of the things below make sense

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    Defining your customer is really hard
    Target health
    sector?
    Number of
    employees?
    Annual sales
    volume?
    Geography?
    Number of
    hospital beds?
    Number of
    patients?
    Type of
    patients?
    The list goes on
    and on…be
    specific!
    Don’t focus on market segmentation, but do try to figure out who your customer is

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    Health technology sector has many ups and downs
    Make sure you understand where your product fits in the hypecycle
    Source: Gartner; “Hype
    Cycle for Healthcare
    Provider Applications and
    Systems, 2010”

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  19. 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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